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[Unpublished] 1984. 51 p.This listing of research projects funded since 1980 by WHO's Diarrhoeal Diseases Control Programme, is arranged by project title, investigator and annual budget allocations. Project titles are listed by Scientific Working Grouping (SWG) and include research on bacterial enteric infections; parasitic diarrheas; viral diarrheas; drug development and management of acute diarrheas; global and regional groups and research strengthening activities. SWG projects are furthermore divided by geographical region: African, American, Eastern Medierranean, European, Southeast Asian and Western Pacific. The priority area for research within each SWG is specified.
Report of the third meeting of the scientific working group on viral diarrhoeas: microbiology, epidemiology, immunology and vaccine development, [held in] Geneva, 1-3, February 1984.
Geneva, Switzerland, WHO, . 19p.The current status of the Scientific Working Group Program is reviewed, showing an expansion of activities in both its health services component (planning, implementation and evaluation of national diarrheal diseases control programs) and its research component (biomedical and operational). Submission of research proposals is encouraged by the Steering Committee (SC), namely those investigating the etiological role of viral agents in diarrheal disease and the epidemiology of these agents. Recently, the SC has made a particular effort to stimulate research in the area of immunology of viral enteric infections, which has been a generally neglected area. Other important areas of Program activity include site visits to review progress made by its projects, to participate in the initial design or the analysis of studies, or to stimulate general interest among research workers in the activities of the SWG. Workshops have also been initiated and conducted in WHO regions. The SWG notes with satisfaction the progress of the Program and commends the SC's efforts to stimulate and support research activities. SWG recommendations bear on the need for more data on the etiology and epidemiology of diarrhea in the community and the encouragement of further community-based studies. Particular attention should also be given to the preparation of reagents for the serotyping and subgrouping of rotaviruses. Moreover, the Group recommends that research strengthening workshops be continously held. In addition to the review of the meeting and recommendations, this paper includes a report on active and passive immunity to viral diarrheas. Special attention is given to rotavirus diarrhea as it tends to be common and quite severe. Its epidemiology is briefly presented, showing its incidence, seasonality (winter) in temperate climates, age-specific occurrence (most severe in infants and young children) and transmission (fecal-oral, person-to-person). Neonatal ans sequential postneonatal rotavirus infection are addressed ans issues for further investigation clarified; e.g., the relationship between low birth weight and the occurrence and severity of infection. Much remains to be elucidated regarding the serotyping-specific epidemiology of rotaviruses. The Group notes that further immunological studies of rotaviruses are essential to elucidate the role of passive protection. The other area of study in which research activities need to concentrate is vaccine development.
[Geneva, Switzerland], WHO, . 2 p. (WHO/CDD/SER/84.7)In 1982-1983 the Who Diarrhoeal Diseases Control (CDD) Programme supported laboratory studies to identify a more stable ORS composition, particularly for use in tropical countries, where ORS has to be packed and stored under climatic conditions of high humidity and temperature. The results of these studies demostrate that ORS containing 2.9 grams of trisodium citrate dihydrate in place of 2.5 grams of sodium bicarbonate was the best of the formulations evaluated. 7 clinical trials were undertaken in which the efficacy of ORS-citrate and ORS-bicarbonate was compared. All but 1 of these trials had a double-blind study design. 4 of these studies were undertaken in children below 2 years of age with moderate to severe noncholera diarrhea. The ORS-citrate was received by 128 children and found to be uniformly as effective as ORS-bicarbonate in correcting acidosis. In 3 of the 4 studies from which preliminary data are available, there was a trend towards a reduction (8-14%) of diarrheal stool output in children receiving the ORS-citrate. Countries should have no hesitation in continuning to use ORS-bicarbonate, which is highly effective. However, because of its better stability and apparently greater efficacy, WHO and UNICEF now recommend that countries use and produce ORS-citrate where feasible.
Health and health services in Judaea, Samaria and Gaza 1983-1984: a report by the Ministry of Health of Israel to the Thirty-Seventh world Health Assembly, Geneva, May 1984.
