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  1. 1
    296479

    Rights of older persons backed by Economic and Social Council. Acts on human rights, women, drugs, and other social issues.

    UN Chronicle. 1991 Sep; 28(3):[3] p..

    Older persons have the right to make decisions about their care and quality of life, and should be able to reside at home as long as possible and remain integrated in society, according to a draft set of Principles for Older Persons, recommended for adoption by the General Assembly. In a resolution adopted by the Economic and Social Council at its first regular session of 1991, Governments will be asked to incorporate the Principles to their national programmes. The Principles are based on the International Plan of Action on Ageing, adopted by the World Assembly on Ageing convened by the UN in Vienna in 1982. The Council adopted 109 texts 49 resolutions and 60 decisions-at the session. Many had been recommended by its subsidiary bodies, including the Commission on Human Rights, the Commission for Social Development, the Commission on the Status of Women and the Commission on Narcotic Drugs. (excerpt)
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  2. 2
    296456

    Refugee women are focus of International Women's Day.

    UN Chronicle. 1991 Jun; 28(2):[1] p..

    The world's estimated 8 million female refugees--over half of the total refugee population--were the focus of International Women's Day on 8 March. "None have more fully demonstrated the capacity of women to cope and prevail than those women", Secretary-General Javier Perez de Cuellar said in his traditional message for the Day. Visions of women's potential for leadership were explored at "Making Women Count in the 1990s", a panel discussion held at UN Headquarters. Refugees, women and development issues, and women and work were other topics discussed by panelists Catherine O'Neill, Winn Newman and Dr. Nafis Sadik. Ms. O'Neill works with the Women's Commission for Refugee Women and Children; Mr. Newman, a lawyer, has successfully argued landmark legal cases in the United States on equal pay for work of comparable value; and Dr. Sadik is the Executive Director of the UN Population Fund. Author Erskine Childers, formerly with the UN Development Programme, was the moderator. The keynote speaker was former United States Congress member and Vice-Presidential candidate Geraldine Ferraro. (excerpt)
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  3. 3
    296455

    UN commission proposes action to prohibit violence against women; China offers to host fourth women's conference - United Nations Commission on the Status of Women.

    UN Chronicle. 1991 Jun; 28(2):[4] p..

    Action to prohibit violence against women, ensure equal opportunities for disabled women and give priority to international protection of refugee and displaced women and children was recommended by the Commission on the Status of Women at its thirty-fifth session (27 February-8 March, Vienna). The 43-member body also launched preparations for the Fourth World Conference on Women: Action for Equality, Development and Peace. Fifteen resolutions, which also focused on women in vulnerable situations--including migrants, prostitutes and battered women--and the integration of women in development, were approved by the Commission. Most texts will go to the Economic and Social Council and the General Assembly for final adoption later this year. The Commission asked that discussions start on the possibility of preparing an international instrument that explicitly addresses the issue of violence against women. The first step should be to develop a framework for that instrument, in consultation with the Committee for the Elimination of Discrimination against Women (CEDAW). An expert meeting on this issue should be convened in 1991 or 1992, with the participation of CEDAW and the Committee on Crime Prevention and Control, the Commission specified. (excerpt)
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  4. 4
    296459

    Population conference set for 1994; ageing, international migration examined - International Conference on Population and Development.

    UN Chronicle. 1991 Jun; 28(2):[4] p..

    Dr. Nafis Sadik, Executive Director of the UN Population Fund and Secretary-General of the Conference, said preparations for the event reflected the enormous needs and challenges of the future, as well as the notable advances that had been made in the population field, particularly by developing countries in implementing policies and programmes. Egypt and Tunisia both have offered to host the Conference, scheduled for August 1994. Further preparatory meetings are planned in August 1993 and early 1994. It would be the fifth international population conference convened by the UN. Conferences held in Rome in 1954 and in Belgrade in 1965 were purely technical meetings, limited to scientific discussions on population topics. Subsequent intergovernmental conferences in Bucharest in 1974 and in Mexico City in 1984 were concerned with establishing objectives, principles and goals, and making recommendations in the population field. (excerpt)
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  5. 5
    296457

    Exploitation of women workers in family enterprises decried - United Nations Committee on the Elimination of Discrimination against Women.

    UN Chronicle. 1991 Jun; 28(2):[1] p..

    Women who work in family enterprises without payment are being exploited, the Committee on the Elimination of Discrimination against Women (CEDAW) declared, calling for guaranteed payment, social security and social benefits for them. As it concluded its tenth annual session (21 January-1 February, New York), the Committee also recommended that the value of women's domestic work be added to countries' gross national products. Nations should provide information on disabled women and on measures taken to ensure equal access for them to education, employment, health services and social security. The 23-member watchdog body monitors how countries implement the 1979 Convention on the Elimination of All Forms of Discrimination against Women. (excerpt)
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  6. 6
    296454

    Children and environment.

