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Washington, D.C., Island Press, 1991. lxii, 272 p.In 1988, the World Meteorological Organization and the UN Environment Program established the Intergovernmental Panel on climate Change (IPCC) to consider scientific data on various factors of the climate change issue, e.g., emissions of major greenhouse gases, and to draw up realistic response strategies to manage this issue. Its members have agreed that emissions from human activities are indeed increasing sizably the levels of carbon dioxide, methane, chlorofluorocarbon (CFC), and nitrous oxide in the atmosphere. The major conclusions are that effective responses need a global effort and both developed and developing countries must take responsibility to implement these responses. Industrialized countries must modify their economies to limit emissions because most emissions into the atmosphere come from these countries. They should cooperate with and also provide financial and technical assistance to developing countries to raise their living standards while preventing and managing environmental problems. Concurrently, developing countries must adopt measures to also limit emissions as their economies expand. Environmental protection must be the base for continuing economic development. There must be an education campaign to inform the public about the issue and the needed changes. Strategies and measures to confront rapid population growth must be included in a flexible and progressive approach to sustainable development. Specific short-term actions include improved energy efficiency, cleaner energy sources and technologies, phasing out CFCs, improved forest management and expansion of forests, improved livestock waste management, modified use and formulation of fertilizers, and changes in agricultural land use. Longer term efforts are accelerated and coordinated research programs, development of new technologies, behavioral and structural changes (e.g., transportation), and expansion of global ocean observing and monitoring systems.
Geneva, Switzerland, WHO, Division of Family Health, Programme of Maternal and Child Health and Family Planning, 1991 Dec. , 122 p. (WHO/MCH/91.10)This WHO consultation on maternal and perinatal infections reviews the epidemiology of these infections, examines the effectiveness of known intervention strategies to prevent and treat these infections, notes gaps in current knowledge, and develops recommendations for implementation of appropriate control strategies. The report is geared toward maternal and child health professionals in developing countries where maternal and perinatal infections cause considerable morbidity and death. These countries have limited resources for health care (e.g., US $5-10/person), largely due to the worsening economic situation. The report centers on the feasibility, effectiveness, and cost of interventions to prevent, treat, and control the infections. It has summary cost-effective analyses of maternal and perinatal infections and proposed interventions using 3 different hypothetical country situations to help policymakers decide on priorities and policies on prevention, treatment, and control of these infections. The report dedicates a chapter to each infection (syphilis, neonatal tetanus, malaria, hepatitis, HIV infections, chlamydial infections, herpes simplex infection, Group B Streptococcal infections, and maternal genital infection causing premature birth and low birth weight). Each chapter addresses their clinical and public health significance; prevalence in pregnant women and transmission from mother to fetus/infant; clinical effects; prevention, treatment, and control; and cost effectiveness and feasibility of various interventions. Based on public health importance, feasibility, and affordability, the consultants agreed that national and international programs should place the highest priority on these perinatal infections: gonococcal ophthalmia neonatorum, maternal and congenital syphilis, neonatal tetanus, hepatitis B, and maternal puerperal infections.
[Annual report: Interamerican Foundation: October 1, 1990 - September 30, 1991] Anuario 1991: Fundacion Interamericana: 1o de octubre de 1990 - 30 de septiembre de 1991.
Arlington, Virginia, Interamerican Foundation, 1991. , 52,  p.The annual report lists the executive council and the staff of the Interamerican Foundation, provides the letter of the president of the executive council, and a message of the president. In the promotion of national resources, cooperation was established with the Venezuelan state-owned oil company with the objective of assisting local and nongovernmental organizations in development along with a contribution of $200,000 annually for projects. The HOCOL foundation of Shell Oil Co. in Colombia also established a fund for small project development that amounted to apportionment of $100,000/year for a period of 3 years. In July 1991 representatives from the Andean region also took part in the American Folklore Festival of the Smithsonian Institution in Washington, D.C., exhibiting traditional agriculture, textiles, artisans, dances, music, and ritual ceremonies. In 1991, financing reached the highest level in the Foundation's history with the approval of $29.2 million in donations. About 89% of the funds were assigned to food and agriculture, small business development, and education and training. The rest were allocated to assist community service programs in terms of housing, health care, legal assistance, ecological development, and culture. In-country funds were established in Belize, Brazil, Chile, Ecuador, Mexico, and Nicaragua. The office of training and promotion carried out exchanges of information with various development organizations by means of conferences, group studies, and video tapes, e.g., one that focused on preserving the access of poor people to the natural resources of the Gulf of Fonseca. The number of readers of the Foundation's publications increased by 20%. The offices were consolidated into 4 units for more effective operation. The plan for the 1990 decade, envisioned increasing development capacity and reducing the dependency on external help.
