UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
|
| UN Population Division, Department of Economic and Social Affairs, with support from the UN Population Fund (UNFPA) |
|
HDDFLASH ISSUE no. 2, June 1, 1996
Electronic newsletter and archiving service on human development issues
World Bank
Human Development Department (HDD)
e-mail: hddflash@worldbank.org
http://www.worldbank.org/html/hcovp/hdd/contents.html
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* Social Indicators of Development
* XVII International Vitamin A Consultative Group (IVAGC) Meeting
* Health Care Alliance Seek Partnership in Bosnia-Herzegovina
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SOCIAL INDICATORS OF DEVELOPMENT
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The world's poor are concentrated in 65 low-income countries, mainly in
Sub-Saharan Africa and South Asia, with a population of 3.2 billion and a
per capita income of $390 a year. Most live in rural areas; lack adequate
access to safe water and other basic services; nearly 40% of their
children are malnourished and over 40 percent of their children are
malnourished; and over 40 percent of primary school-aged children are not
enrolled in school. These statistics are disheartening, yet over the past
20 years, significant progress has been made in improving social
conditions in these countries, especially for women and children, who make
up the majority of the world's disadvantaged.
* Fertility rates are declining in low-income countries, from 5.6 births
per woman in the early 1970s to 3.3 in 1994. This decline has not been
evenly spread. Over this period, fertility declined by nearly 40 percent
in South Asia, but only by slightly more than 10 percent in Sub-Saharan
Africa.
* Declining fertility has been accompanied by significant increases in
access to education, especially for girls. In South Asia, primary school
enrollment rates increased dramatically from 50 percent of all school-age
girls in 1970 to 87 percent in 1993. In Sub-Saharan Africa, enrollment
rates increased by 50 percent. In low-income countries as a whole,
enrollment of girls increased by about 20 percent, while total primary
enrollment increased by over 40 percent.
* Preventive health care has improved. For example, childhood
immunization against measles in low-income countries has risen from 50
percent of children in 1985 to 86 percent in 1992, with South Asia showing
the most dramatic increase. Access to health care in South Asia rose from
54 percent of the population in 1980 to 96 percent by the end of the
decade, and access to safe water increased from 50 percent of the
population to 70 percent over the same period.
* As a result of these improvements, children born in low-income
countries in 1994 can expect to live, on average, 63 years, compared with
54 years for those born 20 years ago.
Improving living standards and reducing poverty nevertheless continue to
pose challenge to governments and the development community. Around 1.3
billion people (1993 estimate) in the developing world live on less than
one dollar a day. Because this figure conceals large regional differences,
poverty will remain a persistent problem requiring concerted efforts.
Thirty-nine percent of the world's poor live in South Asia, while only 17
percent live in Sub-Saharan Africa. But nearly 40 percent of Sub-Saharan
Africa's population is below the poverty line, and the region has seen a
gradual erosion of living standards over the past two decades. Real per
capita income declined, reflecting weak economic growth and a rapidly
rising population. A few countries have experienced increases in infant
mortality, decreases in life expectancy, and slight increases in child
malnutrition. Others have experienced some deterioration in the provision
of social services: fewer people today than in the 1970s have access to
safe drinking water, and primary school enrollment rates have fallen or
leveled off.
By contrast, East Asia - with the exception of China - has reduced the
share of its population living in poverty, from about 23 percent in 1987
to 13.7 percent in 1993. Annual GNP per capita growth rates accelerated
from 4.3 percent in 1970-75 to 7.2 percent in 1989-94; over the same
period, population growth rates declined from 2.3 percent to 1.4 percent.
In countries such as Indonesia, the proportion of people living below the
poverty line declined from 45 percent in the early 1980s to 17 percent a
decade later. Per capita income rose from $230 in 1975 to $880 in 1994;
infant mortality was more than halved; and access to basic services, such
as safe drinking water and education increased. Much of the progress in
this region reflects a policy of fostering broad based economic growth,
coupled with the expansion of basic services and major investments in
human capital.
(Patel, Sulekha, "Social Indicators of Development," in Finance and
Development, volume 33, number 2, June 1996)
The article is based on information available in Social Indicators of
Development (SID) 1996. SID provides social and economic indicators for
191 countries and is issued in diskette and in print. To order, contact
World Bank at books@worldbank.org by e-mail, fax: (202)676-0581 or
tel: (202)473-1155
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THE "SCIENTIFIC" AND "PROGRAMMATIC" COME TOGETHER TO FIGHT
VITAMIN A DEFICIENCY AT THE XVII IVACG MEETING IN GUATEMALA
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"Virtual Elimination of Vitamin A Deficiency: Obstacles and Solutions for
the Year 2000" was the theme of the XVII International Vitamin A
Consultative Group (IVACG) Meeting, held March 18-22 in Guatemala City,
Guatemala. Representatives from 66 countries were among the 484
policymakers, programmers, and scientists in health, nutrition,
agriculture, and development who attended the meeting.