Jerusalem, Israel, Ministry of Health, 1984 Mar. 195 p.Health conditions and health services in Judea, Samaria, and Gaza during the 1967-83 period are discussed. Health-related activities and changes in the social and economic environment are assessed and their impact on health is evaluated. Specific activities performed during the current year are outlined. The following are specific facets of the health care system that are the focus of many current projects in these districts; the development of a comprehensive network of primary care programs and centers for preventive and curative services has been given high priority and is continuing; renovation and expansion of hospital facilities, along with improved staffing, equipment, and supplies for basic and specialty health services increase local capabilities for increasingly sophisticated health care, and consequently there is a decreasing need to send patients requiring specialized care to supraregional referral hospitals, except for highly specialized services; inadequacies in the preexisting reporting system have necessitated a continuting process of development for the gathering and publication of general and specific statistical and demographic data; stress has been placed on provision of safe drinking water, development of sewage and solid waste collection and disposal systems, as well as food control and other environmental sanitation activities; major progress has been made in the establishment of a funding system that elicits the participation and financial support of the health care consumer through volunary health insurance, covering large proportions of the population in the few years since its inception; the continuing building room in residential housing along with the continuous development of essential community sanitation infrastructure services are important factors in improved living and health conditions for the people; and the health system's growth must continue to be accompanied by planning, evaluation, and research atall levels. Specific topics covered include: demography and vital statistics; socioeconomic conditions; morbidity and mortality; hospital services; maternal and child health; nutrition; health education; expanded program immunization; environmental health; mental health; problems of special groups; health insurance; community and voluntary agency participation; international agencies; manpower and training; and planning and evaluation. Over the past 17 years, Judea, Samaria, and Gaza have been areas of rapid population growth and atthe same time of rapid socioeconomic development. In addition there have been basic changes in the social and health environment. As measured by socioeconomic indicators, much progress has been achieved for and by the people. As measured by health status evaluation indicators, the people benefit from an incresing quantity and quality of primary care and specialty services. The expansion of the public health infrastructure, combined with growing access to and utilization of personal preventive services, has been a key contributor to this process.
[Unpublished] 1984. 27 p.The current status of the Control of Diarrhoeal Diseases (CDD) Program was reviewed, and activities related to the evaluation of country control programs, the assessment of potential diarrheal disease control interventions, and the program's operational research activities were examined. In the health services component, ciontinued efforts to promote the preparation of plans of operation for national CDD programs is recommended, as is continued use of the national CDD program managers training course. Concern was expressed that the level of use of oral rehydration therapy (ORT) appeared to be modest. Case management was endorsed as the major program strategy. The series of studies on interventions for reducing diarrhea's mortality and morbidity were welcomed. For evaluation purposes, it is recommended that the program develop additional criteria for monitoring increased access to and usage of oral rehydration salts (ORS) and the reduction of diarrheal mortality. Continued accumulaton and publication of information yielded by the program's survey of the impact of ORT in hospitals was recommended. In the research component, the growth of research activities is satisfying. While biomedical aspects have developed well, it might be necessary to relate them gradually to specific control interventions in the future. Further studies of improved ORS formulatons were recommended. High priority should also be given to the promotion of breast feeding, immunization, and water supply and sanitation. The underlying mechanisms that cause the intervention to reduce diarrheal morbidity or mortality should be clarified. Research is recommended on the promotion of personal and domestic hygiene, food hygiene, and improved weaning practices. Emphasis on the development and evaluation of vaccines against the causes of diarrhea is supported. Some changes in the balance of research activities should be made. Epidemiological weak.
Geneva, Switzerland, WHO,  27 p.This is the 1st interim report issued by the Diarrhoeal Diseases Control (CDD) Programme, summarizing progress in its main areas of activity during the previous calendar year. Most of the information is presented in the form of tables, graphs and lists. Other important developments are mentioned briefly in each section. The information is presented according to major program areas; health services; research; and program management. Within the health services component, national program planning, training, the production of Oral Rehydration Salts (ORS), health education and promotion are areas of priority activity. Progress in the rate of development of national programs, participants in the various levelsof training programs, and the countries producing their own ORS packets and developing promotional and educational materials are presented. An evaluation of the health services component, based on a questionnaire survey to determine the impact of Oral Rehydration Therapy (ORT), indicates significant decreases in diarrheal admission rates and in overall diarrheal case-fatality rates. Data collected from a total of 45 morbidity and and mortality surveys are shown. Biomedical and operational research projects supported by the program are given. Thhe research areas in which there was the greatest % increase in the number of projects funded were parasite-related diarrheas, drug development and management of diarrheal disease. Research is also in progress on community attitudes and practices in relation to diarrheal disease and on the development of local educational materials. The program's organizational structure is briefly described and its financial status summarized. The report ends with a list of new publications and documents concerning health services, research and management of diarrheal diseases.
The role of food safety in health and development. Report of a Joint FAO-WHO Expert Committee on Food Safety.
