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[London, England], IPPF, 1986 Jan 31. 5, 13 p.This report provides a brief description of the International Planned Parenthood Federation's (IPPF) involvement in and contributions to International Youth Year (IYY). IYY reinforced an IPPF priority program area for the 1980s--meeting the needs of young people--and all member family planning associations were encouraged to establish links with IYY national coordinating committees. IPPF was also instrumental in the formation of a nongovernmental Working Group on Family Life Education comprised of representatives from a range of organizations involved in youth work and is preparing a resource book on family life education for these groups. The guidelines for action for IYY, prepared by a United Nations Advisory Committee in which IPPF was a major participant, urge governments to promote culturally appropriate family life education, encourage young people and their organizations to be active in the implementation of population programs, promote social policies to strengthen the family, encourage community education to counteract adolescent pregnancy, and ensure that family life and sex education are available to young people. Where necessary, family planning information and services can be made available to adolescents within a country's sociocultural context. There is a need to sustain the global interst in youth concerns generated by IYY and to translate into action the recommendations and resolutions on youth that were developed. It is essential that such action consider factors such as the promotion and protection of the rights and responsibilities of young people, sensitivity to local traditions, identification and mobilization of local resources, interagency cooperation, and involvement of young people in decision making. The document concludes with progress reports from 30 countries on family planning association activities in support of IYY.
The World Bank Population, Health and Nutrition Department, Policy and Research Division fiscal year 1986-1988 work program.
[Unpublished] . iii, 9, 5 p.This note presents the work program of the Policy and Research Division of the World Bank Population, Health, and Nutrition Department for the fiscal years 1988. Although this note was prepared mainly for internal review purposes in the department and in the Bank, it has been circulated outside the Bank to increase awareness of the department policy and research activities. This note 1) lists department staff, 2) gives a brief overview of the department's work, 3) relates the history of the department, and 4) describes the department's activities by objectives. The department's objectives comprise 1) population, 2) population in Sub-Saharan Africa, 3) health, 4) pharmaceuticals, 5) nutrition, 6) intersectoral links, and 7) poverty alleviation. The principal population activities include work on the role of the private sector in family planning, incentives for small family size, cost-effective approaches to the delivery of family planning services, and a population lending review. Work on population in Sub-Saharan Africa centers on adolescent fertility and spatial population distribution. The work program in health reviews health financing and the cost-effectiveness of alternative health interventions. Research on pharmaceuticals examines a range of potential policy interventions on the demand and supply side. A nutrition paper is being prepared on the cost-effectiveness of nutrition interventions, especially as part of primary health care. Intersectoral issues include the links between population, health, and nutrition on one hand and other sectors, such as agriculture and education on the other hand. Work on poverty alleviation examines the extent to which population, health, and nutrition projects should reach out to poor client groups. Research activities in each of these 7 areas are described. An annex lists recent staff papers on these subjects.
Bangkok, Thailand, United Nations Economic and Social Commission for Asia and the Pacific, 1988. v, 133 p. (ESCAP Library Bibliographical Series No. D. 11)This 486-item bibliography is compiled from materials selected from the computerized ESCAP Bibliographic Information System data base. The bibliography includes monographs, documents, and serial articles received in the ESCAP Library and the libraries of some other UN agencies during 1987. Contents are arranged under 7 broad subjects widely used among rural development staff and researchers: agriculture; application of science and technology; health and social services; human resources development and institutions; industrial development; physical infrastructure, natural resources and environment; and policies and planning. Author, title, and geographic area indexes appear after the bibliography.
WORLD HEALTH. 1987 Jun; 9-11.The Council for International Organizations of Medical Sciences (CIOMS), a nongovernmental organization, arranges conferences with the World Health Organization (WHO) and UNESCO on new developments in biology and medicine to explore their social, ethical, moral, administrative, economic, and legal implications. The objective is to create international and interdisciplinary forums where the scientific and lay communities can express their views on topics of immediate concern, unhampered by administrative, political, or other considerations. The primary objectives of the Round Table Conference held in Athens in 1987 were: to identify and compare the ethical content of selected health policy issues from the perspectives of different national, cultural, and religious settings; to examine the interaction of ethical factors and other determinants of health policy in the policymaking process; to explore ways to assist countries in dealing with the interaction of ethics and health policymaking; and to evaluate the usefulness of this kind of dialogue. The conference proposed 3 approaches: an examination of the practical problems of making policy decisions; an examination of a series of case studies; and an examination of the fundamental values underlying the interaction of health policy, ethics, and human values underlying the interaction of health policy, ethics, and human values by considering the meanings which life, suffering, and death hold for a number of the world's principal religions and ideologies. WHO's principal theme for this and the next decade -- the goal of health for all by the year 2000 -- was identified as a central issue in considering health policy, ethics, and human values. Participants reviewed 5 case studies, chosen as being of interest to both developed and developing countries: the allocation of resources for primary health care; public policy and hereditary disease; care of low birth weight infants; health care of the elderly; and organ substitution therapy. The discussion highlighted some of the paradoxes in today's approaches to the problems. It was agreed that there should be continued collaborative followup of the issues discussed and that a mechanism should be established that would support regional groupings in a continued inquiry into issues of regional interest. CIOMS will serve as the organizing focal point.