USAID which supports a variety of programs through the OMNI Project to
combat vitamin A deficiency, sponsored 60 participants to attend the
five-day meeting. Among the USAID/OMNI-sponsored group were
representatives from India, Bangladesh, Sri Lanka, Indonesia, Thailand,
Ghana, Tanzania, Malawi, South Africa, Ecuador, Bolivia, El Salvador,
Nicaragua, Brazil, and Egypt. For these participants, the meeting provided
an opportunity to share project experiences from their countries, to
strengthen working relationships, to make valuable contacts, and to gather
useful information all in one place in order to develop and implement
policy and to strengthen national programs.
New data on the prevalence of vitamin A deficiency showed that progress is
being made. More countries recognize the existence of vitamin A deficiency
as a public health problem than at the time of the last IVACG meeting in
1994. In addition, the World Health Organization documented a shift in the
severity of vitamin A deficiency being reported at the country level.
Several countries have moved from the severe vitamin A deficiency category
to the subclinical category.
As a result the IVACG Meeting being in Guatemala, where sugar
fortification has been implemented successfully, this year's meeting had
a greater emphasis on fortification than ever before. Fifty of the
participants visited a nearby vitamin A premix factory and sugar mill.
The Guatemalans shared their more than 20 years of experience in
fortification including problems they have encountered over the years.
These include the lack of quality assurance and problems with the high
humidity and its effect on the vitamin A fortificant. OMNI introduced its
newly published three-volume Manual for Sugar Fortification with Vitamin
A, which was received with great interest by meeting attendees which
will result in those responsible for vitamin A fortification of sugar in
other countries having the most recent technical information at hand.
For the OMNI program managers attending the meeting IVACG offered a
rare opportunity to work with all of their country groups face-to-face in
one location. They were also able to bring people together from different
countries facing similar issues to share what has worked or not worked
in micronutrient interventions. The participant from Nicaragua, for
example, met the participants from Bolivia and discussed Bolivia's recent
sugar fortification experience.
For OMNI Project Director Dr. Ian Darnton-Hill, one of the most exciting
things to come out of this year's meeting was the results of a study on
home gardens presented by Martin Bloem of Helen Keller International
(HKI). "We already know that the income generated from home gardens
generally goes to women who spend more on food and who, as they become
more empowered, generally have fewer but better nourished children. But
Martin's presentation, based on work done in Bangladesh, showed for the
first time that home gardens actually had a biological impact on both
mothers' diarrhea and on maternal night blindness," said Dr. Darnton-Hill.
"While there tends to be a feeling of tension at these meetings between
the pure scientists and the increasing number of programmatic people
attending, Bloem's study was the best example of the scientific and the
programmatic coming together."
The XVII IVACG Meeting was co-hosted by the International Vitamin A
Consultative Group and a local organizing committee coordinated by the
Institute of Nutrition of Central America and Panama (INCAP), and funded
by USAID. IVACG is administered by the OMNI Partner, International Life
Sciences Institute (ILSI). The International Vitamin A Consultative Group
was established in 1975 to guide international activities aimed at
reducing vitamin A deficiency in the world.
For more information, contact:
OMNI
1616 North Fort Myer Dr, Suite 1100, Arlington, Virginia 22209 USA
Tel: 703 528-7474 Fax: 703 528-7480
E-mail: omni@jsi.com
WWW: http://www.jsi.com/intl/omni/home
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Health Care Alliance/USAID Seek US Health Care Institutions for
Partnership Project in Bosnia-Herzegovina
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WASHINGTON, DC -- The American International Health Alliance, Inc.
(AIHA) and the USAID announce the planned expansion of their health care
partnership program with a new partnership in Tuzla, Bosnia-Herzegovina.
AIHA is soliciting expressions of interest from qualified US hospitals and
health care institutions willing to devote substantial in-kind resources,
mainly in the form of human resources committed on a volunteer basis, to a
two-year partnership with counterparts in Bosnia.
The new health care partnership will be part of an ongoing health care
development program financed through USAID and managed by AIHA which
includes forty partnerships in nine countries of Central and Eastern
Europe (CEE) and ten republics of the former Soviet Union. AIHA
partnerships have enabled American health care providers to work with
their colleagues abroad to address significant mortality and morbidity
issues, improve health care organizations and introduce market-oriented
solutions to health system delivery problems. The emphasis of the program
is on professional exchanges involving physicians, nurses, administrators
and technicians. AIHA partnerships also collaborate with related
ministries of health, local and regional health systems administrations,
and schools of health sciences to ensure that critical areas of health
education and administration are adequately addressed at these higher
institutional levels, and that the capacity to carry out other
developmental assistance efforts is enhanced.
