Unicef and baby food manufacturers. Unicef continues to base its actions and programmes on the best interests of the child.
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Bottle Feeding↗
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UNICEF supports birth control despite Holy See.
The Vatican has failed in its attempt to prevent the UN Children's Fund (UNICEF) from spreading the message of family planning in developing countries. Over the strong objections of the Holy See, the 41-member Executive Board of UNICEF has asked the agency to cooperate with the UN Population Fund (UNFPA) and the WHO "to support family planning in the context of sustainable national healthcare systems." A member of the Executive Board said the Vatican held the view that UNICEF had no legitimate right to be involved in family planning. "But the Holy See was in a minority of one," he said, adding that "the whole problem arises from the fact that the Vatican continues to equate birth control and abortion with family planning." A recently concluded board meeting unanimously adopted a resolution requesting UNICEF to "contribute substantively" to the UNFPA-sponsored International Conference on Population and Development (CPF) set to take place in 1994 in Cairo. The board also asked UNICEF Executive Director James Grant to submit a policy paper "on the involvement of UNICEF in family planning, taking into account the health of the child and the mother." The paper is to be presented for the consideration of the board at its regular session next year, with a view to approving it prior to the ICPD. Prior to the adoption of the resolution, J. Klink, a spokesman for the Holy See, told the Executive Board that there were "concerns" over calls for UNICEF to involve itself in family planning activities. He said UNICEF should not be concerned with family planning because there were other agencies entrusted with that mandate. Responding to the support given by Nordic countries to the UNICEF resolution, Klink said that wealthy nations must not impose dictates as to the "appropriate" size of poor families. "The Holy See would not propose that UNICEF halt its current balanced, informational approach to the spacing of births," he said. "Families must be free to decide their size." UNICEF, he pointed out, had clearly stated that it was not involved in abortion or sterilization and did not provide contraceptives. "UNICEF must continue to respect cultural and religious diversity," he said. At a meeting of the Preparatory Committee of the UN Conference on Environment and Development (UNCED) in April this year, the Vatican succeeded in striking a reference to family planning from a blueprint for development known as Agenda 21. Paragraph 99 of Agenda 21 had originally referred to the need for "integrated healthcare, including universal access to family planning services and the provision of safe contraceptives." But this paragraph was deleted in the final document adopted at UNCED in Rio de Janeiro in June. Given that family planning is the single most effective means with which to contain population growth, the UNFPA considered the omission a retrograde step in handling the dangers of overpopulation and environmental degradation. In Rio de Janeiro, Werner Fornos, president of the Washington-based Population Institute, criticized the Holy See "for interfering in the lives of people throughout the world because of religious dogmas." Grant told the board meeting last month that UNICEF would work with the UNFPA to spread knowledge and support program activities for successful family planning which he said was integral to safe motherhood. Birte Poulsen of Denmark told the meeting that reduced population growth was a prerequisite for sustainable development, and the UNICEF "must accord family planning issues top priority." And Inger Ann Ravum of Norway said the integration of family planning activities into UNICEF's program was welcome.
Behavior↗
UNICEF's rich history in emergency response.
When conflict erupts or natural disasters strike, UNICEF's challenge is to provide for the emergency needs of civilians, especially women and children, who are caught in the crossfire or plagued by the drought or swept away by the flood. When emergency situations arise, threatening to derail UNICEF's ongoing work in a country, the challenge is to adapt programmes to better address the changing needs of the affected population. UNICEF's goal in all countries undergoing emergencies is to build on the work already done to lay the foundation for long-term peace and progress. In most emergency cases, certain core interventions are applied to meet basic needs, including health (UNICEF's largest activity in emergencies), water supply and sanitation, education, nutrition, community development, advocacy and initiatives addressing the special needs of women and children. Specific programmes for unaccompanied children, women's reproductive health, child soldiers, land-mine awareness and child prisoners are also employed in many emergency situations. UNICEF works towards the day when children and women no longer face acute threats to their survival and development; but until such time as natural disasters and man-made conflict no longer pose threats to them, UNICEF remains committed to the range of activities required to ensure their protection and well-being.
Child↗
General condition of children in the Indo-Chinese Peninsula and type of UNICEF programmes.
The total population in the three countries of the Indo-China Peninsula is 62.5 million (1980 estimate) out of which children under the age of 15 comprises 43.9%. Over 80% of the total population belong to rural areas. Available statistics indicate that problems such as high infant and child mortality, high incidence of communicable diseases, malnutrition, low enrollment rate for education, poor quality of education, inadequacy of child care services and poor environmental health conditions, are prevalent in these countries. UNICEF's programmes are geared towards the reduction of these problems and thus cover the following fields: (a) child health; (b) child nutrition, (c) water supply and sanitation, (d) formal and non-formal education, (e) social welfare services for children. The extent to which UNICEF could provide in terms of technical, material and financial assistance is rather small compared to the size of the problem and thus significant efforts will have to be made by the Governments as well as by the U.N. community and voluntary agencies to overcome these problems.