POPULI. 1988; 15(4):50-2.Participants in the 1988 Oslo Conference on Sustainable Development explored ways the United Nations system can promote sustainable development by enhancing global economic growth and social development. The deterioration of the environment, and the attendant problems of poverty and resource depletion, demand international cooperation and a new ethic based on equity, human solidarity, and accountability. Priority issues identified by conference participants included the following: developing human resources and fully integrated population policies; protecting the atmosphere and the global climate, ocean, and water resources; halting desertification and countering deforestation; controlling dissemination of dangerous wastes and aiming at the elimination of such toxins; increasing technology cooperation; controlling soil erosion and the loss of species; and securing economic growth, social justice, and a more equitable distribution of income and resources within and among countries as means for alleviating poverty. It was emphasized that poverty alleviation and environmental preservation can be made cost-effective components of development plans and programs and should not be considered as barriers to economic growth.
In: Programmes to promote breastfeeding, edited by Derrick B. Jelliffe and E.F. Patrice Jelliffe. Oxford, England, Oxford University Press, 1988. 86-93.The Nursing Mothers' Association was formed in Sweden in the early 1970s, and the group worked to gain access to mass media to influence attitudes through articles and interviews in which they demanded support and encouragement for breastfeeding. A large number of research reports also emerged in the 1970s, demonstrating the benefits and superiority of breastfeeding and breast milk. Further, the active support from international organizations such as WHO and UNICEF was of considerable value as was the controversy leading to the formulation of the Code of Marketing of Breast-milk Substitutes, which helped to focus the interest of the mass media on the issue. Sweden's Board of Health and Welfare appointed an expert group to propose a plan of action, and the group edited a comprehensive textbook on breastfeeding and breast milk to be used as a national guide. The Nursing Mothers' Association developed to a national organization with representatives visiting maternity units and offering to provide advice by telephone after the mother's discharge. 10 years after the rediscovery of breastfeeding there are several hundred thousand mothers with considerable breastfeeding experience. On a limited scale, Sweden has returned to earlier days when young women learned from older and more knowledgeable women. A wealth of personal experience has been gathered and is being conveyed to others in an informal person-to-person manner. Sweden's baby-food industry has adjusted well to the new situation and has accepted a considerable reduction in sales of breast milk substitutes and has complied with the Code. The dramatic increase in breastfeeding in almost all industrialized nations, including Sweden, suggests a strong movement and that breastfeeding is here to stay.
In: Programmes to promote breastfeeding, edited by Derrick B. Jelliffe and E. F. Patrice Jelliffe. Oxford, England, Oxford University Press, 1988. 235-47.The work of the WHO in promoting, monitoring, researching, and regulating breastfeeding and infant nutrition is reviewed. WHO has always fostered infant nutrition, but took up the subject of breastfeeding in 1974 at its 27th World Health Assembly with an expression of concern for decline of the practice. Breastfeeding is a learned behavior in humans that must be supported and reinforced: secular factors are converging to decrease breastfeeding in most of the world. The 1974 assembly set up a working group to initiate research, to collect data on infant nutrition and breastfeeding practices, composition of breast milk in different socioeconomic milieu, methods of conducting controlled studies on mortality in relation to feeding, and effects of hormonal contraceptives on lactation. 3 distinct patterns of feeding were found, among the urban poor, economically advantaged, and rural mothers. A 1979 meeting concluded that monitoring of feeding practices is necessary to set up national programs Training workshops were held and instructive materials were developed. Papers presented at the meeting were published. WHO with UNICEF are promoting the health and social status of mothers, such as nutrition, maternity protection, and support of women's organizations. WHO is collaborating with the International Labor Office (ILO) to survey maternity protection in 129 countries. A final issue being addressed is the infant food industry. In 1985, the World Health Assembly reported that the International Code of Marketing, involving labeling, marketing and regulation of infant foods, has been adopted wholly or in part by 141 countries.
