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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.
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES. 1991; 626:1-10.WHO defines reproductive health as people having the ability to reproduce, to regulate fertility, and to practice and enjoy sexual relationships. It also means safe pregnancy, child birth, contraceptives, and sex. Procreation should include a successful outcome as indicated by infant and child survival, growth, and healthy development. 60-80 million infertile couples live in the world. Core infertility, i.e., unpreventable and untreatable infertility, ranges from 3% to 5%. Sexually transmitted diseases, aseptic abortion, or puerperal infection are common causes of acquired infertility. Sub-Saharan Africa has the highest prevalence of acquired infertility. In 1983, the world contraceptive use rate stood at 51% with the developed countries having the highest rate (70%) and Africa the lowest rate (14%). About 40 countries in Africa and the Arabian Peninsula practice female circumcision. The percent of low birth weight infants is greater in developing countries than in developed countries (17% vs. 6.8%). Intrauterine growth retardation is responsible for most low birth weight infants in developing countries while in developed countries it is premature birth. About 15 million infants and children die each year. Maternal mortality risk is highest in developing countries especially those in Africa (1:21) and lowest in developed countries (1:9850). Sexually transmitted diseases continue to be a major problem in the world especially in developing countries. Chlamydia afflicts 50 million people each year. The proportion of women with AIDS is growing so that between the 1980s and 1990s it will grow between 25% and 50%. More available contraceptive choices enhance safety in fertility regulation. Socioeconomic conditions that determine reproductive health are poverty, literacy, and women's status. Sexual behavior, reproductive behavior, breast feeding, and smoking are life style determinants of reproductive health. Availability, utilization, and efficiency of health care services and level of medical knowledge also determine women's reproductive health.
[Unpublished] 1991. Presented at the 119th Annual Meeting of the American Public Health Association [APHA], Atlanta, Georgia, November 11-14, 1991. 46,  p.The effects of the aftermath of the August 2nd, 1990 Iraqi invasion of Kuwait, the UN Security Council imposed sanctions, and the UN military offensive against Iraq on Iraq's maternal and child health sector and its public health infrastructure are examined. A review of the UN sanctions and dates of implementation are provided. A series of international responses ensued and are described. By February 1991, Baghdad had <5% of a normal water supply and the system was in collapse. Families, particularly women and children, suffered food shortages including infant formula, burns from makeshift cooking devices, e.g., epidemiologic and disease reporting ceased, drugs and vaccines were in short supply or absent, and sanitation and sewage systems were dysfunctional. It is concluded that OAS and US action against Haiti in the form of sanctions and military action would place a tremendous burden on the poor, and it is suggested that careful consideration be given before steps are taken. Also, discussed is the modern method of conflict resolution which is fueled by weapons technology and the profit incentive. There is a called to action for developing a realistic conception framework for the study and conduct of relationships with nations. There is a need to guide change peacefully and to resolve conflict without threat to life and the public's health, human environment, and ecosystem. The modern weapons technology and the protocols allowable under the UN Charter did not accomplish this in Iraq.
POPULATION RESEARCH ABSTRACT. 1991 Dec; 2(2):3-11.An overview, objectives, implementation, and research and evaluation studies of 2 India Population Projects in Karnataka are presented. The India Population Project I (IPP-I) was conducted in Karnataka and Uttar Pradesh. India Population Project III (IPP-III) took place between 1984-92 in 6 districts of Karnataka: Belgaum, Bijapur, Dharwad, Bidar, Gulbarga, and Raichur, and 4 districts in Kerala. The 6 districts in Karnataka accounted for 36% (13.2 million) of the total national population. The project cost was Rs. 713.1 million which was shared by the World Bank, and the Indian national and regional government. Due to poor past performance, these projects were undertaken to improve health and family welfare status. Specific project objectives are outlined. IPP-I included an urban component, and optimal Government of India program, and an intensive rural initiative. The urban program aimed to improved pre- and postnatal services and facilities, and the family planning (FP) in Bangalore city. The rural program was primarily to provide auxiliary nurse-midwives and hospitals and clinics, and also supplemental feeding program for pregnant and nursing mothers and children up to 2 years. The government program provided FP staff and facilities. IPP-I had 3 units to oversee building construction, to recruit staff and provide supplies and equipment, and to establish a Population Center. IPP-III was concerned with service delivery; information, education, and communication efforts (IEC) and population education; research and evaluation; and project management. Both projects contributed significantly to improving the infrastructure. A brief account of the types and kinds of studies undertaken is given. Studies were grouped into longitudinal studies of fertility, mortality, and FP; management information and evaluation systems for health and family welfare programs; experimental strategies; and other studies. Research and evaluation studies in IPP-III encompassed studies in gaps in knowledge, skills, and practice of health and FP personnel; baseline and endline surveys; and operational evaluation of the management information and evaluation system; factors affecting primary health care in Gulbarga district; evaluation of radio health lessons and the impact of the Kalyana Matha Program; and studies of vaccination and child survival and maternal mortality. Training programs were also undertaken.
