RESUMO
The Primary Health Care strategy introduced concepts which sought to revolutionize the way how to achieve Health for All at the global level. The Declaration of Alma Ata was a prelude to initiatives and global plans that sought compromise to States and society in achieving access to health equity. The Summit of Action for Children and the Meeting of the Millennium, which agreed health targets to achieve by year 2015 were inspired by the concepts included in Primary Health Care. While it is true that the purposes lying below the postulates in Alma Ata were not reached, there was remarkable progress in aspects related to the Mother and Child Health. The Selective Primary Healthcare inspired the so-called "Revolution for the Child Survival", which identified the main causes of the 15 million deaths in children recorded at the global level at the beginning of the Decade of the eighties of the last century, as well as the simple, low-cost interventions based on the evidence shown to be effective in the prevention of this "silent emergency" represented by the avoidable child deaths. Product of these interventions related to children health and the subsequent inclusion of interventions for the prevention of the 500 000 preventable maternal deaths recorded worldwide at the beginning of this century, has achieved remarkable progress at global level. Peru was one of the countries of the Americas that showed greater progress in reducing maternal and infant mortality. This article seeks to find an explanation of procedures and processes that allowed these achievements at the global level and in Peru, inspired by the principles proposed by the Primary Health Care strategy.
La estrategia Atención Primaria de la Salud introdujo conceptos que buscaron revolucionar la forma como se aspiraba lograr la Salud para Todos a nivel global. La declaración de Alma Ata fue un preludio de iniciativas y planes globales que buscaron comprometer a los Estados y a la sociedad en alcanzar el acceso a la salud con equidad. La Cumbre de Acción por la Infancia y la Reunión del Milenio, en la que se acordó las metas de salud a lograr el año 2015, estuvieron inspiradas en los conceptos incluidos en la Atención Primaria de la Salud. Si bien es cierto, los propósitos que subyacían a los postulados recogidos en Alma Ata no fueron alcanzados, sí hubo notables progresos en aspectos relacionados con la salud Materno Infantil. La Atención Primaria Selectiva de la Salud, inspiró la llamada Revolución por la Supervivencia Infantil, que identificó las principales causas de las 15 millones muertes en niños, que se registraban a nivel global a inicios de la década de los años 80 del siglo pasado, así como las intervenciones sencillas, de bajo costo y basadas en la evidencia que habían mostrado ser efectivas en la prevención de esta emergencia silenciosa que representaban las muertes infantiles evitables. Producto de estas intervenciones relacionadas con la salud infantil y la posterior inclusión de intervenciones para la prevención de las 500 000 muertes maternas evitables que registraba el mundo a inicios del presente siglo, se ha logrado notables progresos a nivel global en estos propósitos. El Perú fue uno de los países de las Américas que mostró mayores progresos en la reducción de la mortalidad materna y en la niñez. El presente artículo busca encontrar una explicación de las intervenciones y procesos que permitieron estos logros a nivel global y en el Perú, inspirados en los postulados propuestos por la estrategia de la Atención Primaria de la Salud.
RESUMO
Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and socioeconomic status of mothers and fathers have significant impact on the health and survival of their children. We conducted a literature review to explore the impact of the death of parents on the survival and wellbeing of their children and the mechanisms through which this impact is mediated. Studies have generally concluded that the death of a mother significantly increased the risk of death of her children, especially during the early years; the effect continues but is significantly reduced with increasing age through the age of 15 years. The effect of the loss of a father had less impact than the effect of losing a mother although it too had negative consequences for the survival prospect of the child. A mother's health, education, socioeconomic status, fertility behavior, environmental health conditions, nutritional status and infant feeding, and the use of health services all play an important role in the level of risk of death of her children. Efforts to achieve the Millennium Development Goal No. 4 of reducing children's under-5 mortality in developing countries by two thirds by 2015 should include promoting the health and education of women.