In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988]. 7 p.. (USAID Contract No. DPE-3040-A-00-5064-00)The US Agency for International Development (USAID) and the Institute for International Studies in Natural Family Planning are at work to find ways to remove barriers to family planning breastfeeding promotion efforts. Barriers include lack of or conflicting measures of program success along with lack of information on the breastfeeding/fertility relationship. The 2 organizations have taken the following steps to assist family planning organizations to increase their promotion and support of breastfeeding: identify current activities and potential barriers to breastfeeding promotion; develop guidelines for breastfeeding support and promotion; assess feasibility and impact of the guidelines; and disseminate the guidelines. Much remains to be done to integrate family planning and breastfeeding. The keys to success are: generating and communicating information which can be used readily by both the population and health policymakers in family planning programs; developing and disseminating guidelines and prototype materials which can be adapted to program needs; identifying, implementing, and evaluating programmatic ways to promote breastfeeding in community and clinical settings; and involving the population community -- at the local, national, and international levels, and in research, service delivery, policy, and training -- in an ongoing dialogue about the relationship of family planning and breastfeeding.
Technical Working Group D report: government and donor support for breastfeeding in health and health-related programs.
In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988]. 3 p.. (USAID Contract No. DPE-3040-A-00-5064-00)The focus of the working group was to design a general strategy for government and donor support for breastfeeding promotion in health-related and other nonmaternity health programs. As a start, it is important to examine the reasons why government and donor agencies accept or reject programs to support. 3 steps must be followed for governments to accept breastfeeding: statistics showing declines in breastfeeding within the country need to be gathered; the benefits to the country of promoting breastfeeding would have to be demonstrated; and the link between increased breastfeeding and the decrease in child morbidity and mortality also would have to be demonstrated along with the fact that breastfeeding promotion programs can be done. Both economic arguments and data are necessary. For donor agencies to accept and promote breastfeeding enthusiastically, the benefits of breastfeeding should be shown to be synergistic with benefits from other donor priorities. 2 particular gaps in breastfeeding promotion that would be likely to garner donor support are training and communications. Regional centers for breastfeeding information, advanced training, even newsletter publication would be invaluable. Further, donor agencies could support projects like a review of textbooks and the effective distribution of donor publications.
In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988]. 7 p.. (USAID Contract No. DPE-3040-A-00-5064-00)Breastfeeding is on the decline in most countries, despite the fact it can help prevent the 38,000 daily deaths of infants and young children through its nutritional, immunologic, and sanitary aspects. The World Health Organization (WHO) and the UN International Children's Emergency Fund (UNICEF) have combined to issue guidelines on the role of maternity services in promoting breastfeeding. In the most developed countries, breastfeeding has increased despite generally unsupportive hospital environments, the availability of clean water, and the fact that breastfeeding was virtually a lost practice in these countries 40 years ago. An increased awareness of the benefits, some of which are outlined, coupled with mother-to-mother support are most likely to have influenced this increase. The guidelines developed by WHO/UNICEF seek to put into practice specific recommendations agreed upon by pediatricians, obstetricians and gynecologists, nutritionists, nurses, midwives, and other health care providers in national and international forums. The main points of the guidelines are as follows: every facility providing maternity services should develop a policy on breastfeeding, communicate it to all staff, define specific practices to implement the policy, and ensure that all staff are adequately trained in the skills necessary to ensure implementation of the policy; facilities for 24-hour rooming-in, initiation of breastfeeding immediately after delivery, and demand-feeding are essential in every maternity ward; every pregnant mother should be informed fully about how breast milk is formed, the proper way to nurse a child, and the benefits of breastfeeding; and harmful practices, such as the use of bottles and teats for newborn infants, should be eliminated during this early period and exclusive breastfeeding maintained for at least 4-6 months from birth. These activities, when fully implemented, will ensure that every mother/infant couple reached prenatally, at birth, and postnatally gets off to a good start. Then, other support services will be more effective. These standards have been successful in the field and have had a positive impact on the rates of breastfeeding. A need exists for collaboration and an interdisciplinary approach to the promotion, protection, and support of breastfeeding, and, hopefully, this workshop is the first of a series of technical consultations.