World Health Organization Technical Report Series. 1984; (705):1-79.This document presents the recommendations of a Joint Food and Agriculture Organization (FAO)-World Health Organization (WHO) Expert Committe on Food Safety. Illness due to contaminated food is perhaps the most widespread health problem in the world and a major cause of reduced economic productivity. The safety of food is affected by food systems, sociocultural factors, food chain technology, ecologic factors, nturitional aspects, and epidemiology. It was the assumption of the Committee that, if food safety is given sufficient priority within national planning, countries can prevent and control foodborne disease, especially pathogen-induced diarrheal syndromes, and interrupt the vicious cycle of diarrhea-malnutrition-disease. Attainment of this objective requires a national commitment and the collaboration of all ministries and agencies concerned with health, agriculture, finance, planning, and commerce as well as the food industry, the biamedical and agricultural scientific community, and the consuming public. Prevention and control interventions should aim to avoid or minimize contamination, to destroy or denature the contaminant, and to prevent the further spread or multiplication of the contaminant. The Committee outlined a series of recommendations for achieving a worldwide reduction in the morbidity and mortality caused by foodborne hazards. Food safety should be considered an integral part of the primary health care delivery system. Food safety should also be regarded as an integral part of the total food system. National food control infrastructures should be strengthened, and regional, national, multinational, and international surveillance of foodborne diseases should be carried out. Each country should aim to develop at least 1 laboratory capable of identifying the etiologic agents of diarrhea and other foodborne diseases. Health workers should be trained to play a role in identifying and monitoring critical control points in food production and preparation. Health education, within the context of the cultural and social values of the community, should inform the public about food safety hazards and preventive measures. Finally, the hazard analysis critical control point approach to prevention is recommended.
Regional resources. Resources available to African countries from UNFPA assistance to intercountry activities.
[Unpublished] 1984 Jul 1. 37 p.This 2nd edition of the booklet of regional resources is intended to improve the utilization of intercountry resources by making "user friendly" information available: short, regularly updated, translated (French and English) explanations of availability, obtainability and cost. It should be read in conjunction with the UN Fund for Population Activities (UNFPA) publication "Guide to Sources of International Population Assistance 1982." The following regional resources available to African countries from UNFPA assistance to intercountry activities are identified and described: regional advisory services (demographic statistics, Union Dounaiere et Economique de l'Afrique Centrale, demographic analysis, population and rural development, family health, population communication, population education, labor and family welfare education, and population policies and research); regional training institutes; other activities funded under UNFPA Africa regional programs; and intercountry activities from which African countries may benefit.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(2):130-61.This paper sets forth the number of malaria cases reported in 1973-82 to the World Health Organization (WHO) by region. Excluding Africa, the total number of cases rose from 3.9 million in 1973 to a high of 10.7 million in 1977 and declined to 6.5 million in 1982. It is noted, however, that reporting during this period was often deficient and uneven. The prevalence of malaria has remained relatively unchanged in Africa south of the Sahara, with the exception of urban centers where transmission has been considerably reduced. In the Americas, the number of cases reported has risen steadily since 1973. South East Asia experienced a dramatic increase in malaria cases in 1976, but intensive efforts haveresulted in a decline almost back to the 1973 level. About 28% of the world's population lives in areas where malaria never existed or disappered without specific antimalaria efforts. Another 18% lines in areas where the disease has been eliminated by improvements in health facilities, environmental changes, and specific antimalaria measures. 46%, or 2117 million people, live areas where the incidence of malaria has been reduced to varying degrees, ranging from a slight reduction of the original endemicity to the near elimination of the disease. A final 8%, or 365 million people, live in areas where no specific antimalaria measures are undertaken and the original levels of endemicity remain largely unchanged outside of certain urban centers. In addition to presenting data on malaria cases by world region, tables accompanying this article summarize malaria eradication registration, the importation of malaria cases into malaria-free countries, and the development of resistance to chloroquine.
