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UN Chronicle. 1991 Jun; 28(2): p..Environmental degradation is killing children. That is the alarming message of the 73-page report--Children and the Environment--published jointly by the UN Children's Fund (UNICEF) and (UNEP) in 1990. The two organizations examined the effect of environmental quality on the child in the womb, on infants and children, as well as the special problems of children at work and those in distress. The study finds that "children are too often the victims of pollution--their young bodies make them far more vulnerable than adults to the poisons we spew into the air, and toxins we sow on Earth". It states that global warming, ozone depletion, loss of genetic resources, desertification and general land degradation are "this generation's legacy to its descendants". Before it is too late, the report urges, "intergenerational equity", which incorporates the welfare of future generations into developmental planning, must be implemented. UNICEF and UNEP warn that achieving it could be "the foremost challenge facing policy makers in the closing years of the twentieth century, and beyond". (excerpt)
UN Chronicle. 1991 Jun; 28(2): p..The United Nations Children's Fund (UNICEF) has made a "promise to children"--to try to end child deaths and child malnutrition on today's scale by the year 2000. The Fund estimates that a quarter of a million children die every week from common illnesses and one in three in the world are stunted by malnutrition. That broad goal, declared on 30 September 1990 by 71 Presidents and Prime Ministers attending the first World Summit for Children, includes 20 specific targets detailed in the Plan of Action for implementing the World Declaration on the Survival, Protection and Development of Children in the 1990s, adopted at the Summit. Among them are: one-third reduction in under-five death rates; halving maternal mortality rates; halving of severe and moderate malnutrition among the world's under-fives; safe water and sanitation for all families; and measures covering protection for women and girls, nutrition, child health and education. Other goals include making family planning available to all couples and cutting deaths from diarrhoeal diseases--which kill approximately 4 million young children annually--by one half, and pneumonia--which kills another 4 million a year--by one third. (excerpt)
New Delhi, India, WHO, SEARO, 1991 Dec. , 35 p. (Regional Health Paper, SEARO, No. 20)The Joint WHO/UNICEF Nutrition Support Programme (JNSP) began operations in Myanmar in 1984 and expanded nationwide in three phases. A detailed situation analysis of nutrition conditions and nutrition programs in primary health care (PHC) were conducted prior to JNSP activities. They served as the rationale for the decision to implement JNSP activities nationally. These activities are almost entirely administered through the Ministry of Health. JNSP redesigned nutrition training for village workers, their supervisors, and district health personnel. It has strengthened nutrition units at the central and regional levels. All JNSP-technical activities revolve around nutrition monitoring and counseling. JNSP participated in the establishment and operations of a food and nutrition surveillance system. It facilitated implementation of the nutrition and nutrition-related aspects of the People's Health Plan. The JNSP was evaluated in 1989. During the JNSP period, mortality among children less than 3 years old fell. 3-year-old children grew at a faster rate than prior to JNSP. Improvements were also noted in young child feeding practices, health seeking behavior of mothers, counseling by voluntary workers, and health staff performance. The evaluators concluded that JNSP directly benefitted the health and nutrition of children less than 3 years old. External costs of JNSP added up to US$5.63 million. The government put in another US$5.43 million. The communities contributed US$2.9 million. JNSP covers 30% of the total population. Per capita annual costs were US$1.67. These low per capita costs suggest that JNSP is sustainable and replicable. JNSP's further expansion depends on expansion of the health delivery system. All levels regularly provide support and supervision. Planned evaluation and feedback is the norm.
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.
[Child health in the states of Ceara, Rio Grande do Norte and Sergipe, Brazil: description of a methodology for community diagnosis] A saude das criancas dos estados do Ceara, Rio Grande do Norte e Sergipe, Brasil: descricao de uma metodologia para diagnosticos comunitarios.