Cholera: ancient scourge on the rise. WHO announces global plan for cholera control. (25 April 1991).
WHO FEATURES. 1991 Apr; (154):1-3.Vibrio cholerae spreads quickly via contaminated water and food, especially in areas with a poor health and sanitation infrastructure. Its enterotoxin induces vomiting and huge amounts of watery diarrhea leading to severe dehydration. 80-90% of cholera victims during an epidemic can use oral rehydration salts. A cholera epidemic is now spreading through Latin America threatening 90-120 million people (started in January 1991), particularly those in urban slums and rural/mountainous areas. As of mid April 1991, there were more than 177,000 new reported cases in 12 countries and 78% of these cases and more than 1200 deaths were limited to 5 countries: Brazil, Chile, Colombia, Ecuador, and Peru, WHO's Global Cholera Control Task Force coordinates global cholera control efforts to prevent deaths in the short term and to support infrastructure development in the long term. Its members are specialists in disease surveillance, case management, water and sanitation, food safety, emergency intervention, and information and education. WHO's Director General is asking for the support of the international community in cholera control activities. These activities' costs are considerable. For example, Peru needs about US$ 60 million in 1992 to fulfill only the most immediate demands of rehabilitation and reconstruction of the infrastructure. Costs of infrastructure capital throughout Latin America is almost US$ 5 thousand million/year over the next 10 years. It is indeed an effective infrastructure which ultimately prevents cholera. Cholera is evidence of inadequate development, so to fight it, we must also fight underdevelopment and poverty.
Review and evaluation of national action taken to give effect to the International Code of Marketing of Breast-Milk Substitutes: report of a technical meeting, The Hague, 30 September - 3 October 1991.
[Unpublished] 1991. 24 p. (WHO/MCH/NUT/91.2)The report of the national actions in marketing breast-milk substitutes includes a review and evaluation summarized in the accompanying annex and the results of a meeting. Participants found the evaluation helpful, that progress had been made, and that the International Code of Marketing of Breast-milk Substitutes must be viewed in a broad context. Lessons learned and recommendations are given for the development and implementation of national measures, as well as the training and education in the health sector, the information to the general public and mothers, monitoring and enforcement, and manufacturers and distributors of products within the scope of the Code. Successful implementation depends on a clear international perspective, on all concerned parties' involvement in development and monitoring, and a continuing commitment to a complex process. Difficulties encountered were lack of 1) political commitment, 2) integration of sectors, and 3) recognition that the Code applied to all counties; there were also questions about the scope of products included in the Code. There is no limit to age group. Partial adoption is not sufficient and has a negative impact. The Code was being ignored in countries moving toward a market economy. Health professionals were unaware of new developments in infant feeding practices. The Code assumes a compatible relationship between manufacturers and health personnel, which is not the case. Manufacturers used mass media and formal and informal educational sectors to disseminate information about their products with the approval of authorities who considered the use consistent with the Code. The expanding international telecommunications systems have proved to be a crippling challenge to some countries without the tools to know how to regulate programming. The feeding bottle is an inappropriate child care symbol for breast feeding, which is frequently found in public places. Monitoring has been uneven. Enforcement is hampered by an absence of, inadequacy in, and inability to apply sanctions. Joint health and industry provisions are weaker than the Code, and marketing strategies do not conform to the Code. Manufacturers apply the Code differently in developed and developing countries. Not enough attention has been paid to feeding or pacifier products. Retail stores sell infant formula next to other infant food products which is misleading.
Strengthening of management of maternal and child health and family planning programmes. Report of an intercountry workshop, New Delhi, 27-31 August 1990.