In: United Nations. Department of International Economic and Social Affairs. Population projections: methodology of the United Nations. Papers of the United Nations Ad Hoc Expert Group on Demographic Projections, United Nations Headquarters, 16-19 November 1981. New York, United Nations, 1984. 4-6. (Population Studies No. 83 ST/ESA/SER.A/83)These recommendations refer specifically to the work of the Population Division of the UN and the regional commissions and more generally to the work of the specialized agenices, which prepare projections of labor force and school enroolment. The current recommendations may be regarded as updating an earlier detailed set that was issued by a similar group of experts who convened in New York in November 1977. The recommendations cover general considerations, sources and assumptions, evaluation of projections and their uses, and internal migration and urbanization. The Population Division should consider the question of an optimal time schedule for publishing new estimates and projections in order to avoid unduly long intervals between publications and intervals so short as to cause confusion. The UN Secretariat has an important role in pursuing work on methodology of projections and making it available to demographers in the developing countries. Unique problems of demographic projection exist for those countries with particularly small populations. It is proposed that the Population Division prepare special tabulations, whenever possible, giving the estimated age and sex distribution for these countries. Future publications of population projections prepared by the Population Division should indicate the major data sources on which the projections are based and note if the data were adjusted before inclusion. In addition, some grading of the quality of the base data should be presented. For the UN set of national and international population projections, a more comprehensive system of establishing assumptions about the future trends of fertility is needed. The Secretariat needs to focus more attention on the evaluation of its population projections. UN publications of projections should report on the main errors in recent past projections with respect to estimates of baseline levels and trends and provide some evaluation of the quality of the current estimates. It is recommended that the UN encourage countries to establish a standard definition of urban which would be used for international comparisons but generally not replace current national definitions. The Secretariat should review the techniques currently used to project urban-rural and city populations and search for methodologies appropriate to the level of urbanization and the quality of data which would improve the accuracy of the projections. The Division should regularly produce long range population projections for the world and major countries and should continue and expand its household estimates and projection series, which provides information essential to government administrators and planning agencies, businesses, and researchers in all countries.
Earthwatch. 1984; (16):7.The International Union for the Conservation of Nature and Natural Resources (IUCN), cooperates with the International Planned Parenthood Federation (IPPF) and other agencies to: actively promote policies designed to attain a balance between population and resources, within national conservation strategies and through field activities to preserve nature and natural resources; take into account the fundamental issues of population and resources in its policies, programs, resolutions, and public statements, where appropriate; keep trends in population and resources under review, reporting back to each IUCN General Assembly; encourage nongovernment organizations, including local conservation groups and family planning associations, to work together to spread awareness of the links between population, resources, and the environment; encourage governments to undertake periodic assessments of population trends, natural resources, and likely economic conditions, their interrelationships and the implications for the achievement of national goals; encourage governments to establish a population policy and to consider the special environmental problems of the urban and rural poor and to promote sustainable rural development; encourage nations to take effective action to obtain the basic right of all couples to have access to safe and effective family planning methods, as established in the World Population Plan of Action; and generally encourage national and international development policies which help create the conditions in which human population can successfully be brought into balance with carefully conserved natural resources.
[Operations research in family planning programs] Investigacion operativa en programas de planificacion familiar.
In: Investigacion en planificacion familiar y servicios de salud, edited by Luis Sobrevilla, Mary Fukumoto. Lima, Peru, Consejo Nacional de Poblacion, 1984. 89-95.At the 1974 World Population Conference held in Bucharest, a World Plan of Action was adopted by 136 countries with the goal of controlling population growth. At the 1984 World Population Conference held in Mexico, many countries that previously supported pronatalist views started to promote family planning. China proposed to hold its population growth at 1200 million. Many African countries also adopted family planning programs. In the 1980s major changes occurred in strategies for the promotion of family planning. Community-based distribution, social marketing, and decentralized distribution schemes were tried. Community participation for promoting family planning was also undertaken. Operations research aided decision making and established links between health, nutrition, family planning, education, and employment. The family planning program could be divided into components such as organization (integration into health and nutrition programs, information about service users, the role of voluntary organizations); marketing (the increase of maternal age impacting demand, the choice between clinical or community distribution, social marketing or the combination of these); operations (the distribution of resources among different activities and among the three phases of the program, and personnel training for optimal resource use); and financing, budget, and control (budget controls for the stimulation of efficiency, the system of cost control in primary health centers, and the improvement of records). Operations research could also play a vital role in the design, implementation, and evaluation of different interventions.
The poor quality of official socio-economic statistics relating to the rural tropical world: with special reference to South India.
MODERN ASIAN STUDIES. 1984; 18(3):491-514.Statistics relating to the sizes of farm-holdings, the output and yield of crops, household income and expenditure, occupation, cattle ownership, and the sizes of villages were considered, and some features of the Karnataka population census were criticized. The main reason for the extremely poor quality of so many official socioeconomic statistics relating to the rural tropical world is the failure to realize that statistical procedures are based on conditions peculiar to advanced countries. The All-India National Sample Survey is a rare example of a wasted exercise which runs into several hundred separate reports. Because of the inevitable unreliability of most statistics it should be assumed that all statistics covering whole countries or large states, which relate to agricultural yields, crop values, and production, are bound to include a large element of estimation. Organizations like the UN Food and Agricultural Organization (FAO) should provide some information on the basis of estimates, and statistical tables without notes should not be published, such as the regular Statistical Bulletins of the FAO. Far fewer figures of far higher quality should be produced. Owing to the diversity of agrarian systems, very few economic generalizations (any presumed inverse relationship between crop yield and size of farm-holding) can be of universal application. Organizations like the FAO should advise tropical countries that it is wasteful to collect statistics that are considered conventional in advanced countries because of the nature of their agrarian systems and systems of land tenure. Instead of estimating the proportions of households below poverty levels, economic indicators of living standards, such as agricultural wage rates and determinants of the distribution of household farmland, should be identified.