Revista de Saude Publica / Journal of Public Health. 1991 Jun; 25(3):218-25.From 1987 to 1989, UNICEF collaborated with state and municipal health organs of the Brazilian states of Ceara (C), Rio Grande do Norte (R), and Sergipe (S) in order to realize a community diagnosis of maternal-child health care. The estimation of mortality required investigating women aged 15-49 visiting 8000 households, examining 4513 children <3 years old. In R and S, a sample of 1000 children <5 was used to estimate most common health problems. In these states, 1920 households were visited, and a questionnaire served for collection of demographic and socioeconomic data. Children were weighed, and a modified AHRTAG anthropometer served for measuring body length. About 1/4 to 1/3 of children were first-born. In C, 19.3% of children were seventh-born or higher, almost double the rate of the other 2 states. Income, literacy rate of parents, living conditions, and availability of running water indicators were much worse in C. 34.8% of the women in C had not received prenatal care; this figure was 15.7% in S an R, respectively. In C, only 24.3% of the mothers had received 6 or more prenatal care checkups vs. about 1/2 in the other states. Hospital deliveries reached 64.8% in C vs. almost 90% in the other states. In C, breast feeding was more prevalent: 83% were breast feeding for 1 month and 27.1% for 12 months. Malnutrition indicated by height and age was 27.6% in C vs. 16.1% in S and 14/2% in R. There was a clear association between family income and nutritional deficits of height/age and weight/age indicators. In C, malnutrition was higher in all income groups. Diarrhea incidence was 12% in C vs. 7.3% in S and 6/4% in R. A lower percentage used rehydration in C. 9.9% of children in C had been hospitalized in the previous 12 months vs. 6.2% in S and 6.9% in R. Coughing, fever and respiratory difficulties ran to 8.6% in C. Only 42.4% had full vaccination in C vs. 61.7% in S and 71.3% in R. 30/5% had been weighed in C in the previous 3 months vs. 45.1% in S and 44.2% in R.
[The problems of supplying water to the rural population in developing countries] Problemy vodosnabzheniia selskogo naseleniia v razvivaiushchikhsia stranakh.
FELDSHER I AKUSHERKA. 1991 Dec; 56(12):35-6.Since 1981, one of WHO's areas of concentration has been the sanitary conditions of developing countries. In many regions of the world water supplies are polluted. In about 60% of developing countries the population does not have proper sanitation technology. In 75% of African countries the rural population is deprived of adequate safe water supplies. In Zambia, only 56% of the population has safe drinking water and in Kenya only 28%. In the countries of southeast Asia which represent 25% of the world's population, an average 20% of rural populations have clean drinking water. In developing countries due to the shortage of clean water, 1000-2500 children under 5 years of age perish every hour because of diarrheal diseases. With the help of UNICEF in some developing countries work has started to establish water supply systems for the rural population each serving up to 1000 people. In Malaysia, Guinea, and the Philippines courses were started to train national specialists to supervise the quality of drinking water followed by the training of experts to carry out water supply programs. In the first 7 years in the rural areas of some developing countries the proportion of safe drinking water increased from 46% to 56%. In order to help the rural population obtain clean drinking water, monetary contributions have to be raised for realistic development of water supplies. It is advisable to observe the drinking water standards laid down in WHO guidelines in smaller communities and rural regions to assure safe drinking water for the population and to establish national standards in countries where none exist. The frequency of water analysis depends on the size of the local system and on the population figure of the community. Usually one test is required for each 5000 people/month.
Improving food security at household level; government, aid and post-drought development in Kordofan and Red Sea Hills.
In: To cure all hunger. Food policy and food security in Sudan, edited by Simon Maxwell. London, England, Intermediate Technology Publications, 1991. 218-31.The question whether government, assisted by aid, is capable of targeting interventions to those lacking food security is examined. Food security is a general concept which includes security against seasonal fluctuations, long-term declines in the natural resource base, and economic conditions which lead to destitution. Food security is analyzed at individual, household, community, regional, national, and international levels. Household interventions are also concerned with intra-household distribution and the level of community security. Food-insecure rural women and children in marginal drought-prone areas were the focus of programs funded by UNICEF in Sudan: the Joint Nutrition Support Project (JNSP) in Red Sea Hills (1983-88) and the Integrated Women's Development Program (IWDP) in Kordofan (1987-91). These multi-sectoral programs were carried out by departments of regional and provincial government along with the reactions to famine. In both Kordofan and Red Sea Hills extreme poverty is widespread, with high vulnerability to food insecurity which is even higher in Red Sea Hills. In Red Sea Hills, UNICEF/WHO had negotiated the 5-year JNSP to cover the province just as the famine broke in 1983/84. In Kordofan, UNICEF collected baseline data on such indicators and then returned after a two-year period to communities originally surveyed for monitoring. In Red Sea Hills, JNSP's target population were the food-insecure nomads. The Department of Health structure became sufficiently strong, at least partly due to 5 years of investment and development of primary health care personnel under JNSP. The department represents the best administrative mechanism in the province for the development of famine early-warning systems. Many food-security measures in Red Sea Hills are experimental and wrought with difficulty, thus the existence of a relatively strong administration will favor a food security strategy based on primary health care interventions.
