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  1. 1

    Review and evaluation of national action taken to give effect to the International Code of Marketing of Breast-Milk Substitutes: report of a technical meeting, The Hague, 30 September - 3 October 1991.

    World Health Organization [WHO]. Division of Family Health. Programme of Maternal and Child Health and Family Planning

    [Unpublished] 1991. 24 p. (WHO/MCH/NUT/91.2)

    The report of the national actions in marketing breast-milk substitutes includes a review and evaluation summarized in the accompanying annex and the results of a meeting. Participants found the evaluation helpful, that progress had been made, and that the International Code of Marketing of Breast-milk Substitutes must be viewed in a broad context. Lessons learned and recommendations are given for the development and implementation of national measures, as well as the training and education in the health sector, the information to the general public and mothers, monitoring and enforcement, and manufacturers and distributors of products within the scope of the Code. Successful implementation depends on a clear international perspective, on all concerned parties' involvement in development and monitoring, and a continuing commitment to a complex process. Difficulties encountered were lack of 1) political commitment, 2) integration of sectors, and 3) recognition that the Code applied to all counties; there were also questions about the scope of products included in the Code. There is no limit to age group. Partial adoption is not sufficient and has a negative impact. The Code was being ignored in countries moving toward a market economy. Health professionals were unaware of new developments in infant feeding practices. The Code assumes a compatible relationship between manufacturers and health personnel, which is not the case. Manufacturers used mass media and formal and informal educational sectors to disseminate information about their products with the approval of authorities who considered the use consistent with the Code. The expanding international telecommunications systems have proved to be a crippling challenge to some countries without the tools to know how to regulate programming. The feeding bottle is an inappropriate child care symbol for breast feeding, which is frequently found in public places. Monitoring has been uneven. Enforcement is hampered by an absence of, inadequacy in, and inability to apply sanctions. Joint health and industry provisions are weaker than the Code, and marketing strategies do not conform to the Code. Manufacturers apply the Code differently in developed and developing countries. Not enough attention has been paid to feeding or pacifier products. Retail stores sell infant formula next to other infant food products which is misleading.
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  2. 2

    Report: Albania.

    United Nations Population Fund [UNFPA]. Technical and Evaluation Division; United Nations Population Fund [UNFPA]. Division for Arab States and Europe

    New York, New York, UNFPA, [1991]. [6], 33 p.

    A United Nations Fund for Population Activities (UNFPA) mission to Albania in 1989 attempted to identify the country's priority population issues and goals. Albania, a socialist country, has made many accomplishments, including an administrative structure that extends down to the village level, no foreign debt, universal literacy, a low death rate (5.4/1000), and involvement of women in development. At the same time, the country has the highest birth rate in Europe (25.5/1000), a high incidence of illegal abortion, lack of access to modern methods of contraception, and inadequate technology in areas such as medical equipment and data collection. Albania's population policy is aimed at maintaining the birth rate at its current level, reducing morality, and lowering the abortion rate by 50% by 1995. Goals for the health sector include increasing life expectancy, reducing infant and maternal mortality, improving the quality of health services, and decreasing the gap between the standard of living in rural and urban areas. Family planning is not allowed except for health reasons. Depending on trends in the total fertility rate, Albania's population in the year 2025 could be as low as 4.6 million or as high as 5.4 million. Albania has expressed an interest in collaborating with UN agencies in technical cooperation projects. The UNFPA mission recommended that support should be provided for the creation of a population database and analysis system for the Government's 1991-95 development plan. Also recommended was support to the Enver Hoxha University's program of strengthening the teaching of population dynamics and demographic research. Other recommendations included activities to strengthen maternal care/child spacing activities, IEC projects, and to raise the status of women.
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  3. 3

    The situation analysis of mothers and children in Turkey.

    UNICEF; Turkey. Ministry of Health

    Ankara, Turkey, UNICEF, 1991 Apr. xxxv, 405 p. (Country Programme, 1991-1995 Series No. 2)

    This report is the synthesis and analysis of data from the interventions for the improvement of the health situation of mothers and children in Turkey. It also identifies areas where mother and child related problems are concentrated. The document is organized into six parts. Part I discusses the state of children and the development connection. Part II presents the country profile of Turkey. Part III is the core of the document and discusses relevant issues on maternal and child health and presents the analysis of the different sectors that affect children. Part III also establishes the correlation between literacy rates in the provinces, average life expectancy and per capita income. Part IV presents the analysis of the profile of development and disparities by regions. Part V briefly reviews the Government of Turkey-UN Children's Fund cooperation with nongovernmental organizations (NGOs) and summarizes priority subjects from the Situation Analysis Report. Reviewed under the chapters of NGOs are the functions and potential of the NGOs with respect to the women and the child. Part VI focuses on the major problems which underline all the other concrete problems related to the quality of the mother s and children's life.
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  4. 4

    Psychosexual aspects of natural family planning as revealed in the World Health Organization multicenter trial of the ovulation method and the New Zealand Continuation Study.

