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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.
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.
[Unpublished] 1991. 24 p. (WHO/MCH/NUT/91.2)The report of the national actions in marketing breast-milk substitutes includes a review and evaluation summarized in the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.
New York, New York, United Nations, 1991. , 96 p.A worldwide educational campaign has been launched in response to the discouraging results of the 1990 appraisal of implementation of the Nairobi Forward-looking Strategies for the Advancement of Women to the Year 2000. As part of that campaign, this book uses statistical data compiled by the UN to describe the obstacles faced by women attempting to achieve equality in political participation and decision making; advancement in education, employment, and health; and participation in the peace process. The objective of this book is to raise the awareness of these issues among governments, nongovernmental organizations, educational institutions, the private sector, and individuals. Each of the first six chapters discusses one area of women's lives and ends by delivering a series of challenges to be met by the year 2000. Chapter 1 discusses discrimination against women (its roots; the lag between theoretical and practical advances; sex stereotypes; and discrimination in marriage, the family, and society) as well as its legal remedies. Chapter 2 defines women's health as a vital prerequisite to equality and covers such topics as the global health boom; women as primary health care providers; clean water, sanitation, and nutrition; the effects of economic crisis; maternal mortality; fertility and family planning; increasing malnutrition; AIDS; genital mutilation; and son preference. Chapter 3 looks at women's education as a key to empowerment and focuses on illiteracy, the effects of the economic crisis on education, and the special problems of rural women. Chapter 4 considers aspects related to acknowledgment of women's work such as the multiple roles of women, accounting for women's economic activity, households headed by women, women in agriculture, women in the informal sector, women suffering from exploitation in the formal sector, and the effects on women of economic adjustment programs. Chapter 5 examines women in political life, and Chapter 6 defines the role women play as victims of domestic and other violence and as advocates of peace. The concluding chapter provides a practical guide to obtaining further information from the UN.
In: Changing perceptions: writings on gender and development, edited by Tina Wallace with Candida March. Oxford, England, Oxfam, 1991. 8-11.The Nairobi Forward-Looking Strategies for the Advancement of Women (FLS) were endorsed by all UN member governments in 1985. Despite this, many women believe that the FLS will only be implemented if pressure is applied to governments. The FLS identify many obstacles to development including the economic dependence of many developing nations on developed nations, the channeling of funds into the purchase of arms, and racial and intertribal discrimination. In order to forward the process of integrating women in development, the FLS stress that women must be included at every level of decision making. In the field of employment, governments should legislate improvements for women. Laws should protect women's employment rights, equity, and ability to achieve economic self-reliance. Primary health care for women should be promoted, women should be able to control their own fertility, and women should be given a key role in the planning of sanitation and water projects. More women should be trained to become involved in the health process. Finally, women must have access to education and training at all levels. Education should also be used to eradicate stereotyped views of women. This summary covers only a fraction of the changes recommended in the FLS which will only be accomplished through a major change in the status of women. Women everywhere should pressure their governments to fulfill the commitments made in the FLS.
Oxford, England, Oxford University Press, 1991. xix, 429 p.The Education and Employment Division of the World Bank's Population and Human Resources Department conducted a four-year study on the effectiveness and efficiency of primary education in developing countries. The resulting book includes extensive reviews of the research and evaluation literature; consultations with policymakers in developing countries, representatives of donor agencies, and primary education specialists; and results of commissioned studies and of original research conducted in the division. Learning is the central theme of the book; it reminds people that learning occurs in schools and classrooms among teachers and children, not in government ministries of education or finance. It also tells readers that learning is foremost and that teacher training and instructional materials are important only if the children learn. Policymakers must consider the impact of the cost and financing of education on learning when making decisions. The goals of primary education include teaching children basic cognitive skills, developing attitudes and skills in children so they can function effectively in society, and promotion of nation-building. This publication examines five areas for improvement of primary education: inputs necessary for children to learn; methods for improving teachers and teaching; management requirements for promoting learning; ways to extend effective education to traditionally disadvantaged groups; and the means to afford enhanced education. The study reveals that there is limited research on children's learning and no research at all on change in learning. The chapters cover the following: primary education and development; a brief history of primary education in developing countries; improving learning achievement; improving the preparation and motivation of teachers; strengthening institutional capabilities; improving equitable access; strengthening the resource base for education; international aid to education; and educational reform: policies and priorities for educational development in the 1990s.
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.
