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  • UNICEF: The State of The World's Children 1986

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    UNICEF
    967 tayangan169 halaman
    The State of the World's Children 1986 looks at the recent surge forward in immunization and describes how the strategy of social mobilization is being used to put this and other low-cost child protection techniques at the disposal of millions of parents. The second part of the report brings together a distillation of facts and examples, recent research findings and current expert opinion, on the major low-cost opportunities now available for protecting child’s lives and development – including sections on growth monitoring, oral rehydration therapy, breastfeeding and weaning, immunization, respiratory infections and female education. To learn more, please visit: http://www.unicef.org

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    UNICEF: The State of the World's Children 1986

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    The State of the World's Children 1986 looks at the recent surge forward in immunization and describes how the strategy of social mobilization is being used to put this and other low-cost child protection techniques at the disposal of millions of parents. The second part of the report brings together a distillation of facts and examples, recent research findings and current expert opinion, on the major low-cost opportunities now available for protecting child’s lives and development – including sections on growth monitoring, oral rehydration therapy, breastfeeding and weaning, immunization, respiratory infections and female education. To learn more, please visit: http://www.unicef.org

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    967 tayangan169 halaman

    UNICEF: The State of The World's Children 1986

    Diunggah oleh

    UNICEF
    The State of the World's Children 1986 looks at the recent surge forward in immunization and describes how the strategy of social mobilization is being used to put this and other low-cost child protection techniques at the disposal of millions of parents. The second part of the report brings together a distillation of facts and examples, recent research findings and current expert opinion, on the major low-cost opportunities now available for protecting child’s lives and development – including sections on growth monitoring, oral rehydration therapy, breastfeeding and weaning, immunization, respiratory infections and female education. To learn more, please visit: http://www.unicef.org

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    Attribution Non-Commercial (BY-NC)
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    dari 169

    THE STATE

    OF THEWORLD'S
    CHILDREN
    1986

    Un ited Nations Chi Id ren's Fund


    (UNICEF)
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    p,.., loy " 5: L ........ &0-. ~ UX
    THE STATE
    OF THEWORLD'S
    CHILDREN
    1986

    -
    James P. G rant
    Executive Director of the
    United Nations Children's Fund
    (UNICEF)

    PUI ,JSHED FOa US 'CEF

    Oxford University Press


    CONTENTS

    I THE STATE OF THE WORLD'S CHILDREN 1986


    Immunization
    o.-.llor . . . - .. dot twO,.... .... _ _.. _
    -~_.. . .... _..,..;r,. .. ""
    leads the way
    :-,tlS,~...:::~_ ""'~"""~~-::'
    ..".j, • ., • _'0 - .
    -:':---:
    Mcoo-. __ io
    .. ..
    ~
    ,eli,... ·_io....."
    ,II<'" ,_ ........bfIW<>Ilo<.-...
    '" -.II _ • .-
    opnd.r_oI
    tlo< _ 011 ~,..,.... .... _ _ _

    Reaching
    all children

    .._o<_.. . _.._ _ _
    _.. _. -
    .-W-_"'..-olboat7__ __
    ~

    The benefits .... _.... _


    4oJ. 's io ' _
    for women
    ....
    _ of _
    .. ...
    . _ ... _ '" - . - ..... IIdp .. IIftIIoI _

    _ i1 ......,.... _ _ .mlW -"


    The self-health
    potential
    -----
    --._._-_--......--:-_ .. _..
    .......
    ,
    ?
    r .... '
    .,... ... _ _
    -w.. .. _
    _
    _ .. _
    ,
    .... 1._
    .. _
    ._
    ......,
    .............-.n.
    "
    "
    "
    *
    ~
    '

    _
    _ , "_
    ,p_ _ 0I i 1 _e
    ........ >'":r ... .....w_ ........

    __.$ . _T.. . . _ ._.. -"


    Children and
    world development
    l1I<~

    _
    ~ _.----_

    _ _
    ,....,
    . dM
    ..
    _ _..... _
    __..
    __ •

    * 2
    "

    .. _ - - - , . $: .. ...... _ - - ..

    il il '
    _
    ",-. "

    -..--.
    . . , . _ . ... _

    Jcw
    _ Mo...,,"'.._ _Ioooi< _ _
    , ."lIIia-...
    ,
    II LIFELINES ill STATISrICS
    E% l rrt ~ and ,llInIJWi.. from rCC<:Dt research Economic and social amisticson the pallonsof
    and ",ri, ing on COi\I..<ITeruve $lra,q ies for , h. world, with particular reference t<>
    p">le<:t;n,l the U_ and lIOI'1JW development children'. wd l-bting.
    of lh. world's cltild=

    F ull index

    Growth monitoring
    - ""
    ~,
    A .... OIl I!>< .... iDdn ... in/." ,
    .... cIIild......wy
    A1pb1be<ka1 - . to """",ric>
    /101'
    _lll
    no

    Basic indicators

    --
    .... lll
    Oral reh ydration
    therapy • Nutrition !'"II' l~

    -,. •
    Breast-feeding Health
    - '"
    Immunization Education
    - '"
    Iron, iodine and Demographic indicators
    vitamin A _107 -'"
    Economic indicators """. 1'1
    Acute respiratory
    infections """. 110 Basic indicators for less

    Combating malaria _II'


    populous countries
    -"
    Sill.. -.t " pIaM<o-, ..,..ru _.
    ...... <lit. _lOS
    Female education ..... 111

    Food supplements _11 9 .......


    I'........ ,. ti l ..ble< _1 ' /
    r<l< l lll

    _lS I
    ~-
    Family spacing _Ill N",. .. ...n.u..o. io I"' ~ ,,;,IW> .-"" ... _ ISl
    PANElS

    ~tion:
    a ~ pge Iorwan:l 1 ......., Ci,e""'.... 14
    ""~ WI
    Immunlutlon:
    a new SU'08 Iofward (coot) 2 Etlliop\tl:
    15
    the $llenl emergeocy
    Turb y:
    to imt'nurnze 5 milliOn 3 Balli1adMh:
    16
    visl!Ing 5 million homeS

    EI Salvador.
    chOClI80 - a zone or peace 4 Niger" :
    going naliOn-w!de 17
    C<I'om ~:
    a chikl Sl.n'IYaI pliIn 5 Sri u nlte:
    18
    leaching lhI poOIesl

    6 """,
    _ 19
    8urklna ':..0:
    a . . . . ii1lJOn OO,"".dO OAT reaches !he ITIiIfOrity

    ....... .....
    Domlnlcan Republic:
    7 ' '''''
    IOwaIOs • 20
    l)OIic)-free Madras

    ••11."
    l1ICluclng ch ,kl oea.1tIs 8 1lI8Iland:
    PH(; in prlIC!ICe 21
    EiYpt :
    lead ing 100 WOfkl on ORT 9 Iodin.:
    22
    protecl,ng !he mifld

    BriWl :
    wec::dnellng 20 miIion 10 a Cod.:
    The
    pl'ogr_ repofl 23
    P. "" q,n:
    SlM"Ig 100.000 lives 11 P.rasltes: 24
    !he diVnllge 10 grow1h

    Hlcar8gu.:
    chid dealhs down 30... 12 POp 'lI, tIon:
    25
    less dAh - less t.1h5

    IlIdou....:
    cne miIion hea/lh worketI 13 Vlt8m11l A:
    _22
    $IOfY ot • bfeaklhrough
    TEXT FIGURES

    Fio. Estimated 3!111Ua l numbers of (Jea lhs and prevellled OO,Hhs !rom VacClflIt-
    ptCVC011able diseases (chtld<en undel 5)

    Fig 2 Imml/fOllng all children by 19 90 progress achill _ea and prog,ll$S '9Quued

    Fig. 3 Percentage 01 pregnant women immuniZed a<;jatrlSl tetanus


    F. • Petcentago of Children immunlled 1I1 me first year ot Ille

    F. , 5 l'etcentllge of infants fully immunized. Paklstan, 1980-1 987


    F. Global SllppIy 01 oral rehydra tJon sans {WHO/ UNICEF fo<mu",)

    Fig. 7 Dechne In bleast·leedioO. SAo Paulo, Btaz~. 197 4-1980


    Fig 8 1mpa<;1 ot ORT on ""'ant dearns. Alel<3nd<ia. Egypt. 1980-1984
    Fig 9 Changes in l'eaUT1el11 lor <1iarrhocal (lI$CilSO, $odan, 1980-1 982
    Fog.! 0 DevaIopmg coonlnes prOllUCIJlg oral rehyarallOO sans
    FIll.l t Male and lemale shares 01 agriculllll's i rases and lr81nWlg, AfJK:a
    FIlI 12 RelallVe rales of inlecbon by feed,ng meThod
    FIQ.13 OwoerSll,p Ollarld ana oa)~ Inta~ e 01 1000. Manaras/11ra. If\Clla , 198 2

    Fig.14 Inlan! deaths by btflh interval, uneducated mothers, 25 eccouee

    Fill 15 DlaI1'tloe3I illoess by teeding method and oncome. Dar-es-Sataam

    FIll.16 Energy content of children 's ccts. nell and po(lf nabons
    Fill 11 Breast·feedlng and cacoe jntake in 100 secooc year of hTe
    Fog . ' 8 Effect of OAT on welgh! gam ltl ChIldren W11l' diarrhoea
    FIg. l 9 MlUtaJ'f an<l akl c, pendilures, ,nouslrializcd naiIOOS, \ 960- 198 2

    FIg.20 Food r><oouc1iol1 pof person. Atnca. ASIa . and la~" AmerICil . 1961 ~ 1983

    FIQ 21 eeeese in low b.,lh--weigllt. Recilc. B'31~, 19 77- 1984

    FIQ. 22 lncroase 111 child malnutritlon, GIlarl3. 19 80- T983


    PREFACE
    Tho lange at _ which <:aJId legoldT\lltely be SOCIal. tislOflCal. 5l'lOO<l\IlI'IOClII. IIQflCIiIurIL But ..n<d
    """"""'" ....",. D>e titIot I"., SIaM 0: /I'le ~ 's Is I{lQ\IIrel;I now 011 no! 8 mole ' e!1IIlJd and ~Ieo
    ChiIttJIen" clea rly _ ""'" 1M focus 01 """ year 's 8N1~ 01 ~ to.rl rJlOf<I Pfactical and aIfeocIIwI

    ""'"
    In PWlOJIar. lt1e eHe<;ts 01 eocooornoc ' flO ' .,
    ways ol ~ poopI& 10 _ale lt1emse1Yas
    from n.
    continue 10 ..... beI.te IIIIougfI Itle worId "s poorest To actIIeYe ll>et means ,,*,ll/y1ng Pf3Clocal $lartl<lg-
    ~ as Inct......... ~ ani! taM..... PD/nl!l. FDI tile prDOlem O! IeSll 0I<eIv to M::<:umb to 8
    reaJ 'Na\I9S bear down most Iltt3Wy "" """'" """" ~ ana ~ oot 01 BDIUti<lns .,t,1Ch
    sPe'ld !he ~ percen tago 01 ' - Irocome on """" to t>ll 'ea!izecl all al """" ttwll0 a $lnlC!Ul' od
    nec8SlIIt~ - !he POOl AI ee
    SilITlI! Ilmll. gcwernmeol _ D1llC!l1evab1e pie wnich, Whllo! lle<ng mxx,>n&n!
    CUl-backs on sum...._ IIems 01 ~e aa i'l ~, aIsD IIIlIp to l!Ia(l " " wat. stGll by
    _ bod SlltlSiIl.es also leave e~
    dnc$ III'(j acnievable Sl"ll, towa/<!s more com~ lonrr
    lMose "'"" are moot ~ on """" SOlIVIces - \erJ1I P< <>O< _ .
    "II"'" lIle poor As . resull. progress !OI ChIldren II
    To find IIl.O;:/l bego ....... ~ Is v/taI 10 IlOClI lhe
    t>eong se-ee down ., """'" natJons Dr<! ll'iI""'" ln10 aceurr>JtIllecl knD,A'dge 01 a _lJOtl 01 deYeIo:oD-
    ,......se In O!he<a.
    ,,*,1 al!DtI$ and lei """ tl'os pas t e><pene(lCe to ~
    ....1 yeas • s;>edal UNlC[F $l""Y ~ rile /mpaI:l or the a :taek "" DIeserd PfDlllems
    Wctta f/e( e:>SiOI ' "" CtWdten- 08I3Iled the llIC1CeSS by
    _ !he ~ bu,-.
    01 fIC(IOiOOroc rec8SSIOn .. '"
    In !he (lrOCeSl;, many 01 tt>ose II"IDS1 cioseI'y """CWecl
    ara <:omofl!lto !he~ ll>el we are row t3l*l no1
    mDISI ClISeS paswl on 10 IhOOll """ are leasl _ 10
    ~ wittI 11"""1 <lolf!O.lllias ll<rt IIISO Wltt1 a Yf!fY grea t
    IIIISla<n~ This year. ' '''''''''''" '" II>e CDIIl."""ll1mpacl DQIXIItuf'W!'I FDI n Os cIeaI th31 mate are OON .......eral
    of that process on \he _ 01 the pooteSl Cl\ildren ..
    Iow-<:Dsl and poI""tJaIy "et'/ PD'W'!<luI WO\'$ OIIl'DlGCl-
    conbf'UirolllO conI!! In lsee, for e"""'llle. r 001 . 21 iIld ing !he Ms and rhot norrTIBl ae.eIopmenl 01 many
    22 '" !tie nIlIin_ of !IlII f8lIOI1l. - . . DI dliIOren In Wll\'$ which are DOlil>Cdy and
    _ "'""'*MteIy, 1M CfJsis lor lIle !l0 "....1 IS ~ _ ....., "' :such d ,ho::ull econoIJ'IIC
    s.;rl8Cll'\g Itl SUb-Satw.., Amea ..r>erlt, asai m.. world ItmeS The C<loIII::I<lenc of technical and SOCIlII ..,.
    I'Ios WIIneSSed . IIIe lailur'e 01 (levelopmenI_ and o! IIIol ....-.- WIlid\ IIItI CI....lGd tl'II$ ~ Os ,.... !~
    ,...... - !IaS pus!l(I(Ilw,md. - oIlhOO5an<lS oIlM11loes 10 """". and lis poIIlnllal lS t!lerelDnI vasI:iIi <nIere>.plooted .
    lhe m;org..., 01 SUN1YaI and Ile'/<>n<l Beo;ause 01 IlIlI ThII1 IS WIly lM; \'881'1 Sla!e 01l1li WO!ld"s CI"oldrel'
    <ltWJt\lIlV anl! 00tIIPIe...... 01 lM crisls. lJl\lCEf Ms IIIiS ,epon 1"""",,, on • Iom<lad ~ o! """""",,tIIa 8IIlII
    _ 1J,JI;IIistIOO • SfP8<3le tel>O" 0I11h11 D1oll1&ms n(l\O/ sucn "I "'_ lmmt.nIzallDll, ItIe SIll'MIl or oral
    tac.'lll "'" p<lOfflSl ~, """ P3tIlCuIarIY IN rehYQrallon ther3O)' (OAT), ancl ll1elDw-QQ$l P!8'tel"l1iOn
    C!IIlOrtIn, 01 Akg DI malnuII\tion - .-ns WIlid\ at. ''''''''''IID lIIe _ 01
    S<IC/l PJtIbIems hi... *'
    ~ted ,alt>el 1ha<1
    caused by immedoale prllSSUtes sum as tee .ion ond
    children OON as ..... as to 1or1gar-19f111 ~
    In tnis oon le><l, the ,easons lor seIecllng 1l>8Ia
    IlfOU\lll1 E""" In j9Im 01 ~ ,• ." ... . " ""'I' millooros parocu!ar I)tI(lriIlaI ~ be ""'PI'; a><pIar,e(l.-
    01 r,Na,en at. Il'ow.ng UP o:l!!lJorlWld of whal m:J$l
    peapIe IM<!ing lM page WOUI<l ~ to De _ o TaKen IOg&IIW, \tlICClnOl-ll''''''''liID1<l "'fecllons,
    1'I"O!I$SIl0llS oIli1e -8deQuate bod, <:le"" .... ter. sate d<arfhoeal oseese. anclllOO< 001rl!1QfliIi 11e1111ll, CO"ISII-
    ......<l!M. ~ tlducallOl\ 0 .-.:1 compelenl - . IuIa II'\' fat rn. II"IDS1 imponam pro!lIam ., ""l" GlbIacIMl
    cace, COf'llOdera l"'"of the 'SUIte o! the lio<)<\i;i'1 ~ '
    Common 10 _ all - eIOpi< 'lI CO<.<ltnos, II1ey
    8IJt IaceO ..rh a mvnad Oh>«sc prOOIems, BI'ICl an accoont lor ll>a great majonI)o of fr.e 15 .....", .,tam
    IIIrl1l;JGl ~ s/IoI1iIge 01 resourc«I tor o:IeaIlng W!tfl Mel crIIld dee.1h$ in lila world eiId'l yea. and a~ the
    !hem. IhOOll cl>arged "" Ih 1M ~DilI:y 01 l"fl"g 10 orint:lPal cause D1 both Dh'/SClIland mental ~
    bnng atlOUl pmc\IClII ~lS ... !fie ...... 01
    cllben """" no <:I'lQiCe 1>.>1 10 """,0 """'" <lto<>slons o The t8<:tlI"*'Oy acd ll>a io.r"oN1edga 10 soIWI tlIesoo
    problems ilIO row ava ilat*' ill a COSI I'tIoch most
    """~ . nafoons ancl """'I IatniOBs couIcl 8i'lof(l _ In hard
    The 1"_'" 01 ~ are ..1imely ",,,,,pi',. The econorn<: w.- -
    espeaaIIy Wl1/'l a mo<lCI.<I'I ot lIlIIliflla-
    ca_, "" II wefI i<ncMrl. lIl'e POiI>caI . """""""". , ~ ..".,
    a MollirJ\lIlIwell
    ~
    "IllOi*' 01CIlMI
    III. ... " " " " - _ ..-.
    In! _ encugI1 lor
    ~
    _ _ _ lOlIero......... !*' . . . . '"
    _ _ I .. ""'" ~ III NCNl IIIInII'\'
    _ 0 1 _ 0 1 ' " '...
    ~ _ _ " ......lU .
    _~

    IIl<'" ...- . - , '" c!oII).


    __
    Within
    -'''--~
    0 ' " """'"_
    _ . . , ... d'
    .... _ _
    _IIIIIPtr'
    tlllJ'l:IIt' r-. .. _
    "' _ _
    _1Ic.it:W 1 0 - . ......... _
    " ......
    _1'1 .
    ~
    ~
    Human
    Reach-
    'i' iQ ~'

    -
    twpplI\ ...
    .... ' >JOt n. .. ". -_ ~ corn-
    _

    .._ _ Ill lolll ' ~.

    _
    _
    Ortr
    . ..
    ,..
    '_41
    IIr.dliQ _"*""'"
    _ -.g

    _ . . . " . O R T _ ~ _

    It.e ...
    I*lPIa
    ......illlV-.g
    ~CIn
    _
    __
    ......
    _
    "
    __
    ... afuture for
    Africa'S children
    __ .. .1'1- ".•••.
    _ _

    II'""*Y_..... ~.
    i Ill< ... - .
    _ CIn" toI

    FoI
    roo
    "'_• •
    "' __

    .,...I-'
    """*""'" nus san1al u~m' n'p.n
    OOCumlns~~d~
    - . --.; -
    ."._ "*"" oIiIr1an_
    ...... _ " , i t
    lor ..
    ' I llIDIIl trlJn:I uc lkdine d t.q ~an:lards
    il \Cfb ani ~ tIE IR1kal
    .......__"'.knl_
    .... n I ' ClIlPC>'V!IIY Ill<

    _ _ 10 _ . . , . . . . _ '"
    '" '
    ~_.
    _
    ._

    ogonI
    step> _tlI:tl C3Il ani are ~ IlW.'n
    10catnn th: mss, The maP'
    - ' Y_1II "..,. 1ftd .. ""''''' ' .. argumerl d ~ 1l1JOl\ is 1hiI. UI'
    fa''' '" .. _ b::I.- .... _ Il.'gkn u tIE bJman dilntrtiirl' is a
    . . . ~ -tfld .... "'-1I*:Ik -.I coe....
    _ _ I!!lXtI CIn co. .. 10 biG . , , , _ maJ:r c::3IR d ACooI's prem.
    . " . _ _ • -.g ..•.... ·0 .... · - . . prOOIc:m; am 1M. DUns " iI
    ............. - b' etob'en "' ,.., IldllY dqmd 00 linlq "'lI)'S 10 IiIQa&c
    alii enIwk:e ee l.U'tl'ib.lm ..1*.11
    As ... DrIIlJ .... .. , ~ _-'-1 id\ iOOaIlTOl and ..unm rnaI;(> 10
    '
    ~ - ' -by ~- -Fo'""""JIlIl
    - - - ... _ ....-..,
    _ ..." Deong
    • the. dt.'\~ d ire lXlItJtICI'L
    _ 'eQllll . <;01 .., .... . -.-.10 ....,., .....
    ~ , .., <lI!IQoII _ '" ..-uIQ'1OClel\' The repIrt is a-.'3ilati:l in I::nelish and
    10 ~ bnI'lQ ". 0l'IIV'I2..... gI . . . ~'rcndI. nee u dIiV"ge. from LL\ K};F
    - . . . . . . ""'c7I .. .-aolI' IOKIIiC 10 ..", HcadllllalU.'lS (866 UN rtrza, 1'OcIl'
    tell>T/ _ ..,.. ~

    rcrt. Nr IOOl7.lJ&\j. from U,\JQ;r

    ~
    n. _ co'" ...... IacIIlt .. _.101.
    llUIl'1e _CMJ' rtolle_ "' llIClI lOI~ gOalS
    net ""' UC:i!I:kjOOltCT'S b ElIfOIXl (PaIat;
    tb ~(}i- 1 211 Qn."lllO,
    _ <:a'I toI tUlItYtd Ill< _ now r_ tI.
    S'foilMland). from ruDlnal and
    _ ""*
    ~ "" """'C/'l ....., or-. '" IlII COIl I\elI) III lito."".

    -
    AncI "" 000'lQ IIIlI ~ """",, _ _ I1'gIooaI UNI(U' c-nk:ffi. md from
    or-. ~ IiIIl _ ac:Iloe""'ll "'" ilV4ldt Nlliooal QlITIlTI ~tooi for UN I(}; ~',
    - - - -1 - -- -
    THE STATE
    OF THEWORLD'S
    CHILDREN
    1986
    James P. Grant

    Immunization leads the way


    Reaching all children

    T be benefits for women


    The self-health potential

    Children and world development


    I THE STATE OF THE WORLDS CHJLDREN 1986

    IIII,""l MortalitJ Rate


    "1'boo infaat lDllrIllity "Ue (IMR) .. tIM: Il lU11M
    fA cIeatIlI bd'0ln' 1M I&l' 01 OM JUt -pc IIJ'/J
    1m birtht.
    Fipra Ii..", lor the ia!mt lDlIrt&Iily rita vi
    .,.ua.Jar ~ ill boch the lal aad
    _ ..jsrinl tabla 01 this rqxJrt,. an. l::AilDlllS
    prepared b7 do<- Van"'" N........ Papt......
    0;..... _ . . ;"temrim.Dy ~ bias,
    IIIiIlI ...an- -=s. l l l _ ~ u.- ....,.
    IiifJcr rrc... " aliJmt...
    M-. n u 1lMR licurcs an: coIk cud na"l'
    live or tal l'OI' • pm or the n . . . . .1 ~
    and do _ I'd ldI«t tbe impKI of uy vi II..
    remll CllIl~ and child ..,mval ptIlIruIIIIICI
    Illf:fItional in !he
    tal.
    .. ; <

    Immunization leads the way


    IklpilC Ihe coo1inuillic:rWs in Africa,' lbcK is portillo of I nation'. par<:ot. than ~ normally
    dl'LlDltic prOSral to 'CJKll1 this year on lhe tDlOdled by modcrn bealth smrm. T ogctbct witb
    S[TUU Ie 10 implOV1: l be ~.cs and lb. health of impro,"t<! vxcinc tochnologies and thc traitlioB of
    "","y millio... of !he world', children. lIWIy thOUSlltldl of immUoiutiOD tUI1ll in WC
    [n ,b. la, rigJuttn months, "",.raJ nations 198iA, th ese new O\Itrnch .tntcgies now offer a
    new dlan« to bring immuniutioa to thc vUl
    ha. c doubled and trebled their 1"",,1s of immlmi ·
    majority of lhc world'. dllld ~n within tM oat
    zatinn agains t tht n<rin~pm'.nlabl. diseases
    which were l,illinS al""",
    4 million cbildre n a
    fcw yean.
    }"..r and leaving onolnt' 4 million permanc",ly Acting "" tbis infOn'llllion , th c Scc~tary­
    dis>bkd. Throughout 1985, world-wide demand General of lbe United NatiOD$ h.ol; tlIkffl the
    for """"ines has bom running al appmn m'" cly UIIpread.... ted ..ep of writing to tbo preside nts or
    ,lue<: \;m.,, ;1:1 1983 ~l ' and the annual number prime miniSlC," of alii S9 J1tO'Iltber it. lC$, drawing
    of cl\ild denbs being p~nted by yllCrioes is now their . ll('lltion to tltis new poIcntial and ~
    CStimaled 10 be app roaching one million. ynr for their pcJSIlIIai support for tho goo.! nf intltluni_
    (Fi,. I). utiOll fnr 0.\1tboW<>rld'lC~n bytbe yu r 1990
    With , b. co,uinuil\J: and n p;d uptu.. of oral (Fig. 2).'"
    ",bydnll;on therapy (ORT) ," the new figures Sc:"oral nat ions art already moving to within
    mean ,hI, ,h. Ii_ of ..ell O'"Cl" o ne million " MOB dialan« of that goal . N aplnSl an
    children hIV., been saved_ in ,he las' . wd .... 'VC!IiC of I... than S\\ immuniutillo covorago for
    IIIOIU"" - by Ihe recem spl'tld of tWO of !be least lbe child ren of the dcvdopina world only • few
    apen.;.... of au cbild proleclion tcchniq..... ~an ago, coverago rates against """'" or aU of the
    vaccine-p",vc.ntable discaseI ha ve rcttlltly beell
    pu shed til ~, 7~ OrCvt'll 80\\ ill Pakistan an d
    Turkey, in El Salvad<>< and , h. Dominican
    IlIUIIunintlon for aU by 1990
    Republic, ill Bolivia and Brazil, in Colombiland
    l'hi$ sudden acccl. ", tion ;0 immun i~tion Nicaragua, in Burkina F.... and Losoth o, io Saudi
    ".m ,n ge hIS bec:n mad. """,,ble, in tU!" paM , by Arabia and Zimblb_, and in pam of India and
    O<:w Kntegics for reac;hing I much grr:1llcr pro-
    """.
    • UNICEF lou dli. 1"" I ' U _ • opccioI r<pon "" tile t... Wo_ OIlT ). UNICEF ~ ...... Lb<.,.....4 or
    ................ focifla
    pt<focc lot d<uib ).
    tIot <llildmt ol "mo. (...
    bos i:l ,be 'o<boiq.. iI _ 1 ....... 00'<1 SOO,OO(I ~•• Ii><t
    "",b 1""
    .. Onl ..Juodnb<>a tIl<npy IOIlT J io• .u.,.l< t.c/uli~ '" lot
    _ .... mel Ifntina tIot <Iianboetr <ldl)'ln..... _
    •.• no or ~ " ...,n; . ., " " lot oil <biIobnI by
    19\10 bl' Lb< World H....b "-mb!y ;" 1m ODd
    """"" tIot u- 01 ~.l, • ,.;n;.., clIildr<o"""'''''
    ""';, tIot It.ooliooI ~ oJdIiId <It. ... ;" Lb< ~ _
    iI 01 tb< k<y <"-o,. oJtIlc World lteoIth o.. .,.;z.";,,. ~
    .......u ..,.. ol''''lIth for AU bl' ,be ,.... lOOO".
    I THE STATE OF THE WORLD'S CHILDREN 1986

    Immunization:
    a new surge forward
    EICIfmII/eS !f(rn !till Iosl egtI _ ~ of II.- 1!I'II'Ilnl1tlocn ~ ," ot!he majOf doMaseI
    acIIOl. _ and 0l:I'7II'7IIlma In me """W/<I 01 ~ it .1)eCIIld 10 be aet>iIMo(l by lII&
    fOlQ'l1I !till ffl'lII.IfU8!lln 0' '" CilIt/IlI<J bY r99Q. II1I(J(je or 198a (see p;IIIII n
    o_ In lndIa. """'" Mnste< Rat< GIrd'i fl8I
    .... .,ear 1'>01 -v diIll
    ~
    a In Brad. h
    _
    lIfQlIII mrronzaIjQn
    . . . . _...",...,,~~ i F'-
    ~
    bY
    irIm.nmg 20 "..", d'iiIlWIn 0I'l _ al _
    bom III _ " III boI hi 'MIll " .'101" III r.
    "*""'Y ol n _ Inclra Conch ........... v_.-co, ~ ~ _ 1or·... lISl
    __ ... -.e,.... 'iKU"

    _-- ..r.-
    IS~llIfgM ,~.
    In_
    l~ _ wid OPT
    .... _ .. _01 , _ _-.. _ ~ _ I'I1II I'IOOt
    ~

    _ _ 1o ,*". _ " DoIh _ _ ...... _ 6O'\io _ . -ooI0I95.. 111r 1985


    1o 1'8Id'I" laII;JIl . . ..-. mnu:>~_
    ~_'-"'''''''''''''IIl_'''
    .............. _
    fWI 8Q1lo WI Iid!o _
    Ir<m _
    ..
    20'10 1 I l _
    -~
    ~ r ,.,.,~
    .... ",
    IIll
    o In tin. en. _ ...,_, no-. _ ...
    4 0 ' 10 llO'o
    o....'WI_ e' -. "*-'0 ... .. 19&t

    ....01 .... -..._._;qo_ol90 .... __ ... _ ·& _ _ 10


    ........- _ ..., _ In IIOO .OOO~

    ~ --.cl . . f \ _ l ,.. ... 'fI* __ rro;n..,7$'bheof ... _ _ _


    no<n::IId ............ w ..... t..IIi.-1Il .. I .PI " ' 01 .. ~ ......
    Iew;I'l lIS'li . . . - . . - QMf9 ~ ... ~ IhiI .. WI. . PV" " " &'IWIU"lllt'lI
    ...... '
    encCll l~,
    I .... _"'o-~ .. ..... ""*""
    ~C
    o.rM . . . . . no .....". _
    I I t . t-PanIIl $)
    of

    o In EISPladot 1M l'U. h8l _ _ lla)'S ol


    -"re _ by llCIIh _ In tt. CMI
    O Wl Ec:uador. ". lor$l llMse of & ..-1"""
    _en --.l 0lIl> IlCIoon on 26, 21
    ~
    ~ ~
    _ 10 _ two-lhIrds 01 !he ......... ·0 400.000
    aod 28 0CI00eI (1 90851 ""'" 1h8.." 01 ~
    .............m. l""J"',I «I'UId t.'lI PfOIeCIed 80% oT IhlI nat>on', 1.f1deI_ (an;! 9$'ll\ oT
    IlIM* I". maJDI inlec1lOU:S ~ 11"_ on ""ee those lIQIIO 0". 10 t-> "IJ'I"l$I 1he . . mejoI
    Nal\onII vaeenalDl Oars, 8orog.-lg the ~ Vlol:c> ~ds ,_
    Dwr III an IIlIlll on 3 r...",..., 198 5. 0
    SelIo_'.
    ""\IOn
    0 " lloIMI IhiI yoea<. ~ roll. ' -

    --
    ~ D.olrI<I ~ ~
    bMo'lllUll'*110 _ 70~ b POIoO_1O8$' b
    "... naa.. <la)I 01 ~, .. '*Y d . ... "",01
    ~ "'0I0Il0 ... ca.ogh. _ ..... t-
    hOIJt/ IMeIlltld 4 )
    o""Pi
    In TliIUY _
    .... _ 01_....,.,
    I1110/SecMo._ 19l1f:01
    0 11 PoldooIan, ......."""" of """"'-' Uf\OIf
    M.-, _~·~~
    1W'lCI d'IbIrI
    "'" . " 0
    --=
    ....IIl&9. 10 _ _ SO.. 01 . . _
    Mill'" l:'lIIDf- .
    b\lh_al . .,.. In"
    '.
    " - _ k n W .... $
    _
    ~
    Ne.!y lHOIIO
    'M ') U ""-.,~w¥ _ _ 01
    ....... ~bulCD_<&J')'_... _
    Soic:W._ t MS). _ _ 3 _ e t * ' - ' _ 00..-_, -
    " ..,. "-P al _ hi ""'"" Cll III '8 ~ B. I .. _ 10 Wl::o'IcI _
    • _'**31
    0 11 ... Do"';'_
    __
    . "","otI'ic. _ /'IIloOIlIl
    b t _ ~
    01...-••
    AlA*' UP _ _ ...., _, . - . . . . -
    _at,.
    110,000

    _ _ lM'\'I ' - -.oy ~ ..... lIlOIll .. _ ...Pa& I _~1l ~


    _ is ''al-''~ 1lOlO _ _• ~ ... f'4I>CI~

    ,
    In all, al'P- =ttly 40 nations wi,h appmsi. It is I revoIulion which could help 10 ~uce
    mal~ly ,W(>.,birds of Ihe developinJ world'. chil- binha I I well I I delltlts IJId JO contribule to the
    dre-n '"'" rap;dJy occelcnting ,heir voerioalioo s1owi"ll dOW1l of popula,ioa growth {see panel
    proarammes :and now hive I rulistic chance of 2S ).
    immunizing almoat alilheir young cbil<mn by Ibe
    II i. a revolutioo which is " ready beginning in
    year 1990.
    seven! of Ih~ n.tiom whose rommilmmt md
    Immunizatioo IIKl oral rehydralloo ,henpy achievements ore briefly sUlJllJ\lriud in ,be pands
    (ORT) '"'" therefore beginning '0 lead the way on ,be lef,·lto.nd pages of tIIis year's rtport.
    towards Ibe ,,"olulioo in ohild surviva.l which Ius Above all, il is I revolu,ion which depends
    been the main theme of lin. repon for ,be lISt
    l.lIl'Rely on lhe commilment of a ~,ion's leader.
    Ihree yean. ship ond on ,be mobi~ulion of I na,ion'.
    h is I revoIulioo made possible by new o'!!:lJIiud ruourceli in ordtt 10 hreok pr=J1'
    knowlcdg~ aboo, how paren,s th~o1SdVCI migh, kno....ledge and lechniquCl out nf the mrdicoJ
    I.ke action 10 pro'''''1 ,be ~v.. and nonnaJ chm and put th<m ;'110 lhe IwId. or lJIIJIy
    developmen, of lbeit childtrJ:l qoins' "'''''' of ,he millions of paten!$.
    WOrsl effCC\ll of the poverty mID whicb they '"'" Recen, achievements in ut~nding immun.iz:o·
    boro.
    tion coverage flOlll I. . thaD 20'l ln lIlCI« rllIn
    h is. revolulion based On • small nwnbtt of BO'l of I nation'. chilcln o l"",,,fore hive. double
    rtJotively simple and inexpensive methods which impnrtaDCe for the '>'"Ie of Ihe world'. children '.
    Itt' now known ' 0 exert powerful le'et'2l!e 00 NO! only h.ve Ih.... sharply occeletlled immuni-
    chUd health-me,hodllike ORT and immuniu- ZI,iOl\ PI'O(tl"lDlDlCl saved ,eos of thousands of
    tion, brnst-f«ding and improved weanillll, main· ~v .. and p"" 'e med ,ens of lhousands of diubjJj·

    ,-
    lainillll vilamiD A levela and checking weight ties, they h.ve also pioneered DeW wa)'l of wliJq
    gain, a\'Oiding low birth·weights and leaving h oom ..n~,iq,u It> h<uit ~IIA problorll,,,.4 puui",
    longer inlervals betw~o births. ,lnn <11 llu dilposol Df llu _jority Df IhiM who orntI
    1, is I ,,"olution which rould reduee child
    de.llu Ind child malnulrilion by half, in lJIIJIy And il is precisely this lair. _Ihe lair. of making

    ,....
    ollions of the world, over ,he nen .....n or eigh, ou I nwloive scale wAD' is Dlm>dy
    . yail . bl~
    h"""'- lO'hicb could lI{)IO' help 10 bring lboul I

    FIg, 1 Estima ted annual numbers of death s and prevented deaths


    h om vaccine- prevent able diseases (chll dren under 5)

    ......
    2,COO.cm
    T......
    0l3.<XX>

    ----
    -- _,-- _,--_ . _
    _----- _.. - -_....-
    ..... -_... _- _
    --_.._---_.. ._... __--... " -.... -._-
    ~-=-_

    .............
    ...... ...
    ....
    ...........,s_._
    ,,~-_
    . ..
    ~--_.- _-_
    _
    ..-
    _----
    'm -""'"""-- -.---"',,-
    ...

    -~------_ ~
    _111

    _ ----~
    _

    s..- _ ..... , _ - . - " ' _


    --~-
    -"- = - - ' - '
    ,
    I THE srATE OF THE WORLD'S CHILDREN 1986

    Immunization:
    a new surge forward (cont.)
    tn.
    In LanlI ..
    $<I

    "Il 1~' 1 ~ren,


    _e."
    oor lIMI\lf\IUI<IIll\a$#eaI3ve.<lllII'108d 1"00'''''''''''
    , _ _ over "'"
    l/le P I _ I lIr'ICl Prlf'l'lll
    0 11 SotnaIII . . . _ ~""
    1965) haS ,_led
    ~ (9 ...""..,
    llII , tgoOrno 10 l:W_re tor
    I/MU"IllIlKIn dllYllII lO tePei\11l>e SlICe to l/le
    ~ "'00 Iaurlchea a r_ dtNe (6 5epteo ,iOef "lOll 01 Harge,sa an<! MogadI$lllJ _ e more '"""
    1965) .-.a W iO iOo»:IIhllllOVll" il11ElhlIll ......... 1I0'llo 01 ~ lJ'IGOI fWO Mve been ilIVnuru.cl
    .............. lIle -.:l 01 1986 l.- 1*lIII It-. _ e- I*lIII , . ~
    '" '" • NIm. o In 57"1. _ ."., . . . - --""'0 .. .,...
    o0"f'I'I'II
    ~ lIIe _ .......-- PI<>- _ .~ • • "" n ld\lng _
    -.g ......-_ 10 _
    573.000~..,""'_""'-ot
    11N15
    .... .,..... ~
    -,.."'
    110m 13 " 10
    _-_...
    &3'" ...
    1M RIggi _
    "gowtf-
    ... 8ddoc.m ID'" 3503.000 _ , . , . , 8lICI'I nc<a'!& 11\ CCUWy
    _ lit _ _ .................ogo_"'• .,
    IlUlg . . _ . . . . - . _10 -'I' 100. tor o In 8uI1<lnI; FaICI, • " _ _ '--'1ll 19
    N"_ 5tll:*ri_ lM<1 lid ID . . ..........-,gol_....
    'Va;g d~"'''"'_ClU ....,."COO I b'
    0 11 ,..-g..,.. .... lC\a<I()tJ .. ~oI RI'· ...
    IIlUJID-. _ . . .• '4_ .......,. tlrOugIll 6S.. 01 _.
    11\ <lI'«> _ """"' _aoo _ . - ~ "'*Jr1In ID 0. hi ..,," ed
    _ ...... 1~ 10 ....... _&0'-. .. _ .... _~ . . . . . . . If ..a .........
    r-eMl ~ hl0l1esAs Irtrn re CiJIPII;II OCG .... The ..... epoden>(:e.. .. - . Ihoo I cit 01
    lit II ' 9 _ 01 !'ligoN __ .... -elIll1ll "'" c!lIlnn . . .., _ 01""" do ... cNfOr<!n IIJlI
    _ • IIIlIlIY et*lrllll ~ IleonG _,,*,eac/'l _ CIUSIy e, _ 1I'>e«<>V _ P< ". _ -~
    rnonIIl • ..., .-:tlecl ...... 1IIll ~ !hi! I'leallh _ . 1lI~ .. _ ID
    _ _ 01 198-4 lSoe PWlII , 7) buoIcl -.<1:1 I _ ... f09IJl;lr IrnmurWITICIf-.

    O InT..-n/a ~tOOll~r>as_ kif all <;:hoIdfe'l 1C8"lll1l'll 0'I3f0I' ,,_~ .


    PI*""O fO 5 6~ to< polio, 82 '10 to< ........, lIr'ICl I ble "" P (MIl pa<lII 6 ).
    54" kif IuI:leICI.b\I$ a SUrinl.... ............ b<In CO\/eI'39l' 1\ilI_,
    o In Ihll Sudan. ",",,', ""'Oe'I I;OUI'IIry ID 6 0" I ller II'Ie QrOCIamoIl>On oIlh1 Na/looIej
    VlLOIOIlIOo , Ad - . I'lC/ft ~ tIlI1 II
    200,000 cI'lInn 111 M QIIlI\Il aIY '" Kl\aIIw'II

    -
    _ _ ~ .............. (l lNI5)-.:l me c!'oIdrtIn ...... lOge ....... tie ~
    u.r- 01 HIIIIlIII hal rfIOU'IC8d lIIal #Ie lP(lU'lIl dii>Nf* _ ' 0 ctIJl/o, _ . . ,
    ~ Qj ' . . . . . ' . . . . . . . . . fNOo ..... oJ •
    . ., _ , .. _ _ 01 SU*ol'. <1IIIIhn !ly
    ,ggq 0.. _ _ .... 110 III SWon I 0 -. ... Q,I, CIfo'Iwo _I-=t>e<l ..............
    ~"" be "~ .... _ or 10' tIr _01~".utt
    _ Cll:lDtlef , ll&§ ThI '-"*d ,...,~,.
    Idler - _ - lit' """"'" 1986 _ _ 6O'co, ..... 01. _ _
    o ~ ~, .... _ at HilIIlrI ,.., SaLd _ N l _ IlS _ _
    _ ( 13 F-....y I iIIS} . . . ., _ , 10 _ 33.... lIMO III IS 198A
    .......- . - y """ .. AddIt _ IQWllII ...
    -.~ ...,~ O -' KaW.. ~ .· t .. ~ _,,,,,,,,,,,-

    ............... __ ..... a,.s..-.- _="""'II ......... t:ft1. ~..-_


    , gaS, .... SO'Io '" Voe 011" ~ I'..:J ~ ~ lrom !III Nfl 20 .. » m;n , . , lM)<j,
    _ _ t-lIWlIl I 5j _ _ .. _ , .....*iOf _ _ ,,;,;. .

    •
    rcvoIution in child survival and prnICC1 <.he dmlicaJly increase their children ', chan,," of
    normal growth and d ~dop menl of many millions survival and IlOmlIll gro wtb - i/ 1M 100)'1 ond
    of lOOIY' chiJdrm Ifld to:morrow'l cituc.... For In means CI1l ho found 10 put lhol knowledge 1\ lhe
    Ifl ofreo unjust world, I mojor impravement In <fupoaJ of ,'''' lIlIjorilY.
    <.he pnllCC1ion afforded 10 the child ~n of <.he pont"
    .. unJillely ' 0 come .bool lhn>llgltany l<~ P rUe in In the PlOCCSl, large oum ben of paunll ore oJ",
    incomes for the poot<SI <him oft"" human fomily bccnming iovnlvcd in pUltini O<:$h ond blood On
    for 01 IUl< the nexl len or fifleen )"Un. Prott<'iing lhe bones of the primary heallh care idea. By
    tives ond health, during thaI time , will lM~f_ knowin& IlIOn' ond demand1Dg more and doing
    conrinu e 10 depend , for the mosl port , on lhe kind mnrc obolu such basic Mahh Itnn cgies ... immu _
    of ='" which fllllilits . nd comm uniticl; 're oble In o;2ation and ORT, latie num belS of people arc
    I"'O"ide, !t.nd il .. in <.hIt letling thaI recem 6nding I pnlCtical stoning-poinl fram ..hieb " ,
    b<cIll<.hraugh, assume OIICh impnrl once. For ir is prosrcss. su p by odut">lIble slep, toward. lhe
    now possible fur fllllilia themselves 10 quite II.fiCJ goal of more comprebensive primary hnJth

    Fig. 2 Immunizing all children by 1990: pt'OQress achieved and progress requ ired
    Tho l;,gel Ill..-sot .... I'MU1i!IIM tJ,o two ..... Tho ..... ' .... Ihow Il>o IClUlll""" ... _ _ (I QIG-83l ;,
    """""'" Oy No "'-riJlV"' 1Qn ia_ III orm>rirrog""""'''- """ ~ '" ,.. ~_ .
    ltoI! """ _ '" "" _ _ OO""' lUt"........ TloI_!nl"dcmosN "'~ll983-
    {IOIIj '" _ b' M tJ,o tho..... 2000' IlQ , .... lat\IOl "'~~ "1O ""moI t>, 1990
    1983 io IIW> 1al:$O! _ In< ,.... . - .

    "Xl

    -=.:.---< rsso
    1975
    ""
    .__"
    -.._. ec--_. . _.-_
    ~fl'IHOI_ "' ~ P, t9 ..
    ~ f3'!I ;' tQ7 4 .
    _. "- ltoIl _"'~
    ~-
    _,__
    ,,,. on
    ""P*l lOr

    ,
    1 THE STATE OF THE WORLD'S CHILDREN 1986

    care an d a Sm.,•• dq:= of COllUIII oyrt Lboi. 0100 and fttl Ih. Ixgi"inv of a rmalI fevcr. Ai... a
    and tbtit families' helhh. d l Yor two, lhe f..'t'T is higher, appeti .. is gOflC,
    COOJ,hiog btgios, a, d a vivid !lorid rash il
    This YUI'S S'tU D/ llu WlWld'f ChiL:iffll repon
    appearing 00 \h. ~kin all if fl'OlQ 'owh....,. As ,h.
    ,h... fort IUnu tim IGan attOUO' of Ihis ul"'llfic
    days pass, lhe dillThoeli begins,Ih. W.o d ries, and
    in immunization ro'es, of how 'hey.... bein, Ihc ruh IpreadS until ,he tya also becom<
    XhitVN, md of whal lessons ,hty migh. hold for
    putling OIlier ~ child prolection techniques II inr"<"ed and i,fIamcd. By 'he Krond w"<'k, Ih.
    ,he disposal of Lb. majori.y of ~nl"
    ra.h has Ixgun III ~l, le3ving OpeD ra W IOrtS OJ>
    th. skio , and by now lhe cou&hins is persiR.n l
    and prolOlllled and 'he dian-hoeo is u, ,,,mining.
    No foOO is being li ken , and WlI1e<, p h s, and
    n t .....u.i.DJ: of i"'''' W1izatioo nutrients ~ draining from lhr wraUoed body.
    Immuni....tlon coverage ,oday rallies btlWttn Dehydraled 10 the poi,1 wh. .. the \hii'll is
    20S and 4<n of tbe dr.,doping world's children ullbcon. ble and racked hy ~hing fits which arc
    ( F ig. 4) - despite ,h.
    lheor<1ical availabili ty of becoming lOll weak 10 d ear Ihe lu,p bUI lOll
    Slroog fOY the muxla of th • .<mall he m , the
    vaccines 10 • much gretttt propon;on of their
    populations. BUI in 1M lan cight~ mOlllhs 10 lighls of thc body begin to go OUI.
    lwtl yun, sevenl nations Iul~ effectively COIJI-. Inlhis way, me:osIa killed 2 miUiOl\ chi ld rm in
    milled .hemsch·cs 10 Unmu.a;,...ion coverage of • 1985.
    different order of lI1l&o;,ude.
    o. it may mean tho' a ",",her notk.. that he<
    Some of ,b. ou,,1.aDdinj; mmplc:l of .his fou . -dl y-old hohy !\OemS ~udd...,ly In feel ma.e
    conunillnc,u ~ LIId x hicvcmto t - If'' listed in ,h. tc'se. As she wooders whether .he is GIlly
    linl tWO pan.1lI of this report. In sum, 'he:I< imagining Ihot something is WfORi, ....C .... Ihc
    ",,"mples «'present an inBectioo point in ,b. lil'lt s1ighl'paoms ~"llth1Wgh the musclc$ of
    grap h of immunization'. progress, and 'h e facts hcr child. The lnfanl sleeps, ilS mUK1.. 'elax, and
    on<! ligUle ciled are the hard rvilknQ r",. all sec"", peaceful again.
    UNICEFs belief that uni""csal dlild immuniza·
    lion by 199(1' is 110 loDger liD impossiblt drum Whe n the child wakes, Ihe mother speaks and
    lhe respcmse is. spasm l;hootiog through th e tiny
    BUt 1m the perttn.ages aJld the millions frame. Now every Mise, t!¥¢ry.<mall dmurbancc,
    bctv"'" mcaninglO$, lhis is what il mesns if every co mforting lnuc h, produc.. Ii""", $p;o$<n$,
    immun.i2lltion is not avaiLable:-
    holding the baby rigid, arching i\l..,..]l back.
    Al fim il may mean \hall child who is slighlly
    malnourished btgilu 10 los< his 01' hc. ap pelil e
    Ov¢. tb ¢ oOXI !by and the Oelil oishI, the
    ,~come longer and m(lf¢ ofl¢n , ho lding tb.
    bo.by lncked rigid for long SCCOlld' at alilOC. All
    cnOliCt produCQ another $JIasrtl and even bfQ5t-
    • I. pt><Ii« .. _ '1 . ..... ;" III< Ia<lUlUiali ba. fcediog has '" SlOp. In bl:rwcm, rhe bllby visibly
    .... xlli<vod loot. ;m"'''.i'''ion of ... rMd:n. ·UIll.......
    ~ ;,. ,_ b<so iD«rpr<o'" .. isIpI u.. weakens. Nn Ol1ids COIl 1M! ,. k.n in, 00 mUCl\$

    IUI><maIooio.
    POIiooryo~1io, IlCd
    00li<o -
    ,11<0 _ _
    w ..-;do:
    "i'"""

    <loiId.<lo """'
    _r""' ' .
    iIl<ol , Iw .. c!IiJ<l _
    di"".-"""_
    b< _

    • • poIl<" "
    at ,"",«lion
    "'"'" _uai
    i...." i"'

    ......... It -.....,.,....ny II&f'Od


    i>,
    ~

    far
    ........
    (......""... ""'&!> 1. """""
    at _ or IIIOt<
    llw

    ., dioo1Jp<<d ..
    u.. """""'"
    (pmwidi... ,bo,
    ,be
    'kared from th e lungs. By M W, lhe $pi$Olli hovc
    ,pread In 'he muscles of the m<>IIth and lhe
    roolh.r is loolti>lg down 0 0 an ago,UcrJ grin .
    A, ot h", nighl and !by an d ,h. spwos Iltt
    toolting impo:aibl e demands on the baby' $ bean.
    .....;.my at ,be,.,. iood """,,1oIioo ... .... ..-......,«1 Now the whnle body is bcioi held riaid, Ihe . iny
    .... Im< .. ba< --.~, ......n.. Iow). 6su c1enc htd, th. r~ fised i, gnm.cc, the bac k
    I' ;, ...., impartoo, d dril<lmI .... i- e " iood """'" ,be arched , lh. $Inrnach locked like imn, the mil
    ch..1 clam ped dnwn against all breathing. For
    .... .
    tin> _ at liIr >04
    _ ~-
    _ ati o· ;n....................
    ;,. _ ...- ,hiny uow serond$ the smol1 bod y is l<>eked in IhioJ

    •
    vice, then !Jowly n:laxe:l, o\ll$d a l wilChing as O'llpclli"l air unlil, . , th. end, <he cb.ild finally
    they l<>O!lto thei r grip and !he spasms recede. inhales uncontrollably, smJJowing coug hed-up
    A g...tle, comforting touth and lmmodlatelya mUCUl from the bronchial 1m: aod choking from
    the vomit d....wn intn the lunl S. With . vcry lit
    Imal body spasm locb Ihe chi ld <iBid all 0''U
    now comes more vomitin g as Ihe muscles of Ihe
    again , as if il we", ",pcllod by its mot h..,', 10 ,.".
    stomach contrlCt wil h 'he coughing and fo~
    In !his way, manus killo<! alm06t a millio n everyt hin g, food, dri nk, milk, hack !hl'OUl-b <he
    iofam s in 1915. throal and nOlle - o nly 10 be inhaled cbo ltingly as
    that inwanl breath is finally tok....
    Or il mo:uts that a child, in any <>Tdinary village
    or oeighbourhood, bogi", 10 mime or cou gh with Weakeno<! by vomiting and cOUj.blng,struggl_
    wbat seems Uke the boginlliogs of another oroi- ing 10 breat h. tbl'Otlgb longs blocltcd by muctl.
    oary cold. Over lhe nO'lll week, very slowly aDd
    11_ ollDooced, lhe rough bo«Imrs d..pcr and Fig.3 Percentage of pregnant women
    mon: pcrmtenl. Soddenly, ;t is 00 loog... o rdi_ imm unized against tetanus
    nary. The <:<loglling II<l W is SO n pid-liriug, a
    ston ering engine pompiog air from lhe luogs,
    Lbat Lb. ", is 00 time In l:de any inward b""'l h lIS
    lIIOfe and mon: air is hlJllInotfd oOt until lhe'" is
    no n. al a1llerl 10foel ""other coogh and the cbild
    !JomP6 for....ard. cba t collapsed. SI"",ly, wilb •
    sboddor. <he cllild hrealb'" ;11, relua tbe leo.Yon,
    and .... op agaio wilh sWQting skin and frigh l_
    ened eyes.
    At tbe Dell 6t, lbe parents 100 are growin g _ Two I....... _ _ in oeQo.Qd 1'1 progvtty :o
    frightOtlod as Lbe child', face darken. and !he _ ~ _ rJ tne.-.. """""
    """""" lor 1lla_ ~ rJ lnlrol _ _
    coogbing goa 00 and 011 no til ;t .... tnS tbat ."
    IN ""' . . ... """'*'
    inward brealb will lIevOl' be l:den. Now, the
    whole body of the eb.ild is gtut'd to the luk of
    _ 1'1_
    "'<J,,"_ 'NCP""_r,,_
    d... . . . - - . ..... _ _
    _

    _.
    ~ . 32
    Fig. 4 Percentage of children Immunized in th e first year of life

    33

    "'" -
    ~ rn~

    - "" _ .
    ""'-
    NaIr. n. _.-.ce_
    BCG
    ","~~ n .
    -"
    tne"""'"
    _ _
    ~
    OPT III
    i'o" __'
    _ _
    Polio III
    AW .. Asia _ rJ ~/fl

    S<:UI> & Eeal A$Io - ....1 rJ"'" ~ ~ wNctl . "'"


    StolerJ!t>lIWG"d'. ~ "llM ' " ~ 1l:t nclJ<IOtll'1 1Ha labIol.
    ~~i'o","d .r _ rJ ~ ~ ~
    llPT .. ~ ~ twr'IOOPflII <'O.J'I"f. /II'"(! retarl.S.
    """ Ill' ""..,.,. ~ .. o:ta\I coIae1iot, w!'icIl r'l """'" <:<IU"CreS DPf _ . - . _ giYII<1 i1 .... "'*" .""
    ~
    _~mom_or<!lQ
    __..._
    ............... CCI\'EIIagIL
    ....,,,,_...,.;v

    _~ "'l>-. _ "" __
    _ to _ ~b'
    l'I CCU'III1eS ~ ........ va:;:cn1ib)n " QHtrl _
    rJ 11 """"'-, "" 19n"'" . ..... ~ COoe'agD rJ
    1 Ie 5 _ oI:ls.
    lho IIIJII

    ,
    I THE STATE OF THE WORLD'S CHILDREN 1986

    Turkey:
    to immunize 5 million
    ~ rIls ~, .,.., I"fI" ~I¥>I """'. l OWl o! allhe .... oon'. """"-""" 10 1IlCI_ ~
    i'l1i'!<J 00tiFItly .... ~ .. '" .. ,. , l urloll>
    'I)' IlIIlI It>e "' ~11 01. an<! I/lII derMnd b', ........... l ...
    " ' _ Kenan E_. <1umg, 11 5e(Ilel,ltl8I
    ceremony M """"'" lie .............-d n lnl _
    iIlItInls., ~ au"",...1*lQllI. ,.. .........
    """""""'
    ",,1lQr>.WIdt Don10
    '" The ....... _~.

    "'" ,,"bOneI .lIoIl _


    -...as on", .. aadeo ..
    bl" ttM!l MirosIIy III
    ,..,.. In ........ -.Jay _
    HeiIIIh F(O' ... ' " _ _• III 6 1 . . mel
    ~ _ Nn 80' ", ... !> moIion . . .• IDgiItIlur .. ~ -10 ne t:>neIcI on ,.. _ .
    ..... ~ "" - _!"OW-.g ~ ICIlII _ peeted 01 "*"- The l U'lulll _
    .......... SOIl 1 _ <:tIIIdoen ~~ IorI:es llUt " . ..,... "'"' _
    rlOfll" _ 1llIIIIoml, """""..... TWQt.lI _ ...., 1_
    0 l : I I I _ ... 1IlIl.... 1CI8V'_' ... _
    ......""........._'""" _ til" ". ~
    ...... _'~
    .... __ . .30
    '<l'_' _ ."'5'0_....
    .-

    -...
    ..... '" he_
    T~.67

    ..
    ~,_
    woe .....-...g
    Dlke. _ """"", Oil...ot _III at
    ...... r.,~~ .. 1IlICh .h_
    1Ii..-...a..,. 10" ~ ,eo .
    ..,._ .. - . o f ......... ~ _ « 1

    ..
    ~ A lOIII of $.000 Po • • ftlIIO _ 60
    _ _ 11.'_' of . . 1_
    P
    ,_.
    ~"'X \ _ .. _ .. ...-.. ~ ~.....,. AIcI
    _ ". • . . . , . . , . , . , lOW • _ ElWIll er- .XI'II - _ W-"" _
    ~ ... s..o.., ..., Synlr. """ - . . . . CIO'lF The _ _ ....
    pr-""d ........
    _1Iit1_'_'j
    E..., 10.,.,.. ~ III ... - . of _~_I0'

    lIa' l/Ioe _ _ beloIe r>e tn:l 01 . . 0lICI0e Sll(Jnftg..x:roll A _ _ ...., PIiId lor $
    ................ ~ T..mey l\8IlIll. 3S - . _ ........ " '0111 10 "....,... 0<It'Ilan<lg • chid
    ol vao:::o:>e l\ad lIrrNed 111 h . 5,000 ............ lIl.On .............., _ . • Q<OWl!I _~ -.d ~

    1181'::-'
    ~
    *""III 536 ~ (IDeal dlsltl(:l
    __ also ~ cIIklr""
    go blIac ""., I\MIllI'o , * -,

    In "'" monlhS ~ uP to 5eIl1emr>et, <ITIIIfII


    0Wr Ihe ne>:1 ...". <lBys (_ 10'lt '" I!le lIllCI _ I ., _0,00 0 ~ lIllCI roogl tOOul-
    _ Sla!lOJ1ls IIamg ~ ., 1I$ lhoIl ~, IlIllPed lly pnmat'/ !CIOO le8Ct'eIs lI"(J
    IICQCIUI1l _ to IlIBSSl.• lOIII ot 3 2 .....,.,
    _ _ _ _led - 1\oICHIlr05 01 !he nat
    _ PUPob. . . - .... l1\li --.._ "'-
    ll!x>Jllt'll eIIl'<*9" And lIS 1he _10' lI'le Ionl
    !l<ltI'.l,n(jojr.,.... KI<lf'O(I _ , .......... '"' " " " " " " " " _
    .._ ., s.o 000 . . - - -
    m_
    • aICII <:a'I1lIt· h.,,;oncl
    ...,....., ro.n;l:I ~-.d NcMo• • ' 1ila5l
    $ *'.. ~ ifill ."1 _'II lui _ _
    ... T...u, be on lot _ _ - . ., T'"!<e1_ .. .....",.". ........... ~
    _tJr _ d 1908e - _ _ 01 .., _ ,. of Qtr.'QfY _ aN ~

    ... 1990 ""IJII_ _J'Jelor9-..... oe I .",... ","~r~


    _ tItIIIngs • ......:::£F I ' . _
    voro.. .... e - lot e - e.:.- .. ...-.
    '" New ....... _
    ..._or"".., .l_ lXki"."'.
    "..,..... Ardn

    rd I _ ID _ CClIollc. • ........- carr>-


    I*!l"" - . . I......... r..- ,..........
    "'-_""""*11)_",,
    ... ... --..t.,
    ...........