RESUMO
Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and socioeconomic status of mothers and fathers have significant impact on the health and survival of their children.We conducted a literature review to explore the impact of the death of parents on the survival and wellbeing of their childrenand the mechanisms through which this impact is mediated. Studies have generally concluded that the death of a mother significantly increased the risk of death of her children, especially during the early years; the effect continues but is significantly reduced with increasing age through the age of 15 years. The effect of the loss of a father had less impact than the effect of losing a mother although it too had negative consequences for the survival prospect of the child. A mother's health, education, socioeconomic status, fertility behavior, environmental health conditions, nutritional status and infant feeding, and the use of health services all play an important role in the level of risk of death of her children. Efforts to achieve the Millennium Development Goal No. 4 of reducing children's under-5 mortality in developing countries by two thirds by 2015 should include promoting the health and education of women.(AU)
RESUMO
Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and socioeconomic status of mothers and fathers have significant impact on the health and survival of their children.We conducted a literature review to explore the impact of the death of parents on the survival and wellbeing of their childrenand the mechanisms through which this impact is mediated. Studies have generally concluded that the death of a mother significantly increased the risk of death of her children, especially during the early years; the effect continues but is significantly reduced with increasing age through the age of 15 years. The effect of the loss of a father had less impact than the effect of losing a mother although it too had negative consequences for the survival prospect of the child. A mother's health, education, socioeconomic status, fertility behavior, environmental health conditions, nutritional status and infant feeding, and the use of health services all play an important role in the level of risk of death of her children. Efforts to achieve the Millennium Development Goal No. 4 of reducing children's under-5 mortality in developing countries by two thirds by 2015 should include promoting the health and education of women.
Assuntos
Humanos , Masculino , Feminino , Criança , Saúde , Promoção da Saúde , Mortalidade Infantil , Relações Pais-Filho , Pais , Sobrevida , Educação , Estado Nutricional , Condições Sociais , Fatores SocioeconômicosRESUMO
PIP: Survey findings pointing to the worsening health situation for children in Kenya that were highlighted during the National Dissemination Seminar for the 1998 Kenya Demographic and Health Survey (KDHS). The survey indicates that currently, 1 in 9 Kenyan children does not live to his or her 5th birthday. Under-five mortality stands at 112 deaths per 1000 live births, a 24% increase over the last decade. The high prevalence of childhood mortality is associated with a short preceding birth interval, a low level of maternal education, and rural location (under-five mortality is 23% higher in rural than in urban areas). Moreover, the risk of children dying varies greatly across provinces. A comparison between the results of the 1993 and 1998 KDHS also indicates recent setbacks in the fight against vaccine preventable diseases. Full vaccination coverage has fallen from 79% in 1993 to 65% in 1998. One of the more positive findings is the continuing decline in total fertility rate from 8.1 children per woman in the mid-1970s to current levels of 4.7 children per woman. In addition, knowledge and use of family planning has continued to rise in Kenya. Lastly, participants in the seminar also discussed the need for further dissemination of findings and further analysis of projects.^ieng
Assuntos
Coeficiente de Natalidade , Criança , Demografia , Mortalidade Infantil , Pesquisa , Adolescente , Fatores Etários , América , América Central , Países em Desenvolvimento , Fertilidade , América Latina , Longevidade , Mortalidade , Nicarágua , América do Norte , População , Características da População , Dinâmica Populacional , Taxa de SobrevidaRESUMO
PIP: Both Colombia and Brazil have introduced vaccination programs against Haemophilus influenzae type b (Hib). In 1998, Colombia added free Hib vaccination to the country's routine vaccination program. To date, 600,000 children (60% of the target population) have been reached with the vaccine and this effort has stimulated coverage with all vaccines. Initial coverage rates were hindered by civil unrest, rains, and a hospital strike a week prior to the campaign. In Brazil's Curitiba municipality (Parana State), routine Hib vaccination of all children 2-24 months of age was introduced in 1996, in part because Hib was implicated in 16% of bacterial meningitis cases. Hib incidence among children under 5 years of age dropped from 35.5/100,000 in 1996 to 9.7/100,000 in 1997 and there have been no further cases of bacterial meningitis among vaccinated children. The Pan American Health Organization is establishing a regional epidemiologic surveillance system for Hib-associated meningitis and pneumonia in children under 5 years and standardizing laboratory methodologies in the region.^ieng
Assuntos
Criança , Planejamento em Saúde , Mortalidade Infantil , Saúde Pública , Vacinação , Viroses , Adolescente , Fatores Etários , América , Brasil , Colômbia , Atenção à Saúde , Demografia , Países em Desenvolvimento , Doença , Saúde , Serviços de Saúde , Imunização , América Latina , Longevidade , Mortalidade , Organização e Administração , População , Características da População , Dinâmica Populacional , Atenção Primária à Saúde , América do Sul , Taxa de SobrevidaRESUMO
"This article presents a multivariate hazard model for survival data that are clustered at two hierarchical levels.... We apply the model to an analysis of the covariates of child survival using survey data from northeast Brazil collected via a hierarchically clustered sampling scheme. We find that family and community frailty effects are fairly small in magnitude but are of importance because they alter the results in a systematic pattern."