ENVIRONMENTAL CONSERVATION. 1984 Summer; 11(2):167-9.People living in the area just south of the Sahara Desert in Africa face their 3rd major drought since 1900. This drought brings about famine. Drought and famine are only manifestations of more profound problems: soil erosion and degradation. They diminish land productivity which aggravates the population's poverty. Yet soil erosion and degradation occur due to an expanding population. Continued pressures on the land and soil degradation results in desertification. The UN Environment Programme's Assessment of the Status and Trend of Desertification shows that between 1978-84 desertification spread. Expanding deserts now endanger 35% of the world's land and 20% of the population. In the thorn bush savanna zone, most people are subsistence farmers or herdsmen and rely on the soils, forests, and rangelands. Even though the mean population density in the Sahel is low, it is overpopulated since people concentrate in areas where water is available. These areas tend to be cities where near or total deforestation has already occurred. Between 1959-84, the population in the Sahel doubled so farmers have extended cultivation into marginal areas which are vulnerable to desertification. The livestock populations have also grown tremendously resulting in overgrazing and deforestation. People must cook their food which involves cutting down trees for fuelwood. Mismanagement of the land is the key cause for desertification, but the growing poor populations have no choice but to eke out an existence on increasingly marginal lands. Long fallow periods would allow the land to regain its fertility, but with the ever-increasing population this is almost impossible. Humans caused desertification. We can improve land use and farming methods to stop it.
[Unpublished] 1984 Jul. , 193 p.As of 1984, Lebanon had not yet formulated a clear and specific population policy because laws existed against contraception and political differences among the various ethnic groups also existed which culminated in a civil war. Nevertheless the government condoned the creation of the Lebanese Family Planning Association (LFPA) in August 1969 and its activities. The government also helped spread family planning through its own institutions such as the Ministry of Health and the Office of Social Development. Further some of LFPA's staff members have been part of the government itself. LFPA conducted a survey in June 1975 in Zahrani in rural south Lebanon and it showed that the people wished to limit their fertility, but could not since birth control was not available. Therefore LFPA established the 1st Community Based Family Planning Services Program in Zahrani which later spread to other villages. Wasitas (field workers) served as the major means of providing birth control and information to the women. They emphasized child spacing. The wasitas also served as a major adaptive and indigenous agent of social change and development. Initially they underwent intensive training lasting at least 1 week, but in 1979, LFPA hosted annual 1 month training sessions. The wasitas use of traditional communication methods resulted in not only an increase of contraceptive use, but also in meeting the elemental needs of the women for psychological comfort and self reliance. In some instances, however, some wasitas resorted to deception in encouraging the most uneducated women to use birth control because of strong incentives, e.g., the wasita received 50% of the money earned for the sale of each contraceptive. LFPA needed to reassess those measures which lead to possible encroachment of the dignity and freedom of choice of the women villagers.
[Unpublished] 1984. 4 p.In addressing the International Population Conference in Mexico City the New Zealand Delegation identified its role concerning the issues of world population and family planning. As a national member of the global community, New Zealand recognizes the importance of a worldwide balance of material goods and resources and population. Between the years 1974 and 1984, following the Population Conference in Bucharest, mortality trends have shown progress. The world population is gradually decreasing in developing and industrialized nations. however, during the same decade, the population showed an increase of 770 million. Many of the countries who experienced the greatest population increase were the least equipped to serve the population influx with proper food, shelter and health and education services. The Population Conferences have allowed for the global community to come together and review past accomplishments and to look at future needs. New Zealand's position on the role of women through family planning is to support women's exploration into positions beyond traditional roles and that women be fully incorporated in the process of development.
The state of the environment 1985. Environmental aspects of emerging agricultural technologies. Population and the environment.