    _lO_....-- --
    ~ o r t : N t J,

    _.......: ",..w... '" I\gf 11l1S 10"-" 01 chld /WIWl to. II) - . . . r¢l1!r II) II
    ~ - . . Ito",.. ca'. • I The _...,.,..
    lIf1IoI_ ........ ."...,., gonf*'" . . . - ,.".- - -

    ,
    and rood, lbe dUld begins anotber 61, unconl1Ol- WOlken Utined in lb . "",nag.menl and orsanizll·
    labl. cnughing pumping lbe air un remittingly liOll of immunization Pl'Oll'lllllllCi.' In Lbe 1981l$,
    from Lbe lungs, finally f<>tcing lbe cbosl In lherc h.u bee n solid proe:..... on aU lb... £ronlS.
    cnU.psc, lIumpina Lb. cb.ild forward until lb. fi. lb. 1.ICSl frccze..dricd measles vK<:ines, for
    ends and Ibe bouse is suddenly silent. Only Ibis mmple, nomain pctem £or up to Ihree ....ki
    time, lb. cbiJd d DCll no! breath. in. rooD in l ropical I.mpcratu.....• Cold c~ns o£
    rc£rigcntiotl - hased on k.roocne, boItlcd 'llS,
    In this .... y, wbooping cwgb kiUed eere Iban
    clcaricily, solar COCl'iY, 01" icc bo>;os~llI'C no ... in
    balf> million dilldrcn in 1985.
    place in most Mlionl. Mosl importanl of all, many
    lb. rosl nf pmucticm qaill$l all Ibis is Lbnusands nf immunizalion lum< hive been
    .pproximalely 55 per child. The ron of immuniz. lrainalllld 6clded sine. the W HO launched Lbe
    ina all cb.ildrcn, an d ,,"ving more <.ban 3 millioJ> Expand ed Pmgrammcon l nun unization ( EP I) in
    cbildren from dyins in Ibis way, is 'PprozUnalcJy 1974. To dal., almos, 17,000 peoplcfrom over [00
    $ 500 mil~on per year" - slightly less th an Lb. (00 natiOl\i uve beeo lrain ed OIl COUlll:S $pOII5Ored
    of Ibree ildvauccd 6ghler planes. by W HO and UN ICEF and many limes more
    ha w: been lrained by IO""""""'nli ,bCIllSClves.
    The lWObRaktllrouaJu; Cb.i"" alone, for exampl., has dra....n on EPI
    programm<:s 10 Inin Over 100.000 heal1b WOlken
    Based on infQnl\Jtion . vailable IS of mid·198S, in immunization man agemenl. '
    lboo< cou.nlriQ accciculillll Iheir immunizalion
    programmes 10'A'lrdJ <.be 1990 loal include:_ BUI Ihe sco::ood awl equally imponllOl advance
    A'1CUlina, Bangladesh, Bh utan, Bolivia, Bot· is ,h. 'demand hr...b hmu gh ' by which some
    01nl1a, Bmil, Bur kin. Faso, Chile, China, C0- lhirty or fort y nalions .... oo w mobilizing, on I
    lombia, Democralic Yemen, the Dominian k- massil"C sale, 10 make immu nizatioo .Y:l.illblc in
    pubUc, EcuadOl", Egyp!, EI SaJvidor, Elbiopia, pl"lCliceand no< jUiI in ,heoJ)'. And il is fNllilital
    Haiti , India, Ind onesi<l, Iraq, Jordan, Lesot bo , commilmenl 10 ne... "'0)'5 of reaching oul 10
    NiClll'lllOJa, Nigeria, Fabllll, Peru, PanIIIla, inform lIOd suppon lhe .....jori/)' of jIOftllIS w hich
    Rwanda , Sal>di Arabia, SencgaJ, Somalia, Sri no .... offen MW ho~ for punm, in,o practict:
    Lanka, lb. Sl>dan, Suriname, Syria, T .nzania, o< hcr child proIcctinn ....'..ia on a acaIc which
    Trinilbd and T obago, Turkey, Lbc United Arab is commcOSUI1lI. wil h ee problem.
    Emi rales, Uruguay, Viet Nom, V. men, and Zim- To brio, vaccin'lioa III peo pl., 10 inform many
    babwe. l.no of milli<>m of pattnlO of the wbe n and lhe
    lbis .udd.n ou'1. of pl<Jllrcss, a ourg. which ....b.~ IlId lbe why of immunization , IQd tn gCl
    will bring man y n.lions wilhin $<riling distance many more mil~ ..... of chiJd f'C1l 10 lbe righl place
    of univon:al immunization, is h.appttlin8 in lh. I t <.be righl time on ..,vera! "pOl1lt. ocasioo.o
    mid. 1980s bcoU$C of lwo diffcrcnl bruk· eac h JICllr, is I massive organizlliional lIOd com-
    lh!tlIlg!u. municalions II!I<. ...hich usually far . KCCdo Ih.
    capacily IlId th e experi.nce of over·stretched
    The 61'51 is ...... pp1y btc:aklhl'Ollg h' I>r<>ugbl mcdicaI xrvkes. In 1110$' developing n.tion.,
    . boUI by morc hcaHl.lbl. vaccines, by "IOn' ,hose medic:aJ servi<:a reach only lboul l~ or
    reli. ble 'enid chains', by COnlilluing research and lS", of <.be people ItId .... inevillbly mon:
    Imoina, by Lb. insl lUilli of more equi pmcnland conccrocd wiLb ~ina d.mand IbllO crealing il .
    ...ppIics, and by ,b. , fi)Wjng numbers of beal,h
    F or all ~ reason .. comprehensive immlUl;'
    , hllbuIIP ar;:n..-rcco If< _ it .... p l of ani........ za,ion coYC<I/l. h.u risen only slowly, oll.n
    • iWM>o '" IWO.. "'b<-._.."'
    ocly rauaim. 1f.m.cnaJ im.." i'll"" h I. Ix - . t.....
    .... n:aching only on. in 6v. of I n'lion's childnon,
    cYUI "bell vaccination IICrric:c:I have b=t lbcor·
    _oiD<d. ,11<0 ~ io Il1o <OIf1I~ 10 fiAd ol ~

    -
    eticaJly .vailabl. In <.be majorilJ £01" ","ny yean..'
    ,. ~ " ' _ tniaiDa,"' .......
    "' .... fIObti<, n'..,;". "' .... =, ' h M.... C1car1y, somtLbing cI,ra is needed, some new
    dyrwnic, some ne w way of foro:cfUUy lalting tbe

    •
    I THE SI'ATE OF THE WORLD'S CHILDREN 1986

    EI Salvador:
    children - a zone of peace
    ~ QO'\'e'm1IIOI am _ sobers
    ~lIi_~ W:""c.Matsaid "' .
    ~ S\CIlJP8d IOOolIllg 9iiCll olher on 1965 WI\iIe lIlller to Preso:lCnl NapoIeon !lllarle '" EI Salvador
    tho oat"" COfllron'.ed a COO'III'On foe _ the <lil-
    ....1'IicIl 10.1 some ~O,OOO smail chClr"" a 100 war was but one otlStado! Wllh 5 8~ 01 the

    -
    _
    )"lilt aro:llJ\llWl\ """'l' 1tIDUSlIn<I$ ft'()t8. ""Ill ~ h 'SIS, ....." mal<olg parents

    nlrlle P&/lIOUS oav4cng pauses on 1M TghIJnQ


    """"''' 011M ~liOf\ <:anII'lIQ1 was. """""
    SO "ad
    lM1 edgy olbooIs stlI9Cl away lrom calhng
    IlJem ceaSfH_ or UI,OI;ll$ -enatlled some QUInta< 1iouse-1O-lIOuSe ...... by 3. 100 _ worl<e«l
    of a ..-...on chIkl<(lrI undilr IiYe to bI vaeonaIOd to lQCa'e an<! "'form ~_ incrnase<:I l)o!twWn

    agains1 ~, dIpI' ~lll!J8. telanllS. !I"IMSIe!I aM ,he his! and secoocl Y/ICGIOlIlJQI1 days and wete
    wIIoopor>g cougIl. Iltoeti cnldittld lor llle """eased nUlTill<lt ol
    C/'IIIOIOOl.... ntrlg up 10 !III im" .....zed OIl 3 Maleh
    The '<!irYs '" UBnQuoMy' - llQ!eed 10 by lIO'M"-
    .....11 and guenolla lea<la<$ ""th tho haIp '" '-klg I'os161S and IJ1flI8d twxlbllls arlIIOOf\CeCI Ina
    Roman ealllolC prelale$ - alrnc:<lllell QllaN on . ' <!aleS tor VllCQn8Ilon and ......, 10Uer, 1><:l<els
    camad tna carmaoon emblem e:!d lhe sIoQan
    ~ -- ' - " ' "" "3Ct."IBI" _ '" I'lICOJ'Iale .. 10
    Hoo.n b8Iote !lle ~ '" 11>0 sec:or>llllllllOi'lal P'"",""t Cl\heI P<JbI!al>' ncl\.<le<l "" drOOlS 01
    ............ ,"'" day, on Sunclay 3 ~, "'''' laafle1s ., lIIIOOla eees Mole COIIVCi'ltlorlllty
    20.000 rteaIUI ~ rod 1IOlun1""'" ""'"""., " - ", magar..... radoo and ~ sla-
    more IhIIn 2,000 vacanMoon cern"", lICIQSS!he loOrlS ea"llId many ~ 01 ~ _
    COUIIhY. _ oN03IS llUptlunIIslcally caIIe<I a pIaeed tJy g<M'lI"""""! and tJy pmralO busniiosses
    'moIilary ~' ".,,,,uOflell.., """""'"
    01 bgh l. as _ as le.1""a <UliCI8S and news _ 00 1M
    "'0 1M! COUld MYe ~ ""'" ;"k> l:he lIfSl dayol
    the Cll'T\Pa9' and scamd oH man y PIlfeIlIS and ClIl''''''' iIseIl
    CIlbeI' PrOflll'll lnl(JM.lflloon by rep'esentalJv9S 01 [8C/1 &.nda1, dl"'''9 IIl8 woekS lO»d<ng up to
    Il>e Roman Galt>ollc ChulC/I prevented a COllapse !he ~ ~, llle C/'IurCh ClIJried me
    tacto tn.o:e. ~ 10 lh8 people !rom llle puIpo1. Ielliog

    ..........
    01 IhIl d<>
    parera ,! W8$ ' - .My '" PlCIIeC1 Ihaor clloO:l,en
    TIw:Iu(Ih tho lOIals lei sI>or1 01 IIlft taI~1 oj
    >'3CCIft3ltlll 8O'J. '" EI $aIYa<lQo", 400,000 Ufwn-
    murorod chiIo:lIlII1 under 1Ml. on '0l,l0(! 1l\ll"'llS Tna 81eas COIlI'olIed by guemIIas 18OOII'ed
    2 17.000 C/llidren -.. 'each!lCl on 3 ret>ruary, sp8CIlII lrea lfll«ll, ""Tfl 1l8a11tl """""'" !rom llle
    262000 on 3 MarCIl and N 1000 on 1M las! itlten'tlll>Oflal c:.omn-.u. 01 llle Rea CI_ opaIal ·
    "'lI "'" """"""latoon posts PoolOi'$ 8O"ef1l5ed ee
    '" Bul ~ tho
    """"",,,I"'" <lays "' IllCI5e dIWlclS _ 1>Jl Wl"",,"
    lXll'tlPI!Ile llM1UIlIZlIoon 01 QIWllI!he dates, t>eC3US<I !ebo!I avthort\ieSIIl'ISIIed
    ah'05llWO-llIJrds at 'IS -..n _ ngI1 t~ tIaiIed 10 _ gMrlg llle ~ 01 b!IIno <lIelllte<l1O
    as I '6tIlaII<at>le lIdlilMlmarll rn a 031"", at war tJy !he _""""" .
    with dSell
    A1 one pclIf1t guemlas abducIed No<) <lOC1OIS
    .•rills r<JCOI'ICIloabDn lot lJIOQ(ass Ittll1 !lie cal ' and ""'" t/'Iem 10 1\11 "'""""""" _ <:<!<lI,a,
    mon good ........,....,.", I:JId)I (I~"I; oom- - . . _ a I IIi"OOlS aro::I e/'IoIdIen Wl;Iited 10 !III
    m.rmen l 10 • p(iQIM> rum", _ ,.,. _ /Ill v;o::onaled. n ", .........-.es admolliS\el'ed, It>e !we
    n\P<ail<>', ro tho rest 01 lI'Ie WOrld.' · u..ted NabOtlS ~ """8 "''''' '''''' 10 IMor _

    "
    world'. _ powtrluJ public h.allh lec hnol"lY and play, by cinema ODd 100000pcaker. by school·
    off lhe ped..I:oI of in \'301 poImtilll and pUlling il tesc h... and villall.lcad.... by members of parlia-
    10 .~ryday W<llk ill a million , ill.."" llOd ment and panc hayal, by Rotary d ubs and worn--
    neighbo urh<><><b. <n·. OIJlonization s, by Hindu and Methodist
    leaden, by youlh _ tJl<oUODd f1miJy planning
    Sumelhing .pe<:ial is n..-ded. And """,,,tbing
    """""ia,ions, and by .he bundreds of Yill...
    •peciaI ill whal Ih. natiol15 who an: nnw movin g
    ""lunt.. ~ "'ho lravelled hnWIC to house '0 mal«
    IOwanb full immunization ha,'. begun In pion.....
    1urc Iltot aU JI1«'nts we.. aware of the need 10
    in Ih. mid·19llOs:-
    ..aecinale and '0 remind tbem of Ihe lime .IlIld
    plat:o.
    In l'lItiIt-an, 7,000 , at:<inat<m and IS,ooo
    SociallllOlnli"",tinn
    tradi tional birtb an <ndanlS have been tnincd and
    Bruil', N>tional Vaccinalion Days, for lhe number of immuniution post~ " - been
    UlJllpl., ha, . mohililed ec less l han 400,000 ineee ased by m in the last eighteen monlbs
    ,00unt ..... - from all section. of sociely _ to , up- alone (Fi g. 5 and panclll ).
    PO" the he:llth ~ in manning 0'..... 90,000
    In Nigeria, tbe pushing of Ihe immuniulion
    ...accinltion poots mel bringing irnmuni~tion rate in the , ..I It. . of Own from 9'!10 to Ovt1" KO%
    within w:olklng disIan« of almost..,.,., family, Al
    within twelve monlh, -an achi....ement now be-
    tbe oamc ti me, tb. conntty's mass media ha~ ;ng attempted in ..,.,., sta,o _ _ made JIOS'ible
    nude 1iU~ that vinuall ~ ..... ry pamu in the
    by the IUppon of th e community leaden, th e
    cunnlf)' ;s wt:1l-infom>e<! abou l lhe lime, place,
    ",hoolleachrn. Ihe Indilj~ ehieb, lhe tn<ISS
    l1IId imponan« of lhe immunization days th.m-
    selva. On lelevision l1IId radio, 3O-so:cund inunu·
    nization 'ad~nise"",ot.' h l~ been broadca.sl
    IwenlY nees a day . In lhe _imilalion
    Fig. 5 Percentage of infants fully
    n. .... papas, pagCl of editorial hav. been devoted
    rm m uni~ed, Pak istan . 1980 - 1987
    10 the ~"",pai gn for .....\:$ ill advance. On wall.
    l1IId in windo.... Ih"",ghout the land, I..., of /1 71 --,------,
    millioas of POOlers ha~ kePi the meuaa. in from
    of the public. On ban k otatemen,., electricity
    r-t-f-t-f-t-
    bills, and louery licltt lS, lh. remind... hl5 gone
    OIIt that e~ry child mould be immunized. In
    supermark. ts iI:ld football $lIdiutIlS, l he publi.
    add~ 'l'Stetllll ha". iI:lnllUnccd the same: mcs-
    uge. And in 10,000 parishes, Catho~. priO$u and
    ,,.
    the Church', 14,000 health woeke" have lal ked
    wilh miJ ~ons of PllflllS . boUI vaociDaling lbeir
    child ren (we pan el 10).
    In Ind ia, <heimmunization of mo.. than gO!lo of
    the youog ~b ild ren ;n dimiet, of Delhi and
    Kama, alta "- been ..hicoed nOl jusllhrough lhe
    passi~ avail.bitity of vaccinr:s, bUI , brough Ihe r 21%
    lC1ive involvemenl of ...tirc communities. T o
    -II~ ,
    bring vilCCinatiOll withiD th e ....h of all pare nlS,
    ., ,.,. 4·2% I

    _"'==------"
    G_" "' _. . ."."-
    immuoi:t.:ltioo posts wcrc "" up in l. mpl" .IlIld
    ..bools and pol~og hooth .. To lel paren ts know
    abou t ,he imponl1llcc of vaccination, messag..
    ieee et B2 83 84 B5 87
    wt:.. carried lry radio and o. wspapcrs, by l'O"1er
    and cu stic k.r, by bann....and proc<$Sion . by song

    "
    I THE STATE OF THE WORLD'S CHlLDREN 1986

    ....w., I1le MUIlim aden aad a..-.1Iw Cal .... !'limo MlaiMcr, te¥aaI ahiDet miD....... tile
    k bisbopI aad priom. die iDtenlII.iouI ....... Aqnd..... III ~ aDd _ , diff=D1
    mel 1M IcQl crpnju...... <_
    ptDd 11) . <kpanmmu III bolh pro.inciaI aDd DllioDll
    pmunml. 1M COIItIuy'. 2lO1#J primuy
    In Colombia, llx fu1I immuniratica ol 7S~ of ICbooI lnCbcn belaa wert thm: weeks euly to
    all ull<kf -foun ~ bee> 1lC~ by Ollf ol l be bdp ill 11'1/ p••panuioou; for tIIII a m,," i,n. The
    _ sj.nj5an ~ rettIIl eumpl.. ollm$l partici-
    ~Ii&ious lt1dm (I1IU(tU1 lUld imams) dcli"fffd
    potion in public bealth. Watched by obKrvttI 5IImIOlI$ in ""ppon of the immunization pro.
    from Hail;, El Salvador, Burkina Fuo, and g<2nlIll< from 5<4,000 lIIO$'lutS. Tbll military p_
    BnladOl", 10,000 immu.nWlioo pose. "01: let up \'idee! tran sport lJId fuc:I, . bll JOVllmnwn, ', mell
    .,.,..... 1M nllion- in healtb c ~n ia, ICbooI.. d vi<: and lilb ~hOllla provided cold lIonall for
    ""uu, markt-plao!:I and porb. To inform <be nccinIIa, and lIudcnll "' Hxcm~ U..;.,m"
    natioll'l plfCllIl, &1mosI alllllljor lll:wspIPftS IUld ,ook on .be Dlliona! ""rYt}'I ' 0 cn!UI'" Y1«i.rIa-
    ~ aU rIdio aDd <dtvi$ioo -*" promo..'" Iioa w . a ... bolh before aDd after tile q mpolil D
    tho a m" !!10 • poial ~ iI . . rinll&1ly 10 lOtI!, $10 1llillioII'a wonh of ,d .. iNoIl aDd
    ........blo: lOr ~ 10 ~_wvc olwlw::R aad
    wbm md "y dIiId=I "-I 10 be taka lOr
    ,..m.Mioa To p'bWi". aad . . . . . . \.be IiorH
    radio tiIIIII hal bem 6oDalee! to publicilc ~
    ampoip (_ poIIld 3) ,
    NIlioul v............ Days, lOO,OOO tcailm La 1M IuDaic:M, ' M Dinaor oi 1M Pm
    ...... on_" IS ill. ........ _l,llllll pri- Amaicaa H<alth Orp!!izwjm (PAMO) haI _
    au .. eocbid ;.....,nj7aricwl from pulpits ill "«'I _ ...a d pIaDs for I -.-.., "'1 jw,., rJJ-t
    . ........ ,., --.-. -J ,.. Jr- tfw
    paiah,.,...,. 110,000 """Wileen, pl.. the po&e
    aad Ute anne<! ior-, bdpcd ';llI tbc ....... 01
    tho: , . I C". aDd IppiO:U"'lil ldy 1),000 0Ilhm-
    A--.....Dr.·
    ~
    10 tile ..... 01 PAHO', Dina_
    CarfyIc Gucmt dc MJado" lhi$ CUI
    ' ..... f.- 1M CoIambi:ul. Red er.. __ Old the b1111dUncd _ by tIlc haolth ..... iocs..rom......,
    IteaIlb wmm "';!h lbe lICluai YXCiDatioa oloou bal by M."..,,., .......,.., .., ·Mn- iIl ...."
    Illrtt-q lllf1m of . millioa childrrn (1ft pIJld 5) . fftll l»', ;"n/illfllw ~iI1tIllf ..v __ ...n..
    ""-'q iAliitWturI f-iJies IIW . . . . .""irirf _
    In El SalV1dor this ytal', 1M immuniution of 11M ~ II ",,1ilM-mu ./Jon ;" tfJt'Y _~/1y,
    0"" I q......o:r of I Q>iJ1ioa duld~D ...... mod. dtdi«lltd W II ( l H f I _ m lllllfY, rIIIfllllil1td '" II
    ~blc by the lov•....",.n'lIId 'M IlICrrillas, by """_ ,..,,1 ... ~ ,!It Ii.... hI>s ~ fur III "' UI:I
    rhe health smriceI and the Catholic CbW'(h, by ,I..JI II ll llllQ(ltPUlbJ. fur II ~Y dild i~ ,1.4 A .....,"
    the ROl&rian. and ,he Boy s..W lI, by lh. Rod '0 SlIffrr t- ,.,Iio",'
    en. todtIiu IIld the international .,.,acia, by
    TIle huhh lott\'ica """" ptoridcd tIIIIllCh.n1>--
    14,000 1Il_ 1I<;l:IIItII1S 011 I'ldio IIld lmvisioll, by
    losy al\d tIIII .-li<:aI Itllpenisc for all Ibao:
    lloo 5 ,000 'llI"M'OICJ1' who "ent """'" 10 boule 10 :achit.cmu,lJ.. Illl, II•• , teclutology anel blow-bow
    iJlr_ ~1S atlAo campaip, aod b)' die 20.000 has bem IIIIdc .nilablc 10 JOI, iDslcad ollK 01
    ncciDatioa-lClDl 1!lC1llbm wllo manMd 0ftJ
    tile people bca_ it ""'" bcI<rI fil,ed to 1M maillt
    lIJI» IC:mpCInIY 1laJtlI pcIIlS l a c . tlo< Ulioa
    (.... puel4).
    01 -w mghiljnrioa aDd zand 10 wwbta
    t.luwcb I wbole raIlF III orpnioal ' ...........
    u. Kabul, Afabon ;,ua, l""' m"'" of ~ with I '-iaI radl' ..... fat bcyaDd the IIIlW
    IIno: breIl jm""""iPd ill ""*fIllS lhiI: ,... _ !be lllIllQCb III lhe- hclJlh ..mcc:s tb........h a.la tbiI;
    ....,n·bs Illd !be ' IOOiry IeIOc:n "'"' jl:Iined
    .ilb llIo: baah ocrri<:a aIId !be .... lDOdia to
    qllldnlpk !be jrmmrn jzwjm talC IlIIOllI Kabura
    """".
    1ft Turkey, this yar', "'mpo;,D to immuDiJz
    _00. .-_.
    - _...... '_._....--_. .
    · _
    _

    ........
    ....
    _- -. n 'WIfO ......
    .,.,J.... .
    .
    !of _ . ',...
    ... . _. .
    m."tCU _...........

    ~ JOI, III 1M !Utioo', dUld= l\I$inWJlwd II«


    iUII 1M IlcaJth Krricu but tile Pr$dcnl IIDd
    - . •
    .w· .....
    ~
    odp- ~-_
    .-. ..,l _.-.~
    ..... .... EI'l.
    u
    way, in nation after ~tiO<l , it is provinl possible doing I>"IO<e .boo. ,h ei, own and their famili",'
    lO inform &lid involvc ,he majority of purlllS and heal th. It is fill" this rc:wn lhat immuniz:l.lio:o
    '0 help boIh o;Jttle &lid mee' • much lnuder Protlummcs CI.II "rYe boIh 1$ an end and ... .
    dcllllDd for th e immonizatlllll of childl'Cll. <OCIfI. of prinwy health care, .c hicving both
    immed iate protection against specifK: dlscasa IIIId
    the invol\'CmCnl of ...bole socicti", in the wid...
    lmmwtiulioo ,..1<1 priJury bea lLb care
    and looger-term <:IUIC of heallh promotion.
    Thc$c atraor<linuy efforts :ul' of I;OII.f$C at-
    tend«l by a twwknce of C<lIIceml about their Such cunccms deserve sustaioed . " ention . But
    sus,ainabili,y, abou ' the rompl:acency they may afle' I~IY ~ean of va<.:tine availlbility, lhe
    denial of ill protmion 10 t~ hinb of lhe
    temporarily ind1le<', IlJ>d about their place in
    d....eloping WOI"ld's children deJlllllds th.1 s0me-
    Idvanciol the broader loa! of Il>Ol'C compreMa_
    sive and permaMlI1 primary IteaIth eare suv~. thing new m....t nOW be lried.
    It would of course be prel.... ble if there we",
    Sustainabi1ity is a legitima le worry. A ehllOie nf
    govcm ment or of. key minister, a fa.l.ling-ofl of """""" fuel IlfId ro-ds and n<frig....to<s IlJ>d
    inlO1C$l by 'he medii , • failure to edoale new
    clinic:s and scllools IlJ>d hca1th .."..kers SO thaI
    every paI'CIIt kJlew all abou t immunization, lived
    parents .bout the impomncc of immunizatioll -
    within easy reach of pcmLIIIent immunization
    any and all ofthcsec can tnClJI a dwindling . way of
    ..rvie... l'O<'l:i,'ed computemed mnindm in the
    coVCfllle .... es and ,h e sudden ",turn of tetanol,
    mail, IlfId bro ught his or h... child",n to he
    measles, whooping cough , or polio.
    vaccina,ed al c:n.ctly th e right time for each
    luToth... W(>ITy is that tbe boosting of immuni- individual child. BUI th.aT U 10 say nothing more
    ....tion cu.crage to tWOor throe times ito previous thllfl thaI il would be prdel'lOble if de-eloping
    lco<cl will be considered achievemenl enoogh. 11 COUntries were not d....eloping eowllrics. And lhe
    thl' hlppens, then the ida of Immun ization for !ICIIlellCC !lutt Mnittmal i"' ,"MMiMrioll ",MSI <ltWi,
    iIIl will nOl be carri«l rigbt through.o .he p<lin, pcmur_ ,
    ,">I,,,,,,;,, dnot/op1Mlo' cmd IIv """in, 4 d
    where i. reaches those who:arc the hanl..t of all to willi clinic'" ft""JI fJi/1t.ge ill simply. llente""" of
    rca<h, those who belon g to th e vcry P"I"'C'1 ~ IlII.neccssary da th and disability lor lIWly mil-
    of 5Ocicty, those whooc lack of money IlJ>d time lio... of todlly'. childl'CO IIIId for eveo Jl">QI'C'
    and information &lid confidence means thaI .bey millimu nf l hose IOho In' still to be borD.
    an: usually lef, in ,he margin s of I IIItioo', life,
    thooc whooc childJ'cn :arc most in need of th.a. If immuniulion rcmai.... t loda Y. levels tben
    poli o, to IIlke just one eumple, will paraI)'$C for
    deg ree of protKtioD against plvmy which immu_
    life IPprtWmately 2.5 million childl'Cll over the
    oization CIJI pro'lide.
    nelrt u n run ( Fig. I ). Ln addi lloO !O tM
    A thin! question mark over ...... imm\lJli....tion J'Cl'1JOnalwfferilli, the process of economic de.-eJ_
    asks whether such campaign. an: merely. substi- opmen, it..lf will . h«eby be dep.iv«l of the
    tute for the more patient and Is spectacular con tribution 01 most nf th llliC childl'CO and of most
    WOfk of building cu mpreheosive and permanent of those upon w!>om they be<:nmc and ",main
    WUC'l1l"C! of prinwy heal.h """'. dependent. Wh en a cheap and simple techoology
    10 prevent polio is already ,n 0\11" bands, it is
    In answer to thcsec COIt<'ClIIS, u pcrn,n<:c to dale
    Ihcrdore neither humane nor economic to allow
    SUggCSlS that the ClUse of prinwy heall h care can
    the disease to continue crippling over • quaner of
    in fact be sitl:nili=lTly odvanecd .hmugh th e
    a million children. ytllf.
    invol. ....... , of bealth profc:aion.als in a major
    achievement lor national dCl'e!opmcnt, through 111 the case of nxules, th e lij;urcs become
    the piooccriq of .... ys IJId mean. to bring. basic uothinl<.ahlc. A, presen. ~ls of immunization
    pi""" of health technology within reach of the COYCr.llle, • Imalof at ICZS1 20 million children In'
    majority, through Ihe 5Cl.tillj up 01 the neccssary coodemned 10 die over . he oel.. ,en ye:us flOJl\ •
    o u, ~h $tfU<:torcs, and throllih .he in "Olvemcnt disease which can be preven ted by • single
    of th e majority of the poblic in kno wing more and injection (Fl,. I ).
    u
    [ THE SI'ATE OF THE WORLD'S CHILDREN 1986

    Colombia:
    a child survival plan
    "'ll . . . . _ o l ......
    £ _ 110m h ' - ' """.OW til' P
    IleIunc llelIncu- on _
    ---.0 01 , . PIIn lOr o.t s..r- ...,
    WI
    " .sa, <l'I'" ............ at<:t*hn· . _
    0., ' . i. l .. CoIII!Io. on ' 9 O&oa, ~ I 9&<

    11'
    we PfQIll ID l»
    ..., _ .......... . _
    .. <Ill tepor'I on ,,,. Sr.1'" 01 N _
    It. - . i '" pro.
    til' IJNICEf

    Iflll b'fll'll WOIId HlWlh Or~ r10tsplan \01


    's ~
    ---
    *we-
    YJe. . _IO~"""~"
    10 . . ~ '" CoIDn"coI ., ,.. no <:l:>ll<IIen ...

    We a' p>g 10 '*'P "l1InlnUlQ . , . . . - . . .


    ............ ""_...-01 _
    _ lot ,.. til' "'" ~ 2000 ~ .. goong II> ~ looll suppieI,." ,IS 10 "'"
    c/lIklI'.." 10 ~ Lnl8r lWO. and 10 pregnanl
    wa _ ~ on a "'II'"'~ dIar>go In "..,..., ill nul"'''''....
    <l3rVtI All<! we Btl 11"""11 10
    WI lIl\'lIQICI'I lO '-<1 110 lld\IcalloIl jfXI lt!e ptOrrlO- llICM1e ~ .. "fit"""'l lO _ ... Sl,ltltnng
    lion 01 ..... 1«1............ WI _ t>egI.f1 to lr<Im ~Ill fll5pOrl lCry onlclctiorl!l
    - - . .. _1II1d .. lIIl<:lOtS ol lhol ~ llu1 - . .. IO ..... ..., ....,
    ..tv _ I C _ ...tl as me . - . na!JOnBI
    'f3OCO'lMlOn ~I wtlocf1 , )'CI<l d .8(:81. III>t ~ .notl WlIIl . . lIle ......... . -. ....." 1l>ll
    1IBd .. ~ oo;hQ ... lIC>iJ\lIIl:W. ot all III \'011, <nl 01 Ihe enIInI
    conwnurol'\' 10 ~ tau>ers ..., r'I'IOIhOr1 10

    --
    , .... ~ 1 " II.- _ we sliI . - l 0llellCt lII8l Ihe\I _ _ sn'QIe I<l IO ' ! ~oe aIlCI WI'II*
    ana _ "l" _ .. .eto'I E"'It'/1'- " (;oIcm.
    " _ o~. I 'Il lhe _ano ... 01
    ~ 60 000 ~ \RIel M s1II OIl !rom
    " • • Illy _ . ... __ ' '''' doe '"""
    "","01-' _ _ • • _
    ""'*'i. __ .. "' -'. <lnlg To del 11'0I. _ WIll _ t.C> . . . . .01.,,,"..

    .
    _ . .ij(Ii .... -.:I \lIUl,IlIllDllIl' EluI we lie
    TIw _ . .. . . . , 1IurIWl ...qAi _ _
    _ -.ng b . .. . . -. at ... ...,..
    '-110m - . 0 _ _ 10_ en..
    __ "'"""'""'.9
    QIlImU'ofI' ... ..-.,. bPOla. IIIe 1«1
    Ioe "'*"-Y _ _ Ioe _ _ .........

    _
    ~ -,.
    . . __ -'0 . . _
    ....... ~ """""""'" - . _115 .. ~ _+
    our' _ _, •• Jb>Or .. cu - . . _ ...
    _Ie"'.....""
    --""'"
    • r' .... l<qIOIlol ~

    llunn;_I'Ml"'~ IN
    _d60,OOO~.-y_TOxr-
    -.
    _
    PO ID
    ......
    puI"" ..........,.01 .....
    s1.., Ol ... MonIIWy 01 1Il ~ ..clII " . "' ~. ,'" ..., CtIICIaI
    '-- _ • PIIn "" 0IIIll Str-. Ii. . I. . . . . . ~
    _ _ Qllld_ 01 " el _ _ 01 "*"'-...
    n. DIl . . _ ...... _ ...
    ... - _... j - j'lll.IIh ~
    .. CCIlorr'Cl<I' lor .....,, ~ _ ...."., ..... _......, _ _ ........ Ollle
    we_PIlIllI_each_, _ _ d
    N........,._ .
    ~ 01_ Toc:uy, CdorrDlo his IieI;IlJecJ 10
    ..... 3 , _

    _
    <:r*l!M W"*
    we _ P"II IO. -
    . ..., _
    yurt; or •

    lNW~.
    _IO_...,.lI-
    ~., .....
    c::oI_ ..
    _

    ~
    no! 10 go 10 _
    Qo'rY CllIl . . _
    _ _ 01
    _ 01 _
    _01 ....
    "'" (WI !he 00I'hfy 10
    Cobl~1
    ltle _ 01
    cNdo'erI

    "
    Thm:;" nn valid rea«ln for fume r del. y. And fJJ«/d, wMrt """/Niil)' "ltd """uzlil)' for -..In ore
    there ;" no pre-crdained reason why the develop- ~itlsn, WOIlId '" twit f'(Q ltr. .. 0 prelillf;IfI)'Y
    ing n.tions should tread the same penh In full " .../yriJ ~f """ ilV p<orrollf/IfD ;~ 1M I..,., eo..."
    ill\Rluni..,ion 0$ was bea.,en by Ihe indumialized for .""",pll, '"",,,u 1M />eJwfi' 10 ",.. rori<> "",y _ 1I
    world .gen....tion "In. f or like JJW:ly nf Ihe lllher t xcud 20:1",'
    po...erlullow<Oi\t ba$k hahh $,ta,egies .,oail.bk
    10 ,be developing wo<!d ' O<UY, immuniz'uioh
    N.w leclutolotiu
    could become I oomributing elU.. m her tMn In
    eventlLlll Cilnsequetl« of ec<lnomic: I"Owtb and So fa" i' has bttn conv~lli~o, 10 discuss lhe
    tomprebenl.ive heallb care. 11 io dear lb.t tbere is lecbno/OIlYor immuniU l;On IIId the Sltategies for
    • Jong-leJ1ll Cilnne<:llon betwee n lb. men w IIId malting il mere widely availabl. IS t....c xparote
    pbysi<l.l developmen' of children and 'M! socio.I componems. In practic e, of course, lechnologit:al
    and economic:developmen, of 'beir n.rions. And changn <an h."" • Ioigoilicllll effect on bulb
    haic ".ps ,oward $ prou,cting the lives and ht:alth supply and demaad.
    and norma/growtb of lb. young are tberefore I
    lIowly maturing but uceplion.lIy high-yielding And lodly, vaccine te<;hno!otly bill moved on 10
    in.mmcnt in ec<l<lomk d.velopment ilOClf. the poin l ....h. .. I hallon', . bilily 10 reach high
    [e",,1s of immunWlion COVC1'aie bas become:
    There ore also shorter·teJ1ll e<;0<l0JJIic benefi's. oignific1ntly las dependent on ilS 1.,'.1 or o..-nolI
    In lhe industrialized world, the immediat. ce<>- ownomie developmenl.
    nmnk gains from immuni:ta1ion programmes have
    b}' nOw allllOSl been forgotten. BUI to lue lhe h has been commonplace for some years, for
    Ullited Sill.... In e..mple, the prC$C<l1 COl' of u ampk , for two drops of oral polio vaccine 10 be
    vacdnarion progtalllJllC$ agliDSi three of the acIminiJ..recl by vWaae helllh worken.. BUI re-
    Cilrnmon in fectiow diseases comes out ., S96 cen, trials in Cen,ral and Soulb An!crKa have
    $hown lh al chUdren can also be injeclcd Wilh
    million I y..... Witbou l lbio P"'llromme, lb e cos,
    vaccine- against DPT IIId .......1.. _ uloinB diJpote
    10 sociely of dealing with tb_ three d ~ (for
    hospitllllttUnenl and reh.hililaliO<l) would be al able $yringes in ' he hand. of conununily YOlun-
    1..., SI,400 million I year-meanins tb.uppm";_ tten wilb I rew houl'$ well, thoughH, ul Inrinin~
    (see panel 7). And .. thiI repott gDes 10 I'ffl&,
    mold y Sl. is saved for " ery SI invnled in the
    .<Krin.,ion programme! Similarly, the United trial. are bqinning in Gu. .. mal. wi' h the
    ' E,"ject' 'j'$tem of vacQnalion in which both
    Stiles io now avilli SSOO milIiO<l • year on
    meW.. lrealment _for III out lly of onl y S5<I vaccine and needle come packed l"Ielher in I
    ~le-1h0l disposoblc plastic JYl'inge. AI yel,
    million I year On ~nting measles by immulli-
    zarion PfOI1OII1I1IC$-' ACl'ording 10 D1'. William lhe re h.. been nO compiet. evaluallon of llU$
    focg., former Direc,or of lbe Unilcd SI.les method and lh. $yrillJe-nredk-vaccin. pacbge io
    not in commercial prodoction,"
    Cen lers for Disease Conu<.>land DOW hud ofth.
    international T..u. Force on Child Survival:" BUI in the last few y...... more conv.ntional
    M17rc "'~m "" 'IIC ~ On ,...... ,....., in 1M dtulopi", kiods of di.posabl. syriog. h.o.c demonslntcd
    th.ir power to Clliend lh. ou lreac b of immuniza_
    lion's arm in seltings as di fferenl as r akislan, El
    ' 11>< T.... f""" I.. CbiIoJ s..m..I_Iormod bip- SaIVlldor. Bm::il, ond lh e Dominican Republic.
    k-o<l ~ io BdI";" "01,, ;" 10$>, I'<I«:I<>J
    <0IIII";'" ill iD<r<asiDJ "'" ul1/'i"i"S~ '" <OW....,
    '0 i<IeIHi/;' ........ ~ _io oJ>< lioId oJi<I>olwO_. 0001 10
    ~ '"""""" for i.......i..,;...
    F-. ......·N·' ·d br. _
    _fUIIII<>.
    ...,..,.
    110< T»lt
    l6, !to< .........
    .. SfI<cific U'IiJUol: " ~oir<d 10 ... ohe ·Eleja;t· ..... !Iod01'
    . _. ...,.,. .... ...1<••..,., of "'" lioId lri>Jo
    . - _,
    """"oed willi tbild bnltlo: WHO, U1,aCE ~ Wcrid . _ • JnlOIp d lJIOO <1IiIdIeo ill &.1>1
    ,""""Nr b)' ...., 1-. ~ _ ";Ill ,be ·E>rio«'
    _ be
    Il&ok. til< UI'i,e<I N""'" 0..01 1 ,,,",,,,,,,,,,,,,
    (U !\UPj . - ' ,he Ro<l<f.lIn f~ 110< II<IloP> .,.....,. __ «IIIdU<t<d ill .... Uoitod So".. _ Cool. Ili<o
    s""'" h<IoJ it> >«D<NI aior ...... i.... ~ lI· . oi eon. ""rioa 1976 _ 1m , hu' ,,,=, .. . om! l<Jr runb<t!lrid
    f<"', ~ ill OCto!>« 198~ ev>l",,;"'.

    "
    I TIfE SI'ATE OF THE WORLD'S CHILDREN1986

    Burkina Faso:
    a vaccination commando
    III one Ihr......... eeee, S\aIIJlllI on 25 Noo· The CorrmtHl8:l b' .,. DeIerJce oI lto! Revl*J.
    ....- 198. , BurkmrR!lOh<II~Ie<l _' I01lCOAsj- POIillCal .aII.<I_ Ql OUP!l llCIMI II
    molIoon ol flli ~ 803fISl1ll6aSlel.. vIIIow tewIt IIYf:Iy ~. lOWn ...... -- '<.place - look ort !he
    "'" 10__ 9'" '" t>e _ 01 19 81. me_ mosI c:ruoaI _ 01 .. ~ t'- COIIWn,f'II.
    _ IIall ............., onl\I 25.000 01 lIle ~
    ..,."....... hill • _ c!lollIren urdef 1WO
    As 25 ~ _ . COR " . ,_ . __
    No e>.P8'1 -... ., Buttu,o,. F..,. lIIXII' 10 ooor ~ IN lBlef:Cs 01 ......... _ ,
    /omIIrIIt \JllIler - . • INtf . ._ to< ..",
    ___••,.ll 0...0:- ; l)llCII Ile3!l: Of
    10 _ _ 1l'Iey I'Jl,lI uP _
    IO'lI1 lltJ1*: _ _ III _
    WI~ , - .

    1>1 ~ III.' 1 I
    .... __ '" """O1l f ' - .... or IN r.gr,. _OO~ ....., \ l*Ys ""'"
    ..... "O' .... i _ .. ,.'-'O_ l ~ ~ _ _ _ _I*bn"ld ~ The
    , .000 ~ _ less ..., " . of l N ~ I\Al
    P"C".....
    0 .-.c
    . •_ 01- .
    _""""""01. __
    """"lI ~ .. d'oOClll\'
    f
    ..-_IIr9
    . t _........ _ ~ ' "..
    . ....-o__.,.....,_
    _ g .... _ _ IO . . caAnlI ...... "'¥ came n
    .....,... _ _ . .ClUIWyoUng . . ory ......... \I'llI _ _ p.-s - - ' IllI b
    _ .."", F..-y 1O..u... The _ . . "' _ _ ~_0If ~N! b _ ~ "
    ,. . . 5 ' . ClIlllnIl<s _ _ 11 _ _ gl _ ...., d'Iben *".,*' b Wo-
    _ "':lol" _ol~1lII Salone ....... --'r wMf'lIlI'o'OI.ql"l»y
    carne "..- ... _ kim
    r...-
    __
    _ b.II _ .. a ba<l_"~C*l90.nogn ~

    as ' 3.000 ClOSeS . - . lIIeI1lIll til' _ re:;alMlS '" illmrIa Fa$O


    CtilcIrename _ _ "..- _ . ..... _ •....,
    n- ........ .--ed 1IIlI ~ I now *""-"t ~ ~.." .-lIOn ~ 10 '*'
    go.e< '.' ", ~ 110'Vilfl[lr'IlIUon Com'r\iIr(Ig- - . mas·
    """"" ..ttl .-.cconlI because lat /IIOIe C/lIlcIIen
    SIVe C&1CI'I-uP IfTI/nlIf'OZlIllOII til".. 08SIgnIld 10OMJ Il.rnN! ~ _ eJ<l)eCIN!. _ have - . on
    me 1leaI ~ _ a_ 110m me ~ ' IOC
    IhlIITlOI'e i'l Burlunll FlI8O. as .. al lIIecounttOfi ot
    _. _ • b'88lIl~ on _ to pj«ll",
    tIIll &ough1-1lnCk.., 5ahaI
    ~ "'" regular vacdnalIan CO¥efalII.
    1o _ people's 01 lie ...... cI The -.II . '" I I!"9_ oIl'J1l" - 1 ......",
    O'I'II'lIUr"OUDOn. V_ Co ... eoOO_ lIle 62'l. gl - . . ...... III.-. life """"""'*'
    0'
    V Illl:Il known as
    ,.101m
    .. _ _ 10F.
    In IUluNI ,
    lJ""I _ .._ "''"*_......
    agaql ' - -""" ~ .. ~ """.0\jIIII.
    lII<l--'
    _ _ ant, .... stooIbW ............. ,...,.... , . . . frOm 7'" k11i1l'1o
    On 19 SocMi'iOS IN CClA:iI 01 " " ' - ' _ ................... '" CD' .agoocanbe..-..cl
    .. _ TN _ _ ....._ , Coo ~ .. "' _ loci '" ..... Cll:U*'(I d . . . -
    _ lJf .... ~otl'ldc~ . k1111-. llulV ,Co," ,. d;>_ _
    _ - - ' IIor:l . . " . _ 01... _ ....... ablgo'.'ll The 7 ...... _ _
    • bit.... \ ..,."...., ..., _ . .., .."",.... " " - 11> ....... ClIIclMrl·. _
    .... )01. " - -
    .. _
    01 _ _
    or
    ......... , W'i'- . . \1l1l ~ QN;Mi .
    .-.ct. ~ _ - . lHCU . . . AId c.... . , . - . gon kim •• • ....... ~ r_
    ltd CIitIIr lib _OIl ...... _ ..,.. _ .... '*-'*' .... b~pmWy_
    _ p_" •• e, llCCIEIIy er....,.. Aop.t>. . . . 10 .. II 30 llIOO' _ • ....,..........-.g at II
    Ie oIl<orea. -'W"M Ieo::tnclll =...... .....,.,_ _ by 1090

    "
    '" panicul;ll", ,he UK " f disJl<>Uble syrinSes in
    th e hmds of «Immuni,y VIlIUnlttl$on certlin SCI
    ..nt 1Ui" ~ '" """l j",,,," ,,,=,,iorr I~ all
    <hildml ill 1M IDDfItJ ~ /990 II(IW Uirm.l ' ''fIIlhk ~f
    da ys '" .... d ,s of the yrsr is "pening up broad new ...,I,=,';"" if ,Irnr is " u>ill 10 .tt ,M ji""l .fftm."
    pubs I" the immunization of all chi ld=,_
    '" th e las' y= and I half, me ou'Slandin,g
    o !lcrIux the syringe is dispootd m rolhn ,hOll ~nmples of Illa, 'will' Ju,,,,, bf<n KCO ;n Sl'"ttal
    oa,ions of ,he dc\'Cloping world. Thty ho"" been
    steeitized for mISC, vaccinal ion P!'ORramJII[S an
    be: frttd from Ihe weiBh' of ,ime llld energy mmples ..., by head s of state and government
    It'quitcd rc boil syring ... for 20 minul ... bc:fon: miois tries, by health xrvicc adminissrotof1 lind
    n:use (al the W\>[ time .. reducin S the por;:sib'~IY prillW}' beallh care workCf1, by dOCIOI$ and
    of disease tra.ll<mis>.i"o via muhjp~ ux of 'he nu nes, by local 80vemmenl officials Ind civil
    same n =l~ ) . lm'1fItS, by the 'NQI:I><O'S "'llaniaations ond the
    you,h lOO\'tmems, by ,he reptt:SCmllti"cs of ;n":1-
    o !lcrIusc: r<>mmuni,y ,'<lJun'e<rt can be IIUVII natiooal qeocic:a aDd of voluntary " rgmiDtlons,
    '0uS[ ,he syrinS', immuniza,ion P!'ORramJII[S an by jourollisll ond broadcasIen, by priests and
    _ape rrom . he Slrail-jar ke, of the dorIor's wbile imams, by leacllm and SllIdeo ll, by ,he Red
    COI.I ( fully qualified docIon an p~ a supeni- C.... IJld the Rotarians, by ' he priv ate sect or and
    iOl)' role in sucb PTOllraJllllltS, ra ther than ~Ili tho tnd. unions, an d by llWIy millions of patenu.
    penonally inV<llved in giYing ...b aDd <wry
    inie<1ioo ) . 10 mos, if nor III cases, lhe mobil ization of a
    5OCiety" reoources on sucb I >eale an d behind
    o !lcrIux vitLaae varcino'ors rttciv. supplies such a ""USC has heen lllade pos$ibl~ by rhe
    00 jus, ,wo occtSions I yur and u,e ,hem within decision of a notion's political leaders to pu' thei r
    days ,,{ their arrival, lmmUnizatiOCl P!'ORramJll<:S "wn per$OJl;O/ and po~tir:IIcommiun~n',..,d , heir
    <»old be cu' f_ from ,he <:old chains of ll"yemmcnt's finan cilll and mpnlza,ional ,.".
    refrigmnion. seurces, be:hind the d fon 10 immunize the OUI
    OIlIj<>rity "f t be os',,,o', child..o. In EI Salvad<>r
    oimmunize
    And becau se lhi. method [()Illd be used
    such a biSb proponion of ch,ld ren l ll a,
    to and ,he Dominican Repubije, in o,lombia ond
    Brazil. in Turkey and Sri Lank.l., in Burkina Fa.o
    one , ime, il mi8h, mun , hl l ,he lransmission of and the Sudan, fIIC«Sl $0 f;ll" Ju"o bee o made
    lhe io rtcti<MIs diseues W;II $0 sc~n:ly ;n,errup,ed possible by I oalioo'l lcallership decidUl& 00 I
    tha, I dCVtt of pro ,ecUoo would be provided lloal which it could see was both d ramaliclllly
    ....0 '0 those ...1>0 W<rl: no< reacbed by ,be: lntp<ll1an, an d reoJisl iaUy achievable,
    neeioolion juel f.
    Techo<>ltllicaJ d...elopmeol1 of 11m kind an:
    Ille",fo« malting il tnCIf[ pos$ible r", OIhe! The illdusuillliud worid
    "'llan izcd =tions of "",ie,y, far Srellel' in lhei ,
    In ,h. indus'riaJiud world, ,h~ COlIUni"n~n'to
    OII,n:ach thIIl the bealth services th emselves, '0 world_wide lmmUnizatiOCl bas $0 far, and with a
    bec<lm< inVlll_ed in . x«odinS immunizltioo ' " all few ho nounble e~C<pOOns, been modesl. An
    a nl tinn', chi ld..n.
    aceptinn large eno ugh '0 demand acknowledge _
    BUI makinS uni~na1 immunization possible by 1Il<'tl\ is the $100 million allOCll,ed ,his year by ,he
    00 means lIlIkc:a n in... itable. And 10 toll...rt ,1m gOV<ntIllCOl of Italy IS a special roOlrihution
    oew po,ential f<>r uni""rsal lmmUniulioo lo,,, II« 'owards ........., rli. lit>t1 of 011< ",ill;"" (lIiltJrnI","
    loCIull vxcinatioll of all child....., an act of (Hulll, ,b. rl<,.. lopin g rooo,ries ,be,.,..lves
    gaJ .... izinll poli,ial will -by a nation's lcallen - is
    If[prov idinS oyer SOll. " f the: t'CSI>IU'C<S for their
    ,be: c:a, lIyst wbicb ,. $0 d<SJlC'ro«ly oceded. AI Ill.
    neeinatio o progrmuncs."
    S=c,ary-Generol said ,his ScptClllbcr (I!nS) in
    1m n:port ' 0 'he Geoeral ~mbly nn 11« Mean wbile ,be 'otlll :utIOIIJI, of :sid bring
    <><CUion of , he fortieth anoiven&l)" oftbe Uni led provided by ,be gOYcrntnCnll of <he ind llSlrialized
    Na,ions:- nation. for all health suvic<s ;n th e de".loping

    "
    I THE STATE OF THEWORW 'S CHILDREN 1986

    Dominican Republic:
    reaching every home
    l he II'Ba I8Sl'""!jlo lfftall<> ' - ot aet»evwlg chdd sately "IJ"lf\$l measIios. I"" f9d Ir3I<WIg
    a """""bOn ., d'IIIi:l health is ee <liHOCUIIy 01 COIne haS been foIowed by all 2!1.00a voII,on-
    TOOrlI. WOIlmg ill m l
    !l't'IJIlII U'lClt< ee _
    leaching "'" WIlY poooresl 01 "'" C1e" e'JP"ll
    -"'"0 C/l.lOrCl1. $ion 01 sPecIallY _ IlW!l<IIlMI Dutmg lhlI
    1t>o d lll:<:uhv SIems from !he fac t lha t POOIeI
    eeeee I1iwe less ~llon ana
    C<lI1ftlence. less
    by lI'I"'l!I cac!l _ an ""toon
    tranng >'llIuo!\lflrS practISed ac1lJaI ..........-.z.31ion
    01 _ .... 12 a
    stalL.l!l and access. end _lime and _ IV'Id Durlnq !he C3II1l'l9" iIseII. <Iisl>oseble symges
    1lo'Il81 makes if ooutlt,t imP<><\<lIIl ;S \lie fact ilia!
    I'Iealth J)f(lblems SUCI1 as _ d _ 01 ...-,
    __ u<M to otwIate !he d ;fl,cu'hes 01 SleoOZIOII

    _ are both moRICOO' ....... ,andmor.. _ Aline ena 01 1985 Ine ..,..." .... 101"" I$llue 10
    _>g "'" poorer _ fIOne (II ;my SQQet ~ irrrJulil:e ell VIQI1lef1 ot clIIId·~ "I/tl ilgaII'ISI
    IeIanUS. so 8lso PfC_"", lhe ncw-t:>om bafloft!I ot
    Tl'ioll I••\Ila(I'8 '''''' prOblOm \1"'0$ 9IleCiaI sigoIl~
    <:I>i'oca to _ 1 IS tlO'" beong ~ -and !lie M UM . Al !he same llrM. all c!Wdlen unO<or two
    pIanneO- ., Ihe Dorrw1io:a1Ile1lutl1oC ..... doe to be ~ Ine l:<$l Ollhe lI'lrlle ~IOI'IS
    IIQairosl diI>Illnens . wf'lOOPonO <:W;II1. IIIld lei""""
    0It>et ClDI.WIIOCS M oe a n<'mple<l to ~
    O'eal(ll' J'I\IAItIer$ 01 the IlOO< by setlinlllJll ~ PrOVldOd the CUl rlllll 5CfledI,.iO;>s ",,, mel . llle
    'aI'I lI'IIIT"OJ....zallOtl posl$ dDser Ie pe(lJlI!l'$ tunIls DorrOncan FIeputIIIc ~ have """'InleIJ l'>e IIasl
    BuI 1"" Dom>nocan RSllUbhc is goong all "'" mllp' Ll\' 01 ~s und!lI·l.ves ~ the ""'"' loUer
    .....~ ~ CII"Y""1l oacdnahan right i<lt<> !he Mrne 01 ~ o! c!lokh:.lOO by rrOd-1 986 -tf'j'aa aoll a
    every sOr>gIe famjy hal! year, _ oIlne iJltomauonal target dllte.
    In 19113. the t.linislry ot _ 's ...... syslem By w.sMu llng r\ll.tiOnill v&eanallOn dII'/S (...",
    wM1 "'to 81:1"'" 101 "'" !ltSl _ as 20 ,000 _ sen! out [USl iJl advance !rom 8 """,,<II
    ~ gave OI'aI POlio . _ 10 choIc2ren COlil :l!o<agol <lepoI). the progranme "- scI'ved
    un<leI I"", One ol I/>OI'le '''llIu'IIOOfS' WirS 11... the prOblem of ~ year-'wn<l "'.. lgm....
    Pr_ 1(l1 1!Ie Oomncan Repo.Clloc - wlIO ...11tIe lion IllI!Vef)' 1lea1l!1 cJiroc By lIll1/1111\l tnOllSaIl<lli 01
    . <ampie ~ I'W!I$f>t """..... zng 27 etWll",n " Ills ilCUo1OOiS. Ihe prO\ll""""" lIeS _ Ihe pral).
    0WIl l~tlOOd . Some 9S% oj IN MIIon". lem 011101 tleVll1g ..-....gIl llodors 01 p<Ilamedic8
    cNIdreo !\aYe bee<> ,...,. prOleCle<.l "9all'l$l poIIa By VISflirIg -.ry home, meprogrlll1Wlle 1Ias_
    _ sn:a . and flO now cases MWl be""
    '''I'OI1ea !he pr-., at feacIlII1g the POOl"" By 1lutI01~
    101 0I'8r t¥l'O l'88f& the S\IIfl and fundlng fer nalIOnaI vaoornlo:Jl1 daVs
    inlo !he Mnslry 0111001""" ""'" budgellinl:l\ll:ll"ll
    follo\w'lg tne Hea/tll MinISIer's Slep-by-SIeo reouw

    ""--
    PfO"'SI(II1 fQI tho lIaonroQ 01 ~
    pI/In. !he syswn -.. onIO BCl><:o1l>gaJ'1ll 0cI0ber vo/l.UlIeeIsl. Ihe prograrnrne 1IeS!llCl<Je<l 1/'18 DIal).
    t 985 - u... lime 10 lal<8 01'1 "'" mom a U""'" lask
    01 -aconallOg all tne n,u.on·. clIiklr~ ag8OflS1
    measles In malt)' 1ll1IicInG. """" QUlIlihecl (lOC/Or.OI
    .....- ,,'" IIIIcY.lId 1O I'SelS'fl"'lle5 and ~ to
    To IlJPPOI1 theSe e/Ior1S. 1/'18 _nmenl ..
    AUQUSI 1985 IauocIled 8 Natmal f'rogr8llVlll: 10<
    _ ~ . But ., 1M 00rn0'I0:an Republic. Mol!'ers end Cl>iidren. 00\h the ~.?"" on

    I9aCIwlU package-beid
    teS1e(I ogan Dy !he MO'IOllry 01 _
    me ""'"C t .,Ioomat>col a -0101'1_
    1_..-.
    PlOII'l"'InQ metho<ls hMl reecee Iho UiWW>g to
    oriy lour _l/'><lIq'I1<Mll hOurs , An ,, <,I(I ~
    and
    - C(I(IVfIY'!
    _ 10 I"ljeCl a
    irnllrOYll1ll tneIr '' 'XlIIll8i "" III llOOl rural am si,m
    or"""
    M\IoCe
    , he plans r>cludc larrllly p/emIng~ .
    pre.netal CiQ IIrIO ,...,..;te lIaorOo\; , aklI10 ...m
    on OIeasl._ng,
    0"'1 ,~"""
    gowt~ 11"I0I1I1OI1110. end
    to IorestaII diar<hoeaI <)eI1\'dt1lbOfl

    "
    world i< only abou' ~ ,DOO million a Y"ar " -th~ been able In diK:ontinue smallpox vaccination and
    tQ.uiV:l.I~nt of about we dlYS' militllY apendll1R dismantle ill elabtlnl'~ quan.nti ne aDd surveil-
    ( F ij. 19). ADd of that ~ billion, only about 10'- lance ,YSlems _ which w= =ting IpproWnately
    goes to 11I1 m<llb~r Ind ch,ld heal,h servict5, Sl 20 million I }'Uf in ,<>day'. ,~rms. " In other
    ,1I<:IOO,ng imm uniution ." words, the ~tion or I major disease has
    mean, tha I th. Uniled Stala i< now ... vil1R tflt'Y
    By conlnsl, many priYlle groups ;n lhe indus-
    few """'1M ~ Iballthe tOiailmO un',1 invell,ed
    'rialized nations '''' heavily and generously in-
    in th e e1"Idiralion P"'lrammc: irsolf.
    volved in conlributing 'oward$ ,h ~ goal of imm....
    nization for aU child",,, by 1990.. To mc:Dlion As we have already menucned, the United
    anothc:' particularly ou'standing mmpl~, ,b~ one S'"lelI i< 'oday .pentlini approximat~ly $50 mi1-
    million mc:mber$ of Rotary In,ernational bave lion a year on vac:cinalion and routin~ surveiU""""
    conunim:d the:mso:lya 10 PlIyillJ fo, all lhe: lll ainsl measles and will ecnnaue '0 do SO rOl" as
    vaccine required in any polio cam paign in lOy long II _ I.. i. a, Iarg~ in ,he world. A
    d~vdoping country 0"'" ,b~ live years from no w $u=fu1 er.Idiation programme would ,h~re­
    un til lhe }'Uf 1990. The loW COIIt of R01I1Y rore lave the United Smell $SO millioo a year -
    In' UI1J.llonal'. 'PoIio 1990' campaisn mIlld bo in <:Ye1)' year fmm now 011.
    <h~ "'lion of SIM million; <h~ tOlal ben efit could
    bo ,b~ prevention of mon: than I milUon C'ases of The humanitarilll CIS< for immunizing all
    PlIrllytk poliomyelitiL " In many ;ndustrlaliud . hildrm ia boyond all question. The ,echnology
    .oun tria, utionol ronuniTlees rOf U NICEF and for imm unizin x all ch~d",n ia radii)" lvaillbk.
    other non~ov,,",me"lal organiut,Of\lI a", also Th e ctl5, of immun izil1R aU child"", would be
    worlcing '0help nisf: funds -and aWateness -'0 ",paid many , irneli over for boIh ,ndUitrlaliud
    support the goal of immun,za,ion fOf 011 th~ and developing nmOllL And th e all·imponant
    world'. child",n by 1m. orgarliulional and rommunicatio ... capaci' y for
    Then: are pe, haps two oWn ",asan, wby the l'elIChinX OU' 10 ereo", and met'l Ihe dema.nd for
    immunizing all children, has been sIIown to lle
    go""mmenll of <he indUSlfialized wOfld migh,
    wi, hin ,he power of ,hose nltion. with ,h~ wUJ
    wish to consider a much grea ter level of IUppon in
    order '0 help ",alize thi! new polent,al fo, and commitmrnl'o do it.
    u",venaI immu niut'on .
    In tM process, imponlnt mid.. could lle made
    The lim, and m<l5l imponan" '" thaI lhe 'nward$ primary bcaltb .... fOf all and new ways
    imrnuniution of IlII child "", ",OWlIS one of th~ could be o pened up for putting other pHo:ea of
    gm n e>! of all human,tarian goala. vila! heal,h I<.nowledge and other Inw<OOl.technc>-
    T1>c second i< that it would abel ","ult in vr:rj lOll'" at Ih~ dispooal of th~ IOIjorily of the p<:Opl~.
    signiliaonl economic goin. fOf the ,nduotrialized
    Th . next cha pter of th i, ",pon dixUSl<Ol $()nIO
    nati"", th......I....
    of , hose othe, low..cost l«hni qua I nd Ioola I I
    Eyjd"""" fnr thi< i<'0 bo klund in the an nal. of whal CXIl bo l~amed from experienccuo fa' in ,h~
    th~in ,ernational ampalin 10 eradi"l~ omaIlpox:- all empl to put ,hem II tb e diopo$al of ,he
    majorily. And as wjth inununization, Ibe solution
    10 1%7, omallpox killed an estimated 2 million
    does nOl ..... solely in the lechniqua th......lv...,
    pe<>ple. In 19n, th e last case of smallpox wu
    bu t ""her mid.. in the w ~1 and the capaci,y of
    n:corded ;n Somalia. Th e l:OSl of the er.Idication
    natio"" _and Iheir leaden - for ",aching OUt to
    campaign was I pproxilf\ll, ely $24 millio n a year.
    inform and .uppnn parenti in ulin x those ,ecb-
    of which about ont-thini came from Ih~ indUllri- uiq u.. 10 taIr.e mo'" controlnve, their own and
    a1ized natiou, and , wc>-!hirds came from Ih~
    their familia' healt h.
    deY~loping countria IM"""Iva. " F or Ih~ d Unl-
    tion of th e programme, the Uniled Stata ronlril>- If th l' ClIII be achi.. <d, and if in 'M Pl'OCCSll
    u,ed I total nf $32 million (in 1970 dollln ). ~ health eare can come tn bo IttO not only .. pasoive
    Sin"" Ihen , th~ Un,,«l Smell g~rnmen, hiS reeipienoe of services when sick bu, ;OS aocti,-e and

    "
    I THE STATE OF THE WORLD'S CHILDREN1986

    informed ifIvol""....nl in lhe daily proc:aII of bring . bou, • revolu tion in c hild health an d CUI
    $llIying well, thO'll the lechnolOllies and the by II lew IWfthc n lc of mabull'ilion, infection,
    kno1olq e D<lW a vailable,,"", cheap enough and and death among ,h. childre n of the d• ••lopiJII
    manageable enough ror parents ,hemselves 10 ~, ,,,-

    Reaching aU children
    Paten ts canDO< make <hcir own vacci nes. BUI </IUd ..,In.,n',;"" uJ <lIilJ tIrolll i. 1M .......
    'h= is a product which pamlrs can make, whicb
    t hey can gi•• '" Ibcir OWn duJdnn, and whkb " -~
    At present, only abou t 20'4 of 1M world '.
    jU$l as ,mpon ant for ptOIecting .bcir Ii""" and
    families kn ow ~o01l&h l bou l ORT 10 be . hle 10
    thor hnlth.
    u.se ir. BUI il ill aireldy "'Wnlllrd 10 lit saviog th~
    Tb..o.t prodUCt is on.! rehydration mlut;on. It tim; of lOOIl' tblJl hllf a miJlioa chil.mn a ycu.
    Old "" 1tIld. -.vilb nne of the 200 million _ h. .. of
    oral ",bydnllion WI . _ rut h wen: mass.produced TCliether with risio g immunizat ion rovenge,
    th~ spread of O RT .h~rd.,... h<llds ou l lhe
    in 1M d~loping wmid 10$l. yc:u (Fill. 6). Or it
    call be mad. I' bllllH' usinB ci'lI.... .al l and rugu
    promise of a d<utic reduction in dtiJd. deo\ ~ and
    oolu,;ons or tAditional remedies . uclI as riel' child malnutrilioa ever lhe ntlt few ye"an. Bu. as
    COll~ or <:aITQI _ ps.' ElIhU WI)', such • wilh Unmuniz:a.wn , rulizing this tDormo"" p<>-
    t~ntial D OW d~pends not on Ih ~ Id~ntifi< break·
    solution COP dl"c<:ti""ly prevent or lltt! ,h.
    dWrllooll dehydnt;on which is $tin killing apo- through itself bUI on finding the ~ulv.lenl 'social
    prolcirnalely 4 million c hild ,..." _b 1"',' hrultLbrough' whi<:h <111 pUt O RT I I t h~ d.isposal
    of lIIIDy millions of ~nl""
    The technical de ,aib of O RT a,., KI lKI' in Part
    II of this "'PO" (xc lifelines: ORT ). BUl luch I
    hrellklhrt>uih hnrs restating in all itl simplicity:. .. TIlt lI.i,td StoIa o\icII<}' lor Lo t~ Ut" loiWaiil
    (liSAIO). _ do AdmimIo",.. ,..., ." " ~ III>
    171m is MIll nn iotmdibJy dwp, fi",pk, "'ft, alii 11II6<...... '_., '0 til< pn;>oaioo of onI "b1dn-
    •ff«riw /lVlhod ~ ",/lic/l po...... ,,,--1m, .ww. .... ......", in til< _ loP.. _
    .........1ioIIy 10 . . . - 01 til< . . . OllT _ _
    ..... is _ ,ribW..
    ...... ptNr, <>:1ft jJrQ<tt:, 1M Ii«> IIJId , .."" ,/1 ~f ,lvi, .. din thio ...... "',.,.. (I« _ I n The lINDP ....
    cllildrtn aga;MI ON of 1M """" """_ "'run of oloo rio,... • Iiltoili<u, 1<1I< ill .... _ ....-' triDc-
    """, 01 oral , - """"'. l!lh>qb it> ......
    "'pport 01 .... I C<out !<It IIiotrllo<ol Uitt_
    _ b 10 Bo011 • "" (ICIl DR.B). th.wob .. _ ..........
    , Lo .... r- ~. OP-T _ _ -u. "",, 10.,;.... <mid of . hiclI OllT _ ... ;, ... . ".." ..... ' ........b .. """
    I"O<! "'" _ o.n..", <$lito<k of <lianboea. T. f't\"IAo:< til< , - - , "p ( _ WHO, UNICf.F "'" us.o.1 D) of til<
    <»<AtioI ~oidI .....
    odmiDiP.<ted b\l' til< _
    ool l ~ ani .... )'drMiooaoI_
    .. in til< <AiI<l~ """ _
    "'" b<
    _,.",.
    Io I_ Cod , _ o..I lt<II,..... The<an.TIlt
    _ _ 000 _ ;, _ in "' ,00 D.C.• tIIio
    citba. 10 «III _ of _ ....'fdntioo 001<0; 0< . _ ' ~ ..,.. ,. _ a1>d -ill apio brio& ' 01 ltoto_y
    _ 001. ,* of oo/t. "'I-'< (0< rWo< rowd<r). ood ...1« (i<> <liIl' , .. tiooo, . ....... ..... ~ """ "'" <Ii=lly
    .... ""bl _ _ h Of • v<nioo of OIl< of til< <ff«tj""
    l.-JitioDo1 _ _ • • rita _ i<c> Of <VJOl _ po.
    ....... ....w, 10'Ii oI lIII ""'" will _ ....... opodali>«l
    in
    "
    l UNFPo\l
    _, FIlIld !<It """"'I'"
    in ' M ,.. 0I 1IfOIIlO'ioI a RT. ADoUct UoiItd

    -.1< .. ~ I_tri_ to ....


    A<1ioitirl
    ttQl.IIItlI, {oudo .. til<_ of WHOj UN la ~ lormul& <nl -uk of lCDD R.B..... iollO"i<ulu. ... fuzIdod .........
    "'"'Pl'l . "'" io oil . lUo:h - . . . . . . du' _ '" dIil<I _
    ....ydn<ioo.
    """'" til< ri>I<
    <II of
    ..- 10, _
    ....m, 01d<b~ "
    ~
    -... .
    ;,~. b\l'
    tb< ~
    '*""1y ~
    IimpIr lII<2OUt<IliI:t ORT. neo Iinlttd to <fktj""
    '0
    l<>d l>oo ~ ""-«l....-.;..J
    !II< , ao1miIlioIruioo of oral l'\lfotioo> "' tb< - . ,.,.. ...... d<diIo< .. -..IM"'I""",b (_ ....... I l l .
    Rosie proIe<:tioo ..,d vita"';" A cllildmt who arc now dying exh day in lhe:
    de"eloping " wid.
    ORT and hnmunin.lion 1"",0(= 'l"",d in the:
    from line of a rnolulil!n in child iUM val BUI It has been found , fot u&Dlpl.. !h11 babies in
    lhey do nol fland alone. poor communilies who :In ooul...fed .... lWO or
    Ih"", times mo", likely 10 die io infancy than
    Ove, lhe lut th"", yun, tl>c: 514,. oj 1M W",./d'i babies who are breast-fed ( Fig. 12). R... r>iDg
    C.ildffll rq:>(In has broullhtlOll.tha raean:b "",d the l",nd 10Wliros the .... of artificial infant
    aperie""" from :around lhe world 10 show lhat fottIlulas ( F ig, 7) «Iuld th.refore Ave lh.c ~ ... _
    ....eral such basic brcal<lh'OUIlIu have BOWbeen and p7QIC<:I the norm.aJ gro wth - of hundreds of
    Imde. Taken 1000eth..,., lh.y could enable _ tbouwtds of infanu in lhe d..... lopilli world {Itt
    pw:nl' in poor communities to protCl:l !he ~v.., panel 23 Ind lifelines: b.et1l .f~ }.
    and nonnalilrowlh or their childn:n.
    II is also no w lhoushl that regular growth
    Specifically, pre,iOllS )'CaQ' "'pons b"e d... . hoelting, al""g with ebanges in the lUning and
    monstrat ed lhal knowlcd.lle abo ut breasl·fcedilli, mr!hod of _ inll, could reduce by half the
    impro\'f;d we:oniJli, and rcogular tDOoi\o}rinll of incidence and ~""rily of maloUlrilioo among lh c
    chikJ",n', llrowth could , aIooll Wilh immunizalion pon. wwld', children (_ lifelines: llrowth
    and ORT, ssve the ~_ nf II leul balf lhe 40,OOO monilorilli) ·
    This yea" anoth..,. poIcotial. bl'9klhrough 10\11I
    Fig. 6 Global supply of oral rehydrat ion be added 10 tho list, The findin g, from • major
    salts lWHO/UNICEF formula) child health study ;n IndD<lClia appc# 10 have
    '70 ronfinned I loog-held suspicion lhal a lack of
    .itllnin A in lhe child's diel, long known 10 be I
    ""
    ""
    cau.. of =<>phtb.tJmia (drying of lh. cyet) and
    ....cmull blindnl::ll, is 'll1lO an important delcrmi-

    "" nanl of a child', overall healt h. Pag. 12 illUSlralCS


    Ihe remarkabl. findioglhat lho incidM<'e of both

    . ''''""
    ~ 110
    respinUOl}' and dimhocal infcctioos {the two
    ttIOSI CQlIlblOI\ c~\ISe:l of illn.... and dealb amoog
    child rm of lbe d.....IOI'ing WO>"ld} i. c1o.d y
    ~ '00 assodaled wilh Ibe dCS"'" of Yitamio A defici,
    ency.'
    § :; Al Ml, it was believed thaI Ibis IIIIIOciatioo
    could h.c explained by lbe idea Iha! the lack of
    " 70
    ~
    ,ilamio A Wll$ probably only an ind w,110, of Ihe
    60 IIIUt1: l encral malnutrilion which is w.U I:nown \0
    > 60 predispose a child 10 illncu. BUI fonbcr anal]'1il;
    so hOI lug.gated lhat Olhe:twisc well-nourished
    childtw who lack Yiwnin A are lOOre prooe to
    :JO bot h dimbocal and =piralory iIlnCSlCli than an:
    eo poorly nourished child. en who happen 10 have
    adcqual . 1.....10 of vilamin A.I
    '", ""J"..ao-~~-"",-~!,----,J~ In the OM maior lest of Ibe prxtical $ignili-

    _ co'",......·
    F_....uI!:I n
    "
    lIdOIIon 10
    can« of lhose findiogs, 'I oppeatl thaI diflri bu-
    lion of the fl andard UN ICEF vilamin A capsul.

    -
    pmclL.Clion ..cry IiI lOOOlhs has suc:cceded in , educilli child
    1'WI_~, .. _
    IO_POdalU ....
    ~ ~0Cte~ .... _8C dealh r:atl'$ (in the "ie 8r<)11P one 10 lbru ytVf )
    by apprnlrimat ely 30% among I population of 0" '"
    IS,ooo cbild no in Indonesia.'
    -~

    "
    I THE STATE OF THE WORLD'S CHILDREN 1986

    THE VITAMIN A STORY

    _--_
    A_.... . - _N_
    ~. _lrQ - . """"" ..... ~ :r.;o,ooo
    ...... """""'r _ IN -.:JIr<I I.NICEF _ A
    e:tW<nn _ blndo<l-r _ tt,o "'""4Joll ....... 1><O.g1l oro _ _ ora -V "'" rroiIhs _ hoi .. """'" told '"" l"ll

    .. ""'_ .
    lly _ _ , ~ono ~ IioId "'"'Y
    -. _ by..,. """" -.... A ..........,. .. ""'" 0
    ",_
    Ol _ A 8rll ."..... dlI1d _ Fe< .... 18 porilxl, AI ctoItnn _ _ 1Il "'" begI .... 01 study ..-.l
    • .000 10> i - . ogoa 1 10 5. """" gt.eo_ Ihon" , _ _ lo,.,(alIof _ ~ , .. ,..
    _ -V It'noI ~ _ Irom • lI)t.oI al te:l ........ _ _ rJ_14,
    ""'" :>0.000 ~ 'l1'II<l

    _
    ,t:too lNl _ .. ""' .. "'" . - . _
    Inl WIIIlCIUl _ A ~ !lO _
    -.. _

    tt,o ""
    cJ _ MctelO-. .... _ 0 1
    "., _ .... by """ "....., '""""ll _
    """"'A'"""""'<I_""" ...
    Oogmo"'" l<ro '" ey&Jif#. flOOlliIlo.Cll _ "., ~ "GO ~ <:no_.
    Tte '"" """""'., c:Nrl A. n..,_~rJlhiIIn.ct,<"",,,_~lC>lI)I
    .. prFo:;opel ....... _ , O <. _ ~.
    M _ - . "'" l1'II<l _ JlO. _ ~ ""'"
    0Il0I:tI " " " - ...... <l!IliJtIe 01 _ A <!IIk:i!n::V 'Tho .... "'""""'" rJ It'eM ~ It otM<:w. '" _ b
    Tho ......... -..
    _ """ _
    "'*' .. _';'oed ""'r
    "" """" I'IgI1oor among """'" Wfh......,
    10 "" 10"""'" coo.nrills .... 00 ..... WI>
    _
    J<n:)w IIJiIl lM> to \Orl '""'"
    ~ mid _ ........... ,... ""'"'" ""'......, "

    .
    _'''_ ...-<In!la-._nWI,
    . " " '.
    ,,-.:y. As..., """"'>.eO\<>VlgPOi"ll. lI'e ....."lookecI al do(... q,~_.~lrWellgo.- . ....aIre'e
    1hI...........0l_"""""''"'"
    1
    on:!~-'...."
    ~WoJ::lmII­
    "",oIh....., _ o r_ _ ,,1heCll!' ' ,' .. _ . . - ......,,, .........""1. a """'~
    ~". pr~.-
    *".. """,,,as
    g~.
    Iho ~ "'" ~ In et>aIl 8
    '*"""'" ", •. Ie ,g ......... " ~"Wl' - . . be Ire fI'IO!Il

    _-- _ _,-
    AgGIR. "(I'>aol """"'" ..... dtitn willi ...... A
    .... """'" _,..".lkIit)' lOoonIrW;t"'''~_ _ ~ olIoldMo n-.. b ~ <Hd .......... ., !no
    'eII'i _, lie'> ' ,+g-."
    ..
    i "JelU llt
    8.f . . - io on _ _ <bLJI '" bol _ oto..l _
    ..-arnn A- . : t ( .... . ...... ... 4 _.,1Is""'" .".... ..... ..,
    __
    ~

    .... ..._10
    fVlI"I Or fJSl '" rOc8ta Ol !he """. _al ......-
    t»_rtd...;ml'/gl:WrraleSoIe:tlOCI
    ...._m-..
    Tho
    -.
    ~
    -..n,,_ ••,
    ...:...-...." ..
    ~
    _

    ...',. . . ., ......
    st..ar.~

    _ .. __
    Tc lncl out. IIlll _
    -
    ished .... ..., -1Iof>O _
    lO'I(l_
    CIl be
    - """'" ~
    <I"IIi)'\lI'l

    "'"' """" """,,",>j


    . Tte
    n IhI stu2y __
    ,.,.... 6lIeo._ _ ..._" ...__10_.........
    _..........,.~~a_".,..
    ....... w_a;y .... lhirl lOOl11. DoIII ~ .,.,.. """
    _ _ .. _
    tu

    "" "" ' - '" -.,., "


    ~
    _
    <
    O
    O
    >
    '
    .
    -
    v
    c
    .............. ... e:twIc.