Assuntos
Características da Família , Mortalidade Infantil , Modelos Teóricos , Características de Residência , Estatística como Assunto , América , Brasil , Demografia , Países em Desenvolvimento , Geografia , América Latina , Longevidade , Mortalidade , População , Dinâmica Populacional , Pesquisa , América do Sul , Taxa de SobrevidaRESUMO
This study evaluates the impact of the Trivers-Willard (T-W) effect on human populations, using demographic data collected from vital registration data in Venezuela. The evaluation of the sex ratio at birth (SRB) and of fetal and infant deaths supports the existence of T-W effect in the Venezuelan population in extreme conditions. This T-W effect was observable in the SRB but not at later ages and is related to the marital status of the mother. The results indicate that the investment in females associated with environmental adversity is greater than the investment in males associated with good environmental conditions.
PIP: This study relies on stepwise discriminant analysis to evaluate the influence of socioeconomic status (SES) factors according to marital status on the probability of the child being born a male or a female. Data were obtained from the 1988 and 1990 Venezuelan death and birth registers in the Central Office of Statistics and Information. Fetal and infant deaths numbered 87,229. Births numbered 577,976 and were reported for a variety of demographic/socioeconomic variables. The study evaluates the Trivers and Willard (1973) hypothesis that the sex ratio at birth is correlated with socioeconomic status. The focus is on the deviations in the sex ratio at birth (SRB) in Venezuela. The authors refer to studies confirming sex biases in mortality and sex biases in allocating resources and care and refuting the Trivers-Willard (T-W) effect. Findings indicate that the SRB was 0.5124 and confirms other estimates. The SRB for married and cohabiting couples was 0.512 and 0.514, respectively. The SRB was lower for single women (0.508). Differences were all statistically significant. Findings suggest that the T-W effect may be stronger in women who do not live with a male partner. Sex ratio deviations varied by SES. Higher educational status was associated with a higher SRB. Extreme poverty was associated with lower SRB and had a stronger impact on SRB than high SES. The T-W effect appeared stronger prior to conception. The T-W effect varied by maternal marital status. Females were more advantaged when mothers were unmarried. The sex ratio of neonatal deaths was 0.562; that for infant deaths was 0.574. The sex ratios for mortality did not differ for any of the SES indicators. There were differences by type of births and gestation time. Single births and early gestational times had higher male mortality. Infant deaths among mothers aged 30-34 years showed a higher sex ratio.
Assuntos
Morte Fetal , Mortalidade Infantil , Seleção Genética , Razão de Masculinidade , Viés , Distribuição de Qui-Quadrado , Estudos Transversais , Análise Discriminante , Meio Ambiente , Feminino , Teoria dos Jogos , Humanos , Recém-Nascido , Masculino , Sistema de Registros , Fatores Socioeconômicos , VenezuelaRESUMO
BACKGROUND: Local supervisors used lot quality assurance sampling (LQAS) during routine household visits to assess the technical quality of Costa Rican community-based health workers (CHW): measuring and recording weights of children, interpreting their growth trend and providing nutrition education to mothers. METHOD: Supervisors sampled 10 households in each of 12 Health Areas (4-8 hours per area). No more than two performance errors were allowed for each CHW. This LQAS decision rule resulted in judgments with a sensitivity and specificity of about 95 percent. RESULTS: Three categories of results are reported: (1) CHW adequately weighed children, calculated ages, identified children requiring nutritional services, and used the growth chart. (2) They needed to improve referral, education, and documentation skills. (3) The lack of system support to regularly provide growth cards, supplementary feeding to identified malnourished children, and other essential materials may have discouraged some CHW resulting in them not applying their skills. CONCLUSIONS: Supervisors regularly using LQAS should, by the sixth round of supervision, identify at least 90 percent of inadequately performing CHW. This paper demonstrates the strength of LQAS, namely, to be used easily by low level local health workers to identify poorly functioning components of growth monitoring and promotion.