    France MM

    In: Natural family planning: current knowledge and new strategies for the 1990s. Proceedings of a conference, Part II, Georgetown University, Washington, DC, December 10-14, 1990, edited by John T. Queenan, Victoria H. Jennings, Jeffrey M. Spieler, Helena von Hertzen. Washington, D.C., Georgetown University, Institute for International Studies in Natural Family Planning, [1991]. 118-20.

    Successful natural family planning (NFP) use depends upon the day-to-day sexual decision making of users. Given the important role of psychosexual factors in this decision making, they are an important influence in both the effectiveness of natural methods as well as in their acceptability as a means of family planning. The World Health Organization (WHO) Multicenter Study of the ovulation method was conducted in Auckland, New Zealand; Bangalore, India; Dublin, Ireland; Manila, the Philippines; and San Miguel, El Salvador with the secondary objective of obtaining psychosexual information to identify factors leading to the successful use of NFP. Findings were reported in 1987. This paper reviews some of the WHO findings and compares them with some preliminary findings of the current study in New Zealand on continuation rates of NFP users following the symptothermal method with the goal of determining rates of continuation and reasons for acceptability. The WHO study found that the more satisfied people were with NFP and the less difficulty they reported with abstinence, the more likely they were to be successful users, as measured by their avoidance of pregnancy. The New Zealand Study, however, indicates that for many couples abstinence may not be the main difficulty in using NFP, and that long-term acceptance is not necessarily influenced by pregnancy. The authors notes that the two studies involved different NFP methods. The challenge for the future of NFP services is to learn more about what leads to acceptability in different countries and cultures, remembering that for a natural method of family planning, success depends very much upon the decisions, attitudes, and resulting behavior of the couple involved.
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  5. 5
    Peer Reviewed

    [Reproductive health in a global perspective] Reproduktiv helse i globalt perspektiv.

    Bergsjo P

    TIDSSKRIFT FOR DEN NORSKE LAEGEFORENING. 1991 May 30; 111(14):1729-33.

    The 4 cornerstones of reproductive health according to the WHO are family maternal care neonatal and infant care, and the control of sexually transmitted diseases. In recent years, the AIDS epidemic has caused concern in the world. The world's population doubled to 4 billion from 1927 to 1974, and it will reach 6 billion by the year 2000. The rate of growth is 1.4% in China and 2% in India vs. .3% in Europe. Contraceptive prevalence is 15-20% in Africa, 30% in South Asia, and 75% in East Asia. Shortage of contraceptives leads to abortion in eastern Europe. In 1985 in the USSR, there were 115.7 abortions/1000 women (mostly married) aged 15-44; and 6.4 million abortions for 5.5 million births in 1989. RU-486 or mifepristone combined with prostaglandin has produced abortion in 90% of first trimester pregnancies. After approval in France in 1987, it was used in 40,000 abortions in the following year. 90% of the estimated annual 500,000 maternal deaths occur in developing countries. In Norway, the rate is fewer than 10/100,000 births vs. 100/100,000 in Jamaica. In the mid-1980s, 26% of rural women in Thailand, 49% in Brazil, 54% in Senegal, and 87% in Morocco went without maternal care. In Norway, infant mortality is 6-8/1000 live births vs. 75-150/1000 in developing countries. A WHO investigation on causes of infertility in 25 countries found a 31% rate of tubal pathology in 5800 couples. In Africa, over 85% f infertility in women was infection related. Venereal diseases and infertility are associated with premarital sexual activity in young people. Various donor agencies and the WHO Special Program of Research, Development, and Research Training in Human Reproduction are providing help and resources including AIDS research.
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  6. 6


    United Nations Population Fund [UNFPA]

    New York, New York, UNFPA, [1991]. v, 36 p. (Report)

    The former government of Romania sought to maintain existing population and accelerate population growth by restricting migration, increasing fertility, and reducing mortality. The provision and use of family planning (FP) were subject to restrictions and penalties beginning in 1986, the legal marriage age for females was lowered to 15 years, and incentives were provided to bolster fertility. These and other government policies have contributed to existing environmental pollution, poor housing, insufficient food, and major health problems in the country. To progress against population-related problems, Romania most urgently needs to gather reliable population and socioeconomic data for planning purposes, establish the ability to formulate population policy and undertake related activities, rehabilitate the health system and introduce modern FP methods, education health personnel and the public about FP methods, promote awareness of the need for population education, and establish that women's interests are served in government policy and action. These topics, recommendations, and the role of foreign assistance are discussed in turn.
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  7. 7

    [Contraception via a vaginal hormonal ring] Kontratseptsiia posredstvom vlagalishten khormonalen prusten.