In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988].  p.. (USAID Contract No. DPE-3040-A-00-5064-00)In 1986 the European Regional World Health Organization (WHO) Office convened a meeting of health workers' organizations to develop a strategy for implementing breastfeeding promotion. The elements in this strategy are outlined along with the reasons why some countries have seen increases in breastfeeding and a discussion of the possible ways international organizations can help. The "International Code of Marketing of Breast-Milk Substitutes" constitutes the clearest mandate for an "action program" in the field of breastfeeding. It provides a framework for action and for the formulation of a breastfeeding promotion strategy. Further, the "Code" identifies the obligations of both governments and health workers. According to the Resolution recommending the "Code," one of the obligations of governments is to report regularly to WHO on the progress in 5 areas of infant nutrition: encouragement and support of breastfeeding; promotion and support of appropriate weaning practices; strengthening of education, training, and information; promotion of health and social status of women in relation to infant and young child feeding; and appropriate marketing and distribution of breast milk substitutes. The WHO member states in the European Region have taken their reporting obligation seriously; 71 reports from 29 of the 32 members states have been received. The picture that emerges is one of large diversity with regard to breastfeeding both among and within countries. The European Strategy outlines 7 priority areas for action: the basic attitude of health workers; maternity ward routines; the formation of breastfeeding mothers' support groups; ways to support employed mothers who want to breastfeed; research in breastfeeding; commercial pressure on health workers; and the need for advocacy of breastfeeding. The promotion of breastfeeding is the cumulative effect of activities from several different disciplines that becomes evident in the statistics as an increase in breastfeeding. Factors that contribute to an increase in breastfeeding, based on the Scandinavian experience, are outlined. In regard to establishing a breastfeeding policy, the various activities that can encourage and support breastfeeding fall into 3 categories: making breast milk available to the baby by influencing the material conditions of breastfeeding; increasing knowledge either about human milk or about lactation management as well as about changing attitudes and behavior; and assuring the quality of the milk itself. Ideally, an organization with an advisory and to some degree an executive, decision-making function coordinates these activities.
In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988]. 13 p.. (USAID Contract No. DPE-3040-A-00-5064-00)The World Health Organization's (WHO's) Control of Diarrheal Diseases Program (CDD) is seeking ways to prevent diarrhea and has identified breastfeeding as an important factor. CDD has developed activities in both its research and services components. In the research component, results from recent studies, some of which received support from the program, have shown the strong protective effect of breastfeeding against diarrheal morbidity and mortality. Exclusively breastfed infants are at lower risk of experiencing diarrhea than infants who are partially breastfed, and those who are partially breastfed are at lower risk than those who are not breastfed. Breastfeeding, which also may reduce the severity of the diarrheal illness, has a powerful effect on the risk of diarrhea-associated death. CDD's priorities for research support in the area of infant feeding were reviewed at an April 1988 meeting. Further research that the program feels is needed falls into 2 broad categories: trials of hospital and community-based interventions that aim to promote exclusive breastfeeding in the 1st 4-6 months of life; and evaluation of approaches for implementing tested breastfeeding promotion interventions in the context of national diarrheal disease control programs. CDD's services component has as its basic responsibility collaboration with countries in developing national control programs. It applies the results of research and involves activities in planning, oral rehydration solution (ORS) supply, training, communication, monitoring, and evaluation. It is in the area of training that specific recommendations on breastfeeding have been made. These recommendations are outlined. The training courses are being used to train approximately 5000 supervisory and management staff a year. The program plans to monitor the effectiveness of the training and develop future activities based on that information.
Plan of action for the eradication of harmful traditional practices affecting the health of women and children in Africa.
[Unpublished] 1987. 14 p.The traditional and harmful practices such as early marriage and pregnancy, female circumcision, nutritional taboos, inadequate child spacing, and unprotected delivery continue to be the reality for women in many African nations. These harmful traditional practices frequently result in permanent physical, psychological, and emotional changes for women, at times even death, yet little progress has been realized in abolishing these practices. At the Regional Seminar of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children in Africa, held in Ethiopia during April 1987, guidelines were drawn by which national governments and local bodies along with international and regional organizations might take action to protect women from these unnecessary hazardous traditional practices. These guidelines constitute this "Plan of Action for the Eradication of Harmful Traditional Practices Affecting the Health of Women and Children in Africa." The plan should be implemented within a decade. These guidelines include both shortterm and longterm strategies. Actions to be taken in terms of the organizational machinery are outlined, covering both the national and regional levels and including special support and the use of the mass media. Guidelines are included for action to be taken in regard to childhood marriage and early pregnancy. These cover the areas of education -- both formal and nonformal -- measures to improve socioeconomic status and health, and enacting laws against childhood marriage and rape. In the area of female circumcision, the short term goal is to create awareness of the adverse medical, psychological, social and economic implications of female circumcision. The time frame for this goal is 24 months. The longterm goal is to eradicate female circumcision by 2000 and to restore dignity and respect to women and to raise their status in society. Also outlined are actions to be taken in terms of food prohibitions which affect mostly women and children, child spacing and delivery practices, and legislative and administrative measures. Women in the African region have a critical role to play both in the development of their countries and in the solution of problems arising from the practice of harmful traditions.