    UN Chronicle. 1991 Jun; 28(2):[1] p..

    Environmental degradation is killing children. That is the alarming message of the 73-page report--Children and the Environment--published jointly by the UN Children's Fund (UNICEF) and (UNEP) in 1990. The two organizations examined the effect of environmental quality on the child in the womb, on infants and children, as well as the special problems of children at work and those in distress. The study finds that "children are too often the victims of pollution--their young bodies make them far more vulnerable than adults to the poisons we spew into the air, and toxins we sow on Earth". It states that global warming, ozone depletion, loss of genetic resources, desertification and general land degradation are "this generation's legacy to its descendants". Before it is too late, the report urges, "intergenerational equity", which incorporates the welfare of future generations into developmental planning, must be implemented. UNICEF and UNEP warn that achieving it could be "the foremost challenge facing policy makers in the closing years of the twentieth century, and beyond". (excerpt)
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  7. 7
    296458

    UNICEF pushes efforts to cut child deaths, hunger - United Nations Children's Fund.

    UN Chronicle. 1991 Jun; 28(2):[3] p..

    The United Nations Children's Fund (UNICEF) has made a "promise to children"--to try to end child deaths and child malnutrition on today's scale by the year 2000. The Fund estimates that a quarter of a million children die every week from common illnesses and one in three in the world are stunted by malnutrition. That broad goal, declared on 30 September 1990 by 71 Presidents and Prime Ministers attending the first World Summit for Children, includes 20 specific targets detailed in the Plan of Action for implementing the World Declaration on the Survival, Protection and Development of Children in the 1990s, adopted at the Summit. Among them are: one-third reduction in under-five death rates; halving maternal mortality rates; halving of severe and moderate malnutrition among the world's under-fives; safe water and sanitation for all families; and measures covering protection for women and girls, nutrition, child health and education. Other goals include making family planning available to all couples and cutting deaths from diarrhoeal diseases--which kill approximately 4 million young children annually--by one half, and pneumonia--which kills another 4 million a year--by one third. (excerpt)
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  8. 8
    288719
    Peer Reviewed

    Women's rights in the Universal Declaration.

    Morsink J

    Human Rights Quarterly. 1991 May; 13(2):229-256.

    The Charter of the United Nations forbids discrimination on the basis of "race, sex, language or religion." Some of the delegations involved in drafting the 1948 Universal Declaration of Human Rights felt that this short list of four nondiscrimination items was enough and should be repeated in the Declaration. Others wanted to be more exhaustive. The matter was referred to the Sub-Commission on the Prevention of Discrimination and the Protection of Minorities. This commission recommended that the article in the Declaration state that "[e]veryone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind such as race, sex, language, religion, political or other opinion, property status, or national or social origin." Everything after "religion" was added to the Charter list. A few objections were raised, but nothing was deleted from the list. Instead, the two items of "color" and "birth" were added to the Sub-Commission's recommendation. Article 2 of the Declaration is thus an expansion of the Charter's mandate that the new world organization promote human rights for all without discrimination. This theme of nondiscrimination runs through all the deliberations about the Declaration, and whatever disagreements there were about the various items on the list were minor. There was complete agreement that the article on nondiscrimination was a keystone of the Declaration and a gateway to its universality. If we take away someone's race, sex, and opinions on various subjects, all information about his or her background, about birth and present economic status, what we have left is just a human being, one without frills. And the Declaration says that the human rights it proclaims belong to these kinds of stripped-down people, that is, to everyone, without exception. As Mr. Heywood, the Australian representative, said, "logically, discrimination was prohibited by the use in each article of the phrase 'every person' or 'everyone.'" That is why the prohibition against discrimination is not repeated- -as it well might have been--with each article, but is stated at the beginning and made applicable to "all the rights and freedoms set forth in this Declaration." Given this opening prohibition against discrimination, there is, strictly speaking, no need for repetition. But that does not mean that the temptation was not there, especially in the case of sex-based discrimination. Nor does it mean that the final product--a litany of the words "everyone" and "no one"--was arrived at without struggle. For there was a struggle, especially in the case of women's rights. (excerpt)
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  9. 9
    274914

    Indicators for assessing breast-feeding practices. Report of an informal meeting, 11-12 June 1991, Geneva, Switzerland.