    _ -,... --
    .....,..." " .
    mcnll'O'"110
    . .-.. _ .. """ bonl( - . g "'" 10< • ~ 1'...:>_
    ~
    "...,., _
    ~.., _ hi _....,...; "" be
    . - . thiollt'ooe """ _ _ II!I'j .......... BIl ...
    _lhirl_bo _ _ ., ,,-,--.g.....-_
    dWlC_.~ ....~mIt1""'-""A
    .-boo.., .. 61 ~ ISk cI ~,.., <$.
    _ctrIdM1lcU-....A - . c y - _
    ~ __ . ". .
    . -,.".......,.. """'-
    ...., _ _ ..... '*"<-...o ""
    IIW "._01.........," ...cJ
    " . _ ~ _ j ili
    ttlk 10 ltIIl_l1wI" ""'drId"5 _ _ -..s.
    ..-nn
    ~
    --.:;y •
    .-.1 ., "'""-" _
    "' ", _ ~ """"_a
    . . - . _ _ " '"

    "" - . ...., .. ~ progo:aon, N


    Tte _

    ~
    ........
    ...." ,.". to \ty 10 lir'Il WI _ _ 1r>O<Igs
    ""'*' btl .... to . . . . - .... - .. """" Vl<>"ll< wW<l Iho
    <tIf d v:\in"in A ~ ?10 ~ '-* in
    -...,..,""""*"- ...".- - --- "...,.
    ...".,....
    ...
    _~
    ""_ .V
    2OO.OOO l,i_
    ..._
    _ ...
    ...._ '~bv .~
    ..._........hI
    _
    _.wI .""" _ _ a
    "'8 "'t~_.Fu1fo_'"
    "".
    o-.v"' _ _ ' ,.". .. """-'- _ _
    ~
    " " ' ~ " 'Ob
    ...... 0<\1 .. ~ A - . . " " , . . _ S!U:tt _ " ~ _a _ "' ""'*".._,, _
    _ 10 I0OI< '" h-.Ol3J.(XXl . . - , " " O l _ .... .--."

    "
    o-tA ~ _ 1oI""""''''~_, OWtC _oId""-_l'eIpO'mory_
    (incli<aIoo 0 1 _ A ototusj .
    _._-
    _. g~--~
    0Iith0ut ~ .lb1'Otl

    NB + 8S
    45·5 O -.,.., ...w oa....,. ffln MlO ............'..

    g 35·5
    BITOT'S SPQTS (BS)

    -
    ~
    ~
    ~ 14'S _NlGHT BUND IN ~
    5.
    NORM'C~
    Eyesig11 stalUS

    Ctwt8 _ 0 1 _ _ ~ _

    wiIIlouI.....",...,....!bY _l
    ..-.g - . . . willi _
    =:-!=.
    0 -

    . N
    "
    .......... 011_· _ >baplolld ," ·

    :§ ===:.,
    ~R~;::;;::;;;;;;:::~,
    3 ~

    'I:- "
    lfu
    o 200
    RespWatory disease ra1lI (pet I.COO child Inlervals)
    soc
    5 N ~

    4 3:1.
    3 SIl'

    """ 1
    , III
    " 00 ~wm<m
    f.-- \orr...,..,.. A
    ~
    -

    o
    RespIra10ry eseese rate (pel' 1.m
    w'aiUl... . ~ Ml'1 .....,.., _ 1l1;Kllll
    250
    j" ~

    ~~
    "MIhOuI
    "'" -. om <lI"'" 3 monItl - . - ' - eo - \lIT_ A ___
    ~

    VI<ll'1 oaiUl'• • ~ ""'"mid ","w ,a..,.. ~


    tIQI'Il blio.o_
    .....,<lillie i"Jlerw;lj.
    '""*'" 1lOoo .. """'II III"".. ""'"""'..., 0- -
    AfJ8 at first oose

    "
    I THE STATE OF THE WORW'S CIllLDREN 1986

    SboaId tbcK fiad;.... be COIIfi:nlled, t!IaI .... up IDd c:uiaa for !aft dti:kIr¢a. A.:ld thillIIaDI
    1NilI1~ ol aa adcqUlI~ Ind iii l'iwnia A WI lIll' bmdiu: til thiI ~ c:wIcl br IIIIfk
    .;u jola .... l'UICof .......... puml~ . .}'I aYIilol* 10 aU doiIdrm IDd "'" just 10 lilt ffW
    '" procectiq lAo health IDd Ii_ or childtm iJI who hne _ 10 oopbisrirM«I -.tic2I fKiliticq.
    .... poor COIIIllIunilia of IIlI:. woOd.. For r¥nl if BUl by 1M ....... ak.e:n. m. chal "'~ of lbe
    ,be "",,-'h1y a pouleo aI1' _ l"aiJ.blc (alld child luniYIJ rnollilioa bas DOW bmKnc Ibe
    ,My COlI OIlly 1 or 3 ""nlS eac h), then Ilkqualc cb.alJtnle of bdin& "")'I1IId lI>CUlJ 10 mobillu:
    vitlllllin A kvcls can be chelply ll'IIialaiofd by much IJ>On rlNnchinl f~ ,han illS. the
    pbtOt. lhtm$Clva _ iflhey ~ cmpolnrt<l with hnhh fKilitin ill order 10 reach OuI 10 inform
    the knowkd • • that ";tanUa A is vital for <heir IJId suppon the ... IlIJjori' y of panOI$ io llIi.olI
    clIikllc n', I>calth and if they know thaI it aD bI:
    pI'O"idcd by tbe cbrk1r«11 lwy ftlou bl..
    ..!lith lite: allIOIII .... rom .........' aDd chclpesl
    foods ill at- all ~ or .... dntlopiq
    ....,
    Ibis nfW knowledao 10 brio. Iha l rnollilion
    .
    This)Ut. oeftfaI ....tiom ha"" lDObili-' lMir
    wMd. ' Or ..... Exca~ Oinaor or Hdm IOOietia 10 double and trebIr m.
    1'"="•.,. ol
    Kelkr laurn otioall! h2s c:qwe.td ii , ~ A dlildrtlI orilo ~ rtal:btd by immll nju,ioa Kf-

    • -'.. . .....,..vn-.,...
    II • ...,., Io.-I .......... tIw, .... _

    .......... diI4Ifto~.'"
    -W~ _
    .... ri<a. 8111 _ IlIIioGI hi"" abo bcea ........
    IUaliq Uw tho amqyol mgt,il irin.1ll poIIiblo
    orpnjn" IIIIddYoodl olmmmRD;c"ijoa aD
    . . . be -.l 10 puI o<htt IooH:oI1 methodI ol
    doiId pralectioe • lIll' diop'Fd of llll' mliorilJ ol
    Aca- .. me 'dW lha'. ~· III pamuo. s..-
    Ulmpk=s:-
    TOfClba", lI:cx -"uta ia t.ic dlilcl bQl th nt A........
    pnlltaioolldd III' 10 • flO'"" i" lC'tOllllion fat .... III 1ln.D1, dlild SlUViYIJ IfIIIl d... dopmrlll
    ~u., . ldd'. dliIdrtII.. ADd iI iI;. rnolutioa hrioa IaWldled _ _ ly by lIll'
    pro(i; rII1II\lIII 1ft
    ...bicll ewlcl ........ surtiJla:·poilll for buildina
    III' ........ DDCDprd>cnsiyc baOc: I>eaIlh fySl md
    Miaislry ol HW lb bill by ~ differenl
    mat. ministrie: iJI eo-opemioo with lhe: Cltl>olic
    'OYml-
    10 lIdp 10 pmIlOIc tbe kind of hnhlliu, ........ Cbun:b, l he: _ media, lite ~ AI$islAlltt
    producti.e, ond ""'"' coaliden t rommllni,iQ Uaa\l(, Illd Ih. 18.00G-stl'llllJl Bruilil n Aatocil-
    which m the pel__ I.IId Lb. PuI'J"* behind , he
    lion of Paodia.ricilOl .
    I'fIlllI'I$$ of d••el0pllIcm itself.
    To promoIe btnSl-roodini. IJId '0 ~OIK
    Bill lIS wilh immunization lechno!oly, the ruI
    poceatial of lulmrlcd&c br.u.throu. "," about
    llruil', loIIs..,aodioll ''''lid
    10wards anificiIJ
    ioflm fOOllllIal, rno:n Ihall ~.ooo bl'alth workm
    QRT, .bout infant.focdiDtl methods, or .boon hi"" beI::o trained 10 iJlform and ..,ppon Il>Olbna
    n,amiD A ~Is, raida IlOlOIIly ia the d6cKy ol with praml ltnowlrd,e.. A, tho ...... limo, lilt
    .... IcchDiq.... ,"'""-loa bu t ia lbe ra<;lUIM lhey
    _lIXdilI ba"" dcYoIod $1 lIIiIIioll iJI aif.limo 10
    CIIII be pvl mIG ", oo:tier by parm.... M OIl of ....
    DC'W ICCIarUqua an: dleap aDd Iimplc CllOIIP 10
    ee l-.k of pruwMillll lile fxto 10 1M IftlIIl"Il
    public.. 10 the IUIe .,...,.tjc;ol mi' 8 0s, lbt ...we of
    ~ l*"l 01. lIIlllbor's 1lGnlIIIIl1nJ of brillaUII
    _e . .
    -_.._.. __.. ..
    m-.{ftdiII& io _ . ~ ) ~ Alld
    il:l all mIity IrapiuIo. .,....................
    . o.a... • " ..01 _
    ~ w--fttdiac &ooll binIl iI _
    .- ....,. staDd.ard pnoni<:c..' Iolemau....u,., the UNFPA

    ... -_ ..... . ....


    ..... 5 ' q • "_ fL hal lO1lo<Med S IS DIiIIioa in ...ppon of thiI
    ompeip

    .." -
    M __ ..,. . . . 1JSA1D'" iI . . _
    -.onioC* •
    Growth ~Iorilla iI also brinI llklpI:od as
    Ilmdard P""Iicc ill all mllauaI and ohild bnIth
    _ .. U_ .. .-A ............ _ diIIJcs and • new ~ian ,rowtb cban iI DOW
    beilll.tsInl.
    ~-
    "
    0"" ~hydfatio<> th.... py, backed by tM f= signed an _ , ......,nl 10 support na,ional cltild
    diMribulion of OVer 10 million sacbets a ye:or, bas survival pl:ua in Belize, Coa. Ria, III Salvador,
    now $pJUd to d.e point ....btre al k1l51 5 million GualW\ala, Hond~ Nicarag ua, and Pan......
    aocs of d iarrhoeal illness in Brazilian children All of ,be regioD', governmenu plan to " 0
    eeve been tmlled ..ith 1M new therapy in lbe Wt national' with O RT and to pu$b lbtir immuniu-
    lwch"C months. lioD ra,« above 'M 8()'j1, mark befo re 1990 aspan
    To increase the ouuuch of lbe child $UfVivoJ of an effon In bal"" the region" infan, _"a1ilY
    ."",paign in t he dC5pCnllely poor nonh-G5t, ,be "'Ie and save l hc lives of IpproIimately 90,000
    childl"CQ eloCh year.
    National Council o f Brazilian Bi5bllpll has decided
    lba, its 'Puto"'te o£ 11>. Child' prngr;OIIUUC will In Nicaragua, U N IC EF ha5 li ~ 10 provide
    meh I million o£ lI>e poorest ch.iJdn:o by tbe end I.S million sache," of nrsJ ~hydra.ioo $1.11$ per
    of 199~. Pillll compaigllS in ,he $OU,hern ,own of year _ £0. diltribulion lhrnll/lh the caunuy's IOU
    Florcslopoln _ including immuniza<io n, ,rOWlh of , housandl of "",,,,",uu (Ilw l b voIuntccra) ..
    ll'IOnilorin" oral l"ChydntioQ 'M:nPY, and chi ld well 0$ 'brough commercial pharma cies, com• •
    Spacin8 - have oharply reduced infanl and chi ld "'opt, market-ualIen, and t be 35(; nrsJ rehyd....
    d... ,hs and 1M prngrart>Irl< i) nOW being ulmded lion uni.. wlticll ha"" ~ set up ac...... , he
    10 20 ether cilies. ' In all, lbe outreach capac ily of cou ntry 0"'" t he W I thr« years. Al . he IDOmCnl,
    BnozU's Calhulic Churcb includes nOl ooly in an estimaled 58'1 of aU CISCS o f ch.iJdbnod
    S,OOO parish priests bUl 14,000 heaI,b workers, dimbn.. in Nicarag ua are brin, u cated lil'itb
    1,200 Catholic hospilsJl, 120 Catholic radio sta- O RT. Othc:. ch.iJd proteclion '1lntcgics are now
    tions., 23 n"'"5pa""", 3S maguin.., a maior brin, put II parmI" disposal via ' he lh ....
    publishin, hou$C, Ind OVCf 3,000 bullwm and P..",le' , Healtb Days which mobilize 20,000
    newsleners. ~ni.l joml idD h ~ po~~,ill4 ri reporu volumccncacb year. Sin<:e 1982, for cnmple, no l
    UNICEF'< olfiu i~ Brtuilio, "'if ..... bri", 1tW~· I .single case of polio ha5 been reponed ( pond ll ),
    liuJ in <mkr ro hriJIl child ",,..,,,,,, 1JlrtJurin '0 rAo
    Ml"th-.," ( sec panel 10) , In Haiti, 0 ''''' 80'l10 of Pll"nU in lh. oJums of
    pon -l u· Print:e-and 30\\ in 11>. rural areas _ ha""
    In ~Ulral Amerka, U NICEF and 1M Pan no.. begon 10 tnC O RT. Sachcu o£ th e salts ha ve
    American H callb OrpniZition b."" <his year been di$tribulcd lhroll&h lhoUAllds of sm.u
    commercial OUllets: and demand has bee n C~led
    Fig.7 Decline in breast-l eeding, sao by prornoliltll lb. ORT idea ,hrnugh ne wspaper
    and n1dio advcrtiscme.lls. To rein£ntee 11>. imper_
    Paulo, Brazil, 1974-1980
    F'l:>CO"W.O\IO 01 01.... _ ·100 ll>r _ ......... or ...".. sonal nxuage of the media, one day'. 'roning in
    O RT hn been Biv.n 10 all otpnizcd 8roUP'll "1Io
    are in regular conI'" with I ..;do public -.he
    5Choolte:lChcn, Lbe bealth IVOrkcn., the I3ricult.
    ural ntcn5ion ",or kers, lbe uadi<ionsJ hulon,and
    "'" ove, I 5,000 members of ,he Boy Seou l. ( pan . 1l9),

    In Colombi., 1M Presid.nl b.. announced a


    Notional Plan for Child Survival and o.""lop-
    men, "", Jtmtt"' ,.. tkf,,/u of 60,000 childmt twry
    ytor". Ilacki"i up 'M professional bcal lb $ervie.....
    lhe plan will involve the Catholic C hureh, , he
    mass media, tb e Red Cl'OtlS, tbe volunlary organi~
    "'" uliOP$, 1M co-opcra,i,"CS, lhe police, ,h. army,
    and ..,.,.. of t he 120,000 mmmunily volunl""

    _--,"
    ..ho bn. been involved in lI>e """" I immuniza_
    _
    ....
    1974
    •••_' _"-d_ _
    1976
    ""_ '
    "'"
    _ tion campaigns. ., W. <m goi", '" mu:h Nth Mta.o,
    tafh o~ "1 011' J.6 ",ill;"" chiJdrm ~Mcr /roc yeaTS

    "
    [ THE srATE OF THE WORLD'S CHILDREN 1986

    Bolivia:
    reducing child deaths
    De$pll! ~8b1o oo::ooomC Dllic<lIIoes. l/Ie
    ~ oJ BoW.a lias !)eM can'YJ'Il oul a
    llIogrammll 10
    50'110 ovel l/Ie
    redox:e ilS .,ram ooath Illtes by
    ne>:1 l...e y<Ii1tJ, '*'II kl'w-<:osl
    te<:IInQJes !lOCh 3$ 8l<llMded ltI'IfIII.O'hZal"'" arM:!
    -
    eM '" SWIfy _ 01 l/Ie CII't' wrong Sunday

    Two days before II>e leurd1 <late 01 10 Marcn.


    &*via'. nabQn;)l t,_ ......,.,
    called • _lII
    $IfIk<>, 10,000 <lemonIIlrators POU'e<J """ rhe
    oral rehyOralion thetac:tr
    capnal, La Paz. and roao-tlIOCI<S WOOl UP 00 rom
    ,,.,. " ' _ ""'" cIe3rII' _ r,;g Iof l/Ie heaIlh
    _ 1 0 ladde aIDnB The reou!'l ~
    orograrrwno. to< example, was ,eaenong _IIWI a
    """""orBoIrvia'. CIUr:Iren. ....!<l lleon\l l_
    uca8y ~ 10 'II , So in f etlluafy 1983 !tie
    a_
    1"II1''''ll\'lI lhrougl1Ou! "'" ooun1IY But ,",Ill "'"
    III'I,o,n 5Ul»Ofl. "'" vaeenaIioo campajgrI ",aN
    ,-""""",ell I'> lOIaI, 1~ ,OOO health """"'.
    en;, rnostIy ..........1-.;, """""'" 5.000 ~
    po$IS and . aconaled 21 5.231 ctold<en - liS'\. QI
    de<::i<led 10_
    Uinisler 01 _ Il1e heIIJ oIlho BoIMa's _en uncler _ , In Ill""""'" '"""",
    oounIIy'. O!het
    ItlIt the mass _
    ~
    oroarozeo
    teSOUIC<lS -It>e !IChDoIs,
    . IIle _ _ m._
    l"DIe \IlICanII haP react>ed ooly lCl.. 01 uooer·

    .......... llncllhe !armers' ..........- .. order to 'each _ "'""" ~ III BolMa's dlIki""' -<1IaI·
    mor" ~ ltno:l SUPIlOl1I11em III i'nIJ<O'M\IIIleI' _ oetly(lrBlIOO - is bo:lInIl t<:M.:l<lIld bY SlIlUn\1 up
    """"....,. l!leII Chldr<lO " heatttl ' ~ ' 5 _
    (:(III'fIlI\\8e' , e:acIl _ by a ~ 'pe-
    or" tellyarallorl ........ bD'J11O IlfPllIY oral renyara-
    tlon salls and 10 team P"'l"'U1 ......, 11M how !O
    (lflifl's tlfallll r~lNe· . _ a oe1 uptrwouol'>- """ !hem 10 tores1a1 <leIYyd,atoon. So far ~ ,OOO
    001 ElolivIa uroIS , moo:! of !ham manageIl b'I' "'" peopIa',
    h8a!ltl "'P'~lawes. II;Ne beo<> ~ To
    The "'$1 10Sl carTWl will'l lhe aflb.p<JIiD Cl\O"I'IP891
    01 lettl 19 83 and e<Vf\I 19 84 E-V IlOS$IIlle <nate Iha <lenwlo:l and 10 teadl "'" ;)Ublic; Ilow 10
    usa me saIlS. all QOSSIble conl'I"lIf'ICatJon C!'taMllIS;
    "'!I'''''''''
    was IlII'Illk>IOO 10 If'IGfealle the av.m-....
    01 rfIO'UlIl;IIion and 10 inform parents ot itS
    _ - . USed - k<:wn CIlur<:l1 _ 10 ra<loo
    11M _ '_ _ Is' , lrom Wee! dra-
    irr,oorIance, 1M ,eso.AI ..... lIIallhree $IIOtI 01 or"
    polio """""'l! reached 70'" ol cNldrOll III llolMa's mas 10 WId """aIS,
    RJflIl IIre85 and BO,*, 01 1M cnokhn .. _ and I'> a h.o1her """'" 10 saleguat<l etokl<.. ,·a """
    Om . beong, aI stlla mIIternity flOSPo\8lS t\lI"'l lklOPle<1
    !he polK;y 01 'fQOrnng-J:l' new-O<;o'n bioblelI .... Ih
    A lew n>::Wl~ lator. on 8 AprlI 1984 , the meiI II10lhers 10 1IflCOIjI<>gIl b<eBs1.Iee<l,ng Tho
    maclw>eIy """" inIo ac1"", agaon 10 ~ the ~ IS aI!Io ~ laDle $81110 <;OlIrllilr
    MlIOn" CI'I<kltM ~ measles -and ag801 ,
    icIdone <Ie!laer<:y, SlflC<l 6S.. oll301Nen!lChocll-
    ()I'\!f hall a million thldren _e V8OCIt\iIred c!liIdren $lI11er Tmm godIa, And n : I SfIll' 00 c!likl
    In 1985 3 6lfOIlar llSS3U~ was IauncheO 00 SUI'o'I\'al ...a nowpan 01 lila CU' ''''''''''' 0/ Mal
    pnmary &Ch;)OIs 11M 00I!lgeI
    cllllhU>eria. pertussis ('WI'looponQ CO<.IgI1) and Iels-
    ....... l.'Sir1g OPT 'u iple """"""" , Newspapers, The Mnostry of Helllln', programm& tlaS .... Nojy
    - . m loons and sarno 80 radio SliIloons saved It\ousatIM 01 C/IIldren'. '-11M PUt tJaso::
    :lIe<t9d parents to me (;(IfI'Iing ~ <:lays. _ _ 01 _ CIl,e at Iha dISll<;>$al of threeor
    The people 's II8a/Ih le(I(eSeOlalNeS V1Sll«l lMlrV 10ur limes lIS many c/liIIj-en ason P/l!'IIOlIS years. n
    _ 10 . dorm .. p&llrllS 11\II1 vllCQl\ll/lQn _ Tn<! JlI0g0...",1tIcan I)e """'.......,. n .... bnoIl a
    llVaIIabIe ard _bal. In hl crly of SaIlt.a en...
    .....
    a """"1M"'" WI cl\ild ........a1 1o !he.,.,..,.,.ry.m.cn SlIIl
    spec.aI messaI)'l ~om lhIt E\I$tI<lp, ~'9l"Il P8<e<l1$ lIltS "'" IIIghe51 r>Ianl and clW;! <l8aln 'slell '"
    10 _ 1_ C/W(lren to "'" Immur-.zad, was r&l><l
    """'
    •
    1m""
    .,......~ laid Prnidc1l1 8ewIcw
    of the CIlDpqD; MnJ....
    F.wa - . . ..,."...,..
    ~ 1M IaWIChin&
    MI_'
    -1* 1I<n- .,
    t>:il.li olJ
    IJld Ilome-l>IU.ioI·l;Utriculum .. aU ,lie COIUI,ry'I
    run! primary lCbools (_ pand I ).

    ./1«n.- ;" llot "."..,.. -I , ftJJrf,, )


    "',i
    pr.-
    M
    C_ puld 5).
    ID HoDduz-, dcatha froID dianbocal ddll"b-
    tioa Inc rtpOncd 10 bo: falIi"I aClCr . ......,ar
    ......po;p to market ORT .... t~aad...uo.
    Willi _1llCdiI lDCSAIa t.;ka:I lI.p by 1,lOO
    ...wac III 1Ddia, whom: ee
    ...
    I'liIoIe MiniA.... --n·
    HoDd ....un
    bdllh llomc
    t ->ilia, _ thc
    about '" _ .. Ilas opaxd the '"Y for • utiooo-nk
    """"
    ~ '0 '''''''''ai.. aU chiIdrro 0ftI the naI
    ........t,o lor diarTtIocM ilbls IIIld ~ !oM haft 6ft faJl, Ol!lcr cbiId 1lI'OI«Iioo SlnI. . . . ~
    bqvA UIi"'I 1..MoM-m. Iocol bnad _ _ for
    ,"1:nIl)' IJDioI dlllO II:Iino 'ria the lnoqmed CIIiId
    on! rdJ.j'dIotiaD WtL Dt.elt>jml Su ,itu (KD$l """ tbc U. .

    ..... -
    III ee-lor.' _ ......1 pba hal beea IauDdord Balic Su,icu • '''',,OJ _bill'' outn:adIpai«a,
    10 ~ bit .. thr _ bail: IIlBlqja of c:bild. whido, ia tbc _ .. tbc ICDS ..... ~ _
    ....m.I (........11 dIo;killa. cnl rdrydtaUoa t!oa'• proridina !laic can: 10 10 IIIiIlioa .. IAdiIo',
    Il'f, brasl-fmlial uod iIDpn:m:d ftllliDI• .:I
    . . . . .o j. . . . . ) Uno pcxtiec .... . aM;"'ol oaJc.
    to ..., IR3O, the mula .. llle ICDS UC
    The Minislrin of Ed , ' Il" , J)rimce,...s Social :oImdr C'i'idc:n. in. kowt f2'lU .. D8lD..uiIioD,
    Wdfan:, • "'ll:ll • 11K MiRisuy of Health, ..., liillina nus <I. ..... binJo.~ hiP<r ~ <I.
    ilI0'0h-td _ thc pba ill beiDa mpJlOfWIII b1 the im_ oi..... coou .... """ (twa" dlild dcMIaI.
    _1D<d:ia, thc Satioaal A...w;. rJ. Medico l Sar<IrI< SIlIdics in 15 SlOta h:ove - - . WI n 'l'
    Sdloab, uod thc Nilioul O ,,, neil ol AAbopL <I. ma1Dollrisbed dUkltc:o . ... wei&ht I!ItIluP tllI:
    Yk .... bail: cblId IleIhh 1tnl4;;a IR boia& ICDS docme - ' lloc 0Wnam .. tbc ICDS
    ~.~~~~ilI lO thc~ =of ~ ~ aad
    ':' 1..,.W<iItIa
    ,,",If, ....
    Jthooll; IIIld "'CIhm,
    ~
    wtiftniry . ...
    ;""""'011 fJI :aU
    Tech-;""! ea-.:.itlft arinwa .... almnoI
    10D,lllIl dWdn::a', Ims ~ alro:ly bmI u "fd. '
    Tbc primary p:onicipuu ill lloc ICDS ..., the
    :fOWIC dIildrta .. ~ ror
    1M ...uo.w ...... ADd 0ftI m. nat 6ft"""" lbc ochccnoc ;.
    ...,;.... ioe ~ IthtdWcd ... rudl 6010 <I. Ihc dIiIdral liYiIll ill
    Ill. VC'llnIIl'!. 6Oll,llllll childrm an: _ l"KCi... l...m'. poor .,...,mbon>os.
    iq poonlI lDCIOitori"l cbam wl!dl ... any Bro.d...m,; the baK .. \.bit ptO)ItCI&, IDdiI'.
    ad\'1tt 011 bnat·fudiaI, i!Mll, n jZMion, and ....."'l driDkiDa _.. prncnmaICI ~ _
    ORT. rac:hcd lDIII'C lhall lOO,OOO viIbI.. md uc
    10 Iloli'ria, wllm: _ 10ll,llllll child ..... han belioaia"o ha"'l'" df<a ... ~ iDf«Uorl.
    be><!l drinl I!:IIliI yar from dianboeal ddlydra- to R'all*b, the ' OVU1UDCD'.. ...... N I!ioMl
    tiOIl,_ 5.000 oral tdlyditiioa u.aill han DOW
    bfen 1ft lI.p _ 7Oll.ofthem _uftity-t.Kd _and
    On! kcbydmioo PnIcru=c il4iltributinc 0ftI
    17 IIIillioo achctl. .. ~ rdlydrllioll AlII each
    _ 2 million _ bm of onl rdI)'dmioa alII
    yar md the m:olIItDCdia ..., bel...... '0 crtIl. ,be
    haw: bem dislribute4. To pl'OlQOIc bteast·fccdi"l, demat>d by ~ the ORT mesAl' in,o
    Slale """emity boIpil.ab hive ~ to poIicin mil.lioat al b _
    of 'roorniq.ill', IClevisiorl and radio IR mU:ina
    the ram ~1I11l1"" publ k , md I natiooaloc.k Meanwhile ,be 8an&ltdcsb Rural Ad~
    it bciaI dn"'" liP 10 prcYCll\ the marketinM of men, Q:lmmi" ... {. o....-sO¥'Crnmeo'II! otpaiDo
    m ilicill infant fonnu* dir«t 10 tM public: (_ tiool hzs ,rained Illd fielded II1moo 1,000 ORT
    paMllJ) . In I llPpon of these policies, the bIooic: wor l<cn who hive so rlf m;,ed ... er j millkla
    "'"""II" of 1M 'l:hijel lurvin l l nd d.,~lopmf;Dt m<>l.hm md 15,800 :ICboob: 10 live pl"lCticll
    rcvoIution' h,," been imroduml ;,uo,be 'health delDOl1$lra\ions of why, whc:n IOd how .0 UK

    "
    I TIlE SI'ATE OF TIlE WORLD'S CIllLDREN 1986

    Egypt:
    leading the world on ORT
    E9\'IlI has ~ the 1\lll1·lVily IlOJlIIl d$ 1fV& To capt~ Ihe _ I Q':nel"looo 01 neautlllfOles-
    war can"""lI" III P<O<\'IOlll oral rehydration!hef- ........., OAT c:aII!le!I have lleen " WOOUCe<l onIO
    allY lORn and _ thellYes of !he 80.000 antl r... t\II'rlCI.M of .. meoIcal coIeges, 100<:II0'l0
    mor" choIoren whc> .,.... dOl eacn _ from """"lIIls, and ""'50:lIl schools
    dolIrrhOe6l <latlyO"aloon ResullS so tat """"" mal
    Cfl<kj <learn ,at"" havu - . ClJI l>Y lIllllfOUIlatoly
    l he Iarget 0001" 10 _ rnoIIJorS !te,_
    3D'\> In I..... Ies! ~ale 01 AJe,,"''''''' 10 ~ dOOvora llOll ana 10 prol9Cl tr>e C....:fS
    ""lr1llOnal hcal\tl 0)' me early _ 01 OAI, 0)'
    !MIg w!Ial ,.,.. Il»r~ "' ~... the ~ 10 _ pIerJIy 01 food and lluds, And
    pr(IjllCI 0$ ' ''''''' PIlI ''''!ll»WIOO As 01 ~~. rrod-, esoeoafv ~ COf'1lJlUrllI tlrllilSl'IooaIog, lUiro,I
    ""'" ~ .OOO cW\oc$ !htoug ~t E\NPl1'llMl "'ailed ~ of <!IaI1f'lQea. In tr>e AIe><ancln3 lnaIs,
    oral Illt!Y<Jrll100n cel ~'es 10 _ _ 00 I and 10 ~ convnercials lor OAT Iwod oeen _
    teadlll'<>lhet$l'lOw to use the new l!lefapy Mea<! caS! every nogIIllor a ......... 111 8. P8lllI "'il'Mng lImeS.
    01 SC!>e<lule. the pnq........... is already ~ By !tie enl ol "'" "lDIllh. nlO5l mclt1a13 IiMw
    In have an mpa<:l on the .,lam doom 'a l~ n;JllQ<1- aboul OAT IlOCI 36 % h8<l alreadY lleglm --.;I II.
    ""'" ·' By ftlll _ oI lhrsptOfl'C/.'· saysa"wribet Now II1II _ ~ to t,.,;ng _
    01 tile campaogn team III C8',o, " Wl! /lJIt't f/XPIJCl,l;;I oalO'lally and 1ne 001 symbOl IS fOPOIllId 10 00
    ..a- a 2~ ~ 'educlJOt' .. (}Wl(8/I mc>'Uib1y Ihe _ wo:lely recogn;",a I>dYeo1is<>merd In
    lIffl<Wlll (gyp!"'" cIliI\*M "
    '-'
    rO/ ten 1'l3"I. OAT has bee!> an ol!lclally
    ,,,,,,,,,,'.eooJud "ealmen1 .. ElMll. 8u1 Ihe $111!(l
    To meel the
    SllC/'Ie!S 01 OAT
    _><I ' III pharmaClSlS Slock
    A 30-% pro!~ n'illrQll1 lor the
    were llOIV .......- M IlIflSCI'Il'/lO antlll>ele_ ~ -~ h oe OOf ~ ~
    ' I!le poo""o,,,", to the JIUbli<;. So PlooaoI'/ !ewe< """"Ch can 00 SllIO 10 CUSlome<s -;, ~ to
    1M" 1~ 01EgyplIM pa<en1S were """'" Il>echeall
    """_llrugs
    _.-
    CO"'Ptllosate tor prolots 1051 on sa_ '" ant..
    ite.savlnll brwl<!M:IUgI1 ......encoukl enable ltlem ('ohcIlar<> more _ _ ana ..
    10 t..", It>e II/>gIe llIggeSll/'trlW III !heir r;:I\jd"",'s IOlatt
    most cases .-.effecfMI), Na.oonal prCldlCUOt1
    _ and Plea,",
    But on JilrIuaty 1963 . after $0>: years 01 eate!ul
    ol "'" _ Is. _ IS fKNI """""lI 80 a.
    ptllPllRllO<Y _ and lOaIs, 1M Egyp\I;In g0vern-
    When lIle Nalional ~'fIIOe8I ~ ConlIoi
    ment llolCar\'Ie """ 0l 1'>e ftslin lrOI WO<ld 10 pod< f'rogt11tM'lll comes
    10 an and If\ 1987, OAT
    uP the OAT wellllOO on a 'llItJOool :lC/I18 am
    _ be 8 normal part Of the nalJOn'S neatt~
    -.. ,,''' on the ~ _ '' ~tcr
    sysl<!m 8M Of tho people's.,..." """1Ih betlavJooJ'
    I'IaIt oIl1l1 C!IId 09al/tS 0'1 [gypl WiTh lI>il ~ 01 " In the rMa<1tJme, Pre$otlcrIt Mubar(lk has an-
    giant 01 $26 ....."'" kom 1M lhlOl(! StateS ~
    \01 ~1I ~. the MirMsI'Y ol rouro:ed Ills \lO"E"'I~Il8I11 'S ImeniO . to sece lIle
    _ IaLlf>CllfMj the NalJOn3l ClIarJ1loeal 0-- ne~t l/Ie>J' ~ lor 1l'0Ie0:\Ir'Ig Ihe li..es ancl
    Control I'r<lg!aIlYnI UIlOi!f a ~8<l seem- 111e growth 01 Ihe nat"",'. chddr"" - acceIet;ollng
    lhe CW!IlJ)"S ormlU/'IIZ8lIon progr3!1VJ>e lI(/8II1Sl
    Iarlal WIl!l a leIa l bullI/eI 01 """" II\a<l $ 50 1Tl!Oo(wl . me "'fec llOUS _ """<:II fKNI ~ """8 !/lan
    SIlecoiIily ""arI\IIlllIeClurM. _ ':Illoos, iWlides 50,000 EQ\'llIlOO chldten eac:tl yeIlr and leave a
    II medi<:aI ~ . ooa """'""" 111 a dolen .......... ruT1tI<II _ lhe large! ..... be mel
    ,. ..-s>liE$ - plus ltIo >Ie/llng UP 01""" ll){1 ORT balorn 1990 and. n 81 all posgbIo, by September
    traonorlij ur>1o - ..wea ted !wile ......oors 01 (gyp. 1987 - me morty-film """""-~saIY of Ihe EUYP<"'"
    tIan \1DClOI. aM nurses &bout the new U&alJ'J'Ie(1! .-..,

    "
    h<>m,e.made on.! rebyellltl ion solution' (see pmel en nnw kn nw abou t ORT anel "" at im;oted 1St.
    16). In Dbaka, the 1,000 urban volun teers who m ve begu n using Ibe ne w tbenpy.
    elisnibute 4.000 ..chell of 0IaI ...hy<lration Alt'
    eacb w~k are abo now d istrib uting viIamin A
    In PWstln, 1,300 d OCtors and 4,500 paramcd-
    i<$ ha ve hcc n trained in ORT and an annual
    tlIpoula and bringing p = t know ledge Ott
    su pply of 2.2 million sachet. or 0"'1 rebyd"'tiou
    c1iarrboul disease control and imp roved wtaning
    Ill!IS is being promoted 10 the pu blic via te lcvWon ,
    and feeding mcthod$ to t he pooresl a..... of the
    nCWSj>apcrs, post ..... meeti np of community lcad-
    "'ty. ers, 1fIe1 by th e uaining o f 5,000 tBditional hinh
    (0 ThaiWld., more than half of the nation's 3.3 att enelant . each year (sec paJlel 11).
    millioo under_tbrees arc uOlV l'I'8ularly growth _
    In Kabul, Afghaniatan, I nmpaign hu already
    cb« ked anel more thm half of . be nltion',
    begun to hal ve Ihe city's inClUt mortality ",Ie b y
    patCIIt. have begun '0 use OR T 10 treat diarThoeal
    ~In ... (see pan el 21 ).
    1990 th rough basic: ehild .urvi\'ll st rategies.
    Approslmalcly 100,000 children now have 8rQWlh
    In Inelon"", "hil d survival .tratqi.. art' Min i chs.ru, immunizotion ",tes bav. begun to riso
    in trod uced , . ia t be Fontily NUlri tion Improve- sh arply , and an initial I million uehets of 0IaI
    I!IC1It Prosramtl1C, inlO l lVOo-tbitds of the ""un try'. reb ydn.tion WIS have been made available
    67,000 villaga. A few days' lraininl bas been throuSb bealth posl., day-care CC1Il res, local
    givcn 10 400,000 YO!um.... n u triti"" ~ woo s ovem mcn t offices, ronunm:isl pbartnacie$, ~ t.,..
    = nOW able to ad.i", parCflIl on b2sic healtb IUd acy ce ntres, kind erganell$, and th . ci,y's youth
    infanl {tcding and refer lDIII'<: di fficult tlISC$ 10 on e and womon's Otl';lfIiutions. T o reach tbe pu blic
    of over 5,000dinics. By 1990, tbe aim is to in volve ..ith the tJlCMIge of O RT , over 100 td.vision
    vinuaUy all l odon esian lIIOlhm; in the regular 'sdvcrtisanents' have beCfI broadcast, ra.dio hu
    "h""king of their ehildren ', . rOWlb ( panel 13). carried th o in rormslKln up to twemy til1lC5 a <by,
    anel 300,000 lcallell and postm; h2., e gon e up on
    In the /'lIilippincs, appro;cimately 70% of moth_ walls and in windows throughout tbe capi tal cily.
    Backed by the lu thority of 250 paediatrician..
    Fig. 8 Impact of OAT on Infant deaths, heallb W<ltken arc o:artying chi ld su rvi val mcs-
    Alexandria, Egypt, 1980- 1984 saga into the poorest bomes of K.abu~ o 'er 4,000
    t....h.r'S art' no w introducing 'child protectioo'
    009aI ..... _ .. lII """"""ltDtlg Iho 1knTnOr·_
    ICSSOtII into th e city'. schools, IUd most ....ter and
    pa....
    ~.;' ~~El/l'Pl.
    ~ "'" '"'" t- ".f9.,<w"
    po< ~ ;, ago w<JUP. Slt\ilatino ptOBmtI1I"lC5 .... also beinll \lied to
    pron>ote boIh O RT and imm uni ution.
    IViOO (35-2)

    Ajri(a

    •, ,,"'j
    In EUPt, d eath rat"f from di arrhoeal di .....
    h.ve beCfI hal.ed by O RT in a l"'l!. p ~OI

    i•
    2.000
    ~
    campaign whicb has 0 ",," beto ""leo eled to th e
    wbole nation (Fig. 8) . Approrimately 8,000
    eloctors hue been l'C1rainui and, 1$ of miel-1985,
    I, .. 500 ~ ,,'H) 4,000 dinios IuKl Slaned to "'" ORT agaitlS1 the

    ~
    dimboeal dehydr:ltion wbic h lUlls me re than
    80,000 EU pt ian childn: o each year . T o promote

    !, ~

    ~
    ik"",~d, television commercials for O RT have
    been bro:ldcas< oiI htly an el all doctors .... Ming

    --
    z ' .000 asked to =-ornrncnd th e ne w the",PJI. To tnC<1
    ' 980
    _ _ """" _
    "" "_'2
    "" ''''
    Ct>«I,, _ _
    tbe elemanel, 80 million sacbm of salts • year arc.
    nOW being locally prod uced anel made available
    ......
    "
    I THE STATE OF THE WORLD'S CHILDREN 1986

    both from "...1111 I'OS.\I and from ,housand, of In the Sudan , Nsic ch.iJd .urvival "',,,egi.. I t t
    COIllmtrciai pharmacies. pnwing their slwpcncd ..levlnCl:' in the mid" of
    In la,. 1981, only 5"
    of Alexandri a'. mothen
    drought and fantin~ Through the emergeocy
    opention>, and [hf0U8h [h. llrfl~ le Wi t...
    k.rl~ about ORT and only about IS IIad ."c.
    supply progl1Immcs, ORT and immun ization arc
    uoed it. Today, 90'1. know of ORT and 50'4 have
    combating the dia,.,hocll and ot.hu discO$C$ 10
    lIsed it (_ paod 9).
    which ovcrcrowdcd refugee camps I nd emergency
    Following lb. SUCl:C:5iSfuJ wunch of lhe O RT feeding centre! an: particQlarly vulnereble, So far,
    prnsramme, Pl'tSi<kn, Mubual< has thi, ~.r c' - 10 6 mill;on ""hCl' of oral rdll"lnlion AlIS
    mad. the cammillllelll \Ouniven:al ,mmunwt;on bOYt bc<:n di"ributcd during 1985 and hundred.
    by or b<fOl't 1990. At 1'''''''''1, IlIOn: tha" ~,OOO of rommwtily Mahb """ k.n bl"" bc<:o lrailled
    EgYPlim children ~ dying ncb year from in their usc ( Fig. 9). Rtron' UN ICEF's uffice in
    VX'Cin._p...vtnt:lbJe d~ Kharloum: ~AII w40 Iurot wM lite 1011' _ including
    In Djibouti, Ihe OJuncil of Milli!um hIS ,Iu ~sIy 1U1>1wl-S4Y 11141
    M
    ,Mi. _//.., is
    appro.«J I ,,11lIl I" halve tb. counuy', infant ,.,.",kdhk. Fot both ORT lAd the present
    lI>I)rIaJi,y by 1990 and h.. launched. N ational immwtizatiwl dri"e, demand is hcinll promoled
    by every means from media bJilUS [0 ,ra".lling
    Child Sumval Plan, to be ro-or<!inatm by •
    ,roupc$ of nomad p!ayc",.
    central committee inchldiDg ~en.I govcrnmrm
    minis,... ""d repraenlal;vts from the mass media
    and the ",.UMa! women'~ urganiut;ons. ne soc:ial brcaktbroqh
    In Ethiopia, wbf!T the dfon 10 relic,'o tbe Nut aU o( , , , - IIObi,ious progl'alll/lltS will
    dmnalic suffering of the countryside h.. b«n 'M .uccud. And ~ of the difficuh ics whicb f:occ
    focus of world .wid•• umtioll, I quieter effon is lbem will be di$cus$cd in Ibe oot cbapw. 8uI an
    also bcing mouou,d to try 10 Cl.lPl' with (h. ...tnordinary beginning h.. been maok. And in
    .veryday crisis facina: """'y of the d tildn:n of aU of these cases, i[ is d t ... ,ha[ [he 'social
    Addio Ababa. Last year, the Minis.ry of Heahh breaklbrough' in ....ays Illl<l mean! of rucbinJI out
    ODd city cQl,l/Il;i1 :se1 th"'llSClvcs the thcalleoge of In th. "",jonly of paren u iI just as impon1lll[ as
    rtducing Ihe <ap it al city', inf1lll1 monality , " [ t any scientific btcaklhrough in kno wkdg. about
    from 136 pu 1.000 in 1985 101m lhan SO per cbild heahb,
    1,000 by 1990. Supponed by th. Mioisuy of Slead~y o"er "'" WI leo or twenty YC2rl,tml\y
    Hcah b lAd UN ICEF, "'" Addis child survival notion. """. levered ,bcmsclvCl into a pesition to
    camJ>ailln is now goill8 into action lhrough [M make t""l 'social b...aklhrouSb'. And [bil now
    city's 284 Cily d....llen' II!S<lciation. or lubtlu. potential for mobilitiog organiml resceeces, and
    Volu""''''' from oach lubtk , trained lAd super- for n'aclUng out '0 inform ond involve the \'151
    vised by I 'lw.lifitd communily helhh and ma;orh y of citizen., ia today ooe of [he vel[... of
    developmen[ ~cn[, arc promoliq ORT,wpni..... a1llCSOUro:I oot onl y (or ilIa'easina "'" prota:tioo
    ill8 immunizatioo, and helpiog lnO\he.. to moni- whicb can he offordcd [0 children bu. abo for [be
    lor [b. progress of their children on [h. ne",ly. promotion of not;onal developmenl ;uelf.
    dCloigned Amharic groWlh chan (.... """,eI15 ).
    This ae .... potential has bc<:n urivcd 01 by •
    In Somalia, I monlb of radio hroadcast>, largely unnoliccd procas of chang~ And [he
    ntwspaper wicks, TV Pn>lranllPCS, loud.peaker sh..... sca\e of that change is w.1I illus'ra'ed by
    lnIlounccmcnu, and oommunily lIICC1iogs hi"" wbol bas bc<:o happening in India. Ovtrtwenly or
    prepared [ht groun d for 0'1'" 2,50(1 volunl«tS, more years, amid lIlIny ... p....ron. of hope-
    drawn from poIilical parties and women'. orglOi. lmn... from ouulde commen!.O[on., ludia bas
    ulions, to " isit 150,000 bomes in the capilli cily steadily ronsll'UClcd • _I mechanism for lOCial
    of Mogadishu -rqi'lcrlog child ...o Ind lIlIing d.velopmenl wbich iI 0"'" Cllpahle of ,oucbiog
    thtir pamllS 10 bring lhcno [ 0 lhe """,ination tbe lives of the V2It """iority of the ~tion's 670
    cellIrcs. million people.

    •
    Each of th e couotry's 5,100 'de~lopmc nl Not ha~ the mass media been Olalldillg stiU.
    blocks' now has an Oll[.m~ 1!ruetu", wilb th e Toda~, l be lIilian has It least 20,000 ne wspa,,"",
    capacily 10 begin rnching oul 10 infonn and includin, 0.... 1,000 dailies, and rad io servica
    iovoh' e communi,i.. in developmenl .....ivili... 00'0 reacb more lhan 90'- nf Ih. nalion." And
    AU of lhoK o1c""lopmcnl block.s now bav.11 ICUI unthinkable llII it mi,bt ba"" .cemed oo ly a
    00. pritrwy health <:col ", and an • • erag. of mo.... decad. "10, it is BOW estima,ed thallelevision wiU
    than len ... ~nl""" T o Sl aff Ihac heallb cenlra be within ....acb of .. llIlln~ as three--quorte", of
    over 300,000doctol'l and 300,000 paramedics ha~ India'. people: befol. the rod of th e decad•.
    ~n lnined. And 0. ... the nu , fi~ years th e Not least :unoPg these ine ruses io resources for
    n umbe r of 'health guides' is scbeduled 10 dou ble developmen, is the growth of tM more lhan
    10 600,000 -00. for o:«ry villJg. in India. find 12,000 nat ional and intooatiooal voluntary or_
    no w, und<:r 1M ICDS scMme, an oddilional5,ooo ,anizalions whicb .... new opcratill1l in Indio,
    a"",nwa4i WOlke", and 2,500 NPCrvisol'l an: ofl.o in the .ery ~I"CSI <:(ImIDuni,ies.
    being trained CYCfY year 10 b.lp bring b;qic
    services 10 all of Indill' s famiti...• Thac are rI"ll8eno g acbio:«mcn ts -with equi-
    valents in many O\her oatioDl. ADd since, in IDOIt
    fll lhe ...... lime, Ims of lhousands of schools ...... tM health servicc:s 'b......lves arc a neces-
    u,~ ~n buill aIld hundreds of thousands of SItY bu, sci11 not sufficienl l'CSOIIfCe for rtaChin,
    luch... ha~ bcf:ll lraintd - pul ting a primary l b. majori ty, a full io .... IOl)" of th ese 'ou treacb
    school within one kilomet .... of ~ of Indio '. resources' will need to be tol<~n if praco,
    children. As a rcsull, 8011 of the nation's chi ldren 1tIIowltdg. abou t Iow<OSt ehild pmtCClMln is to be
    nn w start ochool, an<! tilcracy - bringin, wilh il • placed al lb. disposal of all families.
    vas!ly incl"CllSCd caPK ity for til< communielolian
    of 0.... koow!cd8e - is steadily rising." R tsOU",H lo t ou~ub
    P. rhaps the tlIOR undcruscd of all those re-
    SlIurces is the formal education sysl.m itseU. Over
    F"IQ. 9 Chang es in treat ment for Ihe last twenty yars, the developing nat ioos .. a
    diarrhoeal d isease, Sudan, 1980-1982 whol. hay. tllOl'C than doubled the propottioo of
    0:>Irl;J0" -..<>I_.-
    ..".,.,....,.,....
    ,,...,.. _ _ """'-
    ORT \taOWlg _ _ Ie< _
    their child.... n who are enrolled in school. And
    lod ay, a, lENt ~ or all ehildreo are enrollina io
    ~ 19aO-I2 ~ <>1 01 _ otaticnsI.
    fonnal cdtlClltion for at ICUI I few )'t'lI rii.
    OJ
    By COntr:tlt, only . bou , 2()lf, of the dcvdol'iol
    70 warid's childre n b... lOy regular conI..... with
    OJ formal health servi<:ci. III 10<!ooC$ia, for enmpl.,
    tb..... are 5,000 primary heal,h ~ entnli wi, b 0""
    ~ 50 dOCtouacb as npp<>sed to 100,000 scbools wil h 10
    l\'efSllC of six teach.rs each .u
    I '" In ot her word$, the school S)"It= is on e of the
    f 30 lIIOSl ;mpottan t ~hann els of <:(Immollication with
    20 the VI$! .... jori,y of 'oday'$ and tomorrow's
    parents. By tb e most elemeo,ary d riinitioo of
    to ed ucatioo as a p....paration for ~fe, prc$COI kno w-
    ot-t-:-:-+--
    2 1980 3 4 1981 1982 5
    ledgc lbout lwic ~ hild protec1ion lechoiques is
    $1U"C"ly W<Ilt.h ito plaoc in the world's schools. find
    1 __ <>I OAT (M1<d1 I!IQ the uampl. of Thliland , whe", ch~d survival and
    n".,g """"'" api<JIric Un! 19lQ
    2 0..."......." d..·. loplQCflt lessons an! now being introduced
    _ "- _ IO<;!<JDO< I!IQ
    • s...n monlIliI_
    3
    0010 the fonna1 curriculum of 6.3 million school _
    traiToII l<sl ~ 19811
    5 _ .....- _ ~-.two (o'ool'9ll2l
    ehi1clren, is . u....ly on. worth~ of beill1l follo-.l
    _ _ n-.""'-'''' by et her nations."

    "
    I THE SI'ATE OF THE WORLD'S CHILDREN 1986

    Brazil:
    vaccinating 20 million
    61.... '5 ""I..... PlOOfammll !of molI>e<!l an(I bCl<ets e:atrj Ihe cal 10 '<lCCiIIlIl"", III 0 - !he
    cl'Oldlen. law1ched '" 0c10be< 1984 .... Ihe wakeol C<IUI\lryBrazIl can ,..,.. draw on 400.000 "Xp"'''
    a s" , tsJ<,.j tnasl-lli'lIClkIg eampajgrl, <;<lmll!neS enced ...o....neers - irtcluOl>g 1eaC!ll!fs. bremen,
    ,.q lIIe _ ~ """"""'"" <l<SCU!Wld "' The and pelIce-1O man 90,000 VllCClnallCln IX>Sts
    $lJ1<'I 01 Jl'I8 WotI:l sCl'loli-erl repon - 3ClOSS a lOml"'Y lBtoer lNIn We!ilem ElIIOJ>e
    a TheIll""""
    IheiI
    rl9Jlar
    ~ lho
    we.gIIIng Gl clIiIdrllfl
    to IIlO<"IOr
    Il'ogramme: me fO'$l
    In a I""'aMeIlTlOYe 10 sall9l'lJ<l CIlIk!<tIn', well-
    De>IIg. BtBlll ~ a """""'" b",asl.Jae<lIJ'lQ
    hea/l!l IfIQrI<etS began IheIr ~ a"""O .., oc_ eatIljI8ogn, 1<1 \ 981 , whid1 os ...... pall at Ihe
    198-4, '" 10 01 8<lwI'. 23 states. ano:l A nal>l:lnal moItw BOd CI>okl programme Pos\er!. e.<!Olling
    lJIOWIh charl IS """"II tesIe<I. tlroasl·t-'Irlg __ <lI5tr b<Jl8<ll\illoor-Kle. near!'1
    o 1o COUIl\eI 1I'olI 80,000 dlIid (!ol\llhIl a year S 1 mtlioon WO<lII 01 r<KlIO and 1eI8\18IOl' lima was
    lIOn&Ie<l lor breasl.\eedIng <XlI'I'VnIl<ciaIs' , I".
    Ifom 0IafJ'M00I <:IefIy(lra.too. ell'" '" ""'" rJ'IlWlU-
    lactuoog or" n'hydm1"'" _ !of I'ee ""'OM! I>3f!(li3lric1ans' a<llOCIAbon, 18.000 SI""'ll. 80-
    IMIIy PI'omoleS Ihe campalll". an<! Bt<ll:U ' s " -
    OisInOulOO lItItl b ~ 10 ~lIl!l Sllll""
    An estm'l<llad 5 ""*'" cases oJ _ "'
    EltazOlao etliklreo WIlle treaTed Dv oral 'lI/Iy(Irabon
    cal schools now indu<le breas~ 1<1 It>cir
    ClOricuIum In Ihe d lY ~ Reole, 10 C1'" DII8
    !hetlIOI' '' \985 ...""""". Ihe fIOOPQOllOo, 01 cI"oIdren bfeas1.JfId 8l
    three' mon1hS tes C\CII.08(j,
    o 10 reveffle ltle ""~ _ llQIUe-teedlng,
    Tile catholic Cluch ~ reeo a Ill.1lOf BIIy .,
    50 ,000 heaIlh PeI'ml\IoeI ""'" ~ m....ed to
    J)I(ImO\/l tIfeasl·leUng Tt>e '~' 01 nsw-
    these e/Ions lis 370 bi$I>opS an<! $ ,000 POBSIS.
    3IO!'lg ..1tI H.OOO rT\llIll<$......, 01.0'lS NO)1Qng 1<1
    oom _ """ ""'" rMlI'Itt<$, to """""""I ClI<1lC!l 11osllrta~ backecl lli _ •.
    DreasHeedlllO. ill ....... """""'tory ., all gCMlOI-
    nMllll·ba<:I<ed I1col>\als magaz all" 120 ra<llo "'au",,", mall. It a
    p<IWIl<lull"«lll'lOO" B<azoloan o:IaiIy ~kl In 198$
    o Unlj Bra" 1tJtJodI.c:e<l vaconabOn <lay> in Ihe Natbnal ConI",ence 01 BtaziIiM Bosr.ops
    l!l6O, some 2.000 <;!IIIdreo WIlle 1l3Ia!ysed l>/ esIatlllShOO a 'PaslOffila 01 Ihe ChI<l' 10 dlS5Mlf.
    l)OIIO caetl \'8il' IDClay lIIe Ill""S Jess lII8n 40 SIl< nala CIIoId "'''''''''' me<>sures The Paslorntl! IS
    ye3IS on "'" NabOrl!ll VaconaloOn Days are an ""panclo'lg 1tI.. yea< 10 tack.. an ambotrr:o.tS goaI _
    _ compIemenl to !he regula! _
    roocI1lng a "'"""" etoI<lrM un<le< SO' ., lNI
    _ In 1984 OIfler vaet:nlS - . . aaded t<> ~ r'lOrlt>oosI . wtlemlnl3o"1l"""'8lI1y is
    !tlIl J<lIIIIlf PIOleclJOn 01 CI'oIGren l.O'Idefone agansI ~ if !'ooJC<l1he nalllllal rate
    measles nas ,,,;en !I'om seq,:, in 197810 80 \10. anlI
    PfOIeC\W)II agansl 0i$lIllhe0a. whoopoog <XIU\lI1
    On 29 .... ugusI 199$, 1t>a l/Cl'V'll<OO1eI alSO
    an<l1fllao.",!tom 39q,:, on T980 to 61'1(" Ana sn:::e ~ a map roaw O'lI\lalova 10< chrld ........aI.
    Ero::tIOXa\lOO l1V two llO1Ol protedS"' urban slum•.
    June 1985. all _ .... l\lffW'll up 01'1 ""CCnal1On
    day nave Dee11 ,..,. registerea and \<iloCCWIalion DII8 01 """C!I b«:IuO"l
    10 20 pet 1.000 M _
    .,honI_"""'" kom 76
    . ItIa Po_u has
    CM<lS ~ to IheIr . . - .
    10"""""" a na t"...., 'C/lolct r-"",' ~ , 10 be
    On ""'" oJ II>a Moo yearl)' """"""'loon dayS PUl "'10 8CIiOn l1V me EkWIlNl ;,....13""" legion
    mewe III8n 20 n"" Chil<Iren..n1el bveha>'& bae!l ..Ih fInlloo 01 S1$0 IllIllIon lor 1t>a lir!;l yea<
    vnoon819d "l/lIlnSl (JOIio. Wo:TIeI>'s gmops, Slarllng "' Jaru:lry 1986 ., pCIOI" UIban area« 01
    schc<ils, e/'IufCII or~ BrIll !he amw:l !orcfIs Iha JJOtlh.iIasl, Iha pr"I1",,,,,,,a WIlt locus on low·
    MYiI ..1 par\JCiIl&led. " " - , ,, ,3(100 and COSI wa)'$ '" rnpove cl'liI<lre.", cI1ances 01
    te\eviSIOn. IooodSpea.... sysIern!; aM """" lottery ~

    "
    ... -..d ...... raaa= for radWIc I ....;om, 'm"",*,,", its -md-wido: 'OUId AIM' ......
    tJ. aU pwmtl is ~ W _ awdia ilMff. with 1M 1aT sp<ci6I; i111e111io11 • k n.,
    ....I'lh I ,lllII of t,DllO...rio p l........atiDc r lriU ...... .,. n I " , .... _I _ ", . .
    UIlO aI.- eoay ~ u:k ;'" ~ ...,.... t1trnlW"."
    10 ~ tJ. W PftJllk ill _ IIJ'bu. - - . IIld
    ...., 1iIUX]' IJria&Uq; ill ita -aU I . . . . .
    ~ roadoonI1j", W " lClopiq ~,
    dmroDic aDd prulled _ media _ U"' 'M
    poteotWlO ........ _ iafonn l1Ioo ... ma;om, 01
    W pcoplo ill 01_ all COWIIricL
    UIUllIy. 1M _1Dfdia '"'" IIl«-.y b," oat
    sul'liaall SOWtt 01 _ iafurmation I boII! _
    ,bin, .. fUDd' nrntal .. bmil, hi!:l hb . If thi!
    MeV'''''''
    _her is to make I clwIac La ....... llpe('! of dIiId
    are, Ibm aM will IlC'ed 10 bear I boIIl ii, ODd be
    .-vinoed of it, r""" leYen.I rapoc1ed JOUtCeI,. en?. ..
    The bal.ic ll'ICISIIe may be first hurd or IUd COST"""Cl
    DOI_ teAN f6'UBUC
    l houl 0fI tbe rsdio or in tbe newspaper, bu, it may e. $OI..Y.ooa'I
    need '0 be m nfOl'CCd by the he..hh worke r or ~

    ,""""'"
    -
    d«tor, san<'1iooed by I ~ligioul 0. politkaJ
    Inde•. or I ppro _cd by bu peer ,roup or parco...
    in·Ia.....
    - ,
    Nonctbelcs&, it b..II ","olly been lhe lnIII
    lPcdia _bid! hlft PUI suc:bsubjern as ioununa.
    ,ion., ORT, and brasI-fccdinf; 0.110 the OI1ioaa1
    lIen4I -1J1d 01110 tbe family acCDda - ill COUIIlries
    Iitc p~~ TYtt.ey. Colom bia, Bmil, HODd...
    ,., EaYPc, ODd the G&IIIbia.
    III otba _trios, l1Ioo alalaI1In;"'jms ....
    ___ cI 0fIIIlizcd ~ - 01 W prina; aad
    !be Calbaijr CIlwcb ill Brazil, lAkmhil aad e
    Sal......, • lbc moo- aatl MtlSlim Iadm ill
    I. ' =;lo-a,lDdtllePlailippiaa, ...... 1loe
    Bo»dlliM prieRs ill tile ...w:.a •
    Burma md Sri
    lub-loI..: abo bdpcd to hriD:r; _~e
    It.! dWd pmt<etioo 10 , mil1_ • r--
    from "_uuaed .........
    ellIS, ....

    NCJ:I eeeethe ~ orthe priql. "lIl1lll-


    1IIY .,I" i"ion, R:so&iaI from I -w. .....1
    ........., orpoinrion with 2IlO III<:IIIben ill I
    Y\Ibi•• lllCliIIO I Rowy lllicml Uoal 1 wM I
    million _ _ ZI,DOOdubi ia 1S9 DltioDs,
    lhe _ tol .... &DiD..... brte been I
    pan 011'" aetioo in aImoP eYa'J f i l l 01 ehild "'"0 REGION
    sumnl <Ia1P'li1n1_hieh have re:ac:lIfd nu, to tbe ":i.. .CIlIlIgt~ .."
    ftSt lIIIjority of I lWian·. parmtl. _ ceu.-"
    _ _ _ _ _ 13;_ _
    ~_ .. _lI.6:iIrC
    To qht dialTbonl discaoc. the Rcd CrOI* IIaI
    "~-
    "
    I THE STATE OF THE WORLDS CIllLDREN 1986

    Pakistan:
    saving 100,000 lives
    In -Ule 1985. Pa1<isIarI'$ hN/lll pI3oi"nerS orew StK:aISSlul n cruatn;I oemand l/'laII ., U'ICl8aS/TIQ
    UP tNI baIatIce _ !of
    1M "OunlrfS tllr.... Y8l" SUIllllY Man-; OOC!O<S """" l'$l to adoIll !fie
    Ac:ceIIltWlCI Heallh Programme. lao.Jnched ., It>erapy, many phalmaosts pre\er 10 ..... mora
    1982 to ta<:kIe PaIoSlan"$ hlQh .,f/lrll rmrIaOty ,ate l<:rawe -and irlllflecwe - "'''9''; and lI\IQ IS lIS
    ol120 deat!l\'l Per 1,000,,", borlhS. yeI no greaI ~ In PUIring """ ~"'r>v
    o V~ disease: 60'1> olllle bull- _n', parenl5, TOllaV PIlfl\all$ only 10<;, 01
    ~ al ee d!sPosaI 01 t!>e vilSl 'TIIIIOOlY 01
    gel 1"8$ 3Ioeal\ll;l 10 an aklul eIIon to
    ~
    parents . . oral ~lI\lOn ll'erapy -
    ~ eve<V c/1iId ~ !he iii>< d.... ases PakJslan'.
    de5pne t!>e Iacl INt <barol>Oeal <leIWratlOn ' ...
    """"d'1 k,. a (JI3rIlJf 01 a lTIIion PakJSlanl c!lIl<Iren maIllS tne _ one IolIer 01 Pakisla<lo <::hb""
    -r year [->- P' '''''''Ce haS O<g3rIl e<l mass
    ~t.on d...... which d,a.. OIl SllIICIaIy_ In an eIlort Ig Ium !he Ide. !he PaldoI..,
    wo<kers. m mMia ClIIl'1pa1gnS . a<"d '"""Y 8\IlIil- P~ ~", Assooal>i:ln lIaS IOl>boo<l succesoIuIIy (llf
    able fl!$OUl'OO 10 morivata conm_, 8 V .Nne _ anl><lo_ 1 <lr«;lS '0 be laken ott Iho
    1965 O"l!f 3.000 VlICCIIIatiCV\ POS!!I , molMI tw o"icIal Of\lg JegISI&', ancI ltle Mnslryol Hl:lalJh !las
    toams. and . - ~hOn ......Is were ..
    OPllfa\>Oll1hrougl'loul tile country
    I8oJnChe(I a "*""
    ~ 1lor0000od al doc1or.
    as ........ p:venIs, 10 onc<ease tne demand fororal
    'eh)U'atlOn TIlle'tt$Ion ~l$ ",a being
    The 0'80/1 on page 11 sOOws me resultS. In
    1982 llareIy 5110 of un<\er.!ivw were 1fM>.IIUed. br_ iOl ..-ima ""'" to u.ocata pa,eots aDouI
    by rtlid-1985. 65'11> _ .. WCClrIa1e<l . wnlcl1 oral'l!t¥ltal>i:ln ancl_ Icfw.coR Il'IIlIl5U'IIZ lha1
    means !hal llklIa ""'" 100.000 _ life Ueady
    can"'$ tt>lIir ~ '.1ives
    ~ _ ......... year, and 3 miIion ilIne$$es o Trllli'llng ~aoibonal bor1h lI1leno:tanls: tne IIwO
    _ led, The ~l" confiOOnl Ihlll 75'11\ elemenl IS ee nnng 01 ll'aOollO<lal
    bIrttl lltler>-
    QI cNIcIr.., ";1 be PlOleCted by"'" em ol llle yea, ""'"" [TBA'J rOO' ilia majorrly or Pakislan'.
    In the Punjab. """""'" 55'1. 01 Paki$lan'. ~ 1l'IO!t>ert, TBAs are !he malemal ancl ctOll:l _ Itt>
    live. ~. lias aIread)' passe<lllle 60 " marl< _ . 'hel' (leIivet80'lool_ in ....-a1 ar.....
    Co«espondingly. OO>I'lIaoe "' ar_ SUCh as B!IIIr IIO<l U- ....... 01 ~-abou1 PlagMrICy.
    ct'islan IS below _age and II'<SiJttioenIlO pro- sale oetrverv, !'Jl'QIl!ne, ancI ;,ram C<IIe- is a kay
    tr(lI8 'hekl immunity' _n • • ~ or matemal an<! ctOkI r -Itt> througI\
    lIle Mbor1 .
    To l:>acl< UP me ..-.......zalJOn 00_. Pair...."
    Is now one 01 !he lirsI oew.lcpo~ COIJ1~'" Ie Tho anllS 10 tr301 50,000 TeAs SI,Il!lat <JYel'I
    l:>eC(Ime seIl....._ .. . - vae::<;IIllI , _ VlIage ancl . .m 1'1 ~ an v.iII _ a tlotast one
    10 a P«lWct>oo plant ~ in 1 9 a ~ arw:j TBA able 10 dell.- ba bies ..!ely and 0He< soond
    hnanc:«I tl'1 !he e/IoIIS 01 HIlI Royal HigIIness acMca on - . . care Sc> tar, 15 ,000 llaw
    Pnnce TaJal 01 Saudi AI_ 'eceMld """" rnc>ntI"e' lraitWlg IItld _ re1~

    oIhe 0Iat""""'" 10 lII!!II oonmnIies.


    dehydt8llOn;lhOl """'*'t 01
    second
    lICCelera\eO progratnme II 0181 r«¥Jrallon
    the<ltl>Y, 10 lO<8Slal !he 0 0 _ <lehy<lr"'"",
    WIIiCIl kills oearIy 300,000 Pal<JsIano dloklroo
    _llI\
    Wi," l\lII balance shee1 lookng "l

    Programme
    is ... _ng "'" Acceleraled Heall1
    heaIth~.