    Vasilev D

    AKUSHERSTVO I GINEKOLOGIIA. 1991; 30(1):49-52.

    Research on the hormonal vaginal ring began in the US in 1973. Its prototype with a diameter of 55 mm releasing in even doses small amounts of hormone was introduced 17 years later. Its high effectiveness with a failure rate of 3-4 pregnancies/100 woman use years is similar to that of most IUDs. The first type contains a combination of estrogen-gestagen consisting of levonorgestrel and 17-beat-estradiol as in oral preparations. It has to be used from the beginning of the menstrual cycle for 3 weeks and removed for 1 week. The second one, devised by a special program of WHO, contains gestagen only in the form of levonorgestrel (LNG) releasing 20-25 mcg of LNG daily. The third type contains progesterone only which is suitable for use by lactating women, as the progesterone eventually absorbed in the maternal system does not pose any risk to the nursing child. At present its effectiveness is being tested, and then its practical application will be examined. The introduction of the prototype was delayed by 2 years when initial investigations showed that the substance used for polymerization of the plastic used for the vaginal ring was carcinogenic, however, this was refuted in subsequent investigations. The vaginal ring is already sold regularly in Great Britain and in some western European countries. This new method allows doctors to provide an alternative contraceptive in addition to the existing ones.
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  8. 8

    Covenant on Economic, Social, Cultural Rights. [Additional parties and location].

    United Nations

    In: Multilateral treaties, index and current status, 8th cumulative suppl., compiled by M.J. Bowman and D.J. Harris. Nottingham, England, University of Nottingham Treaty Centre, 1991. 158.

    Since 1983, the International Covenant on Economic, Social, and Cultural Rights has been ratified by the following countries: Algeria, 12 September 1989; Argentina, 8 August 1986; Burundi, 9 May 1990; Cameroon, 27 June 1984; the Congo, 5 October 1983; Equatorial Guinea, 25 September 1987; Ireland, 8 December 1989; the Republic of Korea, 10 April 1990; Luxembourg, 18 August 1983; Niger, 7 March 1986; the Philippines, 23 October 1986; San Marino, 18 October 1985; Somalia, 24 January 1990; Sudan, 18 March 1986; Togo, 24 May 1984; Democratic Yemen, 9 February 1987; and Zambia, 10 April 1984. Provisions of the covenant guarantee equal rights for men and women, pay equity, maternity benefits, social protection for children and the family, and the rights to housing, education, and health care, among other things.
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  9. 9

    New trends in EC-ACP relations: Lome IV and structural adjustment.

    Parfitt TW

    In: Development perspectives for the 1990s, edited by Renee Prendergast and H.W. Singer. Basingstoke, England, Macmillan, 1991. 17-35.

    Lome Conventions have provided concessionary aid from the European Commission to 67 developing countries signatories in Africa, the Caribbean, and the Pacific (ACP) largely in the form of grants and low interest loans with low conditionality beyond the stipulation that funds be spent upon European goods and services. The fourth Lome Convention signed December, 1989, however, provides aid in a manner tied to structural adjustment program policy of the World Bank (WB) and the International Monetary Fund (IMF). WB and IMF funds are made available only on the condition that recipient countries implement macroeconomic structural changes recommended by these institutions. Despite the slow disbursement of Lome funds and ACP country internal structural and macroeconomic problems which prevent maximizing the full potential of Lome, recipient countries have benefited from its import assistance and general tariff-free access to European markets. While planning to broadly see eye-to-eye with the WB and IMF on conditionally of funding, the EC feels that strict adherence to SAPs may not always have the intended effect upon the growth and development. Accordingly, the EC will not apply conditionality universally and instead hopes to influence the adaption of SAPs to meet country-specific circumstances. Program impact upon social groups should be considered and programs implemented at varying rates as need. The author feels that while EC rhetoric may be commendable, the Commission's limited experience with SAPs and limited influence upon policymakers in Washington will likely condemn Lome to simply following strict WB/IMF SAP policy. Both EC sand ACP development goals would be better served, however, if the EC were to instead pursue a strategy of structural transformation in which elements of traditional adjustment policy would be combined with initiatives designed to diversify Third World economies. Devaluation would have to be modified along with public sector cuts, reliance on traditional imports, credit squeezes, and doctrinaire privatization advocated by the IMF and WB, but traditional sectors could be maintained while developing others. The current system of proffering development aid has been promulgated by EC forces interested in only limited ACP diversification within the context of European economic control. Much needed transformation would instead consist of partnerships promoting the development of more independent business sectors with their own dynamics.
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  10. 10

    The EC and structural adjustment.