    World Health Organization [WHO]. Division of Diarrhoeal and Acute Respiratory Disease Control

    Geneva, Switzerland, WHO, Division of Diarrhoeal and Acute Respiratory Disease Control, 1991. 14 p. (WHO/CDD/SER/91.14)

    An informal meeting convened by the WHO Division of Diarrhoeal and Acute Respiratory Disease Control on behalf of the Organization's Working Group on Infant Feeding was held on 11-12 June 1991, at WHO headquarters in Geneva. The purpose of the meeting was to reach a consensus on the definitions of key breast-feeding indicators and specific methodologies for their measurement. In addition to the WHO participants, the meeting was attended by representatives of UNICEF, the United States Agency for International Development (USAID) and the Demographic Health Surveys (DHS) Program of the Institute for Resource Development/Macro International Inc., who had played an important role in developing the proposed indicators. The Swedish International Development Agency (SIDA) was also invited but was unable to send a participant. The participants are listed in Annex 1. This report summarizes the discussion and consensus reached on breast-feeding indicators derived from household survey data. No consensus was reached on proposed breast-feeding indicators to be measured through enquiries at health facilities. It was agreed that this topic required further discussion, bearing in mind, for example, the monitoring of the "Ten steps to successful breast-feeding". (excerpt)
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  10. 10
    274803

    Technical bases for the WHO recommendations on the management of pneumonia in children at first-level health facilities.

    World Health Organization [WHO]. Programme for the Control of Acute Respiratory Infections

    Geneva, Switzerland, WHO, Programme for the Control of Acute Respiratory Infections, 1991. [26] p. (WHO/ARI/91.20)

    About 13 million children under 5 years of age die every year in the world, 95% of them in developing countries. Pneumonia is one of the leading causes, accounting for about 4 million of these deaths. Despite this fact, for a combination of technical and operational reasons, pneumonia has been a neglected problem until very recently. Clinicians and epidemiologists thought that the control of respiratory infections did not deserve high priority because of the difficulties involved in preventing and managing these infections; it was said that antibiotics might not be an effective treatment against pneumonia because patients are often weakened by conditions such as chronic malnutrition and parasitic infections, and that a wide variety of viruses and bacteria are associated with pulmonary infections making it impossible to identify the specific etiological agent in each patient (1.) On the other hand, some public health experts felt that a programme aimed at preventing mortality from pneumonia could not succeed because it would be difficult to deliver the available technology (antibiotics) through peripheral health units and community-based health workers. At most, one quarter of the pneumonia cases in children can be prevented by the measles and pertussis vaccines included in the immunization schedule of the Expanded Programme on Immunization. There is a clear need for research to develop and test vaccines against the most frequent agents of pneumonia in children. Such research has been pursued by WHO, notably within the Programe for the Control of Acute Respiratory Infections (ARI) and the Vaccine Development Programme; however, WHO has simultaneously been utilizing current clinical knowledge to formulate a case management strategy to reduce the high mortality from pneumonia in children. The present document is not intended to provide detailed case management guidelines. These are to be found in the manual "Acute respiratory infections in children: Case management in small hospitals in developing countries. A manual for doctors and other senior health workers", document WHO/ARI/90.5 (1990). (excerpt)
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  11. 11
    185923

    Guidelines for the clinical management of HIV infection in adults.

    World Health Organization [WHO]. Global Programme on AIDS

    [Geneva, Switzerland], WHO, 1991 Dec. [92] p. (WHO/GPA/IDS/HCS/91.6)

    Infections and tumours are the paramount clinical problems confronting health care providers caring for patients with HIV-related disease. Treatment of these infections and tumours is of great importance as it decreases suffering and prolongs life in the absence of effective and non-toxic antiretroviral drugs or immunotherapy against HIV itself. However, clear treatment guidelines are lacking in many parts of the world and health care workers have often not received training in the management of HIV-related disease. To respond to this situation, the WHO Global Programme on AIDS (GPA) has developed guidelines for the clinical management of HIV infection in adults. There are wide variations in the presentation of HIV-related diseases, availability of resources and health infrastructures. It is hoped that the guidelines will provide a model to assist all countries, but especially those in the developing world, to formulate national guidelines in accordance with their own particular needs and resources. Adaptation of these guidelines should take place through national/institutional workshops. The guidelines represent the consensus of a number of clinical experts working in this area, and will be revised from time to time in the light of experience. Comments are welcome and should be sent to the Global Programme on AIDS, World Health Organization, 1211 Geneva 27, Switzerland. (excerpt)
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  12. 12
    180705

    ICASO: a model for an NGO unified response against AIDS.

    Arauz R; Hernandez-Chavez JJ

    AIDS and Society. 1991 Oct-Nov; 3(1):12.

    The International Council of AIDS Service Organizations (ICASO) was founded in 1989 with the support of the World Health Organization's Global Programme on AIDS. The most recent meeting of ICASO's Council of Representatives took place this past June during the VII International Conference on AIDS in Florence, Italy. As an international consortium of AIDS service organizations (ASOs), ICASO's intent is to deal with AIDS from a broader perspective which includes advocacy for the contribu-ion of voluntary community organizations in prevention, access to care, support services, education and human rights advocacy. (excerpt)
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  13. 13
    172346

    UNDP guiding principles on HIV and AIDS.