Adolescent↗
Nutrition mission to Iraq for UNICEF.
At the request of UNICEF, the authors conducted a rapid nutritional assessment of children from birth to five years of age in southern Iraq during the second half of June 1991. With support from local UNICEF staff, the nutrition team examined 680 children, measuring weight, height, and mid-upper arm circumference and observing clinical signs of anemia, vitamin A deficiency, and dehydration. These measurements and observations were performed in 14 rural, urban, and periurban settings in Basrah and Amarah governorates. Evidence of both acute and chronic malnutrition was found in large numbers of the children examined. However, the acute nutritional signs of impending famine were not evident at the time of the survey. This is true notwithstanding epidemic levels of infectious disease, market prices for basic food items three to 20 times prewar levels, and a reported crisis in mothers' ability to breastfeed. Other signs of impending famine (distress sales of family assets, disintegration of social structures, etc.) may have existed, but were not evident to the team.
Child Nutritional Physiological Phenomena↗
UNICEF's child injury league table. An analysis of legislation: more mixed messages.
This paper presents a summary table and discussion of legislation related to child injury prevention in member countries of the Organisation for Economic Cooperation and Development. The table is an expanded version of the one which appeared in the UNICEF Report Card "Child Deaths by Injury in Rich Countries" (2001). A commentary is provided on the variations in legislation between countries in terms of range and form of measures and an estimate of degree of enforcement. As legislation is generally considered a powerful tool in injury prevention, the paper examines whether those countries with the widest range of legislation and the strongest enforcement have made the most progress in reducing child injury deaths since the 1970s. It also considers whether a commitment to extensive legislation is reflected in a country's position in the UNICEF league table of injury death. The initial conclusion to these two basic issues is that no clear picture can be seen and we thus need to know far more about the relationship between legislation and societies and cultures as they vary from place to place. This paper hopes to stimulate more widespread debate about the role of legislation in different countries.
Accident Prevention↗
Global millennium targets: UNICEF Child-Friendly Hospital Initiative.
Twelve standards for children's hospitals have been drafted by the UK Committee for UNICEF and are to be piloted in the UK. Here is a summary from UNICEF of the targets that will help to change attitudes to child care.
Child↗
UNICEF policy and perspectives: child survival, population growth, environment and development.
UNLABELLED: Rapid population growth is clearly a major problem in the world today. But to argue, as some do, that attempts to reduce child mortality by such means as vaccination should be abandoned, as a means of reducing population growth, is a fallacy for the following reasons. (i) Reducing child mortality has only a small effect on the population growth rate. (ii) Increasing child survival leads to a reduction in the numbers of children conceived. (iii) POPULATION: land ratios are not the main source of environmental pressure. (iv) It is the affluence of developed countries which contributes mainly to the pressure on available resources. The policy of UNICEF is thus to improve maternal and child health, to support and extend family planning programmes, and to seek to reduce the prevalence of very early marriage and teenage pregnancy.
Child↗
Breastfeeding promotion in non-UNICEF-certified hospitals and long-term breastfeeding success in Germany.
AIM: To assess breastfeeding practices using the World Health Organization/United Nations Children's Fund (WHO/UNICEF) Ten Steps to Successful Breastfeeding for Baby-Friendly Hospitals in unselected non-UNICEF certified German hospitals and to examine the influences of breastfeeding promotion on long-term breastfeeding success as assessed by WHO criteria. METHODS: Information on the fulfilment of the Ten Steps was collected in 177 randomly chosen maternity hospitals by a postal questionnaire. Breastfeeding duration was assessed in 1487 mothers delivering in these hospitals. Multiple logistic regression was used to estimate the association between a low breastfeeding promotion index, defined as fulfilment of fewer than five steps, and the risk of short-term breastfeeding, less than 4 mo. RESULTS: A higher breastfeeding promotion index was not associated with early breastfeeding but was significantly associated with full breastfeeding at 4 and 6 mo. After adjusting for confounding factors, delivering in a hospital with a low breastfeeding promotion index was associated with an increased risk of short-term breastfeeding [odds ratio (OR) 1.24], although associations with maternal demographic variables (young age: OR 3.34), low educational level (OR 2.81) and upbringing in East Germany (OR 2.27) were stronger. CONCLUSION: In unselected German hospitals even moderate levels of breastfeeding promotion identified by WHO/UNICEF criteria were associated with long-term breastfeeding success.