    Stevens C; Killick T

    In: Development perspectives for the 1990s, edited by Renee Prendergast and H.W. Singer. Basingstoke, England, Macmillan, 1991. 1-16.

    The international financial institutions (IFI) World Bank and the International Monetary Fund (IMF) provide conditional economic assistance to developing countries. Aid is generally predicated the following actions by respective developing countries: countries must move toward adopting free, competitive market economies; increase the role of the private sector; stimulate domestic savings; liberalize trade and payments; maintain realistic exchange rates; correct price/incentive distortions; and reduce budget deficits. The European Commission (EC) through its Lome Convention agreements also provides financial assistance primarily in the form of grants and low interest loans to 69 country signatories in Africa, the Caribbean, and the Pacific (ACP). The EC, however, traditionally offers considerable latitude in spending to recipient ACP countries without the constraints of conditionality imposed by the IFIs. With Lome IV, the EC will join the IFIs in imposing some degree of conditionally upon aid beyond the present stipulation that recipient funds be reserved for expenditure solely upon goods and services from the EC donor countries. While planning to not publicly conflict with IFI policies and recommendations for developing countries, the EC will maintain its independent relations with Lome countries and divest its funds accordingly. Where IFI conditionality recommendations are well-received and agrees upon by the EC, Lome funds will augment those provided by IFIs; where the EC disagrees, Lome funds may still be provided to member countries without or with modified conditions. Overall, 1150 million Ecu of Lome funds will be potentially subject to review for conditionality, while traditional funding will remain available to support developing country import expenditures. The EC's plan to independently decide upon and allocate funding reflects recognition that OECD theory and developing country realities do not necessarily match. While the IFIs dogmatically retain and impose Western market assumptions and conditionalities upon recipient countries, the EC acknowledges by virtue of a strong French intellectual and colonial tradition of tolerance that practical limits exist to conditionality and will negotiate and fund accordingly.
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  11. 11

    [A human dimension to the fight against AIDS] A dimensao humana do combate a SIDA.

    PLANEAMENTO FAMILIAR. 1991 Jul-Dec; (52-53):17.

    Between 9-10 million people are infected with the human immunodeficiency virus (HIV) according to the estimation of the WHO. This number is expected to double or treble within this decade resulting in the birth of 5-10 million infected children. By the end of the 20th century there would be 30-40 million infected people and 10-15 million orphans because of the death of 1 or both parents. The number of AIDS cases reported to the WHO up to October 1991 totaled 8,418,413 cases (3/4 infected via heterosexual contact). There were 676 cases in Portugal. In AFrica it is especially difficult to treat AIDS victims who also suffer discrimination in addition to mental anguish. UNICEF calculated that there would be 5 1/2 million orphans <15 years of age by 2000. Most sensitization campaigns are directed at the cities at the expense of rural areas where tradition and culture tend to hinder action. It is effective to have seropositives and AIDS victims participate in prevention programs to alert the people that the reality of AIDS cannot be denied.
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  12. 12

    Tackling Africa's slums.

    Egunjobi L

    WORLD HEALTH. 1991 Mar-Apr; 14-5.

    Less developed countries are undergoing rapid, unplanned, and uncontrolled urbanization at the expense of their populations' health. Physical expansion of cities has outpaced the abilities of city planners and management and has contributed to the spread of tuberculosis, pneumonia, influenza, threadworm, cholera, dysentery, and other diarrheal diseases. Overcrowding, lack of access roads, dangerous roads, drinking water scarcity, frequently collapsing buildings, uncollected garbage, lack of sewers, inadequate air space, and houses littered with human feces are common conditions contributing to high mortality rates especially among children. In this context, the World Health Organization's Environmental Health in Rural and Urban Development Program, which is designed to promote awareness about the association between health and planning, is noted. Guidelines for change are also a component of the program, and are encouraged for adoption by planners of less developed countries, especially Africa. Urban rehabilitation and upgrading are recommended in the guidelines while maintaining central focus upon promoting the population's health. While examples of rampant urbanization are drawn primarily from Nigeria, ancient Greek and Roman societies as well as the UK are mentioned in the context of urban planning with a view to health.
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  13. 13
    Peer Reviewed

    Risk of breast cancer in relation to use of combined oral contraceptives near the age of menopause.