    United Nations Development Programme [UNDP]. HIV and Development Programme

    [New York, New York], UNDP, HIV and Development Programme, [1991]. [1] p.

    An integrated and comprehensive approach to this epidemic must be based upon an understanding of the way it affects personal, social and economic development. The coping strategies of communities must be central to the national response and community-based organizations will be instrumental in ensuring human survival, human rights and human development. Policies relating to HIV and AIDS must encompass and be accepted by all sectors in a society. Those affected by the epidemic should be involved in the policy dialogue. A proper balance must be found, over the course of the epidemic, among programs for prevention, social support, research and development. Collaboration and coordination among all participants is essential for an effective national response. Programs to succeed must take into account and explore each culture's ability to evolve and change in response to the challenge of the epidemic. The power imbalances in interpersonal relationships and in society which create women's subordination must change if women are to be able to protect themselves from HIV infection and its consequences. Each individual has the responsibility to protect himself or herself from HIV infection and to minimize further spread of the epidemic; The means of reducing the risk of HIV transmission must be affordable by and accessible to everyone. HIV testing must be carried out with the specific, informed consent of those being tested, with pre-counseling and post-counseling and with the guarantee of confidentiality. Confidentiality in relation to a person's HIV and AIDS status must be maintained. The rights of people with HIV and AIDS must be respected and those affected, including survivors, must remain an integral part of the community. (excerpt)
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  14. 14
    117893

    Africare health sector assistance in Nigeria.

    Africare

    [Unpublished] [1991]. 10 p.

    This document presents an assessment of the health problems faced by Nigeria and describes the assistance given to Nigeria's health sector by the international agency Africare. The first section of the report provides background information about Nigeria. Section 2 describes the current state of maternal and child health and family planning (FP). Nigeria has one of the highest maternal mortality rates in the world, immunizations are not delivered effectively, FP services are weak, and large families are the norm. The third section covers HIV/AIDS which is reported at relatively low but rapidly increasing levels which could make AIDS a leading cause of death by the year 2000. Prevention efforts are made by the national AIDS program and by several nongovernmental organizations. Section 4 details the effect of river blindness, which is a serious constraint to development in Nigeria. Africare has been involved in organizing the safe administration of the drug ivermectin, which keeps onchocerciasis infection from progressing to blindness. Section 5 looks at the administration of essential drugs and notes that while Nigeria shares the problems seen in other developing countries such as poor manufacturing, irrational prescribing, and patient noncompliance, the situation is exacerbated in Nigeria by the manufacture of fake drugs. The final section outlines Africare's work in Nigeria which began in 1978 with the donation of hospital equipment and has expanded to three field offices which oversee such activities in the areas of 1) FP, 2) training programs, 3) research, 4) river blindness control, 5) village development, 6) drug storage and supply, 7) AIDS prevention, 8) agricultural development and water supply, and 9) child survival.
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  15. 15
    113131

    Annual report of the administrator for 1990 and programme-level activities. Role of UNDP in combating HIV / AIDS: policy framework for the response of UNDP to HIV / AIDS.

    United Nations Development Programme [UNDP]. Governing Council

    [Unpublished] 1991 May 9. 9 p. (DP/1991/57)

    The United Nations Development Program (UNDP) HIV//AIDS policy framework outlined builds upon and strengthens existing UNDP HIV/AIDS policies derived from Governing Council decisions, the WHO/UNDP Alliance to Combat AIDS, UNDP documents and directives, and the resolutions and decisions of the General Assembly, the World Health Assembly, and other organs, agencies, and institutions of the UN system. It is supplemented by a more extensive policy document outlining strategies, strategic options, and implementation arrangements for the guidance of the UNDP. The HIV/AIDS policy framework also attempts to communicate and clarify UNDP responsibilities with regard to the HIV/AIDS pandemic within the framework of the Global AIDS Strategy. This framework will facilitate UNDP working relationships with other UN organizations, multilateral and bilateral donor organizations, national governments, community-based organizations, and nongovernmental organizations. It will ensure that UNDP resources and efforts effectively reach people, communities, and governments. Sections describe the HIV/AIDS policy setting, long- and short-term policy goals, priorities, HIV/AIDS program delivery mechanisms, collaboration, institutional development, guiding principles for policy development, and monitoring and evaluation.
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  16. 16
    107089

    Strengthening government capacity for national development and international negotiation: the work of Save the Children Fund in Mozambique.

    Save the Children Fund

    [Unpublished] 1991. Presented at the Annual Conference of the Development Studies Association, Swansea, England, September 1991. 27 p.