Nairobi, Kenya, UNEP, 1984. , vi, 43 p.World production of food crops has basically increased from 1945-1985 due to the emergence of agricultural technologies such as petroleum- based chemical fertilizers and pesticides, efficient and sophisticated farm equipment, hybridization, and, recently, genetic engineering. However, only developed countries and a few developing countries, for example India, have experienced this growth. Social, economic, environmental, and political factors such as inequitable access to resources have prevented this phenomenon from occurring in developing countries where the people often experience famine and malnutrition. Nevertheless the technical path which lead to high food crop yields cannot always be adapted by many poor farmers and landless laborers in developing countries. Further, this path is energy intensive and destroys the environment. To increase production in developing countries, the governments must encourage environmentally sound agricultural development, such as integrated pest management and minimum tillage. Despite any attempts at increasing food production in these countries, however, rapid population growth hampers any increases. As population grows, the availability of fertile, tillable land for food crops decreases. In addition, soil degradation and deforestation occur because more trees and plants are cleared to grow crops and, immediately following harvest, a new set of crops are grown quickly thereby depleting the topsoil and its nutrients. Further, people gather more wood for cooking. These governments, with cooperation and aid from developed countries and international agencies, need to address a multitude of problems such as poverty, population growth, environmental degradation, and women's status, in order to bring food production, the status of the environment, and population growth into balance.
[Planning and management of community programs. Handbook on program development, formation of leadership, and and management of group programs] Planification et gestion des programmes communautaires. Manuel sur l'elaboration des programmes, la formation aux fonctions d'animation et la gestion des programmes de groupe.
London, England, IPPF, 1984. , iv, 116 p. (Planification Familiale et Amelioration de la Condition Feminine)This manual is based on the experiences of a training seminar for directors of the Planned Parenthood and Women's Development (PPWD) project organized by the International Planned Parenthood Federation's regional bureau for Africa in Nairobi. The chief objective of the seminar was to strengthen the PPWD program by improving the programming and management capabilities of its directors. The need for training and for training materials affects all field programs at various levels and is particularly acute in Africa. The principal objective of the manual is to prepare workers of all levels for activities at different stages of program development using the participatory techniques of the Nairobi seminar. The manual also seeks to share experiences of the PPWD program and to suggest other useful training materials and resources. The manual is in the form of teaching notes with references. The material is divided into 2 parts, the 1st considering the origins, objectives, philosophy, and program activities of family planning and improvement of women's conditions and the experiences acquired by the PPWD program. This material forms the content for the approaches, methods, and techniques recommended in the 2nd part of the manual. Each section of the 2nd part contains brief observations of the reasons for undertaking various activities and procedures. Procedures relative to program and project development and motivation of groups are then explained and accompanied by exercises to aid the motivator and group members in applying the procedures. The most opportune moment for introducing each exercise is indicated, but the final decision always depends on the needs of the group and the time available.
New York, New York, United Nations Fund for Population Activities, 1984. viii, 60 p. (Report No. 79)This report presents the findings of a mission from the UN Fund for Population Activities to ascertain the needs for population assistance for the Republic of Botswana. Botswana's population is growing at a rate of 3.46% (1980-1985), a consequence of continuing high fertility and decreasing death rates. While there is an awareness of the implications of he high growth rate for development, the government appears to have relaxed its emphasis on controlling population growth, limiting its role to maternal and child health, and concentrating on the family welfare aspects of fertility control. The Mission expressed concern about the absence of a clearly articulated policy on population. However, it is hoped that the creation of the Botswana Population Council will result in the inclusion of such a policy in future national development plans. Migration is a major problem facing planners. The high rate of rural to urban migration and the reduction of migration to the Republic of South Africa for employment, have resulted in high unemployment rates within Botswana, particularly among unskilled workers. Critical gaps have been identified in the collection, analysis, and dissemination of population data, which are essential for the formulation of appropriate development strategies in this area. The Mission recommends that support in the form of training and technical assistance be provided to both the Central Statistics Office and the Registry of Births and Deaths, in the case of the latter to promote the establishment of a nation-wide civil registration system. Present health policy focuses on the concept of primary health care, with an emphasis on preventive health and community participation. Due to the shortage of health manpower and heavy dependence on expatriate personnel, the Mission's recommendations in this area stress support for the training of health workers at all levels and the inclusion of population components in this training. A high proportion of households, particularly in rural areas, are headed by women, and many of these households are poor. The Mission's recommendations seek to enhance women's economic status and improve their access to resources such as vocational training and agricultural extension services.