New York, New York, UNFPA, 1991. 44 p.When discussing issues of population and the environment, 2 factors stand out: 1) poverty is continuing to grow, rather than shrink. Worldwide over 1 billion people live in absolute poverty and the total international debt of low-income countries is over $1,000 billion and growing; 2) social sector programs designed to maintain health, family planning services, housing, and education are constantly underfunded and do not receive the priority that they merit in national and international development programs. This report from the UNFPA contains discussions of sustainable development, the problem of growing urban populations, the balance between population and resources, land degradation, tropical forest destruction, loss of biodiversity, water shortages, population impacts on quality of life, and policy considerations.
Ann Arbor, Michigan, University Microfilms International, 1991. vii, 266 p. (Order No. 9116069)The effectiveness of official development assistance in responding to health problems in recipient countries may be examined in terms of 1) the results of specific aid-supported projects, 2) the degree to which the activities have contributed to recipients' institutional capacity, and 3) the impact of aid on national policy and the broader development process. A review of the literature indicates a number of conceptual and practical constraints to assessing health aid effectiveness. Numerous health projects have been evaluated and issues of sustainability have been studied, but relatively little is known about the systemic effects of health aid. The experience of Nigeria is analyzed between the mid-1970s and the late 1980s. In the 1970s, Nigeria's income rose substantially from oil revenues, and a national program was undertaken to increase the provision of basic health services. The program did not achieve its immediate objectives, and health sector problems were exacerbated by the decline of national income during the 1980s. Since 1987, a progressive national primary healthcare policy has been in place. Aid has been given to Nigeria in comparatively small amounts per capita. Among the major donors, WHO, UNICEF, and, most recently, the World Bank, have assisted the development of general health services, while USAID, UNFPA, and the Ford Foundation have aided the health sector with the principal objective of promoting family planning. 3 projects are examined as case studies. They are: a model of family health clinics for maternal and child care; a largescale research project for health and family planning services; and a national immunization program. The effectiveness of each was constrained initially by limited coordination among donors and by the lack of a supportive policy framework. The 1st 2 of these projects developed service delivery models that have been reflected in the national health strategy. The immunization program has reached nationwide coverage, although with uncertain systemic impact. Overall, aid is seen as having made a marginal but significant contribution to health development in Nigeria,a primarily through the demonstration of new service delivery approaches and the improvement of management capacity. (author's)
NURSING RSA. 1991 Feb; 6(2):29.Africa is confronted with the problem of a lost generation--estimated 10 million orphans whose parents will die of AIDS. In Uganda, the problems of 40,000 children orphaned by the disease have alerted the international community to the fact that AIDS can no longer be compartmentalized as a health problem. It has unprecedented socioeconomic consequences, affecting Africa's work force, its ability to man industries, grow food, and export enough to repay its debts. According to recent surveys, in the next 5-10 years 45% of the South African work force and 90% of skilled Zimbabweans may be infected by HIV. As the 1990s progress, Uganda--with an estimated 1.3 m HIV-positive people--can expect 12,000 new AIDS cases a month. Earlier this month the World Bank and 20 other major donors sent delegates to Uganda to work out a multisectoral AIDS strategy. Everyone agreed that putting money into schools, agriculture, roads, and economic planning as well as health, was needed. But a bitter war took place between the bank and WHO, which holds the UN mandate to control AIDS programs. A myriad of small, nongovernmental organizations, which actually do the work, ganged up to stop the World Bank from imposing a monster bureaucracy on them. But Uganda welcomed the World Bank's provision of $30m (about R78m) worth of soft loans for infrastructure such as clinics, schools, and roads. It seems WHO swallowed its pride, realizing it has enough on its plate coping with AIDS statistics and policies. In the past 4 years the only people who have done anything to help 25,000 AIDS orphans in Uganda's worst-hit district of Rakai are a few irish nuns from a mission hospital. Norway's Redda Barna of Save the Children Fund (SCF) has recently set up nearby and Oxfam and SCF UK have backed work in Rakai. But just 90 minutes' drive south of the Ugandan capital of Kampala, a chronic emergency has passed unnoticed. "There are villages here of children only," an official said recently. Sally Fegan-Wyles, representative for the UN Children's Fund, says everyone was "paralyzed by the enormity of it, we had never experienced anything like it before." (full text)
POPULATION. 1991 Dec; 17(12):3.This article describes the recent activities of the Centre for Adolescent Reproductive Medicine at the University of Chile, which receives UNFPA support under a project aimed at establishing a center for training in adolescent reproductive health. The project, a collaboration of the government and UNFPA, focuses on biological and social issues related to adolescents' reproductive problems, as well as on family relationships. The project is also designed to train health personnel in adolescent reproductive health and support university research into adolescent health and fertility. The Centre used UNFPA funds to improve its facilities, provide training, and increase research and education on teen health. A university bulletin reports that last year, the Centre provided 6936 consultations for teens and increased its outreach activities through the use of educational courses and mass media. The Center also recruited 17 professional trainers in adolescent reproductive medicine, built an annex to its main building, and established a library that specializes on adolescence. Furthermore, UNFPA provided the Centre with medical equipment such as a fetal heartbeat monitor, the necessary paraphernalia to perform vaginal endoscopy for adolescents, and other specialized diagnostic instruments for child and adolescent gynecology. The article explains that teenage pregnancy is common problem in Latin America. According to a 1988 study, 1/3 of all women aged 15-17 living in Santiago (which contains about a 1/3 of Chile's population) had been pregnant at least once.
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.
[Unpublished] 1991. , 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.