Oxford, England, Oxford University Press, 1987. xv, 400 p.In this report, the World Commission on Environment and Development does not predict ever increasing environmental decay, poverty, and hardship in a world becoming more polluted and experiencing decreasing resources but sees instead the possibility for a new era of economic growth. This era of economic growth must be based on policies that sustain and expand the environmental resource base. Such growth is absolutely essential to relieving the great poverty that is intensifying in much of the developing world. The report suggests a pathway by which the peoples of the world can enlarge their spheres of cooperation. The Commission has focused its attention in the areas of population, food security, the loss of species and genetic resources, and human settlements, recognizing that all are connected and cannot be treated in isolation from each other. 2 conditions must be satisfied before international economic exchanges can become beneficial for all involved: the sustainability of ecosystems on which the global economy depends must be guaranteed; and the economic partners must be satisfied that the basis of exchange is equitable. Neither condition is met for many developing nations. Efforts to maintain social and ecological stability through old approaches to development and environmental protection will increase stability. The Commission has identified several actions that must be undertaken to reduce risks to survival and to put future development on sustainable paths. Such a reorientation on a continuing basis is beyond the reach of present decision making structures and institutional arrangements, both national and international. The Commission has taken care to base its recommendations on the realities of present institutions, on what can and must be accomplished now; yet to keep options open for future generations, the present generation must begin to act now and to act together. The Commission's proposals for institutional and legal change at the national, regional, and international levels are embodied in 6 priority areas: getting at the sources; dealing with the effects; assessing global risks; making informed choices; providing the legal means; and investing in the future.
Economic and Political Weekly. 1983 Dec 10; 18(50):2099.This article summarizes World Health Organization (WHO) guidelines on breastfeeding issued in 1982 and discusses their policy implications for India. The WHO document notes that early use of combined oral contraceptives (OCs) after childbirth may both decrease breast milk production and cause women to abandon the pill, denying them the contraceptive protection they would have had if lactation had proceeded uninterrupted. The WHO paper further notes the possible adverse effects on infants exposed to synthetic sex steroids secreted in the breast milk of users of hormonal contraception. This suggests that family planning programs should consider the special needs of breastfeeding women in determining the contraceptive methods to be promoted. Grassroots family planning wokers are in special need of intensive instruction in this area. WHO additionally calls for social and health support systems which encourage breastfeeding and urges that such initiatives form an integral component of family planning programs. WHO's emphasis on breastfeeding as a means of averting births rather than strictly as a means of improving child health is expected to attract the interest of policymakers.
New York, UNICEF, 1984 May. 280 p.The data in this set of 135 country profiles for 1981 are made up from 9 major sources and cover the countries and territories with which the UN International Children's Emergency Fund (UNICEF) cooperates. In terms of infant morttality, countries are divided into 5 infant mortality groups: a very high infant mortality (a) group of countries, with a 1981 infant mortality rate (IMR) estimate of 150 (rounded) or more deaths per 1000 live births; a very high infant mortality (b) group of countries with a 1981 IMR estimate between 110 (rounded) and 140 (rounded); a high infant mortality group of a middle infant mortality group of countries, with a 1981 IMR estimate of between 26 and 50 (rounded); and a low infnat mortality group of countries, with a 1981 IMR estimate of 25 or less. For each country data are also presented on nutrition, demographic, education, and economic indicators.
Global distribution of schistosomiasis: CEGET/WHO Atlas. Distribution Mondiale de la schistosomiase: Atlas CEGET/OMS.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(2):186-99.Schistosomiasis, the most prevalent of the water-borne diseases, is endemic in 74 tropical developing countries and infects over 200 million persons in rural and agricultural areas. However, recent advances in diagnostic techniques, new antischistosomal drugs, and accumulated understanding of the epidemiology of the infection offer improved prospects for schistosomiasis control. Morever, adaptation of quantotative parasitologic techniques for the diagnosis of schistosomiasis will make more data available for use in national control programs. The World Health Organization (WHO) has been instrumental in providing reliable reference material on the geographic distribution of schistosomiasis and, on the basis of a survey of Member States, collaborated with Centre d'etudes de geographic tropicale (CEGET), in the development of an Atlas. This volume consists of topographic relief maps that identify the presence of absence of schistosomiasis by village or locality. There are wide variations in the prevalence, intensity of infection, ans species of parasite according to ecologic differences, snail intermediate hosts, and occupational and cultural norms. The Atlas also highlights the relationship of water resource development projects to schistosomiasis endemicity. Attention to such data may lead to the selection of project areas known not to be endemic. More sophisticated geographic analyses based on land form, soil and geologic characteristics, ground water level, and agricultural land use have been used predictively in Japan. The Atlas is expected to serve as a reference point to evaluate the global progress in schistosomiasis control.