    "" anot!le< 1hfoo._ 11lIrn. " 1/111


    """'Y year
    Aro:l here the record is r>:>1 SO second lerm can match 1/111 <KJoIe'U' '''15 oIlho

    ---
    ~. ProcIuctiDn 01 0ID1 """\'CllallOn salts rd , Pal<iolan will _ !l<amIlIIcaI'I ""provao:! Its
    lias - . Sl8pped up, from 1 _ 1 0 22 _ <::!Wclren', chanc:es of ",,"""!II ar<l of heaIIhy
    sachets a year Bult11e programme M5 _less
    ();, !.be immuniution fron" Roury Inlema- "'hydr1tion sal,s througb lb . $IfI1e 5,000 "'tail
    Iwnll'$ Pn~ n 1990 iniu..,iw :md !.b. Sa,... tb. O\ltl<l$. In IndCl>eSia, il wu lb e slrIlClum set up
    Childral Fund', SlOP Polio campai$n""" he:lpill$ to promote family planning, and the: 10,000 family
    go""",,,,,,,,, health ..,."ices ' 0 lij;h,lbe pan.lytio Plartt>in5 workers already in pI""" acr<lSS the
    polio wbicb is Slill disa bling 5,000 cAi!d.trI a liJttk cou nuy, ....Ilieh made po$$ibl< th e sulKquent
    in tbe de....loping world. And IS pan of tbllir launch of Ihe Family NUtrilion Impro~'
    world_wide Child Alive prosramme, national Rod Prosramme (Itt panel U ) . In lbe Midd le Eut,il
    Cross Incinia Mve been heavily in volved in ,h. j, Ibe national women' , orglniution$ ( in Otnan
    and lbe Uniled Arab Eminna ) . nd Ih. WO~'S
    '1I<:CeSS of th e recen, immun izalion caDI!Win, in
    th e AlI>eI'icu - fielding 100'" lban 13,000 volun _ unions (in Ir1q, S)'ri.. and Democra.lic YfiDt n)
    t« r vaccinalOfl for the Colombian cam paign wbo h..ve tqun to take I particular interest in lb.
    alone. prmoolion of immunization and ORT. In Nigeri. ,
    it lias b<en lit< Ir3lIi,inna1 chief. who b••e helped
    For lbe promotion of knowledge .bou, vi'amin
    A, HeI.n Keller hnwtalional ( HKI ) iI now immunization WlI~n$ '0 re:oc:b much Lacger
    numhc:fl of paren lS. In Honduns, local _yon or
    launching a $6 million Child Surviwl Plan ' 0
    alea1d.. h..ve len' 'btU- a.. lhori,y '0 ,It< m<3S38a
    M . . . ..l:t " '""""'lie ;"'p4<1 '"' child ",""""I try abou l ORT going OU' on lbe radio staUol1l. In
    f>rtt'<IIli"l mui ,..... ,Uog "-'f1m'd "'lJlml ~ ,.f tlef":i-
    India, villagers who bave b<en ,rained 10 mainllliD
    tlII)'''' (»;<~17ieo fIJhnt , kildml aTfI ar """,,;u, of
    villas e hand-pumps ..... now also heing train~ to
    b1indlUSf ,,06 chill! ....,,"'/ily..." A, the WDe 'imo ,
    promole ORT al""l wilb lb e d ean .... 'er .op-
    HKl has also moved 5 million doses of vi'amin A p~es. In 8ruil, tb e tnditional healers or rua-
    iDIOIhe camps of E,biopia and lbe Sudan whe:'" il
    dei . as ..... also promoting ORT. In Bombay,
    ia not un,ypical for 10" of child",n 10 h. w
    "'hookbild"'o ba•• hoIb prepared th e list, of all
    advan<:cd symploms of vinmtin A defici"""Y :md
    uod.......,.. in the community and belped 10
    wbere m:my""" irreversi bly b~nd."
    inform their parents of the Ii\ne$ and places for
    In ,he: iDdusuia~~ world !.bere .... nuw """r immuni..,iOfl. In Haiti, O"er 2,000 ord inuy
    3,000 voluD'ary organiza, ion, $tlIding :m esu- 110","" "'Ilicb .... abn omall $bops for cY<')"(Ia1
    maled SI,500 million a }'Qr 10 thllir co un,er part pro vi$i<JO$ like bontries and !IOf, drinks are now
    OflIanizalions in Ihe devdoping world. And in "'" sd lin, _ b", of oraI ldtydntion salts .....d!.
    d. vdoping D.OOO$ themsel vu, UDCOIID,ed lbOll·
    Wl ds of mganiutions - an estimated 6,000 in
    Bangladesh. for elWllple _ """ workin g wi'b ,he:
    people of lite pnnral villoges and neighbourltnndo Primary h",o wodel'll
    wit<", child= .... I0OI1 . 1 risk. When formal health ..rvicu reach on1~ •
    minnri'y of th e popul.t ion, it ;, only by mobi~ ","
    In exh n.tion, laal kno wledg. and cteln ivity
    ing all of IbOK resDlU'CCS tba' preoent knowledge
    will o, ually be able In pick OIIt nther "'"Y" and
    abou, family health can be: broken 001 or its
    mean' of melting ou, ' 0 partu,ular group" of
    par<nl5. In Bruil, for enmplt, child $urviyal is
    medial sho"'~ and put in,o th r It.and$ of
    milliollS of fami~...
    DOW 00. of lbe ' badges' wllieb can be: earned by
    !he nation'. 10 mil~on Boy Scouts. In Colomhia, Bu' u perioncc b.as shown lb •• all of ,b ese now
    th e goVttDlllCflt lias decided 10 booiIt '''' N.lional ideas abo ut heal,h """ pu ' in, o pra<ti<e mort
    Plan for Child Survival and [:lew,lo p.....nl by quidl.l y and mon: . "",ly if !here i' a be.• hh
    cn:ating a fom of 18(1,000 'heallh guards' througb work.., eeea one wil h o nly a few w«ks' or
    • La.... ...Ilieb ob4a all founb -~ar bigb«bonl 0I0II1bs' training, "'ho actually ~y .. in th e <:om-
    students 10 hc: lfIined in cbild survival kno wledge muni,y and who ;, tbere .t !he lime tbe molber
    and to .....e . 1 leasl 100 ho u,", I yur in the _ immedia, e1y oeeds the ad"itt .bout how to
    community. In N.pal, an anem pl is hei nl made use tbe DeWoraI rebydration lberapy, aboo l JOinI
    10 take odvan,qe of a contraoeptive distributiou for an injec<ion in prt8n...-y, .boo, wb"".. ' 0
    $}'Stem in oed.. to promot. _bets of onl lake • chi ld for I third immunization , abotll

    "
    I THE STATE OF THE WORLD'S CHILDREN 1986

    "'lOUnuing ' 0 b rust-feed or about Wh~Jl IO bc1l;n b y a tnioed midwife and a health san itari.so (see
    waning. If Illth a person is part of, ODd av:ailable paneI 21 ). ~
    '0, 'he commuoity, whet h... il be an anganwadi
    worker in lodi.a or • f'TI>I'W- rJ" S4/rul '" In Pakislan, t.ns of thOtlSOrlds of lradiliOflal
    Colombia, [Mn aU OIh<:r IZIrSSIlll:ll from all OIher kin h .tt.ndonts are he:ina ' rained in basic mother
    JOUrceI"", mon: likely ' 0 lake tOOl . and child protect ion str:;u egiO$ (see ~e1 I I ) .

    AI the mom<'lll, ,here is still . long way to go In the Repuhlic of Ko ru, communi'y health
    before cvcsyvillagc lJId ncighbourhO<ld has ac<:ess proctitioo... In' now .vailabl. to ........ llO% of .Il
    ,n lI>Qdcm k<lowlcdge of family health mctbodl; runJ pcop1e.
    via _ kind of residen, lnincd health wmktt.
    In 8aPlliodeslt , there are now 23,000 tnined
    10 JlIO$I lkvclopl,,& COUDtries, ,hrtt-quor'lcr1 or mid wives and 30,000 mort art "'hed uJed '0 be
    mon: of ,I!<: hnhh budg<l is still de_ cd '0 trained by 1m.
    e>:pensivcc hospital and doaor-bucd can: for less
    In Nepal, thm: are now almost 2,l1OO .uxiliory
    t ban 20"' o f lb. population." In moo.I co uo tries,
    heallh wOKk~rs, wilh either eee Or'WO y.....' basic
    primary hcahh tare is m ll lO""'thin g 10 be 'kl«d
    training, working in 800 rural health posts.
    on to the cxis/ing health s<n'ic... - if 'bere is
    In)'lltillJ: left in the bodiet wben 1M hOfpi,m [n Tonzoni.., 90'1. nf tbe pop ulotion n OW lives
    IIId the urban_bucd curat ive lel'\'ices have been " i thi n 10 kilometres o f a bea.hb pos< (ond over
    paid for. [0 0><)$' COU ntr1cs, there are still 'DO few 7(l'Jl; within 5 kllo nx:trcs ) .
    prinwy h<:ahh cart workers with 100 lin l. ' rain_
    iog and supm'ision IIIld wilh not ntmy mough In Nis..., 13,000 community IltIl1th WOrk...
    .uppon from referral ~ lIut dQpit••U til;.. ha... be<n trained to"""~ .!moot 4,000 villages.
    progl"t$$ ~ bffil mad. in the last r~ yeatS.
    And in ,hrt<>-qur.n... of . 11 th e develop;lIi
    Almost all d ev¢loping nat ions h.... DQW <:oUlltries, 'h.... art now some lUnd of ' rai ning
    adopted primary tle:lIth <= as officiJl policy. In PTOllratnme:i for the tradition.1 binh .umdants
    some, luI commi tmen t il llO far on ly rhetorical . 10 (:see po.oe1 I I ) who are rtUed upon by the
    ot hen, Ib= has already b«n a ";Rni 6<an' AA in mojority of ,he world 's mothe.. fnr help ""d
    th~ numbm; of ~ks and community healt h Ildvice in tllIlters of bearina ""d nr1n1 for
    worke r$;- child rm."

    In Chifla 'hert a", O~r 2 mill ion 'bartfOOI In SUrrutlOry, the techniques and th~ k.nowledle
    dOClon' I t work in th~ WDUnunhy. In Indi., as for a rtvolu tion in child SUMVlJ art now avail·
    has :already been m.miOll<:d, there an. nOW ovn able, The ClIpx;ty to inform and suppon JI.roItS
    300,000 health luides at wor k and ,h.rt will """n in hrinllina that revolu tion about _and beginning
    be 600,000 in villag.. throughout 'he coun,ry. " ' 0 pu, pril1\llry h..hh care into ptXIi"" ~ i' a1.., in
    Bu t th ese, the IWO most populous nations of the plaIT in tt>DSl nations o f the world . T he on ly
    world, .... nOl tM naly aampl.. of larz~l. calalyst nftded to rompoun d ,It... two elements
    trainilli o f paramedial staff. in to . practial imprn.......n' in ' he ii..... of the
    world'$ dtildrm is thcnfOfC the politi cal will and
    In Bu""", 26,l58 community health wor k. ... ro nuni tmen t to do ;1,
    and 8,700 .ullliary wor kers hi,'.
    been pl.J5ted and
    the plan i> now '0 put OM commuoity health In sn<tai nOlion$, nation. where th a' political
    worker in each 01 Burtlll.'s loS,ooo viHages. will and commillnent ha~ already been demon·
    strared, it is already clear th . t the~ i.loinllto he:
    10 Thailand, 43,000 village heal'h wor kers . nd a u cc p roll in the nI,e of child ma\nU,";tiOfl and
    over 419,000 ' healt h co mm unieaton' h. ... been child dellt'" 0 ..... th~ oal few ya....
    trained to briol basic hellith """"""80$ '0 fatni1ies
    in .....,. ~ of Ill1 villages. 10 tot:al, Thailand no w But in all <:oUntries, th ere ore important diffi·
    has more tlwl 7.000 heall h ceOIm., uch sl.ffed rulues to be ac kno wledlled.

    •
    The benefits for women
    The 8,eal($\ of ,h""" difficultia iI <.be ran lhOl Then, ofler , pending up to iii or ..,,,,,n hou rl I
    lhe majority of lb. dev<!loping world'a wceee dly plantmg, w...w"l, hwiflg, threshiflg and
    have [00 lars<' a ~ of responsibili,y for family gJeani"ll, Ih. woman relutn$ hotll/! 10 the: tasks of
    ..ell-beiog lLIId [00 <mall a ~ in l h. decisions poundi!18 and winnowi ng, grindiog an d boi ling ,
    which aff~ it. dryUtg: an d storing, al'lYing and mrkrling,
    cookinJ and ..,lYing:.
    For wheth.. "'" are ralki"ll about breast-
    f.eding or -aning, onl .chydra,ion <.bcn.py or Af,e , £ttding: t he men and ..,.,;og th at the
    immuni.,tion, regul... growth ch«k.i ng ur f* child ren ha"" ,",'''', $1\. he""lf .. u I ,mill
    quen, h.ondW2$biog, it is obviOWl tha, ,b. moth... pn,lpnrli<:ln of the food sh e hol; grow n. Then she
    stands II lbe Ctlltre of the child S\lf\'ival ~olu­ tuOU to t he tosks of washing the pots, duning
    lion. tho hOll5(, , w((]>ing lb. compound., bat hing rn.
    infllllS, mending the clo, hl:S, laying ou t the
    Acquirina: :ond applying p = ' knowltdgc balding, f«<l ing Ih. animals, ,.odiog Ihe kitchm
    about child huhh ,hC1('[Ort lIIllMsgrea t demand. guden, golna ' 0 Ih. mar k¢!, fetching tho
    011 the mother. But .. lilil cbapler wilhummariu, fil'(wood , cmying Ih. .....1..., and loolti!18aflCr the
    ..,....,gits for protoc,ing Ihe U"cs of chHm " are elderly, rn. sid . . and th. ch ild n:n .
    n

    also """'''II the Il1O$1 ""1'0"...., stra'<xi.. for In nt h.,. words, women pUI ifI I pp"wmot. ly
    imJlflJ\'lng the li"es of \IIOITleD. loasmueh lIS they twi<:<: u many bOUlll of wor k os mc:n.
    lO"" ronsiderabJe ImounU o f mon O)', t h(')' eff«-
    livel y in<nO$O I woman'. income. Inumuch lIS At th e same time, th. Decade for Womrn has
    they prevent iIIom and disability, they Uberate a also brough, OUt til<: fOC1 t h., many millions OhM
    woman'. time IlIl d cOOlly. !.......,n. b as they sa...., world's womc:n at'( permanmtly in poor hoalth.
    Iivq, Ih<')' hdp In liberat e women fram the ,niP of To !m on. ind icati'" cnmple, almost half of th .
    too-frtq uenl pregnancy (see JlUId 2S) . lnumW:h wont<'U in the:developing world at'( anotmic _ and
    .. lh<y emil'::" "'" a WOman 10 protect ber own and among pregnan l wo"""'" th at figu", rises d_ '
    to
    bOT childrtn'. heahh by h<o' own ..,..ions, they m (_ Lifd in c:s' iron, iodill" and vitamin A ).'
    increase a woman 's I bility and confidence til take Tb. C1.,.., ill nOi usuaJIy a specific ill ness. It io
    m<>re control nver her nwn life, "'ther lh. B""....I ' matern al d ep lttion ' cans«! by
    100 much wo,k and 100 littl. food combined with
    On 26 July this yell, at I World Confaence in 'OIl many pttgllancies tOO cIOK ("lImer.
    Nairobi, the United Nal ions Ik<:ade fnr Women
    formall y d,..,w til :til end. And ah ho..,b it is 001 From girlhood to wOlllllJl bood, lbe ftmales of
    poo$ible h= to .s.arnine Ihe who le f.bric of is$.... lIIIlJIy soci.,ies an: fed IllS! and 1...1.' Malo utri·
    whicb has bo:cn woven during t he o.ca.k, it is tion in g irls is much mol'( commoo ,han among
    useful to follow IbOle strands which Iud d irectly boys and III<: fat! ,bat, 011 a~t, III American
    to th e quality of chilmn's Ii"" and 10 the woman wciJlh$ I pp rnmnotd y 2S... ""'''' lJIan an
    copacity of mothen to bring l hau l impnwL'- Indian WOlllllJl is 10 iN: esplaiMd oOt by rIoCfc but
    eeme- by food.'
    Fuqu' II' pregnan cy slwpens tbe problem.
    Filllt of all, th e Ik<:ade hoo Wsp¢lled forneriM Poo, growtb in ber owo childhood moy ha,'. I.fl
    idea that ' fanmr' ill I ~ne noun. Su~ th e lIIIIIher Ins Ible to wit hst and 1M bl'l vy
    d k r su noey boo showu tb .t womo:n of'en wor k
    """" hour< I""" day and mote days I""" y= in the
    6dds than their nltJlfolk ( F;'. II ) and lhat they
    IfC di=tJy ....ponsible fo r producing more tban
    b.lf of 011 til<: food grown ifI 'he de""loping
    world. ' In Wo:st Africo, for aampl., women do
    70'10 to 80$ of al l ltIlr>cultural wor k and prodlK'C
    4M. In ~ of.1l stlpl< food rrops.'

    "
    I TIfE srATE OF TIfE WORLD'S CHILDREN 1986

    Nicaragua:
    child deaths down 30%
    II> me 1960. ar<l 1910. N"",,"9U& r.aa one 01 'oWce<J "'" If>XIerI(:e of dlllHt"""" """,,og voung
    !he hlQllBsl _ aI 0tIatl1 morIBlity "' latin CIlidren. IIO"Id ClMths kom oenyd'3b/)f'1 NMl been
    ArnefIca DIarrhoe.a was the cnoe! ...... ol lntanl$ CUI by seIlO'lg W 356 01111 ,enyeJral"'" ""'IS '"
    l1IId clllld<flI'. !oIoWed ll',' re5ll"31cwy onleclo:>ns. heal!!' ceeees and I'le.3l\1'l posts Nurses 31 the
    lei......, moasles. maIilrta ancl ~ cougI\ ....'" _ mot!lerli _10 ..... antl ...........ter ",al
    <elr,<lIatJon salls . and also lIduc;ite I""'" '"
    /lJle( lho ~ 01 \ICl"G'1'lrl'IeJll in 19 79 . preWl1"'11 _ _ V«>ugh con!lnIJG'j ~.
    Nlcalllll...•• hea/tI1 and sooal seeuntv Sl'S1e/Tl!I ~ andOll11« ~ in the home I t>e salIS
    _ e ~ to begin ~ II OO'l'I(Irel>en- a~ now doe 10 eeceee wr.1eI)' """'lable Irom
    I'iYo pnmary _ can!I sysIem In lour yeNs, The
    /;Ifig.od<s/as- ano trvough 0U1IC\$ $I.CI\ as 8rTIaII
    I1I>'I"tIeI 01 IIeI,I/Ih POSIS .m;l hea~ cennes was shops ano rnarI<eI-Ulldtn To ~ IN 8XIl<lC:od
    ~_ . and <NfJI 80'l> ol !he lIOPUla!JOO1 now has ~. UNlCEF" S<.(lpIy01g 1S _ pae ~ ets
    access to free ~ nealth cartl_
    of oral ""'y<lrsPorl salls a year
    Umoled 1es<l\lfCCS r.ave IIlIWll """ch'''11 tor Man ~ _ play a 'wy role '" I""
    ~. rwgh-impBcl, ~ v-_ wars at neaItt1 carnpaigns. ~ or\l¥'18tlOf'lS
    ~ !he hioaIth of I'IlOlI'Il:n ar<l )'OU"l\I
    orDOuce tt>eo< own ~. lea nets and nDIJCllJ ,
    ChiIcIren , So - . """"'_ Mve <:eoUod aroond
    c!lkI growl!' (1\0" 100 ;"11 , doatmoe\ll disease.,..,. ana annDulCe lor'\rIcomIng r>Ba1t/l 001\'$ ""'" 0Ju(I.
    uol, PlOOllllrog bleasHeed..g IIl1d "IJPfOPf\illl1
    ~ mounIcd 011 cars
    -""Il. ~ a b/)f'l , t8rnIIy Iood supplemeoIs _"10"1"1 Il'og<.......... """ a1'ead)' yoIOlded
    and !IIlI carll ot ~ ;VI(! l3e1atO'lO women. r........ SIIlce <IfHI rtlh)'ll<al>Oll 1heI"PI' was i<1M ·
    lII>Ced In 1980 , the _ rete amoog 1;/liI<Ir""
    SuI ~ tIeaI!h CllIe Is roll eQualed oot,o Wtlt1 (/i3rmooo in hOsI>!Ilb has _ I>'y ~2 "" , and
    ...1Il1lle c>.pllllSion 01 goyemment _ . ~tth
    .. also soon as !he responabolity ol orgorOW dl3lTlloOO 1l3!l1a1lot11rom too f1r.;t IDthe lltth CIIlIS8
    poopll, ,, QfO\I\lS. 'People '5 /lea~h COU1CIlS' 0!I'\Il0.&
    01 c1tlid _It> lrnmI.nizatlOO ralC$ fJIIaI ItlCISOI 01
    """'" developea CQ<JflIties.... t 98~ . IICCO<ll>no to
    lm<lII ......... neognboI.ohocd OIIl'1" ,atior>ll. ar<l
    ~r ewmaIBS, 91 ~ 01 ",lan11 were ll'ot<lClOO
    liSSOCI3tlCitlS of yCIUr'Ig fll!<lllle and women 10 la1<e
    on aewe ,ole '" C3JI'1lI1Il "'" _ programmes BIll""St lidlet'C\JlosIs. 60'!!> Il9"'/1$I measles and
    76'1ti aganst IlOkI No IlOkI case has lleef'l
    8u11d"'ll on lhll .,.per.ence O! 1IIe na\iorlal r~ SIIlC<t 1981 . ..............lI1JOII ~ ~
    11\ 1980, II O,,"es of PeodI!'s
    . temey ctIJSaCle f!lana, """"",," 'II cough _ fe\arU IS ...,......1"'1/
    _ Deys (1C'ffWaS ~ ... sat.:t was
    ....OCI'IOCI "' 1981 Co-ot"'nale<l l)y !he peopI(I '.
    he!I/Ih t<:IOJf'Ob, !he health liars tIave eeeeee 1111!
    lIla<Ing edge oj campaigns "'9""*
    'PI teYer, POliO and~ In 19 8 1. lhe maJana
    "'""'03.
    (len-
    l1li_
    llu! ""'" 33'10 01 ..fMIA _ My ptOl8C1od n
    t 96~ Naonalal teIanus II &IIIJ PIfMllent. buf a

    r_
    campaign bfIOun '" 1963 IllrTIS fQ
    .lICCIIlalB all....,....., til cIOlO-bear,ng age.
    A/lllOI.lQII lOme n'JIl(>IUIftI _ SI. 10
    ana dengue CllIIIJl'IIQO'I . . - 1 9 .....", peo-
    llle/70" 0l1lle~liO<llMcl 70,OD(l -..:>lam
    OIl fackleO. N0Cil/3IgUIl's lOCuS on fhe PI'orrt)'
    healIh _~ 01 bn<}l>dlSIM E""'V year, on flea/lI'lll'Olllorns 01 women and CIliIdrGt> is hlMog 0
    thr.... _ _ ~ ........ ry ond ..u-...!he l!'l<laSIIIabie nallOMl lrrc>act 8e1_ 19 76 and
    atl!lilOloO 3ro:I mBllISI8S campaogos ,egUartv moo;. 1963 tile oYefal .,IM mortaIily ""a leII by 00lI'-
    ftwU. kom 12.1 1080 per 1.00 0 .... OInns ~ """ at
    1l/;11",~zo.ooa ~
    the JTIOSl </rllmIIUc mpr<Mlmilllts '" dlIla lIIIIVMJI
    I/np<ove<! _ SUllIlIie$ """ _ allOn _ in the rleYeIopong world

    "
    nUln'iona/ burdem of pl'(jlnancy and br=t- infanl formula in a bOlOeis wo rth lhe e. pense as
    [«ding.' A prqnancy (Very eightttn monll.. it means thaI some bod y elsc _a sisle' OJ a
    wi'h oDibing in be, wetn hu' han! work, frcqum t yandmotbCl' -tan feed lbe thild and all ow the
    illness, ...,d poor food, gradually deple, " ,he moth to eany OIl workin&-
    mDiher's body of pro,ein IIld ealories, halth and
    To V(: time and eoc:fJY in the fields, Jhe may
    """illY. And if th e ll,e stqes of pregnancy also
    swile h to less demanding food tJOps like cassa va
    hoPfl(ll ' 0 eoin cide wilh the KalGn of he<tvim
    instead of roaiu: Or rice. not bIowin! of the
    work in th e fields, th m th e mmher·'n-be may
    nutritional I".,.., litis will brin& '0 Itt< chi ldren.
    ~n flilln gain ""y we:if;hl 01 . 11 as h... pregnancy
    advances.' To ma kc sure tUI the: supl. cro p is planled o r
    h.,vcsted, she may n.glect lhe kitchen garden.
    Th e nel resuh is that the: mother', time and even though it is lbe "'W'a: of lbe vesetables,
    eoel'l Y- the most valua hle of all reso urces fo, butts, 0 1 f", its which plOYide the minc rals. lh e
    imp rov"'l; child heal th -are eroded by botb the oils. th e vitamln A. wh ich arc euenti.ll iogmli-
    J'lGveny.nd th e injl1Stice of her cireullU\.aJlc:es. COlJ o r the rou"llchild's diet.
    Inevitably. ohon <U l$ hove 10 be laken merely
    to reaeh the end of the: day.
    To " ve time and firewood. Ihe mother ma y
    Fig. 11 Mala and f&mala shares of
    rook food less fre<lUeolly and in large r quam iii· agric ultural ta sks and training, Africa
    CI- ""riot; i, for Ion!er in uohyt;ieoic: $IIlTOund· 1Male share _ Female share
    irt&S and al trop ical temperatures.
    To allow a loo! day', earniop in the fields o r
    plantl, iOlls., a o infanl may be len with an eight ·
    ~ 01 >InI_
    AGRlCULWRAl.. WORK
    t¥ lOOk ..., _ •.....,.

    y¢at-ol d brother nr slsle, for ,he whole day . LLO')l,_


    T o seve a trip N ek from lhe lit ldl nr tl>< l~ _
    mar ket. a YOWlfl thild may be fed o nly twiee a
    day, al adult mealtimes. instead of the rour o r fiV(: I"'"
    smaller mea ls which a youn! child', small
    sto mach o«<ls.,
    T o iSVe firewood, wate, ma y t,<> unboiled. And
    In $IV. an ho ut's trip '0 th e well. lite family's
    ban d.! may MI alwa ys he ......bed after \/Sin! the:
    IaUine or hefore preps";"! the food.
    To SIV(: tim. io rookin! . the mot her ma y CIlt
    do wo 00 pmtein. rieh foods like pu~ wb ic:h
    llSuaUy ,ake longer ", prepa...
    T o save ll\llk"'l; specia l weaniol foods., thild·
    reo may he weaned 00 a J'lGnid&e made from the:
    same food as is &iven w the aduhs - ..eo tboup ......AGRlCUl
    _ _TURAL. TRAINING
    oao......-. i . , ~

    thildren o«d more ealo rie« nsc: foods to avoid ..-...g f>'' Il'''''''_ .....,.
    beromitl& malno urished. (85%
    To save oomin& bome every few bou rs. the
    IllOIhe, may o nly breast· feed her infant two o r
    lhree times a day - evco lhou £b litis may lead to
    """
    I"'" IQ1JII
    less mill: and lbe pre ma'ure end ing of breast· __ " - '.e-...,....,~ ...'..... _.., ...
    feedirt&- Or she ma y decide th at usin l anHicial - ,~

    "
    I THE STATE OF THE WORW'S CHILDREN 1986

    Indonesia:
    one million health workers
    "' 0YIlI 40.000 01 _ _ 's 67 ,000...nages,
    u...... \OIage
    10 t>oIP theor
    ~. or I<8a9rs, are WQf1<Jng
    caTIII'IIlMy orOl<ld >IS enild",',..
    _.
    o 75", 01
    o Altnosl 90% 01
    II'II:lIl1ct$ brI!aSl.1M for IwO 1'fW8 01

    moIherS _ vegoIables and


    1'oeiI1lI1. Ono ,e&JI " II\lII 5 moIIon ~ more energy.ridl tood to the< cM:l', dIcllle!O<e
    _ _ ale now J1l(IUIa"Y weogIWIg " - cllolOren
    \he ave 01 a year
    ;nj ~ 1.O l)I'\ tn8IIl1aw1/l.

    f1lll _ara <:/lu$m by l!1eoI commuroIi85 lOt


    ollb!lC\.Oosls
    51 % 01 ChilOren """ bee!1 ...........-:l ~
    and 57.,. roo Md 8hoIs agaOl'lSl
    two
    bnel tran>g and osualti _ 10 to 15 house- dop/l lher... ~ cough ana letanus
    IIOlds Thew do"ll9S :nckJOe 1\eIflir'll moU>ers to
    W9IQIl Uf1(ler-l,.. ......-; monlt\: P<OYICI<lQ a<l'YK;:<I oPI..........
    65'1.atlTClhe<s I<,new 8boo1 0181 rnI¥l<8!lQn10
    de<1ydra_. 57':1> ooJId """
    l)I'\ nutrioon. <l<SUlbolng food """'*"'1(\"1$ to _
    the ~ oral ,~atiDn salts ar'IIl (7'10
    ~ chiIdrfIn, ~ "'!"""" A, 1/011
    IlIJI)pIernenIS aod oral rehyoralkwl s"lIs, pmmootlQ I<MW 1M lI'IgIfldo&r'lt$ "" making 8 sail am ~
    !81l' lly pIanfwlQ aro:l ISStMlg <:001'~ . ....., """ it /lome
    ~g ~. lor """"-""UlIlIO<. Suet> IIg<.OCS !>a..... yel 10 be react>e<l on a
    Cloae 10 oM _ klOWSara now .. pIlIC(! . ", Mllonal oc;IIe lrnPIoved chikl nu\<u.... has - .
    8 count,,! "'1I'l 160 "*'" pe<>pI8 ~ QUaI\('i ota "Ml1O documenl, ctWWen" ' . - at ,e'ar'lIIlJM!
    ";pped trwOUlJl> IIIe nel, Mel ka<Ia<s h8ve _
    ...1Ion of """" wc<1< ""'" "'" tarTIIIV planning
    P'''Il'''''''''' Some 400 ,000 """""""!IIe F8<riIy
    tlmes TIIlIen $lof1 "' Ihe t~ lasIc of
    Nulnl>On ~1 I'fogr;orrwne, Ttvee-<lU¥letS
    oour--.g mottIets 8Il<Ju' Iloalth aJlJ r uU, _ A
    QOJlI/Ief 01 the ( OQ,OOQ flIM\JOn I<a<Iets _
    01 , , _ """' ",II> ~ ·s IaInly welfare
    rl'I<l'<'<!d Of <!lopped O<.ll
    !I"IIlVemO:!flt as WlIlI Many ~aders wcwI< ""Tn IwO'"
    """" 01 Ihese <l lle<.." PI<JlIIiIrmleS. Nl!\IOr>._ ~ 5ll,*, 01 C!'IIkl...... wno <:'O'JId
    The <l8II 01 """lIe ...... meer. is "'" oow TO rome fo< ,~ W(JIQhing 'Cll"'~ do SQ. an<l
    lh<;>$O wno Slay iway may .... De _ IIUl ..
    1n<lOoesoa. ThlllgOHlldUOOllOrl 0I~ .
    01 !nJ1ua1 self.heIp. 0UIlI gr$31 value on VOIunlary
    _ -a Il«>bIem common 10 most P'OII'ammet
    _ lor lh&~ . lnl played on WT(lO(Ian1 3"'"'0 at UI'IiveIsal """"""ll'
    role ., SPloadong lhe message 01 lhe "Crlllll' [>'e'\ 00. Ihe JoJIe 01 50$ comPlllc:'l_ Wllh
    RevoUloo' """"'" 3D oo.mabCaIIV , _ In<lon8- Itle I ll'" 01 """"'-IIYes al!(!rdng '-1It1 cIfIIcs
    $llI'. nee ~ III The 197& lat\J8IY nee"'$8 of
    !hoi """"'1BJy trad<OOo. !he basoc """""""
    bl' ......~"'" _CCSI only 52 Pel' dlii<I P91l'"r
    A 1983 oIudy _
    1"_
    the alfoc:hVenIlSS ot
    "roo' me
    ".....,oa
    l)eIl)lel<"'O
    "e now
    "11/..,1'1 01 _
    lleIrog booo.9'! IOgO\heI .. me
    UOS)'atIlIu - '"" 'Oloe-SIOP' _ IAJ5l

    !Of _1ft, . rrnl.. ..zallOn and !amoIy pIar"o\InQ


    Ihe_e
    monll1ly W8lgtlo'l\l :IIl8SIOI1 Blso ~oes IIle r;ett,rog
    kadl>/!;

    ,,"TnIJOO _ " ' seven ~ in Ball Jal'a and ~


    Sumaua WIlt! a l<>IaI POPUlat>orl of 16.00 0 TIl<t
    ,esearCllOOllounlllhal- AnoIher mAon I<8Oers ee dlllllO be 1 ' _ by
    o 119'l1o 01 00(ler·1.- reg<JIarly atrenoe<,l "'"
    .....1IhIy ~ ... SSIOnS.
    11(_
    llle eM 01 "'" ~, and IndOnesI.a kicks ...1 to
    as statM gMIs tor 1969 -
    ",18<11 rnortahIy 'ale to 70 <lea"'" per l ,llOll Jo.oe
    no as

    o IlS~ ot moltle<. DelioMl<l III ""'"U......1Il Of bol'\hS. ''''"'''II "'",...f\IlabOrl 1e'\teIS lOa m",,,,,,", 01
    IflCfN:Ilrog It>Br food ontal<e <lurinII PfeII(lallCy - a 65... . IIIlll eo<\erllIIng tho r;,rnily NulII\lOll Improve.
    P'lIC!>Ce "'"""'Il eo<m'" 10 trad _ _ "'e,n I'fogr8rnrne to """'Y .,.~ "' Ihe COlOlIry

    •
    To .., e 10l!0i~ a day'. work in lbe 6elds duriq Prolectiq the normal pbysjeal and mental
    barvesllime••be may decide that one immuniza- dcvdopment of children is clearly essential if ' hal
    lion is enou&h. <yd. iJ cYf'r to be brok"". Today, bcca .... of n. w
    knowledge and new outreacb CI~iIy, lhal pi'(>.
    To .."" an bour·. "'allr to lbe dini~ when Jhc is lecUon ean bc provided to the majorily of tbe poor
    prepanl. and poJJibly 1"'0 hours queucin& in Ibe world's oItild= al a "IIil which is within the
    i un when Jhe getJ lbere, Jhe may decide not 10 capacity of _ of ,b. poor world'. familia. IIUI
    bother wilb anOlher prc-lIalal checlt Or a second for all the ot her l:i.ads of ,uppon whicb wi11 he
    lelan llJ mjection. And to .., e yel anOlher trip oeccssary to bring lhis ahout , lbe critical heal<.b
    wilb an ei&f!l-monlb -old baby 10 <any• • be m.oy ",or\:et II Iht ecru", of the child sum..,.) rcvolu·
    decide not 10 bolher we;y,il\& lbe child Ibat tKln is .tillihe ch~ d' s mother.
    month.
    Doco lb. fOCI that 10 many WlImC1I Ire :lO
    To ba"" more bd p wilb aU of !his. a woman o,."" orlted me.an thai lbere iJ no "'aJistie hope of
    may decide thaI sbe needs more: dau&hters- and n ~w knowJ<'dS. and new lechniqu es bcinS ac_
    Ib,1t lb. needs them a, home. not in Khool .' quired and Ipp~ed? Or an lh. ltUlior Iow<OJt
    .....ys now .-ailahle fo' protectiR3 child health
    also allow mothers themselves 10 sa... borh lime
    Sariaglime, 1II000ey, an.d elIe"" and \DOlley and COnSCT\. . their OWl) health ...d
    stn:ngth?
    All of lhr:se dnnand. on the time and enugy
    and hnlth of women help In explain, if nor 10 AnsW<:rin,l thaI q uestion means laokin3 a, :lOmC
    501"", one of rhe <noJ1 inU1UlligCllt of aU develop- of tbe practical and everyd.y ISpccll of tb.
    mem's probierm.tht problem of "reKhing lbe l.cttniques themsch-es:_
    poorest'.
    8~ti l_ foeding. a1lbough lalti"ll • eon.;d cnlbJe
    For al<.b""8h i' is among Ihe poo<u< 25% or ImOUnl of lh. mother', time, can save the $200'0
    m of a nation', people tM' lhe problems of $300 a year whieh is <.b. average COlt, in I
    mllloulri'ion and ill heallh are <:<lneettlnIM, il is d~,..loping COUntry, of bottle-ftedin. I h:tby on
    al$o mlhis gr'OUp ,hat women ba, e ' he least time anificial infant fonnulas.· A family living on ue
    and ern''1ly, the lelil infonnatinn and COtllide""" official minimum wage in Mexico, for example,
    to become in ""l~ in acquiring and .pplying would need to sPetld 25'1 of its food budget on
    new knowledge or liol<ing advantage of anib ble milk fonn uJI to provide enougb for jll$l one
    .= infant." In Africa, <.b. proportiona,e COW . '"
    ev.n ltigher - alld C' 'CJl an employed penon, say •
    Tht pr<>blem i, one whicb ruM IiI:• • faull ~J\C h""pital deane. or I govem menl cieri:, would
    Ihrnugh m<tSl. d.""lopmclll effortS in most oa_ have to spend OW:r ]~ uf his or her monthly
    , ioll$. For whelber we an: taUtiog ahour JJ\CIhods salary to buy enough milk I"lwder for a two-
    of imp1"Ol'iog Ibe prodl>Ctivi,y of lbe land or nloo,b..,1d infanl."
    melhods of impnw in8 lb. growth and de""IOJ"
    men' of child", o, i' is Ibe poor, lh_ wh_ need In addi tion , hl'Cl$t.ftc<\ing usnally dclaY' Ihe
    if grcll.'eJl , who h."" the least surp lus of fCIOIl l'Ce$ "'lum of menslruati oo and uffe... the motber a
    -of money, time, enerllY, heihh, lutowledge and rotI$iderablc dcgrcc of prOIec\iOl\ agaittSl the
    ""ofidCllCl' -10 invest in impro""menl1 ThaI is st~ of anOlher prrgllll1C)' foUowinll too d ose
    tbe catcb·22 of po....n y. Aod it means thll the upon the last. On Iverage, the post.lll <a1 periCld of
    problem is pcrpttlllted througb a cycle of pooT in fcni~, y lasl. foc 3 \DOlItb. for a WlIlZWI wee
    nutri' ioo, poor heallh, poor P<Tformanec . l lCbool does not breasl_feed I I aU and for l] monlhs fon
    Ind It work, poor productivity, low inoome, nO WOman whu brelSt_feeds fot 18 monlbs." And
    su.rph.'s money or effan ' 0 in>'CS1 in improvement, a1thwgh IlOl a 10000ly "'liabl. method of COOtra-
    leading to """tinued """e.,y, ""otinu<'d poor t:eplion from the individual woman's poml of
    oUlrilion ... and:lO the cycle goes on. view, it iJ still , h..... tha" on .-crage, each

    "
    I THE SI'ATE OF THE WORLD'S CIDLDREN 1986

    addition&! """,r.h o f br<:alt-feeding em Jive the Immunizati on would ta k. nu l :n leas' 'WO or


    IllOIher 111 additiotlllllllOluh or pftll"Clion 'Ilainsl t h ree major, wonyilll ilIJlCS$CS whicb I chi ld
    Pl'ql.llancy." wnu ld OIberwise hlV. to be ounal through. It
    would abo pttVcnt at least half of t hc c hild hood
    Not I.... , bttasl· f«ding can halve th e number
    dil.IIbi~ties. especial ly panilytic po~o and blind-
    ur illnesses - particularly diarrb""'] and rQpira-
    ness, whicb nave a serious dfect on t he ~ fe of t he
    lory infections- which I child bas 10 be nursed
    mother as well as 00 t he dcvdopmcnt of the child.
    through;o its lim year of life (Figs. 12 and IS).
    Wilh full immunizalion, fOf example, me c hances
    0 .... rdldralioo therapy also offen ..~;"gs of of a c hild becoming d isabled arc m1uccd hy
    boIh money and l ime. For of aU the c hildhood apprnximaldy ~ .
    di~ whic:h I IIK,Ithor bas to Copt with, SinUlarly. Iow<OIt action 10 fortify di m with
    diarrh..... is Lb. mIl$I {mju.n!. Each episode vitamin A, iodin., or iron may be essen tial for
    usually lasts foot or ~v. daY' and !he.e "'"1 be Il$ protecting th. nonnal d.velopment of young
    IIlIIlY iii m. Of ecre tpisodC$ a yur. And ia the chilm n in certaio arc2! of the world (see panel
    011< ",udy 011 the subject so far. i, bas bttn found 22 ). And the time tak CJl tO includ. these mi.ocnls
    that Ih. lve~. length of diarrboeal illn<$S was and vitamins in ,he diet _ Of to coIlCC1 capsulca
    reduced from iu" under five days III apptOli_ from a clinic- can also protect the DlOlber from
    maldy lWO and I half dol'S in homes whm: ORT lhe ronscquencca of a c hild 's d isablement . Vita-
    was 1Utd." The mull is 001 Oflly I mluctio n of min A supplements, or the inclll3ion of IIl<ll"C
    nuning and worryilli time, b ut also less bathin& green vqClablcs in th e c hild 's ItIC'als, could save
    of chiJdn o and I... washing of lKlilfd doth.... the eyesigbt of the qUln.r of I million ch ild re o
    Once I mother h.. 1M COQ6dcr= to UK O RT who no w go blind each year from vitamin A
    in ha own hOll1l:, beina cmzin th>t it is the tim deficicocy , But the same action could al!ltl SI'.th e
    possible therapy, th C1l the time , U1lvdling .,._ mothe.. of those c hildren from the "3ooy of
    pUlKf . nd "Ullmnt «Jots of clinic and b""p;,,1 watching t heir child ren 's eyes slowly doud "". r
    visit!! em usually be Sllvro. In IOOSt developing IOd from the ~fclong alta WQrk of bringing up.
    nluom today, diarrhoeoJ diR_ ..,d respiratory sigh tlcss child. In ot her arus, going for iodine
    infections = 1M tl"O most common ' ' - fot injections or buyina iodized salt it n ~ to
    I'isiIS to pharmacies, hcahh clinics, and bospitals. prmect both the foet us from brain damage and
    In some counlrics, families 1Ir. 0 0... s~oding up the mother from the consequ.nces of Jiving birth
    to 10" of th eir income WI anti-diarrbncol drugs to. pmnanelllly retardc<l ba by.
    whlc;b arc of 0 0 valu.," Th. early USC of oral G rowth moollonOi will oonn.aJly mean. visit
    rehydration in th. h ome will nomWly mean that to I din.. or I villlgo wrighioa ooo tre onoo I
    dehydraunn will nOl $t1 in and a clinic visit will mooth. But it too an rcp,Iy with interCSlthe time:
    IIQI be ncccswy. But .... n if t h. diarrboea ~l'$iStS iov.:nc<l. Th. main aim of regltl.o.r srowth moDi·
    and dcbydtatl<lo bcgi ll$, a ch Ud wh o hIS been t<>rina is to bring th e IIlOIhcr into regular l.-ontlCl
    treated at home wit h an oral rehydration SOIUMO with basio odvicc ond help on c hild health and to
    will arrive a, a clinic in bet l.r condition an d an givctbll """het urly wamin8 o f ony fal«rina in
    be Jiv.o Ih. ne<:cssary treatment ( wit h her ohild 's growth. And II thlt .Irly SllJe,
    WHO/ UNICEF_formula oral rdlydratioo salts relatively ohea p and simple action can be tltoO to
    in lIl(Ir<: Utrcmc Ca$C$, in ...... enous therapy ) in "Dp the c hild fl'OfIl lJip pi"i ioto tbe oyde of
    Qt ,
    I... time and at leu
    c. ruim y of SIlCXCSl.
    .s""".. and wit h g....ter maloutrition and freqUC1l1 illoO$S - I C)'('lo which
    takes sltoh I to ll botb on tbe ohild', arowth and o n
    th e moth .....s time: ond .nergy.
    Thole demands on I Yl"O<tUIIl'. time causc<l by
    t he lhocr flC<l",eOC'Y of ohiJd j]lnnscs oro h.ard to
    • Tho ' - ' ond otlc d .. r i ~ dr\q1 !>II _ lIy
    ima,gine from the f'C'l!p«:tivc o f th e iod us uwized
    b«oI _ ia /«<IaII ..... lbo _ ...... ill S"u. lbo world. In very poor "DIlIl1ncs. children lilly be ill
    JOl'Of'Ul'OO1 1U\IoOI;a for ""'" pood.... _ _ ";'bdn_ for 3O'C. Ul 5~ of th oir YOUD8 1ivcs. Accordin g to

    "
    one . urvey in IbogJadah, for eJW1Ipl., the Growth chedting, ., a focal point of cbild
    1>~r2ie child h.s oee lIlnOM or another for 75" of hWlh prolCClion, could bring together present
    all th e ~ of ;" lif•. " Such 6f!u,.. P>eaO that a kno wledge both ,bout the prevention of illness
    !DOther, with perhaps three Of four ch;ld~o to and aboul l b. , ptciaJ _iog and fcedins nee<b
    look after, is permanemly COP;nl ";tb the illn~ of the )"(lung: child. The "'IIuh cou ld be It lew ,
    of at I...t on. child. And nOl onl y d.... this take 5 ~ <eduction in th e daynpeol in i1ln~ during a
    time, ;t abo <'0$" In<Iney. Many families in the child'. carlic:o' year$.
    developing world spend Over lin of their income
    o n health _;0 ItIvtlliq ..peoses to clinia, in
    <:oW of medicines, and in r"""
    ' 0 dOClol'1 Or The 'th ree F. '
    tradit ional healers. In I CC\IIIU)' like Malawi, for
    In previou$ ~' rcpotU, child ,lU'Yinl and
    ..ample, it h.s been calculated that one-third of well_being has also been show n to be closely
    the lUtio n'. tOlal elp<n<!ilUftc o n health is apent ~lated to the 'thtce F,' of family tpacing, food
    hy families thentS<I.,ea.~ Or in Hon d u.., when:
    ~upplerneD1S, Ind femak educa.ti<lll. AJI of these
    the lV.rog. family ,uataina about thiny illneuca a
    ...n powerful upward l..... rage 011 a ebild',
    year, th e dim:! cost to the family is app roximately
    chances of s.urvival and normal growth , But all of
    SU O per ill..... or a tOlal of over S200 a
    them also exm pow.rful upward I....Cf'Ol!. on the
    year - half of whicb goa on dNg$." So 'he well-being of women th olll$Clve:s:_
    financial COO" of illness, as...·ell as the <:oW in tb.
    mother" time, en.IlI Y, and wony, .... propon;OII- Family spaciq. LoaviJ1ll I I leasl t..., yearI
    alel y mIlCh bilb.t than in tb. ind um ; aJized betW«n <IIIe prcsoancy and lhe nOlI can <educe
    natioas. tbe ri!k of I.Il infant's death by 5011 or lDOlC (f jg,
    14). BUI it is also 0 0 . of th e most imponanl ways,
    perhaps tbe moal imponant way, of main'aioins
    Fig. 12 Relative rates of infect ion by tbe health of tltoK ..hose bodi.. arc depleted by
    feeding method the heavy nutritional RrcssCI of 11_ con tin u_
    OU$ p<egnancy, child·beating, and btt:aot-fccdin g.
    D 8leBsI.1ed 80 ttkHed In _ d.....loping countries, 'matern al t l Uses'
    ate the leading ""\1# of dealb lor women between
    USA
    the asCi of 25 and 35." In other word.. """" du.n

    -
    rxerroee a Ihnugnd young mot h.... an: nn w dying •• uy
    1978
    day _and many of .hose 'mat.mal deaths' an: th e
    1979 1:;;;::::;:==~ "'IIull of too many birth. too dose togolher .
    Female edu catio n. Th. education of the
    moth er has been fo und 10 be perhaps th e moM
    imponant social det.rminant of a child', chancca
    of survival _ e~n allowing fo r differeru,a in
    UK economic class (scc Lifelines: femal. ed uca.tion)."
    But it too is a powerful fOftt For im proving Ihe
    Gaslroenterrtis
    1936-1942~ ~~!!!• • • •II.I!!:=lI:::l~ Ii... of motben Ih<mscl.,CI,

    Ras~~ E. en with only fuuror 6"e yean of IICltooJiog in


    which to achi..... basic IiletlC}', a WO!llOIl SlIZlW I
    o~ ","~O'-'~5~"~'-8~'~'·Oc,c,c,',c,.,c,c. very mIlCh hiKher chance of acquirioa the know-
    Relative risk" oI lnlection ledge ...d th e conlid...... 10 plan and space het
    pte&.lIouci<s, to lNke usc of a"Oilable h. a1th

    -_ ,-_... _-
    --.."""II"'roII'

    ---
    l:*"OI _1Q t t '9"lW_..
    Jod _ _ by .... _Q1 ... n ' OO ~ ·

    tllIIliM tom l1lt.-no aodo-........ ,.. ""' O,t "' .


    . "" .
    <1M "'"
    services, to disrov.r and ap ply new kno wledge, 10
    work ou lSide the hnme and earn a biKber illC'<>JM,
    and to panJcipate in 'be flmily and community
    decisions whiclt affect her life.
    1 THE SIl\TE OF THE WORLD'S CHILDREN 1986

    Somalia:
    protection in emergencies
    rtle I:WIC SVIltelWS flOW ~ lot MngonQ lot cfwmoea . the P/lI'II3tY _ eMe petsonneI
    II!XtUI a _ _ In CfId(I sumva/ fMfI ~
    worked day and ,.gill aIongsode II>e lOWl'"fl'lOlllo

    = or _cm . me
    .....,... ,.,.." lIl.Wl In AI1/CIJ. """""
    ,..>0«1
    P$ S>:acet'OaMg l>.1Sic _
    tne """""'I
    ~
    all p<XIf ctlmf1JUMI8S An
    10 Veal w:lJmI BOO call"'" me epcleoiOC 'ho
    OUlllreal< was SlemI'I'l!kl oef<,xo ~ 0QUlr;I cbm mole
    IIJlIn 33 lives.
    ~ trom Soma/I;J- A measles ",,!bIMl< IolIowtlll lI>e _ . In
    I:UJrJo;j Apr~ <nl May 1995 3t1 epdernc oj
    _ a, ItJe swllesl and "lOS! IelhaIlll Ooar_ ,.,
    CannlII 365 chben eee . In Halge.sa no chlill
    dI:;eases. $W<lpI lhrough lII1 er\Cafl1llmOltlt oj [rocaII8ge<l IIy ~ <e$JIIs. Ih!t ~
    45 .000 (1/lIOl><8Il 'MYgee9 aI ~ "' no<l~· lIdoIlled II mora ¥T\tNIIous goaI- imrrIuntD1g the
    _ 5o<TNl1la, k-.g 1,300 people. ""'"'1 oIl11em 65.000 chokI!en at ee capital <:>t1 0I~ ,
    IOOOleO and~ , In !he r1eIllIItlol.oJng ltl'WTl 01 _a tI'ol,~ \IlICClfIlI1lOn _ wera '0001:1\.
    HarQeI$a ~ 33 PeOPiII """,-_to H3<g&- IIIIl GIlly 11%. 1M t~Sl S!ell_ II P'Ol ~
    osa's Ilm'W\' N!ailtl eee llIOllIa"""" and tr.e In taoty 1995. in II pOOr ~ _..
    roeaIlh WO<ker$ .mo _e """""""'11 <:nolO<oo _ lMn 3 'lo at .".,"'" un<ter lWO wt!fO t.-y
    llgaoJISllt>e ...." _

    Hat_. MIn • ~
    llI5eases 01 d'*jhoo<l

    01 _
    JlOI)UIol1«1
    .,.
    ""'OC«I'lted. m """ mO,II\'\$ ltle "'''' ~ 8d ..-. l<>

    120.000. IIlIhecapita l oI00eot Jen legions whefe 1M Inl <(lI..n<l at ..... t:Itl'_ canlpalgtl was
    pnmatjI _ tlI/e """,.oes are IleIrIIl _ Iao.ncI>eo on 3 .l'*t ar.... II roon!l1 ot . """"""
    _ . BuI """" IhougII ~tJoI> was avaij. prepam!JOn'< itl¥oMnQ ""'" 2.000 POlotJtal and
    0010. ~ 15' 01 Harge<;a'. cr.1"",,, _" tuIv CQtIlJTIIJtOl1 """"",,", 500 _ "*"'100<1 . ... '0(1
    >'aCOIlalod As 1M posUIoIrty ot IaIT*'" lO<l<ned "' 500 SIucSent vaox.\atots, Commo..nIV _~

    !ale 19/14,lIlong WIItlIhe fISk 01 measles oeatl'lS in _ tJr9t"'"Zed. l'anng COI.OS8! 001 UP, anatadoo
    CIlIIOfe(l w&ai<lInIld by maln,muoon , "'" <loosoon tab. Sl>OflI and ,ngoIes broaao;ast tMIfY "'y I'rOS$
    was made to Yl!<:Ula1e 1iat1l.1ISO". ctokl,en 115 1IIl;elEtll Illl6'Il:IOtl pttlQIllInme5. b!(lSpeal<et iIt1'
    ~1IS_ble nooocernents. loollets. 1l8t1net$ and eat ~ .
    S\lCl<ets PUlllicQe<l ~toOfI. VoLn\eerS
    The 10'Sl ra;m oj VllC\:II\1lI00rts was se1 !or V$Ied some 150.000 _ fQ ' - " " cI>iklren
    patlltl\S l<> 1III<e lNlmlO one 01

    _e
    Jaro.oary 1965 To ~ lIa,_'s 'oogulal unclot t"", and _
    ~tors . SlUOl:<11 nurses were tr_, V3a:O:llI I\'Ie CIll"1 62 VlICClOaliOfl """~es. 50 oj them
    ~ o<de<ed .. , local offioals ...... <Jl>Ilt"ld ~ lor lila _.long ca~9'
    twoeleC, 3llO tna lc.lders 01 !abelIoo !UIlltS of 50 Mora man 55.000 chokI!eon 865 '\0 at me c/IiI.
    t~J ,eogosteroo .. I!le choIOr"" ..-.de< """ "' lit"" """ tIa<l OOM l!lgISIereIl- """,a btougIll to
    lheir /atleIlIt Radio ~, ~ IoI.<l. tn<I centres, and ""'" 17,000 women _
    $pIlIll<Of$ en::! $I>CI<en _ _ the carnpalgn
    Ou<'o>\l t/la,l.-sl 'OUrol. ail <>lHat_',
    15,000 ~-
    ~ _ ana UoQatI"""" ~ """ con'4lIelOO
    lA1er.h¥es _e V<lCC'oIaIed againsI measles and When
    ~.....""""""'tJon p<ogr~. aboul II IJIm ol
    feawed lIleII 'RI (loooo !or POlo, d~.
    ~ <:oug~ arl(l IeI3nuS $omalifs chiIlir.... wia till ptQlel;lOO The ~
    tJaI dirflC\n'e 'MIIC!1 eslablisllecl lIN! MogadisI>J
    Tile second rOUnd W3$ atlOOl to . tM ....roen eatTIP3'Q'l '8QlI9Sted all _ "lgIO<1S ot ! ~
    _ . broke wi .1 GarvIel aM II'Irutenea me COU1lty to....., _ , ~bon CMr\P!lIl)tl$. SO
    lawn. A.irM<!y lra.'llld In <>raI reIlydrallOn Iherapy mal allIIN! COU1tr{1 ChoI<>'en .... till ptOIGCted
    Food lu pplemeots. A relativ.ly small amoun' h.ve I,oditionally used for 'minor crups' '0
    of am. food each day, rot" 'l-ris\: progn"l1 improve md vary the family diet . for during Ihe
    womeo, b.. beeo shown 10 reduce ,he incid",,"" Dec:ad. for Women, _ seri.. of .ut\-cys has sho....n
    of 10.... binh-wei5h' wbitb is "Mnit>tr'S<Jlly alld in all lhal lb e C<I~lintiun of cconomi.. in the
    populatio!1 """P>. tile ""lie ItWtr i.. parwnl dtlmn- name of d.vc!opmcnl b.is frequenlly rcsuhed in a
    illanl aJ 1M ,/ullll"-of 1M _"""' 10 nom... alld fa funher Ir....fer of pow.r from womeo 10 men."
    <xpfflnia ImlI,Ay """"rh alldIkwlapJfIel""," Simi- MO<II women, for ....mpl., used 10 Iulve _
    larly, eJIl'll rood for ~r-feeding W<llDoo can dogltt of conlrol over whal was done wi th lhe
    mean IJIOI'C ",,<ussful and looger I"",alioo ." _Vlilable land and ' he food Ih........ Brown OIl ii,
    whereas men bav. almosl Inial <:ontrol over wh..
    Bu' os well os being. kty child ' ul'Viv:al ill dooe wilh ee ineo..... from cash crops." And
    " "' logy, um food is obvioruly ju,' . . .;ral for Ihc evidence iSlha< women devole. significandy
    maitlrainiog 1M nUlritioaal hcallb of lhe motb ... bigber propo niOl1 of Ihe incomc al thei r disposal
    he~lf. In the indll$tri:ilizcd world, an ,...,rag. 10 the feeding of children.'"
    wom:m goins .pproximolely 12 kilos ill weight
    during bff proglW1<y" _ much of which i. ac- NUl, women nted credil and lraitti.., (F ig.
    counl"" (or by Ihe fal Slorcs and Ihe .nCrJ:y III in ord.r 10 buy 1lIld 10 use Ihe feniliun,
    rcservtS needed for child-btmng .tId brCllSl._ pesticid... inigation cquipmc:m, and ether lceb-
    feeding. Many of Ihe dc...,loping wwld', wom- nulogin wbich could increase their productiv-
    .n _ " '"",,,n wi,h 100 mllCb bird work 10 do and ilY_ and their in...l>bl••urpllil- as the prineiP"l
    100 Unle good food ID eal - gain only 6ltilos or less producers offood . And overthe WI f. w years, th~
    in pregoan cy and ,herefore da nOi build up any 50,000 landl... women of lhe Gramccn Bank
    odcqual. rcservcs." BUI lhe boby will "ill be boro pruiett in Banglodcsb have di.proved the id.a
    and will still bJnI,l-fm! - al Ihe inevitable COliI of tlult poor women II'C abI> • poor credi, risk.
    deplet inJ Ih. moth... •• own nUlritional beal,h. Loantd a 100ai of $ll million, lb. Gramccn Bank
    women ha_e inVCSled il SO successfully ill income-
    caming oppo nuniliel lba' lheit communilY re-
    Suppol'! for wome o paymenl record b.is rcmai.o"" at l~. n
    Applying pr,*nl knowledge ,houl prorecting in many ...... of Ih. wlllld, women Ibn need
    Ihe ijv,," and Ihe normal developmelll of childrm Ialld refOl'1l1 lo et1iure Ihallhcy are nnl f~ to
    could Ih.refore be ,he kind of invcsuncnl ....ltkh grow food on ...er smaller ond lI>D1'C marginal
    would yield 1'C'lurllS in timc, money, hcallh, . nd lands: before finally having 10 pack up and Ic.w:
    enClllY for WOIl1C1l in poor communiti", BUI rc for the n....... cil y where th.y must set lObI!
    ,ake full a<!van'lIle of Ihis opponunily, women in wor k Ihcy can while otruulin5 '0 bring up lheir
    masl poor communi , i" will need more support- children in overcrowded slums.
    from their owo lOCi~ from lhe: imemalional
    F rom c",plnyon in ,b. cities, 'O'Ot11C1I nted lIOt
    communilY, I.IId above a.lI from men.
    only a dec.m day's pay for a decen t day' s worl<
    They need basi<: I«hnologi" 10 sa..., lime and but Ibn civilized provisiOl1 for child care, brem-
    ene'SY in Ihe growing , processing. cooking and fceding, and malernily lcavcs. And in lb. coun lry_
    ,loring of food -including improved IIlriculiUroJ sid~ , th.y need _ ~ving " 'age for day·labour
    lools and ~hincry, grinding mills for gnin, irmead of n<lel wbich II'C so mucb 'lower lhan
    more fucl..fficicnl SlovCS and ur.nsils, easier lltCII'sthal, 10 lake an Cllamplefrom Tamil Nodu ,
    me,hods of C<llIceting and conserving ..... 1.',
    and womeo can 6nd employment for 310 dal" of lb.
    I... back-brcaJUnl .....ys of g.,ting food frum Ih. year wbcrcas men can only work for 190."
    fi.ldsto Ih. market.
    From the beallb services, rhey need more
    They nm! the kind of dtvelopll>Om pro- <:onvcniemly localed and bener organiml ~linics
    IlramtIICI ,,'hich do nOI dl..,rimin... againsllhem 10 Iba< lb. ",efaile wailini time is less Ihm lhe 2
    by cnlistin5 lheir Lobo", in casb-<roppin5 10 bours 42 minuI" wbid< _ recorded in a rcccn,
    imPfO\"t men'. iuoomes from land whicb wumcn survcy in West Africa." And Ih.y need immuniu-
    .,
    I THE STATE OFTHE WORLD'S CHILDREN 1986

    Ethiopia:
    the silent emergency
    19~5 tIBS t>een Il'le I~ kr me !he omI ~'1IOI'l ...lIlJIe ~.. kom
    Il'llll'llmmlI launcned • rea< "l/O by Elroopa', k_ ~ . we ato< ...
    Mnslr/ 01 Heoollh and 1hII CIIy ClOOOCII 01 _
    .-.- to CUl ltle "'!Y',
    m.nl
    l!Wtlt, 10_ """ 50 _llef 1 , OOO ~ _
    """*""
    by _
    The ~, ,_...., ""Wh&Ol' ....
    " ! Ill«' on cNkl - . I, an<! .. ~
    ~_

    ""
    ~....,. N
    .-....._-~-~ .....
    -
    101""" by ........K'P ............ ' ""'""" ........ )'eiQ
    SW'l1l'l'lll!lft 01 dfW,jtIl_l'U'illS' n I\ilScJ~~iIiltncY. . . 4r1mCflll
    .. [ r - _ bKorr-. _
    .i.""'"""
    ~

    ... -em 0 - hi _ '-:r4l ..... _ ... _ ...... . . . .. 0" I S


    f;ftIkItwI 01 . . co.r'*Y I QIJIllIl ,.. ~ _ -
    *"'d Y " _ ' ~.OOO~ __ dp1g fllbn8'y 1985 IN "*- or HIiItlI_ ..
    ..."...,0... "".-0'" _ . - - 10 ........
    - r ,..
    -........ -fIomII .."""""
    _ " __no
    " - - <)'ougP'C 01 .... - . - o:t'*" ...- I0IO 0IgII'C

    --
    .....,

    10'" ..... n ...


    --
    bIlJulll'Il_ CInClI l'IClm
    _ 1_ _
    _ _ "000
    olr;hd_n~ _ ~

    ...no....,.._ Ii" -'"""


    ~W1dl

    _ -
    ""'" tlWoll_IO_'" I I
    .:l1lW'lV
    __
    .... ( 11
    1N
    """'"
    36 OlIO - . . ... II AI III '""" ctr'I H
    .....,.._.., onJIr ' " 01 tIIeQi.' _
    at

    CII'I'" '_"**-'",OCWOIclCO_,,_ .......... _ , .- - SIealIIy


    ~

    aoo
    II> _ _ <lIIi'>',O_ tOllI".,,-.
    Jt9llIr gil""'" nO ....... 10 IllIlp _
    foOm . . . "*'-10
    IcnU ~
    _
    ' ThI_., pr«:eclIld l7I' • _
    ftoocled_
    d\Ilclrell lKIln lIII;:Jllon(j IfIlO h ~ d
    n'IInI!r,oon ..-.cl inleclon
    IIlDI 01 - . .-
    - 110- _ ~.
    10 dOOf
    - l.Ogong _ idio<e
    p.omoIerS - -II It>I
    ~_ MIlmbln of1llllwomen', _
    Solar. 1 . 062~_IlOOt' _ I_ J'OO1ll _ tlOl" "Ill! fM/I('f hc<J!lonold, regoster-
    _ 'ect\II«l . !l/tlefYISolld by 128 QOIIWIUlIIy 1ng chIldr9n 11"<1 P<OIl" "'. \NOI'I"l9O> $0 thO ~: n
    .....,." _ _.....neo aoe<IIS ",m two montr'oll
    ~
    _ <;a'l foIow lIP on ''''''"''ttenel8rI, On 1l1li
    ~-.g

    ~,
    _ - 1.~.OOO
    II_
    SllCI'IelS
    disIrC>Jle<I.
    y
    _a _ll"O"""_ .....
    01 o<aI flIt>\'G'aIO'I salls
    ..... of \I3COJ\alJon Clay , 1l)! ~ ......, _ 11111
    eeee Ill'·' Ibi'lllt>l tal 10 QCClII/O'>
    _ *'*"""
    "~~ oell
    ".. Aln_-. one CIl'f_ Till ~ ' -
    Ior.sI
    ~
    _
    ..... dIl' I\1iIl IIII1lC
    7,5000 -.... _

    - '.". ,
    Ii
    ,-_", "-.0.-_10<_ CI'Ob.-I _ In! ........_ sa
    /a!l!lIIe$ 81' ... ...., 01' Soo*W'_ SMo 01'
    ... CIIY·s cI'*lrIn _ ..........-
    TllI :no ary-a n .. : l' : • ( ~
    .. , _ . . efklrI. AI 01 .... C!tf' , S _ to _ ......... til""'..,.......lOt!Of(s _
    T" _--.,._ "'" ,..., _ IlfW1lI ....

    ..
    it Ii . . ~ " . ' _ i,
    I"OIC _ _. : ,.... ~ _ ..
    -';IO_~ pIsmsO 11;0 ~ __ ~ CIW1 _ _

    planilD.._...P""'..'.'.ID110"*'",. .....
    .. _ _ -.sct ..... 1. . . _ ..
    ..... II:> 0. - . . . . - TN
    _ ~lliCMdby"_~
    _~_IO_,..._
    _
    Jl9CIIll,IO_...-Ole"",,·s _ W I I t l i
    - . . . - . - d -...... ,., _ _
    1I'"'*'d Ircm ... - . l .................... bN'lI

    •
    lion dlIys _ bil:h m: _ Ie! d...u., l be .-b 01 l"l'KJI,Itce$ and ...,.1:. ......... fm: badly ill .-
    barint llricultunl 'Wlrl; or It titDts or the l'Qf ,.,Qnics ollbe wwIcl- rid! or poor. Bw io poor
    _beD poor _ _ ~ ' 0 tn'td 10 _k <by- JOcieties, il is Ibis .-qual Iood .bJctt abo
    bbow UI OOIlr)' or plaamioa. 1Xpri_ 1O ",""y """""" of bolb the limo: and lhe
    ntUI1' arid !be rduatioo 10 ~ their .....
    F..... !be .....' _ they Dud _ b.. . 10 and tbrir clliIdn:r>', lift$. ADd lbe .....m tJI.
    obtiF
    np;dly
    flthm
    ~
    10 bdp SUpport lbeU dlik1ml ia
    ..n..o __ bet<: II»- Amartya Sea. althou&b -nntll ~ 10 lIIld
    fur his"'"' -,""y,1IO to tho ban of ,he man... ill
    KioIIaI ItN<tILRl 0( obliptioa and fC$flIlIISibilitr

    .......
    ...., IlO Ioafl... be ... foond by 1ft)' IWwI 0(
    muatril:l otber t!wI Irdia.~

    _
    ~ 0.,-... . ~.triof
    '" •
    pnUu .,. ....... dha
    ,,"p i.a'--m, . . . ~ • •
    ,.m./ft« .{.,........... no, _ _ w J- ~

    '.....,.Intdn.
    .
    FI'OIII !be rd_ on, they Dud poIiCa -.hicb
    ~ _ &irk 10 mrol ilIIlCbocl and .midi _ ... npIMItJ ~• . ... k ....
    aDo- 0 ( _ tlnibililylO tab ;"to KaIWI' !be' _ _ p.»U '""'" tit: t-J • •

    """ -"
    :::::.:.; bbow "", ' ibj JiIJ 0110 _

    U11.....0ri00·1
    "_ ;",wI",
    Fl'OIII l1lriI'
    til: am •
    r pm PI

    . orden, and f.....


    11, """"'Il
    ocal _ oaIr ilI-...::a' ad cmfil IDd tniaiA;
    ...... Ill
    mp«tiut
    ~ .j

    a4 ... ~
    oaqww.t ~ I b . . JUyt
    ,............ri. '" ...... _ i
    .....,. ...t . . .. a4 _
    pItty ....
    ........
    " . - ,..._
    A __ '"
    ~ _~ ~

    , aiM ~. . aU .... . did ..


    bon abo I fair mUCll far tbc:ir ~ F..... 1bt
    0iIil"", plaa ~ 01 !be' AmaiCIa 10 !be' Ia.
    ....... 01....... _ _ ~ 100 hard rot looloocl
    ~ WI , .. a,...
    'Y1G"..........""
    ..""" -t W')' -*'IJ'difjIrta,
    ~ ""...., II , ...