The new partnership in Bosnia is intended to further USAID's objective of
promoting ethnic reconciliation and strengthening the on-going peace
process. USAID and AIHA believe that the partnership will reinforce the
credibility of the new Muslim-Croat Federation -- a cornerstone of the
Dayton agreement -- by providing tangible evidence that the Federation can
serve local needs.
The Bosnia partnership will share certain goals with existing CEE
partnerships, namely improving medical and technological knowledge,
expanding the role of nursing, and enhancing institutional management and
financing skills to develop in the Bosnian institution a capacity to
sustain itself financially. Moreover, the partnership will develop
community-based programs impacting the populations served by the Bosnian
partner institutions by, for example, improving the delivery of primary
care and strengthening linkages between hospital and primary care
practitioners.
According to USAID, the success of the Federation ultimately will depend
on "the political will of local communities of Croats and Bosnians to
devise the institutional means to begin their own recovery."
At a later stage of the partnership, AIHA anticipates that the community-
based programs will develop an active multi-sector community participation
that would encourage local leaders to work together to determine local
priorities and implement community-based intervention strategies.
AIHA and USAID expect that the CEE partner will be located in Tuzla, a
city in north-eastern Bosnia where the U.S. military presence is centered.
The hospital component of the partnership may target critical
medical/surgical procedures, emergency medicine, or rehabilitation at
Tuzla~s teaching hospital in addition to management training and
development. The focus of the partnership's community outreach component
will depend upon the priorities of the Bosnian partners.
AIHA/USAID is not the principal funding source for partnership activities,
but rather supplements the voluntary and in-kind contributions of the
partners and their respective communities in the US and abroad. Existing
AIHA partnerships have leveraged nearly three dollars of voluntary support
for every US government dollar expended. AIHA/USAID funds will mainly
support travel and other costs essential in establishing and realizing the
full potential of a partnership program, including communication and
interaction with other partnerships. AIHA staff in Washington, DC
and in Europe will provide logistical support and assist in monitoring the
progress of the partnership.
Interested US partners must have the willingness and capacity to meet the
specific health care delivery needs described above, and must satisfy the
following criteria:
* Be institution-based -- e.g., a hospital or group of hospitals; health
care planning consortium sponsoring a healthy communities project; other
institutions engaged in the implementation and/or the evaluation of a
healthy communities project. If a group of institutions is involved, a
lead institution must be designated;
* Be supported by the institution's senior leadership and Board and
clearly identify an overall partnership coordinator;
* Make substantial voluntary commitment to the partnership through
significant contribution of resources, including human resources;
* Actively involve the local community served by the US partners,
including any significant emigre community that may be present;
* Share information openly and participate fully in AIHA's efforts to
exchange information with other US/CEE and US/NIS partnerships through the
AIHA Partnership Clearinghouse and dissemination conferences and seminars;
* Adhere to AIHA's rigorous objective-setting and results-oriented
approach, including:
(a) Enter into a formal Memorandum of Understanding (MOU) and work within
the overall coordination and guidance of AIHA and its designated program
coordinator;
(b) Develop demonstration-type interventions with significant training
components and capacity for replication;
(c) Establish mechanisms (such as training programs and conferences) for
the diffusion of partnership successes; and
(d) Participate in regular program evaluations to assess partnership
progress and achievements.
Hospitals or health care institutions wishing to be considered for
participation in the new Bosnia partnership should send a short statement
(10 pages maximum) by JUNE 15, 1996 detailing their interest and ability
to enter into a collaborative relationship with a Bosnian partner under
the AIHA model. The statement should describe the institution's
commitment to the partnership program, the human and material resources it
will devote to a partnership, and specific strengths of the institution
that enhance its ability to address the needs of the Bosnian partner.
Working with USAID and an outside advisory panel, AIHA will select the
institution or group of institutions which best match the needs of the
Bosnian partner, best fulfill the criteria listed above, and offer the
greatest potential for sustaining a partnership beyond the availability of
AIHA funding.
Statements should be directed to :
Mr. Donn Rubin
Program Director, Central & Eastern Europe
American International Health Alliance, Inc.
1212 New York Avenue, NW, Suite 750
Washington, DC 20005
For additional information contact Mr. Rubin, or Elizabeth Schroth,
Program Analyst. Tel: (202) 789-1136; Fax: (202) 789-1277.