PIP: Nurses and rural health supervisors used the Lot Quality Assurance Sampling (LQAS) technique to assess the quality of growth monitoring and promotion (GMP) conducted by community health workers (CHWs) in 12 health areas in Costa Rica. Each supervisor made 10 routine household visits and spent 4-8 hours in each area. The study allowed no more than two performance errors per CHW. CHWs could correctly identify children in need of the nutritional services of the primary health care (PHC) system. Yet they were weak in their referral, education, and documentation skills. The supply system and the documentation system that support growth monitoring did not work well. Perhaps the inadequate support system may have contributed to the CHWs' inferior use of their skills. The finding that there were inadequate supplies and poor documentation of required GMP data suggest that CHWs did not regularly conduct growth monitoring, perhaps due to a lack of scales and growth charts. The PHC system did not follow children with nutritional deficiencies, suggesting that health facilities did not keep a register and refer these children systematically. This would explain why CHWs did not refer malnourished children to health facilities. CHWs had significant time constraints that influenced their ability to perform regular growth monitoring. The evaluation team required 4-8 hours to observe growth monitoring in 10 households. The PHC system expects each CHW to conduct about 10 complete household visits/day, which includes growth monitoring, vaccinations, pre- and post-natal care, oral rehydration therapy training, and monitoring blood pressure. With each subsequent supervision visit, the misclassification error of substandard CHW (i.e., the probability of identifying an inadequate performer) decreases. By the sixth visit, supervisors could identify almost all CHWs with a performance quality of 80% or less. These findings suggest that supervisors use LQAS methods to regularly identify GMP problems.
Assuntos
Transtornos da Nutrição Infantil/prevenção & controle , Competência Clínica/normas , Agentes Comunitários de Saúde/normas , Transtornos do Crescimento/prevenção & controle , Atenção Primária à Saúde/normas , Garantia da Qualidade dos Cuidados de Saúde/métodos , Criança , Agentes Comunitários de Saúde/educação , Costa Rica , Técnicas de Apoio para a Decisão , Países em Desenvolvimento , Avaliação de Desempenho Profissional , Humanos , Estudos de Amostragem , Sensibilidade e EspecificidadeRESUMO
This paper investigates variations in the strength and structure of familial association in neonatal mortality risks in four populations; Bolivia, Kenya, Peru, and Tanzania. Exploratory analyses of the structure of the familial association are presented for each population. Random effects logistic models are then used to estimate the strength of familial association in neonatal mortality risks using a standard set of control variables. The results suggest that the strength of familial association in neonatal mortality risks is quite similar in these four populations which would be consistent with a biological explanation for the association. However, some differences were found, particularly in the form of the association in Peru, which may suggest at least a small role of other factors.