New York, New York, International Women's Tribune Center, 1984 Sep. iv, 116 p.The 1st 2 issues of newsletters in this volume, Women and Appropriate Technology, Parts I and II, emphasize resource materials and appropriate technology groups and projects from around the world that might be found useful. The 3rd issue, Women and Food Production, focuses specifically on the need for women to have greater access to land, technology, and capital in the production of food crops, whether for their own use or as crops for marketing. The last issues, Women MOving Appropriate Technology Ahead, concentrates on strategies for introducing appropriate technology ideas and approaches into one's own community. Together, these 4 issues combine several issues related to women's access to and uses of appropriate technologies, with practical information for concrete action and sample projects involving women from countries around the world. Originally published between 1978 and 1973, all 4 newsletters in this volume have been updated and edited in some parts to assure their continued relevance. Resource groups, UN news and conferences, available periodicals, training, credit and loan information, cash crops, international nongovernmental organizations, and government agencies are all discussed.
BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION. 1984; 18(2):188-92.Outbreaks of yellow fever in recent years in the Americas have prompted concern about the possible urbanization of jungle fever. Vaccination, using the 17D strain of yellow fever virus, provides an effective, practical method of large scale protection against the disease. Because yellow fever can reappear in certain areas after a 2-year dormancy period, some countries maintain routine vaccination programs in areas where jungle yellow fever is endemic. The size of the endemic area (approximately half of South America), transportation and communication difficulties, and the inability to ensure a reliable cold chain are problems facing these programs. In addition, the problem of reaching dispersed and isolated populations has been addressed by the use of mobile teams, radio monitoring, and educational methods. During yellow fever outbreaks, many countries institute massive vaccination campaigns, targeted at temporary workers and migrants. Because epidemics in South America may involve extensive areas, these campaigns may not effectively address the problem. The ped-o-jet injector method, used in Brazil and Colombia, should be used in outbreak situations, as it is effective for large-scale vaccination. Vaccine by needle, suggested for maintenance programs, should be administered to those above 1 year of age. An efficient monitoring method to avoid revaccination, and to assess immunity, should be developed. The 17D strain produces seroconversion in 95% of recipients, and most is prepared in Brazil and Colombia. But, problems with storage methods, instability in seed lots, and difficulties in large-scale production were identified in 1981 by the Pan American Health Organization and WHO. The group recommended modernization of current production techniques and further research to develop a vaccine that could be produced in cell cultures. Brazil and Colombia have acted on these recommendations, modernizing vaccine production and researching thermostabilizing media for yellow fever vaccine.
New York, New York, FPIA, . 227 p.This report summarizes the work of Family Planning International Assistance (FPIA) since its inception in 1971, with particular emphasis on activities carried out in 1983. The report's 6 chapters are focused on the following areas: Africa Regional Report, Asia and Pacific Regional Report, Latin America Regional Report, Inter-Regional Report, Program Management Information, and Fiscal Information. Included in the regional reports are detailed descriptions of activities carried out by country, as well as tables on commodity assistance in 1983. Since 1971, FPIA has provided US$54 million in direct financial support for the operation of more than 300 family planning projects in 51 countries. In addition, family planning commodities (including over 600 million condoms, 120 million cycles of oral contraceptives, and 4 million IUDs) have been shipped to over 3000 institutions in 115 countries. In 1982 alone, 1 million contraceptive clients were served by FPIA-assisted projects. Project assistance accounts for 52% of the total value of FPIA assistance, while commodity assistance comprises another 47%. In 1983, 53% of project assistance funds were allocated to projects in the Asia and Pacific Region, followed by Africa (32%) and Latin America (15%). Of the 1 million new contraceptive acceptors served in 198, 42% selected oral contraceptives, 27% used condoms, and 8% the IUD.
INFECTION CONTROL. 1984 Nov; 5(11):538-41.In 1978 the Ministry of Health and Social Welfare (MHSW) of Liberia launched the Expanded Program on Immunization (EPI) with the 5-year objective of establishing an 80% reduction in child mortality and morbidity from measles, polio, diphtheria, neonatal tetanus, pertussis, and tuberculosis. The program at first adopted a strategy of using 15 mobile units in 11 operational zones to deliver vaccinations throughout the country. However, by 1980, despite support from the Baptist World Alliance, the UN International Children's Emergency Fund (UNICEF), and the World Health Organization (WHO), it became evident that the mobile strategy was neither economically feasible nor practical. Therefore, with support from the US Agency for International Development (USAID), the EPI shifted to a strategy of integrating immunization activities into the existing network of state health facilities. After 5 years, in 1982, the Program was evaluated by a team from the MHSW, WHO, USAID, and the Centers for Disease Control. The evaluating team felt that the EPI's strategy was good, but its goals were not being achieved due to deficiencies in funding, clinic supervision, and rural community outreach, as well as shortages of kerosene and spare parts needs to keep the essential refrigerators in operating condition. Measles remains endemic; in the capital, Monrovia, only 9% of the children have been vaccinated against it. Immunization coverage is particularly low in the capital the countries. Other reasons for low vaccination coverage in Liberia are lack of community awareness of existing facilities and the importance of vaccination and lack of coordination at the community level to use the existing facilities efficiently. International assistance is still needed, especially to develop heat-stable vaccines, so that maintenance of refrigerators will not be necessary.