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.
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.
[Health education needed more than ever: women's position must be strengthened] Terveyskasvatusta tarvitaan kipeammin kuin koskaan --naisten asemaa vahvistettava.
KATILOLEHTI; TIDSKRIFT FOR BARNMORSKOR. 1991 Oct; 96(5):18-9.The International Union of Health Education (IUHE) and a Finnish health education association held the 14th World Conference in Helsinki with the participation of the WHO, UNICEF, and over 1200 participants from 92 countries with more than 1000 presentations. Female authors pointed out that globally women's health education efforts had to be bolstered and their role enhanced. Matti Rajala, the new president of IUHE was pleased with the meeting that offered an opportunity for valuable personal contact. The address of the outgoing president touched on health education in schools, education on AIDS prevention, involvement of people in programs, the continuing education of professionals in basic health delivery, and the situation in various countries. UNESCO representative Victor Kolybine underlined the obligation of the state to engage in health communication to the populace which entails a common effort also for health care professionals and scientists. UNESCO was more concerned with the facilitation of health education programs in schools. The IUHE president declared that health education faced competition from a surge of information, new knowledge, and lack of funds. The budget of the tobacco industry far outstripped health education promotion. It is unfortunate that prosmoking advertising and marketing target developing countries that can allocate less money for health education just when smoking has declined in developed countries. A Hyde Park style open forum allowed free debate among participants. A Finn-Health exhibition was also on display, and the next conference was scheduled in 3 years in Japan.
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.
In: Child care: meeting the needs of working mothers and their children, edited by Ann Leonard and Cassie Landers. New York, New York, SEEDS, 1991. 19-24. (SEEDS No. 13)In Ethiopia among the Melka Oba Farmers Producers' Cooperatives which are 120 km from Addis Ababa, child care was managed by the cooperative itself with the assistance of UNICEF and the Integrated Family Life Project (IFLE) interagency committee in 1983. Funding was used to employ a consultant to train child minders and establish the center, pay the cost of training, purchase resource materials for the training, equip the creche and kindergarten, and buy tools for construction of play items. A villa was donated to house the day care program. 8 child minders were selected for their interest in children and their educational level. Training was for 8 months. The child care center has flexible hours to accommodate working mothers and allows breast- feeding visits during the day. It is open to children aged 45 days-6 years, and includes a national preschool curriculum and immunization and health care services. As a byproduct of the center's activities, a family planning, health, and family life education program are operating. The evaluation in 1985 found that there were many reports of improved health among the children and less anxiety for the parents about child care. Production has increased and absenteeism has fallen. Pressure was applied successfully to obtain a local elementary school. A literacy program for adults was also begun. Of the problems encountered, the most difficult was persuading men, who felt that there was not a child care problem and that the women took care of it, to share in child care responsibilities. IFLE and UNICEF replicated the effort in Melka Oba within the Yetnora Agricultural Producer's Cooperative in Dejen, Gojjam Region. 12 lessons learned from this experience are identified: 1) child care needs must also take into account the interrelated needs of working mothers, infants and young children, and child care providers; 2) child care must be accessible, available during work hours, affordable, and trustworthy to mothers; 3) high quality care must have an appropriate curriculum; 4) local women should be trained as providers; 5) need is dependent on the child's age; 6) providers need payment and support; 7) community involvement increases commitment and learning; 8) byproducts are parent education and more schooling options for siblings; 9) teaching needs to be learner centered; 10) no 1 solution is best; 11) quality of care must be contextually judged by mothers and the community; and 12) political commitment is necessary.
HEALTH FOR THE MILLIONS. 1991 Dec; 17(5):24-5.While there may be no documented evidence that mortality decline is a causative factor in demographic transition, there is a close association between reductions in mortality and fertility. The Indian experience of more than 40 years shows that consistent efforts in the promotion of family planning will be rewarded with demographic transition. In the Indian state of Kerala, population 30 million, improving child survival, female literacy, strict child labor laws, and effective high coverage primary health care reduced mortality and fertility. Its infant mortality rate is 22/100 births, which is 25% of the national average. Its birth rate is 20/1000 and is continuing to fall. In the past decade population growth was only 14% compared to 25% nationally and 28% in the northern states. If Kerala's figures were applied to all of India, there would be 2 million less infant deaths and 8 million less births. The impact of reducing infant mortality on population growth in raw numbers in insignificant. With a mortality rate of 150/1000 there are 850 survivors. If the mortality rate is cut in half there will be only a .18% increase in population, but with a 50% reduction in infant suffering and death. Historically such mortality declines are associated with a 25% or more decline in fertility. This is the reason that UNICEF has been a long-time advocate of child survival programs as an integral part of population control measures. Euthanasia is surely not the solution to the population problem. The daily loss of 40,000 childhood lives is a tragic part of the human experience. However, helping these children to become and stay healthy is the best method of reducing population.