[Unpublished] 1991 Feb 14. , 20 p. (SEA/MCH/FP/99; Project No. ICP MCH 011)>20 participants from UNFPA/UNICEF/USAID and 23 participants from 10 countries from the WHO Southeast Asia Region attended the Workshop on Strengthening of Management of Maternal and Child Health (MCH) and Family Planning (FP) Programmes in New Delhi, India in August 1990. The workshop consisted of presentations and discussions of country reports, technical papers, dynamic work groups, and plenary consensus. The WHO/SEARO technical officer for family health presented a thorough overview on strengthening MCH/FP services in a primary health care setting. Issues addressed included regional status on population growth, urban migration and development. MCH status, management of MCH/FP services, strategic planning, and management information. In Bangladesh, the government integrated MCH services with FP services, but other child programs including immunization, control of diarrheal disease program, nutrition, acute respiratory infection remained with the health division. Obstacles of the MCH/FP program in the Maldives were shortage of trained human resources, preference of health providers to work in urban areas, inadequate logistics, and insufficient supervision in peripheral health centers. A nomadic way of life among the rural peoples posed special problems for the delivery of MCH services in Mongolia where large family size was encouraged. Other country reports included Bhutan, India, Myanmar, Nepal, and Sri Lanka. A case study of the model mother program in Thailand and the local area monitoring technique in Indonesia were shared with participants. District team work groups identified key MCH/FP management problems including organization, planning, and management; finance and resource allocation; intersectoral action; community participation; and human resource development. The workshop revealed the national health leaders with hopes for WHO technical assistance were developing a rapid evaluation methodology.
Tabular information on legal instruments dealing with HIV infection and AIDS. Part 1. All countries and jurisdictions, including the USA (other than state legislation).
[Unpublished] 1991 May. 136 p. (WHO/GPA/HLE/91.1)National, subnational, and organization-level legal instruments regarding AIDS and HIV infection are presented in tabular format. Legislation from 83 countries (from Algeria to Yugoslavia, including European nations and the US) is included, as well as from Hong Kong. Listings include instrument type and number, a brief description, and reference location in the International Digest of Health Legislation where appropriate. The 2 extranational organizations listed are the Council of Europe and the European Communities. The former lists policy recommendations, while the latter spells out the basis of community policy on some aspects of AIDS, and addresses medical and health research coordination.
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1991; 69(6):667-76.WHO's Programme for Control of Diarrheal Diseases (CDD) promoted and supported research the purpose of which is to develop and evaluate vaccines against diarrheal diseases, but it focused on diarrhea control. In 1991, the WHO/UNDP Programme for Vaccine Development (PVD) began coordinating diarrheal disease vaccine research, yet CDD remained actively involved in vaccine trials. In March 1991, CDD and PVD cosponsored a meeting to specify new research priorities toward vaccines against rotaviruses, Shigella, cholera, and enterotoxigenic Escherichia coli (ETEC) infections. Synopses of clinical trials on vaccines that have undergone clinical trials are presented. Different methods of developing vaccines against rotavirus included heterologous rotavirus adapted to tissue cultures, incorporating the VP7 surface protein of human rotaviruses into an animal rotavirus, and naturally attenuated. Live oral vaccines, different ways to immunize with oral encapsulated antigens, and a gycoconjugate approach comprised the Shigella vaccine research. There were many candidate Shigella vaccines which the meeting participants found to be promising and challenging. Cholera vaccines included killed and live oral vaccines. The results of a large field trial of cholera vaccines (killed whole cell/B subunit and whole cell culture) in Bangladesh revealed marked improvements over injected vaccines. A study of children in Indonesia showed promise for strain CVD-103HgR as a 1 dose, live oral vaccine against cholera. Adult volunteers who received milk immunoglobulin concentrate with antibodies against several colonization factor fimbriae (LT and O antigens) and then challenged experimentally with ETEC were 100% protected. WHO emphasized the need to develop both living and nonliving oral ETEC vaccines which will grant broad spectrum immunity to young children. Specific recommendations follow each section on the various vaccines and general recommendations are included.