New York, United Nations, 1984. 108 p. (Population Studies, No. 85; ST/ESA/SER.A/85)The 3 parts of this report on world, regional, and international developments in the field of population, present a summary of levels, trends, and prospects in mortality, fertility, nuptiality, international migration, population growth, age structure, and urbanization; consider some important issues in the interrelationships between economic, social, and demographic variables, with special emphasis on the problems of food supply and employment; and deal with the policies and perceptions of governments on population matters. The 1st part of the report is based primarily on data compiled by the UN Population Division. The 2nd part is based on information provided by the Food and Agriculture Organization of the UN (FAO) and the International Labor Organization (ILO), as well as that compiled by the Population Division. The final part is based on information in the policy data bank maintained by the Population Division, including responses to the UN Fourth Population Inquiry among Governments. In 1975-80 the expectation of life at birth for the world was estimated at 57.2 years for both sexes combined. The corresponding figure for the developed and developing regions was 71.9 and 54.7 years, respectively. In 1975-80 the birthrate of the world was estimated at 28.9/1000 population and the gross reproduction rate was 1.91. These figures reflect considerable decline from the levels attained 25 years earlier: a crude birthrate of 38/1000 population and a gross reproduction rate of 2.44. World population grew from 2504 million in 1950 to 4453 million in 1983. Of the additional 1949 million people, 1645 million, or 84%, accrued to the less developed countries. The impact of population growth on economic development and social progress is not well understood. The governments of some developing countries still officially welcome a rapid rate of population growth. Many other governments see cause for concern in the need for the large increases in social expenditure, particularly for health and education, that accompany a young and growing population. Planners are concerned that the rapidly growing supply of labor, compounded by a trend toward rapid urbanization, may exceed that which the job market is likely to absorb. In the developed regions the prospect of a declining, or an aging, population is also cause for apprehension. There is a dearth of knowledge as to the impact of policies for altering the consequences of these trends. Many policies have been tried, in both developed and developing countries, to influence population growth and distribution, but the consequences of such policies have been difficult to assess. Frequently this problem arises because their primary objectives are not demographic in character.
Development: Seeds of Change. 1984; 2:66-7.UN International Children's Emergency Fund (UNICEF) experience over the last 20 years suggests that successful development for poor people is not possible without substantial grassroots involvement. This is the experience both in the developing and in industrialized countries. In the 1960s it became increasingly clear to UNICEF that if programs were to succeed with the small and landless farmers and the urban slum dwellers, there was no possibility of finding enough money to meet needs of these people through governmental channels. It was equally clear that in most places the existing patterns of development andeconomic growth would not reach these people until the year 2000 or thereabots. It was this that led UNICEF to adopt its basic services approach in the late 1960s and early 1970s, which implied that the cost of the most needed basic health services, education, and water had to be reduced to manageable limits. At this stage UNICEF began to articulate the imperative of using paraprofessionals, the need for much greater use of technology that was appropriate to rural and slum areas, and the importance of involving the people in this effort. Looking at those low income countries which have managed to achieve longer life expectancy and higher literacy rates, they are all societies which have practiced much more people's participation in economic and social activities than most other countries. These 3 very different societies -- China, South Korea, and Sri Lanka -- all have had a rather unique degree of people's participation in the development process. Grassroots participation in development is a very important element in developing and in industrial countries. 1 example concerns the whole question of proper nutrition practices, the promotion of breastfeeding, and the problem of the infant formula code. It was the people's groups which picked up the research results in the 1960s, which showed that breastfeeding was a better and more nutritious way of feeding children. The 2nd example pertains to the US government recommendation of significant cuts in UNDP and UNICEF, and the refusal of Congress to give in to those cuts. In regard to the developing countries, over the last year it has increasingly become the consensus of international experts that a childrens' health revolutioon is possible. The conclusion was based upon the fact that there were 2 new sets of developments coming together that created this new opportunity: some new technological advances in the development of rural rehydration therapy; and the capacity to communicate with poor people. With the whole emphasis on the basic human needs of the last 10 years, and on primary health care in the last 5 years, literally millions of health auxiliaries and community workers have been trained, a group of people who, if a country can mobilize them, can provide a new form of access.