Assuntos
Comparação Transcultural , Países em Desenvolvimento , Saúde da Família , Mortalidade Infantil , Meio Social , África Oriental/epidemiologia , Características da Família , Saúde da Família/etnologia , Feminino , Humanos , Recém-Nascido , Masculino , Fatores de Risco , América do Sul/epidemiologiaRESUMO
PIP: According to a United Nations Children's Fund (UNICEF) report, which evaluated progress toward fulfillment of the 29 recommendations of the Childhood Pact signed in 1993 by 22 of Brazil's 27 provincial governors, large-scale vaccination programs have been successful while attempts to improve education have not. The pact covered the rights of children and adolescents, the reduction of infant mortality, and improved health and education services. Massive vaccination efforts have eradicated polio from Brazil and reduced measles from 23,000 cases in 1992 to 124 cases in 1993 and 14 cases, to date, in 1994. However, 77% of primary school students are over the expected age for their educational level; plans to increase literacy among adolescents who lack primary education were frustrated, and teacher's strikes in many states cut into their time with students. In 1993, classes were suspended in 10 states to protest poor salaries and a lack of respect for teachers, another issue to be addressed by the pact. Provision of lunches for at least 180 days of the year in order to prevent malnutrition and boost school attendance in the poorest areas was also in the pact, but 17 of the 22 states which signed the pact have yet to do implement lunch programs. UNICEF, the executive secretary of the pact, has released a document, "Expectations for 1995-1998," suggesting renewal of the pact in combination with other measures to ensure the survival and development of Brazil's children.^ieng
Assuntos
Adolescente , Desenvolvimento Infantil , Serviços de Saúde da Criança , Criança , Educação , Planejamento em Saúde , Mortalidade Infantil , Serviços de Saúde Escolar , Nações Unidas , Vacinação , Fatores Etários , América , Biologia , Brasil , Atenção à Saúde , Demografia , Países em Desenvolvimento , Saúde , Serviços de Saúde , Imunização , Agências Internacionais , América Latina , Longevidade , Centros de Saúde Materno-Infantil , Mortalidade , Organização e Administração , Organizações , População , Características da População , Dinâmica Populacional , Atenção Primária à Saúde , América do Sul , Taxa de SobrevidaRESUMO
PIP: Using indirect methods based on information about live births and surviving children, the author reviews estimates of infant and child mortality in Mexico. Data are from the 1980 and 1990 censuses.^ieng
Assuntos
Mortalidade Infantil , Estatística como Assunto , América , Demografia , Países em Desenvolvimento , América Latina , Longevidade , México , Mortalidade , América do Norte , População , Dinâmica Populacional , Pesquisa , Taxa de SobrevidaRESUMO
PIP: With a decline of almost 60% over the past decade in the mortality of children under age 5 years old to the current rate of 33 child deaths/1000 live births, Mexico has joined the 20 countries listed by UNICEF as making the most progress in reducing child mortality since 1980. Much of this progress can be attributed to Mexico's immunization program, which has brought the proportion of fully immunized children under age 5 years to 94% over the past 5 years. Mexico's president has been instrumental in the program's success, having a personal interest in childhood vaccination and supervising the twice-yearly immunization coverage surveys. Even though presidential elections are being held this year, the immunization program should remain strong regardless of who wins because all of Mexico's political parties have pledged to remain committed to immunization. Awareness in the population about the need for vaccination is maintained with the help of the mass media, especially radio and television. The country's enthusiasm for vaccination seems to be paying off in terms of declining child mortality and the eradication of wild poliovirus. The immunization program reaches all but 2-3% of Mexico's children, despite some logistical difficulties and resistance to vaccines among certain religious groups such as the Mennonites and Jehovah's witnesses.^ieng
Assuntos
Governo , Imunização , Mortalidade Infantil , Liderança , Mortalidade , Vacinação , Pessoal Administrativo , América , Comunicação , Atenção à Saúde , Demografia , Países em Desenvolvimento , Saúde , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde , América Latina , Longevidade , México , América do Norte , Organização e Administração , População , Dinâmica Populacional , Atenção Primária à Saúde , Taxa de SobrevidaRESUMO