Household survey of diarrhoea case management. Enquete dan les menages sur la prise en charge des cas de diarrhee.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1991 Sep 13; 66(37):273-6.The Diarrheal Disease Control (CDD) Program in Nepal conducted surveys in the Midhills and Terai regions of Nepal (9033 <5-year-old children) to determine the extent of diarrhea and knowledge and practices related to diarrhea case management and to evaluate the effectiveness of its activities. 11.7% of the children in Midhills and 7.4% of those in Terai had had diarrhea within 24 hours before the survey. Incidence rates stood at 3.5 and 3.1 episodes/child/year, respectively. 99% of all mothers who were breastfeeding continued to breast feed during the episode. 75% of mothers in Terai an 61% in Midhills also gave at least the same amount of food during the episode as they did before the episode. But only 28% in Terai and 9% in Midhills increased fluid amounts during diarrhea. Even though almost 66% of the mothers knew about oral rehydration solution (ORS), only 8% of cases in Terai who had had diarrhea in the preceding 24 hours and 10% of those in Midhills received ORS or sugar salt solution (SSS). Moreover, only 1.5% received properly prepared ORS. 6.3% of cases in Terai and 4.2% of cases in Midhills received SSS, but only 7 mothers prepared it correctly. The leading reason for improper mixing was addition of too little water. The mean amount of ORs and SSS given during the preceding 24 hours was 362 and 253 ml in Terai and 453 an 424 ml in Midhills, respectively. >51% of all mothers received ORS packets from a government physician or health worker. 21.8% of cases were treated with antidiarrheals some of which were provided by physicians and health workers. Only 19.6% of mothers in Terai and 25% in Midlands knew at least 3 correct reasons to take their child to a health worker. The CDD program should increase access to ORS, train mothers in its correct use, and promote an appropriate homemade SSS. It should also step up training of health workers concerning diarrhea case management.
Towards developing a community based monitoring system on the social and economic impact of AIDS in East and Central Africa.
[Unpublished] 1991. 4,  p.Proposed is a short-term, initial study of the potential of a community-based system to monitor the social and economic impact of acquired immunodeficiency syndrome (AIDS) in Eastern and Central Africa. The study was requested by the United Nations Development Program (UNDP). Its initial phase, which will be conducted in the UK, will consist of a literature review and preparation of a proposal for a pilot project. Particular emphasis will be placed on poor households in which family survival is threatened by the death from AIDS of an economically active adult. Assessed will be the extent to which a community-based monitoring system can aid households and communities in coping with the excess mortality created by AIDS and also provide information to national leaders that can be used to guide the formulation of national AIDS policy. Components of such a monitoring system are the regular collection of data, processing of the data into a form where they can be used as the basis for initiating actions, and definition of a set of interventions. Such an activity assumes the existence of both institutions that can collect and process the data and agencies capable of initiating interventions. Examples of successful monitoring systems exist in the areas of food security and child malnutrition. Their success appears to have been based on the availability of data at the points where action is to be taken, involvement of existing community institutions, a convergence of community and external agency objectives, and a common perception of problems and their relative importance. The pilot project is expected to involve a small number of areas in one or two countries of East and Central Africa with a high incidence of AIDS.
Colombo, Sri Lanka, Family Planning Association of Sri Lanka, 1991. , 54,  p.This report describes the accomplishment of the Family Planning Association of Sri Lanka (FPASL) during the 1990-91 year. The report opens with a section describing 1990 highlights, a year that witnessed great strides in clinical, contraceptive retail marketing, rural motivational, and AIDS education activities. In June, FPASL hosted the Regional Council Meeting of the South Asia Region, a meeting attended by IPPF Secretary Dr. Halfdan Mahler, who praised the efforts of the association. Designed to coincide with the regional meeting, FPASL organized a national seminar on "Family Planning Research and the Emerging Issues for the Nineties." IPPF invited FPASL to be one of the 6 countries do develop a new strategic plan for the 1990s. Other FPASL highlights included: increased AIDS education, Norplant promotion campaigns, and the establishment of a counselling center for young people. Following the highlight section, the report provides an overall program commentary. The report then examines the following components of FPASL: 1) the Community Managed Integrated Family Health Project (CMIRFH), which is the associations' major family planning information, education, and communication (IEC) program; 2) the Nucleus Training Unit, established in 1989, whose primary emphasis is to organize and conduct AIDS education programs; 3) the Youth Committee, whose activities include populations and AIDS education; 4) the Clinical Program, whose attendance increased by 15% (this section describes the types of services provided); and 5) the Contraceptive Retail Sales Program. While condom sales increased by 5%, the sales of oral contraceptives and foam tablets decreased -- a declined explained by the turbulent situation of the country.