    Thomas DB; Noonan EA

    CANCER CAUSES AND CONTROL. 1991 Nov; 2(6):389-94.

    As part of the Who Collaborative Study of Neoplasia and Steroid Contraceptives, physicians gathered data from 2796 cases and 18,900 controls from at least 1 hospital in each country between 1979-1982 and stopped between 1982-1988 to examine the association between breast cancer in women and combined oral contraceptives (COCs), particularly around menopause. The countries included Australia, Democratic Republic of Germany, Israel, Chile, China, Colombia, Kenya, Mexico, the Philippines, and Thailand. The relative risk (RR) was higher in women who had used COCs in the last year, but the increased RR was no greater for women who would be near menopause (45-49 years) than it was for women <40 years old (1.3 vs. 1.4). In fact, the RR was highest in 40-44 year old women (2.1). Further the RRs were greater in women who began using a COC >45 years of age than they were for women who began using it <45 years of age, but the RR did not increase with duration. For example, the RR for women who began to take the COC <45 years for 12-48 months was 0.86 compared to 1.4 for those who began >45 years. The RR for women who began to take the COC at >45 years old remained at 1.4 for the other durations. In addition, the RR in women who ever used COCs was greater in women who underwent an artificially induced menopause than those who underwent a natural menopause (1.7 vs. 1.04). This higher risk in COC users occurred no matter the duration between last use of COCs and induced menopause and the method of artificial menopause. In conclusion, this study did not support the hypothesis that COCs increase the risk of breast cancer in women who use them around the time of menopause.
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  14. 14

    Maternal mortality ratios and rates: a tabulation of available information. 3d ed.

    World Health Organization [WHO]. Division of Family Health. Maternal Health and Safe Motherhood Programme

    [Unpublished] [1991]. 100 p. (WHO/MCH/MSM/91.6)

    The Maternal Health and Safe Motherhood Programme under WHO's Division of Family Health has compiled maternal mortality data in its 3rd edition of Maternal Mortality Ratios and Rates. The report contains data up to 1991. These data come from almost all WHO member countries. 1988 estimates reveal that 509,000 women die each year from causes related to pregnancy and childbirth. Most die from preventable causes such as aseptic abortions and lack of adequate health care. 4000 of these maternal deaths occur in developed countries. Thus developing countries, where 87% of the world's births occur, experience 99% of maternal deaths. In fact, the lifetime risk of death from causes related to pregnancy and childbirth in developing countries is 1:57 compared to 1:1825 in developed countries. Women in countries of western Africa have the greatest risk (1:18) and those in North America the smallest risk (1:4006). Even though the maternal mortality ratio for developing countries fell from 450-520 per 100,000 live births between 1983-1988, it increased in western African countries (700-760). This report consists mainly of tables of maternal mortality estimates for each country and in some cases certain areas of each country, for the world and various regions and subregions, and changes in maternal mortality since 1983 for the world and various regions and subregions. The world comparison table includes live births, maternal deaths, maternal mortality ratios and rates, lifetime risk, and total fertility. Country tables list year, data sources, maternal mortality ratio, indication if abortion deaths were included or not, and reference.
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  15. 15
    Peer Reviewed

    ZOOM: a generic personal computer-based teaching program for public health and its application in schistosomiasis control.

    Martin GT; Yoon SS; Mott KE


    In 1989, staff at WHO headquarters in Geneva, Switzerland developed teaching software that can be used on IBM-PC and IBM-compatible computers to train public health workers in schistosomiasis. They tested in several schools of public health. They then improve it by incorporating a schistosomiasis information file (stack) in ASCII file format and a routine to organize and present data. The program allows the addition of other stacks without abandoning the user interface and the instructor can change data in the stacks as needed. In fact, any text editor such as Word-Perfect can create a stack. This software teaching program (ZOOM) organizes and presents the information (Dr. Schisto). Dr. Schisto is divided into 8 chapters: introduction, epidemiology, parasitology, diagnostics, treatment, data analysis, primary health care, and global database. Users can command ZOOM to communicate in either English, French, Spanish, or Portuguese. Basic hardware requirements include MS-DOS, 8086 microprocessor, 512 Kbytes RAM, CGA or MGA screen, and 2 floppy disc drives. ZOOM can also configured itself to adapt to the hardware available. ZOOM and Dr. Schisto are public domain software and thus be copied and distributed to others. Each information stack has chapters each of which contains slides, subslides, text, graphics, and dBASE, Lotus or EpiInfo files. ZOOM has key words and an index file to access more information. It also can do user defined searches using Boolean logic. Since ZOOM can be used with any properly formatted data, it has the potential to become the standard for global information exchange and for computer assisted teaching purposes.
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  16. 16

    Global Programme on AIDS. Update, AIDS cases reported to Surveillance, Forecasting and Impact Assessment Unit (SFI).