PIP: The USAID-CARE Bolivia Child Survival and Rural Sanitation Project brought water to Tauca, a community on the shores of Lake Titicaca. Water is used for washing hands and vegetables which leads to better hygiene and nutrition and is crucial in view of the current cholera epidemic in South America. Farmers often start small irrigation projects for vegetable gardens. A gravity-pumped water system was designed by a CARE engineer but built of local materials by local people in the Bolivian village of Phorejoni Junco. 2 community-trained water operators and 2 health workers visit each home and inspect the sanitation system every month. Llamacachi, a model community with 77 families, has built a clinic with minimal material and labor commitments and additional money from water fees. All 17 children under the age of 5 have received health cards. Only 10% of the children are malnourished, and half of the 79 community mothers know how to prepare oral rehydration fluid for children with diarrhea. In 1989 the CARE project, funded by USAID, set out to improve the health and self-sufficiency of 48,000 people in 160 communities in the Bolivian departments of La Paz, Cochabamba, and Santa Cruz. A major objective was to better the survival rates of children under age 5 by constructing water supply systems, reinforcing community organizations and improving hygiene. In Bolivia fewer than 31% of the rural population has water services, fewer than 13% of the people have latrines, and fewer than 30% have access to health services. The mortality rate of children under age 5 is 100/1000, and 75% of those deaths are related to diarrhea or parasitic illness. The Bolivia Child Survival Project reduced infant mortality in these communities from 210 deaths to 100 deaths per 1000 children under age 5. CARE's Bolivia Child Survival Project was recently funded for 4 more years to serve an additional 160 communities, demonstrating that a sound child survival program and a focus on health depends on quality water systems.^ieng
Assuntos
Controle de Doenças Transmissíveis , Serviços de Saúde Comunitária , Diarreia Infantil , Órgãos Governamentais , Higiene , Mortalidade Infantil , Saneamento , Mudança Social , Abastecimento de Água , América , Bolívia , Conservação dos Recursos Naturais , Atenção à Saúde , Demografia , Países em Desenvolvimento , Diarreia , Doença , Economia , Meio Ambiente , Saúde , Serviços de Saúde , América Latina , Longevidade , Mortalidade , Organizações , População , Dinâmica Populacional , Atenção Primária à Saúde , Saúde Pública , América do Sul , Taxa de SobrevidaRESUMO
Observations made in Antigua indicate that children consume significant amounts of food between main meals. Some of the constituents of snacks are nutritionally valuable but much of this intake is undesirable and could be laying the foundations of ill-health. Continuing efforts in the field of education on nutrition are clearly necessary for both the children and their parents.
PIP: Protein malnutrition remains a problem throughout much of the Caribbean region. In Antigua 5-7% of children are malnourished, and 15% of children aged 17-19% are obese and at risk for diabetes, hypertension, and stroke later in life. Problems of malnutrition are exacerbated by the high cost of fruits and vegetables and nonnutritious imports from the US of fatty fast foods that are high in sugar, fat, and additives. Nutrition education is introduced in home economic courses in schools and in parental education efforts. The Caribbean Food and Nutrition Institute has a pilot education project operating in elementary and secondary schools. The aim is to study the nature, extent, and quality of snacking among children aged 9-11 years of age. The study involves 20 children who keep a log of foods consumed in the course of a day. Snacks are considered to be all food consumed between meals or after the evening meal. Nonbasic foods are identified as those not fitting the basic six food groups. Findings show that every child eats between meals. 60% of the children eat between breakfast and lunch. 41% of all energy is obtained from foods consumed as snacks between lunch and dinner, and 8% of all energy is obtained from morning snacks. Principal snack foods include soft drinks, fresh fruit and unsweetened fruit juices, sweets and chocolates, sugar, and based products (listed in highest to lowest frequency of consumption). Over 33% of daily energy intake, almost 50% of carbohydrate intake, and almost 66% of added sugar are obtained from snacks. Daily consumption averages 61 g of sugar and ranges from 8 to 101 g. 33% of average energy intake is obtained from meals.