Adult↗
Disseminating research to different audiences: lessons learned from the UNICEF Innocenti Report Card Project.
As the academic world becomes increasingly aware of the need to improve the dissemination of research, this article considers some of the theoretical issues involved in the communication of research to non-specialist audiences. It also demonstrates how theory can be put into practice using the case study of a UNICEF Innocenti Report Card on childhood injury.
Child↗
The Child-Friendly Healthcare Initiative (CFHI): Healthcare provision in accordance with the UN Convention on the Rights of the Child. Child Advocacy International. Department of Child and Adolescent Health and Development of the World Health Organization (WHO). Royal College of Nursing (UK). Royal College of Paediatrics and Child Health (UK). United Nations Children's Fund (UNICEF).
OBJECTIVE: Although modern medical technology and treatment regimens in well-resourced countries have improved the survival of sick or injured children, most of the world's families do not have access to adequate health care. Many hospitals in poorly resourced countries do not have basic water and sanitation, a reliable electricity supply, or even minimal security. The staff, both clinical and nonclinical, are often underpaid and sometimes undervalued by their communities. In many countries there continues to be minimal, if any, pain control, and the indiscriminate use of powerful antibiotics leads to a proliferation of multiresistant pathogens. Even in well-resourced countries, advances in health care have not always been accompanied by commensurate attention to the child's wider well-being and sufficient concerns about their anxieties, fears, and suffering. In accordance with the United Nations Convention on the Rights of the Child,(1) the proposals set out in this article aim to develop a system of care that will focus on the physical, psychological, and emotional well-being of children attending health care facilities, particularly as inpatients. DESIGN OF THE PROGRAM: To develop in consultation with local health care professionals and international organizations, globally applicable standards that will help to ensure that practices in hospitals and health centers everywhere respect children's rights, not only to survival and avoidance of morbidity, but also to their protection from unnecessary suffering and their informed participation in treatment. Child Advocacy International will liase closely with the Department of Child and Adolescent Health and Development of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) in the implementation of the pilot scheme in 6 countries. In hospitals providing maternity and newborn infant care, the program will be closely linked with the Baby Friendly Hospital Initiative of WHO/UNICEF that aims to strengthen support for breastfeeding. United Nations Children's Fund, United Nations Convention on the Rights of the Child, child protection, breastfeeding, pain control, palliative care, child abuse.
Child↗
[Mortality rate of children under 5 years of age proposed by UNICEF: critical analysis of its validity as a health indicator].
The relationship between the Mortality Rate for children under age 5 as proposed by UNICEF and classical mortality indicators-infant mortality, mortality rates for children under age 1, for age 1 to 4, mortality for children under 5, and the probability of death from birth to 5 years of age, is evaluated. The theoretical equivalence between the rate and 5q0 is shown by means of a Lexis diagram. Practical evaluation is carried out using data from the 24 areas under analysis in the Inter-American Investigation of Mortality in Childhood. Kendall's Correlation shows high agreement between the rate and classical indicators, mainly for the Coefficient for children under 5 and for infant mortality.
Birth Certificates↗
A letter of concern from the People's Health Movement regarding the appointment of Ms. Ann Veneman as Executive Director of UNICEF, effective May 2005.
This letter from members of the People's Health Movement to U.N. Secretary General Kofi Annan expresses concern about the appointment of Ann Veneman as the new Executive Director of UNICEF, based on her past performance on issues affecting children's health, and criticizes the processes used in making this and similar U.N. appointments, which reward powerful countries with the ability to make political appointments to important posts.
Administrative Personnel↗
A fundamental shift in the approach to international health by WHO, UNICEF, and the World Bank: instances of the practice of "intellectual fascism" and totalitarianism in some Asian countries.
Navarro has used the term "intellectual fascism" to depict the intellectual situation in the McCarthy era. Intellectual fascism is now more malignant in the poor countries of the world. The Indian Subcontinent, China, and some other Asian countries provide the context. The struggles of the working class culminated in the Alma-Ata Declaration of self-reliance in health by the peoples of the world. To protect their commercial and political interests, retribution from the rich countries was sharp and swift, they "invented" Selective Primary Health Care and used WHO, UNICEF, the World Bank, and other agencies to let loose on poor countries a barrage of "international initiatives" as global programs on immunization, AIDS, and tuberculosis. These programs were astonishingly defective in concept, design, and implementation. The agencies refused to take note of such criticisms when they were published by others. They have been fascistic, ahistorical, grossly unscientific, and Goebbelsian propagandists. The conscience keepers of public health have mostly kept quiet.