    World Health Organization [WHO]. Global Programme on AIDS

    [Unpublished] 1991 Jun. [2], 7 p. (GPA/ER/CAS/91.06)

    As of June 1, 1991, the WHO Global Programme on AIDS (GPA) reported a cumulative total of 366,455 AIDS cases from 162 countries. The number for May 1, 1991 consisted of 7000 fewer cases. The number rose because WHO received reports from Africa, the Americas, and Europe in the interim. The Americas had the highest reported cumulative AIDS cases (217,729) followed by Africa (92,922), Europe (51,914), Oceania (2802), and Asia (1088). Tanzania reported the highest cumulative number of AIDS cases in Africa (21,719), but the last time it reported number to WHO was December 1990. The Seychelles claimed to have no AIDS cases and Sao Tome and Principe only 1. The US had the highest cumulative number in the Americas (174,893; last reporting date April 1991) followed by Brazil (17,373); February 1991). Montserrat had only 1 case (March 1990). The Sudan had the highest number in WHO's Eastern Mediterranean region (265; January 1990). 4 countries in this region had no cases. By March 1991, France led Europe in the number of cases (14,449) followed by Italy (9053). Thailand reported the most cases in the South East Asia region (106; April 1991). 6 of the 11 SE Asian countries reported either 1 or no cases. Australia had the highest cumulative number of AIDS cases for the Western Pacific region (2494; February 1991) followed by Japan (374; March 1991). 9 of the other Western Pacific nations had either 1 or no cases. GPA intended to publish the last monthly report of AIDS cases in July 1991. After July 1991, it planned on issuing quarterly reports--the 1st to begin in October 1991.
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  17. 17

    Integrating development and population planning in Turkey.

    Dulger I; Kocaman T; Polat M; Uner S

    New York, New York, United Nations, 1991. viii, 67 p. (ST/ESA/SER.R/112)

    Targeted to planners and policy makers as a tool helpful for policy formulation, this report describes the integration of population and development planning in Turkey. With economic development accompanied by rapid population growth, Turkish planners have considered the important relation of such growth to income and social welfare. Reducing the rate of population growth has been a part of all 5-year development plans. The paper presents background information on Turkey, describes the structure of the study, analyzes positive results and difficulties, and discusses the information, methods, and institutions used to efficiently integrate the 2 subjects. Chapters discuss development and population trends, issues and objectives, and frameworks, knowledge, methodologies, institutions, and procedure for integrated planning. Plan implementation is then also considered. In closing, the paper notes that the concept of integrated planning has no been fully embraced by the country's planners, and that population policy formulation has yet to be truly linked with development planning. Demographic data has, however, been introduced into both overall planning and at some sectoral levels.
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  18. 18

    From abortion to contraception in Romania.

    Pierotti D

    WORLD HEALTH. 1991 Nov-Dec; 22.

    The experiences of Romania show that legal decrees will not deter a woman determined to end her pregnancy, and that it is easier to switch from illegal to legal abortion than it is to introduce the practice of modern contraception. On Christmas Day 1989, Romania abrogated a 1966 that banned abortion and all modern contraceptive methods. Through the 1966 law, the former regime had hoped to raise the birth rate, which at the time stood at 15.6/1000. Succeeding briefly, the law ultimately failed to its objective, since by 1985 the birth rate had fallen to the initial 1966 level. If year following the abrogation of the decree, 992,265 abortions were carried out, 92% of them legally. The number of abortions is expected to top 1 million in 1991. Maternal death due to abortion has fallen by more than 60%. Romania has also witnessed the establishment of the Society for Education in Contraception, a private family planning association. UN and donor assistance has begun to arrive in Romania. 20,000 women attended family planning clinics in 1990, a figure that increased to nearly 50,000 in 1991. Nonetheless, the case of Romania illustrates the complexities involved in introducing the practice of modern contraception. In addition to commitment from national authorities, setting up a program of modern contraception will require the following: convincing physicians and clients as to the superiority of contraception over abortion; ensuring the training of health professionals; developing public information programs; creating acceptable conditions for women to seek services; and making contraceptives available and affordable. In order to facilitate the transition from abortion to contraception, UNFPA and the WHO have initiated an emergency family planning program.
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  19. 19

    [Populations on the planet] Populations sur la planete.

    Levy ML

    Population et Societes. 1991 Dec; (263):1-3.