Amsterdam, Netherlands, WGNRR, 1991. 48 p.This report summarizes the activities of the Women's Global Network for Reproductive Rights (WGNRR), an organization that campaigns to reduce maternal mortality and morbidity, during 1991. In addition to its summary of activities, the report provides examples of local, national, and regional activities which illustrate the efforts of WGNRR's campaign. The report explains that the organization has succeeded in establishing May 28 as the Day of Action for Women's Health. For 1992, WGNRR hopes to make the issue of adolescent mothers the focus of the Day of Action. Having presented excerpts of Martha Rosenberg's paper entitled "Rethinking maternity: a women's task" (presented at the University of Salamanca, Spain on September 1990), the report goes on the describe the work done by WGNRR groups. As an example of a local initiative, the publication discusses the efforts conducted in Tanzania to end sexual harassment. This topic became the focus of the Day of Action. The Tanzania Media Women's Association held a seminar do discuss issues such as rape, media images of women, violence, and harassment in the workplace. The report goes on to describe a national campaign conducted in Chile, a campaign entitled "I am a woman. . . I want to be healthy," which focused on women's demands to humanize health care. For its regional experience, the report discusses accomplishments of the First Regional Workshop on Maternal Mortality, held in Managua in April 1991. The workshop attracted participants from Belize, Costa Rica, the Dominican Republic, Guatemala, Mexico, and Nicaragua. The report also includes an evaluation of the campaign conducted in Lima, Peru. Finally, the report presents excerpts of letters and reports of activities conducted by member groups around the world.
Evaluating the progress of national CDD programmes: results of surveys of diarrhoeal case management.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1991 Sep 6; 66(36):265-70.National diarrhea disease control (CDD) programs need to evaluate their effect on diarrhea morbidity and mortality, but this is often difficult. So national CDD programs often follow the WHO Global CDD Programme model. It uses 13 indicators designed to measure the extent the CDD program is being effectively administered. These indicators are mainly concerned with diarrhea case management in the home and in health facilities, e.g., oral rehydration therapy (ORT) use rate. WHO is enlarging the list to include breast feeding. It suggests that national CDD programs use WHO developed household and health facility surveys to evaluate their programs. These surveys can also identify problems and demonstrate possible solutions to bring about effective implementation. Evaluation teams have used WHO's Morbidity, Mortality, and Treatment survey almost 400 times. China, Ethiopia, the Philippines, and Viet Nam habitually conduct 1-2 evaluation surveys/year. Ecuador and Kenya use them to train professionals in conducting WHO surveys. 1989-1990 surveys in 17 developing countries reveal positive findings: 89.8-100% of mothers in 16 of the countries (49% in Iran) still breast feed during a diarrhea episode and 60-70% of mothers offer ill children at least the same amount of food as they are offered when well. On the other hand, caregivers do not always use ORT (13.4 [India]-91.8% [Indonesia]) and increased fluid intake is low (15-30%). 13 surveys show that water was the most commonly given nonmilk fluid offered. This information helps programs to identify appropriate home fluids. A 1990 addendum to the WHO household survey allows program managers to assess antidiarrheal drug use. WHO's 1990 manual provides protocols for observing case management practices, interviews with caretakers and health workers, assessing health facilities and supplies, and reviewing records.