New York, New York, UNICEF, 1991. 60 p.The 1991 UNICEF annual report contains an introduction written by the Executive Director, James P. Grant. In it he outlines the goals of the World Summit for Children which include: initiatives to save an additional 50 million children, reduce childhood malnutrition by 50%, reduce female illiteracy by 50% , and eradicate polio and guinea worm from the planet. The report discusses the programs conducted during 1991 including: the World Summit for Children, child survival and development, basic education, water supply and sanitation, sustainable development, urban basic services, childhood disability, women in development, social mobilization, emergency relief, monitoring and evaluation, inter-agency cooperation. The report also outlines UNICEF's external relations, resources, and provides several profiles including Africa's AIDS orphans. Income for 1990 totaled US$821 million for 1990, and estimated at US$858 million for 1991. Expenditures for 1989 were US$633 million, US$738 million for 1990, and estimated at US$847 million for 1991.
Oxford, England, Oxford University Press, 1991. , 128 p.The State of the World's Children for 1991 begins with a promise by world leaders to adopt an ambitious series of goals for 2000 with an objective to end child death and child malnutrition at today's levels. Keeping the promise will not be easy since raising the resources to meet this goal will mean giving children a new, higher priority. Success will only be achieved by following certain principles, for example, reaching the immunization goals for the year 2000 will require almost every organization and person in both developing and developed countries to work hard. In order to succeed in only 10 years, a new ethic must develop which gives children a number 1 priority even in bad times. Reducing child deaths by 33% during this decade will mean essential steps must be taken in the process of reducing births and slowing population growth. The current generation will be charged with caring for the largest generation of children ever. Their performance will ultimately be judged according to the outcome of the children of the 1990s.
In: Child care: meeting the needs of working mothers and their children, edited by Ann Leonard and Cassie Landers. New York, New York, SEEDS, 1991. 1-4. (SEEDS No. 13)The overwhelming majority of women in the world work to make a living. In 1985 the female labor force amounted to 32%. In the developing world industrialization, urbanization, migration, and recession in the 1980's forced women to seek employment. In Ghana over 29% of households are headed by women. In the US 57% of women with children under 6 are employed. In Bangkok, Thailand, 1/3 of mothers were back to work within the 1st year of after childbirth. In Nairobi, Kenya, 25% of mothers were working when their child was 6 months old. Availability of child care is often scarce: in Mexico City during the recession of 1982 mothers were forced to take their child to work, or left them with neighbors or older children. Grandmothers live in only 15% of homes and extended family members in only 10.8%. A serious problem arises when older siblings drop out of school to take care of the young. Organized child care programs vary: in India a nonformal preschool program covers 25% of children aged 3-6. However, inadequate resources often result in operation of only 3-4 hours a day, no provisions for breast feeding, and custodial care instead of nutrition and health benefits. In India mobile creches at construction sites provide child care for female workers. The International Labour Organization fostered the classic factory day care facility, but transportation distances and costs have diminished the popularity of these. The community-supported model in Ethiopia has been successful, and similar projects are tried in Mexico. Child care workers are paid little: in Ecuador trained preschool teachers make 40% of the salary of primary school teachers; and in the US in 1989 they were earning only 30% of the salary of elementary school teachers. Better options for child care are needed for the safe and normal development of children.
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)
HEALTH FOR THE MILLIONS. 1991 Dec; 17(5):28.UNICEF advocates the reduction of infant/child mortality because it feels that such an action will reduce both fertility and human suffering. It was feared in the beginning, and today as well, that increasing the survival rate for children would cause rapid population growth. However, there is a large body of evidence to the contrary. When such measures are combined with measures to promote and support family planning there are even greater reductions in fertility levels. This is why such organizations as UNFPA, WHO, and UNICEF have advocated this course of action. This strategy is also present in the Declaration of the World Summit for Children. Anyone advocating the reduction in support for programs designed to enhance child survival as a method of population control is confusing the issues, misdirecting environmental attention, and stirring up the debate about international mortality. The evidence clearly shows that family planning without family health, including child health, is much less successful. Further, child mortality, even at high levels does little to slow population growth while such death and suffering greatly burden women and families. While rapid population growth and high population densities in developing countries present serious problems, both are much less important than the high levels of consumption in developed nations. Each child in the industrialized world will, at present levels of consumption, be expected to consume 30 to 100 times more than a child born in the poorest nations. Such suggestions in a time of instant global communication only attempt to set back international morality and tempt those in the international intellectual community to embrace ideas similar to the eugenic principles that led to the holocaust.