    &ad for too link. To ciu: eee e ,. . . . . . . ~ ..,..._ ia ... ~ '" um.. ·J-:ibo
    aoillioo po:aible _mrk, !be' _ _ woden 01 ......... no, J-iIy if '.)1IralIy _ - cull ,..
    ......., IarIeat lalilo faaory, I aut.idiuy 01 "" _ _ _ -t ..... "'..... "'--./iu
    !uroeriealI .·.Y
    . ~ pat SOcmtI POI" dar, ,. _ _ .-I _ J-lly <l1li u.t t1tr1_U
    riaitla 10 S5 CCIID POI" <by aft... "" yean' ....,;,.., ........, dm.-.m.ritI. na,..w dewJIl '"
    ( 19S1 1irum). Witb~m- _ _ Qll ... _ ill ... IIlIJIt- '" J-~ _w..
    a.no .lDlIdI. SI6 1 _lll, -"idI is _ .......p ....... /toptJasly .n-I ., IWt ,... n tIW_ '"
    to mm lbe baait IIeIICb ollhaaocl.... IDd lhotit ..... . .-J u-' 1tICfi} ias J- _ ".....
    b milW Eadl 0( tIait WOIIIIe1l fIlmS out _
    tblIIl _ htmdnd pain 01 &Iofta . dar - eJo-
    ..,.. _~ilI, ...
    ,.....- t _ ;"
    ~ IfIdWI -'<t1. no, aoditiMtIl J-~ if .
    whidI .... C"O'ftlttllllr 1OIcI;,,!be UAi,rd Stu.. for fMM ~ '" _ 0 . .. ,... _ ltat aU
    _ thaa 40ll times that _ i daily "''I;Ie.'
    ~"" .. dor",""_
    T'Ilm: it IlO jllSlia: in lhis. AM althoollb it it ~/. ... /VU -t u.Wr.;".J-~ oliunh ..... ,...
    _imn 11M! thai m jr rdatiortJhj". .... ~ ~ ,. ~ if . =rill pm ~I.
    _ !be _ _ 01 OI$lltiutionll IiU UNIC EF. ~ ilJJ<lf. N ..., ...,...,., ~ , . 4trp iuIt~l­
    1M day-to-day . .II. tJI. ItICb ~tioDs is
    COlUWltly briD;ia& them up opifut lbe !act l hat
    iria ,u, crin rrjltm 1M MpdI ./ 1M. ,,,,,,,"IIIWi
    '" "",II ... .......-., .. ....,.,;" ,...... R<Ik ...... of
    or
    the principal elUJt ill ba.lt.lllllli poor nutrioo.. ...,.. ad 6iTls ' ''';11 ,M. iMpIid,ly /« I. "",..m-
    aIDINtI 11M: dlild,.... tJI. ItICb -..men is ,hat <heir m of 1M mperlir:rr pIlSIlioIU.
    IIIOIIIm .... DVCfW'IIl'ked and IIlId«paid by the
    syst~ or tl:OI1omk rdf.lioBUti". _hic h no- MI, iI won. iJIftI lJIIII;'" iIr IAis W llnt '411' I.IQ
    pttftiIs both betwem IlId wiLhin ILltions. iNq""tiria i. M ......" " aNl li/t t lllnJC tw')' r/toTO'
    ;" tMia........'Y. I, "'" Iwa Nwmrd ,...., tiTls
    /lt1Ulitll 'M fZIG of I a4 S oWtI 0 .ipi{ltllntly
    Alai,." clnl bt the flJllily .;'~ WWIIl1;ry rou ,""" boyJ. :n.. diffntJIM ?'
    Finally. _omen need I fairff dnJ wilhin their f..,J a>ItlMMpI';'" oW- /'O</ltlkt<ly .oW", ,.
    OWJI fmUlin. In th' d~u; bu lion of food illtd disl"" 1;'lIGriom _ 17wrr;, /It. "" orA roidtNu II""

    "
    I THE STATE OF THE WORLD'S CIllLDREN 1986

    rltf jmtlJW ,MU_ ...m., "lICk 1m ",";,,~i ~"..- dirt/it. ,;,"",..... " II> ""'. . rJw "'bitt/if" fK"«~
    ,.... IM~ 11M '''''II,o.. J'''' ...,IeJ-I
    ,Aild_ dl>. l~· riciN"'... </osn l<IIM"....... rnJIil)l. no pUid", 11/

    .,....-
    ",,,,,lin.. ill II. . dum.'"",
    f/l.~

    '71lr fIIrf1ItttIW .,
    tlf ...,AiN
    JJ. .... ,.01:;' ",...J ""Imf of "I4tint
    . "Its ..,. " """ t- J-
    IM l1li)' -Jim ., .. _ .... _ of tttnU J-oJ
    ,lit _ ilttJ.JiJ<t Ii"lt p!J, ...
    ,........., - . . ill . . . Milia"", "c~f11f4
    . 1I....Jtf.J
    ...... ... ..-.u,. .....
    .......,. ,~ ., tlw
    ~ b ~ fr- Iltt
    .........
    .__ orr"'"
    lilt ,....... .,

    f w -... A
    of ..
    ... .".., f«iIi- _ J'",ai,cd _"• • faaJ:/. ,..,... of iaml-f-iIy 4UrriaIn. " _
    R<Il,. -ij '_J--rw_'7m ;' - ' -" 1'U! """
    ,..-. w,.....
    _..,...
    W. alii . . • lOr __ ..... " " " _
    of ,.lor ,..wn. itMlj,'" ,"''', wp .. ,....,.... ...

    The self-health potential


    If pumts aa be""'I cut with DeW kDow· """ it' IIoey W'Ott oqjJabk, ~ aat~ ""T-
    Iedae .boIR dliId ptllI«tioll -1Dd alppxI<d rram Ill;., liU .. ou-a • wall cl bait r-vt«1ioa
    all . . . ;., tbe usIr. ol pontiac tbII ~ . iDlO aroouwI. srowilII dliId .. c:llIl beptooidtd by ee
    ~ -l!IQ il _ _ pcG~ 10 Ilal.., I_ '*< ;"formod IICIioOII cl lM dIilofl OW'U pamlU ;" !hi:
    01 child m:alaUlritiOll aDd child death il:I tho: child'. OWII borDe.
    lkftlopiDa ..... Id at I rd&tivdy low cat aDd
    ...ilhin I rel.ll;...,ly lobon ~ of ,i..... Al_ xU of lb~ IIIOJI 1'O....~ rfui mc1bodl oo w
    a""; b ble fo' proI~iU8 ~hild1t'u'l liv.. Uld
    Bill this a lraordilW}' p<llcor,al "'ill lIOI be
    lrow lh If( b-.l on ltoow!odle, decisions, :and
    rulimI if rhe task illltto simply IS lhe Itxhinl ....'iou' by ,...... lJ: -
    of .. DeW let of 'cdu.iqucs« 1M dolinry olio _
    set ol llCl'Yi<:a. Far lDlft fl"'d·....... Ia1Iy, I.... dIiJd Wbnhu • _ _ will ban • lin k IIIOf'e fC:Sl.
    J\It\'iql rndulioa is P"1 of the antioa Ill. _
    oad • link IIIOf'e food ia PfOIJW'CTo wbetMr ....
    tthic: aI bWtb can: iudf.
    will 10 f« II laM 0Ill' PR-1lIlaI dlotct oad 1ft

    u.-
    La lUUI.I u-.
    -.I ia ~ all -xs."""'"
    ill whidI IDCIdcra medical ..me... an: _
    _tHNalA ia;.aa.; wbetXr bcr infIal will be
    ""-t-Ied oad for bow Ionc; .-hom .... will bqia
    IniIabk 10 aU., ballb an has 00IDf: 10 be tbout:hl • pi... oad orith what mix til food&: bow IlDd
    of on!! • tbe curift& '" iJbMw by medical how til,,:.. 10 prqlIft • dill<! ', IllOd; w""beI' 10
    rrdellionols in bOlpilab OC' dinia. 10 other pi)' pmiculu .nnniou 10 f~ia& • dilld duri"l
    word$, "".lIh bas ~ oometbi"lto bo Klively one! orl... III iUne$$; wbnhcr 10 maJr.~ lip . nd use
    d~li""rul by ~'p"ru I ud plllli•• ly l'Ctti~ by th~ OJI on.! rehydr.ll ioo ",l ution du rinl ~piood .. of
    llily. diarthooo; whether to cbeck Ih~ child'i ...alht-
    S'" rq u!atly; whnlKr 10 take • child 011 Ih ree
    Ulldcr such I ddinltion of health ~, 1M oepar1IlC occasioas 10 be lwnllUiud; oad wt>nher
    PftI"III poImtlol I... I ~utioa ia dUld IUr>'inI
    lad ",",dopaxul ~ bo n2liiled _wholnc:t ... when to bne _her dUld - llIc$e Ire all
    &cis' whid:l ho"" for I'lOn! dJm 011 whfthft •
    1M leo:hnic:oI ~ II itt diop'tpl cbild &tel ... dieI, wl>eIbtt . dIiId ~--u,.
    ODe obtious _ is iIw tDOdmI mcdic:aI or.. RlUlta1, thoa 1Il;)'Illiac I doctor or • lapiral
    .....m ~ _ rqaIorty 1.mJobIoe 10 I be ....;:.;lJ' nil do. Aad wbtlno:r , be Olbtt , ,, 0 ,,","," II ploy,
    vlllK "".dopiua
    WIIO"ld'I f·mil;'" But... equally
    imponIlIll f.,... iI thol doalll'1 and bwpilU,
    ohty 1ft 011 do • • , wbidt 1ft lakeD oad Kled 011
    by tbe f.omiI)' iudr,

    ..
    Dq,.nd.n<~ On profmi<mal modical soffl= is All in th o Soviel Uniaa during 197$.' And thar is
    Iherd""" not rh. duld', Ii...r ~ne of dofen<:c wby a WHO n pon comminee, d rawn from
    ogairu;r poor heahh and l""'" growth. And only if profa>on of medicine and directo... of health
    famili.. IUId communi rio:l como ro "'Ihe"""l... ..nica in both industrialiud and d• ...,lopinl
    as the active promo lOfS of health, and only if aarions, has r«rntly ceponed:.
    PMcn" con again como 10 _ th...... l"CS as Ihe
    "17It ou;11ldt IMr /ltol'A e<m if JQ""<lJIt (~ j
    mosr imponanr of all frool·lio. heallh work.....
    will pracnt know lcd.!le bring i" brn.filll 10 lhe
    ...ptnuibil;1y is liJlW I" 'M J«' 1""1, ;~ 1M ""'I,
    ,,"llh "",Jmilffuzls 1tator '''~ """'Y /ro'" 1M ptDpU
    mljoorily of 1M world's children.
    1M' dtdnotr·",di., fX'WtT wirh rrgard iii /ita/til.
    [0 th al itllS<:, rhe dilld survival rov<>lution is TlrntJ"'" "w .Jfrm "'Nil ""'" Ii< IfUUk '0"'" ,lie",
    part of I m""h wider s.bift in thinkinj abo ul h.>cA tMir e""jidma alld iii M/p ,hili dnJelop tM r
    health care. World.wide, il is now boromill3 ~lo:a1 sAilh iw mdiorr 1M rir~' ./u>iu$~.'
    <.hat I~ nnl 8.n....lion of advanoa in human
    The murning of prinwy cesponsibiliry foe
    health win com< nor more doponden<:c on
    health ta t~ individ ual oad Ihe b mi ly is therrlore
    mtdi tal servica hUI the m um of primary
    romilll to be ...n as a more Iikoly . . ... u. to
    responsi bililY fo< health rn lh . Uwl;vidul, rh.
    family, llld lb. <:ommunity.
    be"er heallh in both ricb and poor worlds. Thia
    rqXll1 Iberd"" lurns now 10 look a' bo rb rbe
    For tbe child .urnval rev<>lulion, Ibis chang., I poten tial oad th e danl" inbtrelll in rbe id.a llf
    .hang. in the cotI"""tional wisdom abou l whal '..If-heal, h' _ I pol. ntial and a danger whith can
    corIruru tcs healTh a r. I nd who is ro be primarily most cl.... ly 110 ...0 in wh. t is 00.. hqinning 10
    resll'lnubl. for providing it, is much IIIllJ'<' impor_ b<lppen in the iadustrialized world itself.
    tant lhan any speci6. br>'ak'hroUf;h;" knowltdj.
    or recll.tUque. And il is achange which is """, illSl
    begin nin g to btcome evident in bot h industrial- Mo~ health al ' - "OSI
    ized ond develaping nllion•.
    In the ecooomically ad~ n.,iool, it is lh,
    [n ,h. ind\lStriali ~ WOTld, man y modioal llOOring COl' of h. al, h sonic.. wh",h Iw begu n '0
    profc:ssionala SO<: th o decad.. ahead as an "tn:I i~ <:lOSr a k n8, h~ ing lhadow of doubt lhou.
    did proJmiuMllwllh con proWhn ...; // ploy 0 wbether ~ and more medical lechnolOllY is
    Imnri., roll iw rlt.lI'wt oj pt<>p~ ""'ik illlliwll4h really the best ....y forward rOl human health.
    ka", ;1lC1'</Ui",/Y hl ""i Ni... ikw/op, on4 1nW as T oda y in the Uni led Sral... fOl e,,"lOpl., Ih.
    Ih rtf>/1riwy oJ, iwJormoriJ;m, JkI'/b, on4 CO/JI"' u~ iry­ health in dUllry is Ih, n. tio n's bigs..1 em plo)'tl,
    IJosd mlII/ruI" " ' " wpporu "",hH", IW ltI higgest speadee, and big.. r lrowth poinr _ 'OIl ·
    porlicipolt ""'.. /Nlly ;w {m1IfUJIi~1 11Iri, ""'" ing Ihe aalion a1mool S4OO,ooo million a year, or
    htilllt.'" mere than $1,500 pe1" yeas for ..ery man, 'NQIOaO,
    and clliJd,'
    [n rh. developing world., Wilh illlq uite different
    cin:ull'llran.... sevtt:al 8"""rnmeou ..... &Iso now If this roloual OIpeadi rure - 2S ,imos ... m""h
    piooeering the idOl lhal pres<1l1 know ledg., .II in lb••arly i 960s_ wo", rapidly maltin g Ih.
    comhioed wirh prese nt communicationsapacily, United SlIta I healthier nation, then ""rhap:s
    can open up Ihe WIly 10 muc:h high...randz rds of ",ch I eOSI would be occepllbk. Bur as on.
    h.alth. And it can do to by dnstkally ;ncr«sing Atnnican healrh eduCl.loc Iw wrillen;·
    the ll'lwel" of famili.. th."""lv.. 10 promot. thci r
    oW<> physical W.U.OOIli. ~W1Iar is SO disrll' lIi", do"' ,h Mrh CO<l11/
    mdicill ' " '' is IMI despilt 1M 101fm( wr /lat. SO
    Th a, i, why "td",,,rifnl «»tu"';Jtg "...,..i/i~1 ' llIt"/y _Jtrnd orr IIIe JLn,lopw1l oj llilnRdil:o/
    w l rh ~ 0l1li rh "",rW oj pmIOJIri"l "M trSlQrd "M rtt h",,1oao> ri"", lite / 940., ' Ml ;n<...-t-
    e""I",lIi. , ,...... " w., liSted fin r among ti&h, basi< .-., /w """/y JoiW '0 poJ",. (or iI' INsl il is
    principia wltkh emerged fro m the Inl ernational U'iIk/y 'hmoght II) ' Ih />NllliI: "lid ""'w)' po/icy-
    ccnrereece on Prilll3ry Heallh Cat. held'l AIIII3 "",Am ,,, Iwu Jaiild iii prod..., ) a ""I0'Il i~ ,h

    •
    I THE STATE OF THE WORLD'S CJfl1DREN 1986

    Bangladesh:
    visiting 5 million homes

    •
    _

    _
    Or. rIIly<hI_
    F'
    hIr . , 10 lIB "'*'"""Ing
    _ KnII'N - . . . was
    Il(lII'tl

    ""1'IO&qlI "'" ,.., 000........... aulol


    ",_""~""""",,olsr.ua
    .......... 23 . ...-l . . . . - . _ _ ...,.
    01 10.000"'" _ ..... _ ..
    til _ _
    ~
    on
    ....
    --_.... _-
    _~
    Most ~ """"lI _

    ,O.-,-..... i_.'*'IO~
    n:ll ... " - , , _
    ~ ... "
    ft\iIllUllDn 1I'IaI QIIIIII'lO II1IlCl l)IlOpII! 10acluIfIt . -
    .... ,et......... 8Olulu'l ..u<! _ """ ,...,

    ..

    _01_
    IlIUlIIm - . AIanI! ~ MI'loul ,.. _ _ deloe.... bUI n " . . _ _ _
    01 . . .....- _~,..,IaII ........... ..., _ _ • • ~-U_i • • V.-IO ....

    _ __IO_
    ooo..... n .. lUlXaol~·._ ~ _ ~ ~,.., III r.. ,.. bt:61 br ....
    "'~~oI,prGlol
    a'lIjlI """' ...., ~ ~---
    . . _ _ ... 4 :: .. 01 .. ' ...,.,.. _ IIIlion In '~ol""
    IO_~
    ..,.b

    _'*"..'..
    .../'ow_ _ -10....._ _ ",*,,1" <IiII''''_'~_
    -. _ ..... £\IIIlIlII'l r.e.,_ ot.. . . . _ .......
    oars 01 . . ..., prgper
    ......-._IO_.. ..... ... ...... l'II' /IrIl1lU
    ""
    . . . . . . , mosl
    ~ _

    ~ _
    . _o!_
    N o!" e-et1dltl' __ D\II • •_ _ of"
    -=- ~ """" "''' _ I.now """ -.-.0~

    IIlfI Bang!aclesh
    Cofm"ltoo (BRAC) boga/110 """'" _
    ...... _ _
    01 ... """"",
    _ . n a t l s IIlllUll medal
    IV. MII.... , . ~
    II> I'>\l<Iae
    _
    _
    ' \r8IClItJoI'aI NIl1lln
    .a.calOrI ....,
    aJ1I IT*k II) II'MllIIlI
    DI~
    " ' ..1OCl '"".
    Imm 1t>e00ll'0lUlfly •
    SpecoII """'-
    ICIklUIclIti en iIIItl

    AI Iw$l """"" l'/1I ~o:aI W"t oorne 811 Ille


    ~
    ~

    '" BIngIecIeslI , 6'1 me ...., of I ~85. IIleoI " " -


    ~ WI!I _ ¥ISIIell !> rrollIlln ol ll"e 'O«J"Iy 16 W(foj Kl _ I't'em WI\!! ~ mere aub&!ant...
    _ _ _ tn .. """""'Y WId me_oI ~ It>.:> _ 1 BRAe it ptllQlTlalO: ' ~ rt _ "'"
    "'decAF ~ o l _
    so i'_III.,.,.".,orne.-.;l-"
    __ .. _ _ they .., "." W1 _ _ ~

    HIfO.worl<rq ~ - . .... ~ Mar\. POOf. BRAC ~ lei ,.. . - . . " . ••


    dUl . . Jle ~ 01 . . elIart. _ .... b' /Ii.d...... our

    . 0_.. .
    .......... 30....- 'fIl'Iy"" _ " ' _
    ""',,_-."'" '<*1_""..
    _
    . . __
    1Go1ll1llll0'l1'ow _ _' " "'" an .......
    $ • T"1'l
    UW1l1 "'" ,., _
    ...,. (]I
    ""1tW _ . _ .... .

    I<nstWllIIoIOo'Ica.1I _
    ~",.

    0 ...._ _ ....... _9'1 _ _ .. _


    '* ,._
    -*-''IN_ flIIItdo....- ._ _•
    _ ......do: ",)). ~ ~"" 1Nn_ fnIl'elj~1W
    '" _ ... <nil ....",..(10. - - . - hi 1"'-
    .....-._.,.,..l.000....__ ""_'-11_.,·
    TN IIlb'l .... I'IaI ....... !Io'n_ ..... 'MIhllI.f , . .......... ~ , . '*"Y ; ,.., ~

    --,. _ *-'
    lI\I ~

    -
    _ INS),"", l*:lt . . _ " " " , . . _ .... '" $ • ~ "'" _ _ -*' 1'10I
    ..... d _ _ ~ . _ l SO.OOO , _ 10 CII ...,....,. .... "'" - . _ -.fl:l_

    •
    lann of a millClitnl ;" _bidiry """ """III/iry 1M' "..,iortI are nol yn going in,,, action on • sc:ole
    am be anuidnd prop«liI1tIIIle /() ""r i~(\"'metI~ II'hicb matcb.. this oppanunilY. Th. Uniled
    71lif fail~" al cosily, .iKh-lechMiarl dismu Imll- Kingdom IIId <be United St..... for enmplc, are
    lJII'II' Ms, ;" 11m" 1<Xl'Jed " , " I ml<m' "" ~,­ stlU d.voting mlJdt Ie$$ than 2'lli of government
    ;", /ltgl,. aM 1>'"""li", 1m"" i~ I'Idc ro mI",. heallh . pending to the Pl'I'vcnt,nn of dise2se ""d
    ,/w <mrry blotdtJI al ftmIl4l~" dearh """ difabi/iry".' the pl"tlmolion of health.
    Looltini Ir IIremltiv. Ipproodlcs, the ....... Yel the cc<morni. sense mth. new approach is
    writer c<>ncluda: ~"'Mral UJ '"oil af r/w.., alrema- relle<:led in Ihc mor<: immtdi.,. response of Ih.
    lim if lite m~ ... of pri""''Y ...pmtsibiliJy for1tM/1. busin<:lO' world. In recen, yC2ts, 11 I."" 50,000
    la IN iJUlirilllll1, ,Ite fa1rli/y, alld LV ",,,, ,,, ~~iry". AQterican co,ponlllo n, have <tant<! 90,..,. kind of
    "",i.e programme ' 0 inform and ,uppan thei,
    A similat concern is olsn moun,ing on , he other
    empl()~ in taki ng bellet care of thei, own
    oid . of the Atlaatic. This year, for . xample, Or.
    health.' One compan y', progranune to provide th.
    Jurg So:.>mml:r of &sle Uni~f$ily Tl'llChing H05-
    time and f.. i~,iCJ for .mploy.... ' 0 tak••egular
    pilat in S wil~r1l/1d h3S ""';\leo:-
    o:rere'" hal; resoltcd in 36'!tli 10ll'er health care
    ~._ a ....w af rite /'U>"Ilt~ .. rn>tIJls lil/t. tuitJe"a costs. Anoth., company's 'wdlncss' programme
    11..11 fim /wr i "".,llJII'IIr< ;" medical ..,rt1iUJ i~ fnund ,hi' ,h .... wit h 'unheallhy ~f.-slyl es· were
    tkl>eWptd ""," rFin a';/I 1Md /() a~'y """btl red",_ g6~ more likely to be off work On Illy given d.y.
    rio... ill ot>mlll """'<l/iry alld "",rlJidiry "un. TIle Another found i 26", rt<! oetlo" in high blood
    pw capila .;<pmdir~ ... 1M /ltg/ I. <tlte a"""'l p......... 'ID>Ong emplnyccs of,., •
    COD1pany
    Wttlnll IIIII"""S rory by mart ,hall 1110' bIo r 1fI(If' af stan t<! on employee 'Live fo, Lifc' programme. In
    l1ui.Iwa/lh i..dicn ro ry by 1m 'ha" 5$ alld I n is sev.ral . uch prog=mes, ,h . health COS" nf
    "1<11 romu,r""" MlWnlIt4e rwa. Oru:e a ...."""'We employees who dn not m><>l<c b... been found to
    .. i"im~... af Mlk4/ (11ft MIs /Iml ~ f<N:1Jm be 3~ to W'\ 10",.,. 0'
    arlwr 1M" medical cart -dit~ lift-lryll, 4erdiry,
    errlJi""" ,rn u _appel" III haw a ....... Ia'ft' e/fecl ""
    Iu<ilrll ani "'lI#riry rka" d«l ""'" medil:al c<m. Blam ing the victim
    Y., Swiunu,'" if ClIrmnly iJrr.""ri", a" adtIiriaMl Tbe early resul.. of ,hese new oppl'OllCh..
    1.5 bill""" Swu. /rrIJla rot»' ye<lT i" rntJical (art.... confirm thei, poten,iaI. Chang.. in ea'if\l: hlbi,s
    F"'-"Cl wi,b <b. evidence of rising com "" d in the United StOIcs, 10 tak. jusl DOC exampl e,
    diminishilli mums from increasing d.pendence have a1read)· helped to red uce dea,hs f,om I>cart
    on lI>Cdical 1ICI'Viccs, the industrialiud world is disease by .ppmrlma..ly one-third. " And i, is
    beginning ' 0 o:rpnimen, wi,b the opponunily foc now thought possible thai a change tnwards
    'more heallh .. Ie$$ COlt'. In <b. Sovi.. Union, for healthier m....tyles could push i verog. m. expec-
    example, a $SOO million lIW.1--mcdi.I CIIOpWgn h3S tancy in the indu.. ria~zed world ,n well over 80
    iust be<:n llunched In t<!ucate the puhlie in years for both men IIId womeo - SOfllCthing that
    h.all hi¢>" behaviour _~nIr ..ing on heu .r di_ dou bling and tl'\'bling ,nd.y', vas' expenditures
    e,s, I... alcohol, more ex.rcise, I nd ' <llular on mcdinI servicc:s could not hope to do. Aooml-
    physic:ll check-ups. And in New yo , k Cily, the ins 10 the o,ntert foc Discuc: Control in , he
    Department of Health hu ... nounctd an I ntmp'
    '0 cui the city'. inflllt monlli,y ,a.. by 20%
    befoce the end of 1988- mainly hy mean' nf a
    mass-mr:dia public educa tion CIIOpWgn aDd I • WbrIlor.- m • """'''l' "". _1. _ 1I<tI,~ Is ""'"

    pr<:,.....tiv. programme to try to reduce the: ~ lI1nrsI ""'" Amcri<m ""'"""""" .,...,. -lOO
    II>illioo _~"" ...,. . p<->r>d """" ~.",_
    incitkoce of low binh·wcig!ltlIlIKlng!he poorest ....tioo>. t.o oddirioo. ""OIl opm4io. GO ,he h<oIJh of
    nf N.w Yor k>, moIher' ! 1O<tioa_"
    nnpIor<eo il1Ioo:o<IIiaa ...... fa<t"" m...... $~
    of .... ru"'~_ ""'" of ~ G<",.,.r Moron <or, r..
    Witb the possible exception or the S<=din.- ,umpk. b .... oIIo<ao>l ,. IIlldicaI ""'" rwG,acnI "'......
    vito.. Ih. gov..,"I,.n ,. of ,be ind",ui.aJj;<ed '0""''''.
    n
    I THE STATE OF THE WORLD'S CHILDREN 1986

    UllitN swcs, ..... ,010 , tho:.-. AmaitaD SimiJuly, lbe .,"""" 10 ~ il t - by


    IIlIIie CllII .,hirw an 11-,... iJlcreIR ill lift ed....u.e 1be Pl'bIio: ia tho ~ 01 brua
    ... ~ by ro.u t.i< idf..beall b actiooIf; -1IOt baJlh ubi.. f;:UlIIOl ip<rr """.........sal folna
    .......;..,. driakiDI ""'" in IIllIdentioB, tal<i.Da _hidI mar bdp 10 ahapc or lCinfora: bdul......'
    rqulat eecse, and a1tin1 wisely in bot h qlWl- roodocM to poom bQIth. Stoppin& anom.l , for
    ,; ty aDd'lual'ty. aampl ~ may do _ for an irJdi,idual'. baohh
    F.uiUlIlI: nl . bout 1M presen t pcKCfI,iaJ for than ... y amoulll of """pIn mrdital techllololr:
    ~nti~ . nd p rolOOli~ 'scl f·b~lhh eu,,' in th.
    bUI is it rntinly fair 10 place all the: I"Q(lOIIJibility
    01\Ibr individu.oJ irJ • lOci.,y whkh 1Pl'lIdl o••r
    indl»lr;~ world ill therefore justifiable,
    lOll timc:I III much on advmisi.o8 ,ot>aa:o III it
    BUI ... try ~1V<1' ~ninl bas ill cloud. And in .hi> does on ro \lC'ltill,llle public aboot it. dalll rra?U
    .-- 1M cloud ill hai pun;'" aU tho: mlph.... on
    Iif~yl<t ll'Id iadi,idU1l mrxmsibili,y ..... bfth h
    Witbou! doubl, informed actiolI by iDdividuala
    tWld .., be lII<d ... w.y of tll<iq 1M m1~ and familira irJ W:mt primary .... ponaibili'y for
    their 0W1I baJlh _ offen far mon: opponu.niry
    ..., {..., 1M politio:aI, -"'I. end « - ' t
    tlIl1MS III in bnh b whicb =
    !arid, btyond the for .m-:a ia hllllllll baJtII thaa fun1ler
    aIIItrol of Ibc: iDdrriclIIal bID _ hieh prob.odly '" 1;nl OIl, IlId a d _ ift, eunU..... lIlfdie:aI
    ,...... . ... ..ioL Bur Wt doa _ ....... ilia ..........
    iIII.ll_1bc: ~'. Iife.«Jk libilily CUI be alJropud by lloaoe JOftRIDCIIIII
    Ia all 1Ocinirs. tho- . - ........., of Iife«yk or ....mm::iII lon:a . . . . Klicm bdp 10 IIaape
    wbid is Iikdy 10 ...u _ diff~ to I tho ti" p _ _ 01 rho irldmdal IIld ee
    bmily', Ioeahll ;.. fNAily'1 ~ (FiI;. U ). In famLIr. Or • Dr• ./oh.lI AUeJn.a:c, Dila:Ior oltho
    ",ral R.a"l'-dah tho: ia£u:I. ....... a1i,y ..." il ,...... Cn,.. for HcaItII Pt<mw..... II ColiIIIrbia
    • IIi&b . - . Ibc: b mjtXs III tlloK wDo OWD DO UDi......n,.. ~ pili it:-
    Iud. In Manu llu, l!Ic iDfan' IIIIllftality ... is
    l~ .. bCb ~ familia .ho Ii"" DOI1b ol
    IlSu. Slim . hi 19th-anllUY EW'OJ!C. the infln' Ftg. 13 OwrMnIIIp of lan d and clarly
    monaJi,y fi le in lhe aJums wu II'lIUI>d 200 deal"" intak e of food, MaI\anlshtra, India, 1982
    ~ 1,000 billies: in tbe f'OJ*I ("";lico of 191.11-
    cen tu ry Eul'OJ'l" the inf....' mortality rile .", "eoo
    'bou, 12 del tlu pc1" 1,000 bat»eo-lllllOlt .. low ..
    in the lIlOIl medially ad ~aJ>ted rouDtI)' in the
    world today."
    So if lbe drift for betta health il lO tM'*"
    ...-d of .halllel in Ibc: lifHty~ or ,1M: indiridual.
    !beD it _ amnlDl 1M fact 1Iw llWly of Ibc:
    iad llll ~ ooorId'l families III'C Ii";", wabcal-
    thy Ii r~y\ct primariJy bra_ Ulcy .... po<Il'.
    AIIll • Wt poial., il bmNAe:i ~ thai
    , ' .., m1 pnIicin, """nina poIicia, II'd bo$il;
    ....a waul ..mea lllUSl abo be P*tI 01 "r
    potier _ 1lidI _ b 10 iwpt Oit llalt1l byd!IOP'II
    1be am,,"_ ttodor whidI iadi 'idIuII 1m:
    1beir Ii-. 1Jr, 1M Ulli1td Sales. for t:pmplr, if
    ~ be a po oa...... oltlor
    'adl"-baJlh' 10 ip<n lbe
    rcp,K1 10 lbe Ntw York ComIllulIXr SaM
    po<altial for
    oIlhia """a
    Societr. _ bidl pololcd 001 dw 1M nlll"btt ol
    chiJdrdl Uvinl in J'O'"d1r _ probably "tDtl1 ......
    llil .I(} pmtlll ...... M.

    "
    --_.._---
    ~... ""' ~)' fJf 011' ....~ , 'ffom '" 'M i",pkrMn l" - In nth .. word$, there i$ all the difference in ,he
    /ioIl fJf ,t."",,,,,/ ,.,Ii<y in
    t-Il/o p.o..a,itn!
    ,m,o", />='fII/ioIl Ir<Iu Iw7t effom 1M' /unit
    0"" world bctWffll a policy which IUCS the va",
    poten,w for 'lClf· health' IS an U<."II"" '0 pau 00
    alJrrJralfd "'" """" I ...pomilnliljl ' 0 f'1'<l"Nh 'M the "",ponsililli,y for poverty and ,; ckness '0 ,he
    1«;"1 and """"",i( wPfIIJrIJ frr IlI'MSllry OIi"~Wr' poll< and th. sick, and I policy which ma all the
    ,iMurl fJNl"'1'1'.... """'01</wltft', So, whih ... ""'Y l'C$OUl'CCS of a llI1ioo ' 0 in form and support ,he
    IuJw Iwn I~;di", 'M' "", "",iMurl .,,,1,. polK» majorit y of it< people in tb. lask of improvi ng
    and "'" own iooll .fforo a' ptaIItfJlu., Joeol,. /Iy thei r OVID heahh by their own tctions.
    ",,,,,.i,,, ,lull iMl!;ci4l1fJu " "flM '" dfJ ,..", for
    Families need Ihe wppon of new knowledg e
    ,Itt_I",,, /Iy 'u-Ivrs, ""'Y br".",.. h"",,", """.
    abou' low<Cl5t ways of protecting lire and gro wth
    effrrli<Je, "ltd SfJd/IIIy omp'ablt: l/wn ""'" <O$lIy Ind healrb. But lhe y a1$O need ,he support of
    ud~ /ik ..Niall "m or <t>nrit>ll _ 11$ Ii.,
    rommunily beall h W{Jrkm 10 reioforc e Iha,
    PII~il;t>II Iqilkllitm Ilr.al ",,,,poll c.a""" J a", hfl
    kno wledge and 10 act as a channel for ,cfctrina
    0111)' '" a'l"" l/wl ~""'~, "",,, ...., abarrdan IItt
    ",h i, lias PI4yrd in "lflllali", 1M """",p/lK. "Nl
    ,,,b.idtri,,, J«ifJ1 """'il...... ,.." lacili'au or'"PPO"
    IlIOn: complicaled iUnesI\CS to mocc specialized
    itmc.s. And from gOVentlQClllS 0JId the lnterna-
    I;" oal wmmuni,y, they need the suppon of
    br.latoion' 1I"''''.'la br MIdl;cit'l '" /wIlli. Tltil U, I dC\'c1opmem programmes wbich set Ihe pro vision
    IIrIkw, ,., >inth "",,, i",porlOllI """"I issw ffUi..,
    of basic SICl"riccs- water, HJlitation, edu cation,
    ,/wit 01 III tt,1ro " I' /Wli. dll(alw", as" I« b<JkJry
    housing, 10Jld, jobl ~ at tbe ....,tre of thcic sighll
    in ..." """npu 10 ",",",' d;-.~u
    and 001 al lhe periphery of ,heir vision.
    With Ihilltind of suppon, informed oaioo by
    familiel <:oIIld no w be: I beginning Dot JUSt of I
    The reopollSibiHlJ of ",¥emmeo" ri$c in ,he level of bcahb but of a rise in a
    comm unit y'l ronscioUUlQl5 and confidencc that n
    I.a !he develop ing world, the oced 0JId the c;ln ,"ke rnon: co,n rol over ' IS 01"0 circums ,an ces
    polential for indioiduab and communities ,ue '0 by ill own 1Cti0fl$. And thlt is . process which is
    more conlrol OV'" thm own heal,h is e'o'C"n great . boIh a D1CIlI.I and an rod of developmen, itself.
    Ea,c:ma.l mtdical itm ces arc ~ery much 1...
    aVlliJlble. Le.eb of famlly heal,h arc gentnlly
    much lower. And lIIIlly of tb. most buic prob- Sclf·health In poo r eommllDiti.s
    lems I re more suscepti ble ' 0 action by famllies
    'Self-bealth· is th.n:fo re an idea which poor
    0JId parenll Ihan by dOCIon Ind hospital1.
    rornmun itla are '0 be suppo n ed io l'Ilh... ,han
    In ~ular, presen, kn nwledg. , and presenl aband oned to. But Ibis docs not alter ,be fact thai
    capaci,y '0 rommWlicll,e thlt know ledge, add up ' be majori, y of ,he world's poor familia will
    ' 0 the poso1.ibiJi,y of a quite drastic imp"wemenl in remain poor for some lime ' o ro...... And protCC'l-
    the cap...:i'y of poor fllllliJio:s 10 pt'Ot«l the lives ing the growing mind. and bodies of young
    and normal growth of their children. ebildn:n from tbe wors< efftJ<:11 of ,b.t poverty is
    Bu, as in ,he ind llSuialized world, litis opport_ essential 10 the brea king of the cycle by which
    poverty itself is perpetualed. This report tbcrcfon:
    uni,y is shadowed by ,he dang ... tha, 'familia
    ' UrN no w 10 a mocc detailed loo k a, the potential
    doing more' migh, br in lerpre'ed IS 'JOVC'l'fltnCllU
    of pte1C1I' kno wlcdge for empowering and 1tIp-
    doing 1<:$1'. For atlIOng the basic clemenll of 'Iife-
    poning parents themsclvcato prot«llhe livca and
    "yle' in the p<lOC world which "",lribule 10 poor
    oonnal gro wtb of their cbildl'C1l.
    health are lite IllCk of dean water , safe mi,atioo,
    decen, housing, basic education, land n:forms, WhI, arc Ibe poor world's "'I uiV2lonts of , b.
    arI"'1uare Ul<:oJtl($. And ,he pn:vcntion of ill flCls lhou, hean disease, stro ke, CIfICCf, diet,
    health is ,hen:fon: a n:osponsibili,y nOl jU$1 of StJ>OkiJlg, ea=isc, . holeste",1 levels, blood ~
    individuals and familia bu, of govern .....nll IQd sun: - b . .. whicb arc nOW pcnnca,ing public
    th. in'entatiooal communi ,y. consciousness in the industrilliud world? What
    ~ r
    , -- - - - - - - - - - - - - - - - - - - - - - - - - -----, ~

    ,IIJWHW1IUh !!Iii~ih i-umh ~"~ ~


    j • lD
    dlil~ '!if'ijor.... itl~£~' Il'~"~~ j["'l.:!! ~
    I l
    p~ ;. ;§n"I'! ' !I-I ioh ¥.' '1"1•• £{ co :::!.
    i f;~ WiW~: iHh~:~ IHWH i.lnHfi ~ !l! ~
    ~
    i h~ jlh;!tl!ii~~!~;i h"i!'r!H H!;IIH~ g" ~
    • l~ ' ~h§lfl.l~:ji~gil; i~ .. ~[, il,HH{ :i:
    ~ [i~ HdH~§!li~IH~1 ~! lhHi l;i~!n!~ c: ~
    I d .• fll~h~!i•• • h., ~""'Il.f .; .. . . . ." lD
    l,mm·mUH!iI nWHUfI mfmJ~ :HIt
    ~
    '~'" h •• I~~.' ~ WIU!'!'li '~!!Il-[Jl Uil ! ~
    Wiph~~ I~hi:'i "UH'hl a ~! 'H H~~.
    "hlifllj~~~'! h l"!p~n. ~'!r ' II' tru
    !!h!!-Hi~iu~m ~fl{IHiil 11iH!;! f1iU ~
    .f,' '1 -!.!.j'·14!-.\'··~p r~ j.·i-! I •• ~
    [iHj!!h~'!.,h 'J H'i:·' 1l:~~:I! .Jag
    h ,H.p. "hI" ··!·"!~l llh~ . HOi
    l;hh •• I~hqH ! hH,., .. h¥!h II ..
    ~ Ihe rorrespolI<li~g b'nluhroughs in knowl- space of a, le"l IWO or ,line yu", hetWet1\ one
    edge which can Mlp families I~ p"'venl 0 ' lrt:al binh and the n.1a (F ig. 14).
    lhe major co..... of dtllth and illn... among Ihe
    developing " " rid's childre n _ the respi..,ory in- o h is also knO\VII Lbll 100 ~nle food Jdld 100
    much hanl physical work in pttglWlCY arc
    f<c,iDn$, the di:arrhoal illnesses, the commun-
    "';owIy dllnliing 10 I woman's health _ and
    icoble disca.es, the poor nUlrition:ol heallh?
    serioudy teereee Ihe risk lhal a baby wiU not
    The problem!! and I"'I"ible $(IIutiQllI '"U'j from grow properly iASide the womb. If the result i,
    communlly 10 communil Y, country to cooo,,)'. lba, ,he babY'1 weight I I tnnh ;1 1.... lhan normal
    But Ibe", is • co'" of basic low-«JSI 'self-health ' (i.e. lower Lban 2,500 8"""""")' lhen Ih. risk of
    ..tion, which have a1"""1uni. ersal rele.llI.., llId death ill infan cy il roughly doubled." E~n I
    which deptnd fOT mo,. On parents Ihan on hand ful of .." a food taclJ d~y of the P'''lInancy,
    doclors. And Wf<11u:" they are po~rfulenough 10 IIId a balf·hour'. Ulra resl, can make a significanl
    red uce by :as much :as ""If ,h. inciden ce of difference."
    "",Inutrition, illn.... llI d early dtllth, amotIJ the
    child"", of the developing world.
    o II is a1.., known lha, immunizil\lllM IIlOIher
    Illainst lOtanus in PretlnallCY autumal;cally Imm-
    Slra,ogics which =
    already going into action uni"", the unborn child. If a CQJ\I./IlunilY knows
    ..ound lhe ..orId, such :as ORT llId aettle"ued ,h e imponance of ensurill.J lhal a pttgoanl
    immunlulloo. ha.e aJrndy been louc!ted Ul'OlI. woman ,eoei, es , wll lllti_I<1l11l1S iIIj«tions, and if
    OthCJ1, which could be equally imponllll, = oat basie health ..rvices art within mlCh, lhen
    ye1 widely enough known. appnnlmalely goo,ooo infanl ~,tS a year an he
    For lhoo;e read... who = 1101 professionally
    saved." If immun illtion IgWllClaDlIJI is iu", 1101
    I"'I"ible , lhell ,h e presence of a uained penon at
    invol.ed io heallh can, II may Iherefore be useful
    the binh - someone who knllWS the itnportance of
    ' 0 IUJIlJlIariu ,hose ""'I"lIies - and Ihe relalioo_
    ship be, ween them. dtl/l hands, I d ean deli~ry sheel , and lb.
    hygienie cun i~g and dressing or the utnbUicaJ
    And as ,h. only lrue importance of such cord _ is almosI .. effecti~ in prot"",ing lhe child
    knowledge resls in II heiog PIlI al Ih. disposal of against the di sease,"
    1W'C'IlS, <.his brid accoun, makn no apolOgy for
    stripping lhal knowkdge of lIS medical ,""",h-
    ulary:- BIU51-fud.i1li
    For the 6"'t few moolhs of a child'. life, the
    he:lI I"'I"ibte protect ion which any tnother can
    AetiOll io prqnaoey provide for I"" haby. l>Onnal hco/th and Ilr<>"'th
    is esdU>.ive htr:as<_fttding ( Fi!. 12).
    A cbild 's nUI,;liono/ heallh hegins 001 al birth
    It il now known th~t ht=1-mlJk contains al
    bul II CQIIccptioo (Jdld ... 0 he significanlly
    lrall shl ""l i·infecti~ agrnlS ag~ illSl some of Ih,
    . ffected by the nUlril;onal "'en-being of Ihe
    IlIOil rommon illnesses of infancy." It is also Ihe
    molher duriog her O\VII childhood and adoles-
    mool lIutril;ou s and hygienic food whkh any baby
    <:enc.). Th. lim ri lal actiOflS for prolecting
    can be gl"" n.
    children ~ therefore to be laken hefore and
    during prqnancy. And p....OI knowkdge ...," Bonle--fttding, by conl rasl, rrequenrly tDtlIIIS
    gcsls lhl'« btsic K\ ions ..hich mlllYpoor families lhal • baby is fed OIl a 1... nUlriliOlll m ilicial
    migh, be able 10 lake -if Ihey had Ihe neces&ary formu l<l whleh lnlIy .....,U be over..<Jiluled wilh
    infotm.ltion and suppan'- uncl.... w~,.,. in III unsterile bottl. ...
    o h is now known thai becoming pregnan, In OIher words, ht=1-feeding mitig3ltS the
    api.n SOOO afler pring binh rollihly doubles lhe risks of poverJy llId poor hn i. ne while bailie--
    risk ' 0 th. ~fc and health of boIh n>other and fttding exace,bates th _ ris... ( Fill. 15). And in
    c hi ldren . ~ To proI<Ct boIh, twe should be a dlUCns of surve ys ill poor «Immunities, il has now

    "
    I THE STATE OF THE WORLD'S CHlWREN1986

    Sri Lanka:
    reaching the poorest
    Sn l anke ranks t*)o l(ISI(lC 0!0rIIJ in IhCl'MnlIl/'Ial
    a eountrylWlCl rIOI boo netllO n:mase <I!l~'1
    o Sn lBnl<a Ms1915 Ia1""
    tee/1nIQIJ(l SInce
    OS(!<\ lPQWIh r'I"IOI"WlorinO
    ~ My m:J1nour0Shed
    """"""" at........,w Des!>le an a_age capI\a ""*""" fa $UIlPIel'lOI'\8.fy !eedIog. Po new growTh
    """""'" '" IrltIe mom th.)o S 3 00 a _ ' 50 UInka Char1 for """"'" 10 k""ll at I'>ame was 1roed 001III

    _e
    IIal; br<lughI lIS Inl¥l1 ~ly QeIOw 40 dwll'f 198 . and .. ro<I baIIlg OlI'<X\uIXld flilllOO8lly
    PO< 1,000 ...... llW\IlS. 66% cI 11>0 POIl<J\<IlOln ~
    loUIfate. an<! on """,ago . 65" 01OIl8'\"" "-old$ are
    o To oounlel 1M <II,ft _ bolti8-'-long",
    hMy immurozed In SeQIemt>er 19 65 Sri LaoI<a
    ...b8n ~,_, 25\110 01 worl<.-.g ..-.:>me<s &lOP
    100k "" !he ctIa!IenQe 01 ~ lmmurIl1.8ton 10
    breasHOO()ng bekwe t/WeEl monthS. \IW oovem-
    "'l'JI'1 enforces a .-.t law bannong If'.e ac!vOrtJs..
    toe r"",.;"",g ttwa 01 its chikt"" _ ltv1 lwdest 10
    ~ oI ~~~* ~M~ Ma~~ ~w fa
    reacn WlII'IIn a ye.v, WQfl<lI'Ig moll\IlrS Ms _ 00UbIed fO lIVee
    '0lDIUtIS to eocourave b<~-!eod"'ll
    Long-S""""",, commolme<"ols '" lree .Ido.e,"""'.
    kee meoieaI c¥c ano IOOd s,,h<lC109s lor _ Irl VoUIIeera play a ~8'/ ,011 III Sn Lanka's
    ~ ~ Illlhe ' - ' (\1 $/, ~ 'S ado:e,."...ts attempts to ~ ~ c:overagoe Ido<a Ollar>
    ."... me ,...,. E..", so . anest,matea ",,"U'" at AI 10 ,000 yoI.IIlg _ voJur-. _ "'"""""'" III
    tlabIes are DDm ,n:lBrw\109I'U. W1lh the a!tllllllan\ t/'leIl V!IIaIIeS Mel some • •000 S1all altho S/lrvo-
    nsl<soI!1d<nes!1ano <k!aIn, _ _ 45'" 01Sn day. S t , , _ voIIage os. ,Io ~ .. «"""""""'I
    lMka.', 2 million clliI<hln lJnC\eI lNO arc maIOOOI'.
    _ 10 some degree Doal_ ~ '"
    Sn lanl<M I;hIlOren a ""*
    ""'"
    2 .000
    an<! unOennorleS me
    a,a worIung low3rds d'wId ............ " 3,000
    VIiIagaB Many 01 SrI l ....ka·. 19.000 8l>:l<J"05l
    pr~ ll«I illso prorool:tlQ cnoId ~ The
    nulllbl;N'lal SIan",01 many1 _ (Mfa 5au1lVaOana rr«lICaI >QIuf'Ileer l'I'IO'JeI'TIII. 511

    -
    Lanka AM Cross. Boy $<::001$ and G<rl Guocles.
    a Sn::e 1978. wilen Sri ll!flka lsunched lIS
    .. . pancje(l rnm~al"'" prog"".......... "'" Jnc:j.
    l.Ions dubs and Rol¥ 'l d\.ClS are aI acIMl1y
    dCf'lCe at PCIIoO _ """OCll<no oougn M$ gone
    To fllL'lO PllfMI$' awareness ol _ 10 Io"lll'O"'l
    <lOwn by 65'" lind tne ft:>deoce 01<!<phtnenu. ano
    thou ctWdren'. chBrJce& oI l1l1M1'a1 SIllI healtI1y
    J>KW\lIll>I te\arIu$ fly 90 'llo . Over ~ one-yeaIlorrn.
    Ihe ,_ ilCceIe<alGd P'lQ'm is ~1!I(l1O"'" "....elO(l". 1(, me nali(:oW tlroa<lCaSllf'lO nelW«k
    a petrnllI'lIll'I !lase for lui I'BCCIM1Ion at ... !he ~ I' ee lV·"""'. ro8WSP8POl<S and magal""'"
    country', children welIl:>ErIof1I 1990 M regulor tealuros. PIlVlte COI11ll8IlieS IlOIll etlIId
    $U'IIIVlIIoncssaoos on P81 SliPS. ClI'* baQa .
    erM!Iolles lIIld e.8fC198 Dooks Aod ", S9P\emtlet
    o The IIlIllOfiill 0Iil'fl>:>eB conIIoi f)r<>gtll<lVll8 .
    1965 ttl8 If>:ltaO and Sri l ~ ""tlonel CflCI<e1
    I'IIIdl reacIled m e IIIan a Il'lird ol !he pDJ'lt.CaliOn
    by tile end 01 1984 and ..... due 10 aetlIIM! l<!llm:S llII'eed To hoi..... lI'e m " _ " 1rrimI.IIloze
    """",,"I COYfII_ by IIII! oond ot 1985, _
    'fOI,O' cIlIld l"""y ' PIIin1ed III ~ WMe
    letIets on me poICI1 U5tJl! fOI lI>e Tes! MaICll _ and
    uMillooal '.."'eel. ... available .., ......, Ihe poo,,1Sl WlII<:tHl ~ a I/lIIMsIon ~ 01 lens ol
    _ . WCI'l as "'" COI"I)"" (gfUflll, 10 p<f!'V(lf'I1
    millions "' boI/l Sn l.aIllIII and ~ n g _
    oehydrauon eeee <t SlatIS Hill ~n<J"otIl1l
    .......m.ctSOS oral reItyIl,alJOO saIlS 10< _ e n 1M IIflecl oIllM1Se measures will ~ 011
    ""'" MIld """"" ueatment Pr/Woouslv oblaotIabIC tOYeiIlOO ll'V a new sysIem 101 moMonng <:hOd
    <>nI)r ""'" <ridwrves """ _ c""ues. c-.e WIS suMvaI and ~ Talung a naXl<lal sam-
    ..... now B'V3IIabltl 110m IlIIatmllClOS anll goet'Wal Ple 01 0'0t!I 15.000 pregoam women, 1M system
    pracll1lonBrS _ , and Irom OOI!I' \98a on WII WIll follow Il>8fr P«IIl'ess -iIIll:l 1tla1 01 tha". ~
    ll<! ooId by tnan 10,000 'etOll OOlle1S. ,..., _ 101 lI>e """I we years

    "
    b«n $/Iowo mIt bolll~fM babies ar1!:OS much as II is also al <his poinl ,bIt <»tt of 'he leas'
    I.... 0< IArN l;lJW 100ft ~ ktly 10 die in infancy thaD undnstood and mosl imponalll of all IoW...:o&I
    babi.. who Irt ndu$i...ll' b,....,_fed (0' 1M 6.... child prolection stralegies COIIld hqin 10 play ilS
    f.w monlhs of lif•." "ilIl patI. Aod bttause il Can serv.:OS I .....n' and
    an aim and a nteas..... of IImost allth. other IO'O'-
    Applrini 'his knO'O'1od8. can bring 'M majo._
    COlI' acti"'" whicb pare:nlS might lake 10 prot«l
    ity of cbildrtn in poor communities 10 the age of
    6v. or $i1 mon,hs in good nUlritional bealm. So
    their children in these: ";,01, vulnen.bll: )'('In of
    growth, lb. snal egy of rtpUJr f'OWlh rlltrking
    far, 1M infllOt h.. bee>l "' leas, panly in,ulated dese..... a tnOt'e detai lM consideratioo.
    from povmy by the womb and the brusl.
    But fo. millions ortbe poor wo. Id's ch~ dr. n, il
    is now mIl th. trouble btgins. For now m. child Prot tclitlg growth
    btg ios '0 COOIC into incrtUing coOtllCl wilh lbc Th. insidious aspecl of child malnu,rilion
    II\OiSI
    .nviron....nl of povtny -I povtny which begin.l
    is lbll most molh... do 00< know Ibat lh... is
    10 gnlw "' normal heal'b and growth ." it "' this
    anythin g wrong." And lb. ... ry fact tb ll lh.
    poinl Ibl mt l.mbl. 'growtb gIl" btgin, 10 opt"n
    d~lopm.m of malnu,rition i:l invilible - . ...n '0
    up ooween ,b. smo<><b upward PrtlJ""" of pxdial riewll and oven 10 parenl! _ is <»te oft he
    children in Im u. nt communities and lh. sudd. n main rt:oson, for i" pr lenc. and $tV. .;,y.
    weighl Io&ses, frtq u.nl ~I~ and faltering
    IlrolVtb of child,.. n "'ho grow up in poorer In OIOSI cases, n......oo nOli.... lhe Jock of
    communities. adeqUlte weight gain, and m. c hild limply Ii"..

    Fig. 14 Infant deaths by birth interval , uneducated mo thers, 25 cou ntries


    iIllorll_IJl.. 1<lr_ ""'" til« WJrI (IMs lhItl2 \'6InI-1OI"IQ r2-O >-"1_ ........... To ........
    """'"" ............... 'Ik; "". . . . . .. h ~ I9no ~<rif 10 """""** wilO nolonTW_

    o Long blrth interval

    200

    ''''
    '00

    'W\lrnon"'" h3~_'-'_lOOtew_ no_


    ...... --- ~ - ",_ ..... ,....
    "
    ~ I i ~

    'g'~!J~li wI , Wi~!Ho iiU~¥·"i. HH. O::J: ~


    fj['!l!ll! H~i; ~.~,i*iit~ IIBi~1H!i ~.'!! :l ~
    .i'j-'h o 'j'!
    lgila; ~ ~ ;~d
    ~6g:i !! !J~
    s e Iipoi rO'i ! I"~ : ~ l~il:"l ~ ~ (D .. §
    l j i l. tHo ~f!'l [I., ~[i, niH !ilh~l i, .: III
    i - i~'~5ft l'.~ i·J~·I'~ rl· ••• ·~ !l,!~ n >;J
    !h,i§:!i! !i~~[ ig!iH[h li~fHmi ~;;~! l ~
    '0 ••
    Ji lUff i!iUlH haHHh 'ml ~
    •• Hdllgl _ I;:
    ' of. ! ..... hil ••HH dH
    !IH~I~j~i['~ IljlU, UUlIW' ifh ~iP S ~
    ~~!Ih~ li·~h H!tli! -IU~!ilii i~!i b' g:
    :J11!! niP! .:lh!i ~ihjlUi hi! ~h§ :<
    !~!ih. I .!~ !~a~i n '!' ~. "'~ ~~~!
    lh!~.¥ lhl.; ~!-t'"5 lj~l~fr" i',a :1.1
    il- ," !~,., ,~~o~ " '~i!ol~ ',' 1,1. ~
    [,!1($
    ~§ ~ 8
    .:j:!l
    § '"
    ii~ilt !~t~.~~!~ M
    & .. ~ ';~i ll' ~<t! ~ ~
    alii
    a ~ .
    l,f. <Iill! ulbs .HhH.~ ~h ~,f~
    on wilh poor gfflwth and ft(Q u ~n l illnesses. In a FIg. 15 Diarrhoeal illness by feeding
    minorilY of casa, the probl~m of m:oInulrilion method and income, o er-es-sataern
    docs eventually ~ ";';hl~ - bu, hy tha, pain, ~cI_ "'IlOI'tIII rid Goao'TP'Ql8 " Ire ttno
    gfflwtb i.1 a1nady ...nou.ly afIect<:d and tb~ task of
    pUlIinJ Ib~ d tild back on ccurse has ~ very
    ""'""'" .,..."10""" ~

    ..
    mudl 010'" difficull and very mucb m<I1't u pm_
    sive."

    Pnvenlion i.1 usually po&$ibl~ if!»«D" und~r­


    5land Ib~ imponan« of growtb and can mmdlow
    ,
    lDeaSutt: il, :I« it, and tak e lCiion to main tain it.
    And if an y fal,~ring in growth cou ld somehow be
    5«0 al a m uch earlier Jtag~, then the", are now
    se,-eni ",Iat;vely simple and rdali"ely Iow-<:osl.
    >clionl wltich poor !»«DIS can take 10 keep the
    child on course and prevem senoua malnUlri tion
    ffflm R'liling in, !u>d therrin litl th. imp:m""""
    ,,.
    of . egulu monlhly weixhing.

    Th~ d.,ails of th~ growth moniloring procc$I


    ""' brought together in Pan II of lhi.1 J'l"1"m (sec
    Lifelin..: growth monitoring). BUI the essence of
    th e idea is th ai rqular mon,hly wrisht gain iii the Breast- fed
    b<st single indicator of an y cb.iJd'. normalgtoWth
    and tim Ihe procas of rquJarly re<:ording thai
    weigh, J ain, Or 'he ~k of it, is an essential
    technological aid 10 I"" mother in doing whan""
    is , ryiog ' 0 do anyway - hring up _ hulthy, well- thll the normal 4.velopment of the child, Or the
    nourish<:d dlild in vory diffielJll cin:uD:lOtanctl. lack of it, ~ be ma4e v;';b1e to the "". ~n
    who cue mllSt and 1211 do IDOSl to make SUR:lh al
    Simple as i, ....y seem, lh. growth cbecking lhe chi l4 liTO"" and devel0p5 normally.
    idea is beset by WWl$wered qu tllKma _question.
    about the right kinds of growth cbart s and Bul in itself, grn wth checking neither feeds
    wtighing acaI.. 10 use, _bou, how Ihe "'iUlar clill4. en Ollr protectl them from disease. There--
    ",'eighioJ of all young childre n is best promot<:d fore III only true value rcsicles in wha, <1<' ;""
    and organized , abou t whet her graphing llfflwtlJ is J!U'ClU tal<e IS a l'CIIuh of gCtu ng much more
    too a1i.o a coucep' for moth... wbo may well be timely and precise information about th. IlU,ri_
    illil....I• • and a\>eYe all about ho.... 10 inform and tiona! 5la,us of ,heir eb.iJd",n.
    in vulve milliOtlS of molhcn in tbe process:"
    The de'l:aiI<:d 1Ctillf\S which an y particular
    BUI the IUkc:s arc hiah. Fur th.", is .......,n to paren t Can 'ake ....., of counc, prcocrib<:d by ioclIl
    believe thai if parenll could be inYillvM in an4 cil'C'llmstlltce. But = 1 adYIIICCll in kn owle4g e
    informed by ,be regu lar ,rowth checking of Ibeir have $bown tha, the"' ..... certain kin<ls of 10Yl'-
    eh~dreo, then child mal nulrition could be teo COS( riM which mM !»«DU could take til
    duced by II mucb as hal fi n tbe poorcommunities provide basic pmu,cl ion for f"IXDIh.
    of tbe d• • clopinll worl4.
    Th at kn owlcclge can broadly be: diYi4ed ;ntl)
    The hean of the mail er i. the informcd kno wledlle about the .pecial OUlritional needs of
    invulvtlmlll of tbe motber. ~'or the mother's the )'OUll1l child II'Id kno wledlle about reduciq
    participlliion in reguw IIlVY1'th eheckinll mcl1l5 the ftequcocy and severity of illIIess:.

    "
    I THE STATE OF THE WORLD'S CHILDREN 1986

    India:
    towards a polio-free Madras
    .... indoll pt_ ... ..,.lIempl................
    ~ 01 l>eIS oIlt1<l ~ llr(J Rolllry cIUtll;,..-o ".'Ibiol

    __..
    11," Cl\IIcl«ln Dr 19 90 , _ IIeI-tC3Ie PlOQI"""- ot me ~1lI ~ Touring 1_ on POlio_e

    _.. ,........, ......."' "'


    are voetW.. ~ e>DeI.e<lOO 01 /'lOw 10 rlYOMl $l1OWIl1O ~01~ Thenatoonal
    II ~ ,-..rces '" fOIC/WIQ out II> II>t """" Il1>O MIl . ..... _ "'" _ _,e,1S
    pOCHIl QI'tIU(IS This_ !lUC/'l ea ............. doo::>mer>la". n
    mola_
    ItIe .......,..
    ~

    '*-
    .. 111ii.,.......__
    I*I1II _ammes r - 01
    ...-.ount>IlU me _ _,
    ~-""
    Tl-._ r.cilyGl MDaI_1n ~ on'"1'8'"_
    _ e_.
    dlJyI A mIol
    <>1'/
    IN l.Cl ~

    ~ ~ .. _PQIoOOy........",,-,g
    _ ~01 • . , . - . -..... ......_
    .... _N_tlet .,IlCkI __
    /vwj 1ltoClI* _ _

    .-y ~ lIS"""'115 1 OOOOl"CIII(.~ n. Maar. _ _ ocm'lllf"Ifr.'l"MI ~


    _ '- _ 'lICItlII'II
    "'''.ilII'
    III lle;'I _ _ C1'QIlId lIJ peIiO ..

    'MIll _ _ l<nl:Mon • III MicQI ftO'II!'f>-


    ''*'
    EliOC,..
    • '0'"
    _10"'-"'" C 1O _ _
    _iCe
    , . . , . _ . _ .. ~ " " ..... A '
    IK.*'
    ~n"'" lle\'1lIdoIlI
    01""""""';: -.0

    ---,
    ......· _1I'I 19&I • • _ _ I: .
    111 _ _' ....... 1.... - . . . . , PIqoa _ _ _..,,,,,tu._..
    '.....- . . . . , _. ' " _ ...
    lor lb
    mp.:li . . ' • til 0fVI"IlMIDnI worIonlI .,
    _n....-01 ~~_*"'<:an '_
    ......

    _ ..._ilor_
    ...... _1lIIDl .... ' _. ....... - . . car-
    WII;lI: P .........,. _ ~ouI for..,. 1911$ __'__ , _ ., ~ ,. ' di

    ...,..01_""~~ A
    .,_..,on"'.
    -
    i.~· _~~

    T,.,.I1111 _ _ peIiO ........


    WIllI ,... ~"'" lnt!IaI' bu8l Rowy ......... 00 WlgOo1g fllllll n 1\S111180S 01 cool".ca1
    _ _ II'M!I Uno1M KO'V:lDIt> sa.... the CtoiIDI...,
    rcno:l, II'M!IlIIate 1llO'iI<trY'" """"" ~1e<l1M ~ M;I~ "'., JuIoI, me ma,orrty O! m.C/l)" .
    ,«! IIIJIY 600.000 ClOSeS durI/1O;I ~ NtIy """''''' t lllklren _ . .. lIIlIf'h«! auao"Sl POIoO. dDsQrIe
    ... \he I'8N '0 ~ tIIe....cane cool ",,111_ was lOme IIIWlO'OfI III i l l _ . ( .... 110. 9. or
    . -. 11"'* P"lI'3le comparoos "'*"-00 ~ !he C1 ~'1 CI'IIklrcwl oeceHed !he Jorsl CIl»u. 8 8~ ...

    Cili t_. /11(1_.


    "''ll8'.1Od ..._ _ ~ . _721li:o 1I'llI1t-.;I- • .",.,.",. _ lie!

    - '"
    ""'I' be J'o9' erougIIlO ~ 1M hOe,

    -"'-_ __
    Ilul. _ QilaI DIQ'IIl'Il-
    ~n"'''' I10~-'''-
    "'G'" ~ '" _ . oIlen .. _ wro-. __
    _ ... N '*"'-"d TIe _ _

    ...
    ~

    """'.Q "-. ~---

    _-~ -----
    ....00
    "ow _

    -_-.._ ...-
    ~_
    , "-P..a

    ...
    ~

    .. *-<hMllCl., _ _
    d . . ot(i' _ _ On _ _ r.-
    ... --,.
    -..-
    .....
    "" Q
    _Dr
    ...
    _
    n
    ;

    ot1tI'
    d alllOo<lCl_ !UCtlo -

    n.. ca,_,_
    . . _ . _'
    me IIfIIIIl;I nc.
    _

    _
    "_~"'-"'"

    graup
    "' ... _ _
    _
    e....
    ~ 00""." -no.
    . . - . "" • . . - . . .. oIllOA:11c •
    ..

    =_...
    ..-. __•.,"__,_..-coIeo;Ie
    -
    ~ ... _ org;nl(R _ KhooI- . . .. _ 01 0II'IU'<DIl0n wi ~
    ........, -.u ,"\09."[. 01
    ...... local"""""'"' "'*' ~ ......... _

    •
    Impt'Oviog diets At the other o=me, Ihe inlroducrion of other
    foods II tOO urly till "ie Slet')lly IlId unnecessarily
    Oae of the 1Il(J$l comman fU$OO S for the
    fIlleting of I youog t hild's growth is Ihat the
    inlraduttian of at hor foods, in additio o to breast-
    milk, \:qins too lale,
    ,-
    inaeases th e rWr of diarrhoeal IlId othe r infec-

    Preoenl knowledge abou t when to begin w.,;w·


    ing w llld therefore help moIhen a¥Did QfIe I>f th e
    After aboul Ii'" months, !mast_milk alone is no maio< tlI\1S1:S of falm i ng growth.
    loogor Sullicirol IlId other fonda mllSl be odokd if
    the thild is 001 10 bc<:ome malnollrisMd_ Yel in JlI$t .. imporunt is the q uestion of how a child
    many pam of the ""Ofld, OIher foods...., nOl shook! be: .....aIled:·
    inlrod ucM uo,i],h. child is well in,o Ih. sr:mnd In a p(IM CI)tIIm ,rnhy, th e altempi 10 wean a
    sis monl hs of ~fe and , for many" whole year g_ child 0 0 nothing hut Ihe same suple food os
    by bd'ore any OIM. food is tneo. In t1lrallndio, adul ts is likely to lead tlmetly 10 malnulrition .
    fo r exampl., III cstim:aIM 4O'i of all infants an: F or I t hild'i &mall Slomath tonOOl la ke eIlough of
    stW being udusi vely brusl_fed al th e "ie of one
    ....."
    }
    the bullty, 1"",-entfllY foods whith Ilre the slapl e
    diel or the poor (1'41. 16), Th e child may wdleat
    eno ugh to Alisfy i\O hunger IIld be: said 10 eeve
    'ealen a good meal' . But il will nOl ho'" ealen
    Fig. 16 En&rgy co ntent of children's enough to meeI ito enagy requ~nlS for
    diets, ric h and poor nations normal hallh IIld growth...
    TM11iIP" """'" I t e _, toy~ , 01 tho!DO<l Whd'I
    ....,. tle _""""" <lllyto saIisIy.... """'W _ _ <J1 Th e ilaple fonda of lhe poor, unlike Ibose of lhe
    1I"""""lI~-.,_-.LoI""'<lI' t ... _ , 0 rkh, th erefore tu1)' a bu ill_in dllIger of t hi ld
    ~ n:u:i-lg o ~ fU ....... ~ on:!,.,... 01 maLoutrition ( F ig. 16). To roun ler that danger, I
    i"<> 1te"""'J)' <lOnOiIYal o <1'ikl'. tlad lO _ tho
    ...... _ .. INI ala <1'ikl it> It"e ~ wort:l, thild has to be fed IIIllOl'C fKquenl in lerYl1Swilh
    1,750 more energy-<lenrc foods. In pracli~, thol mea.os
    tnixina fm IUd oils, and peeled and mashed
    "egetables, ioto the t hi ld's weminll food. Aod il
    Ibn mean s ronti nuios wit h one of lhe 0l0IIt
    eoersy-dense fonda of alI_ brusl_milk ( Fig. 17).