    This work contrasts 2 world population atlases published in 1991, 1 the work of a demographer and the other of a geographer. Both works synthesize the concepts of demography as it is currently practiced. The work by the geography, Daniel Noin, (Atlas of World Population) has a more detailed bibliography and glossary and concentrates on the contemporary population situation. The other work (The Population of the World. From Antiquity to 2050), by Jean-Claude Chesnais, takes a historic approach. The 2 works are complementary and neither raises ecological alarms. They stress different issues in their conclusions, Chesnais asking whether the nations of Europe can compensate for their loss of demographic and economic power by regrouping into an entity large enough to maintain influence, Noin identifying fertility decline in the poor countries as the major current demographic challenge. Both authors use the same analytical instrument and rely on UN statistics. The UN, since its origin, has been the site of a confrontation between 2 schools of demographic thought, the American which is preoccupied with rapid population growth in the poor countries, and the French, which stresses fertility decline and demographic aging in the developed countries. The analytical instrument in both cases is the theory of demographic transition, on which both authors have already written. The 2 authors classify the countries differently, 1 identifying 5 stages of transition and the other 3 stages and 8 types of countries. Agreement on the basic phenomenon of the transition is accompanied by some difference of interpretation.
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  20. 20

    The epidemiological evolution of HIV infection.

    Greco D


    Delphi techniques used by the World Health Organization predict more than 6 million cases of AIDS and millions more to be infected with HIV by the year 2000. In the absence of quick solutions to the epidemic, one must prepare to work against and survive it. The modes of HIV transmission are constant and seen widely throughout the world. Transmission may occur through sexual intercourse and the receipt of donated semen; transfusion or surgically-related exposure to blood, blood products, or donated organs; and perinatally from an infected mother to child. There are, however, 3 patterns of transmission. Pattern I transmission is characterized by most cases occurring among homosexual or bisexual males and urban IV-drug users. Pattern II transmission is predominantly through heterosexual intercourse, while pattern III of only few reported cases is observed where HIV was introduced in the early to mid-1980s. Both homosexual and heterosexual transmission have been documented in the latter populations. Significant case underreporting exists in some countries. Investigators are therefore working to find incidence rates of both infection and AIDS cases to better estimate actual present and future needs in the fight against the epidemic. Surveillance data does reveal a rapidly rising and marked number of reported AIDS cases. The cumulative number reported to the World Health Organization increased over 15-fold over the past 4 years to reach 141,894 cases by March 1, 1989. Large, increasing numbers of cases are reported from North and Latin America, Oceania, Western Europe, and areas of central, eastern and southern Africa. 70% of all reported cases were from 42 countries in the Americas. 85% of these are within the United States. Increases in the proportion of IV-drug users who are infected with HIV are noteworthy especially in Western Europe and the U.S. The epidemic in Italy is also specifically discussed.
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  21. 21

    Population and vital statistics report. Data available as of 1 April 1991.

    United Nations. Department of International Economic and Social Affairs. Statistical Office

    New York, New York, United Nations, 1991. 19 p. (Statistical Papers Series A. Vol. 43, No. 2)

    The Statistical Office of the UN Department of International and Social Affairs compiled a population and vital statistics report with data that it had received by April 1, 1991. The report divided the world into 7 regions: Africa, North America, South America, Asia, Europe, Oceania, and the USSR. It listed population size for each country or area within a region based on the latest population census, latest official estimate, and midyear 1989 estimate. The report used registered data to list crude birth rate (CBR), crude death rate (CDR), and infant mortality rate (IMR) for each country or area. It also gave estimated rates for some countries. China had the largest population in Asia and the world (1.12 billion). Afghanistan ranked the highest in CBR (48.1), CDR (22.3), and IMR (181.6) in Asia and the world. Italy had the lowest CBR (9.7) in the world followed by Japan (9.9). Samoa had the lowest CDR (1.10) in Oceania and the world. Iceland had the lowest IMR (4). The population of the USSR stood at 287.6 million. Its CBR was 17.6, CDR 10.1, and IMR 23. Nigeria had by far the greatest estimated midyear 1989 population (105 million) in Africa. The United States had the most people in the Americas in mid 1989 (247.35 million). The report concluded with 90 footnotes that qualified much of the data. For example, the CDR and IMR for Japan were based on only Japanese people actually living in Japan. On the other hand, some countries data included nationals temporarily living outside the country.
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  22. 22

    Foodborne illness: a growing problem.

    Abdussalam M; Grossklaus D

    WORLD HEALTH. 1991 Jul-Aug; 18-9.