HEALTH FOR THE MILLIONS. 1991 Dec; 17(5):25-7.The article on human entrapment in India by Maurice King is just another example of the dogmatic, simplistic and reckless way in which the white scholars of the North formulate their ideas. It is these people who are responsible for the opium wars, programs against Jews, and carpet bombing, defoliation, and massacres in Vietnam. King's idea os using UNICEF and the WHO to kill the non white children of the South is just another example of this kind of racist brutality. It is based only upon the written opinions of other white scholars. In 1991 King produced no data about human entrapment in India. King ignores the writing of non whites like Ashish Bose who presided over the International Population Conference in 1989. Other mistakes that King makes include a failure to understand the applications of immunization (EPI) and oral rehydration programs (ORT). The EPI was implemented without ever taking baseline data, so that its effectiveness is impossible to determine with any accuracy. And nowhere in the world has ORT worked as well as UNICEF claimed it would. Further proof that King advocates genocide is his labeling of the insecticide-impregnated bednets as a dangerous technology in increasing entrapment. King fails to acknowledge the overwhelming influence of white consultants on the policies and planning strategies of family planning programs in India. Their list of failures includes: the clinic and extension approach, popularization of the IUD, mass communication, target orientation, sterilization camps, and giving primacy to generalists administrators. They should be held accountable for the 406 million people added to the base population between 1961-91 It should also be noted that India had the ability absorb this large number people while still maintaining a democratic structure, gather a substantial buffer stock of food grains, consistently increasing its per capita income while decreasing its infant mortality and crude death rates, increase its life expectancy at birth and improve the level of literacy, especially for females.
NURSE EDUCATION TODAY. 1991 Aug; 11(4):245-7.The international aspects of midwife education are discusses: the 5 most pressing questions concerning midwife education, steps taken by world health bodies to improve midwife educationists. The most challenging issues are international health studies in all programs; including the role of WHO, and other international agencies; instruction analyzing influence of Western on developing nations; content on demographic, economic and political factors affecting health of developing countries; and how health care educationists can achieve health for all. In the light of the WHO Safe Motherhood Initiative embodied in the slogan "Health For All," midwives all over the world are committed to reduce maternal mortality 50% by 2000. ICM/WHO/UNICEF made an action statement in 1987, the World Health Assembly published a Resolution on Material Health and Safe Motherhood, and a Resolution on Strengthening Nursing Midwifery. In 1990 the Governments of 70 countries committed to safe motherhood, i.e., 50% reduction of maternal mortality, as part of the World Declaration and Plan of Action on Survival, Development and Protection of Children, at a meeting at the UN. 1990 40 midwife educationists met in Kobe, Japan at a Pre-Congress Workshop before the International Confederation of Midwives (ICM), of the WHO/UNICEF. They discussed ways to approach the 5 major causes of maternal mortality: postpartum hemorrhage, obstructed labor, puerperal sepsis, eclampsia and abortion. Each participant assessed the status of midwife education in her own country. Some of the factors affecting maternal and child health are illiteracy, low status of women, population growth, and inadequate food production and distribution. There is a shortage of midwife teachers and teaching materials, and curricula are usually based on inappropriate Western models. In Europe, midwives still have much work to do to reduce maternal morbidity.
HYGIE. 1991; 10(3):16-22.The Executive Director of UNICEF stresses at the 14th World Conference on Health Education held in Helsinki, Finland the importance of grabbing new opportunities in our changing world. An important boost to health educators is the World Summit for Children which witnessed for the 1st time world leaders committed to comprehensive and specific resolutions to improve the quality of life for children--a true opportunity to solve a global problem. Health educators can play a key role in solving global problems by showing leaders how health education can help solve these problems. Indeed political will as demonstrated at the World Summit for Children provides the needed impetus to launch a revolution of improved health for all. Now they can help convert the growing international consensus for human centered development into reality. He also points out that the success of the campaigns for universal child immunization and for oral rehydration therapy are due to health educators. Health educators should apply these successful techniques that simplifies modern medical knowledge into basic health messages which in turn empowers families and communities to save and improve lives to further improve the health of the world. A challenge that remains is promoting healthy life styles, especially among adolescents whose health problems include pregnancy, sexually transmitted diseases, and alcohol abuse. AIDS presents another challenge. Health educators need to encourage hospitals to promote breast feeding and to provide maternity services centered around the infant. Improvement in child and adult health cannot occur, however, if the people do not demand changes in society. Health educators can lead this movement by communicating and advocating healthful changes.