[Unpublished] 1984 May 8. 31 p. (CE 92/12)This report shows how demographic information can be analyzed and used to identify and characterize the groups assigned priority in the Regional Plan of Action and that it is necessary for the improvement of the planning and allocation of health resources so that national health plans can be adapted to encompass the entire population. In discussing the connections between health and population characteristics in the countries of the region, the report covers mortality, fertility and health, and fertility and population increase; spatial distribution and migration; and the structure of the population. Focus then moves on to health, development, and population policies and family planning. The final section of the report considers the response of the health sector to population trends and characteristics and to development-related factors. The operations of the health sector must be revised in keeping with the observed demographic situation and the projections thereof so that the goal of health for all by the year 2000 may be realized. In several countries of the region mortality remains high. In 1/3 of them, infant mortality during the period 1980-85 exceeds 60/1000 live births. If measures are not taken to reduce mortality 55% of the population of Latin America in the year 2000 will still be living in countries with life expectancies at birth of under 70 years. According to the projections, in the year 2000 the birthrate will stand at around 29/1000, with wide differences between the countries of the region, within each of them, and between socioeconomic strata. High fertility will remain a factor hostile to the health of women and children and a determinant of rapid population growth. Some governments view the present or predicted growth rates as excessive; others want to increase them; and some take no explicit position on the matter. The countries would be well advised to assign values to their birthrate, natural increase, and periods for doubling their populations in relation to their development plans and to the prospects for improving the standard of living and health of their populations. An important factor in urban growth is internal migration. These migrants, like some of those who move to other countries, may have health problems requiring special care. Regardless of a country's demographic situation, the health sector has certain responsibilities, including: the need to promote the framing and adoption of population and development policies, in whose implementation the importance of health measures is not open to question; and the need to favor the intersector coordination and articulation required to ensure that population aspects are considered in national development planning.
In: Tras nuevas raices: migraciones internas y colonizacion en Bolivia [by] Carlos Garcia-Tornell, Maria Elena Querejazu, Jose Blanes, Fernando Calderon, Jorge Dandler, Julio Prudencio, Luis Lanza, Giovanni Carnibella, Gloria Ardaya, Gonzalo Flores [and] Alberto Rivera. La Paz, Bolivia, Ministerio de Planeamiento y Coordinacion, Direccion de Planeamiento Social, Proyecto de Politicas de Poblacion, 1984 Apr. 51-251.A study of colonization programs in Bolivia was conducted as part of a larger evaluation of population policy. The 1st of 8 chapters examines the history of colonization programs in Bolivia and the role of state and international development agencies. It sketches the disintegration of the peasant economy, and presents 5 variables that appear to be central to colonization processes: the directedness or spontaneity of the colonization, the distance to urban centers and markets, the diversification of production, the length of time settled, and the origin of the migrants. The 2nd chapter describes the study methodology. The major objective was to evaluate government policies and plans in terms of the realistic possibilities of settlement in colonies for peasants expelled from areas of traditional agriculture. Interviews and the existing literature were the major sources used to identify the basic features and problems of colonization programs. 140 structured interviews were held with colonists in the Chapare zone, 43 in Yapacari, and 51 in San Julian. The 3 zones were selected because of their diversity, but the sample was not statistically representative and the findings were essentially qualitative. The 3rd chapter examines the relationships between the place of origin and the stages of settlement. The chapter emphasizes the influence of place of origin and other factors on the processes of differentiation, proletarianization, and pauperization. The 4th chapter examines the productive process, profitability of farming, the market, and reproductive diversification. The next chapter analyzes the technology and the market system of the colonists, the dynamics of the unequal exchange system in which they operate, and aspects related to ecological equilibrium and environmental conservation. The 6th chapter concentrates on family relationships and the role played by the family in colonization. Some features of the population structure of the colonies are described. The 7th chapter assesses forms of organization, mechanisms of social legitimation, and the important role of peasant syndicates. The final chapter summarizes the principal trends encountered in each of the themes analyzed and makes some recommendations concerning the colonization program, especially in reference to the family economy and labor organizations.