[Unpublished] 1991. Presented at the 119th Annual Meeting of the American Public Health Association [APHA], Atlanta, Georgia, November 11-14, 1991. 7,  p.Maternal health affects child survival in many ways. For example, and infant in Bangladesh whose mother has died during childbirth has a 95% chance of dying in the 1st year. Further children <10 years old in Bangladesh, especially girls, who have lost their mother are 4 times as likely to also die. In addition, there is a relationship between protein energy malnutrition in mothers and low prepregnancy weight and meager wait gain during pregnancy which retards fetal growth resulting in a low birth weight (LBW) infant, LBW infants die at a rate 30 times that of adequate weight infants. In fact, child survival depends on maternal health even before the mother is able to conceive. Daughter as well as mothers in developing countries often eat last and smaller amounts of food than male family members. Females who remain poorly nourished often experience obstructed labor which causes several complications for the infant such as respiratory failure. Maternal infections such as malaria and sexually transmitted diseases are also closely linked to LBW. Some can also bring about preterm birth and congenital infections. Pregnancy and labor complications are responsible for about 500,000 maternal deaths annually. Hemorrhage, sepsis, eclampsia, and obstructed labor cause most of these deaths. A woman's fertility pattern also contributes to child survival. The high risk birth categories include too young, too old, too many children, and too closely spaced. In fact, the median mortality rate for infants born <2 years after the older sibling is 71% greater than that for those born 2-3 years apart. The World Bank recommends improved community based health care, improved referral facilities, and an alarm and transport system to improve maternal health. The World Bank, UNDP, UNFPA, UNICEF, WHO, IPPF, and the Population Council support the Safe Motherhood Initiative which aims to reduce maternal morbidity and death by 50% by 2000.
[Unpublished] 1991. Presented at the Demographic and Health Surveys World Conference, Washington, D.C., August 5-7, 1991. 22 p.A supply-demand approach is used to estimate total and unmet demand for family planning in Indonesia over the last decade. The 1976 Indonesia Fertility Survey, the 1983 Contraceptive Prevalence Survey, and the 1987 National Contraceptive Prevalence Survey form the database used in the study. Women under consideration have been married once, are aged 35-44, have husbands who are still alive, have had at least 2 live births, and had no births before marrying. High demand was found for family planning services, with the proportion of current users and women with unmet demand accounting for over 85% of the population. Marked improvement in contraceptive practice may be achieved by targeting programs to these 2 groups. Attention to unmotivated women is not of immediate concern. Women in need of these services are largely rural and uneducated. Programs will, therefore, require subsidization. The government should gradually and selectively further introduce self-sufficient family planning programs. User fees and private employer service provision to employees are program options to consider. Reducing the contraceptive use drop-out rate from its level of 47% is yet another approach to increase contraceptive prevalence in Indonesia. 33% drop out due to pregnancy, 26% from health problems, 10% because of method failure, 10% from inconveniences and access, and 21% from other causes. Improving service quality could dramatically reduce the degree of drop-outs.
New York, New York, UNFPA, . ix, 66 p.This paper discusses Sri Lanka's population policy with special focus upon UNFPA's role in establishing and implementing a successful multi-sectoral family planning program for the country. Progress made in the past years must continue, while ongoing efforts are made to attain the goal of 2.1 TFR by year 2000. A suitable program must be better coordinated with a view to cutting waste and duplication, guarantee an adequate supply of appropriate contraceptive supplies, streamline research operation, more fully implement its educational programs, and recognize women's centrality in population programs, and recognize women's centrality in population programs. UNFPA assistance should be offered to effect such programmatic change and development, with service delivery needs addressed 1st. The Government of Sri Lanka lacks adequate resources to supply calls for an integrated approach focused upon creating a National Coordinating Council; developing a more sophisticated and targeted approach to information, education, and communication; providing contraceptive supplies, software for service delivery, and client counseling; training providers; and improving coordination with other multilateral programs for child care and human resource development. The present population and development situation, the national population program, proposed sectoral strategies for implementation, the role of technical assistance, and general recommendations for external assistance are discussed in detail.