    90% of individual cases of foodborne illness in industrialized countries are unreported and as such do not appear in official morbidity statistics. This figure grows to 99% in non-industrialized countries, yet in developed countries the associated cost of these illnesses is estimated at US$10,000 million/year. Microbiological contaminants are responsible for 90% of the episodes of foodborne illness including: typhoid fever, non-typhoid salmonelloses, cholera, diarrhoeal diseases, bacterial and amoebic dysenteries, botulism, hepatitis A, and trichinellosis. In industrialized countries most of these illnesses have declined; however, salmonellosis and a few others have increased 10 to 20 fold in countries like Germany. Similar trends are present in the US. Canada, Finland, and the United Kingdom. In the Netherlands it was recently estimated that 1.5 million cases of foodborne, microbial diseases occurred in a population of 15 million. Contaminants are dangerous because their numbers can be so great that our normal defenses are overcome. Some can produce toxic chemicals that are not destroyed during cooking. The WHO has created 10 golden rules to follow in food preparation and storage. These rules were created to be practical for low-income economies and households.
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  23. 23

    World Bank raises population lending.

    PEOPLE. 1991; 18(4):33.

    Never before has the World Bank (WB) spent more money than the United States Agency for International Development (USAID) on population and family planning programs (FP). The WB's budget calls for US$340 million dollars for FP compared to USAID which has budgeted US$322 million, some of which may not be allocated. The 1991 WB figure is double the 1990 of US$169 million which was an increase of 40% over the 1989 figure. Total international FP in 1989 was US$757 million including WB and USAID. In the last 25 years the US has Contributed over US$4 billion to FP. Japan contributes about 8% (they announced they will increase their spending on FP by 1.8% for 1991). Norway, Sweden, the Netherlands, Canada, Germany, and the United Kingdom each provide about 4-6% of the total. However, FP accounts for only 1.3% of all total official development assistance. In 1991 the WB has 13 new programs and loans which will be given to Nigeria and Rwanda for the 1st time. The United Nations Population Fund (UNFPA) estimates that a total of US$4.5 billion is needed by 2000 just for FP, with developing countries contributing the same amount. The US house of Representatives recently voted to increase spending with US$300 million for FP in addition to USAID's budget bringing the total up to US$400 million for 1992. Estimates suggest the US should increase spending to $600 million in 1992 and US$1.2 billion by 2000.
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  24. 24

    Trip report on Norplant meeting, Turku, Finland.

    Rimon JG 2d

    [Unpublished] 1991. [14] p.

    Jose G. Rimon, II, Project Director for the Johns Hopkins University Population Communication Services (JHU/PCS) Center for Communication Programs, visited Finland to attend a NORPLANT planning meeting. Meeting discussion focused upon issues involved in expanding NORPLANT programs from pre-introductory trials to broader national programs. Financing and maintaining quality of care were issues of central importance for the meeting. Participants included representative from NORPLANT development organizations, the U.S. Agency for International Development, the World Bank, and other donor agencies. Mr. Rimon was specifically invited to make a presentation on the role of information, education, and communication (IEC) on NORPLANT with a focus upon future IEC activities. The presentation included discussion of the need to develop a strategic position for NORPLANT among potential customers and within the service provide community, the feasibility of global strategies positioning in the context of country-specific variations, the need to identify market niches, the need for managing the image of NORPLANT, and the need to study IEC implications in terms of supply-side IEC, content/style harmonization, materials volume, and language and quality control. Participants collectively agreed to develop an informal group to address these issues, concentrating upon universal issues potentially addressed on a global scale. A meeting on strategic positioning is scheduled for August 19-20, 1991.
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  25. 25

    International Conference on the Implications of AIDS for Mothers and Children: technical statements and selected presentations. Jointly organized by the Government of France and the World Health Organization, Paris, 27-30 November 1989.

    World Health Organization [WHO]. Global Programme on AIDS

    [Unpublished] 1991. [2], 64 p.

    The International Conference on the Implications of AIDS for Mothers and Children was organized by the World Health Organization (WHO) in cooperation with the French Government. Co-sponsors included the United Nations organizations UNDP, UNICEF, and UNESCO, along with the International Labor Organization (ILO), the World Bank, and the Council of Europe. Following assorted introductory addresses, statements by chairmen of the conference's technical working groups are presented in the paper. Working group discussion topics include virology; immunology; epidemiology; clinical management; HIV and pregnancy; diagnoses; implications for health, education, community, and social welfare systems; and economic and demographic impact. Chairman statements include an introduction, discussion of the state of current knowledge, research priorities, implications for policies and programs, and recommendations. The Paris Declaration on Women, Children and Acquired Immunodeficiency Syndrome concluded the conference.
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