Idrc Reports. 1984 Oct; 13(3):18-9.Every 6 seconds someone contracts a sexually transmitted disease (STD), according to Dr. Richard Morisset, chairperson of the International Conjoint STD Meeting held in June 1984 in Canada. Under the patronage of the World Health Organization (WHO), this meeting brought together 1000 specialists from more than 50 countries. Several workshops dealt with STDs in the 3rd world. The workshops revealed an urgent need for drug therapies and assistance for women and children in developing countries because these groups are most affected. A resolution to this effect had been adopted during the annual meeting of the general assembly of the International Union Against Veneral Diseases and Treponematoses (VDTI). WHO was asked to take aggressive action in this area of health. The VDTI resolution also mentioned the fatal cases of acquired immunodeficiency syndrome (AIDS), the connection between cancer and venereal diseases, and the increases in the rates of mortality, infertility, and neonatal infections resulting from chlamydia, a bacterial infection. The need to form a common front in order to review and improve diagnostic methods and various treatments was also emphasized. Dr. King Holmes, an STD researcher at the University of Washington, claimed that "even though a reduction in the number of cases of STDs is possible in the long run, the immediate future is rather bleak." Efforts of the medical world should focus primarily on chlamydis, according to Holmes. This disease is similar to gonnorrhea but is now believed to be much more widespread. Currently, it is estimated that more than 500 million people throughout the world are afflicted. The resulting infections are said to be responsible for a significant proportion of cases of pelvin inflammatory disease and of ectopic pregnancies. US show that when the disease goes undiagnosed in pregnant women, their newborns risk contracting conjunctivitis (50% chance) and penumonia (20% chance). The longterm effects of chlamydia on newborns are unknown. Women and children suffer the most serious complications for STDs. Half of all infertility in women is caused by such diseases. Cervical cancer is the result of an STD. Dr. Willard Cates from the Centers for Disease Control in Atlanta appealed to governments, WHO, and other international organizations to concentrate their efforts on pregnant women, if prevention and treatment programs for the entire population were not feasible at present. Research in progress in the US and France has identified the virus that causes AIDS, but neither group of researchers believe that the production of vaccine is imminent. 1 conclusion of the Canada conference was that without a profound change in attitude, scientists will be unable to stamp out the epidemic of STDs.
Who Chronicle. 1984; 38(6):249-55.This article highlights the central features of the 5-Year Regional Plan of Action on Women in Health and Development, adopted by the Pan American Health Organization (PAHO) in 1981. Although the Plan does not mandate specific actions, it encourages certain activities and establishes an annual reporting system concerning these activities. The Plan recognizes that women's health depends upon numerous factors outside of medicine, including women's employment, education, social status, and accepted roles, access to economic resources, and political power. The low status of women is reinforced by the sexual double standard that makes women responsible for the reproductive process yet denies them the right to control that process. The Plan advocates an incremental approach, in which projects 1st focus on priority areas and groups and then expand to provide more general benefits. Programs exclusively for women are not advocated; encouraged, instead, is the integration of women's health and development activities into the mainstream of general activities promoting health. Among the areas targeted for action are the collection of statistics on women's health, women's nutritional problems, environmental health, maternal-child health services, screening for breast and cervical cancer, and family planning . Community participation is proposed as a good vehicle for local action and an essential tool in the campaign for health for all. Efforts must be made to enlist women's support in identifying community needs, planning health actions, selecting appropriate resources and personnel, establishing and administering health services, and evaluating the results. Overall, the Plan provides a solid basis upon which health authorities of the Americas can build.
Mazingira. 1985; 8(4):28-31.Desertification is a result of overexploitation of the land through overcultivation, overgrazing, deforestation, and poor irrigation practices. This process is a result of the growing imbalance between population, resources, environment, and development. The principle problem causing desertification is not population increase per se; rather, it is due to mismanagement of the land. However, rapidly increasing population densities in the drylands of Africa, Asia, and Latin America have upset the former balance upon which subsistence agriculture depended, including long fallow periods to allow the land to regain its fertility. Arable land for the world as a whole is projected to decrease from its 1975 level of .31 ha/person to .15 ha/person by the year 2000. Population increases in the remaining croplands are expected to produce further encroachment on rangelands and forests and increased ecologic degradation, in turn producing further population pressure, poverty, land degradation, and desertification. The basic need is for better resource utilization. Halting desertification requires the restoration of the balance between man and land. Development, good resource management, and use of appropriate technologic advances are key factors. There is also a crucial need for each country to relate its population policy to its resource base and development plans. Population increase cannot continue indefinitely without regard for the realities of resources, development, and the environment.