    FinaUy, there is the """enl hreaklhrough in


    kn owlet!Je l bout the importan~ of vitamin A
    (set: l"'8 e 22 ). In pra<:tioe, tha' hrealtlhrough
    means that a daily hllIdful of the cheapest dark·
    green leafy vegetahles an help both to protect 1M
    t hild'. eyeSight and 10 reduce th e number of
    dillThoeallllld =pin.tory infctti1>lI.< whic:h a ehild
    sU$tai D$,
    ErnJlD"'erina parents wit h Ihi, vitI! knowledge
    about th e special nUl ritiona l needs I>f the wean-
    ling t hild -in lelltlS whkh ~nlll CI.D under_
    stand and a<:t Oll -c:ould Iherefore red""" tnl!nu_
    T)'lIlc.oI _ uK_ lrition and hel p to maintain growth.
    But in llmost aU tun, Ihe oils, fl,", and even
    o
    ---_..._..
    1 2 3 4 5 t heap veselabl.. will mean It leas!. a lillk more:
    Age or child... yeat$ apeD"". The very poDrat familia wW therefore
    nIX be: I ble to make these small bUI vilal
    ~----­
    0 . - -........,_""'" '0" improvements to their t hildre n', diet. And fo r

    "
    I THE STATE OF THE WORLD'S CIllLDREN 1986

    lid f,=j '~ ~ . . .tlfU&IIe -. __ ~ lllllririoa, _ resaniI ........ !lao suuaud 1Iw
    aDd ......,. IiiljAO.tukUl Clll WJPO<C Ibeir diai,botaI ~ &IaDI:.
    , cspmsibk bftWtQI ror
    dIIiIdrca'. dLuca vi Ii", •• I. Ii" 15' _ 7SS 01 ~ faltaiQ) . - . I.Iw
    Blll iI if _ lllu • sipiljaonl perea>- dIiIdiaI 01 poor fwnil;,, "
    usc vi . . -wi', IIIa1DouriIho!d dWdtm ~ ill 'J1:I( rc:tJ poblml .lberd'lR _ au.er 1DIiII...
    bolDa wbm Ibere If ~ food Ul prorick aD lrilina r.. illfa:tiaa bur bol:h-_ mabt~
    aclcqlWe dirt for • ,......, dIild.. 1JI • ltttIIl iudf pno;t..... I.Iw dtiIcI III _ ... r...-tioM
    naioD-widc NnCy" InA ;', for cpmpk,_
    dilanaibll: difl'~ ... foaDd ill tJ>c, _ , «
    w1aidI lad iO further DUuiIianaI ~. Or.
    HOIIIcilI Qhowmi hal wrinCll: kPo. .nn ad
    kiIld III food • ....w..bk in 1M IIoma of cbiIdreD . _ """ .,.,..urir ~f/«u ill 1Jn1CfIlign.,
    ..bo -..: ~ aDd . . Jw:ma; cl ~ . . .ttiNM ......, diltbn, """ "" ,.... _ ....
    ...bo -= ltOt." n:.1I,1~ - . . . #f iajrcriaII """ _p1 DLCmli
    ill .. ~.;14 \ tN, rtIOtI14 ......... ...,.,.....,wI< ..,pd, ,.
    I.a this amu.callCl:, prc:Kll1 bIowlcd&c about
    _ben IUId bow 10 _ • _ chiJd could ..,..,a., 'If.....-../ rwmwr.-
    rod"",, bodl. tilt:: ~ and the orvenly of While dninI .. hal is lID'" IJOIIiblc 10 iml""'ft
    child malnulntiotl - if Ihlt kJIo....Je<!&e -re to ~ diel ., IIId especially wnainI d icls, ",h l l Ibm ate
    made widely avail, ble. lile lo....:nat M:lion. which parents can take to
    ml\lCt iUlltsi l
    But din it nOl all. \II~I the child'. body does
    with IhI: food 1M! 1$ taten is ilia as imPOruDl lIS
    food itself. And in f'C«l\' ~an, evid....ct' bas boo:n PI'VIKtlOII apinlt diar'h....~ il1Qeu
    accuJIUIlaLinJ bcki.lld tM idea that I poor ' DIm
    of food may lIOI be llle OIlly Of even lbc: main The _ comP>Oll of all childhood ilw...." iI
    cause of child malJIUlritiarl.. diarrhoal d ileuc, 10 ~ poo< a>o:IDIW>itia, for
    ftIiIlple" dilld may fIOOlrllCt. diarrhoeal Wee·
    tioca P"haP' Iix or mon: Ii...... year _wilh ...h
    ~ Ia$liaI foe In'cnI days. If <lie ""'P'J"tII' 0(
    lhdlKiaa: ill,,"US the paml li is to with!lold food and drW:, thcD
    ~ of lilt _ impan:Ull nl all l'f(ltfI[
    diai, ....... lIlIy 1DtIIII thai. powinachild .. ........
    ntber lbaa at.:lcbizI& lMNriIIuDau foe. Iou! 01
    odnDa!I "" kaow~ Mlooll dI.ild ",,*,,11 io lbc u p 10 4(1 daY' ill tbt year. AIld lila aIoot is
    IT"'in';'''' l!I&t fralucat iafectioD is as impartan.
    • QUSC ol llll1llutritioa. • tbt bd: or food iadf." e:tlOIIlIh '0 (:II"" IIO<maII'O'"h 111 bit"" " ThaI ;.
    wh,. ....,. ...uir;".... _ ~ tlw dia<r.

    To 6Pt aD iIlDaa, • dlild's body reqWm: am !loti! Wmioa • _ of the major aIZIIS 01
    man'. Bw at- asaaUr __ • ' - or chikfhood lIllIh>utritioa ill tbt de . ........ - ' d
    oppotin: - .. . . body m:c:i_ lao eDCrJJ. _ toda y,"
    ~ U..uy, tho: itt- n.tf abo tbal
    IIlCIllS
    So.".. can p&mItJ ill pooc ........ Dm _
    lao 01 lloe food Wl is QI"'" io .boOibed IDd
    rnilablt lot ~ AJod if . . m....;"."'Otn:$ lko 10 ward olf thir, lhI: Etalat threat 01 all 10
    diarrlloeI, ibnl llutrimlS an: dIo dniDCd , bolh thc Iiwa and tb. iIOi1IIaI crowtlI 01 t1Icir
    rr.., tbt bodJ. AI the ...... tiaI£, tht , 01 "'"""">
    _ pumlI (all ~ lor doaon) is ... M_ rreqlll<Ol haAdwadUo& with _ aod
    'IrithIlIIId food driDIt.. b all III that ways, tht Wllter. and ~ hyp..ue oqys ol pr<plIriiq and
    thild'. lIutrilioIlIl _ ...k -r ~ .,..uol) UId ..orilla foo<l, ate I.Iw 1-.> ...... ~ ;., whidl
    freqllnlUy lkpltltd by illMa. 1M r=Jt can be p&mIt:I an bdp to ~t dOuthtc:al di..-- if
    ma1JIuuitioll IUId poot powtb - __ ;f edtp.u Ibqr haft adeqowc ....pplia ol-t>. Wllt". f.....
    jatIJ if /lWIkI1>k i/o ,lit "'-... and time.~
    Many dnailrd Rudin h.I~ oow <klnonOl"Ud But for tho _ ,.n, piCVCllUoa depends 00
    this aUlll Klatioa.hip !le1W«1l iIIncsI and mal· imPfO"cd itIc'omo:s and livial t'OII~tiolls, Arlit

    "
    anir.._ lIfId _"" Ollpply, IIId IleDCnI .... ia Fig. 17 BrNSl-leeding and CItlorie Intake
    tbe It'I'tl of lIftIth em",,;'" lJr, ~ wmlt, in the second year of life
    ~u.. .. rdaud 10 . . , .... . . , . ia public

    ......
    ,..,........_ " ' _.."_,.-<$...

    --
    bealtlo whiclI - . iD wu, doeeIy rdIItd 10 lM
    "...,.u It'I'tl of .. I" ' ''' lJ,e.eloctikOL AJld 10
    ..."" lM """Inll of diInboeaI ~ to lM
    p>dUII IIId litful ~ of 0'
    _
    ' If'l'"l.II
    lariat 4 miIliorI. J'lUOI dlildmI 10 die
    _ee-
    ado JUt -aDd ......1 ",jlljMs _10 b. 1m ia
    malouuil'" ·llIltil -U ia,o .... 0ClII ~'Ilr1,
    TIloI:ft is _ no QWSe for ollowi.. tIw 10
    """-
    Mppm. For thl: dia:o,u, ofllnl rdItdntioa
    ......P1, Iwcb<d upon .. lbr btJinnina of IU
    I'OIpoI'l , mraas Wtth.... il OO'II' I .beop""".unpk
    mnbod by which III pII'O'Otl -ridl or poor -caa
    pt'Olo:l their child= from tho WIlnI dfa:l$ of
    diurhoeol diMuc.
    In I""'viOlU Yffi'S, this npon has dOCllJtltnltd
    lh. fOCl lhol ~l'OIn t. lh.......I. .. . ... """k. aod lite
    oral I'OIhydntion soIuti01lll md holp .0 A v. tM
    !i1'OS of Il10R ohhc 4 million chiJdl'Oln .. 1>0 lIOVI die
    nch you fl'ClllD. diurbocal dcbydnUOll,
    ~-- --_.-----
    Bu. ORT h. I I... spoaacular oidc '0 jl$
    nll~ !:val for tboot dtiIclrm .. ~ Ii_ ....
    15'lb ,.....,.
    001 diKaly thrtlteotd by ddlydmioa, ORT
    roWd bei::om< lIIIC of Ihc ..... iJIc:iIj", oflooh for
    CIIItia& jatO tbe c,dc of iarectioa md aWalltft.
    tioa whicb __ bokb '-;): tbciI' 1J'O'IfIh.
    TIle fin! md _ baic dcmml fIi ORT bas
    -------.:~-- - --
    _bj"l lOda with ,cd"'*'u or special 'om ull.
    or f.oiI..w,apptd -w IlIoas ... do with iaf_
    i"Il*Ul$ tIw it is ilr4porwlltOpmia iD p.iDc
    I dlild food IDd 6Wck dtIriJl& _ cpioodc of
    diarrlooa..••

    • \'_ _ .. .,.. _ _ t_ oan .


    __ tf
    ~ . . _ _ .... """_tf
    ; ','_ Ior _
    ~

    .... _ _ ' ..l _tIK1


    ...., _
    . _ · tf .._ -r ...,.d""
    ...· _ ~ DEACI1'. C*-O IS MOl

    --".. --",._,---"'
    IIIIEAST -no .. _ I'u.R Of' un:.
    _ _ _ "'_ ,,..,.tf,...
    -_.
    f ...., ..... rio:< ""' _ _ DUI'I"TI< INCREASINIl OTKII fOODI .... _
    • ,,1 " 4 _ _
    O ~T.
    lOiPI, <fIo<tioo< _ .. __
    ... .
    .... _- ~--

    "
    I THE STATE OF THE WORLD'S CHILDREN 1986

    bq;nnj nl 01 diarrIoor:aI IIOl1alllritioD. ADd it oaT il; lha efo;n .... flllbrdlapno ..... _
    bdplllO lalla 1M R.uiij IDd dunlioa ~ tbc dIccti'ft onJ'l ill wbich pareDli ihl:msd_ aD
    m-Ddl. rtd..... lbr impKl; fll illDaI ... I chikfs sr-tJo.
    ADd by bdpiq 10 mai:ltaiD DlItritiooaI wdI-
    Ben bca&&w dial'; ., illfcaiom do ruluau..
    bcilIc. the _ thcnpy am bcIlli ID IllIiDtaiD
    bod"" apcicy ID -'-'b &Wd$:a<Id IU'ttil:aU, tho , • 1!Itt ...... atloer ilIfco " . n 1D . . . . -.it
    th.- of ~ illtill pmmL ~ oa:OIId
    "* • OJtT ;" tbercfan:..no..
    tloc IIIaItiq Ill' 01 •
    il CIll N 1 force ror
    (OIl~ lbr doota-.d
    opeciaI oral l'dI~ whidI aboald be:
    'I'inl iDto III upward spiral. ADd lbr .... CIll ~
    .ad foe' lbr _ balk ....mod by whicb pumlS
    ~ to lbc dWd 10 drink ia q_Utics SIlftio:XD,
    aD bel p 10 dcfcad illcir cIWdrca'sJrowth opiDIl
    '0
    ~ ,be - . . . of lluid IaR durina ee
    lhc: tImat of illnaa.
    dW'bota.
    SUdl on on! rdI~ioa JOIutioll CUI be lDICk
    Up iJI , hf homt IlIilla tilllI Ialpoonsfuls or IUpf VKciH.-ptnfllllble illa_
    ,0 lIOC or wi ill l lilft or ..... (or by ...ui... Up
    dfcetivc tnditioDal l't'llledies 0llC.il .. C2/1'Ol llO\lpll 1M ~ ~ in immunizalion ooWftlc
    Of ria: cooiocal. All.mati... ]y, pUftllfCl n "''''' lilt ~usttd eatlict ill lhis rq>011 aD, of COIl"",
    P~paI;~ _hcu of orll rebydnlioa salu whic:h pre""nl .... enJ of Lb¢ most seriou. childhood
    an nOW bcromilll I nil' ble ill most rounula. illlH:Uft. BUI in 1M oomn l of . mlnh, it . .uma
    Eithn ... y, th. _ "'. of Ih. formula is that the Cyen Inaler imponance.
    1l1ucose alia... ,be body 10 .lnorb Ill' 10 2S lima
    V..xint-prt'I¢nta blc iIlncsscs til:( ~ cs or
    more 6uid &lid IoIlUilhao is nonnally the tIK ia I
    wboopin. OO\lib, It wd l .. Ibreatenina I child',
    child ' ufftrilll fro"'. dilrrlloa.l infection."
    lif¢, also 1IlIvc I bnvy nulrition al impacl." lllttt-
    10 I ",1I,;n'y _II ~I.,. of asa, the fon immllni..tinol _aiM these spcci6c disc......
    diurl>otlI .nil pmiR UK! tbc clilld wiU ba:omo is .... I putw 'immuniDtinol ' .,oinsl malnu.';,
    '"UJ' obriolqJy ill. III RlCb dmunswK:c&, if 11 aU tioa. It is likely, for a&llIplt, Ihat ......,. mort:
    ~bk: , lbe pua>1 should lledt tIIc lllria! of. chiklml die of maltlul,;tinol ..... illDaI in <.be kw
    bcaltll WllfW Illd Ihc ~ on! rdroyd... _tlolt r..uo.m, III Inaa of lDUSIa than on
    00.. a1u, lIlIOk lIpla tbc a:K'l WHO/ UNICEF Itilled by Lbc: mcasla iudf..- A:>d Ibc n:IQl is
    lormala, 5bouId pmttlbly ... used. . .. thai ........ hat kd 10 nlllritinosaJ - - . ",,""h
    If Wt ...... proced"", io rolJDwal, lh<!l
    faltlll'illl. In_ a! , . aN"', lIIIIft dianilneal Of
    IilcnD, "';11_ 01 childtm -tao art _ dyiq rcspinI..,. mea...... further...;p. ' - ' .....so
    ... \llltil t.bit whirl pool fllillflOCtina ..... lIutritiou1
    ..,., 'tal wwId l'tCOOa' • • dittt'I <aWl of 1M

    ......
    l.mlJDnIl p...... by llorir OWl! pumilia lh<ir "'"'
    JIIR • imporunl, thiI same pn:adun' aD
    dqllctjnD -ttt lbr dIiId down below dlt ItYd of
    IIl1lfitl,..,a1 bcaltb .. whidI life itxIf aD be
    p . .oi"""

    I m lll" lIi m .... iudf an IJoudoi, alon IIdp 10


    sipikanl]' ~ tbe olllritiolW klIICS ca.....:I
    lllrow lbr 'donwvd S)tkiPnt' fit poor 1I11lritiall
    by diarrlooal m- and • bdp ... 1M mainum ..... freqocn. ill bcahh into ... "II:pwanl1JDU....'
    - - ' IfOW\lI 01 tbc dIik1. Ram. J1:IWdI ia fll..mal ",,""II ..... fcwu iBfcctioDs.
    TIlrUy, lDdia, I"",. llot Gambia, IDd tbe Philip-
    piDa lias Iho-a lhIt tloe lIK'diaA difJaaICC in
    ...apt piD bn_ dliJclfUI who w= tmItal
    ..Ill ORT md tbooe wbo ftR" 1>01 . . . _ _ 70 _eaplra...,. iak<tiou

    ., ...... __ ._"""-
    ar=mes pu _tb ( Fia- II ).

    Idoydnciooo tIotnpy _ IIiII lit..".....,.


    ORT ..... 1mtJwni>::atinol an shidd a child from
    lIIIftthaa half ohhe ill_ • I _ hic:b M M lllif.
    and l'OWIb in lhc: CI1lksI )"'Clin. But lhal alill
    In._ IUK'bcckt4 Lbe mainrily fit <.be rcsplnlory
    inf«liont -ilIftctioos liM influtDZI, sinusitit,

    "
    A g . 18 Eff ect 01 a RT OIl weig ht gain in , omiI lilis, laryngitis, pocull>Ollia, 01;10. media
    - which underlie 'be deluhs of more Ih.ilIl 2 million

    _. -. ..
    c hil dren w ith diarrtloea
    child reo a year and und ermi ne 'he gf<lWl b of
    o WoigM ooitl II> group WolgN DIiI> '" group lIWly millions 1DlII"C."

    ""-, -~ -~ BccaU$C )'Ou"8 lunp aJl' 001 full y dev tloped,


    all ch Udro:n an: mere Y\Ilo=ble to l'e$jlimory
    -~ ,,*,

    ,.- -
    - . -...igrIl goln l * 0'ICIIlIll "" • • disease. Aod a chi ld wbo is weakened by frequenl
    illness and poor nuuitional hcallh is ~ vulnor_

    ,,-
    ""'" <> -
    * "" able 51ill. II child who COOITlClS bronchitis or
    pntumnnia in Ihe devcloping "",rid is therefore
    ~
    -<.-
    H_ * more than SO limes m<m likely todie from itlhan
    is a child in EW'Opl: or NOM America."

    ,-
    ""'" =
    7_12 """""'" !lO9
    f or thOR who survive, glVW\h is often tc1 back.
    10 a IlCVC", t.UC: of bronchitis or pnCUlDOllia, for

    --
    uample, a child lIIlly ' - as much as 12\\ of lhe
    »-n_ . ~
    ,~-

    :i proccin from his or ber body." Weakened in lhis


    _y, the child is then ~ 'lI$Ctplible to fut1~r
    infection and funher malnulrition. To keep the
    ~- '"
    ==
    7-1 2 ...,.,.,.

    -
    13-2. """""'"
    »-n_
    •
    • -..JI'
    ~
    chi ld away from the edge of that stecpeni"8 slo pe,
    bask pnltenion api.<lst the main resp iratory
    infection . is tbudore ab" ncccsary. And he'"
    100, there arc IClioru which parultS lI1d famili..
    thcmselvCl can 'ake.

    ,-
    """" -a- ;rn

    - -,-..
    Fim of all, breast-feeding offen a co nsiderable
    dq= of immunilY "llainsl rc:spir:Itory infections

    ,,- " :::e iD the lUst year of life." Secondly , immu niution

    -
    offers prolection qaiDSI four of the wom offen_

    .- -- .""
    -
    d= -lubcm!losis, diphlberia, whooping cough,

    '~-23
    ",.
    3-11.......,..
    """""*
    - and Ihe respif1llory complications which often
    wait on mcasI<:s.
    BUI if respif1lIGry diseallC doeSilriltc, lhell th=
    ,~-
    '" * art also 'wo vilal pic<:a ofknowledge by whicb a
    """eel
    -
    >1 011liWX10
    """""* family can acbild from the worst dl"cets:_

    1i:
    3--11
    12_13 ""'""'" o As wilh diarrhoeaJ infection.. paKIl\$ noed to
    ~- • kno w lhlt conl inued fcedinJ ~and especially

    ,.-
    breast -feedin g -is I vital part of the tn:I.IIqemcnt
    ..........,
    ,- <,- - ~
    of respira,ory infections. The child needs both
    CJ:lnl foods and tlua lIuitis. Anll if ;\$ appetite is

    .- ,.-
    .........., <' -
    *

    .- glll1e, theo freqllCol lI1d penistenl autnlpts ' 0


    fto:d will he I1COC!I!W)' for th e dural"'" of Ihe
    iIlnta.'.'
    , o$)'IDl"nllll
    Secondl y, famili.. nced to kn ow Ihe ....ly
    of an acut e lower respiratory infection
    W th a, Ihey CI O,if I I all possible, gCllbe chi ld 10 I
    """" JV.-;" -iII. ....o-.x.re
    WWlT' lI'"'..... _ _ .... _ . ceIn O'O'lfit
    health WOlker or I clinic hefon: life il3C1f i.

    - -,-----"'--'"
    'Ooto_oa l n g _ li>mpa.. _
    _ .__ .......ar_,_ thre atened. The ""'" revealing of these I ymp-
    llIlOS, in almost all cases, is the suddenly rap id "tic
    I THE STATE OF THE WORLD'S CHILDREN1986

    Thailand:
    PHC in practice
    W!II . .
    .....-. Th*'d _,...d.-,,_a
    1Oi$"'/',/I.S06 .000~
    bn:aq'Il _
    ...........
    _
    _ _ 1l"P $
    _ _, . " .
    _
    _
    b.r'Ill
    ,$

    III . - . . .
    _rwne
    ••' ' ' ' VlG'l<."
    r..a ~

    MfIliIl- ooal I'IIfIo1<)'" •


    1m

    "' 0.....,.. 1M ligon _ QA ICl _ .. .. 10 ... _ ~ aI • ..-go etIbl!tI


    l OO'lo ~ _ 01 'g e~ - -.u T-.l.".
    01 foe
    _
    _ _ ID II'I:JllOlD llI'IfIliI"f _
    IPtIClOtl. _ _
    -~1"" ..,...... .. ."".,.", ~ more ....
    60'" 01 ~ $,IJiO<k'IWch*l<tn 10 IOOMIlf
    "* growIl'I _ _ ....-.s on
    .. '_"'
    ',11. CIIIpnn'011lIrf __ palocy aclallI!IcI 01. ~

    ~ _, _ ID 1fIIOl" n'IIkJn CI*Ioen ~ bel li I 19 72 ...,


    ~ ,,*,_..-.lWng """'"
    01 ....... . _ lor w. 1lays as ...-- _
    ~ ~) . pass on IInO\floIIdge about
    1'lU/Ih. nutnoon _ "'tlI*"e 10" -
    T....

    ,.,.,.olltuI..
    '982, OI"'Y . 9 '1> _
    0115 _
    _
    d'lilclren
    be ...... _6<1 _

    ~ 11l\l1o
    nour·
    iot-.d. bul boll, . ., 0cI00el aro:l Douo iibio 19M.

    Mild mahJ\r_ """ ........ rc • IIwd


    _a_
    10. 15 houJol/lcIlOs eo. 01 - . , Ietl V!iCs IS 1IllIrI IIld lli!ItlWS llIIRlIli1lOll lO .... eogr.th a1 lhli lIIIrlief
    ~ b\' !hi 0"*-101, 1uIl!>eI15 day3' , . _'" _ CII7wIh ~ has <>.so !leOn lnl/O<
    "" . . . . he;l1In ~ (VHVl Bacled b\' • duQId., n......... 1'1 31.000 ~ schooIt and
    CG"!PelOlli _ ne!WOIl< 01 heooIl1l t8I'\lIes ..., ...-y ochOOlt/lild ""'" has • ~ ~. 10
    """"..... 1111'4 -an ""'_ 10 mo:nlo< trleor
    W ,. . ""W _ ., - . ea«l _!lOa
    *"'II fnI aod ..a
    SI.WY tleInll lllllOlll>C:«l lhli Clm'.:IN:n
    gtMlI'I ,
    _ ~ ..., ~eatmeol,
    _ t\aSIC ckug <lisInOuIe
    '" _ 20.000 ~ vtN. opIIflIHI . . . .

    _tluy_lcoslInll_.. . ·
    lUQllIefreruty IoMI "" ch*hIn _ - - . - In
    . - ~ mocI-l'85 , .'9
    300VHC:. _
    ""'" _ 10 . . . . . IIa1 ... dn.O' ...
    " " _ 10 -..II8ger.I ill I . . llflCl! • 7M. of
    "ogsdo . 3.000 VHYs ~

    ThIilrIrd', _ _ ..""'.,, '.. ~ ifI. iltull_ !floI ~w I '*"-


    .., _ .. l'77.08lIIlillSon " ' _ Qldy of ~ 10 - . I I _ 9 l l n : l DnIQIS_
    lOe>l*IlO_ ......
    IOClIgIIRa"""-_ 'lhl piWOO.... 'ol
    ~ _ ~ OUII _
    oI......-_
    ' •• ' ...,.,...
    IlW1 IlOUgI1l _

    go 10 ,e• •'" .~ . ~ Ite _ r •••


    ._llIIlM-ThI!.........,..,.
    .... _ ,. .... ill • - . . .
    aro:l $OIi;l1O"""" ill

    """"' ,. ,
    ...... _ _ -...,.j

    ~
    "'.......... 0IIlIII'I _
    ,__ dP.·..
    N _ _ "'."..,.."

    -... '- _ ...


    IIOCl • • • • "'''' " . . . . .
    ft
    _ _ _. - . _ 0 1 6325......
    101'' ~~

    ~. nm2 ' " " 1M210 S3""0'I 19&1 ...., 'O'OIt on... _ ""' ...... V*gln _ .-
    •• I I . . . paIiD. _ .. l!M2 . ,.. __ ..-.y IIOCl I , , _ .... t>r C'c cb-..,
    .... 0MC:I'.:l $3 , ...................... _ go ,,' •• ..., Lt«:EI' D _ ~

    --
    _ .:.NPiO\iii."'." 19&1 In Il1n.,.. ,.."..._ , lol::oa b _ ........ C< Ii;;'_•
    . .. " ' _............ la ..- 'MVIo-- .... Ioo<l ~.D-.Iw'
    1O~ , 1'I 19M ... ~

    _ .~

    T1'cIIIn:I'. _ -"'" _ lIu;l •


    """."i._ ...
    ~

    .II _ _ or• .....,...... _b._luuebrr..~ The

    _.-
    1dIDn .. 1980 . _ . . OUW''''w. no.-".... CCiUl'lWy • ....-cI 1986-I0IoII& _ 00Id
    _ 3_ ~"'cnI,IIIIi1dt ."" ,_ _ y.... ~ - _ . _ ....... on
    • _ VHVs _ YHCI . . 1*\1 • I<ey """ .. " .._'" - . . - ... ..., _ ........ 110:'-
    "'.... ,_ ..... _1l>Ir1Irpy to c:orrQM _ "'" _ - . __ " o ~ <ale. ....-Jy one of Itoe
    cWrydra!Dl L-. """*' ana """" _

    •
    af th••hild's b"'"thing, &looK with fev..., abviaus F. edi4t; in ilbleu
    breathing dislms, IlWinK af lhe dUllf' aourils, 111$t .. impo<tln l .. th e paren,,' respon$C ' 0
    and I dmoilll! in of the sp;><U b<1W«'Il the ribs."
    an y of IbC$C specific iUnesscs is Ihc kno wledge
    In the home of Ih. community Malth worker , 11m all Ulnesoes threatea the child'. autritional
    or It I c~n ic, th. rna;o,.;ty of ..... t.....pira,ory h.alth In d aormal growth. And th. proclial
    inftetiOlU COD be dfteti.cly !rOl,ed by in jrojon s signi6ca.ncc of thai knowledge, to ~nu, is thaI
    of penicillin ar by ,abl... ar antibiatics. "'00 SO lhe", .... tWo basic 'hillP whic b I fomily CII1 do to
    comman and $0 dang""",. are ,h. ....pirltory minimize the nutritional impocl of iUn.....
    iIlD<S1CS, that lh ere is now the $lrongo:st possible The lim bas altudy ......, mentioned _the
    CUt for makiag antibiotics Ivailabl. nOi onl y vii
    imponance of persisting with food aDd Ouids,
    doctOl'1 but al$O via much ~, numbel'$ of
    freq uen tly and in small amoun ts, .....n whea the
    COll1llUII1ity btahh wo rk. 1'$ (_ Lif.lint>: "'eIl l<
    sic k child'. appcUte is low.
    n:1plratory iDf«<inns)."
    The secoed io specia.ll1\ention 10 feeding in th.
    Th. cost is aegliKibl. -less than 10 cealS pe, few dlYS gfter III iUn..... 1t io now knOWll thl', ia
    d...... But the dfCCl COD b< dtamatic -a!ml'li$l I
    the bri. ffew do ys foU_inl l boul of diarrhoea or
    ~ reduction in th. p""wnonia death ra,e in one
    I resllitalory illness, a child can gain -;iht I t
    major trill"" far." th, ee, four or even 6•• times ils normal ,*tc - if
    The hes and the grOWIh of child...a can panicular In.nlinn is paid '0 feeding. ~ Iture
    thereOn! be lihelm ed, if nOl romple tely pro- ;tilCIf has Ihere"'" provided an opportunily for
    t«"led, again3' ....pJn., ory infectiaas by empower- catchin g up on ,he numtiOllal l".,... <u ffered in
    iag parmlll with basic knawledg. an b(ub prem> - timcI of illness _if parclIt.know thallhe o pportu-
    uce and lreatmeal and by empowering comm- nily uins:-
    uni ty hca.lth workcl'$ to \IX antibiotic. (_ Life-
    ~No 'WpClIli€ tI/fll i.las i'"PII'Ulal ~ lAc rupid
    lion: Acule ....pinlory infcctions).
    r«<1<J<ry "f pr<-iII_ writ!u af... an". i>lf«rilm.
    Finally, malarial illness must be included Ftxid SIlpplnmrU dun", rhis ,~"'" "' fiw !ky> i"
    amana ,he most importall l Ihrealli 10 the life IIld ","N/n(trra "'lIY /Ie _ of 'M """r ,ff« riw """""
    growth of child...n in scve:al rqioltli of 'he "f ,tdtIci", IN "u'nrioMl ,ff«r of i"fH'i(nu tmd
    devclopillJl world.n In Africa lion., malaril is lUlun.., rM","';"wd aM,.,.;,......1MDIt~ of 1Mchild.
    now CiiIUn>led 10 b< rcspoMiblc for the dtatbti of nis "IfMim ftctli", wi.h ..tidily dift'rtd ftxJds,
    almost I million child ren I '/=. By the end ofthe abti"istertd 'lumttilwr ,,.. t!4;y "I"""r as if ""
    dccade, it is quil' possible thll I 10fF-«lSl a.nli· pmfflp,ilm. BMr 'M oppottNail)' ;, " ~f tmd
    malarial ,,><rio.wUJ have laken its place along- fWri", lIM which"""';,....o Itt widely ,><pwid."
    side the other vaccines ill ....'ional immunization
    programmes. But in the meantime, a dcg~ of
    basic protection is possible II ,elatively low cos,. Growtll ched i"l
    CommunitY health wod.e... 0' villq:. "nlnotccn,
    can distribute chloroqui ne '0 all molhers-In-be in In all of IhC$C ways, paren'" and families an
    ord '0 p... "en, malaria in pregnlncy (whicb is provide basic protection for ,he Ii... a.nd nnrmal
    d ly l\iMCilled wilb both low bit'lh·wrighl and growth of Iheir child ren _ IlOl jwn against malnu-
    mllemal monallly ) and to 111 young children tritlce or specific iIIdividuaJ iUnCSlCl, butljllin<l
    who $how sialtli of hly-fever -tbe major symptom Ih. <}"lI«gjstic oombi:lltiOll of the lwo.
    of malaria. ( ROUline t:hlorOljuin. propbylOl<is is And it is o.s:aiml ,Itis bocqround of possible
    no Ioager m:ommcnded for yoIlag children IS it protCCl' nn llro.t..ics that the imponllLCC of rq-
    can interfere with the development of Ihe child's ul.,. g rowth checking is Ihrown into clear "'lief.
    own immunily.· C)
    Regular monlhly wci&lIinB, and th. m:or<!illl!
    of ,b. rc<tIltl, makes visible the subtl. , vital
    process of th e child's growth ~ dnwing • lin.

    "
    [ THE SfATE OF THE WORLD'S CHILDREN 1986

    Iodine:
    protecting the mind
    r~ ~ $ua1ll11"" ~ n IhI$ rtIPOfl IO,,lUBtorl 1l/IlOI811't'>es .. !UCfl CO\lnII1IIS as
    ",. 01 DlmosI ~ ........ lQII BuI_rl'/ ~, eo.or-, CIwla. Bta8 , [ _ arod
    etlecINe om .... parlSII'II 8Oluliont .-0 .... lor Z- 118.. hIiPtd 10_ _ bortl'-weoghts v-
    _ llI'ObIoo'rIll _ IlIhlcI ~ n l.pIlO/Ic ...."... II'lOII3lIIy _ ~ oct""*l ••
    1*11 cI .... _ A au.lIr 01 " ' _ . "'I . ~ Q _ _ In oet*aI , .........
    .·,...-eallW 'OO.'"

    ----_._-'"
    CI'obtn. b' -.pie, . . " ..... Jrom - . . .lIfO';II'ilMllIt
    ... _ 0110 _ _ 1.. 01 DarnIllOnll
    t.lcn
    ~lC" "'_'*-.g_",~ _ll't9'
    ~

    PaoJIl_Gt.-
    De ...... - . 'ttl! IlIdr.tIng SIlI-1he

    --
    ....-sa
    .....edy -~<ri,20'3 _ _ l *

    lolIo Ard_-.g . . . ...,.


    OIo_. ..cl..... ilJIt,..t
    _ ""*zed .... . . . . - Il'\'"';' • !Dr _1Ddtzlng
    ........ ..,11> _ _
    l !'Iooql br..:l _ aq:IIoM .end - . II.IgII'
    wr ••• _ _ 110m ......... r - _ _ ".~_I&d'''''''
    ~ regG'lS ..a Ioocl-prene _ . ~ II) _ £... 10. hcustl ...art.1"'I1I b
    ...... _ _ 1ft! bw .. iOGne sew. • PClOI~ . _ _ ~ 01'"
    "",,,,*C. ca'l'*S ....... 01 oC , 1_ Ill ' IlI'Ilb*!I dCr:IAllO oe-. 0 "',.. ___
    __ IIDn _ ..., . _ tor mz.l . ......
    .."",...
    ~ ~ b N ~

    "'-ll"""9'. pCO' ~ oxotlo __ .. gtIlQ ,.,*,-~~ .


    ~ 01 f'OIl ~ gland II 1IlI!l _ oIl1'oe a.I ... ,.. ... _ 01 o;One ~
    1IvOIIQ. _ _• _ . . . , 0 . . . . . " Bu! dolor"'" hM _ _ . ....,." ..., _
    hi GllnIllQll dOnI !:PI \eS$eI' dlq_ 01 I(lllIne coo.-IlnM ... 1etumong 10 "'" allad< s..er..
    defoeoCf .~~'ecogr'IIled E_
    moIcI _ _ dIItce-cy l.fIdeI..-.- choIllloo', p/ly. Mclelwl 00"1"'"'" iI$ h;t>e Iu1ched All IOlIIlrlII
    " Dgi'llII1II'm , . . . . """""ll """ """ 01 • fM;t.
    IicIl and "*lllll grawlh. S8PIlOOI Ther llIllIIlIV IlO<l yeJIJI d""'O 10 in11C12 moIlootl ot lIS iXlllUkIloon 0118
    -"'0 (/Ie J)(Ol/teSS 01 IlOlh ~ and ....... 1I""u".,.""""" ompotI:S ,r. sa~ ~'"" _ .
    ~ onstaIed WI o:xhong plan! at • l>otdw cr-.ng
    I\B$
    - ..
    - . ..
    SO"'"_ cwr&l'(1 .-II _now l1elIIed_
    _ gooIreI"",200 n h;lla
    _
    lo<:!of'Ill DeliOeo'Cf" ~ n .... Andes ..
    fI'IIDloll<IrIca. ~""'oIln1 SaIw ..",.
    _ aoc ..- . g mm .... _ C.,-.gIl al ..... 1ronl_~iCY.~_.-
    -...a ...,.
    . . ,lIj. . . . I O ~ _/I'Il,lrm_ IDdIllng
    1nII! ~ ' I . . _ ........or
    Ot'ft • """ 01
    IClile<I ... N
    ... CIwIe _ """"" _c..n.. _'"
    ~ "_",.1CDled
    -
    OIi'l'C\lOO lOot."...,
    01 ~ £- . .
    _ _ gooIr8I ..., .. InBotwo SS'll.cI~
    01 1<1 I!> ........ l*IIIla ... N """'- _ P, .......
    ~
    ~....,be-''''_01'''_ ',
    - _ c , -..g pcy..., In " "... '" M ".~,._~~~ 'Co:on:1I lcrh
    Oookeq D8c:<'*1 _ _ I. . .., . . . . .
    ea..a 01 _
    . . . , . of [...aer, 6O'llo '*Ill'*- - . . ..

    _ ...... ..., .. ,.,..,.....,.30'l i __


    ......,.".lMlQI.ii '... ,., 01 ~ ' ......... (19M~ "'" lNC(f II:aXIIt. 1<1 _
    ...... ... ~N~c....I-=ai _
    gCIWM-

    -
    """*'....-. ..In:Iil. z.. ...,110m"""'
    In IIogit _ of
    ~
    '" e..-.
    "
    01 _ _ . .
    _al_<lli.. .
    ~
    producas, ~
    , . . . . . ..., t.cIIIng ..... -
    -..:I IlIl _ _ ...
    c~_Ien~

    •
    whi(h is th~ child', 'lifeline ', the sinlle mosI fail to pUI on weigb, ov'" I I W()- or w«-rnornh
    impom.nl indiclilOr of its well.being. period. Special belp is th rn ncoded -u it is th m
    dear lba, the child is amply no! getting enough of
    The basic aim of rqull\f growth checking is
    'he righ t kind of food to eo, Or thl! there is I
    <.herdort 10 gi"" pa""ms urly . .m ing if a child 's
    spcQfic hcolth problem lucb IS I heavy pa.rasitil:
    growth is beginnJng In falter. At <.hal early Sl<lie,
    load, or cbronic OIitis nlCdia, Or silem tuben:ulG-
    _ chiJ,,"n can be PUI back on course by <.he
    sil. In this WIly, the reguJu growth dlecl:ing of all
    ronge of !W"OI-based IICtiwu jUJl discuaed. Bath
    childreo also allOW'S ot Mr taOIlfCCS, whClher il be
    <.he lechni que of det"'lil\g tho problem - and <.he
    food lupplcm:nu or more Iptcializcd heal'b care,
    pncical 5lepil' wltkb C&Il be tum 10 remedy
    it - ace cheop ."d ample enou gh In be pul 01 <.he
    '0 be uxd more efficiently by being largeted '0
    <.hooc llIOiU in ncod.
    disposal of <.he \'1$\ llIIjoJily of pIlfents. Thol is
    wby Ihe gro wth cb«kina lechnique is pot entially BUI in the OlIjorily of ~ Ibe VIlli. of growlh
    the g""" lest brulr. lhroog h of all ..aimt Ihe cb«king Iia nOl io the lCftttIing of chil,m, n for
    malnutrition and ilIfectiOll rom pl<:l ..hic:b hoJ~ lrealmen, bUI ill the edl>Clltion of """,ou for
    bock the nonna! dewopmcn. of"" matly of Ih~ prevcntioa. n Il is wby there is vuy little 10 be
    dev\'loping world', child""n. gained from tbe groWlb cb«king tecbnique if it
    "'1 the monthly growth cb«k, hcaltb workcn mcrdy mttIlS lhat I mother qu~ea up fOf an bow-
    10 u ve her bahy weighed hy • healtb " 0"'''' ..ho
    C&Il di.. uss with the parents I ny and all of tIM:
    10w..coP actions now o..-ailable- whether it be <.he tben dra .... lJIeIIIinglesa marks on I mt:Iflinglas
    liming and .pacing of b1rth$, Ib~ nM:! fOf ema card befon' calling for the nel t mother ill the lin• .
    food and lUt io prqrulllcy, tbe impozUncl: of I To fulfil iu JIOlential for drastically improving
    full coune of vaccination, the: llIICthod of roping th. nutritional hcaltb of childl'cn, grnwtb . beck·
    with diurboeal illnc.es, the importlllcc nf con·
    ing needs to he o'lonized on • mon,hly basis for
    tinuing In brel lil-fM:!, knowle<.lge of when and
    small groups of WOIlltll, p""fCl'lbly It a ntisb·
    hnw 10 Weill I cbild properl y, Ihe reasons for
    hollJbood gathering. And if tlte ideo is well
    frequenl Iwld~g with IOap, or lhe value of undcmood lOd tbe weighing itself i. wdJ orp-
    Jl"yiDg particular on ention to penislent fOC'diog niud, the n gro wth cb«king is something whicb
    during ...d immed.i.olcly afler. child', illness. lboukl be looked forward to IS I time for mOIhcn
    ""d because it iI • rqular lICIivity, brinjing 10 diocusl bow thei r child ..... In' doing, 10 meet
    mIllbers and chiJdttn iolO monthly and predia· and a clwlge elpetlCllCCl; witb friends, to spend I
    Ihle COIl tlC! wilb community heal<.h workeR, relue<! ...d inftll'tnativ. few min utes talking with
    growth ched :ing proYida the ideal opponunily <.he hcalth work r, to bin ,he chance to III:
    for beginni ng to bu ~d COllUlIllnily.Nscd primuy questions and rnsc.....rn... to pick up important
    hellth core. It can provide, for ,""""pic, • praclical tips, to fel$$Ufe th. msd _ ... d be
    pnctical focus for the demonstralion of bow and complime nted on the fact <.hit their child iI
    ..ben 10 mak e and use ... o;nl ""byd...tion growing weD, or lO gel an c:arly warnin g and ~
    solution. It can provide I fol'llJJl fOf lhe visit of an ""alisric advi ce if thing s are 1lOI.
    immunization leam or for the dis<ribution nf
    vitamin ", supplclllcnu. Il can be the aetivity
    hi ruch I Itt'ing, the idea ond importance of
    growth cbccl:ing nn be und....tood by UlOIhcn
    through wbich to supply paren ts with cbIllfOo-
    quine tlbleu or anti·Jl""'Sitic dl'Up.1t can be the
    who llIlly never hI '" bern ro scbool. ."t
    its
    amplest, undef'ltlllding the gro wtb dlecl:ing ideo
    npporI umly for parents tbcmKl _ to dis<;uss
    means undemanding <.hI1 I normal beall hy ehild
    th rir """0 rotJctnlS and priori tiea.
    should be s liD ing wcilbl evcry mon lh. On the
    NOI ItISI, regular lrowtb checking provides I curt, it means undemlllding thl l I risinS lin .
    filter for finding thllS" dU ldtcn who arc It sp«w meana I child is gro wing woU, I lcvd Iino means
    risk ."d who ncod sptcial help. Even if """,n ts do ,bit thorc In' lhings to be dOQ~ tll get Ihe line
    all ' Ut is no w f'OIlo'lble 10 ptOIect I chi ld's grow<.h, moving upward. "el t month, IIld • falling lino
    Ih= will still be a minorilY of cIlillInn wbo will showsIbll there il l dtfinite problem ..bleh bu tll

    •
    I THE SfATE OF THE WORLD'S CHILDREN1986

    be IIClN on li night aWIY &lid which I mother


    needs help wilh. And;o nplaining th is, lt is nOi
    the moth..', iiItnt:)' or numency thn lIIIlt crs, But more imponlJlt .han 1M m«honia of th e
    bm ,he lim< uken, the setlsilivity shown, Ind the growth dart ilXlf is the principle of 1"'=',.1
    reaI.is.m of the adm given. involvcPX1lI In the cOlI tinUing promotion of lb.
    clUJd', ha hh Ind growth. And iD tha t sense th e
    For III the dif!i<:ullia: - . nd there are maoy child', growth cbart -ill Ih. hilJlds of the moth-
    - thl: ro nctpl of groWlh chcd u "i could therefore er-is • "l""bol of • ch",,~ in l he <:ol>I:epl of
    stand ., <.be cu n ", of ,be web of $IlPpon which ;t hallb arc whkh could bring more benefi'l'o l he
    is DOW possible fot PUC01S 10 , prud under thor d e. elo~1lII world 's childJu lban any lechn ologi_
    children', heal th an d normal growth. aI ad"""",,_
    Al the mocn<nt, d iffc",nt kinds of g roWlh Fim, lhe growth chan iI a prxtial symbol of
    cham are being introduced in different co unlri<$. ballb arc as ,be "OlItinuing Pl'OlecIiotI and
    Scvaa1naticns, inl:11ldins Brazil, China, Ethiopia, promoIion of heallb ralher !.b.o.D as lhe periodi>:
    Haiti, :mel Indont$ia 1\.0..... dl ~nlly d",WJ1 up IUpou"" 10 illn....
    national "rowth cham lfId an: in [b. p1Otf:S$ of
    isluina ,I><m '0 paKOIS of aU young children. 10 Second , the g ro""b chan is a pn>nK:al ll'mbol
    InlIII cases, Ih. growth chart alsocarries infonna- of Ihe chanj; e from Ihe idu of beal,b eat" as
    lion abeur immunization and ORT,.booll brust- passioe recipie nt:e of set"Vices 10 a co nc:rpt of
    fcedinll and chi ld .pacinl, alld about OIb.r Iow- bealt h arc wllich sees parenlJ as active parti d-
    . "", action. which the parents of • particular PIIIts in Ihe promotion nf lb eir own an d their
    nation or rqion C'lJI take (0 pl'OIecl lhm OWn family'. halth.

    Children and world development


    Growth d tec:kiq an thttdom d raw together packet of ora.I rehydrltion lilts to pnYCIlI . chi ld
    I nd unify the range of IoW"",OIII parent_based from dl'ina nf diurboe:al dehydration roold be:
    Ktlons now l vailable fllt protening ,he life and .<aid '0 be: merely luaekinl S)'lllptoms. Except fllt
    Ihe normal development of I ehild growillll up in lbe flC'! thar lb e symptom aIsI'l hlppens to be: a
    I poor .:ommUDity. to rombinl!ion, \hose KUons child's life. And o:wept for Ihe flOl , hal l b"", illIIl
    nOW hove lhe pDlCIl,iIllo live Ihe ~ve1 nf at least o bvious and profound <:otInecIion between Ihe
    bolf of Ihe 40,000 Yl"lllll ch ild ren who are DOW meDIal mel physic:ll dovelopment of child ren and
    d ying eoc:h d l Y in ' he deve loping ,,"arid. JUS! as tho social and «onomi<: developmenl of notions.
    imponont , ,hey rould belp to prolecI lhe groWl h
    of OWly millions of lbe develOpWl world'. infants
    Any action - like \h e usc or oral rehydl'l.'ion
    an d ehiJdrc,D.
    s.alu or inununiutioD or improved wean -
    ina -which protecIS nOl only the chi ld'. lifo bUl
    Thol is wh y \he J't<1"D' o PPDn Ullily for Ihe lIS normal Irnwtb, .. tbomore simulunOOUlly
    pro1<cUon of chi ld ren is oho oornraJ to the J'<lIC"1lI Illadting boIh "')'lIlplom or poverty an d a a _.
    of devtloplnc:nl.
    The aim_ mel the pDlontiol _ or the revolution
    O t2rly, higll d""lh ral eo, prevalent malnulri- in child _U_bc::ing which ill nOW p)lIJiblo, is
    tion , and frequen, illness ore elosely linked 10 \herdore nOl onl y tb e Jiving or liva hOI the
    poveny ( Fig. B ), And in lh a! sense, using • pl'OItct;ng of RfOWlh. And o n lhll basis, tMre is

    • •
    abo . powufuJ ...:on<llllic euc 10 be made for an Ih~ nq.Iceted factor in the SUUUlc for 1!C00omic
    aU-OUl d fMl 1<'1 pUI whi t is ntlw U(IWII ot the: developmenl. As Nobel Pri ze. winning economist
    dispo$Il of III parmlS. Thea Schol tz has commcoled: "/0I<1tOfeJ ;,. ,..,
    ""'ioirtd abililits af r-P1t. ,It""', ....., lito ttJlJrlJ, alld
    To cil~ on ~ . p~ciii< eumple:-
    ad~ ;~ MJlftd AJWWIt.dge, /ro/4 lit< My W filIo n
    M1'M km,-'mtI .fftcu of "",I~w;,iart ;~ ;"fa'lry tc"""",i< pmloc' ;";/jI olld'a """ ,; brlriolu w It""",~
    alld rltildltDod 0.. O1Ily ",,",I/y btUtg "",blilW ....../I·IIn..,.-..
    Thw ;" a 17-yoar foIlauMlp "vdy of llIdia~ "ildml Similarly , th~ World Bank, in ita lllOtW repan
    KordtT {rrJt. ""'" iL''''' Md n4fnod r«01Id #r ,ltird- 00 th e progress of wodd lkvdop<Otlll, hu COlI_
    dtpu "",I"o,riri<m UIfff f"" M '" ...." a j tJ':' dtjri, c1 oded: "FnD """,III dispou lAoI 1M "a/'It, d ""....
    iw m d capacity, Ilf YOUI ,,,Mu, iL'.m. UJ1IlpamJ I;"" alld wtll-btirIt of ,It< "",jority af ,.. po.>pk ,~
    .."",, ,.., utd pnforma>lLf af co,,, n>t JlIbjlfu Jr-
    ,....."" social clasJ OM ";IIOf" .~t
    iJufll$lrialiud t:OOnll'iQ art! ~ ' a/iU, Ilf well Ilf a
    "",I~ af narional /"O'JJeri/jl. S ,,,,ilarly, ptoplt. fIIIu>
    Similarly, il is II.., known lbo, men Ial de.-.,Iop- an wuAd/1M alld...,,t, ...... Ijll~ ""'tri""'.... 10 a
    mtln ml abo be held bod , by poor OU\C;tiOllai CIJU"'ry~ """"""i< "",",It" ,'
    heallb .
    From her<: it is bUI • shan Olep 10 Ih~
    By lb~ q;~ of Ihree or four yurs, 90'10 of 0 c<>ncluslO<l IMI s~nding an I u<:h so:l'\'iceI as
    pmon 's braio ~11s are .hudy lio ked 1M physi- bealth and ed Ul:lllion- an d especially om the
    cal <Ie.-.,lopmcnl is ad vanced 10 the poinl wh ~ re protec,ion of rhiklA:o'. oormal growt h _ sho uld
    lhe pa""" is $leI for Ihe r<$I of 0 ptfWJl'S life. lIOl aUIDmlucally be listed Wl l he 'c<>olUJ:llpi ion'
    ThCItsc early )"eIJS therefore cry Oul fur pl'Oloc. side of Ihe natiooll ocooomk oqual ioo . For they
    <ioa _ both 10 ddend. th~ child's tiah' 10 Iif~ md are 1M most ~ of invemnenll in hllllWl
    in ri3hl 10 d~""lop 10 in full mental md ph yskal cap ilal. ArId if il an he "'own, as the World Bank
    pottlllial- and 10 iovt:U. in the: developmc:ot of has show in !IeYm.l specific illsJ.ance., IMI halth
    peupl~ .., thallhey an ~ fully <:oolribuI~ 10, <In' incrrast:S wnrk capaci, y or lh ' l primary
    and brn~fi, from, I h ~ ~ll-beiog of th~ir famili.. ed ucaooo iarrasa lbe produetivily of f,rmen,
    md nati OO1 Ihen why sho uld spc:odi og on bcallh or educa<ioo
    be classified I I 'consumplion' ralher l han 'ioVCSI-
    In man y pons of Ibe world, il is dar thaI mtnt'} ,
    <C'OIIomic: <Ie.-.,Iopme nt win l10I Iifl the mojoril y
    nul of poveny wi,hin I h~ nel<! few )'nft. \l7ilb Equally d early, a renewed Slress on t be impor-
    lhiI ia miad , • = 1 ~pon prepared for the l~ of human capilli leao;lo naturally 10 I
    WHO/ UNICEF Join, N olrilioo Sopporl Pro-- co""'"' for ,be special problems of Ihe young
    g""""",, hIS coo duded:- ehild. ..... HaIlS Sioger, Profew>r of Dl:~lopmenl
    EcoO<lmia" Brilain'slnstitUI~ for DevcloplMnt
    " ... pnlul". ,.. ""'" ;"'J>Ol"I<I.' toa/ '" . triw Siud ies, said " I UNICEF O)'fOposiUIIl held
    U/fI>2rdf is '" prolH' II_ ""'I'lt IlIIddtwlOf""'t' of earli... this year. " A".)' 1tml-1nIIO ptllicy of "'"",w
    ,.., "fXI,.-ari<m of yo""" "ildml ;" 'M ,"""III) irrvnnll"'l or Ito""", r" pi",/ farmol;"" "'0" IWrI
    pi>IlI"t$l rqiMt~ I, iJ tIrtJt , ltildrrn tMo ,"WI
    "';11t lOday'. rhildmL.. "",I. om ';"" a"""'fll rMId·
    ftlflllI".lIy Im4 IItfi, "",~,ria 00' of «<mom ;"
    "" Jraj ""'" dnIIlf'a,,'1lI ~-nd ""'" ;rmJm['blt alld
    "apa';"" OM iw", a~ "" af rapid dtw lo~~ ~' ""'" Itmr--""" tff«1J "" ,It< IoIU,. prodoclivity af
    , lti/dmo IIta.. is ,.. 'lUf lDi,'ado/I$. '~
    BUI in Ih~ real world of """'Ot yean, lhe logic
    HWIWI. capillll of investing 10 childltll has made Iinl. progress
    In l his :It'Il s<', ,h ~ ptoll...,u"" afforded 10 Ih ~ IIpinsl the: he.d wind of eoonomi c m:essron,
    mernal ...d the ph ysical d.....lopmenl of chi ld.." UNICE F'. 1984 slody of no. i",f'd" af _ 14
    is ... in..-..ur>cOl in homan capital. ArId ioth~ lui IfaSricm "" , lti/dml documenll th e cu t· hoclts in
    two decadca, lhere h.. ~n a g rowing lttIizatioo gOVt """"", .pending 0<1 sU<:h services .. hullh
    lMI h uman eapilal formation has perbaps been ...d edoca lioo in the early 198Oa. AMlhis yur'l

    "
    -
    .... - 0
    ".."!t"ll"1il
    --.-t'·- - 60'1 ... a s.a a> 0 · °0 "1'''- -roo ,-,-,," - 1"·11
    " ~'<.~ 0,F .. s:r~~ .~·;;iJl.§.E:!5' j;'Il_"B [ i ·!.i :i: ~ [~~H§OS:~§.w uu -
    I ., .... . H~ , if, 1i'::: ~'i=. ="a. .. - nS-!:lii I: ij ~ 10' &
    ' Cl5.- 1l=!L:rI~1 _ : q-
    i'~ 18 g- CT 5: iO ,Ii =' ".", ~, lfmS!,i'~I •.
    i!:W a.,i~:' r'" i- ..... as e.· ! t"'·l- ., < 9 ,.~
    o:l 5l!', ~g"l;lz ! ,., ~'It6: t:!11 -". 'l!
    " ,,"'" ~
    :"' 0"'Jif[::l~ " ~ ~~i-~ g-E' _.~s. . ll'[ ~ :'~lF e ~ ~t~ a.~l- ;.~.g [~ ~: 5
    ""',.
    ," "i[" •,0. ' '~ " "<1
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    ,I-i ~!:l" it~ ~ ;;!. ig:[J s.c.~~~i" [;s~[tt~~·r~r;. R"~r~~
    _ n n _ .
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    'gFl~i &8. eJ i.<::?J~ i ~ :' o ; Il "g ~~ [!! ~ ~ ~ § ~-=~ ~~~. f~1, S[
    g~il~~B §'S-~
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    "",11 '2 i'~'O~a.ic. Eia.·° 3:':a" ~· lOi ""11-1"-::1"
    n,;'·!·'RI ~ a ll &; i!.C;; l;' s s '" "'Sl ~
    0;:
    a,~ g- ~ ~ P: ~ ti a-a,; .S!J ~tl ..illSglO ;'1I'~~-!ii" "S " i~ ~11
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    ,... . [ .!1 ;. c:'5I~~~lf c 1m g i ~ ? e. ~
    a;l:I e-a: ; 01 ... :I.a.;; ~ l': ;; -~
    •,
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    II
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    I"0 ""5 ,Il"~
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    e... r.e n
    - 'j;! iili ... ~ .,ttC ee a I ~.
    ~
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    ~ 2.[ g~ ~I ~il;.Q ~.g,;;. P ~ .-""~la
    '
    ·I
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    ''i!"g, Ii... ·I .t1~[~. ,s
    i i ,. .. 5_ '< ~ _n
    a .... tlll~ i ~
    "
    01 lbr -"" c:=pl AfrieI touth oIlbr SabanI mlullCd.. la panicuIar, _lrios lib Olil>a,

    ...-
    (FJI. 20). 1Ddia, PakiRID, l nM= ril, and ThailaIld, _
    a A-. raI. iN OI 'h Dw ber:Il .r- !ria wtIicII !<lIftha' ll'C IaDt 10 Darty b.aI! tbt
    world, haft ac:JojnuI. Itt -m, 10..,,55 DeW
    '"ds of ....~ f.lhr Ina - ' &f'lI"'tb 01 tbt
    ! If . ylURori<:olllaDlbnll, llacx I t t . llomlft'tillion (we ponelll ) ,
    abIo: adUot, .... Iku: i1 iJ cquallr dar 1 _
    ~ pull oIlbr cuth'5...n.:e,um prtII Us 8uI ia 1Ub-Sahana Africa, II Il1I tbt ...td ....
    k-. dt.eJocm' _ _ Ollly _ 10 l!lah
    beaI sh''''''"riDI1O a hah iJt <M bl~ 19701 &ad
    bal btpD 10 Ilidt', arrym, mjltion. III "'."iIi.,
    my 19101:- bKk '-m do< tdI ~ 01...t.isI"""" and bc:ll od
    111 Latill Amtrica, .bne aVI:faF ""'" ina-cM1
    b.ut faIIrll by • rna _ l ~'" ill lllally uoo., Tbi:I rear , l op<Cial UN ICEF ~ oa M rica'.
    tiltrc if frqmtawy ba l oIanDiq aiclcllCC 01. comp!n: prol>lem$ has a1rady beaI iawtd. Tbt
    riao: ia 1M iacideua 01m:alI1Ulritiorl and iUMIa, in bUlDlD COllKQ_ 0( u.c.
    problaDll baff beat
    Ih~ num ber 0I1ow binb-wciSlu boIbic1 bcilll 110m ICC1I oa Mually rvetY leJC¥iaino ICrfta and in
    ( Fit. 11) , ia 1be ... l~ of illfanl and chi ld dWl!s, M ullly rvetY ~PlptT in 1M world. Bul lhey
    and in 1M nwnben 01 chik!rm whn ll'C btinl bl ve oC"a" beat mort 11IOVinIJy ea praKd than ia
    l bandoned 00 1M st rffll oI 1be citiQ. 1M I'oaocompanicd """"" of on~ of Africa',
    f0ft1ll0ll1 novdisu, Chioua Adl~bc::-
    On ly ;n /WI, whffl: Sl:""ral of Iht lIlO61
    JlOPuioua nal;O<t$ h.a"" ~D .bl~ 10 ia $ulalt "No """""... tnUi d iU UMU "''''' IMI picr~ ..
    IbtlllM:lva from lht worn t lIma of the indll$lri- of 0 pr. """ 1-'1: _u ... '"""
    ...., ..... '11mdtnrtll
    ~ world'$ lflC:CSSi<lo, "- pros ..... in child '" forFL •.
    beahh and oulrition beaI mailllaintd IIld tvtIl ~Sit ~IJ " , .... ,.a. Itt_ .... w lA, frItd i~
    Mr 'Y' lIIo ,1uru of" _ ... ~,.... a 1._bttI,.
    rwJI ir 11ft .. IoillAoJl ad ,.", - n..,u.,
    ill .,.._..,." ~fJly .. f/tUl U.
    FIg, 20 Food production per person,
    ../. _Mr lijl ......l1li ......... • Iillle MiO'
    Afriea. Asia. lWld Latin Am8i1ea, 1961- 1983 lICIo[""c-.WIIU tejon m ~Gl_ldooI;
    _lIIPO' _ _ -"""" _"" _ _

    ,,. ~b' 1981 4 1- 1lQ.


    _ ' " ftl illiM 1'*'';'" Jo-n .. . no.;,,....... •

    ,,. "uffl]' Nt 01 po_e1. ...


    E.... in w!lcrc lhcft b.ao beaI DO "Yo:
    '" fIlIIiDt, lht 1lI;,,""",1 10 C!CWW!lK criID b.ao
    '" _ I• cvnin& bd< oIlbr kind 0I..mca wIDdI

    ! ""
    Itt till. for tilt prmcflt'lioa 01 bod! lift and
    '00
    1oIlI-ItfDl dewdoplD!:llL 'J1r't'1"k 01 IC!lol:j..
    Iadlcn ~ bcaI d' , • and _ 01 thous-
    OS . . . 01 dWdR:J:l an: _ btinI cd_Iod • a
    so rau/I. food $Ilt.idic$ fOI' prqIIaIIl IIllItbc:n Illd
    cbiIclrca an: bcinrI all bKk IIId IDIInlllritioa ;"

    "
    eo
    mtIIlltIbly OIl lbr me.-c ( F'" , ll) , Oinia Ire
    bdna: ~ and immlUlization prtIIBIIlIIXlI Itt

    -----""-_
    btiaI brougho 10 • bal. r. <be lad ol fIId and

    ----
    7~ 1l1li1-«1

    -- .. _
    _ _-
    ro

    ~"" " ---""-


    M

    ......
    M JPIl'C parU for m.idca. ~ OIl aaeolial
    IOdaJ Knircs ba:5 fallc:n C'VC" in cou.ntOca willi tilt
    . - ~hy u'Ilek ftlCOfdI 01 <:ommitmetU
    to lht p...ection of 1M poar.

    "
    I THE STATE OF THE WORLD'S CHILDREN 1986

    The Code:
    a progress report
    .... PO<>' <;(lImUlIly ol lhe <11'. "~og_ .
    bOItle-1ild _ ha'<e beer! ......... 10 be two 01
    o," Code r~ _ rn"""" ..om""'.
    lly

    .......
    and i waltino;l '-\IlaIIIlIon
    _ _ mote likely 10 <loCI " "'laney 1Iwl E\OIMlI. Cllmetooo, cen~a1 A!ric¥> FItIlubl>c,
    b!Iboe!l who .. e ~ lJINIl.fecl1ot l/1e Ql Congo, CoslII Fbca. [OJOdOI , Ea-. 'f.
    Cull..
    ".,.., l'IdiI . III. . Jordan. LesoIIlO, I..IOya. "....
    ico.~.~. p - . , - . s.-
    &.ol 0':"1 '11 '" '0 • on !hi _ In "'*'Y ........ l.kN.~. f - . Ugi;Inda,
    ..... S-.
    "'_01"'" ' e .. --'d_"" ~Zi,, __
    ............... msbeen o Code ... _
    __ ~""""'_of"'"
    1ltO'~_

    New~. ~.
    ... -...,. ___
    s-lon. 9,no. T _
    11'0 ..... 1981 , _ a _ _ ........,. by . . , 'CIloIpI Y' or

    .In_...
    --
    5 . .

    - , . $ . . . - '"II'"'"
    ..... an:l ••• -.oal ............ roe Wootl HB*l o s- ...... e-·... oo '
    ' " ,• •

    • 'lOIW adIIIMcl "" I.. ... e-ol .....· e.-. a.. Coc* IIlanIs. [l s...
    -.g 01 e-...m.. no. e-_ AusnloI.
    dOr. r_ r _,GItIon.c.r....Ooo.__
    ' _ (I i ...
    Roc>.&.IVou Kcng , Ioary eo., _ .
    . . _ , $

    CO • • - . 10 PI'*'" _ --.-.
    -.g ""'" ..........." c-. onOClU__ OiII -.~. " - - - Pl T-.cl

    --
    c
    ~ "'" '... _ 10 ....,
    ~ Ionnl.Q o:tIftdly 10 . .
    .... "'00'_", of
    Iltaol: or ll'InltI;tl o CollI being IINdlMl by wM<lng PMtY
    ~. BIIw. ., Ilio'llllid""". _ f..,
    (l.«u VcIIa) DerwnlWlt.. J):'lrrww:a .~ , Hgn.
    IJosl ltIIan1·lonnula m;'I.... ,~ havII K- aCf. ~"". Wt IWwaIl r.IaJaoM, Mali. Moroeco
    "'IlItoi 1". Code', """" pr_ ."'
    ~.
    r il T!llI ccee ta" on.,. become Iut,o el'klctMl d ~ IS
    Panama. ~ . 5eoutlI AI_. Senegal, ~
    Vincenl. l anl...... Tufl<l""" Caicos_
    ~ lIP 171 na\lOrllll ~. In lNI lour
    _ • lWl 'fC*' -.:e IN Cocle _ DIc>Iea. "'"
    ec_ ·
    o NarioNll QQ<M 01 n'Wkellng . . . - dilculo-
    ....... ig lion ~"""JICIf_1inlI """"" 01 !hoi 111,....._ 1
    eoa.'. pooo ! II

    _.-
    o CollI in _ .. aca.I ... ........ ~. DImwit.
    "o!aVM. SoIOIn 'Ufkey. V.......
    [hi ' AeI>IoCIIc.
    ~~ Ponl , Sn l¥*lI
    o SooneatlMe-ln _ o v - . . y ooa. po_ell by - , - ~
    ~ o--t<.
    I .. ilral:tl. ~
    E-. _ .1IIIr - - .
    ._
    - 8'
    r--. f"rir4. r _. a..n.. ~
    ~
    r _ IIIipo.ak at e.--., _
    ...... $0 _ _ S
    II

    uw,,,,,a. u.-l KiIgaoIoI


    $ . - "

    !'IcY ..... ~ T...... ~ z.e. a-,. .............


    ¥~.".,. po_ell by _ . '
    z-.La-=_
    0 <><- ,0_ 0<000.. _
    , 1 II>:

    ( _ (eolOIlIC ~ IloOI"I e-
    ~ ~ a-. cu.. CMc:I~_ _
    '"

    -
    0."...._ r........ ~ ~ ~
    ~. fbf._ SoooeI iJI'JIOI\- logo, VIlIl

    "
    As UNICEF hao arped ill its oprciaI ~ OIl ~ ill tho ch..ll....,.. or ~ tbc .........
    Mnca, 1CIi\nlmm1 to ""**""' mas Da!d DOl
    aDd IIloUd DOl iIl~ iDa....... tbc pootm)' alld
    thai. hal boIII:Il made aDd of COIlJlnIaiq • Afny
    lln of bosi< ptol«1.... bda- orhicb tbc pooral
    dcprincil:. vi • ..moa'. poon!SI &mi ' W Sc-if. ramilia aad chiIdrm ril DOl be .uowed 10 fall
    QUy, II slIaWcI _ tit Il1Ioowtd 10 IhtalCll thor As iIlc UrWcd Sau.- Committee l1:Ir Dc , I ~
    lifo _ tile ...,..."w ~ 01 tho ............. -..1 I'Iuu1iq " - . " . . .
    Ilk...roo. ....IDY community -lbo childml 01tile -M...,Africa.'WJ _ ..o ............. ..,...
    poor. hoWIa: ClII !he burdclls 01. ,6 • WI 10 tllca ...., _ior _fImI1 .q.-. 0tIwn -u ..
    _bo hz¥e tbr leaR pM'inll IalIICk I<> . . - 1M
    bIcnr, ODd the IaR ..... omic fll 10 "t.ort. it, is ""'" ,. 6qiJI if /My ., .... - - "
    "'"..... m _ ......., -H«L F~ M". ,10<
    DOl oaly llDiust Illd iDbUlDlll - it abo IIlldcmliIlCl
    1M bclIlth ood ar-th <l the pooral dIiIdrm ODd
    ,.....,......../..v ~_alrin,. __ if
    '... .lws _ /It . - ' " ......." .......lifjl, .
    .. copa with Ux criIiI of today OIlIy br . _ - _ rn.r .., lt4u 11)0 NJnaIW /1-,,,, P
    teeiPI more l;li$Q _ , ......
    Apw ..", 1M """ 4«"""-'"
    A bettet way bas 10 be fowld. And Iinc:c MriaI', TM lim wm<h in W I $lftly M1 or pnxfCtion
    crisis is II mlOCb of the world", mal<int: .. of .... th e OIrl1<qits for pml~ Ihe Uva Ill d ,be
    Arrial'. OW", both justice and humanity no" II'OWlh of ' he pooraI childn:n <on """el (4),
    ""mand UIal thc i,u = ationl! community should B....I-f«din8, impro~ wn.n illl (includin,
    lu pplemcnullY food for 'hOR molt I I risk),
    immunizalion, oral ...hyd.., ion , henpy and
    Fig.21 Increase In low b irth-weight, 'I'OWlhmonilorinl, ~ IlDOtII ,be lJIOIlI ,;,01 of oil
    Recife, Brazil, 19n-1984 lvai lable ,..,bniqllO$ for a>ttIm, lhe oco.b of both
    ' V ,a08orN,llOQt _ _ cl-'l<Io. _ ilnn:w:<liIIe survival ...d lhc: 1oaa·ICI1D need for lhc:
    ..... brI1 4 1- ..... :a:c",.,,'at pnxcetioll of arowUt. And !lo;a1lK III of tlI= mI
    he put inlO action .. ... tlli.., ly loot lXIII, lhey ~
    " !berrien pnaical oymbok, ill lhe 5dd of clUld
    l"
    I"
    e wi' criJa II !be _lime.
    wdl-bciD&, of !be pooabilily at copiIla 'II'ilh
    mber u- monpcirI&, the: fu>ute.
    illoatina ift,

    !" '"
    ",t
    tL: 'OJ & Ul'ICEF IfId ......,. 0lXr orpniD·iopl are

    ! , '" iI _ wortia& with pmlml:DlJ 10 pullbne icIc:Is


    Inlo lICtioc> ill both the -u-pubticiad
    _ . ' . of A.fricI IIId ill !be qlliom criJa

    c
    . OJ diffmed 1!troI.p.m .... de,dopiq 'IfWkl ( Fl&-
    O) .