IN POINT OF FACT 1991 Jun; (76):1-3.This paper describes the serious effect of diarrheal and acute respiratory (ARI) disease upon children under 5 years old, and international efforts undertaken by the World Health Organization (WHO) to reduce such mortality. Combined, these diseases account for more then 1/2 of all deaths in this age group, and constitute the most serious threat to their health. WHO estimates for 1990 that diarrheal illnesses caused 3.2 million childhood deaths and that ARI caused 4.3 million. While some child deaths are due to measles and pertussis, the majority is caused by pneumonia and the consequences of diarrheal illnesses. These deaths could be readily averted through the timely, effective treatment of trained health workers with essential drugs. Immunization as well as improved nutrition, particularly through the practice of exclusive breast feeding of the child's 1st 4-6 months of life, are addition weapons potentially employed against child mortality. WHO programs for diarrhea and ARI control focus upon simplified treatment guidelines, training, communication messages, drug supplies, and evaluation methodology. Despite obstacles such as the marketing of useless and/or potentially dangerous anti-diarrheal drugs and cough and cold remedies, and inappropriate breastmilk substitutes and unnecessary foods, widespread progress in program development and implementation has been made over the past decade. Increased amounts of oral rehydration therapy and solutions are available and used, while many health workers have benefited from training programs.
HYGIE. 1991; 10(2):3-4.A strategic plan for objectives and operations of the International Union for Health Education (IUHE) in the 1990s is presented. The IUHE's principal aims are to strengthen the position of education as a major means of protecting and promoting health, to support members of the IUHE, and to advise other agencies. Core functions will include advocacy/information services/networking, conferences/seminars, liaison/consultancy/technical services, training, and research. The objectives of the IUHE are to promote and strengthen the scientific and technical development of health education, to enhance the skills and knowledge of people engaged in health education, to create a greater awareness of the global leadership role of the IUHE in protecting and promoting health, and to secure a stronger organizational and resource base. These objectives will be achieved by developing an disseminating annual policy papers on key global issues, developing new procedural guidelines for the IUHE's world and regional conferences, clarifying the roles of the headquarters and regional offices, and developing recruitment incentives to boost membership. The corporate identify of the IUHE will be revised, formal U.N. accreditation will be sought, and mutually beneficial relationships will be fostered with selected U.N. and non-governmental organizations. Additionally, the scientific and technical strengths of the IUHE will be boosted, a resources referral service developed, a fund raising office created, worker achievements recognized, and a bursary fund established.
HEALTH EDUCATION QUARTERLY. 1991 Spring; 18(1):5-15.This article contains the findings and recommendations of a Working Group convened by the World Health Organizations (WHO) in 1989 in order to explore the application of health promotion concepts and strategies in developing countries. As the article's preamble explains, goal of health promotion is to foster health development by advocating policies, developing social support systems, and empowering people with the knowledge and skills needed to address health problems. The WHO Working Group, which included 26 representatives from around the world, focused on the following concerns: 1) how to mobilize the public and policy- makers in favor of health, and how to obtain an appropriate share of national resources; 2) how to encourage health planners to allocate resources to health promotion and disease prevention; and 3) how to intensify health education in developing countries. The article presents the highlights of the Working Group's discussions on the following 4 themes: 1) the issues facing health promotion in developing countries; 2) the formulation of health supportive public policies; 3) the empowerment of people for health action; and 4) the strengthening of nations' capability for health promotion. The article also issues a call for action around health promotion. Although the specific initiatives of individual countries invariably vary, the Working Group provides some of the high priority actions that developing nations need to take in order to move health promotion from concept to reality.
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1991; 69(3):277-83.The frequent reactivation of disease in immunosuppressed patients represents a serious health complication for acquired immunodeficiency syndrome (AIDS) patients with herpesviruses. Since the herpesviruses are often associated with the development of complication such as pneumonia and lymphoma, an emphasis is being placed on the rapid laboratory diagnosis of herpes simplex viruses 1 and 2, varicella- zoster, Epstein-Barr virus, and cytomegalovirus. Diagnostic methods that utilize monoclonal antibodies to detect viral antigens in clinical specimens are now within the scope of general laboratories and detection methods for viral DNA in clinical specimens are being advanced. Each of the viruses requires its own diagnostic procedures, however, and consideration should be given to practical and economic issues. The World Health Organization (WHO) has recommended that developing countries use rapid diagnostic techniques that do not require expensive, labor-intensive virus replication. Serological diagnosis can facilitate disease surveillance of the herpesviruses in different population groups in countries with little information on this infection's epidemiology. Who is recommending that regional or national reference laboratories establish confirmatory testing facilities to support the routing virological or microbiological services offered by local laboratories. Other WHO recommendations include the development of international standard preparations and reference reagents, compilation of a list of monoclonal antibodies available for collaborative diagnostic studies, and promotion of studies on the rapid diagnosis of herpesvirus-promoted encephalitides.