    This conference paper offers lessons learned by the Save the Children Fund (SCF) regarding work in Mozambique in the course of seven years. SCF began its involvement in Mozambique in late 1984 supporting the government's expanded program of immunization. Objectives were to support essential services by working with the authorities from national through district levels. Models of good practice were assisted at the provincial level in Zambezia. The program diversified in 1986 with the development of policy about orphaned children traumatized by the war. Nutrition, transport, and emergency support followed over the next two years with a great deal of assistance going to the Mozambican emergency structure. The current SCF program has evolved in two major directions: 1) funding, logistical, and technical support at the provincial level to develop models of good practice, and 2) technical assistance at the central government level by experienced expatriate advisors placed within the Ministries of Health and Education along with training for Mozambican counterparts. The ruling government party FRELIMO was seen to be committed to progressive development policies, particularly in primary health care, education, and social welfare. The impact of the strategy on the lives of children was difficult to assess because of the devastation of the country by war and economic decline. A functioning health information system has been developed based on the advice given by computer specialists of SCF. A special focus of SCF's contribution to alternatives to institutional care has been the assessment of the impact of war, violence, and separation on children. This includes the tracing of surviving members of families of orphaned children and reuniting them and teacher training to reconstruct the child's life in school settings. SCF's food security adviser has also contributed substantially to the World Bank Food Security Strategy Paper approved in 1989.
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  17. 17
    104530

    STDs -- watch out young people.

    World Assembly of Youth

    YOUTH AND AIDS UPDATE. 1991; (1):1-2.

    World Health Organization (WHO) statistics on the current situation of HIV infection and other sexually transmitted diseases indicate the occurrence of approximately 250 million new infections annually, with an increasing incidence of infection. The highest incidence occurs among people aged 20-24, followed by people aged 15-19 and those aged 25-29. Studies conducted in sub-Saharan Africa, Southeast Asia, and the Caribbean have found 3-15% of women attending prenatal clinics to be infected with gonorrhea. The Chief Medical Officer of the WHO Program on Sexually Transmitted Diseases, Dr. Andre Meheus, explains that sexually transmitted infections are out of control worldwide. The levels of infection in most developed countries are not, however, increasing at the rates experienced in the 1960s, 1970s, and 1980s, while in the developing world, sexually transmitted infections remain at unacceptably high levels.
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  18. 18
    104179

    Staff appraisal report: Bangladesh, Fourth Population and Health Project.

    World Bank. Population and Human Resources Division

    [Unpublished] 1991 May 20. [4], ix, 145, [2] p. (Report No. 9400-BD)

    This staff appraisal report was based on the findings of a mission visiting Bangladesh in November 1990, representatives from a number of developed countries and international organizations. An overview was provided of past development activities in health and family planning, followed by a detailed description of the Fourth National Population and Health Program (1992-96): objectives, activities, environmental considerations, costs and financing, and implementation. The benefits of the plan were identified as improved welfare of women and children through greater spacing of births and improved health status. Family planning and health services were expected to be enhanced by integration of services, reorientation of medicine to community services, and improvement in quality of services. The main risk identified was the inability to fully implement the extensive reform in the health subsector and the potential weakness of management of the health subsector. The plan incorporated features to address the risks. Agreements were reached that the Bangladesh government would hire at least 4500 qualified women as health assistants by March 31, 1992, provide transportation for family planning and health workers to attend satellite clinics, and implement the following surveys: a fertility survey in 1994, a contraceptive prevalence survey by March 31, 1993, a facilities utilization survey by September 30, 1992, a feasibility study of storage requirements for family planning and health supplies by December 31, 1992, a comprehensive baseline survey of maternal and neonatal health care in the districts of Kushtia, Tangail, Feni, and Sirajganj/Pabna. 25 other recommendations were listed. The reason for low levels of human resource development has been inadequate past and present expenditures. In order to increase the contraceptive prevalence rate government and donors must expand programs for primary health care, family planning, and primary education as quickly as possible. Long-term sustainability will depend on government and donor resources, the role of nongovernmental organizations, and cost-sharing arrangements. The failures of the past have been in the government's concern with short-term political concerns rather than long-term development. Remediation will involve sector self-reliance and not individual project initiatives.
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  19. 19
    103818

    Population growth: a critical decade for South Africa. Revised ed.

    South Africa. Department of National Health and Population Development. Council for Population Development

    Pretoria, South Africa, Dept. of National Health and Population Development, Council for Population Development, 1991 Jun. 21 p.