Assuntos
Países em Desenvolvimento , Obesidade/prevenção & controle , Desnutrição Proteico-Calórica/prevenção & controle , Adolescente , Antígua e Barbuda , Criança , Feminino , Humanos , Masculino , Valor NutritivoRESUMO
PIP: The Peru Demographic and Health Survey used a multi-stage, stratified probabilistic approach to collect data from 13,479 households and complete interviews with 15,882 women aged 15-49. Interviews were conducted between October 1991 and March 1992. Data were also collected on child health from the mothers of 9289 children born in the five years preceding the survey. The survey found that over the period 1965-1985, the population grew from 11.5 million to 19.4 million. The crude birth rate per 1000 declined from 44.9 to 32.6, while crude death rate also declined from 16.6 to 9.7. The annual rate of population growth fell from 2.84% to 2.20%, and life expectancy increased from 50.3 years to 60.0. The population is more concentrated in urban centers with 67.3% living therein compared to 51.9% in 1965. UN estimates put the rate of total fertility for 1985-90 at 4.0; the survey estimate for 1989-91 is 3.5, much lower than the estimated rate of 6.9 for 1955-65. Contraceptive prevalence is low. Survey data are presented in tabular form under the following headings: distribution of survey sample population by socioeconomic characteristics; fertility trends; fertility differentials, 1989-91; age-specific fertility; mean ideal number of children by age and number of living children for all women; desire to stop childbearing among women in union; planning status of births at the time of the survey by number of living children; contraceptive prevalence differentials; contraceptive prevalence by age and parity; percentage distribution of current users of modern methods by most recent source of supply, according to method; knowledge and use of methods among women in union; intention to use contraception in the future among nonusers in union, by number of living children; reason for future nonuse among currently married women by age group; current marital status; differentials in age at first sexual relations; union and contraceptive status; median duration of postpartum interval; differentials in breastfeeding and amenorrhea; infant mortality trends; infant mortality differentials, 1981-91; children ever-born and surviving; percent of children 12-23 months old ever vaccinated and percent receiving specific vaccines, according to health card or mother's report; percent of children under five years old with diarrhea two weeks prior to survey, and of those, percent consulting an health facility and percent receiving different ORT treatments; type of assistance during delivery for births in five years prior to survey; and percent undernourished among children under five years old according to children's weight-for-height and height-for-age.^ieng
Assuntos
Coeficiente de Natalidade/tendências , Países em Desenvolvimento , Serviços de Planejamento Familiar/tendências , Crescimento Demográfico , Adolescente , Adulto , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Peru/epidemiologiaRESUMO
PIP: Preliminary results from the Paraguay Demographic and Health Survey, 1990, are presented for population, fertility, contraceptive usage, postpartum activity, infant mortality, immunization coverage, oral rehydration treatment, use of health personnel during delivery, and nutritional status. Data were compiled by the Paraguay Center of Population Studies. Surveys were conducted in only the eastern region which contains 98% of the population. Interviews were conducted with 5827 women aged 15-49 years between May 21 and August 24, 1990. 28 tables, graphs, or charts are provided. General demographic data is presented for 1965 and 1985 and the percent change. The percentage of urban or rural women by their educational status is provided. Total fertility rate is shown in 5-year spans between 1955 and 1985, with estimates given for 1990. Fertility differentials are shown for urban or rural residence and educational level. Age-specific fertility is given. The ideal number of children is plotted against the number of living children. Also given the number of women desiring to stop childbearing and the planning status by birth order. Contraceptive prevalence is expressed for residence and educational level, as well as for age and parity. Sources of supply are indicated by choice of modern method, Knowledge of contraception by method of use and knowledge is provided. Intention to use contraception is supplied in terms of number of living children. The reasons for nonuse are generated by age group 30 years and 30 years. Duration of postpartum by status (breast feeding, nonsusceptible, amenorrhea, abstinence) is provided. Status is given by months and mean duration. Survival of children ever born indicates ever born, surviving, and dead. Infant mortality differences are expressed by residence and educational level. Demographic characteristics of those immunized by type of vaccine is given. Statistics on the percentage of children 5 years of age with diarrhea 2 weeks prior to the survey are given. Health personnel involved during the delivery are given. Nutritional status is measured by the status of undernourishment based on weight for height and age data and residence and mother's educational level.^ieng