New York, New York, UNFPA, . , 33 p.A United Nations Fund for Population Activities (UNFPA) mission to Albania in 1989 attempted to identify the country's priority population issues and goals. Albania, a socialist country, has made many accomplishments, including an administrative structure that extends down to the village level, no foreign debt, universal literacy, a low death rate (5.4/1000), and involvement of women in development. At the same time, the country has the highest birth rate in Europe (25.5/1000), a high incidence of illegal abortion, lack of access to modern methods of contraception, and inadequate technology in areas such as medical equipment and data collection. Albania's population policy is aimed at maintaining the birth rate at its current level, reducing morality, and lowering the abortion rate by 50% by 1995. Goals for the health sector include increasing life expectancy, reducing infant and maternal mortality, improving the quality of health services, and decreasing the gap between the standard of living in rural and urban areas. Family planning is not allowed except for health reasons. Depending on trends in the total fertility rate, Albania's population in the year 2025 could be as low as 4.6 million or as high as 5.4 million. Albania has expressed an interest in collaborating with UN agencies in technical cooperation projects. The UNFPA mission recommended that support should be provided for the creation of a population database and analysis system for the Government's 1991-95 development plan. Also recommended was support to the Enver Hoxha University's program of strengthening the teaching of population dynamics and demographic research. Other recommendations included activities to strengthen maternal care/child spacing activities, IEC projects, and to raise the status of women.
Geneva, Switzerland, WHO, 1991. vi, 65 p. (WHO Technical Report Series 807)This report by WHO's Expert Committee on Environmental Health in Urban Development explains that social and physical factors, including the destruction of the natural environment, place the health of urban dwellers at risk. The report discusses the urbanization phenomenon and its consequences, the problems and needs in environmental health, and provides recommendations. From 1950-80, the world's urban population nearly tripled, with most of the growth occurring in developing countries, where urban population quadrupled. Experts predict that many urban centers in developing countries will have an annual growth rate of more than 3% over the next 40 years. While developed countries have seen declines in the level of population growth, the health risks to its urban inhabitants have nonetheless increased. Technological changes, increased energy consumption, and increased levels of waste have placed great stress on the environment and have increased the health risks. But developing countries have seen even more problems associated with urban living. Rapid urbanization levels have led to overcrowding, congestion, and the destruction of previously unsettled ecosystems. Pollution levels have increased. Due to the lack of sanitation services, the threat of communicable diseases has increased. Social problem such as crime and violence also affect the well-being of urban dwellers. The group at greatest risk includes poor women and children. The report explains that tackling the health problems associated with urbanization will require a major conceptual change, considering that current efforts are ineffectual. Some of the recommendations include: strengthening the management of urban development; strengthening the management and technology for environmental health; and strengthening community action.
Community involvement in health development: challenging health services. Report of a WHO Study Group.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1991; (809):i-iv, 1-56.In order to make community involvement in health development (CIH) a reality, countries need to go beyond endorsement of the idea and take concrete steps, reports a WHO study group examining the issue. While the idea of community involvement has gained widespread acceptance, most health services have been slow in making the necessary institutional and organizational changes, and in providing the necessary money and staff time. Furthermore, most CIH efforts have concentrated on the community side of involvement, neglecting the health development aspects and the context in which the involvement takes place. The Study Group, which met in Geneva on December 1989, was concerned with identifying specific obstacles to CIH implementation and providing recommendations. The report discusses such issues as the political, social, and economic contexts of CIH; the methodology of CIH; the training of health personnel; the strengthening of communities for CIH; and the monitoring and evaluation of such programs. Among the report's major findings: most countries have yet to truly commit to CIH; CIH programs lack the necessary support and resources; effective coordination at all levels is imperative; health personnel must be adequately educated on the principles and practices of CIH; and some health ministries promote too narrow an understanding of health. The report contains recommendations for both countries and for WHO. The recommendations for countries include several measures directed at the ministries of health, including a provision that the ministries develop guidelines for the implementation of CIH at the district level.