Asia↗
Treatment in Kenyan rural health facilities: projected drug costs using the WHO-UNICEF integrated management of childhood illness (IMCI) guidelines.
Guidelines for the integrated management of childhood illness (IMCI) in peripheral health facilities have been developed by WHO and UNICEF to improve the recognition and treatment of common causes of childhood death. To evaluate the impact of the guidelines on treatment costs, we compared the cost of drugs actually prescribed to a sample of 747 sick children aged 2-59 months in rural health facilities in western Kenya with the cost of drugs had the children been managed using the IMCI guidelines. The average cost of drugs actually prescribed per child was US$ 0.44 (1996 US$). Antibiotics were the most costly component, with phenoxymethylpenicillin syrup accounting for 59% of the cost of all the drugs prescribed. Of the 295 prescriptions for phenoxymethylpenicillin syrup, 223 (76%) were for treatment of colds or cough. The cost of drugs that would have been prescribed had the same children been managed with the IMCI guidelines ranged from US$ 0.16 per patient (based on a formulary of larger-dose tablets and a home remedy for cough) to US$ 0.39 per patient (based on a formulary of syrups or paediatric-dose tablets and a commercial cough preparation). Treatment of coughs and colds with antibiotics is not recommended in the Kenyan or in the IMCI guidelines. Compliance with existing treatment guidelines for the management of acute respiratory infections would have halved the cost of the drugs prescribed. The estimated cost of the drugs needed to treat children using the IMCI guidelines was less than the cost of the drugs actually prescribed, but varied considerably depending on the dosage forms and whether a commercial cough preparation was used.
Child Health Services↗
Dental caries trends in 5 to 6 year-old and 11 to 13 year-old children in two UNICEF designated regions: Sub-Saharan Africa, and Middle East and North Africa, 1970-2000.
The purpose of this study was to do a systematic review of published caries epidemiology studies in two UNICEF defined regions, Sub-Sahara Africa, and the Middle-East and North Africa that contain 63 developing countries. On-line searches were made of articles listed in Medline using PubMed to investigate trends in dental caries in 5 to 6 year-old, and 11 to 13-year-old children using defined inclusion criteria. Of 493 listed publications, 70 fulfilled the inclusion criteria. The percentage caries rates and mean dmft, as well as mean DMFT scores, were plotted against study year. Non-significant percentage caries prevalence trends were downward in Sub-Saharan Africa for both 5-6 year-olds and 11-13 year-olds while in Middle-East and North Africa caries prevalence remained constant over the 30-year review period in both age groups. Mean dmft scores significantly diminished in 5-6 year-olds during the study period (y = 200-0.1x, P = 0.05) in Sub-Saharan Africa but the scores remained constant in the Middle-East and North Africa. Mean DMFT scores remained constant in 11-13 year-olds in both Sub-Saharan Africa and the Middle-East and North Africa. When the mean dmft and DMFT scores per carious mouth were calculated both age groups in Sub-Saharan Africa showed clear reductions, that for 11 to 13 year-olds was statistically significant (y = 170-0.084x, P = 0.014). In the Middle-East and North Africa the trends in the two age groups remained unchanged.
Adolescent↗
[Experiences with introduction of the UNICEF program "10 steps for successful breast feeding"].
UNICEF's program "The Baby-Friendly Hospital Initiative" launched in 1990 has met with some criticism in various places of Central Europe, since breast-feeding has already reached a high level in these areas. Despite that fact the Hospital Limmattal decided to introduce the program. Although the frequency of breast-feeding had attained over 90% at discharge from our clinic before the program was introduced, it could be further improved after four months. Prior to the introduction of the 10-step initiative, 56% (103) of the mothers had still been fully breast-feeding their babies after four months (82 women had completely or partially weaned their babies, 54 women did not respond). After the introduction the number of fully breast-feeding mothers rose to 61% (129) (83 women had partially or completely weaned their babies, 27 did not respond). Chi-square test: p = 0.01. At present the frequency of breast-feeding at clinical discharge is 97% (92% full breast-feeding); in 83% tea is also fed during childbed (50% thereof with less than the total of 50 ml), 66% of the babies can do without pacifiers, and in 82% the use of the bottle is superfluous. The combination of individual care with the introduction of the 10-step initiative has certainly rendered work in the maternity ward more demanding, but also more satisfactory owing to the staff's improved competence.
Breast Feeding↗
Programmes proposed by UNICEF in support of breast-feeding.
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Breast Feeding↗