Assuntos
Coeficiente de Natalidade/tendências , Demografia , Países em Desenvolvimento , Adolescente , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , ParaguaiRESUMO
PIP: The author's visit to "kangaroo care" programs in Guatemala and Colombia has led Uganda's University of Kampala to consider the introduction of this innovation in its neonatal special care unit. Such programs, which place premature infants in direct contact with their mother's skin during breastfeeding, represents a simple, inexpensive strategy for infant survival in developing countries and eliminates the need for mechanical incubators. Research conducted at the Hospital Universitario de Valle in Cali, Colombia, found that falls in the infant's body temperature. In the Latin American programs, premature infants are entered into the breastfeeding program immediately after delivery.^ieng
Assuntos
Publicidade , Aleitamento Materno , Mortalidade Infantil , Recém-Nascido Prematuro , Lactente , Adolescente , África , África Subsaariana , África Oriental , Fatores Etários , América , América Central , Colômbia , Demografia , Países em Desenvolvimento , Economia , Guatemala , Saúde , Fenômenos Fisiológicos da Nutrição do Lactente , América Latina , Longevidade , Marketing de Serviços de Saúde , Mortalidade , América do Norte , Fenômenos Fisiológicos da Nutrição , População , Características da População , Dinâmica Populacional , América do Sul , Taxa de Sobrevida , UgandaRESUMO
PIP: This article considers the epidemic proportion of AIDS in developing countries, and discusses the U.S. Agency for International Development's (USAID) reworked and intensified strategy for HIV infection and AIDS prevention and control over the next 5 years. Developing and launching over 650 HIV and AIDS activities in 74 developing countries since 1986, USAID is the world's largest supporter of anti-AIDS programs. Over $91 million in bilateral assistance for HIV and AIDS prevention and control have been committed. USAID has also been the largest supporter of the World Health Organization's Global Program on AIDS since 1986. Interventions have included training peer educators, working to change the norms of sex behavior, and condom promotion. Recognizing that the developing world will increasingly account for an ever larger share of the world's HIV-infected population, USAID announced an intensified program of estimated investment increasing to approximately $400 million over a 5-year period. Strategy include funding for long-term, intensive interventions in 10-15 priority countries, emphasizing the treatment of other sexually transmitted diseases which facilitate the spread of HIV, making AIDS-related policy dialogue an explicit component of the Agency's AIDS program, and augmenting funding to community-based programs aimed at reducing high-risk sexual behaviors. The effect of AIDS upon child survival, adult mortality, urban populations, and socioeconomic development in developing countries is discussed. Program examples are also presented.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida , Comunicação , Preservativos , Países em Desenvolvimento , Diagnóstico , Economia , Administração Financeira , Órgãos Governamentais , Publicações Governamentais como Assunto , Infecções por HIV , Educação em Saúde , Planejamento em Saúde , Necessidades e Demandas de Serviços de Saúde , Hospitais , Mortalidade Infantil , Cooperação Internacional , Conhecimento , Marketing de Serviços de Saúde , Organizações , Grupo Associado , Política Pública , Pesquisa , Comportamento Sexual , Infecções Sexualmente Transmissíveis , Fatores Socioeconômicos , Ensino , Terapêutica , Tuberculose , População Urbana , Organização Mundial da Saúde , África , África Subsaariana , África Oriental , América , Ásia , Sudeste Asiático , Comportamento , Região do Caribe , Anticoncepção , Atenção à Saúde , Demografia , Doença , República Dominicana , Educação , Serviços de Planejamento Familiar , Saúde , Instalações de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Infecções , Agências Internacionais , América Latina , Longevidade , Mortalidade , América do Norte , Organização e Administração , População , Características da População , Dinâmica Populacional , Taxa de Sobrevida , Tanzânia , Tailândia , Uganda , Nações Unidas , VirosesRESUMO
"The past 20 years have seen extensive elaboration, refinement, and application of the original Brass method for estimating infant and child mortality from child survivorship data. This experience has confirmed the overall usefulness of the methods beyond question, but it has also shown that...estimates must be analyzed in relation to other relevant information before useful conclusions about the level and trend of mortality can be drawn.... This article aims to illustrate the importance of data analysis through a series of examples, including data for the Eastern Malaysian state of Sarawak, Mexico, Thailand, and Indonesia. Specific maneuvers include plotting completed parity distributions and 'time-plotting' mean numbers of children ever born from successive censuses. A substantive conclusion of general interest is that data for older women are not so widely defective as generally supposed."