    And 10 Clllldude Ibis )Ur'I tqlOl'I, iI " .~

    aisis,
    10 iasl ODe ............. iii thai quietu
    priare 10 I IUII
    ooe 'l'illq;e, lad ' 0 iasl _ of !be
    10 jIISl
    11m 78 79 eo 81 82 83 84 0
    1DIIIy mjnim· ofllllOlbeca with _bam UNICEF
    ron ,W!OOed per rJO"IIh to

    __ _
    D earn ..-.cIll\1llO;ud'IOOe basic Ioocl
    ~ hili maie t'OCIlICt IW'tt lhc: \asl; f«ty )'Un.

    _
    ..,..
    ' _ ..
    _
    . ----lNQ>--
    ~

    -
    Pelca oI8gII d bot brIh·~ b8Iloet
    e-- A

    . .....
    ' _
    .....
    11m. mocher'llIame . Mma AIlIiliI Paj:a. Her
    Itomo is in ... on:Iiuty rutal ..... of South
    America. NOI ioI>a bdatt" lhc: orrin! 011 lrained
    hc:alth worker ill her I'iIlq e, lWO of her cbildml

    "
    I THE STATE OF THE WORLD'S ClULDREN 1986

    Parasites:
    the damage to growth
    the ~ chiIcl.........,. .......- dl$CUSSlld inlecI>on ~ _ "'-1Wl\l
    _m
    .. ctoIdten'. nt,ItnUOt\lll
    cau. 0t8I
    Itll!lll ' 8llOIl can also ~ 1 1qlo1c:anl _ I on . - -, fT>J/Iaple tlurd!Ins cell
    "'" Ptcblem 01 ontesU'I8I _lind 1* """ poIo~IO_IIa~

    .. ~'. grOWlI1 - ~ .
    =oodoog If'Ol IiIcI< or I'IyvlInI _III 8Jea';I- In "'" long l\1li. ~ conlIol entMfIJ brftI<ng
    ~. Icr ~. _ _ cf'oIlh<l ". ~ 01 ooleclo, _ , . _ . n lI'Ie
    8(IaII'lIl IIl& oarvn III coo ,. ,_ .. •-.lmP<MIII_ol.....-.g-__
    IllduSlrJllllfl ..crllI _ ..... de " . '0 c:aJro
    "
    _....-- t>o lIIoco_ • • III _ Il.OllIw' ..., ......
    __ W-••• olll'8" _
    .i'" ._
    <;hkINn. _
    011
    .' • • .....,. r.,
    ~
    __ olM._ '"
    ,.,..... . . . . , CII'I _
    re...,. eIlec:l5 olli'''IClM
    DIe'
    'Mel ~
    ._0<*' .doI.9'....'•• '*' .,.
    . _ lI'ol¥
    b _
    ..
    -....,
    eo ,

    _
    1IIW:WIg~
    ..~_s.afI'

    ol _
    - . In Cosra """" lOr
    -.., _ _ . . . . - . . .

    \WldI _ _ I......_'·' _
    ... * 1 : _ i __. _
    ~_ ..
    _ ... I _ a l __
    ... .... _ . . . 5 lJS _
    ~~ __ • __ . ~ ol
    llullor "*'I' _ -. .
    . . . . . <lr;Wlg _ ~ <lIrfWIOI ...... _.,---.y lllogII """" gg 50..-.....,.
    Qi"lI""W1Cl _ 01 """"" <:hIldr.-l • ...~ ............ _01'1 _
    _ ".", _ can _ bit •
    o, ,000'-'
    lhIl " OIl ......- . . ..,
    peoplo,,,, __ olllle _onlocIS', AsI;:a-JJ ~
    ~

    101 CCIIIW"lI.QI)' toaaIIh ....._


    S!«( Ill'" 0IwQ<In0ng ~ proc)JtlI ..........
    PQOJliIOn. ' --.1\1fOUl_,iB - ~ no ~ III
    ....- _ - ~ 2 8 ll'= " '. ol carbo:llly- diale a'ld """'" ...... ,....... aM enoouoaoe
    ~ 10 ' edlJee Pl!IlISIIic onIec1!(111S by
    drftte • dIIV atIcl CII'I eal l4J '-'I' 10'11. o/a c/lItl',
    IOlII -'11' _ I<rll:>wno ITIOI" and ooona more about r.and'""'"
    1f1Q, r.".gte* food MndIing, 8I/01OItIO conIan'i-
    o_ ~ lnIecls .......
    e:a- _ . . - . . . ""'ong_
    olIeI1
    900 ".", peapIe ~ wale< and Ia/MIaI'Y _ (lI$pOISllI

    ..... -..en.
    1ldI-..-gIlt _
    =_.•
    n:teaSeIl . . . 1Ik <II boo
    iIS _ _ ( IlogII """""'"
    ThII
    e--won
    _ OrQatuallon 10< ""'*'-
    r....... Aao...... ac!rIo'e .. _1I
    " - ' a'ld L.-.l An.-ICilI\ co.dneI•. - _
    0lIOn0
    - ..
    - _.' ... _,- . g 600 _mf-
    111m, _ _ _ 10 - " cornrnurofy I"IlInsl ......._
    _ _ arG 0'I 11onty ....... '" ... _ _ 01
    _..-,at......... ..... ~ 01 ~ • """""" _ moIi : ,
    o n. - _ ot _. ~brr.-.o"' __ a ' l d _
    l*NlI
    __ by I . .-
    iiCIII' ~
    ,..... __
    l' ,",,"'-
    _...-e- "'j_."_
    "" ~ twoIoijjN
    SO R ., 1971
    200 _ s..r.
    1IQllI . .
    ClCUII!)IIlloll....ad
    10 5.3"" .. "~:l9e.3 AI _ d ....

    _Ii _......._--.. . . .2" ........


    1I'tIII'CI"' . 0 '

    ..
    _ _ .utw .OO_Il ..... 1IrNo", 1980• • 6 3'110 III n.oIII
    5d'~ . _ aJiiIiAJ..
    Q'*"n . . - . , . IA''''''''' _ lind ... '"".., _ " ' . . . , '""",,-h . _ .....
    -..-"" ' : . -..",,~
    eggt trIO cytII .-.0 tie wi.., _ _ 1leJ Gel", , . - -.. u " .. hllUIlII
    Cftt.

    . , _ _ IhOV CII'I Foe( -r'-. I.C' "'" _ _ 61 "' .. , . . - .


    --
    bad ditd-OIl( from a r"Spin,ory inf~n and never ..... by anyone wlSidc 'beir OWII = U_
    OIle from measks Or in Maria Aulilia'o eUd nil y. They did nOl dw. illl\lly pani<ular place or at
    anyone particular time o r from anyone panirulu
    <llUt. They were lberefon: nOl f\ClII'S. Su, 'bey

    ,....
    ~FI1T 'h buby l>:>y, I ,riM U> It' hlp. BUll. . I WQJ
    nonctil. less suff.red, and tbey arc nonetheless
    <" nyi", Ai.. f«r hlp, IN j"" dW i~ ..y ImIU.
    ~M:I Ja",IIu. WQJ 1>&. I Ir4d "" kUd '" pIayi", Thein .... lbc 'Ulenl cmctXency'.
    wirll 1m, bti", mrll 1m. Tr', di!/i<1<IL. ir) wJI 10
    .......Ittr IIrM< ru- ",;Ih "'y <hildm<. SIN WQJ In the llW year, rhe 'loud cmclllency" of Africa
    " I';'hl ....v.. 'M ..,...., .. bd By .. idnigh, ,.... WQJ has been met wilb privarc lleneroUty and public
    sid . Sill ditd j"" /11 dDy bll!k COIlccm on an unp=cd.mcd sgI e, In almoit aU
    na<ions of lbc ..."Id, many millions of men,
    "I a.. nor a!JmL I ,', IIappmcd "' a to",!TJXntlm. " womell and children b.a,.. lI>IId. it deu lbo' ,hey
    Maria Auxilia Paja is ;"dttd no! aIou.. In the
    do not filld ouch .uffering atttptable in • world
    last twel~ mon rhs, apPfOximately IS million
    whicb 100 . koarIy bO$ lb. financial and "'chnical
    ruoufCCI 10 prevent il.
    lllOlhel\ like her bave been fOlCCd '0 walch th.ir
    children die. That mpomc is, ill illdf, an important mile-
    "one on rh. road to a n>l)n:: s.npjllCly ci"riliztd
    The ViS/ majority of th<u 40,000 children
    nev.r looked inlo a telcvisioo cammI and w. ...
    world = ,rnity. Forty years OlIO, when UNI·
    CEF was founded , there was 110 md< inl~
    tion lll response to the l reat 1943-1944 famin.;"
    Benlal, ;" whicb even l reater number'! of men,
    Fig. 22 Increase in c hil d malnutrition, WQlIICII and child n:n los< their lives.
    Ghan a ,l980- 1983
    ~", "T""_
    .............,rroJerallll'/ ""*'<>..riIho
    O:-;)ol P6',* 1tIo cJ
    The inlc:rnOlional m pon!tC 10 Africa'o de; pcr.ue
    need thacfo... marks lbe d.....lopmcnt , in l)Ut
    lifetime, of a dirre1••,n degree of Illobal coosc:illUJo-
    wegtC'''''- ,........... ~ nOS! and COtlCC1l1. BUI if it is to malch tbe Kale
    5'
    and wgcncy of lbe problem il$Clf lbell, ill lbe
    52 remaininll years of rbia ~lItury, lhat = m will
    50 ha~ to be ttanl.lated inlo new tI.in>co5io""

    " Fir$!, the COIlccm for poverty and lbe COtlccm


    for justice need to be ttansJaled into I conCCrn for
    "
    f~
    the quiet .mcrg~ncics as well as for lhe loud. For
    just 0$ tbe _ l ufferin B of Arric. bO& bttn
    rcga.rded III unacceptable by 10 many dtizclll in

    ."
    38
    1985,10 lbe unscm and unMCeSSUY mfferinBs of
    lIIuch larger numbers of children in poor = u-
    nitics rhl'llUghou, the world mU$l abo bttome
    38 unacetplablc, 10 botb people and Ill,'c:rnmems, if
    we arc to ron,iQue maltinll 1""8.... towuda I
    '"
    52
    ""'"' Ilenulnely civilized _ and pcaccful - world.
    Sc<:ond, it needs the dimensi on of political and
    30
    cconomi<.: action by SOYmWlCllts. The world-.. ide
    tseo privorc l cucrotity of millions of individuals in

    _......_--- "',,"
    l'CSplllUt: '0 lbe African emergency baa .mountctl
    J F M A M J J A S O N O to pcrb.p' $300 lIIillion. The amounl pledlled by
    ... lo~rnmc:nta in aU'll aid for AfriClO in 1985 hO$
    amou nled 10 approximately $3,000 million . And
    n
    I THE SOOE OF THE WORLD'S ClIILDREN 1986

    Population:
    less deaths - less births
    FOIl1le IosIIhtee ye¥$, !he 51alll of me WoocfJ tact lnal !he '1;IWd SlJrvtVlll 'evolutiOn
    lI\'llflIII
    CllikIfen few1 lias <leSCI'JtIe<l "'" Ilfe8kllvooglls Incr_ parenl$' _ o!oonuol ...... 1IW I......
    w1lIC/\ now mal<e ~ ~ 10 save !he IMlll 0/ PrCll:lQtiy IlIe mOSI ~an! ~ lor tho
    _ ... ".,., chikIr"" eactl.,...,
    Bul l/'IOI """" """""1anOO oT tamIy pIaIYwlg is "'" grlI'oW1g
    ~ asked QU85Iion at>o.llt'os !XlW'IW lor oom_ 0/ 1 * _ lllat IIley can ~O'.e IIIfli'
    a ~., child ~ IS '""",', ~ 1eacIlQeven " - by !l.- OM! inlt>nned decooo .. lW'Id actiorls
    mote rape! paoulal.", 1l/OWIh?' I\ny\hlrIg _ IIeIpS lD roeteIlS8 tI\EIl COOTd-

    PafadQ.iC3Ry. 1M answer IS ' r(> - A ~


    enaiI, as'" palenl-bMed cI*l:5i.ltYlYal Slrawgoes
    (!D, 0keIl' 10 _ _ tlorIt1 ra_
    IS th8rnfool also
    ,.aLM;lJCIn on <::hklO8atr13 ""'lOM lead 10an lMlOl...al
    Jfl(luctoon III PQIlI.CaIJM QIOWIII;. r- ~ In _ ...1 by It<lse co.,n.

    ohomnIlll'O,lfl!
    Many par_ 'lIlSUI" ao- child O\laU'.
    c:IIil<lren Rlll"'enlS oocomeoonfl<lenl
    I)y
    lIIeS wt\od'l haYe aueady Rd\ieIIed a 'evolu!oo in
    ct>Ia..........,. Na!lClllS sucII as CI1ina, Sn l1lt1!<.a.
    1IIal _ 8l<istng Children wil5UMIoe, IIley l(lr<l1O lhe RepuIjic 0>/ Korea. Costa RIca. ano:I So'l,JaPOf<l
    new """" IINt""'-l""" ~ 'Olles-ano!l'e
    Mve 0fiI0 II>e number of <:hoIctllI1 IIley lICIuaIy _ bitlto m l&$ _ ~ !he<leveloping_lI1. Taking
    wont. As ItIIII la'" In<lIra Ga<\(lhI sax:I ., 1983,
    "_ ts lIf<l_ /iIroIy 1l> 'esmcI U- /amoIies " ""'" experiencll as a \IUIde. ~ has 00.. esIImaled
    1lla1 8 CO<II1Ily """'=" t>as _ its inlanl """"'"'Y
    ItIey nave f<laOOllllOle IIS.'ll/I'lIllO 01 me ITS.!iI!tlY
    SIJMomJ oJ "* /100 1;;N(J<etf . •
    ~ !he las! lWO -100 ;ole. can now a,pecI in
    popula1iQr1 Ie 5lal:lobn 81 8 ieYel 30~ 10 ~O "
    o 5eYetaI of a", key IOW<:OSl r;trategteS l<)r &maier \tllIn W<lUkl ~ 1Ia.... 00.. !he ease
    leduco'>g C:IIik:I oeaT~ are also key Slraleg.es 10< PulllnOlIl/!I way, if all cllrOa Me 1tle same low
    r«lUCitlg bi<ths;. inla"l IOOIl;Iltly SOd !he same lOw borlh ,aleS ...
    K<!IallI !>Ial<'!. ee natton as 8 . . - """"-"d _
    Fam1y SPaCing In pOOr <:Om/T1Ur1ltillS, inlom IIpp.o,,,,na1ely 4 4 - . ' - 08alt>s ead1
    mor\aI!ly os lypoC3Vy t...oe as IIIgh """" Ill/! veat - 8<1(1 1.5 miIloon ' - b!<lIl$.
    ............ - . tw1hs .. less t""n IWO years.
    Bor\Il soaong is lIleIelore a ke<y sua!egy b' A """""-'110 .. enid !UrvivaI . tar 110m e<acerbal·
    \1Ikl !lI.M't<ll lIIId 1elluCJ1g i)tI1Ill3l6s Ing lhe prOblem Ol pOpU\a100n grw.1Il , o;ouI\l
    1t>erelorc contribute Ie ferIiloIy <ledir>e That IS WIly
    Fomale ~3CY is lIIlCIlher powetlul <le\effI1inanl lIle 1984 World f'oI:U8Doo Coolel8OC'l OIl Man:::o
    at child ~ A.r<l as 1M WOfld Frity ir1CU:Jcd OIl ns mal dodaratiorllts Slalemonl •
    Survty fl/I:l ~ rtsIng I8IrraIe kreracy abo
    " r llfOlJ{fo _.I<t8dirIg. ""m_.
    Il<IcQuaw
    bnnOs steadily falling birth ,lIteS
    Breasl - _...... also a key 10 child SUIVMII ,
    cIea/I WlIIef. rmIIRla1iorl orogr_. oral
    'llIlj'ClrllI>O<lIhtJrI/iJf. and bitltI $U8COv. a WIU8l
    And a mol!leI who IS breas1·1oollinII IS eee 'lMlItItiOr1 in Q>rfd 9.1T1'iYa1 COUIa 011 Oc:>'lteve<l,
    1l'QI<lCI8d, \., a sigArocaru degor.... ~ t rhol ~ WO<Jd OIl '*<lma'oe" /!ulIIanolarian
    lIecorT\;ng pregnant and I<!tti/Iry lem>s: '
    olind
    ~ at' ..!ant ses. OteaSl'~ otlY\ousIys\Otlt
    tis al!ocl .. inIlotlitng <::oro:eP!ion lSlosI Itlllus
    • r.. ...,.., l>I' " , , _ 0 1
    "" """"'_ "Prxx _ M¥1)' _who .........
    V<Ori 100, ~ a Cflild'slile can helP 10 POC/P<>'l<I " . . aI ~ .. " . old_Of _ IF'"I' ""' ... _lot
    ee nexl llnh "'""I' lI>O _ lot ~ ., old • "'""'"""'" N

    r....,s.n.:. -...
    As OTpottanl as any ol Ine$e ir\IltYdJaI IonI<3
    .....-.. """ 01 - . ~ '"'"
    l"'"'9 1P>t I:> "'""I'- . 1:>.-
    r:>etween lalhrlg lIe<oll'l$ lind laling blftt>J .. Ihe NI ..... _ _ ...

    "
    ia the _w.... the _ un whidl ACricI ~ mlu .. IDllIllJlPOl1 from III -.sa. TIley DtCd tlx
    pIid t.ck 10 the iad.-rialixd wuId ia debt aad IIIpport of their 0W1I poIirial ItIdom Illd of1hc
    ilIl ClQl rqJayaoeali dun", 1m ~ -.aIm 10 ia'...... u ..... l rommllniry. of Ill< bcI11h ....ie.,.
    . . - $1,(100 millioIl. n- fitura do DOl laoal IDlI ollll htmcbcI ol....,.enuncnl , of the tomn>-
    the ~ of the I ttlCrtSty of milliont or thor: lIlIity beaI!b workm IDd Ill< IDaII lMdia, of tM
    mllill it has ..,hif;ved. Bill l bey bnllaUy cknlo<l- IChooh tICbcn aad 1hc rdicious Icad<n, of 1hc
    lItI\e WI ccooomic aad poIitiaJ IC1ioo _ by com.munhy OI'Ianizlliool and lhe W01DtII' SI1iO'ft-
    IOYffllIllCnII in bolb ~Ioping and illlhlSlrial- menll, of lhe empl<>yn1 and !be Il'1dc Ilnions, .nd
    izcd n.tiool -is • rrctt<jllisile of any IOllllion of people'l lnO~OII 10 bolh developing and
    which lnalCbellhe ltale of lhe problem ilId",ui&liz.cd naU01IL
    If lbil opp,mllnhy is lum, lhca 1hc yean
    ab.-d could ~ 1hc ~1 of 0lIC of the
    A elloi« lor 1M 19l1h I tQlCSI l oals whidI maokilld has ~ oct for
    illd£ _bait protection for til< ~ _ Pol 1hcbcallb
    Praom bIowIcd&<: holds OUI I . opportlUli1y aad tbc IIOtllAl de ,dOPUl<lll of III its dIildrm. If
    10proftlc, fa- the 6nl lime, • IlIIic ...u.imwD lhIt opponunity ;. _ lIkeD, thai tlx 19m. aad
    pmuaion fa- tIsc Iiw:I Illd powtll of III 1lll:
    wonr. dtiIdrtD IDlI to do 110 • • w:ry J,c,.. CllII 19901 will be ri&ht!y........ iral .til<~
    ud ia • w:ry Ibon tiIac. whidI bikd 10 prIlla:t IDlI lIIaiallill the Iwd-
    _ ~ ol the pOII-_ yanI IDlI whidI

    x-::.I DIliooos U'C I1rattJ ~no inl 10 Iili pQided Oftf 1ht ~ ol Wljlla:tdtaltd
    up lhIt opportlUlitr- 1Dd with IIIIIIIC rmwblsk fin""";'l Illd , ...ho ....' CI4: Hily witb tlx eat-

    - ""'~
    lia utd .wo1llritDL, RaDDe. IDd dt:lIh of mi1-
    .doIt
    To faIfiJ lbol poc... tiII, it thai _ Iboft all
    dIIO - parmll ""'Id to t. t illj)Owtlm with illfa-.
    lions of ilS _ 'tll1Dt:nblo! cilDtm..
    Tbl: cboia: is OUn.
    - - -I I - - -
    LIFELINES
    Extracts and summaries from recent
    research and writi ng on strategies for
    protecting the lives and normal
    development of the world's children

    Growth monitoring

    Oral rehydration therapy

    Breast-feeding

    ImmunizatioD
    Iron, iodine and vitamin A

    Acute respiratory infections


    Combating malaria

    Female education

    Food supplements

    Family spacing

    •
    Introduction to Lifelines
    The _ _ Iheme 01 II'Ie la$l hee <eporlI on
    ee sra. 01 lIIe lo'otIf*1'$ ChiIchn • 'Illll rec:enl
    iiICVaOOeS WI kllOoI::lge make rt ll'"Wnle 101
    parenlS lheI,iSllh. 10Ole so anec- .lron''''
    '-a:1h worl«Q IhiII 1hey could bt'"ll abouI a
    drasIC lfTOIlfaYemllOl in l:tO' chiklren'sct\aflCeS o!
    SUlVtVal and haalltw , OOImal (j«)WtI1 Allfle Wl1ll
    ltmll, the lIP'ead 01 ee primary health w a .oe.a.
    and ee 1lI'000h or cornmuruc3tions and Oftjamla·
    bonal capacity ,n mosl natIOnS ollfle ~
    n IS now POSSItN 10 put such
    W()f\(j , ...-... IhiI t
    kn:IWlcl:lge at h! Or;posal oIlhI vast l118P'l)' 01
    PIlI_ WId 10 6UPPOfI1hem 10 I*'lO ~
    The W 'O IllIollnS 01 cho;d 1lOl*lCllau IllCtIo
    roQUCS 10 be ", ... ,"*>.:.1 ... on. ........ dii 'll 10
    ~ WId 1DcII~. Bulll'lellO . ........
    '. -.e' ted'r1QlleS cb;IJ .. ... 1*1 at ee

    r_
    NJDI 8Rl c:r-l beaM... !hey 8Rl 10
    tr'IOIl ~ beaM lIley an ne '.'JeO
    al low alii. ber3 !hey an &I • • S rapod
    IJllIWI'l torr.e ollie I!lIlCW ll«ltiIeo'l'-. WId
    ...... .-.ev ............ ee .... at Pf'lN'Y
    ....., e.. by IWlllvIng pnDllIe n 1u»M'lg mare.
    ~ 1f.OIe. ard llllIng _ abllul ...
    (fflflWId theor ~' heal'Ih . In W'l'ItWIIIIIQn ...m
    eaen llI'1oI , IheliIl lIC100nS also oller a OOlliidel·
    able lleQree or 1lO0teebOf1 aaa-1Sl1htl6'fllll'tl'Sl1C
    allianoe o! melnIJlnllOfl ana inftlclioo wtocl'l ISee
    oonUaI "'obICm at chilO survival and child doveI·
    oprneo1lo the work! toOay.
    Thos roar, aecbOnS on 'ResporalOr'1 1n1ec-
    ~ '. 'MalIIria', and 'Iron. ~ and Y11a/T111'1 A'
    hew bean I(ldlld because, in ~ fields 100,
    rocenl adYIlnces .. !Ino'o"eJQt now ol1tr pracllCal
    lllw<o&1waya oIllOllItlCIio'lllhe ~ ancll'lllfmlll
    08'0 '.onenl
    at CI\lidren.
    ~~ • • I'lilS been RlPNIedty Il'lllooofll'lal
    ~ . , . . IacIOts - Iemale tldr""""" , lIIftiIy
    15C*:WlCI. WId Iood .......,. _,- . . also
    ~ fle IT\CI5t ~ levers 101 ~ Ine
    .... 01 cr*l '-"'. AIlhough mere W5lI\i' WId
    " " " ~ 10 adoe'e. ' - Cf_ _ . . (II
    6I,Il;h ...... . 110' .......... - 101 IlIl IiIoes and
    I'lNr.I'l 01 Olllh 'oJII'lltI'e'I ..., dWIo el ' _ 1IItI Iwy
    Il'lU6l alsl now ne COoII'Illld among ,.. tweak·
    1hfOl9'<S in kl iO>O'ltAie WhdI COI.tl CflllnOe ee
    ' llllllllell,tl8nl!le heal1h and WOIlIIh 01 f\IIIlOnS
    LIFELINES INDEX
    o This symbol indicates a new Iron, Iodine
    entl')' for 1986, Lifelines is and Vitamin A
    updated annually .
    lrgn.ddici<n.cy ~

    c..... of iro<> "'"


    l'rn<utinA iro<> dcflci.cD<)'
    Iodin< Ildirim<y <llio:den
    Growth Monitoring ViumiD A dcoo.D<y
    M.muui!io:l 0lId iIIf«tioll
    Mllnutrilion llld wuni"3 Acute Respiratory
    Mo.InuU"itioo- ",her "'..... Infections
    MOIli""i... child pow,b
    The dliId JtOI'lb clw1 ARI, The problem
    E<h""tio<> of """ben Child tickneso
    Child<ltolhl.
    Cb.dI......
    MOlhen' in """""', ea o\RI
    TIl< 1"""' 10 d '. Rill< f on
    I'nv<DtiDJ ARI
    Oral Rehydration Tmti.. ARI
    Antibiotia
    T herapy
    Diurb"", dood" Combating Malaria
    Mo.IDutritioD
    Roo"'lI.11« of mal .....
    Co.... of diatrboe:o
    h"pocI of maJuio
    Onl rehydralioo
    Treat"""" ol ll>l1aria
    1/..". ..1>I<dia:
    CoDlJ'Ol of II>l1aria
    CoutialKd fc:«lins
    Saf.,y oi ORT
    Cosl. orORT
    """
    Female Education
    Breast-Feeding Ed...,.tioD ""d .lIni....
    ..... ind<p<ndca' forot
    Breu...nilk'. ad...",os" fuosibl... plaJuliom
    Cu=nt,~
    GirIJ ill "'booI
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    01lA>'''''''-' ENTRY POINT FOR PHC
    ..- . n. '-""Il_ _ " ' _ """ "'" "*""y .....,...' 01

    .. 01 ""'¥J
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    """' ' ' - ....... . .. lI10 only """"""Ii .. ~ In """""I' '"'""'" ....

    "
    II LIFELINES' GROWTH MONITORING

    -_
    _

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    w ....... _ ... ~ _ _ II... """I ' ·On . ~-
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    ..- -_ ... _-_ _ -


    .... olue 10"""" ~ loB. _d>oIilr"".... _
    """ ... r.gtC "" _ nICI><. _ _ l>r ...........
    COSTS OF MONITORING ........ "*9'" ___
    e-.. ... - . ....... ~ _ _0010,," ,I.." '*IP"""" ..... -...
    .. , _
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    = . _ __

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    .,.... 0';•• - _ " " .... ..._ _ _ I g L O " ... .....-."" _

    _tooooUS 10113 .. 103:1_. . . . _ _ . _


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    .... _ .... h
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    r " , _ .......... Challenges
    CIoiItl ........ _ ' _ ''' _
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    - . . . ...- ...
    ALTERNATIVE METHODS
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    of gtOWll1 moo .........., 001be """""""" Ie>' .. ..,.."' ... ...... ~ twng 00<<10 .. _ t1ol1O llul".,. .. .,..,. _
    I"" """"'" "" _ II> .... """ .,."..,...,..
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    cn..n... ....,. ......., _""""""' ..... _elll''''''''
    lOS 01 lis.,.,.. "'"" 2,000 r~ ,..,.".,.. In
    .... ~ s.. Dnoo Progr.." IoorQoI .. !>''''lI ...... cNtb, II...
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    1>:> '~_moIIws ., ,,,,,,,,
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    ~ . Il'Ol' ' _ _ " !>"nIl ... """"as II ccmo
    Mothers' Involvement r~ lor ..... """"•• _ ..

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    --"_aod_-"_IO-....odtk_oI
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    _'!"'" _ o! P'""""",,, _olcl>ldron In - . . ca.o'llriloo

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    --"'-"'-- '--•
    "-''''
    II LIFELINES, ORAL REHYDRATION TIfERAPY

    $.tO In _.n__
    "Tho<e .... boOn. _ _. . .
    ~. _.to_ ......
    statatrOl

    t_" ....
    """"'" _ " ' " tr>o tUr-.oI _ _

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    """'" Ma'lw ._' _. by " ' ", __
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    .. _ , .. - . otognl hl weigN. - . . . . _
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    ........

    Oral Rehydration Therapy


    Di="-I diMaM ;. 1M 1ffiJ'''' rilllU Jlilln ./
    chitdml ill 1M .u../npi", u:qr/;/- 11M oJ'no 1M <lIit/ Diarrhoea Deaths
    <II_ ./ <lIildlto<>d "",llto/ririlm.
    I C'Tho _ _ IO<IIy . - . . , _
    11w ".....",ioft of .n,,1T"- tkpnuh upon j",.
    pnImIItIIll i. ullrn IUpply. Ja";/IIn.m, aM h~. lI'd< .-" ~ ,,-",,,- _ " " " ~ _ !lI' ...
    Plogo.",,_ dl.rog "" ~ _ _ ....1 Ihey ~
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    dUs,il,o.,.1 d.lIydm.Wm "'It ~ c!lNply "....."rd by ...- ~ '" 11II in the dO' "»''Q 0I>.ltIIh0S. aM "'"

    __ ,_-. ..
    sucn.".. IfIaIl _ UP", 1!>-20'" "' ...... '""'_
    "",t",hydra,Um .1Impy (OR n. aMI oliar~
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    ollilfl ~
    -OIP""""' ..""'.__
    _ ~. -1t>D!IUI

    aM win 1m,,, ...... ,I.ly "'" be rrplllfflJ - k<ulu.,


    UI dtllydJ'llIUm. ORT is I""d "" II•• diJuury IM I
    glwase fFt4l1y illtU<Wf 'M 1Ioody~ ,apacify "' " bforh
    ",1".1Id wain. DriJtltiog II ", I. M 0/ ", 1... ,11ImU
    lind WIlier ",It ,1Itn/_ prrtJt1r' li PId IR;lI "'lIy<t",.
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    ,w..
    Prt-padulgtJ " ,01 " hyd,oM ",II< (ORS) call DEHYDRATION
    ",,/y db..." 10 Mil.\. Hu, 111<1lIi"i 1M ~"""

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    110I... iii.......... de _ .. ~,.. _ .._ ..,.

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    '--'UIWp - . 01 _ _ doc bod1'

    .. -
    """ iklbk 10 <Wry JrovstMIJ is Jto'lIlW01yf frtniblL
    Lr'lho b<XIy """""'Y _ in 1I1e ~.-
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    alUX.l T1It Jeknl;}ic ""iorrale jl1r ORr, OM jl1r b<XIy . - In QOllyO'otion, Do!hy<lratOO' _ _ ...
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    ..... 01 <:f>OlI<•
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    Malnutrition uP" '0.000(: <ri_ ,00_)"",,-._,_
    """""" t>v oiI>od _
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    _ ._ _ i>. CO'IWTIOI1
    ~ ~

    IIWS WId ""'" I ~ _..-j!tom """ Suo:tI _ _ THE LINK WITH MEASLES
    ~ ,1k>1 is . . . I ""'*QMlII ...... ~ ... t:"\!' !UT1b<>' 01 ".r, _ _ 1IluCly," """<ft 5,115 ~"'
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    ---
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    _ 651; _ 1·10:<_ _ • _ _ """"'"11' .. ..
    ~
    Oral Rehydration
    38 _
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    1

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    " ~ A , _ _ 10 dill"""'" oo GO "'"""""
    W 10 _ _..... '*'11 ...--.. __
    Causes of Diarrhoea "Il_ l""""""1,"''''''''
    co,,,..,, _ .. .... temu
    lIO lNtl r . i l _ .
    ('heme

    Mo., ........... p... no. .. diattho• . TIlq oro _ lb) 10


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    THE PATHOGENS (Cl 10 _ _ ..,.".,-.IlOO 1- , . _ .......
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    _ _ ",.., _ . &>rnoneIP /)1lIII1lI'lIl ~ /)1lIII _ " "tlou! ~O ·9 $'io 01_ _10 _1lCUIo>
    ..lanIO. _ bo _ ""'" OAS _ , .. ...

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    fnl~ ""'"' _""""""" IC o<:ao'

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    "
    II LIFELINES: ORAL REHYDRATION THERAPY

    management 01 Intantilc d ia.lhca (based on a n T) was


    ORAL REHYDRATION SALTS established at the UnlYorslty Hospit al 10 19 8 0 , Morl ality loll to
    Oral ~h,dration Jails are formu bted to replace the nutri- 14'Kl dunng !llU l'ISt year. was 1.9 % durin9 l11o seccoe your.
    ents lost during diu rhuca: and has been less than 1 ~ at-co January 198 2:
    11" The formula tor oros recommended by WHO and ..., W PiIl/oi /OI1d lll'..... """"II')iJ'I """
    nQ'''*l' """""""-, /ft H•• 3 I~
    pi
    ~ tI:\II.
    doo,orn.w
    jo,
    1ft /tlill
    FI/chiOId-l
    UNICEF conlams.- c;.". _.A/o)lll ~ j"' A 1 ~_'lJII_oI_""'_
    3 !> gms sodium ctll ondo r_ ... "" 0mI ReIMI'."II(:WI n....;j))I, LS Vl 19.'l'f
    29 gms IrlSOdlum curate ulnydlalc (ot 2 .5 gms soo.cm " In a num ber 01fcsearchSI\.Oes ltIo usc ot ORS lor trea'lr'lQ
    blcarbonate) dehydratOd eh,ldren alllle commurl ily IeYct has dBacased the
    1 ~ gms pola$SItJfTl dllcw10e number 01 dlta\tls Irom dlarThoc.iJ as much as tlQ.60... 0Yf!f a
    20 gms glucose (anhydrOUS) one yem oonod "
    " The aboYe lngr cdaen1s arc dissolved II'l one litre 01 dean ' ''''". _ _ ............ _ _ <lt ~ ~ hir.lJlI' •
    W3tCf 'Nt K) has rocently recommended a cnange 11'1 ee j/JI'IIlW-l()lt.IoIClJo - . , ~ IO I N3
    cornpl(I lO formula , IcplacIog 2 _5 gms 01 sodium bicarbonate
    WIth 2 9 oms
    01 trISOdIum Cilia te ditlydfal0 The new lormula Pteltmtnary rflSOOl ctI '" 19 80 lor the M llonal dl8rmooal
    osoaso control programme Ifl EgyPt found thai early retlYdra-
    gIVes \fie packets a longer sholl life and ISal Ioasl as effecllVO
    '" cor recllOg ecocss and rBdUClllQ stool vOlUfn e. Packets IIOJ1 bY molhors With a sail and sugal milt mace at 1IOlTle,
    containing sodium btcarbona:o are stili safe and enecwo " backed up by ORS from hcallll cere providers, reoucoc pre
    scnoot dliid m()IWllty by 40 % anddlarrhOOa-specirlC rTlOflaltly
    ~ I~ no Ill , _ 'I'l lloItwrl!><lI lM t
    by 50'll),
    I r 'Counlrics stl ould t avo 00 heSilalJOllln c ontlnlllng to use S<m.,.,..,~"" /rof" II a Mol>;" ;M "'0(1 l>/tIon, "nw ,I'-"/ (1,,""''''''
    ons-cearoco eto . which IS hl~h l V enecu-c III the treatment o f Wl llJlIi lIIudy" M,, ~ I1YlJUII/l Ot:JtlOCI 1980 " . Slrm<rfl'll.~lit'll ,,*lI'ilJ
    dehydrntlon However. because or us bcuer stability and even /oIt\1IIl1IlofO....... ~ j ~f:I/OC ' M,..1ty 1lI~' "')'PI
    I fIR '
    g reater olrlcacy. WI 10 and lho Ul"liled Nal lorls Childron 's Fund " A programme o r ostrrbonon o! oral fehvdrat~ packots
    (UNICEF) now recommend t:l<il coumnes use aro o cocce was establIShed by the governmonl In 1980 In 20 01 tho 8U
    OR5-cluato where leaSll)lo r..s
    In tho case 01any new drug . Costa Rican municiPalities ThOsach ets were disl ribum Iroo
    Coun tllOS cIocbflQ to uso QRS.cl tl'ale stlouId care tully monl lo r ot chargo 10 mothers ...... ttJ Pl'eschool ch lldr<!fl 11'1 tna 2 0
    I~ performance d tJ'lflg Ine Iirst new rnonltlS ollIS rOUbno LIS8 " cxlJl:!l ll' l ~ IUlI I1lllrMClpalllJes. lhe resolt, alter one yea r 01
    ~ """WIiO f ~~ CcnroIfIt<y_ owe operallOO, was a 50 % reoocllon 01 N'llant diarrtJoea coaes III
    0 -.... ..,. M. 11(1
    5 19&1 tho 20 mlll'llClPallbeS, no Slgnlllcanl chatl90 was delOClCd In
    " Gll.lC06O IS IOCluded in Iho soIullon princIPally 10 holP the the rert'lall'Wng rnul'llClpah ties wtle!e the IIlIervef1tlOl'l was not
    eHec ted ..
    absIofpllOfl of sodium and fIOl as a source of energy OrOlnary
    SUlJ3l (sucr ose) ca n be S!JbStllUted Jet glucose ...... th ncar eQual
    I _ M *, ""'_ 01~ _
    eftcacy . lhouQh IWICe tho amounl of sug ar IS nooded. _ .. e - Ib ~ ~"' >Of6' IV I!JIJ:J

    In08eSInQ !he amounl 015Ug3r In i re formula as a mo.1llS 01 U nAnother outcome thai may be 'expec lod' IS tha t OAT
    ImprOVlllg palatabil,ty or ImeaSlrlg lIS lIu:l'ItlYe value IS protocts a chlld 's nulnllon In Tfurd WOf1d chi ldren dla rmc.,
    polonlla!ly dangerous as 'I can worS60 the d iarrhoea ••
    lhu """"'lI'II' tJf_ .._ _ ... ~ 0'>tI
    iI*Jl WUfl/ lllG" .... ",,1Vl/ lIIfC. 198J
    ""'Id" _.. . . .
    /'f. •
    alone accounts for 25-75% ret:m:lallOn 01normal growttl over
    A yea. W,lh 2 -3 years ot repemoct g rowth arrcst s d ue 10
    octscoee 01dl3ntloa , ne Pfobable thi'll most rnalnctauon we
    " The presence at cora es uoi In ons ISparllc:ularly Impor tant ceiect in SUM !YS Is related to d,arrhe,.1, a COflCIUSlOO sUp(JOrtl.'(j
    lor the troatill ent of dehyd rated chlld roll. in wtlom pola sslum by fOn glludina l studies in Ocatemala, Bangladesh, MCX lt,:O,
    essoe In dlsrrhoo:l arc Iclali vely high, Stud ies rave sho wn lhl'l l and 11m Ga rn~ :l. "
    urKlerl'lOUnshod children who hevesultered repeated bouts 01 "'~t""r l"'Il;/1Ilflf''' o.,",,"of'Iy(/I'aroortlllt''' 1III' ~ .. _;Jtrt"'IIJ~ ..
    dll1l1hOCa are especially lik€ly 10 develop a blood level 01 1/1'.., _ " _ I"",...-w b IA«:E ~ ""-'I' ! 945
    po l0$SllJlTl below normal It roo po tassium IS not replac ed
    dunng rehydfa!lorl." 'SUPER' ORS
    r/1lt~ d~_ ...,<It~*')d'~ _ _o#Vf • ReKlIl'dl coatinues to Improye o ra l .-ebydntion salts. a a d
    ,ollIr1f 1WC1Im~ _ . .~ 'Ntn . •!l33 ncw forms of '5Ilptr' ORS m<l1 500 D becomc pneticaL Tbt
    Tho World lleallh OrgarcallQn has deve loped a S81'11to CWTeDt O RS formula I"tmedia dcllydration but doa DOt
    aulomallC me3SIJ,ng and pactung mactIlne lor 1hc pl'OOUCbOr! shortCD tbe dura tion 01 tbe dianboe a or rcdu Ct:tb e ¥ollUllc
    01 $lTIailef quanblJeS of ORS Of fer usew/1efe la ohtlus are not of d.ia nhMal 510015; as I res ult, motbcrs somctialts ba¥e
    SUItable lor aulomatiC produc:XIfl difficulty beli evi q tha t on!. rcb1dr.1tio n worts.. 'S uptt' O RS
    I l" Th IS machine has boon designed for easy 1'Iandl1flQ. a C<lD both I bortCD tb c diarrbot a aDd baln tbc Rool ¥ollUllc:
    I'I"llfllmUm of mallltenaflOO. arid l or use unDo! dl Hlcult chmallC rlToo Inl&rMllonal Gentr e lor Dtarmooal DIsease RosoaretJ
    and opera\Jflg COOO/tlonS. A PfQ(OIype 01 thts machtne IS now in Dhaka, Ba ngladesh . has d eveloPed a rICe powder . b.1SQd
    operatIng satlslaclorily In ltle CAS production raol,ly 8t Ihe DRS WI th cksh!1Cl adva ntages over lhe currenl g lucose- basod
    Sla te Pha~ccul;ca1 Corporahorl 111 Colombo, Sri t anita " formula. Because of eherlllca l reacrlOns WIthin the human
    1'1W"""""
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    ~!t"~'
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    lCIt
    IMJ , JnIl
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    r:ll
    198 ~ 1'M (}/ crJll('~
    l .....-m body . rice-bllSCd ORS reduces d~1rrhoca volume by :' 0 '_,
    - thllS ellectlvoly treat ing the diarrhOO<l as well as pre YCflllflQ
    :lc hydla llOl1.
    $IIrr~"i/!iI¥tJ ~<inT WH G,~' IfIHI II M MtJl1 "~",,I-lIiI"""
    EF FECTI VENESS OF ORT 01111 ''''')O''8/lp, "' ''' IJ/r)',. I arlt.·lH t Or.ltl/>I~ t!ffl;> 0Jnd ,\ M Moll<!
    1110(1 !lII'W<lf. ~ t1HS </w<.. ..._ ~1lW ..... >111 OJ ""'!I'
    "A r e~ lflw 01 2 2 .559 p«!latHe reco rd s at IhA Statc
    ,"" ,'noo.t- £l.oIeWI <It1M 'MI(l . , fJ'II'4
    UnIVerSity Hospi tal . Port-au ·Prince , Haill . Ind ica ted a morl(lilly
    01 35% among 9,434 pat iw IIS hospital IZed WI th Oiarmoa and Anomer adVantage ot rk:e-based DRS is that In mil ny
    dehydmllOl'l 00'11'19 lhe PCfled t 9 69 -t979 A pl'Ogmm lor Ihe ooveloPlng counirles rlCC IS Cheaper and fI'lOfocaSiIy ayallablo

    "
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    out:ul .... ~ WI<l """"",""".0-..1'* _ . ' 8'to "':.00 ~ - . . .

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    ........ .. DRS _ 43'1.....

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    ORT AND MALNUTRITION " (al _1oOIl _ _ """," 0 1 _ Nt ore

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    ....II<CI .... ~pacl of di.I..- III • • Ilil<I', ..tri,;".ul """" _ lrO<1"""'" '" ""'-'Ie _ - . S<.o:I1 ~ Ol•
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    ........ '" IJfuCOOO - ..... .. SlIIr<:NO _ ..... can _

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    ........
    Home Remedies _ "Ol""'" _ -. '...
    Who. OIlS _ ........ _ .."Iobl<, ""- ~ .... ProI>lrniI e RI,jIII """ MIl """""'" lrom -...0
    pnI_ . ' - - ' - - Ialoou·m..........._ ....",...
    OI'*Y .... _- __ lNl"....".. ,....
    .,.., IhO _ ""-'<ing
    _ !tom bol_
    • """"'" """' ...
    ...........
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    .... ...-pteI:Ifn(l-, ""'" """"...".,....,.- ., ","y _ . .-.g .... MgeO'f Ol .
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    ...-"'" .... 0'<WCI<Jn '" 0fIS .... 0> ' ...... """" .-..,..,..." - <loy . ..- ... . . . , . -

    "
    II LIFELINES: ORAL REHYDRATION THERAPY

    ooees, pans, or glasses to measure water The lhlrd involVes lime The ctwId Shouldhave at leas! one exna leed a day lor a
    dt$lubutlng 10 each family a eestc
    spoon specifically 00- woolI auc- lho OIilfrhoea has stoppocl ,.
    SIgned IOf l1'lOtl$lJnng the dry logredlenlS accurately
    " Results WIth these mroc approaches have boon mille<!
    r.--01 '_
    __ """ __ WHO,
    til «uIII _ _
    ~ 1985
    ~ lOt'.
    Usmg ellhor Ule P1nch-and-1Ocoop method or ualllg 1hclr own •.A recent carelul Sludy Or young cl\ildron In I1angladesh
    household containers andmeasuung ImplementS, someof the
    women studied In Bangladesh, Hondufas, Nep..1t arl(f the US ,evealed mat. on everese. each child soncec 6 8 episodes 01
    d iarrhoea pc!' yea'. Addod up. \tim meanlthCy had oarmcea
    mUted solutions containing excesSIvely high salt levels.. With for 55 days or I ~ pc!' cent of the year Such chIldren Will end
    all three tccm c oes some Nepalese womeo propared eso-
    up sevcmly ooprMx1 of nourishmenl it they ale starved arine
    liOll Scoola1nmQ so IltI'Ie santhai lt1ey WOl,lld tc rneUecllvo 101
    tlma they ha ve (l lllr lhooa. AlUlOUgh dioes!lcn IS lOSS cneenve
    rel1 ycl rallOll
    during d iarrh oe a , mere is stili a signi fica nt arrcuot o r
    " One dil'lculty m Ilvatualing the flndlngs of mixing and absorption of nuulents."
    measurement studies is thai no dolilli tion Or acceptable results
    KM, 11IitJi1 1l'1lJ W A M "'1f1'"1!, "(;ar,y o , ~ " lJiIlm"....
    has been SOl lo rlh Is 0110 oo ngerously salty sol ution In 10 0 ~,110 '5, _ r>lJlJl1911~
    eccecaoe In a community-basad program? Onein 1,OOO? Is
    one solution In 100 With an IrlCtlectiYilly low salt level too
    many?"
    OmIIllIl~_......-.c;r/OlI'Ib'I;IIt/I'lIIDOII_""'" """""',.""
    ~. _ t /Ill? ~Aj,n rM;'
    " The SVongesl conclUSlOflIO emerge lrom Slud lCS01m illing
    the Importan<Xl of Clll'etul. thorough, and Il'lClivlduallnstnJC-
    1$
    \Ion In Iodonesla most wcrren who had hea,d 01DRS bul not Safety of ORT
    fOC(ll¥9d per sona l InstnJc:IlOn did nol know how to ITlIIl
    soIUtlons oon ectly from packets In lndOncsta lew ol Ihc Conao ra is IO m etimes ezpreued abou t the cfan&en of usiQl
    poo(llo who said Ihcy undefsl:ood !he d&rec\JOl'lS on the DRS too mild , a ft ill oral n b)'dntio D10111.0011, cspecia ll)' if pveD
    pact(et could Il'l lact nllll the soIutlOf1 ~openy A few lTIOI'e to the vUf )'O\Ul&:
    could IoIIow vetbailOSlrUCtKlOS accuraiey Allor the lechniQoc " 'Il!hIlo excets Of! I\ulcl and ele<:trolyte melabollsm conllflUO
    was ac tualy demor6lfaled. howeYu , l~iffly a'llllllCed !he DRS 10 dcbalo the relalMllhoofcbcal ments 01 each f\uIIj compo-
    soIubOfl cor rectly "
    $Ilion . espeaaHy itc sodium concontratiOn used IOf young
    '(Jl4l ~_ '- /OH" Ib' ~ """""'" ~ chlldrco, II ~ lntefesbng 10 note \he 'Mde rango 01 sod ll.1ITl tMl
    ' ........ _ l . m ... _ _ A(rlIM:'
    has gr.oen i\COCPIable results '" S1IXMs afOlnj I\1e world
    Those uSlrIQ higher ccocen r atoos 01 SOOIUffi (9 0-1? 0 nl8Q/ l)
    for treatmont 01 chIldron advocate oHel'lllg extra water to the
    child, while lhose report,rlg lower sodium (50 80 1TlOQ / 1)
    generally adrnlt these SO!UtlorlS are too dilute lor onoceve
    rohyOratlofl 01 severe diarrhoea espeoolly ,n aduIIS... Even
    Continued Feeding young dnld,en or infanls requne a l1ighef sodium level dUfing
    rohydration 10 e.pano Olllrace!lulAl f1ulo and ImprOve Clrcula-
    bon than in the lalQf m<llfllansnce phase whe n more nee walol
    A co mmon ruction among parents is to withh old food -and Is rec urec 10 onset obl igatory water losses... 1 tie teceot
    eve n bre ast ·milk - during a diarrhoeal attack. But starving a s ceouuc Workmg Group convened bY tho WOf1d HaaUh
    cbild wbo bu diarrhoea ca n cause malnutrition or ex acer- O rg (l n!~a1ion 10 ellllm, n8 Iho c om po silion of oral rot lydratJoo
    bate nil til1l malnu tritIon: m ixtures tall thl! evocrcc tluavlly lavoured a sodium level 01
    " The cecoer manacorrent at diarrhoea in the homo also 90 lneQ/l as op timum for a solution 10 00 uS(.'C! world wide "
    mcludes. along wilh the adm inistralion at OnTome pl'ornolion .,t,,,F/IQ RorIIJII/llllfl.-.... _~"'. ·,()t IJlm/ll<1r- .o ,." ,""""tII'
    "'Ill ..-ot*..., . , _ n tl H JrlMlftIlfId r H' JrJ/fIff9 /"'d"~
    01 approprl,lle chIld leading, bo lh durtllQ and flt lflr a oantcee
    ececee. 10 provent excessxc and uncomponsalod loss of
    A<.MlIlc.. n ...,.""fJ(If)jIj __ "'~I ""*1_ >IfI/ , o•.lorI,t
    ~"'- , I H I
    nulncnls In many SOCIeties the ceeot's ,cnodIal response 10
    diarrhoea IS to WIthhold food and Iluld. includmg breast milk. RehydrlllJon lhefapy can usually be achieved orally WlU'1
    III thO mastaken beeetthat thiSW1U stapthe d~rhooa and ease ORS soIullOfl. except In cases W1Ul sevee dehyd,t1 uon
    The Sll'1I1n on IhO 1I11esTlne TnlS ' treatmenl' only adds to the Ul"lCOfltrollabie V(lf1'\I\lng, or anolhof sonous complIC.1tton lnat
    dettydrallOl"l and malnutfllJOtl caused by the t~ne5$ " prevenlS SlJCCOSSIIJI oral lhefapy In lhcse cases Intravonous
    Tlw _ _ fII _ _ . . a t t n l ~ . . . . . - . . o y.

    lherapy IS noodcd CAS soIutkln is also Ihe flUICl used lor


    , . . , ~~ ""'CI, 1913 mSIflleOance lherapy Howevef nor mal dally ItUld reQuite-
    men ts must be orven as IIulCls ollower salT concentration e g •
    I I"AI children ol 4 mar Ihs or oldor, who na Vft been
    pIaln waler breast milk, or diluled IT\Ilk feeds ThIs IS
    weaned , should be offor oo solid load dunng dlarrt1oea. The partJOJlarly rmportanl ll'l 1Il1anls; due lo thelf large SUflaoo area
    beslloods 10 grve 31'0 those :hal are e.."lSiIy dlgesled (suctl as per kg 01 body 'NeIgh1 and l/'lCIr hIgt1 melabollc ral o . und8f
    boiilod fiCO , porridge, SOUPS, milk products egos, fISh, and
    normal conOllions !hey requlfe 2.!:l 11l'l'1eS tnCIIe water per kg
    wolk::ooknd mo.1l) and thoSe COI"Italnv'IQ potasSIum ($UCI'I as Ihart 8OUIts,"
    prneapple, batIanas and coconut water) Some la l Of oil may " A . . . - Ib' fll: _ _ aI . , . _ "" 0 . ,,""
    alsO be gwen EII8fI!hough:he ab5orplion of nut:nents from
    lOOd is lessened duflng DIarrhoea . most o l lne TlYTnents wdl be (Wf 1O/ CUJ/ 5H V80 i'/RfV "
    absorbed 110m these toods . D A ,ccenl study III Egypl touncl UI8I morhers IT\Ixod ORS
    " The child shoUld be alloYoed 10 eaT as much as he wants. Wlltl gteal8f accurllCY If a standal"d container was Pf'OVlded.
    Food should be offered oll en (5- 1 limes a day) dunng and recommeoded ltIat " wt\Ofl the pre-Pilckagod lorm 01
    diarrhoea, because Iho chtld IS no l likely to 001much al each DRS Is dlstnbuled 10 PillionIs, II would be 01 grOOl value to

    94
    -_
    - "-"'-.-"--"'-
    _ ll'-:tuoIod """"'"'""'l <lIl'l........ - . ; "'" _
    inolNeJonI " Costs of ORT
    . .-'- - "-
    ",-... - ...-,
    "-"'ai-o _.I" po_
    a
    It _ krt 01 OIlS MUlIJ . - 001•• rr..
    Ik _ . - . ...... H
    ~ ...
    _
    b .. ...too«<l dlelt by .wilcloiof, .. 0 1T>
    'O f,.. ....""""""'''' _ . , . . . 118_ ""g, ___
    _
    SO.Sll _
    lIII' COO .",,,.,..
    ORS n""'"' S~ =-""__
    "" . ORSOlWI
    .....
    ORT AND UNCLEAN WATER
    ~ .... SIUdy"" .... n .... e...-. ... _ ..... """ .. \IMIn ~ _ ""'_ """" ""' ony
    Ol"""'ll OIlS _
    , _ 0IlS .... - . _ _
    OIlS _ "'""" _ woII _
    ""*'_
    1ha1 .. I1Cll _io-IrolI" 9/...."..,
    oncI
    lroo
    ~II_

    _
    .""""""
    .. _
    ".m_....
    - _ 10'""*~!IJoIaI>I'
    I'ogI'iy - _
    . . . __,
    ,. ..

    --"---
    _ _ .... l'owD1' _ _ ..

    _---
    • ..... ....,,.,.,.,... - ....:>. , - __
    ""'"'*'"' _. W'<l "be _
    -_
    ~"'
    ..., In~

    ...._
    _

    .. '- - ---" -
    _ _ .._

    -
    ......
    ft _ _ i ....
    "'YOflS lodlo_"'33
    .. ~"' '''~~!U<I

    ""'...... _ u.o

    _-_ ,- -", '"ens mo~ pI'\lIlwlg

    _
    .. ~ "O .....

    --_
    '" • _

    ..- "On .... c.o... 01 ... . . - -.b'mIIICtI,


    ,,.,..... ,.. _
    ~
    . "..., I>t..- _<long " " _liOO 01

    ,- _"'_OIlS"' _..
    " (\ 1 ORS _ . . . , . . , lie ",""",OIl "'.............
    rtIOOll"'led....-
    ....-.. .. _H_.
    ' .
    ...... . . ",_.. ..... _.
    .._ . I>Jl ...,., """"'" """ 1>0 ' ''"''''' _
    - - . C>l4' to< V.
    ~. "'" '.... «1 10 _ _ wolf,
    ~ _

    -.
    ~b'I' in _ _ _ _ , _ .. ... "'''' ... .. .. 1
    ""'" _ TIoo<fI _ '" lei .......-don! IlI<lI II>__ lNIl

    ----
    .. "" r$ ~!IlIl ",,', ........ III •.. .... r oloriJng _ h use 01 CR> may ~ ,~" moo, - .
    _
    _ 'IOnlI'1Imo"''''
    ""-_
    \lle Ie<TII tor_
    "(21 ORS _ . o<a ~e:l, ...,.., 00 II'<ll<:CIal
    ...- ~ ~"""

    __"

    -"'-'_
    .... _
    .......--_
    Ol_ ~. ORS _ ~
    1llO _01 "", "" ...... _ _ ""'1'

    - . . --.....- .. ..
    "P I • ~ bO ~. oncI ORS
    _ _ 10 "" _ ..-_
    ~ ~ -­
    ....".... "" _ _ . . . nutr-. "

    , r=...... ' ' ~ , '::-;:.t-. -;:~;::t--_ .


    II LIFELINES: BREAST-FEEDING

    Breast-Feeding
    Breast-milk is the ideal infant food. It is more " Abo ve all, rrotnee's milk prOVIdes direct protection ;Igaillst
    InflICtion" , arc gastra-Intcs tinal Inleclioll$ in partlcctar The
    nutritious, more hygienic and much mort econo m~a l disease rate lor mtecncos is also lower In breas t ted now oorn s
    than any breast-milk substitute. B reast-milk also III HIe wealttlicr classes thall )" u cee fed a rli fiCla lly "
    provides a degree of immunity to infectious diseases, (I. M ~ -... ~ fU _~ ..,." ..".."', c:n.rn...,.,
    , .. r~ "'" I ~;>
    1:l8 1U ' .0
    as we// IJj having a cOlltrauptiw effect through
    Bceeercn in iooe and canada lound that 81lrliclaJly 100
    inhibiting ovulation. inrants were w ee bmes more likely 10 conlJad d iafl'tlocal
    bt poor communities, the bottle-fuding of infants inlO(;\lOnS and l'MCe a... likely to suflor from respira tory
    sluJrply intreasts the ,.ok of mabnmirion, inJwion inlcclJOnS the twO maKI cecscs 01 lnf3tl t ooalh as infants
    who wt!I"8 br$lSl -lod (see table 2)
    and death. Yet in "umy parts of 1M dewloping AM · . ..

    _
    ~
    ~
    I
    O
    ~
    world, the incidence and duration of breast-Iuding is _ Itqla ... 13lJ.':nI-l . 0 111'2
    011 the decline and soles of brttl1t-milk substitute! art
    rising. Table 2: Relationship between method of infant
    MallY flU-lim affect a mother's decision on breast- feeding and incidence of disease .
    fu ding: tlu adwt and example 0/ hospitofJ and the Numbel'" of cases of disease in 24 mon ths
    medical profession; social att itudes and levels of (NOlA CANADA
    knowledge; difji£ulties encountered in breast-feeding SF f<F SF

    -"'"
    AlIment /IF
    ilSeli j pritt, avoilability and promotion of breast-
    milk substitutes; employers' policies and government inIaett<::lO!1 57 109 42 9B
    mategUs. OtJbs 21 52 9 86
    For babus who are breast-fed, the weaning period OietThoea 70 211 5 16
    Dehyci'atiCn 3 1" 0 3
    is 1M tiltU ofgreaten diJtlger to health and Ii/e. Lilu PneuTIOI'lia 2 B
    breast-/eedi"& good weaning maw hea'UY demands
    of Ih.e mother; but knOWIng when and how to uxan a
    child could drastiallly reduu child malnutrition in
    0tUwl11 re r ~ •_ _ .a.u..."""-
    SF ".. Broast·leeOOg, AF - A1tdioel loading
    Ar-. 19IP

    the dnMloping world_ Droast ITlIlk Is !he best food lor mfAnts, and no subs l lulO
    food oxactly duphcate$ rt Sluc!es oi breas l mi ll( and broasr-
    locdlf1Q show mat
    " 8 rOO5I mil k p'<MOOs some InvnunologlC3l protectIOn lor
    Breast-Milk's Advantages the Infanl
    "Breast rTll lk best senetce the Intanl's nulrillOlI;:t1 needs
    Breatl-milk's advanta ies include a perfect infant d iet fnr m e " Oreasl- feeding cos ts ess than feedi ng WIUI substltUtP.5.
    earl,. months, some irnmunil,. from infecti on, a nd a degree "Because 01 Itle Immunological and null1t1cllal ad vantages
    of prote ction apinSI co nce ptio n: of breast milk and because prfl parmg substitutes properly "
    dlUicull in mucn of lhe develOping wOI'ld, breast led Infant:,;
    LJ " Breast-IOO in'Ianls call ihrlve C'VCfl under untlvglenlc are less likoly to deve lop lnfectcns or ma lnutrition
    cond ilions In areas 01 c~tlcnl8 PO'Illrly Tile anji ·mfecliou5 " Breast·reeding protects aga lnsl preg nancy , a1ltlough me
    p ccertes o r human mllj( account tOl' \he very h ~h reseieoee !engttl 01 lhls ceeeececnve euccr Is not predictable.
    of lhO nurslng mlant lc Ifllecl on in general and In part ICular 10 " Many o lhef IK!vantages havo been Claimed !of breast-
    dtarrhea In depnved lropical 8fflUonl'TlCtlts, mos!II1 lan ls grow feedi ng I3nglllg !rom c cse emollOfl8J lies between mother
    adequatcty. even if lhoy have c xoeoeocec lotal growth and d1l1d to groalcr Inlelleclual at:llllty in me r Nlc lor the breast-
    relaroa1lOl1 Of were born prema turely , as Ioog as they 316 kept led child ,.
    at Ihe twcasl during the rlJ$l 4 to 6 monttls of ~le Breastmil<
    has UI'llCIUIl mmunoIogIc, nutntJQnal. psychosoaaJ and eco- ~_og,
    _JfII) 2. _ ~ I H I
    ,.,.,..wi -.w,. PwoMtl '- - ' " ~
    nomoc benehts ..
    l...- ......... · 1N ~ oA to" __ ~ ~-"""_
    II"Coroc:iuslon:> dra'Nfl frtm mvesttga!lOflS at Ihe re4atlOfl-
    _ _ --v CInImI ......""" ~ " ... I ship 0 1 Inlanl loedlog mode 10 InfOC!JOUS eseesc outcomes
    have generally been lImiIed by stUdy desogn probloms, by
    unsl aled 01 mprBClse de rin,tions 01 feedi ng modo Itnd
    PROTECTION AGAINST DISEASE oulcomo{s), and by lack of IflClUSlOll 01 aSSOClaIl.'(1 - and
    "One ol lt1e creet argument s In favou r ol b east leocling has poss itllcCOIl lounding - teeters If' the analyses Nevertheless,
    !ong boon its anti·mfect ious ecnoo . s -ceeuee infanls davel op the WClghl 01 the evceoce IroUl less eeverccoo COUlltrltlll
    fower bac tena l and vuallnfactlons 01dlgcst.ve and rOSPlratory slrongly succcns an Inverse assocmuoo between breast-
    origin than bottle-ted babes. The bo ttle and tho teat are tar feed ing tlnd overal l mortality, and between breast-Ieeonq and
    gretlto r sources of infoc tlon than the breast . parllcu lany fOf di,urhoeal·rola tod morta lity and morblO lty In the high-risk
    f(llll llll,,'S hving unde l doflcleot salutAry conr lilions The Immed i· newborn, FUlttlo r studies Bre noodod 10 chara ctenlo nJoro
    ete con 8urnphon o r molher's milk (from Iho breast to tho
    cnlld's moultll . wllh no handing, aVOIds lhe prohfet~IiOfl of too
    QCl ms present on the nipple and areola ot the breast and !tie
    cloorly tho nature and strenglh 01 theSe relationsh ips ."
    ,lIwwIn M ./dSlln, """MlIWrp_ ,m,ess - . .~ o1I'Ill
    ..r.c:1oCU O'lf MlI-foolll~ 1lI'_"_
    .
    pcoctJll1lon of olf1cr germs whICh abou nd In the 8flVlfonmcnt """ll rooll'll'Ui PwdoIlI'QI "" , . ... 4 UilfI 2 ~ 11/11.
    .,.,.,....,l>'ll_. ~ IO"""t>onOonll. _
    CONTRACE PTIVE EFFECT _ _ po",,1ioos, _ CIlIIiINIll'OlOClIOI1 '" "" ....a,
    1&_ _ ........... ftIlob k _ a l ......... po;- .._ .jof.... _fl!oO<1 ,,_ IO<laV " .....,
    - '-"*'
    Ott _
    1",1 , d
    ...
    -.~~
    _11 • ....a.Nt
    . . .n _,.,
    _ lr ~
    id,raItl< so : l' _ ' ' ' ' ''Il ...,
    ~ - ' d•• _ _ .,
    I>oncIong _ _ """
    ....... 01 _ _ apjoo' k<:
    _.n:..;, .. ... .
    j . pt<pUI- a · !lOI'II ... _
    o>Io<:Ooo<d _
    1lIo< ".,. .., II Il' _ ...... .. ~
    . '" ............,...". _ _ '" bo"Il

    '- - .....'"--
    ~ .......... u. • • Oft . . ''''IJIeCIO<I _ _
    . '. _".
    n
    ......01'"- bUdo, _lUdo" ......... ~.., _
    ............. _ 01 ........ qI aod lo<aldo,........,
    .. l!<tw;I ~(lo:llIyS~_ ,

    ......-_ _ h o _ o I ... _
    _ _ • ....,
    , " , _0I1ho
    - -_ . ~ _
    - ,~
    ''''- '''
    ""'"*"_
    -,---_.
    r.....,
    IOngI< I
    ...-...:l ~
    ....., ,eoogrv,tCl<l trr ,
    . - . "'" iD<Igc< .......
    0IIeCI Of - . . . . _
    ..-... "" .......... _.t_ Current Trends
    -
    ...,. ... _ , E ~ _ onIy ~ " ",",,..._
    "'- ~..,..,.......
    ~ . . ....
    .......""""~ ."""
    ........ 01'""'""""'" """"""'" Tho.,.,.".. ""'"""""" is ......
    ...,. n " WHQ ... _ "'" •
    1M!'"_ t...asl·-
    1In;1I _ _ durOlion _ . ...g

    _Ir>::t_..
    OIl11!y ~ ~
    .. ""'"
    . ...,.,. .. . .......
    _ n

    -"""""""_.--._------
    F~

    _ - . g ....... ...-.w _""'" II> ~ 1>_ 'II arn<:o'III _ _ .. - . r . """-"",,,",


    '~ a
    0Q00tICI ..... ~ """"" " _ - . DIll N , .... on lhoro 10 alSO . INr dur...",
    ~_ ~ " " _ _ OI!omo11' __ .. _ ·IooItong _ .n _ _ ~ . ... _
    ..,.. ,_ .01)0 ""'nino_.
    _01 ... " 0riI' I "'" "'" oro J.

    -.-------,-
    POI " " "
    _ J ..... . . " 'N' ""' ,.. ~ <:NIl•• _ ",,0,_... -""""""'ll
    " "'" 25 __
    Il··__ ...... _ o I

    .------
    . '__1-_-'_-_
    ~ . _M WI\I'l._ _ In'" 1'1 ............. ~
    ,_""" .. _ ' '''''''oigolk:atllly_,

    " ... -. _.-.g---_


    !""C""""" -. .... _ 23 Por '*" _ ..... _ ..........321"",0,,,,,,
    _·

    . ..
    ............ l8rWy.- <><:aning "'
    or~ ill ..... """' '' _ "- <:I>ICI.

    ...... 01 XlC . . . - ""IJOOOIO"'" I

    .
    "A
    or_ """
    rorxtt'O .....".

    - '-"'- , _
    Il'_ ....~ ....,.,
    cari'In ....... _ ~...,."..
    . arod
    I>r IN """'" _.....,.,..,. .....
    Ihor> "*'-l
    _
    ". - - . .. Ghar>o __ 10 ..... _ . - . g, ....

    __.-_
    "'Mdy IOQI'IIoorliW:y .... -.lei...,...,.. tly M _ 00'>, _ _ lOCI """"""'"- la.... _ 0 I rosutQOI\OI> oI ........

    -,-'... -
    ..- ...._---"'-
    10. . _ "' .... r>M\;0I ~ oIIo<:l '" t><_--.;.
    ...., _ """''''''''C .'lIlliCaMIS- " un, "' Il'~ lI:*loolC !II' _ <JIt>ln _ ....a1 _
    '...
    -.. ..... ... """" "",
    '''l .. ........- """"'.- _ _ lor - . pIanno:n
    _ «11.a11OI'S A CfIJOI' 1ecl .. 1NI0<e0Sl.1I:olOn\I " acdirong

    ._-..or.
    . . . . - ........ ~.....-. AI .... _ - . ...
    (Iillo """" ,.., 0<..... . _ ... IOlUIO W I",,*,," _ ....
    NUTRITION
    1I" n. ...-wca ollUl'Oln
    ......... ....._la ",tald-
    11>'"11" _ ....,' SlOmIl
    """""'"
    _ "", _
    bit """'" ., _
    con ...-.....-.
    ...- _ _ """""""'" ..., IhoI _ ... 1Mo . . -
    _ .olel __
    ,_ 10 "'C:tOI;$6 ..