    This booklet presents 1987 data on global population growth estimates and reiterates some of the main points of the Amsterdam Declaration adopted at the International Forum on Population in the 21st Century. These resolutions recognized mankind's responsibility to the future; acknowledged the link between population, resources, and the environment; expressed concern about rapid growth, especially in the developing world; recognized the central role of women in the development process; and defined the goal of development as improvement in the quality of life. The specter of unrelenting population growth is then considered from the point of view of South Africa, which has an annual growth rate of 2% and a population doubling time of 32 years. The booklet then describes South Africa's Population Development Programme, which was instituted in 1984 to maintain a balance between growth and subsistence resources. Each aspect of the program (education, primary health care, job creation, manpower development, the role of women, rural development, and housing) is then discussed in detail with important concepts defined and the ways in which organizations and individuals can contribute to the realization of the goals delineated.
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  20. 20
    102728

    Strengthening nutrition through primary health care: the experience of JNSP in Myanmar.

    World Health Organization [WHO]. Regional Office for South-East Asia [SEARO]

    New Delhi, India, WHO, SEARO, 1991 Dec. [3], 35 p. (Regional Health Paper, SEARO, No. 20)

    The Joint WHO/UNICEF Nutrition Support Programme (JNSP) began operations in Myanmar in 1984 and expanded nationwide in three phases. A detailed situation analysis of nutrition conditions and nutrition programs in primary health care (PHC) were conducted prior to JNSP activities. They served as the rationale for the decision to implement JNSP activities nationally. These activities are almost entirely administered through the Ministry of Health. JNSP redesigned nutrition training for village workers, their supervisors, and district health personnel. It has strengthened nutrition units at the central and regional levels. All JNSP-technical activities revolve around nutrition monitoring and counseling. JNSP participated in the establishment and operations of a food and nutrition surveillance system. It facilitated implementation of the nutrition and nutrition-related aspects of the People's Health Plan. The JNSP was evaluated in 1989. During the JNSP period, mortality among children less than 3 years old fell. 3-year-old children grew at a faster rate than prior to JNSP. Improvements were also noted in young child feeding practices, health seeking behavior of mothers, counseling by voluntary workers, and health staff performance. The evaluators concluded that JNSP directly benefitted the health and nutrition of children less than 3 years old. External costs of JNSP added up to US$5.63 million. The government put in another US$5.43 million. The communities contributed US$2.9 million. JNSP covers 30% of the total population. Per capita annual costs were US$1.67. These low per capita costs suggest that JNSP is sustainable and replicable. JNSP's further expansion depends on expansion of the health delivery system. All levels regularly provide support and supervision. Planned evaluation and feedback is the norm.
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  21. 21
    093289

    Final report of an operations research project: "A Study to Increase the Availability and Price of Oral Contraceptives in Three Program Settings", Contract CI90.59A.

    Apoyo a Programas de Poblacion [APROPO]; Asociacion Pro-Desarrollo y Bienestar Familiar; Instituto Peruano de Paternidad Responsable [INPPARES]; Vecinos Peru; Futures Group. Social Marketing for Change [SOMARC]; Pathfinder Fund; Population Council. Operations Research and Technical Assistance to Improve Family Planning / Maternal-Child Health Services Delivery Systems in Latin America and the Caribbean [INOPAL]

    [Unpublished] 1991 Oct 10. [3], 32, [22] p. (PER-19; USAID Contract No. DPE-3030-Z-00-9019-00)

    In an effort to reach more clients while increasing self-sufficiency, a group of private and public agencies in Peru collaborated in 2 operations research (OR) studies. This OR project, which cost US $62,040, was affected by the action of the newly elected government which ended price controls and subsidies in August 1990 and resulted in changes in the spending habits of most Peruvian families. Sales of all oral contraceptives (OCs) fell from an average of 141,400 to 73,400 cycles/month, and sales of Microgynon in pharmacies fell from 76,400 to 38,000 cycles/month. The first OR study tested the use of community-based distributors (CBDs), Ministry of Health (MOH) facilities, and private midwives as contraceptive social marketing (CSM) outlets by adding the OC Microgynon (sold at pharmacy prices) to CBD programs and raising the price of the donated OC, Lo-Femenal, over time. Specific objectives were to determine 1) if total CBD sales increased with the method mix, 2) whether CBD from homes of small businesses was more effective, 3) if the new distribution of Microgynon would increase sales of the OC as a whole, and 4) the impact of Lo-Feminal price increases on sales and user characteristics. The study was carried out in 44 experimental and 44 control groups in Lima and 20 experimental and 21 control groups in Ica. Baseline data were obtained for December 1989-April 1990, and monthly sales were monitored during the 12 months from May 1990 to April 1991. Data were also obtained from surveys of dropouts and new Microgynon acceptors. It was found that the August 1990 price increase effectively destroyed the significant market penetration exhibited by Microgynon in the first 4 months of the study. Adding an affordable CSM brand to CBD programs will, however, increase sales and self-sufficiency, although the sale of donated OCs for around $0.30/cycle will reduce sales of the new brand by 20-40%. It was also found that most clients who dropped out because of side effects were less likely to be contracepting than those who dropped out because of cost, indicating a need for improved distributor counseling. The second study tested the price elasticity of demand for OCs in CBD programs by measuring the demand for Microgynon. Specific objectives were to determine 1) the level of Microgynon sales in MOH facilities, 2) the level of sales by nurse-midwives, 3) the number of Microgynon users who formerly used Lo-femenal from the MOH, and 4) the number of Microgynon users in MOH and nurse-midwife facilities who formerly obtained the OC from pharmacies. A demonstration project was carried out in the rural departments of Ayacucho and Huancavelica, the poorest areas of Peru. 4 MOH hospitals in 4 cities and 17 nurse-midwives participated. The hope was that the CSM products would mitigate the effect of stock-outs in the hospitals. It was found that no Microgynon was sold because of a reluctance to recommend it and other unfavorable study conditions (the necessity for separate accounting, the lack of stock-outs, the reluctance of the midwives to sell a contraceptive, and the decline in client purchasing power). Cost recovery in the MOH would be better served by charging a modest amount for donated contraceptives.
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  22. 22
    067788

