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Review of further developments in fields with which the Sub-Commission has been concerned. Study on traditional practices affecting the health of women and children. Final report.
[Unpublished] 1991 Jul 5. , 39 p. (E/CN.4/Sub.2/1991/6)In late 1990, representatives of the Sub-Commission on Prevention of Discrimination and Protection of Minorities of the UN Economic and Social Council's Commission on Human Rights went to Djibouti and the Sudan to explore steps the governments and women's groups are taking to eliminate traditional practices adversely affecting women and children, especially female circumcision. The missions allowed the consultants to examine the problem with women and groups directly affected by the practices and within their cultural contexts. In 1991, the Centre for Human Rights and the Government of Burkina Faso organized the first regional Seminar on Traditional Practices Affecting the Health of Women and Children which considered the effects of female genital mutilation, son preferences, and traditional delivery practices, and facilitated the exchange of information on these practices to fight and eliminate them. The UN reviewed reports from governments, nongovernmental organizations, and UN agencies on these traditional practices. All these activities led the UN to make various observations and recommendations. The degree of public awareness about the harmful effects of female circumcision, nutritional taboos, and delivery practices have improved significantly. Governments and organizations have neither studied nor dealt with son preference and its effects adequately. More African governments were willing to address the problems of traditional practices, e.g., legislation against these practices. The Centre for Human Rights, WHO, UNICEF, and UNESCO should work together more closely to effectively take action on traditional practices. The Centre needs a full time professional staff to gather information, write reports, organize seminars, distribute documents, and network with appropriate organizations. The Sub-Commission should continue to have traditional practices on the agenda to keep it in the fore. No less than two more regional seminars on the issue should take place in Africa to discuss it and increase public awareness.
[Unpublished] 1991. 13 p. (WHO/VDT/91.455)The epidemiology, determining factors, prevention, detection, treatment, and programmatic aspects of maternal and congenital syphilis are discussed. Syphilis can be an acute or chronic infection, but is entirely curable; yet, it is one of the most damaging of all STDs to the fetus. Prevalence in maternal serum ranges from about 0.03% in the UK to 13-16% in some African urban areas. The adverse effects of untreated maternal syphilis to the fetus include abortion, intrauterine death, prematurity, congenital syphilis, and tardive infection. The infant is at greater risk if his mother's syphilis infection is acute; he may escape infection if her syphilis is chronic. Common barriers to effective control of syphilis in developing countries are late prenatal care, lack of screening or treatment, and, especially, failure to find a new infection after earlier prenatal screening. To prevent syphilis in pregnancy, the most important program approaches are health education and promotion of prenatal screening, adequate treatment, partner tracing, and treatment. Both in developing and Westernized settings, it is highly cost-effective to screen and treat maternal syphilis. In developing countries, the VDRL or rapid plasma reagin (RPR) card tests are adequate for screening. Programs should include the management techniques of training, evaluation, regular reporting, quality control of testing, and surveillance of maternal syphilis rates. All these systems can be linked to HIV testing and surveillance programs.
African women. A review of UNFPA-supported women, population and development projects in Gabon, Guinea-Bissau, Zaire, and Zambia.
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.
IAP-IPA-WHO-UNICEF Workshop on Strategies and Approaches for Women's Health, Child Health and Family Planning for the Decade of Nineties, 22nd-23rd January 1991, Hyderabad.
INDIAN PEDIATRICS. 1991 Dec; 28(12):1481-2.In 1991, health professionals attended a workshop to develop strategies and approaches for women's health, child health, and family planning for the 1990s in Hyderabad, India. The Ministry of Health (MOH) of India should improve and strengthen existing health facilities, manpower, materials, and supplies. It should not continue vertical programs dedicated to 1 disease or a few problems. Instead it should integrate programs. The government must stop allocating more funds to family planning services than to MCH services. It should equally appropriate funds to family planning, family welfare, and MCH. The MOH should implement task force recommendations on minimum prenatal care (1982) and maternal mortality (1987) to strengthen prenatal care, delivery services, and newborn care. Health workers must consider newborns as individuals and allot them their own bed in the hospital. All district and city hospitals should have an intermediate or Level II care nursery to improve neonatal survival. In addition, the country has the means to improve child health services. The most effective means to improve health services and community utilization is training all health workers, revision of basic curricula, and strengthen existing facilities. Family planning professionals should use couple protection time rather than couple protection rate. The should also target certain contraceptives to specific age groups. Mass media can disseminate information to bring about behavioral and social change such as increasing marriage age. Secondary school teachers should teach sex education. Health professionals must look at the total female instead of child, adolescent, pregnant woman, and reproductive health. Integrated Child Development Services should support MCH programs. Operations research should be used to evaluate the many parts of MCH programs. The government needs to promote community participation in MCH services.
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.
New York, New York, United Nations, 1991. xiv, 120 p. (Social Statistics and Indicators Series K No. 8; ST/ESA/STAT/SER.K/8)5 UN agencies worked together to develop this statistical source book to generate awareness of women's status, to guide policy, to stimulate action, and to monitor progress toward improvements. The data clearly show that obvious differences between the worlds of men and women are women's role as childbearer and their almost complete responsibility for family care and household management. Overall, women have gained more control over their reproduction, but their responsibility to their family's survival and their own increased. Women tend to be the providers of last resort for families and themselves, often in hostile conditions. Women have more access to economic opportunities and accept greater economic roles, yet their economic employment often consists of subsistence agriculture and services with low productivity, is separate from men's work, and unequal to men's work. Economists do not consider much of the work women do as having any economic value so they do not even measure it. The beginning of each chapter states the core messages in 4-5 sentences. Each chapter consists of text accompanied by charts, tables, and/or regional stories. The 1st chapter covers women, families, and households. The 2nd chapter addresses the public life and leadership of women. Education and training dominate chapter 3. Health and childbearing are the topics of chapter 4 while housing, settlements, and the environment comprise chapter 5. The book concludes with a chapter on women's employment and the economy. The annexes include strategies for the advancement of women decided upon in Nairobi, Kenya in 1985, the text of the Convention on the Elimination of All Forms of Discrimination against Women, and geographical groupings of countries and areas. During the 1990s, we must invest in women to realize equitable and sustainable development.