SCIENCE. 1991 Oct 25; 254:511-2.The 1st Director of the World Health Organization's (WHO) Global Program on AIDS (GPA) abruptly resigned March, 1990. Jonathan Mann led the GPA in an innovative, aggressive, and comparatively non-bureaucratic style since its inception in 1986, building a staff of nearly 200 under an eventual 1990 budget of $90 million. Mann's non-conformist style and ever-growing budget, however, ran counter to the bureaucratic forces in WHO, causing him to leave for a position at Harvard University. A 12-year WHO veteran, Michael H. Merson succeeded Mann, and has since managed the GPA in a more conventional, bureaucratic manner. Senior staff have resigned, and the budget will drop to only $75 million for 1992. Staff replacements are used to the bureaucratic structure and demands of WHO, but lack experience in the field of AIDS. This paper discusses the markedly different management styles and approaches of Merson and Mann, with concern voiced over the future of the GPA. Critics are uncertain of GPA's present direction, and whether or not it is a necessary, positive change in the fight against the AIDS pandemic. As AIDS appears with less frequency and centrality i the world's media, the GPA is needed now even more than just a few years ago to inform the world of the dangers of AIDS. Merson is expected to promote relatively simple treatment options for AIDS, with some emphasis upon technological fixes like the condom. With cuts to the behavioral research budget, however, it is almost certain that inadequate steps will be taken to effect behavioral change for the prevention and control of HIV infection.
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA. 1991 Jun; 5(2):221-34.Public and private domestic expenditures for health in a total 148 developing countries for 1983, were estimated to be $100 billion. 1986 external donor health expenditures totalled $4 billion, a small percentage of overall health expenditure for developing countries. U.S. direct donor assistance for development was 0.5% of the federal budget for 1988, with approximately 10% of all U.S. development assistance allocated for health, nutrition, and population planning. As such, the U.S. accounts for 13% of total health contributions from external donors to developing countries. Approximate at best, private and volunteer organizations are estimated to contribute 20% of all such health assistance. Developing countries are therefore required to efficiently use their own resources in the provision of national health services. Technical assistance and donor experience also counting as external assistance, the overall supply of health financing is far greater than developing country demand in the form of well-articulated, officially approved proposals. Reasons for this imbalance include health ministry unfamiliarity with potential donor sources, passive approaches to external financing, unfamiliarity with proposal preparation, increasing competition from other sectors of developing nations, limited numbers of trained personnel, and lack of an international system of support to mobilize financing. The paper discusses 6 years of Pan American Health Organization interventions for resource mobilization in Latin America and the Caribbean, and suggests World Health Organization regional extension backed by U.S. encouragement and support.
ESSENTIAL DRUGS MONITOR. 1991; (11):15-7.The WHO Programme on Traditional Medicine has joined WHO's global program on drug management and policies because there is a need for recognition that an adequate technological infrastructure must be in place to maximize plants for their medicinal value, especially in the context of primary health care (PHC). PHC places traditional medicine high on its list of priorities and emphasizes the availability and use of appropriate drugs. For example, countries should distribute seeds or plants to be cultivated in home or community gardens and taken as infusions. Scientists have not studied most medicinal plants which can be a rich potential resource for developing countries. Countries should apply known and effective technologies to meet health needs in a culturally acceptable manner and to promote self reliance. They must 1st strengthen data gathering and analysis capabilities needed for economic mapping of medicinal flora, then develop data centers on medicinal plants and plant derived products, such as the WHO Collaborating Center in Chicago. Clinical research should focus on the safety and efficacy of herbal medicines used by traditional health practitioners and on developing antiinfective agents. For example, 2 WHO agencies are collaborating on identifying, preparing, and testing extracts for medicinal plants for antiHIV capabilities. WHO favors developing the knowledge and skills of traditional health practitioners within the framework of PHC. Further, interregional workshops promote selection and use of traditional medicine in national PHC programs. Since there continue to be much public interest in medicinal plants, accurate information must be disseminated to the public and health professionals so they can know both the potential benefits and harmful effects of these remedies.
New York, New York, New York University Press, 1991. xxiv, 464 p.This publication contains an UNFPA assessment of the accomplishments of population activities over the last 20 years. The world's leading multilateral population agency, UNFPA decided to conduct the study in order to identify obstacles to such programs, acquire forward-looking strategies, and facilitate interagency cooperation. The 1st section examines 3 categories of population activities: 1) population data, policy, and research; 2) maternal and child health, and family planning; 3) and information, education, and communication. This section also recognized 9 key issues that affect the success of population programs: political commitment, national and international coordination, the role of non-governmental organizations (NGOs) and the private sector, institutionalization, the role of women and gender considerations, research, training, monitoring and evaluation, and the mobilization of resources at the national and international level. The 2nd section of the publication discusses population policies and programs in the following regions: sub-Saharan Africa, the Arab States, Asia and the Pacific, and Latin America and the Caribbean . Finally, the 3rd section provides and agenda for the future, discussing the significance of international efforts in the field of population, as well as pointing out the programmatic implications at the national and international levels. 2 annexes provide demographic and socioeconomic data for 142 countries, as well as the government perceptions of demographic characteristics for individual countries.