Report of an International Consultation on AIDS and Human Rights. Geneva, 26-28 July 1989. Organized by the Centre for Human Rights with the technical and financial support of the World Health Organization Global Programme on AIDS.
New York, New York, United Nations, 1991. iii, 57 p.In July 1989, ethicists, lawyers, religious leaders, and health professionals participated in an international consultation on AIDS and human rights in Geneva, Switzerland. The report addressed the public health and human rights rationale for protecting the human rights and dignity of HIV infected people, including those with AIDS. Discrimination and stigmatization only serve to force HIV infected people away from health, educational, and social services and to hinder efforts to prevent and control the spread of HIV. In addition to nondiscrimination, another fundamental human right is the right to life and AIDS threatens life. Governments and the international community are therefore obligated to do all that is necessary to protect human lives. Yet some have enacted restrictions on privacy (compulsory screening and testing), freedom of movement (preventing HIV infected persons from migrating or traveling), and liberty (prison). The participants agreed that everyone has the right to access to up-to-date information and education concerning HIV and AIDS. They did not come to consensus, however, on the need for an international mechanism by which human right abuses towards those with HIV/AIDS can be prevented and redressed. International and health law, human rights, ethics, and policy all must go into any international efforts to preserve human rights of HIV infected persons and to prevent and control the spread of AIDS. The participants requested that this report be distributed to human rights treaty organizations so they can deliberate what action is needed to protect the human rights of those at risk or infected with HIV. They also recommended that governments guarantee that measures relating to HIV/AIDS and concerning HIV infected persons conform to international human rights standards.
Weekly Mail. 1991 Jun 21-27;  p..Dr. James Chin, the head of surveillance and forecasting for the WHO Global Program on AIDS, presented the statistics on the global spread of HIV infections. It is reported that by mid-1990s, 3 million HIV infections are projected for Asia. In Africa, the number of HIV individuals was projected to increase from 6 million to 10 million over the next years, leading to increases in mortality and decreases in life expectancy. Furthermore, in the US and all other western nations combined, it was estimated that fewer than 2 million people are infected with the AIDS virus. A key reason for the lower rate is that AIDS education and prevention programs in industrialized nations are far more extensive, and therefore more effective, in triggering behavior changes to minimize the risk of infection. In addition, reported intensive educational programs in Thailand and Zaire have significantly lowered the number of new HIV infections.
New York, New York, UNFPA, 1991. xv, 875 p. (Population Programmes and Projects Vol.2)This document presents the inventory of population projects in developing countries around the world. It is an annual compilation of externally assisted projects and programs funded, initiated, or implemented by international organizations. Information in this book is organized by geographical categories and by the type of organization involved. Assistance included in this book covers grants, loans, technical and operational support, training, and provision of equipment and supplies. In addition, research projects are included whenever such research appears to provide valuable information for the donor community and governments of developing countries. Most of the information is based on the original materials--letters, computer printouts, annual reports, and informational leaflets-- provided to the UN Population Fund by organizations themselves. Basic demographic data were prepared by the Population Division of the UN Department of International Economic and Social Affairs. All of the data included in this document refer to the medium variant estimates and projections calculated by the Population Division from national censuses and surveys.
Guatemala City, Guatemala, INCAP, 1991 Aug.  p.The executive summary of the 42nd council meeting of the Nutrition Institute of Central America and Panama (INCAP) contains a list of topics covered at the meeting and resulting reports and documentation. The executive summary of the 1990 annual report contains a brief statement identifying INCAP program priorities for the year and descriptions of activities emphasized in each of the program components: general coordination, human resources training and development, technical cooperation, and research. Another report assesses progress in institutional processes developed during 1990-91 to strengthen INCAP management capacity. The processes described include decentralization of the administration of technical cooperation; strengthening administration and strategic planning, technology and technology transfer, and development of financial resources; reinforcing scientific-technical communication networks; restructuring the INCAP postgraduate studies program; establishing a human resources data bank; and assessing the current status of documentation centers. The financial report for 1990 follows, including the report of an external audit during 1990. The next section examines follow-up to the eight resolutions of the previous meeting of the INCAP council. The report of the preparatory meeting of the directors general of health and INCAP program and budget proposals for 1992, and statements of policy regarding research and information and communications complete the work.
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.