    Selected demographic indicators from the United Nations population projections as assessed in 1990.

    Japan. Ministry of Health and Welfare. Institute of Population Problems

    Tokyo, Japan, Ministry of Health and Welfare, Institute of Population Problems, 1991 Feb 22. [9], 143 p. (Research Series No. 267)

    According to the UN Population Projections of 1990, the world population of 5 billion, 292 million, 200 thousand in 1990 will reach 6 billion, 260 million, 800 thousand in the year 2000 with an annual increase rate of about 100 million. 94% of the increase will be in developing countries. In the year, 2025, the world population will be 8 billion, 54 million. 96% of the increase between 2000 and 2025 will also be in developing countries. The ratio of the population of developing countries to the world population was 77% in 1990 and will be 80% and 84% in 2000 and 2025 respectively. The new UN projections added about 10 million to the previous figure projected for 2000 and 38 million to the same for 2025. The World Bank's Projections are 6 billion 204 for the year 2000 and 8 billion 15 million for 2025. Their figures are slightly smaller than UN figures. Their data also include Taiwan and socio-economic group specific population, both of which are not found in UN data. In 2150, the world population is projected to be 11 billion 499 million with all of the increase from 2050 to 150 taking place in the developing region. According to high medium, and low variants in the UN projections, world population in 2020 will be 9 billion 400 million, 8 billion 500 million, and 7 billion 600 million respectively. Asian population, which constituted 55% of the world population in 1950, will be 59% in 1990. Since 1980, Southern Asia and Africa have seen the highest increase rates. African population, which was 9% in 1950 and 12% in 1990, will increase to 19% in 2025. After 2000, population in some regions of Europe will decrease as it will in Japan after 2010. The world population as a whole changed from high fertility and high mortality to high fertility and low mortality and then to low fertility and low mortality. In 1990, the population pyramid of developing nations was expansive triangular, while that of highly industrialized nations was constructive high rise or near stationary. The age specific ratio in industrialized regions will be 13% in 2000 and 18-19% in 2025.
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  23. 23
    074769

    NGO's Role and Involvement in the Prevention and Control of AIDS, New Delhi. Report of a regional workshop, 30 October - 1 November 1990.

    World Health Organization [WHO]. South-East Asia Region

    [Unpublished] 1991 Feb 19. [2], 19 p. (SEA/AIDS/22; WHO Project: ICP GPA 511)

    This regional workshop aimed to exchange information, inform nongovernmental organizations (NGOs) on the epidemiology and control of AIDS, share the experience of NGOs, identify improvements in the involvement of NGOs in AIDS control programs, and understand the impact of discriminatory measures. Topics for discussion were the global and the southeast Asian regional AIDS/HIV situation and control, the role of NGOs in control, the legal, ethical, and human rights issues in AIDS prevention and control, and the involvement of NGOs in prevention and control of AIDS. participants represented Bhutan, India, Indonesia, Maldives, Mongolia, Myanmar, Nepal, Sri Lanka, Thailand, India, and the WHO secretariat. NGOs provide information, education, policy advocacy, training, counseling, and assistance to those affected by HIV/AIDS. The methods used were culturally-sensitive mass media; a positive, holistic, and flexible approach; promotion of self esteem and confidence in target groups; target group representation; maintenance of direct contact and education for specific groups; policy advocacy; research and monitoring functions; peer group formation support; public awareness creation; and provision of medical services. Recommendations were made to NGOs to collaborate with one another and with governments, to help strengthen international and national cooperation for AIDS prevention and control, to monitor media information for reliability and uniformity and contextual relevance and lobby for necessary changes, and to set an example of human and compassionate treatment and respect the rights of AIDS/HIV and marginalized groups to medical and social services and treatment, education, employment, housing, social life, freedom of movement, freedom of choice on blood testing, and freedom from discrimination. NGOs involved need to mobilize other NGOs in AIDS prevention. Governments should include NGOs on national AIDS committees, particularly those which are community-oriented, and not politically affiliated and those which work with women and marginalized groups. Governments need to update curricula and provide family life education including education on AIDS for formal and informal groups and government officials. Governments should also set an example of responsible behavior which respects the human rights of people with AIDS, fund NGOs to train trainers, and use mass media. WHO should be more sensitive to the needs of NGOs and work to keep NGOs in the information loop of international and national governments.
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  24. 24
    074690