FRONT LINES. 1991 Nov; 16.Indonesia's success in reaching World Health Organization (WHO) universal immunization coverage standards is described as the result of a strong national program with timely, targeted donor support. USAID/Indonesia's Expanded Program for Immunization (EPI) and other USAID bilateral cooperation helped the government of Indonesia in its goal to immunize children against diphtheria, pertussis, tetanus, polio, tuberculosis, and measles by age 1. The initial project was to identify target areas and deliver vaccines against the diseases, strengthen the national immunization organization and infrastructure, and develop the Ministry of Health's capacity to conduct studies and development activities. This EPI project spanned the period 1979-90, and set the stage for continued expansion of Indonesia's immunization program to comply with the full international schedule and range of immunizations of 3 DPT, 3 polio, 1 BCG, and 1 measles inoculation. The number of immunization sites has increased from 55 to include over 5,000 health centers in all provinces, with additional services provided by visiting vaccinators and nurses in most of the 215,000 community-supported integrated health posts. While other contributory factors were at play, program success is at least partially responsible for the 1990 infant mortality rate of 58/1,000 live births compared to 72/1,000 in 1985. Strong national leadership, dedicated health workers and volunteers, and cooperation and funding from UNICEF, the World Bank, Rotary International, and WHO also played crucially positive roles in improving immunization practice in Indonesia.
HEALTH FOR THE MILLIONS. 1991 Aug; 17(4):20-3.Until recently, the only sustained AIDS activity in India has been alarmist media attention complemented by occasional messages calling for comfort and dignity. Public perception of the AIDS epidemic in India has been effectively shaped by mass media. Press reports have, however, bolstered awareness of the problem among literate elements of urban populations. In the absence of sustained guidance in the campaign against AIDS, responsibility has fallen to voluntary health activists who have become catalysts for community awareness and participation. This voluntary initiative, in effect, seems to be the only immediate avenue for constructive public action, and signals the gradual development of an AIDS network in India. Proceedings from a seminar in Ahmedabad are discussed, and include plans for an information and education program targeting sex workers, health and communication programs for 150 commercial blood donors and their agents, surveillance and awareness programs for safer blood and blood products, and dialogue with the business community and trade unions. Despite the lack of coordination among volunteers and activists, every major city in India now has an AIDS group. A controversial bill on AIDS has ben circulating through government ministries and committees since mid-1989, a national AIDS committee exists with the Secretary of Health as its director, and a 3-year medium-term national plan exists for the reduction of AIDS and HIV infection and morbidity. UNICEF programs target mothers and children for AIDS awareness, and blood testing facilities are expected to be expanded. The article considers the present chaos effectively productive in forcing the Indian population to face up to previously taboo issued of sexuality, sex education, and sexually transmitted disease.
IN TOUCH 1991 Jun; 10(99):21-2.Despite obstacles to expanding immunization coverage (EPI) in developing countries, progress has been made in Bangladesh and is described. A February, 1991, World Health Organization cluster evaluation survey indicates that government efforts during the 1980s, with the cooperation and assistance of non-governmental organizations (NGO), have increased the degree of immunization coverage in Bangladesh. 80% coverage for BCG, measles, and DPT-3 antigens is realized in the Rajshahi division, 1 of 4 divisions sampled in the survey. Use of existing FWAs and HA as vaccinators; DC, UNO, and upazila chairmen involvement; partner recruitment for mobilization efforts; steam sterilization of needles; maintenance of an effective cold chain; and monthly vaccination sessions at more than 108,000 sites throughout the country worked together to successfully yield greater immunization coverage. Sustained efforts are, however, required to ensure vaccine protection of the 4 million children born into the population each year. 80% or greater universal coverage in Bangladesh is the focus of continued efforts. Eradication of polio, measles, and neonatal tetanus is possible in the 1990s, while Vitamin A distribution and more effective promotion of family planning services are also objectives. Government and NGO workers must promote awareness of EPI, monitor EPI service delivery, and encourage HAs, FWAs, UHFO Civil Surgeons, UNOs, DCs, and upazila chairmen to provide regular EPI services.
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.