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  1. 1

    Diarrhoeal and acute respiratory disease: the current situation.

    World Health Organization [WHO]. Office of Information

    IN POINT OF FACT 1991 Jun; (76):1-3.

    This paper describes the serious effect of diarrheal and acute respiratory (ARI) disease upon children under 5 years old, and international efforts undertaken by the World Health Organization (WHO) to reduce such mortality. Combined, these diseases account for more then 1/2 of all deaths in this age group, and constitute the most serious threat to their health. WHO estimates for 1990 that diarrheal illnesses caused 3.2 million childhood deaths and that ARI caused 4.3 million. While some child deaths are due to measles and pertussis, the majority is caused by pneumonia and the consequences of diarrheal illnesses. These deaths could be readily averted through the timely, effective treatment of trained health workers with essential drugs. Immunization as well as improved nutrition, particularly through the practice of exclusive breast feeding of the child's 1st 4-6 months of life, are addition weapons potentially employed against child mortality. WHO programs for diarrhea and ARI control focus upon simplified treatment guidelines, training, communication messages, drug supplies, and evaluation methodology. Despite obstacles such as the marketing of useless and/or potentially dangerous anti-diarrheal drugs and cough and cold remedies, and inappropriate breastmilk substitutes and unnecessary foods, widespread progress in program development and implementation has been made over the past decade. Increased amounts of oral rehydration therapy and solutions are available and used, while many health workers have benefited from training programs.
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  2. 2

    [Executive summary: 42nd Council meeting] Resumen ejecutivo: XLII reunion del Consejo.

    Instituto de Nutricion de Centro America y Panama [INCAP]

    Guatemala City, Guatemala, INCAP, 1991 Aug. [60] p.

    The executive summary of the 42nd council meeting of the Nutrition Institute of Central America and Panama (INCAP) contains a list of topics covered at the meeting and resulting reports and documentation. The executive summary of the 1990 annual report contains a brief statement identifying INCAP program priorities for the year and descriptions of activities emphasized in each of the program components: general coordination, human resources training and development, technical cooperation, and research. Another report assesses progress in institutional processes developed during 1990-91 to strengthen INCAP management capacity. The processes described include decentralization of the administration of technical cooperation; strengthening administration and strategic planning, technology and technology transfer, and development of financial resources; reinforcing scientific-technical communication networks; restructuring the INCAP postgraduate studies program; establishing a human resources data bank; and assessing the current status of documentation centers. The financial report for 1990 follows, including the report of an external audit during 1990. The next section examines follow-up to the eight resolutions of the previous meeting of the INCAP council. The report of the preparatory meeting of the directors general of health and INCAP program and budget proposals for 1992, and statements of policy regarding research and information and communications complete the work.
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  3. 3

    [Annual report, 1991] Informe anual 1991.

    Instituto de Nutricion de Centro America y Panama [INCAP]

    Guatemala City, Guatemala, INCAP, 1991. 117 p.

    The annual report of the Nutrition Institute of Central America and Panama (INCAP) for 1991 begins with an overview of the status of food and nutrition in Central America and INCAP s program priorities for 1992-95. INCAP estimates that approximately 22% of Central American children are moderately or severely malnourished. The next chapter provides an overview of INCAP research activity, followed by more detailed descriptions of studies underway in the areas of agriculture and food science, nutrition and health, and food and nutrition planning. Training and human resource development at the headquarters level and in individual countries are then examined. A chapter on technical cooperation describes the principal achievements in 1991 in transfer of technology, methodologies, and knowledge. A table lists collaborative activities with a regional focus, after which activities in each country are briefly described. INCAP s information and communication policy was revised in 1991, and the activities related to scientific and technical information and communication are described in terms of the new policy. General information concerning administration and finance and lists of INCAP professional personnel are included. A list of works published during 1991 in presented in an annex.
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  4. 4

    Dietary management of young children with acute diarrhoea: a manual for managers of health programmes. 2nd ed.

    Jelliffe DB; Jelliffe EF

    Geneva, Switzerland, World Health Organization, 1991. iii, 29 p.

    This WHO manual is appropriate for use by managers of health programs in controlling the dietary intake of young children with acute diarrhea. diarrhea is a major cause of malnutrition because of the low food intake during the illness, reduced nutrient absorption, and increased nutrient needs from the infection. Those most at risk are young infants 4-6 months old, who are not breastfed, and older infants and children (4-6 months to 2 years old). The introduction presents the causes of diarrhea, causes of malnutrition, and recent findings on nutrition in young children and mothers and on the digestion and absorption of nutrients during diarrhea. The selection of foods to be given during and after diarrhea is discussed in terms of the following variables which affect the choice of foods: age of the child, availability of foods, resources needed for food preparation, nutritional value of food, stage of illness, consistency of food, and frequency of feeding. The role that traditional beliefs and practices play in treatment is also mentioned as is the nature of the beliefs. Foods are classified as food and nonfood, appropriate and inappropriate foods, cultural superfood, special occasion foods, and foods related to ideas concerning physiology. Common treatments for diarrhea are starving the child for a short time; partial food restriction; continuation or restriction of breastfeeding; the feeding of certain foods, at certain times, and in specified amounts; the administration of herbal drinks and plant infusions; and the use of purgatives, emetics, or magical potions. It is important to collect information from several sources in communities and to gather data from discussions, written records, and observation. Methods to prevent diarrhea include following good feeding practices, washing hands after defecation, and keeping the children clean. Monitoring children on a growth chart to diagnose specific nutrient deficiencies, particularly of vitamin A and iron, helps in determining malnutrition. The multimix principle in introducing weaning foods is given, and a table provides a list of important nutrients as well as a list of foods rich in these nutrients. It is of particular importance during diarrhea to consume potassium-rich foods, carotene-rich foods, and milk and to avoid sweetened drinks.
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  5. 5

    African women. A review of UNFPA-supported women, population and development projects in Gabon, Guinea-Bissau, Zaire, and Zambia.

    de Cruz AM; Ngumbu L; Siedlecky S; Fapohunda ER

    New York, New York, United Nations Population Fund [UNFPA], 1991 Jan. 45 p.

    In the late 1980s, UNFPA-supported women, population, and development projects in 4 African countries were reviewed during their early stages of implementation. The Gabon project aimed to identify pressing needs of rural women who worked in agroindustries or participated in agricultural cooperatives so the government could know how to integrate rural women into national development and in developing programs benefiting women. It realized that providing women with information about family health and sanitation did not meet their needs unless they first had a minimum income with which to implement what they learned. The Guinea-Bissau project chose and trained 22 female rural extension workers to inform women about sanitation and maternal and child health, nutrition, and birth spacing to improve the standard of living. It also hoped to strengthen the administrative, planning, and operational capacity of the women's group of a national political party to improve maternal and child health. Yet the women's group did not have the needed knowledge and experience in project development to operate a successful extension-based program. Further, it was unrealistic to expect women to train to become extension works when the government would not hire them permanently. In Zaire, women at local multiservice women's centers in 3 rural regions imparted information and education to modify traditional beliefs and behavior norms to increase women's role in development. In Zambia, Family Health Programme workers provided integrated maternal and child health care and family planning services through local health centers countrywide. The projects used scientific field surveys and/or interviews with villagers, local leaders, and organizations to conduct needs assessments. They did not assess the institution's strengths and weaknesses to determine its ability to be a development agency. The scope of all the projects as too limited. The duties of the consultant in 2 projects were not delineated, causing some confusion.
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  6. 6
    Peer Reviewed

    Public and private donor financing for health in developing countries.

    Howard LM


    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.
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