    Strengthening maternal and child health programmes through primary health care. Guidelines for countries of the Eastern Mediterranean Region. Based on the deliberations of the Intercountry Meeting on the Integration of MCH into Primary Health Care, Amman, Jordan, 11-15 December 1988.

    World Health Organization [WHO]. Regional Office for the Eastern Mediterranean [EMRO]

    Alexandria, Egypt, WHO, EMRO, 1991. 75 p. (WHO EMRO Technical Publication No. 18)

    All countries in the WHO Eastern Mediterranean Region (EMRO) have had maternal and child health (MCH) programs for many years, yet maternal mortality and morbidity and infant mortality remain high. The EMRO office in Jordan, recognizing this dilemma, convened a meeting of national managers from the 22 EMRO member states to discuss how to integrate MCH programs with primary health care (PHC). The meeting resulted in the publication of guidelines and goals to help each country integrate MCH into PHC which would strengthen MCH services and improve MCH status. The managers noted the need to switch from a pregnancy-oriented approach to a holistic approach in which MCH/PHC programs and society consider women as more than childbearers. MCH/PHC programs and society need to be concerned about the well-being of females beginning with infancy and should place considerable health promotion for girls during the pubertal spurt and adolescence. They should also promote prevention of iron deficiency anemia in women. Since maternal mortality is especially high is EMRO, the national managers clearly laid out approaches for health services to reduce maternal mortality caused by obstetrical complications. They also recognized the need for a practical alternative to obstetric care provided by health workers--training traditional birth attendants in each village. They also provided guidance on improving prenatal care to reduce perinatal and neonatal mortality such as vaccination of every pregnant woman with the tetanus toxoid. Since the causes of death in the postneonatal period, MCH/PHC programs need to take action to reduce malnutrition and infection. For example, they must promote breast feeding for at least the first 6 months of life. The managers suggested the implementation of the Child Survival and Development Strategy which includes growth monitoring.
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  25. 25
    074766

    Diarrhoeal Diseases Household Case Management Survey, Dhaka Division, October 1990.

    Bangladesh. Directorate General of Health Services. Control of Diarrhoeal Diseases; World Health Organization [WHO]. Dhaka Office

    [Unpublished] 1991 Apr 24. [2], 28 p. (SEA/DD/43; Project: ICP CDD 001)

    Physicians collected data on 4319 households and 3766 0-5 year old children living in rural areas of Dhaka Division in Bangladesh to determine the prevalence of diarrhea among the children, the percentage of diarrhea cases treated with various forms of oral rehydration therapy and with drugs, and caretaker awareness of when to refer children with diarrhea to a health facility. 60.3% received no treatment at all. The 24-hour point prevalence of diarrhea stood at 5.2%. Blood accompanied the diarrhea of 22.3% of these children. Yet only 12% of bloody diarrhea cases received appropriate antibiotic therapy. 13.4% of the children had experienced a diarrheal episode during the 2 weeks before the interview. Mean duration was 7 days, but 22.4% of the children had diarrhea for at least 14 days. The adjusted annual diarrhea incidence rate was 2.3 episodes/child. 33.7% of caretakers asked others for help in treating diarrhea. The advisers tended to be village doctors or quacks (21%), government health workers (17%), and homeopaths (17%). 75% of advisors, except family and friends, suggested drugs. Only 27% and 16% recommended administering oral rehydration solution (ORS) and various home fluids, respectively. Only 22% and 17% suggested caretakers to continue feeding and breast feeding, respectively. The ORS use rate during the previous 24 hours was only 11.9% and just 3.6% of cases drank properly prepared ORS. Yet 93.8% knew about ORS. Most caretakers did not use enough water or all the contents of the ORS packet. Use rate for home fluids was 16.5%. 97.5% of lactating mothers continued to breast feed during the diarrhea episode. 36.1% of children received drugs compared with 25.8% for use of oral rehydration therapy. 70.7% of caretakers gave ill children at least the same amount of solid or semisolid foods during the episode. 70% of caretakers preferred ORS to drugs. The leading reasons for referring cases to a health facility included too many stools (79.7%), failure to improve (28.3%), and fever (26.7%). The researchers deemed only 23.5% to have adequate referral knowledge (=or> 3 reasons).
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