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Iodized oil during pregnancy. Safe use of iodized oil to prevent iodine deficiency in pregnant women. A statement by the World Health Organization.
Geneva, Switzerland, WHO, 1996.  p. (WHO/NUT/96.5)The risks and expected benefits from iodized oil, given orally or by injection, to pregnant women in areas of severe iodine deficiency where iodized salt is not available were evaluated. The conclusions, which were approved by the International Council for Control of Iodine Deficiency Disorders (ICCIDD), showed that for preventing and controlling moderate and severe iodine deficiency, the giving of iodized oil is safe at any time during pregnancy. Maximum protection against endemic cretinism and neonatal hypothyroidism will be achieved when iodized oil is given before conception. The potential benefits greatly outweigh the potential risks in areas of moderate and severe iodine deficiency disorders, where iodized salt is not available and is unlikely to be made available in the short term (1-2 years). (author's)
Surveillance for tuberculosis in the Eastern Mediterranean Region. [Surveillance de la tuberculose dans la région de la Méditerranée Orientale]
Eastern Mediterranean Health Journal. 1996; 2(1):129-134.Tuberculosis is an important public health problem in the Eastern Mediterranean Region. It is crucial for each country to develop a national tuberculosis surveillance system. WHO has developed a standardized tuberculosis surveillance system through which two important indicators for tuberculosis control, a cure rate and a case detection rate, can be collected. The number of countries that have adopted the WHO tuberculosis surveillance system has been increasing in the Region. At the moment, 13 countries have reported a cure rate, which is the most important indicator for national tuberculosis control programmes. It is hoped that more countries will adopt this system. (author's)
Measuring the achievements and costs of reproductive health programs. Report of a meeting of the Working Group on Reproductive Health and Family Planning, the World Bank, June 24-25, 1996.
[Unpublished] 1996.  p.The Working Group on Reproductive Health and Family Planning is a joint project of the Health and Development Policy Project and the Population Council. On June 24, 1996, members of the Working Group met to discuss ways of measuring the achievements and costs of family planning and reproductive health programs. It is particularly important to revise family planning program evaluation methods so that they are consistent with a client-centered, reproductive health approach, and to develop ways of evaluating the costs and effectiveness of the components of comprehensive reproductive health care. This report is comprised of papers on the following topics: performance indicators with regard to making the transition from a demographically-oriented family planning program to a client-centered reproductive health paradigm; monitoring and evaluating reproductive health and family planning programs; incorporating indicators into reproductive health projects; disability adjusted life years and reproductive health; assessing the costs of reproductive health programs; and the cost of reproductive health. A summary is presented of the technical group meeting discussion.
In: Urban health research in developing countries: implications for policy, edited by Sarah Atkinson, Jacob Songsore, and Edmundo Werna. Wallingford, England, CAB International, 1996. 11-30.Several UN agencies have been very active in the implementation of urban policies in developing countries, both through direct interventions and through influencing national policymakers. The agendas and major programs with regard to urban policy and urban health of the UN Center for Human Settlements, World Bank, UN Development Program, UN Children's Fund, and World Health Organization are examined. An overview of international urban policies over the past three decades is first presented, followed by an examination of current policies. The UN system has shifted priority in the urban sector from specific projects to city-wide processes and capacity building programs. That change may result in more profound, longer-term and sustainable improvements for the health status of urban populations. The new approach, however, has a number of deficiencies related to its extensive scope and the lack of capability and commitment in local institutions to take on such an undertaking. The author suggests how such problems can be addressed and calls for research to better understand urban policy processes and their outcomes for health.
HEALTH PROMOTION INTERNATIONAL. 1996 Sep; 11(3):219-26.This paper reviews 10 years of experience in using health goals, targets, and objectives as a planning mechanism. The US was the first country to develop national health goals in 1980. In 1985, the World Health Organization (WHO) produced a defined set of "Targets for Health for All." This review includes the experiences in the US, Australia, New Zealand, England and Wales, and the WHO Regional Office for Europe. These countries used different approaches in defining targets and in achieving the defined targets. Each country's approaches are described. The WHO uses goals and targets in order to define differences in health status between populations and to reduce these differences. Better data are now available for improving the understanding of the personal, economic, environmental, social, and health service factors associated with health. Monitoring of defined targets in the US over a 10-year period has resulted in more improvements in targeted areas than nontargeted areas. In 1988 Australia established national targets. Targets in Australia influenced the formulation of its first national health policy. A stronger infrastructure for health promotion was developed. The evidence that links objective setting to health improvement is not readily available. It appears that target setting may result in a focus on a comprehensive health policy, changes in resource allocation, and methods and structures for improving population health. All countries were concerned about greater efficiency in health system investment. Wales is developing less emotional methods for decision making about health services. The US spent more time on data collection than on implementation. Australia was preoccupied with health issues where there were data. A balance between these two approaches is desirable. New Zealand's program priorities and resource allocation changed with changes in politics. Health goals should be used to guide and measure the results of health system investments.
JOURNAL OF REPRODUCTIVE MEDICINE. 1996 May; 41(5 Suppl):419-25.This article reviews recent epidemiological data assessing the risk of breast, endometrial, ovarian, and cervical cancer in women using the injectable contraceptive depot medroxyprogesterone acetate (DMPA). A review is also provided of epidemiological and biostatistical concepts which relate to the literature on the relationship between the use of hormonal contraception and cancer. Breast cancer is a common and lethal disease in the US, and evidence suggests that gonadal steroids play a role in the development of breast cancer. Two major case control studies (one in New Zealand and the other under the auspices of the World Health Organization [WHO]) as well as a pooled analysis of these studies found no increased overall breast cancer risk in DMPA users. A currently unexplained pattern of increased risk in recent users mimics that seen with oral contraceptive (OC) use and term pregnancy. A WHO hospital-based study of the relationship between endometrial cancer and DMPA use found a protective effect of DMPA which appeared to be longterm and as great as that associated with OCs. Whereas it is plausible that DMPA, which suppresses ovulation, would lower the risk of ovarian cancer in users, a WHO case-control and hospital-based study failed to uncover such a protective effect. Studies of the routine use of DMPA in nulliparous women (who have higher risk of ovarian cancer) will shed more light on any effect DMPA may have on ovarian cancer. The unique epidemiology of cervical cancer (including number of sexual partners, use of barrier contraception, and frequent screening) makes it difficult to assess any association with contraceptive use. However, a large population-based, case-control study in Costa Rica; a WHO hospital-based, case-control study in Thailand, Mexico, and Kenya; and a study in New Zealand indicate that the risk of cervical neoplasia does not appear to be affected by DMPA use. While some issues regarding DMPA and the risk of reproductive tract carcinoma remain to be resolved, clinicians can be reassured that, for appropriately selected clients, the substantial benefits of DMPA outweigh any risks.