Mazingira. 1985; 8(4):32-3.Desertification threatens 35% of the earth's land surface and 19% of the world's population. Each year, 60,000 sq km of land are reduced to desert-like conditions. Of the world's drylands, 60% has already been affected by the desertification process. The direct cost of desertification in the form of loss in agricultural production has been estimated at US$26 billion/year. To halt and perhaps reverse the desertification process, the United Nations Conference on Desertification (UNCOD) formulated a comprehensive Plan of Action to Combat Desertification (PACD) in 1977. However, there has been little progress in implementing the 28 recommendations contained within the PACD. Less than US$50,000, none of it from developed countries, has been raised toward the US$90 billion needed over a 20-year period. Developed nations prefer to give assistance through bilateral aid agreements that allow them to secure secondary benefits such as contracts, employment, and political influence. Another problem involves policies within the affected countries. Environmental programs tend not to be awarded high priority because of their lack of quick visual evidence of results. Government leaders must be convinced that desertification is a steady process that is robbing their lands of productive capabilities and increasing economic dependence on outside sources of support. A national machinery and institutional support to coordinate national action must be established. This requires development of a national plan of action to combat desertification, in which a detailed assessment is made of a country's desertification problems, priority projects are identified, and the institutional support to organize and coordinate the national plan is outlined. The United Nations Environment Program is prepared to assist any developing country in the preparation of such plans.
World Health. 1985 Apr; 19-20.The roles of women in the Eastern Mediterranean region tend to be determined by strong local traditions. In most of the countries concerned, traditional family life makes a clear separation between the parts played by women and men. Men dominate the "public" sphere; women assume full responsibility for the home domain. The 130 million women of this region are active and industrious but largely illiterate. They live in many instances beyond the reach of either governmental or nongovernmental services intended for their well being and development. Weakened by repeated pregnancies and endemic diseases, and sometimes by harmful traditional practices, the women of the region present a health profile that is on the whole poor. In most countries of the region, the percentages of women included in the labor force are among the lowest in the world. Yet "nonsalaried" women -- peasants or housewives -- carry huge responsibilities which may prevent them from spending time on health promotion and family care. Their heavy workload does not count as "employment, and they are not covered by protective legislation. In practice, only a small percentage of women claim their political rights. The natural leadership potential of women, which could be developed and deployed along lines compatible with local tradition, has not yet been recognized. A "women's dimension" has now been added to all World Health Organization (WHO) programs and projects in the Eastern Mediterranean Region, in conformity with resolutions passed during the UN Decade for Women. Maternal and child health and family health head the list of programs bearing directly on women's health. Family health projects aim to improve women's "reproductive health." Looking to the future, the progressive increase in school enrollment among the younger female generation and the gradual improvement in socioeconomic conditions taking place in many Member States of the region are expected to augment the status and well-being of women in their own right as well as the part played by women in health and development.
In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 267-92. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)The 1st section of this paper devoted to population, resources, and development broadly delineates for countries the physiological limits of land to support human populations according to pressure on resources. Subsequent sections examine the impact which an abatement of population growth could have by the year 2000 on resources in general and on the performance of the agricultural sector of developing countries in particular, link poverty to malnutrition, and deal with 1 specific aspect of the relation between distribution and undernutrition. The purpose of the final section is to highlight certain issues of the "food-feed competition" which requires more attention in the future. The frailty of the balance between population and resources is a basic concern of the Food and Agriculture Organization (FAO) of the UN. FAO's purpose is to promote agricultural and rural development and to contribute to the improvement of people's nutritional level. The significant characteristics of the FAO work on "potential population supporting capacity of lands" are the improved soil and climatic data from which it starts and the explicit specification of the assumptions made about technology, inputs, and nutritional intake requirements. Both the carrying capacity project and the results of "Agriculture: Toward 2000" have emphasized the importance of the role that technology will play in world agriculture in the future. Yet, technology is not free and its cost should be compared to alternative solutions. Moving people -- migration -- is an option that suggests itself in relation to the carrying capacity project. Changes in certain institutions, including land reform, size of the farm, market systems, pricing regimes are more suggestions that may arise with respect "Agriculture: Toward 2000" and to the food-feed competition. The ultimate question continues to be whether high agricultural technology is feasible on a world agricultural scale without dire environmental and other effects.