    ....
    ra.ot """"'"" lUIng 1M """ ..... - . (II'1ft. _
    ~

    " Tho-~
    _
    "'"""""" !or. . - """"'" '" ""'"" _ _
    ~ ....... 01 "'"""'" _
    6 _ _ 01 0" _ _ ""'''''.-dtrr ..
    Ny ,.."

    ...... tool 3 10
    """'-"""*
    _ 10- -"""
    <:nIOCaI ..
    ."-' ...-y -
    In «><.<*-

    _ _ ....0(1-
    ,~
    """""'"".
    l"'-"'li <:IliICl _
    _ _ .. "
    ~.._III.

    _.-.g-
    ........
    ,f
    ...

    1 _ 'e_-_$hlI<JlIY
    _ ~ _01

    <NIlIW1>Hf> 1IwOug/oDl.( .... r"""", ... sWII~~_", · 'to SouIn _ "'" po"" "", 01 ~

    """"'" '"._ lI<. . .


    a . - _ 01leoSonIa
    11>1I ~ CooQ,oo . . - "'"
    ......,.. dumIl "" IorSl
    lor _ .aso_

    ,---_ __. _- _.-


    only ..... _
    bill"""' .....
    ~.
    _""~ _ _ ltv .... pro.odo<I1I'4Y ' - " .t
    _1Oml_ l a l O• • "", ..... 55 10 otIOLl J ~ "",,,,,, 01 fir5l _
    '"In Tl'oaoI_ _ or" '969
    ol ........· " " ' * ' l _ !Po _
    '919 .... ....-"11"...-11IOII
    M _ - t"", '2 .~
    .... _ rem Il'O ""Y ..... ".,.. 01""' ''''' __ "1Il IDS < _ .. "", _ _ ~ ..... nllO 17 ~ _ ..
    _ -loci .... _ AI .......s. "
    ..
    _ ...... _ 000:oI_ ... . " " , _,.. " to
    _ _ SJ
    T_ ....""'_
    ..,.. '866 10<l«0lI0n .. lsao llI.owng
    _Ie
    01_ """"""1>',,,,,,""'"

    -
    .............,!tom
    ... &0 .."....,
    ol twas/.-,g 01
    - ,~ _~

    CI'Iob-on _ _ ·tod ~ 110m 1' .8 a8


    PSYCHOLOG ICAL BENEFITS
    I IlrlJO\:l ~ ~ 1$ a $Ir1ll qu> l'(Irl
    ........ _ , _ _ .-.cl'\rO ..., . ..."'
    ""'* Q!' _
    " la< lII3n
    _
    5 POI'*'! ol
    lBradl,
    _ _ ..,...,...,., """""'ol

    """'*
    ~ e.ty~I ._SotI _

    ~ ~
    ll<:tMUl IIrCl <tlIkl . . .....".., The molI'e', ~ .... _ol _ __ ."",
    . _ lor -.
    &0._............
    _ .. ".,
    ."" lor
    ""'" 01 """ .... ..",.., .. . . - . _. or_
    ....._-".,
    .......:=0 -"", n'IllUd\, ....,. sqlI ~. _ _ !II' . - • 101'O I I <Ill """'"G ••
    _ _ _ _..._ ,,' ...., . ~ or o< _·
    ...... _

    -.g ~ - -... - r-.g ..,....,....,. -~

    •
    II LIFELINES: BREAST-FEEDING

    Dangers of the Bottle CONTAMINATI ON


    AND OVER-DI LUTIO N
    10 dcniopinc countri es, babiu who an n:c1ll$ivc ly bre ast- T o be ll$ed safe ly, infant fOlmula req uires access to a pUle
    fed a re mo re likely to s lIn' ive thaD those woo are boltle- fed: ",ater lupply, as well as mean l of s ie rilization and ldri ger a-
    uee, Mothus mUlt also be a ble: to read a nd Il-ade n tand
    " A stUdy 01 1,700 womer'l In l ural CtJilc III 1969 and 19 70 writt en illltnlcooJl5, a nd bave l llffid en i ia come 10 buy
    found lhal postneon,llal dealh rates (between ee am and !he adeq uat e 3 DloOUIIIs 0 1 the product. When these condiuo Q
    52nd week) were three lime hlgl'lCf alTlClOQ Infants who Slarted are not mel, tbe: RSUlUI1J milk solut ion is e ither co ota mi-
    bonis feeding In !he Ilrst three months lhan among ecee who u ted ee ove r-d illl-te:d
    fecerved only weest m~ OUlIng lhal lime. Because the 1f1lants
    WCfe less kl«lly to be bfeast-led , death rates were hlgtlt!f " For mllllY people '" lhe dcYeloplng world the hygl80lC
    among chtIdren whoso mothers had moderate BducoIlOn, ooodfl lOl\S neoe:ssa-y Jot tIlIl propec use ol ,"Iant IOtmuia JUSl
    hl(»her ecores, eene 5arlltallQl'l , and prooatal hoallh care do no4 llXIst TheIr wa fer is unclean, the bellies arc ditty, tho
    lhan ;vnong those WllIlWl a conlffiSl WIth the Influonce ol formula IS dilulCd 10 make a btl 01 pOWdeIed mitk laS! Icogor
    SOC1OElCOllOn'l tecices on moftshty In most studies Ihan it should Whal haooens? The baby IS l ed a oomaml-
    " A recent study In ca 10 under ne aosoccs of lhe nated mrxlure and SOCII l becomes dl WllIl diw rhoelt, which
    Inl omallOOal Fer tility Research Program found tho! ch.ldfcn leads to ootlydrallon, malnutrlliOn, and YCfy allen donlt! ..
    wt10 _ e bieast·led for 1~ 10 20 months had a 93 ceeeeru _~._
    /lI''''''''''''' ~ ~_,. ~
    " I"" '_ Il/ " l7l;:lI1QII
    ~ lot
    ... I'''",!'l.Jl
    lY(lllsr·~ 'II '" ItVl
    probability of SUrviVIngunlll l 'l8 brIm of the nelll ch!ld, whereas ~ A"'*"""'~Clrot.l'!fI .... !5/~ fi !91l."
    children never breast-led 01 breast-led for Joss than tnrce
    mon ths h<ld a survival probability a t about 6 4 cerccru. An Ind onoslan sludy sampled ~3 milk. ec unrcos trom bottles
    AIlI1CLJgh the educational IOI/al ot the rnolher also mnuercec bcllng used 10 lCll d Infants In l our mlllernal aou Chi ld hca l1h
    child sui'VIval, the romencc ot bf ea s[·!eed lng was greater, and c linics Tho !lnd mg s
    lhe lowe, the rrctne-s educallonal level, i re mer e in fluence Ooe- third were Jess lhan 50 % 01 proper streng th and on ly
    breast·leedlng had Among children whose mo ttlOlS had no ha" wotc WIthin 20% 01 recommended concenlratKlrl BCCOrd·
    eouceuoo, eose broasl-Iod lor 9 to 1? monlhs had a 30 ing to \he maoolacluJer's label
    petcenl hlQher SUl'VivaI probability than 1tI05e ~ beest-teo. Milk sampled Irom feedrng txltlle!l 111 1tw1 climes was htghly
    among ctblclfcn whose mothers had at Ieasl. seven ,.ears 01 cootamlllated by faecal OI'ganl5mS, WIth only lour 01 53
    sd\ooIJng, the oneeoce was n
    percent." sampIos haVIng rewer thal"l 1,000 OI'garllSfTlS per mJlJllrtrO
    '*"""' S - tool ".. a..- -.oJ _ "1lac:foNJ _
    "'-' ......, IWJ/Ol\' _
    _ J no 2~ _ ......
    a.e.- l td ' ~ ,....,.
    __- .Il/_'".... -.v ~ """""1l/11q>ClI/
    ~ >d X AiJd 1S6Cl
    SI\JdIes In 100J oountnes In latin Amefica and tho cant).
    ocan -F J salvador, CoIombla JamaICa and Drvll-have
    showf'llhatlfllants breasl-Ied 10I1css Ihan Sit monlf1S (Of no l at
    aU) were sot to lourteeo tlfT'lCS more hkely 10 de In lIle second
    The Costs
    $lit mon ths 01 liIo !han babies who were b reast-fed lor Slit
    months Ot mcec Brea st -milk bas an ene rlY COlt 10 the moth el a nd il
    ~ t..,. .JotJ u wrny " MI<//lI ..." /OlIfflIII:In llItIIlf ~ IbelefoJ'C: not 'free'. BUI in cub te rml it lepr«enls a ve ry
    Mld lllf,onf"'- " Itt N /-ft!Irty~ (eIJ ', NIJIOMtt "..d /'ll1mMl considelable saviag 10 the pool compared with the buying of
    OWfQ<1ucr'::f l """"", " -. 197B
    infant fonnula (I« tabl e 4) :
    A study 0 1 9 ,66 2 newborn babies delivered arne Oa!jlUIO
    Gonerol Hospi tal and MediCo, t Corure In th e Philippines Table 4: Cos t of comple te formula -feeding for an
    teween 197 3 and 1977 to.Joo a sllollg eoneeecn be twee n infant :2 months of age , expressed as a percentage of
    bl easl feed Ing a nd oecrcesec lTlOJ'bidity and mortality salaries for selec ted jo bs in different countries.

    ---""""'" "'
    (see !able 3)
    MIniStry Junb
    ~1ia!I N H U - ~ <l!.l!UnD _ "'eJI"""""
    """",.--y...,~ .JlUl1iIJaf r-.w ' ~
    'a ~'982
    .... ,""" ...ff .....

    """""
    .......
    ..... ra
    '"10' 2 21
    8

    ,.
    9

    ,. ,.•
    --
    G...... ,,,.. 27 '0

    ---
    ~ OO I88tll 3> 51 2'
    28 2.

    ,.,•
    63 45 '3
    81easl fed
    ..-,
    Sri """"
    • •
    T_ 32 32 14
    MlKed·ted
    T~kBy 21 21
    Formula-led
    Total
    UK (LoodonJ
    Yemen •
    17 13 • 11
    N Il~. 'Modt",r~il'IfI IISF/Ioc:fO'l_"""_W'II/~ " &lImI3IIIIi1<1ton:~e.-~_Y~~,M.nnIM-*W
    .JooIr'd1l/ l ropc:,i ~ .... 7IJ. no r5. ~ /9192 _ _ )'IltlIVe:tlidI':n, (1nJ1/ I1Jr<1I11J1101l, /98'

    98
    ........ao:>ot'/ - . SIMI .. oouaIly _ . __
    "_ '-*'"<1 _ _ ""'~""'_.. "" ".......
    .... IIUCOloW1ll. D\Il _ flIIlIlIO. " _ .....
    OI ... _ ...... - . opo1I'IOIIC. "'''' • dry ..,., ,...., . . , -

    __
    b _iUa""" <II trIO _ _ ,
    '-..,... ""'l'. l>UI ~
    o:toafI'. rft'lgonl_
    .... COOl .. _lc>o<Ong_ __
    ..,.,......-.
    , """" _ . " _ 1IIOl .. 0IlICla<Il "'''''"' _
    Sho .. _ "' ".,. cine ... caoo 01

    ..... _.. ... lOr",,,,


    • "' . W,_ • 1Il _USS20(l.S300 "" .... .~ _ . ._ <lol. ..."".,.. I....., '" ,..,
    !ItsI _ .. WI> """""" "","""",,", <0.. ,........ _ _
    lNO """"'1""0.., .._ ..... "'~ """"l'O~ .""" ...... ~ ..
    . ~

    * <;ogr... t ...... '" lacI • ~.........".


    """""""
    "Poor ... roo '.....
    ~_
    _ _ I>,.0 ....
    ~. t...- may
    _ may.........._
    may _ _ 11>.10 S200·l300 • _

    flOl _ lor_
    """'-QI'
    '0_
    .. mo,
    "" ~

    _
    l: '

    _ _
    ~

    ... oJ ... .
    . _ ...,.

    ,~
    _ . _

    l'ro'e .. ~ _ - - . 0 0 0 1 . _ _ "'" 01

    _ltII;".....
    _ . lnoy """y """ .... ""'" """"' .. """" _ _-mI< 0Ulpul an _\Il' _ _ ~ ""'"
    ..."""" ~_
    ""lIlOul
    _ _~ . ' '''''
    _ moy....,., A _,..ogar "'....''' _;w _ lalls t> .. - . o i l y lOw _ """'""

    ....
    <1>1>'>*1 oI_lMClI<IlI"""'*l
    __ COIlIO\!le!lmoll' - . . . . . . In ~ - . . . . """""'" In ... ~ In "'"
    <l!y _ _ ... ........,"'_011~_ ....
    --------
    IO_"'~ ~_
    ....., t> be IIlI<>JI lSOO """1/00'/. 0UIPiII
    __. ..."" _ _ ~ is ~"lC O f " , - " _ _ .. ~ l90""/<l8r in __
    .....".. lAL9Usl-SotM _ 1 _
    _ J ... ,. _ _ " • • AI .... _ .. ".., ""~

    Aver.
    -"'-- -_....
    ~ -avaup.oI
    "'""""""
    _ _........,III oriI' '200 _ /day,
    _lor """"""'" __
    Mc <J<XI " Tho _ogo ~ ~._ on moik or _ oriI' Obaul B3ll "'11»/ ..
    " ' - 'l..-.. ... ...

    or_.
    57 20 .. 10':1>" WID ~ .

    _ _ """'""
    ~ Ire _
    III .. _ _
    0l,l0 ITO"IrIIy _
    Ib>SOI'oCIIOO
    (V 3) _ _
    ---~ ,..,
    _ '.....-...

    __
    _
    SlI 00 .. 3~"'''
    _IIl II.-.... -.l
    fI'lOflItVy """""" "" ..... ~

    0'I<>'l lI \' _"" Factors in the Decision


    --
    """""" (S5Tl_ 56 ~ .. " "',, ""'"

    -,,-_
    .... .. tomW ·,
    ...... .....
    -,-
    _

    . . . . . ,.,.,., _IO_..
    Il''''''''''' , "'1'
    """" """"'" ",.. _
    -.
    .•
    " ' ....... c.oo-,,-.

    "
    ,_
    _--

    _
    ~

    0d00"1l
    _

    . lIOnS
    """'.
    l I'_\QIUo
    M.><y .........
    10<4 lie, cllJoI
    ioI. ..... - . . 10

    _ " " ..........


    _ " _
    pa., • P"'" 10 a _ , ' ,

    .... _
    __ Ilf<lOOt!lI' ---,.... ~01
    '-""
    ~
    <lit..- of _

    ... ...
    _ to brent-
    ... _ _ ....liaJ ..
    _ .. ...,

    Old .. " " __ '-""Ii


    .. _ , "'" 10 lI>O """"""'I' .. ~ ~ l o<lal'
    "__ .1l'>.>IhOII
    .~_""'_"""01~
    ~ ..... MI bAoI ~ ~
    " 1_ " do I. ... ~
    ....". C<>,...... II'''''''''''''D tlIl>\"IDOd """" Iaog _
    ...... ..."......., ' - _ ..., ""","" ..,. "'" Il'O"'"'!l
    .... ..... tlI _

    USS-OOO"'*'" Nldo_~_ n_otICl

    ~ toUt"""
    ,_
    "".. _ _ .. ..... .....,.".,.
    ow""""'l/ .. ltw<l _
    ....., _..... !My...
    _ _ !O~_.""""""

    .... ,...---_... __
    -.y~

    Sl?O _ 10 "'" l!C<>I'OI'I'l' . - ..., •


    ....,...,...•• """" ~ fIIlIUflII u"",..-. • ~ ..
    GOt 01 ~
    _
    - . to""",
    """"'II. lIIOUllII'
    _ -.ca
    -.ng~I!l
    "

    ... ,.. .-
    .. in ll'''''''..........., ..... ond ~ ""' ..
    ana """""
    --
    alii ",.,. 18IlIII1 1ot ........ I'll POOPlo•..., 1IId

    ,-
    "..,., _
    . . . """",,",*". no. .. _ !I)' • . . - ono
    _p-<XM:Il:<I1lI .... ~J'W" t8tIy_._
    -
    --'"'-'--'r_.- . . __
    ~ .-.,- _ ..." - . . Of """ _ ... good ..........., """
    I . ,~ .._ ~ ._dln"'\I''''
    __
    "..... . . - ClOUDl 1Ml lIOr """. <JIll ~"'0I<l
    prlX"uet ;0 good """"4' ....... l>OOy. ... """"" ..... _ "'"
    ICl <II I>"l»$~--.g • • .-uIl <II ... fDIl'I\OI.II ol . - ~ _

    sucl<"'Il ",. It<l '"l!M1 No _ . ~"""" . .. _ _

    - --
    , . . . _ , ..... .... l.><:l ~ """"'9
    .. ""'" .... rnor>I'\' "'... ' ..... The COSl ... BREAST· FEEDIN G DIFFICULT IES
    ~ "" 01 ~

    ,---
    _ 01 -...
    <:011 600
    01 _ Ie IlOO
    _. _ 01POt_<l8I';o. ·l.a<k of,..;.a.';. ........... ei by
    ~ '" """"' . _ .....100 _ _ ""'.., J<. diq _ u-
    '''....-''-
    """"-,..._'''_-
    ',""' - - -.en.
    A WHO 0lu<Iy" tI'.... - ~ . ,..... ~-1Vlgary
    Et!IioI:>I, "'!l'N, ZOinI. CIWo, ~, hi
    -,~ _ 1tIdiI
    I'l .' _ _- ._ tQflClu<loO
    _ ...a ,_ _ ..,.
    ENERGY COST TO MOTHERS rut .....,., ......" II'dot'lIol<l _ . - . ; WlIlI

    B",,~""' _I ..."l''''''''''' '' '_~_


    ......... _ .. It>' """"~
    _ _ ""'"" """"""
    .... ""*"I_1oC lor. """"' _ _ I ~ d _

    - _. . . _--
    drmos""& . - ...

    ---
    ...... . . . - . _ I.
    IKI>lioo,.,..,.. .. ...,J1.r
    • ....-IboouI_ ... l1Ie _
    a..r, uol _ _ tljo 10.. _01
    .....
    "'"' .... """" pooo;tJfI' """"""" l>j wturlII
    ~ _ ,
    !aoo1<>"I "'"" by .... plo,,-,.p ~ .,_..-
    oI....,......_""'<otng"""""'•.,
    • ThI _ _
    .........
    _ """"_ ""• ..,...., lOw
    ... ~._~an."
    " " - " ~ ... ... -"' . . ...
    ",.,~._ - ",-
    ,.'" """ ,. " ..
    ....,
    •
    IT LIFELINES: BREAST-FEEDING

    MeXICO " Responden ts who regularty bottle-ted ITlIlk or


    IOfmula o led the grCilICSl reason 'Of 1101 bteaslleecllng was GOING OUT TO WORK
    insulfictcrll bre ast m~k ... Othef reasons reported by molhofs " lactatIng women whose employment req oues separation
    for nO! breast-feeding mcludod breast protllcfns. Inconve- Irom ~r mtants la ce obstacles Ifl many SOCJC\JcS Managing
    nlOnce and refusal of the llltan i to suddC the o eeet .. lac tat ion undCf such ceconstancesrecores a comple_ lask
    ~" j -'u lItld ~ J J.......... ''l <:mlll'llC .'''''' _ l eQUlflng haoo oKpression 0 1 milk, usc 0 1 Intant tOl'm ula or
    ~ ~ ..."..,.. - . , llo.'l._ _ " • ..nf
    ~

    _ _r-'. J/JIJnII d T'<JPIClI/ 1\ld.1~ q >'!If 28. COW's milk, Of usa 01 a wet nurse. Among tho $lrDtagl8S
    Or:tn/n' / !lIl !' de veloped by employ{)d women are WOl'kmg at horne lor the
    Iitst few momne: worklllQ l]e_lble hours, part Il1ne, 01 shorter
    ., Women are losmg the art of managIng A successful shift S, eoo breaslfooc:tir'lg at m{lht "
    brC8st·!OOdmg relatlons/1lP ~,'h Iheir babi8ll. BreasHoodlllg
    bec omes so unnalW:lJ tbat they find 11 d ifficult 10 co co with It'm~ ~"" r.""!11 "'~ l 11K! G<<loflt~ , '",lOlS1 l_1lI "'.'lW)lIM'
    - " CCfll lla<rJIlI'11.10 (QJOffl""Ile<' , Siudin k1 f ..rn/)' f'lNllwlQ , oQj
    problems - pain or soreness of nipples, breast ol1QOfgemen\ 17 ' "' ~ , "'IlI" l iM l
    and sucking d,fficullies of babies lJullhese problems can be
    solved II mothers understand them and have the opporlUnily " Wolklng women roltorate that breast milk 1$ 1/1(1 best tor
    their chlldron, bul have oct yel beenabe 10 mustll r the support
    to learn how 10 cope. LikeanyoOlO!skill, bfeaSI·loo<!lflQ has10
    be learnt. DUI 101 many women. il has becomo easer 10 gIVe 01 sccc w In ootall\lng a longer malt.'1"My leave, 50ch leave
    up bt'Oasl·lcWrng than to persevere in it " can be VlCW9d not as a prl~iJcgc accorded 10 a working molht.'I"
    as an IlIdlviduat. but as an esccseco et me lUll responSibility
    ~~ ....... ·1'htIP'U"o"'O"(lI_~,, of the entire communlly to uphold lhe need lor mothers to
    'lie . - DI hi """"" . ~ o./on1 ~ ""-. '" 4 bfeast-teed their reecs- and thaI because of the many
    "" adv antages thaI human rrnlk can ol ler society A WillI,Ied , 'Nell-
    nourished. neallny Chik:l is lIfI eseer to any soclCty Ma IE!fl'llty
    THE COLOSTRUM PROBLEM leave mosl bo COf1&ldofed B socer lcspoosrbl~ty thai IS
    assumed rn the aim 01 [)fOOUGlI'Q a healfhy young genera-
    " Breasl-mllll1Oi1La1ly appears as coID:slTLlf'. a COflcenITated
    ycUowIstl fluid measunng 3C4)l'OXlmately 2S mI dunng ee firsl tion."
    24 hl;lI.q The small amount and strange colour ol the I'I'IIlk at ""..
    _
    r_ Sclpa
    01 _
    1, . -.bg<s"oI . . ..-....,. ~
    ~Ootim rd55/56 IHI
    thIS stage Tnl$IMClS many health woncers ana molher!! Itllo
    leeling arooous that the mothe"'!! own mdk fT1IOht not be
    cnougtllo leed the baby, eecacsc of ees. mall)' women resort CULTURAL ATTITUDES
    10 pn;llacteat or supplementat lormula The result IS less " Unlof'l una tOly the West 's eX3glJCfaled concern W1lh
    suckl"lQ and lherelore less t:J'oast-mllk supply In many C89C9. taeaets as sckunl oo,ects ISoIten rcecoo upon and adopled by
    Il1lS PfOO8SS ends In breasJ-teoc:llng being abandoned alto- oIt1ef sccetes Whon perceIVed prima/lly as sex symbols. tho
    gethel .. breasts rrcst be 'doceolly hidden ' -whICh 0 1 course makes
    ~~_ r!lll ~ Of _ I /lMdlnll .. bfeast-leedlng ,1'1 public places dlUicull
    Il11l lll.1.. all!IG _ _ ~ 19114 o..b1l l ~ "'_
    IlIlt ] tbiolJll llellw>q .... I &_1C.Ollr 8t1n1f.toodo'll wi to>_
    O<'b'd~AoP. 1987

    LACK OF KNOWLEDGE
    M eXICO. "nesoooocms wete coencoco as to w-otncr thoy
    beheved lofMISwere healthier II lIloy were brelist-fcd or fod a
    aubetinne fOl' broa st -milk. 52% of Ihe sample rllsponooo Iha t
    Supporting Mothers
    breaSI-milk was belter l or tll o child's health , 2"% believed
    milk 01' lcemula roode Infants healthier w/l ilo ?3% tell tt1at whal If mOlhe rs are 10 be enc ouraged 10 pra eti H b reast-feeding ,
    the c hild was led mado no dlflerence .. there must be a s uppo rti ve psycholnllical d imalll, sta n ing
    _0Ill01\I1C l-v_ r.-.'J
    IIIf;1OrlI .~ _ _'.
    1~ .kmtlmlC'_'"""
    onb'lI ~ ~ '" . ....",.
    ",ilb health wo rh rs d uring a a d afte r p reg na ncy , . nd
    ext~ndiJt& iDIO th e fam ily an d the mo the r'. wor k_piau:
    """"o:;>n _ _ , .b.maI 01 Im(J<;II Ptol.ta/rICI.. ~ 2/1 U"El\8mples ollegislalJon and POliCIeS mat support breast-
    """"" '''' lecdinQ are maternity Ieavo. breaslleecfjng 'breaks' al lhc
    worlw lO, allowanceS slitt er cast! or commod ees - lor [)fog-
    nanl women and new memes. llextble work !ldle<IuIcs lor
    FAMILY SIZE new molhefs. rtlOf1'1Il\O-tn at hospitals/maternity Wards. ChilO
    " in the C39C 01 women ..no formula-fcd. fafTllly Slle may care at the workslte , and a na\Jonal ecce 0 1 mafkelmg 0 1
    have been a oolCmllnant In the leedlng deCISIOn Mont bloastrrnlk SUbSlllUles, As the number of women working
    formula feeding mothers had from ltve 10 10 etllldrCr'l than did ou\Sldo lhe home ecreeees, ImplementanOl1 olltlese types 01
    breast-!eedlng mothcts The demands on ltIe rnothen lime jXlhacs CflSUCStha I women reee.ve support lot bfeastleeo.ng
    doe 10 IaIgc lam:ty Silo and the COI'lYef'llCflC 01 aIloWIrlg an from Ihell health care [)fOYlders and Cl'Tlf)Ioyefs
    older child 10 boltle-Ieed the Inlant may t'ave fMde fTlIIk or GII,eo GitlbDtll 1.---. _ _ ~ ,\,Ighfs

    100mula -loeding 8 more IIItracIlve altefoahve 10fhese rnotners n ~, "Of. ~ "0 J I H~

    Pert1aps ffiOI"e Importantly, the eHect ol a gf OOlcr number of


    preglllll'lCleS and childbirths 0fI these woman's health may ADVERTISING INFANT FORMULA
    have contnbuled 10 Iheu l~or1ect Il'l8bllrty 10nUlse !tie mosI The lDtenaation al Code of M arketing of Bre. lI-mil1 Sulnti-
    recently bOrn Child " lUlU, adopled by Ihe World Hea lth ANtlDbl, in 1981, . ims
    ~IC 1""' _~ J ~ 'r (l(lflO/rrc: _ _ to prolttt and pt'OlDote bl'ell5l-fee ding aa d 10 reduc e the
    ~ ~ """"" .. . . - /IMdInlI """"_ ... ....'IJ pressures o f . d vertising 011 mo lben to boUIe-feed th eir
    .w...... _ '• .I;lu'm/ 01 TI<JPl;III ~ ..." 28 ,
    ~1 9Il" babies:

    lOll
    """"'" " " ------, .,,-
    -"'-,,----"-
    I' "'oI~199" "'CoOo _ .. ' ~ .. """"'""'" '"'*"' ..'" """"""'""
    . .. '"""'_.-
    octmI _ o<:y
    lor.....__
    Ito _, .. ""*"igo'lO<Illllr
    ".,....... _ ~ """ 01 !he IJ\ill ""9C' .. \ 6
    ... _ _ e- """""*...
    _ '"""",.."""
    """"'".._ """""...
    -...
    _ A!ortIot ,.
    .. '6_, "<>:>l/!gas, and ..t>..,.......... ...... """OCY ""'- .
    ~OI"oasl_~",,"_-"""'"

    - ' -"'-,"'_
    """""' .. 13 ~
    _ ......_ _ 'NO' , _ ~ ,., ."_ ,,,
    --~ ,.. '
    ~
    """_d _ ,
    HEALTH WORKERS

    __-..-:1._..
    _
    .....,.,
    ......- . g ...,.
    '*'*"'.._.LJItWI
    ._ tIUI""", ll'I
    only ....
    ~ ~...,
    1"-
    -"'" """ EMPLOYMENT
    I ·'T ,,"
    ......... _ ~
    ......", """'*'lIand" """,,",",
    I-on<u ~l;gn I' Ol "" PIo"""" .
    " aeIIin\I Il10 InIornaOonaI _
    .. "'_. ~
    '" _

    --
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    II LIFELINES: IMMUNIZATION

    Immunization
    For as liuie as $5, Q child can be f ully immunized bolWeen a Quarlel' and a thMd ollhc wor1d's c::tllidlon are now
    protOCIed agB1flS1 them .•
    againsl six of tht most common and cllzngtrous
    diselmS of c.hiJdhood. BUI at preunt, tvtn though
    r ..-dD:l_ lMQt _ 23 ' ~ ,,,S
    many countries haw stepped up {luir vaccination MEASLES
    coverage, fewt r than 40%of t~ /00 million children I I" WlthoUt ImmUnt1atJon, vl"ually 100 ~ cree children II'!
    born each year iF! the devtloping world are fu lly the dev elopi ng WOfId will contract measl es be twoon ee ages
    immunized againsl all or most of these diseases. As a ot sil'. mon l hs and rr ece years - mo youngesl inlants boillg
    Pfotocted by m aternal antibod ies Tho ago at whICh 0 cMd
    result, almoSI 4 million children dit and a similar becomes Inreclod vane s With scca rnrc ecooorotc ccrcnore'
    number art mentally or physu.:ally disabled eachyear. where mee Is ovo rcrowd lng and poor hous ing, it ne mlly occ ur
    Many developing countries Jace serious supply be fore on e year 0' AgO , in be tter con d itions the disease may
    not slrike until SOllie nne In the scccoo vear or eve« Ill ter
    problems with immunization services. Technological Co rnplicaliOflS occur In etoct 30% of all cases, Iho most
    developmenu art helping to overcome some of these important 01 whICh nl ay eeo 10 ooecrocoa. blindness and
    dea rness Those are more Irequcnl and mor e SOVOfe In
    but management capacities needfu r/lIlr szrengthtn+ malnourished children who may have case ralal.1)' taros ot
    ing. 10,*, Of rooo In lhe deVelopM'lQ world, measles is also a
    signiflCllf1l cause 01 maJnull'1I1011 and oarmoea Overall, II is
    Immunieatian is as much: a question of demandas estim ated that some 3'l> 01 children In clevclopIllg ceceees
    supply. Rt ct,u evalUil lUms how shown that cuveroge who acQUIremeasles wi"d ie I,om It Of trom Its complications ."
    rales could bt doubk d and in many caus trebled if 11 /1 t _ D I .
    ~ "
    \'lIccnt ~ . ._
    ~ IrISI IhC _ ' s ",*,,"
    ~ "'
    . . {II_ ...........
    parents look advantage of existing immunization -.~'_r9ll.
    smnces and if thou bringing their childrnr Jor tM
    jint oa«inalion wtre also to return Jor 1M second PERTUSSIS (WHOOPING COUGH )
    and third. '· An 3CUlc OOCI8J\allnlectl()n il rlocnngme respt,atOl"y tr:lC1.
    whooplng cough IS very contagIOuS 1I1 1he Iirsl week 01 two01
    Demand for immunizatitm can be increased in two inlectlOl'l The spasmodic coughing Of 'whoopIog'/l'lat charac-
    principal wayf. Fint, empowering parents wilh eozes tho (I1S88Se 1$ leadily lecognlZed a nd lasts one 10 two
    inJort1lation about immunization can increase the monlhs. Per!U$SlS IS most severe '" cNld ren under Iiv<! months
    01 age ana may lead to dea lh throug h poeumoma Of othel'
    distance wJrid lhey are prepared to trawl for coootoes In very young children, there IS no chaf8C18listlC
    immunita tion services. &cond, making seruias whoop so the ceeesc may be d lrflCUlt10 recognize."
    availtJble at more convenienllimes, closer to people'l
    homes, can reduce the distance parents need 10 travel
    for immunization. TE T ANUS
    " ..
    _ _ Wort! r lllCloiflillW 01 f'IbIt ,..,." ~

    These slrategies combined would enable immuni- D'v retanos is caused by a toxn of t~ tetanus baCIllus and
    zation to bring about a reduction of up to one-third in ca uses pain ful muscutl'lr contractions and genemli~od spasms
    which In severe c ases may reach ue larynl'. end resplral ory
    the rale oj dealh and disabili fY among Ih e developing system, The disease can OCCut at any age, but IS P<i"'cu larly
    world's children. dangerous dunng tho eoooatar period Neon atal tetanus
    results from lhe con tamina tion 01 the umblllca l Slum p by
    unstorlle methods 01CUlling the cord OJ by appl lCallon to tho
    Slump Of maltCl' such as cow dung Of mud The intec ted
    newbor n w~1 lirst 00 unaoe to suck and !hen be unable to
    The Six Diseases swallow Of breathe Some 8 5% of UIltroatod c ases die In the
    jlrst few weeks of Ille "
    Ea~h yur .lIIIost" millioa childnm
    di~ aDd . . ~v.in1~AI number ar e
    ill dI~ dn~lopi,,&world
    mnataUy or pbJlic::a Uy - "
    RII ' - - '
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    r - . t9Bol _
    disabJ«I tIlroup 5is vaccine-plCnotabk diH:aKS: dipbdle-
    ria, pertll5ll5 ( wboopiq cou~). ~taIUl5, lD~nlC:5, polio.1Id
    I\lben;:uIOlis. F~w~r tho ~ of illfaDl$ io den lopiq POLIOMYELITIS
    couotria ate fully immuai%ed .pinsl .II-or eyu. most-of PolIOIS a wal esease spread by OOlItaetWIth ootects, tood ,
    these diH:asa. F1lI1herm~ om y lIbout 13" of ISIOdltrli lIrt 01 water contamlnatod WIth el'.creta In a small ITIlOOIlty Of
    hilly na:iaated. widllttaDllI 10:loid, wlUcb also pr«tdl dlt cases , polIO Icad:s 10 VarytOg degrees 01 paralysis and ,
    atw-bonl .pinst KOUW I~lplll-dl~ m.io killer diwlIW somebmes, dealtl. The 0600r Ihc mid at the time 01M'llec l.on ,
    ill die finl moadl of life; the morelikely tho Ifllecoon WlMlead 10 severe COf1SOQU(lOO8S.
    I 1" 01 every 1000 ctuldrCl1 born IflIO the wodd 5 wilt grow The use o r polIO vat:ClOOS In !he last twenly years II'! dcv8Ioped
    up cripPled by pclllomyohlJS. 10 die ot neonalal totanus, 20 Ole counlnes haS markodly reduced the lnadeoce 01 polio ,
    01 whOOpu'lQ cough , ana 30 or mcwe dIO 01 measles or lis however , i15 relalJVO Ifllr00l.Il!OCY has lecI 10 IaXII)' and
    compUcatlon!l These diseases, along Wlltl diphlherta and occaSional oulbroaks among !he un'fTVTlunil OO
    tube rculOSIS , aro the targets 01 the WOfId llelll1t1 Org anll.a · s...m...,.,ttl"! ~ WorIdr_ _ dl't.t*l_
    lion 's E>c pandcd Programme 00 ImlflUf1lzatlon (EPl), and ~",,'9".

    102
    TUBERCULOSIS (TB) The Vaccines
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    alo<n o;oftol fa ~ _ SCHEDULES

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    ,.
    II LIFELINES: IMMUNIZATION

    pos:sbIc. lOcally. childr en should be Ifllmunl led as soon as oogcs Wt* ffiOI'e hequantly resultlfY,l "orn Illl8CbOns givenbv
    1hoyaltllln the mnmum ages (sec labia 5)and.stloUltI recese 1ocaI IIll6CtlOfllSts or folk healels, Ihts problem can AltO 0CClJf
    SUCOCSSI.... doses at !he 1Il1C''lals st\own l lowever. cIelays win '" organoed heiAlth Pfogr3mS Progmm peI"SlOI'Wl8I shoUld bo
    be IflCYltabie tllmfT1l,JnlzalJonscannot be made available on at urged to roport all serIOUS SIde effcc ts."
    least a monthly baSIS, and p1annefSwin oood to use schedules
    whICh best meet Theil 0WT1 cecoretarces
    _"llMI
    198~
    ~ ,• .(1&_' ()I f\de j~ "-"*""".
    " lmmUll ll a\ioll of woman c t chl ldboallrtg soe IS;'Ineuecnve
    measure In controll1l19 reonatattetarws In areas where most COSTS
    pregnant women seek prenatal care early enough to be given Compared with the cos t of trealmenl of childhood co mmu-
    two c105(I$ 01 tetanus toxOId, these sfloukl be spaced aueast nicable diseases., the C081 of immunization I• • mall :
    lour wool<s apart, Wllh tho second dose at leasl two weeks
    below delivery, A third dose should be given I'll the ne:.;! " $everol sucee have calculated 1I1C costs pel child
    pregnan cy, and all Y chllclren born during tho folloWing live protected or death averted. These studies gene!;llly show thm
    vears Will ro prOlacted .. measles. OPT, polio. and BCG ImmufllzatJons are highly cost,
    effective Immunizations oro substantially rtlOfe coet-ellecbve
    "."""'''''10'. WQItl 1Ilo'W!l/lOl'l ()l I\Il)k I ~ "-Do;t"'-"'!l than such ott'ler Pllblic health measures as providing Cur Qh VC
    "" care or sale water
    " UsIng EPt C061111Y gUIdelines, al'lillyses were maoo 01
    TH E COLD CHAIN ptogmm costs Pel' comple tely protecloo child (OPT. neGjln
    The 'COld eN" n' ~ the name givon \0 the systemusod tor Indonesia. the Ptullpplne5. and ThaJtand Costs 13nged trom
    slorlng and distributing vaccines m a polent slate from !tie US $2 86 10 S10 73 and sccmcd most dependent on
    manulltCfUror lO \I'Ie person bei ng lmmUrlllOO It IS a supply program oroanlZatlOO health cere InPUt costs and p<'ll)UIallOl'l
    syslem whtch 1$ parllCularly cutcer becauso vcccoes are acccsSltlllily
    S()OlIOO bY heal " EP1 planners estimate It1aI deVcIoprncnt costs In starling
    The Expanded Plogramnc on Imfl'\lJl"llla\lOfl has tlWl up broad covet"age immUOllalion programs IOgethef Wllh
    vacanes These are 1) POlio, 7) measles. 3) dlphtheoa,
    pcr1U$S1$ and tetanus (OPT), " ) Iuberro 0Sl!l (BCG) , and
    operating costs once !hey ere underway wi.
    total 55- 15 per
    tully mmuntled ctlIId In !he 19805 , Mota than hall thIS amount
    ~) totanus IOIlOlCl ern
    lor women wtII COI'lSISt of personnel cosis. IacIllDCS, and aperahng
    expenses The 1es1 01this amount wiI be eeoooo IOf vacones.
    SlOE-EFFECTS cold c;:t\alfl equipment. and lransport3tion rPI planners
    AI with mos l druP. \'I en Dn oc:asiDu llJ kaYe uDdninble bell8Yll thaI many duveloprng cccmros can suwtv D8fsoonel,
    tid~R«tL Attordiq to llroe World Heal th O rpa.iza tio... 0011"05 and Q08latlng expenses, but that cX1Ol'I\(Il fl;l9OUl'ce$
    bowe"er, the beoefits 01 immuDiu.ti on far o Ufweip tbe risks WIll ee I'Ieeoect to pay lor !he taller Items In the poorest
    of ad "etK rUeUOfl5: counllies, lhal IS. vaCOlles, cold chain &qllipmenl, and
    transporl Will nood to come from externAl donors "
    " 0Cspl18 the saloty 01 the vacolles usod In the £PI, 1fmIl-. WcnII...__ <II PulJIIc ,..... " - - ' "
    compllcallons do occur Although theil rates arc dllhcuU to
    eslimalo PfoclSely, It L<; kllO'M'l thatlhcy are far less frceucr u
    than the cornlJllCatlOOS caused by me oscesee themSOlvos. "
    ""
    O " lmmunilahon mone of the most ccst-cuecwe measufes
    "Tho cleclslon to WIthhold immunltatlOll should be tak(.'fl 10 reduce childhoodmortality rt uam Itself pro.... des a powerful
    only allet' senccs consoerancn of the potential coosocuences )ustillcauon 10 proVIde the necessary finanCial resources
    lor me IndiVidual child and the curl1 munity Furthefmore. the resources required ale nol large WIIQ
    " It is pi'lrticularly important 10 lnunuutze children suflering estimates e et II costs US$5 .00 to $15 .00 to fully Immunize a
    trom mAlnll1ritioo I ow-gmde Ievor. mild r6splmlO1'Y mrecuoos child. and as IntO lll s \4Onorally comprise 4 % 01 less of lhe
    or dlarrhooa, and other minor noeeees should not be population, a natlonal rmmunil alion progntlTlInocould be Iully
    ccoscercc as ccoueucceucos to ImmUlllliJtlOO " Imptemeflted lor an Investment of approximately USSO 1'0-
    bfIco,..". "",I """~"'Uol""''' "" _'" _ .. I/lII H'f" a 60 per capita"
    WWIoi)'~~1'IIooo.:c"I1 ~ !>9 "" 1 ....... v ' 91f( HII , ~. ''V,1CCnoo ~1b/II * ' - tJI rIliIfIltM
    .N
    Of'tIl>/Inl· . ... l'roN<:'*'1",,_s_. _ ....IlImncn'
    " Parents should be warned of lho common side enecis 01 r""'. flbr:la:lob ~ ' .!IM
    IOlmunuatlOOS, 0:he1WlSC U1ey may suspect mat Immuni1:a-
    tlOI1S cause 'al her than protect BgaJnst mnoss In some cases.
    eeescs vaCCination produces a IT\IId lever easily controlled by
    aspuin and a lash wtllch may QCClJr 8 to 12 days after
    vaccoetce Aeactooos 10 eral po/io vaCCJnC, lI'lCludirog a
    paralysis SImilar 10 poIiomyelltls. are very m,o - perhaps one Ir'l
    every miIhon OO$CS neG vaconahon 'MIl cause a small SOte
    Ensuring Supply
    to develop at lhc vaconation Site - the SOfC usually ~

    ""--
    altel' one 10 two months . Rarely, ltlIS sore WIll bocomc 3 11Ic tcdulica1 aDd manquial difficulties ill placio, i.trunuai-
    ulion at tbe dbpo5lll of parUb aDd chi ldnQ an: fo rflli d-
    " In the caso ol OPT vac.anabons. lho rl'Ul treol.l8rll able;
    'eactions ase Ievct and redness. swelllng , a~ pam a1 the Slte " To organall, orl a continuous basts. lhlllr1YllUf\ll8\lor1 01
    01 Jfll6CtlOfl The per1ussrs component, '" l81e cases can severat m~lion children dunng !helf first year 01 tile whclhct
    calise severAlneu,OIogicreac\lons, somo of 'o'oi'l1Ch are severe tI1cy be In CIty slums or desef1 camps or mountain villages ISiI
    These $(l'I(lI'O ,oacbOrlS, greatly publicu:Cd recently, occur far management problem of fOflT\ldabie d1menslOOS. Add to II
    Ies& hOQUllfltly than senous side elfocts horn the dISease Itsell WIdesPread W~ ler8Cy. inaetllquale loads and transpcwl sys
    In UnimmunlLoo chil(jrcn Iems. nsing fuel prices, budgets!)' cutbadls, lack 01elec tr\clty
    " Mora COmffiOl'l than side E-ltects of vaCCltlCS are infecllOOS tor cold slorage 01 VacCInes. and ovt!f·S!retched health
    atld absceSses cnusod by contammatl!Cl r'IOOdlOS lilld sy- services often reaching only 1'5% of the paputation. and we

    104
    _ ...-_- _ .......-01 _
    CIo<'ml EPI _
    ...-._.-
    HUMAN RESO URCES
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    ,...,

    STABILITY OF VACCINES
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    BCG.
    10 loghI .. .... .. 10 I>OOl _
    rro<d'" 31'<: .-<1 we _ uIlr_
    """,<l'I'O<l

    ..
    L.odo. II! 14equa1< • ..·1 _ .. ~ ;. _
    om- -..... 1_ bl' 1br I!I'l:
    "0.""" ... _ ,*- .... ..-1
    1l'PO''''''''''
    ..."'*'. . . ..............
    "...
    rrt_~_1ogdIoaI~_

    !tlIlocl..,lM;l Nl _ _ ...-nborI 01 $!On rQI


    ""'" _ _ ...... P'OlI'_, """ "'"' ,.,......,.......
    bOM
    ...
    """liIol..t>o..,oI:D1 0Cl talO gMln ' " ~ OI
    ~_,_
    II! .... _

    ......... ....
    '¥-SonDo ~ ~
    ~
    , _ _s..,..._, _ ... _ """"""'" 1Olt>Cr ......
    I<I1lIl
    _ _ _IlIlIO, mDIl '"""'_
    _ may till _ .. 3 1'(; !or """• _• "......
    In. ...,., 1 ""' ... _ l
    ... o t ... _ _ ,"

    ----- - 'I'"'''''''''''
    1II(:r~ W!I ~~""""",,,no..­
    __
    _01 .......... _ ... T.. _ ;Omore_1O
    Id_IIt1I:I~."' _"'~' The
    _
    "*' _ _ "..
    .... _ _ ...0
    lor _ . . . . , _.....

    -
    ~

    lOw _ " " • ""''\l8'.... _ ' .. """,,- • .,...


    SO"""" . .. II! ...", 0Uf0II0n."
    ~ ' "Tho ~ _ 01 1 7 . 000 __
    ... fPl . . . ....".".-.-II<.O .... _ _.................
    ~_"'"

    _ 0'''''_-~----
    '...
    _01 _ _ ..... """" .., _..._
    ~ neWill'S""" ""*,,IOPOS00II 1tlo,......-01,
    _ """""""'_"'

    .-:1_. _.. _---_


    n " ", _ _, ...
    !>oingPl<l'tlOOClIO .... EPIbyVl't'O
    --.., '...... _"""''''' ..... ...."....,...
    ..-- """111""""
    _ ,_ ,_~

    ".".,. _""""' n... .

    - '"' ' ' _


    or>:ll.t«:£F ....... WHO _ dol'-'ll _Io _
    _oocl_
    3rc " ""'~ ""'~ """ WtwIcl _~ , """"'""'ll ....,..... _ ...

    .--
    . . . . . . . . .---
    "11 10 1 _ •• " - , , OJ
    A.... """"*'1Jt<>n.lI1eY """""" "" 01 ""' EPI .. 1ll!2. icIono_ _ 0 1 _ . . - . . - ..
    -""'ll ""' _
    ...
    . . _E_...__ _
    .. .......- """"",""" _
    ' IO_..
    ... Il' _
    H " _. ,_ _ ~ _ _ . ....
    '-' - '-'-'-'- ,...,
    tIII~

    _.,---
    ......... _ _ ... . _

    . ."._'_M_
    -,,-::"'. ' ''_.
    ':::::.
    60'C, ~

    " ...... So .. ...,.,.,. _ till _ """"",*,"


    ~"
    v- . ,,.. Creating the Demand
    EQUIPMENT
    "*'
    ~ AWHO_ OI6 1
    01_.'"
    ...........,..-.........oo""""'._
    _ _ 1n3 '
    · 'T... QUOIOy ot.... """ _
    COICI_ .. _ ..........
    ... _ ....."..." _ _ ... _1918_'!Il:I31ounc1

    -
    ~_
    ....,

    _-
    lJl>T 's-' _ _ ~ o

    _---. ",. -. . .,.


    _ . -, hoe """ ..... _ ... .... .... 1twtl
    ,?"" "
    .._... _- -----
    mo1 '"' -... ...·CI:Ir""" - . "'''' .., _ _...... <arI\J"lIl lrOI'1 Sorw!goIIO 6O'lo 01"... ., ..... _

    __"'""'
    ' ' ' ' _._--, '*"""
    ...... - "..<M>.f _'
    - -""--'''--'
    <>l 02 ' C T'" """'" """ ot , CIUI ""
    ~
    _ , ",.. b '...... _ . ""'u....
    cl,... . kwl/'GO....
    .. _ l':1i""' ""- "If'''' _ _
    ~
    _
    I
    O
    _ '-'li _ _ """""'""' ... _ _ b
    _,_ "' '''*'1_ '''_ _
    ~OI

    MOTIVATION
    "'*"'_....,
    .....,.._,IO __o:toocmc"
    .... """" ' 'T' 'IlQII_ <lI ,_ _ ... '"' _lIwcl_OI

    "",-,_._-_ ..-_
    '"Tho ~ *''''''' ...
    _otI_ """
    QUOIOy ...... _ noI
    ... DPT _ POI"" ." I , 10"'"
    . . - n.. mcol ..,..,. """""' hIS "'" ~ co Ill .... 01 <\ll<lJtIing _ / 01
    _W'CS . . ,. . .. _ ,..,
    """,,"b. II!

    _"'_" _._-
    ... """""'"". """"'" n-~ <ha>Qo c-.. ... '""'" _ ~ "'" long woilrtlll ..... 01 _
    IIlOlII!.....,
    &<PllOOll 10 18:- . ""' ....... clIlM\I ner W>l1'iM
    ...
    " .. ,... oOIcl ""

    -~
    _ age ...... pariod

    --~
    _ '" "~. '1'0> --_
    '" ""'" q ~ 10

    ....
    _
    ·f .. _

    ... .
    -~-

    ,......... r.gn, _
    ~
    -,...
    C'ot'Y .,~
    .......
    ....,,,,", 01
    "'lreOIonwiy.."
    1l'\lO, l'Ie ~
    <011 01 .... _
    """""" ""'''''''''''-''''''--,
    ...
    NEW
    "'_VACCINES
    _ ot _ _, _ _ """""""", _ _ OI............... ""'IJIlO'IC\'t.->g '-_......,hI
    ___ _ ~ _ ..... .,.,""'W·1 _ _
    """ ... "'. _ , OoIwIwing . - - . . . . - . _,,,...
    , - . , . _In.~Il''''"'''

    ..... ... ' " _ ... _IO..cluDo SIrOnII'1 "..... 1Id 10 _ ........ _ , In ...... . ...... lot

    '"
    II LIFELINES: IRON, IODINE AND VITAMIN A

    ~. lew will lra ve! more than a lew kilomolers 10 a hoallh may Include mala rl8 treatmenl and proptlylalllS, and COIJllSOlI.
    cItnic In order 10 ob talf1 Vll CClflaIion " ec W1ltl respecllO C'.hild spacing , no lntlOfl d lJ"lng prog nancy.
    wea ning, c lean water and san ltal tOn ..
    UlnolitI ' - ' ~_""""-ll:It>tt­
    ......,_...., n "-1ll ""' __' - " ' _ arJCl Rj l ' - " " 'E~ ~ ... l / I e _ d ....
    _, ~F1ulOo """. 19114 ~ , ~ 19 8-f O>:fQrO'~fl<ta 1geJ

    TAKING UP THE SLACK INTENSIFIED STRATEGIES


    Taking up the '.hlck' between available immunization RI· n lnl efl Sllied Sllateg~ have been developed In seveat
    vices aod the proponiOD of children actua lly immunized can countriesIn an oHortto raise immurnlalfon levels mow raPIdly
    be done in lWO wayl : These inci lido
    "] 1) PrMlslOI1 ot me services at a coovenlunttocr nlcn near I Accelorated Implemenlallon or c ll is llng plans
    ue residence 01 rec ipien ts a ro at a con voniel11 l imo ; lind (2 ) 2 Use 01 pe riodic rounds ot Intensified ac t,vlty
    acuvcoror ncnon ol lhe service being osereo. When lmmuntra- 3. oeeenenco 0 1 one Of more d ays each year as
    'NlIli on al
    11011, lor example . Is broug ~ll to the rcsoercc at a lime o f day Immu nlzaho n 08','5 ' , on which children In Ihe tarae l age
    wtIElf1 vWagers arc notln the fields01 et the markot ecceptaece group are nn mumzed
    by 90% Of moreiscommon Comp,lIatlleresultsareobtallled i! Some ellorls have been ell tremeiy successnn. wh ile cioes
    imm um2alJOI'\ IS offered 31 coweocnt assembly poin ts whieh have had loss Irnpacl lhan cesreo. POhlical commi lIT\OT1Tlrom
    arc not 100 dlstanl provklod s-et the program IS well org8.rllzed lhe hlQheal levels has been an eeeeonar ChilrACTllf ls l1C 0 1suc-
    alld promoled Roma,kabl y h'Oh levels Of acceptance have cessful tmplomenla tl()(l ~,pohllCal comrm ln'lClll bY II·
    been acncvec when oducahonal and promobOtlal methods self is Insu lliocnl Wllhout coocorma nt manag crl8l . tech mca l
    have been Nllaglrla llve. " and logiSbCaI support. To have laslJOg impact, Imm l,ll'llL8 ll()(l
    __. .. _ .. ()It PfClglamrTlOS must be oan of the goroctal health Siruc turo
    "'*"'"
    ~t,"""",-, ~

    ....,. ,...." ..." ... ~ ... -.11". ~_ ~~ I . . . . of .... , _ ~_ _ _


    _ .... ~ r _ l l i I o ! 4 _ ~ -.,.-.. 71-a~ rM .f _
    M ill rfNl5 /E1'l1'GEH115/ 11
    Parer11s rlCC(l two lypes 0 1 IfIlorma\JOlln ordef to be able to
    ullh1e rmrnunoalbOn SE!MCCS
    " Genef al IfltormallOl'l rog8f :Mg Immunlzable dlseascs. the SURVEILLANCE
    btlfll!flt!;C/lldpOSSlOle StOO enects ol ll"lOCtJlabOOS, and tho need O " lmport8nl .ncreases IflllTlfOOritlallon coverage have cc-
    fa repeal ccees, and curred IT1 mosl deve'ooIng countnes dunng (I)c past decade ,
    " 5oecllic rotes , wee . and locattons and cIcar directions Ofl and ecee oceeses are now being aceelefated In several 01
    who shoUkl come lor oactl Im murllZahon SCSSIOI'I them Although ma ny cccouee ha ve surYOll lanco Gala ado-
    "Parents and otherS who bnng chlldfcn 10 be lmmlnled Quale 10retleCl disease /flCIdefICe trends. lew OCVI:lIODlng oou n-
    shou ld know the followlng ees have surve~lancedala adeQuale lor Pfogramme manage-
    • whJcn dl$OOSCS the Immurnzabons protecl 898mS\' thai lm- ment soveaeree data , drawn either from Itle country itS a
    munI ZatIOnS w~1 no t oroioct aga inst all ceeeees• whole or from selected areas , are needed lor U5(I by EPI
    • whidt ltge groups are to be Immunized and whV o ther age m8nagefS at ali level s."
    groups are esc'ooeo. 1fQ)cVf (II " " f </!iIft(1ad1'roQr,""""" <IrI ~,lIOtI J*1I»I __
    lhe rcoe lor repeat doses. .......~>2 1 -2bQr_ r98. ...~ WMn, lJ;~b /l- I ¥ /.
    ltlat Immuni7.01l0ns are sale and tb at 8l(lO ClfuclS Iiuch as (l( NI"/ I/
    tOVCI , 010 Signs tha t the vaccees l'lle WOI'klng 10 bulk! tho lr
    child" protectlon: and THE COMMUNITY
    tnat vaccin es do little o r no good once a c hilOti as c cmracied lJ " rho Dil rtiCIPo1 11Q!'l of commomuos as acnvc pa rl no rS In
    HIC clscase." planning, implementa tion and evauauoo ls cr lJ()ial tor ite
    ..,. ,..... ~""' .., W~ r~a""" at F>iJb/I(; 1III.1IlIl "''''''''''' ~ success 0 1 jmmunlzancn programmes. and IS a hm da mental
    1911' strategy !Of the developrnenl o f prImary hea lth care as a whole
    vet commuT1l1y Involvemen1 etme lccet level. lind lhe scccess
    0 1'soc lal ma rketing ' 8pPl'oa ch6s at nanonal kMlI , reqUlrO Lll<lt
    lhe health seMC8S have tho ca pao1y to make an adOQUllIC
    Implementation response to the oemands whc h lhcsc actions gc OOfa10 Unlcss
    lhe logi sbC support no s boon well planned. useB ma y respond
    to appeals throug h communIty e eccs or the mass rnod l3 onl y
    Immulliutioll eewen~ is m05t eUttbn whea offered aloll& 10 lincllong W3lltOg Iinos and no veccoes al the chl"llCS wh ICh are
    with o ther , mutually rcinforrinl; primary bulth care ( PH C) supposed 10 be p OVlding serw::es. SchooI leaChers. reitglOlJS
    $e:rvic:es: Ieadets and other opw'IlO/1lcadcts o l lhc COfTWTlUllItY need 10 be
    " While Jrnmunll8bOn seMCes can be dellYlll'ed alOne. they IrrvoIved $0 as 10 encouraQll a lull u t~l/abOfl 0 1 trnmuncal.tloo
    31'e besl oeIM!ted along WIth ether serYlOO$ needod by d\ildron and otI\eI' prrnary hea lth car e seMCeS ~tments In !hcs(l
    ltl 100. Ill's! year of lilc. and ty prcgoanl woman the pcfsons areas. 1'!c:JWcvef, Will need 10 go hand In !'land WIth Ifwestmenls
    who constItu tc the PfKlOtY groups lor pnmary health ca re In tralrung and StJPflMSIOfI 0 1 the heal th SIal! "
    setVIC8S IfI lhe deYeIopog world In add'\JOll to the fllOOIloong of
    the growth 01 Ihe child. the use oj oral rehydrilllOl'l to Irea l
    dl8rrl1oea and the prornobon 01 brea st-leed lng , lhese 5eMCe5
    1 ~ " _.<=I'IIbm,
    .. r........ fU> . I!illf.
    .....,.,.................._
    11" , . . . - - ""'-"'11 ...... _ - . ~_rJJ. . .wr ..
    ~

    106
    Iron, Iodine and Vitamin A
    ,,,,,mm.u to

    --
    Dtfirinocia iN My .. im>N",t'MoII 16 CBM,""" _ " " ' _ ........ ""......"
    or fMrl """""• .......,., .... _ ... III _ .. .,..'"
    ~;,k "lit! of dt4r. au diulbilil)l OJO""1 (Mldm i. _"""' or~_or ..,_"
    1M dn>tl~", "",hi.
    /"'f'I'WUtI """Un' OM dild", . \ d~u ",;/. _"" ",,,,.......
    . _- ~ "......~ ...
    lptCiji( ci"I4/II'. Imd "" 0 0/ ,,,pplt/flt1lu (1m tit 1/ EFFECTS OF IRON DEFICIENCY
    highly ='~f!«li... _ ... 0/ pro,,,,,..,
    <Mldmo', . ' ~ .. III _ """' IeOdlO - . . . llUI ... to
    /iflt. "JIll IlnlrlryfTOWIA. '""', • 0001, _ , 11'_ _ or> "'"
    F« tumplt, i"," ,,,ppkmtnll ",. pt'tlltIIl ~ one ~ t>eI1avI<U III IrIIr _ , I'"
    .",,,,,, .i<z; io</i.,,,,pt>u-..,.
    ",n prn!t>ll ,.,;r.. alld """ ....
    1_ """".
    _ .... ...- .. """""'"
    _ .... <J!..-- _ _""""
    <:11"""",,,,""""- ore """"...,..
    or _ _
    iTt/i.""'; "..J ..",,,,i. II ,uppk-.." ",. punt• • _ 1" , 01 11" r.y _ IrIIr MIM ' "'" lO loolQ,(I

    _ce_............. _-
    _ """'" _ <:aPOI>'" ...-

    -_._--
    " " , _ t o l l l _ E_ "'IJ'V
    blind1ltlS, <m4 mJIIU 100,. ditlrr/wt"/ IlM mp;.allny
    './«""''' _ 1M ,........iJ1 <,, ~ of tIm/. "mlJnl 'M
    ' hiklrno of 1M dtutlopi.., world.
    .... 01....
    ,-
    _ _ '-' ........ .,""MOIX>01UO
    """ _.........,. "'" _

    ---_
    cI _ _
    _ . . . , _~
    _ '"...._
    ..,...
    1lf(tg<\8I"C\'.

    _.. . . .
    _ ~ ·,

    _- ~- ~

    , ,-

    _-....... ... _,-


    0"" ' - """-...._
    - . 0 <NICOmO.
    ooIogoCIIIlI.o>C:IiOo'I _
    ~
    ..

    Iron-Deficiency Anaemia """ 01 thOWI .I ............... ". . -... -.... .. _

    W_ 10 <I0oI. <-..u..n. ,........ .Ioilolfta ....


    "'Il """"....:
    ...... , , -,
    -~

    ... -(--- --_ . -


    ..p«...., _ _ .. Ito. d'Ii<Kao<' _ _
    I IT_ ,0<81"1 ....- " ~ ..... (0l'Pl .......
    A - ' I """'" co 500 _ -'""" .. ~ _Me<! hI .... _..,.,..,.."., _""'II "'"

    __
    """"""'" _ Il>M C/wIa _ IhIl ' S'Io_llf\lU1Il 130 ~ ~ "'_0\10 I:foI<lr<f't
    ........
    hOO ",. ...,
    .,......
    "'" ' -_ 00yl0t>i0.
    _ ~ _ " " "
    _ """""""• ..,.. -..
    QrlIanir..- . ._""'"" """"'"01
    <OIACltlt
    ..._-.o".-
    , rt-.,"
    -.:oobe<l .. ' ""
    ' W","""," _ -..eM
    ' 01 .... ..., ....... ............ -,"""""
    ' 1lII\ll "'"" two""""" ~ _""""lhaI."
    or _ ... """""""'.

    -_
    ".
    """, ... - . ..
    00_... .,._

    "",_ol_ ----,-----
    .......- 9''''4>1 "'II "'9""' . , . - - _ g«II4I
    - . o o n, ~.

    I<>' .......,." "",,,-, ....... bot _lid t>,....

    -""",----- '--
    00>0n;I "'"" ""'"'II ~ ,""" _ _o'r
    _ _ 01 ..... _ , . . . . . - _ . _ in "" c:aoo '"
    _~

    " n.. <lo1iIy ~ b'


    01

    _
    """""",,

    _
    ..... ... "'. ,
    _ """ _ _ " "" last_ "' ~ '"
    -...t>ul.. _I11_,...-;y"""'_,_ 11&
    " ~ """"'"". Thoo . . - eMr><Il tlO "'"' 1:»' (lool
    _ _ _ 1InIl '*' Nt<aI-...-CIl"",
    ....... C<lmII""'" ..... .--.. _

    .-_.
    - __ .. _- _.-
    Causes of Iron Loss
    low_Wr1 - - . oroJ/or!rqlonl ~ -..­

    ~- Jaf....... "",.lfibot< 10 ..... _ .. _ _.......


    .... _---~-~ ""I ' Ie. _ . dcpleot _

    ---_._
    _ _ f ""l_ '.

    ..... ---"".,""
    [ -..... toe ClWIIdO<_ '9'
    ~ ,,'.,
    "'' ' ' '"'Y ..
    ol """
    ......... . lII»Ia 01 dUlCG"" _ _ IN,....... INFECTIONS AND PARASITES
    ~-- " ~to . _. _q _ .. """"""'_
    _ 1i\lO, _ _ 'II '-'1\1 OlIO, """ _ _ .. _ _ Ior

    .....-.. .
    ~
    _
    "
    "
    ,
    .
    .
    ,
    ~
    ,
    __
    , _ ~
    _ ' -"''''
    ' _ • llO'\ICI.OOIIt
    """ _ ''oll" 200-
    .... "'" _01 MlOul 2~ . . "..,. ". "'" _ _ - . , . ..
    tlnI>nl, _ '" <lOW:!..--.. .. _ lOl!lOl'ng It<Im
    ~50 ........ -=-> """",, lr<rn """ ""'<:lin<)' ... h.~

    __
    __ " _ .. _ _ or.
    ...... <J! _ """"""'toP«JbOlJll' Ilb:>ul""' -.
    "
    ~
    -.. " OOy.....,.....,_MlOul 500 __ _ _ ........ _ J"'."'\I _ . _ """""'.......

    _ *' _10 """1"l"CI'IIY


    .......".. 00""""'" F_ """"
    '....
    b6"<l ..
    ~ ......
    P"J',Il'lInI - . ."
    I'UnlI<:n
    - - - .....
    - . ; ......., . ",.., .... . . ..,..",
    (>:;nO'_ _ ". . " Ilj . -
    """""...

    - ~ -----­
    "('10 - . . . , ~ SJIIII!I' 01 """ .. _
    _ . . - llI' _1l'O"'I'-
    _ " " " .. """" lO """' ...... _ . E_
    ..
    DIo'Jrol"'fWsI_-.
    <:oPO - .

    ..... """"'
    or " .. h --'.
    _

    . •-_
    C"'-
    '-"'j-~"'----­
    ' II> .... dIro<:tI'
    _"""""'
    .... _
    -._~

    _ _ II>
    . """"""'" or
    ... - " ft ~.

    ,.
    II LIFELINES: IRON, IODINE AND VITAMIN A

    hOClk w(lH11 Injection There. 1$ also a strong association " In sum mary , ou r ex pe riCrl(;8 suggests tha t , WI1I1 eo ec ontc
    ootwoon ~ I""f!mla a nd mil lari9 " !tam ing li nd llSlrlQ appropria te leclmo log y, commu nity hooUh
    workors can ectoon lor anacnua In praona nt womerl a nd glvo
    t
    ~ >q
    I~I~""', 'PIll "',...." ~
    ....... _ wu n.r_''''"....'1IOI'af
    ut 001>/,""1IflIor,n.>bQo'"
    ",,~ il.:IIlIo
    ~, ~.I "'
    Simplo lroalrnen l , provide adVice Ofl l1utnliOn, arc ma ke
    ~ lJ J_ oS/~ -.:s c..'li'lt'/)' . wY .1.'>, no;> I US" relOfrals lor more In1e!ISI'iO eoaweot as IllCllcated . Mo!8OIICI ,
    they .1pprOC lu1e being given an opportunuy 10 play $\lc h en
    FREQUENT PREGNANCIES Il11pOi'lant role III malemal iIIId cnlld health care , partlcu 'arly
    "In Oangkok. the pl'eVOOIOO of anaemia ,n pregnant srnce II enhances their credibi~ly and pre$ 11QIl m the (,,'QITlmu
    women doubled aller ttle 11'1lrd pregnancy and increased ruly ."
    fiwllold Ittlet the flfth Pl'egnar cy " l.IItlt9Wl_~ l..w.plDM ........,.".,-nonIO. . . .
    r ~ rllol~oI~_ ... __ .. """,_' \t\'WtI,_~ "" s.., , I~
    ~_ .. ~_nt ....... . - . -
    ~ I IidlI'I sa-:. 00...". "'" 3.'> m ;> '84l'

    Iodine Deficiency Disorders


    Preventing Iron Deficiency T byro une, tbe hormone produced by tbe tb)'l'o id cland, il
    essentia l for the physical a nd mental devdopment of
    cbildrCQ, and dependenl on iodine intake. Iodine defic ienc)'
    lron-d ElicieDC)' anaemia re lulu from poor ab SQrption of disorders ( m D) include goitre a nd c rctini5m:
    iron in the intestine as well as inadequa te iron Intake.
    Preve ntive measuru may take ll<tvera l form, : " In many OIOOS 0 1thu world , mAmly In mou ntainous reg ions ,
    the soi l and wate r are very poor In 1001r18; if the popu lations In
    I I" AbsQfpllOrl can be locreased Oy changing lhe oet. Iht.!S6 areas are dependent prlmarlty on !he foods produwd
    but itns approach is Illll iCull lu p ecnce owing to oatl"l'l hAbits
    locally, lIley mtly 001 eeve enough iOOIl'lO In therl dlCl
    IIl1d COSt l hef e arc OthEl( mothods of provenliOl'l; lhO regul ar
    "ln an alfor f 10 COInpenSo.1l0 lor thIS dolicleOCV. ec thy rOid
    admlnlSlJallOO of an won supplement BS a meocoe. and the gland I,Ifllarges SO !tlat II can utlh79 lIle available iodU"Il!more
    8\JrJIhon ol llUl'I tu a fOOClSltJft _. Research IS being camed out
    lI'l devcIoptng countrIeS on Inc poss. biIily 0 1 addllJg iron 10
    ClflClOllltV and produce enough thyr olllllC ThIs palhologll".al
    criotgemefll of Ihe 1hyr0ld gland is known as goiter, wh ICh
    oornmonly used soces and lIa\lOUl'lllgS s.x:h as sail !ish ceseas as a swelling on the lIonl 01 the neck ..
    $8UC4t Of sugar, but II 1$ sMllOO oartt 10 say whether Of not thIS
    approach wtII be successlul In many dcvclopong countnes IllS ... _ QllifU' oJ IftII D
    "'*- ~N.oIIMJ~e.:..-""eo.ou.i;o/OI
    "'*"
    ""*'- ~ 1ft
    Imposslblo to fortify food ....' m won. consequontly , heallh 1"'{ACC/SO'JNSlj
    aul hotllleS distribute 1l'0fl SI.QlIemonts N'l lhe Iorm 01 tabIots 01
    s.,., ~ 10 the groups most e t ' lSk. I e ChlkJrOll and ptognant Tho tully deYeIoped S'fnclrofllo (01100) IS on ly lhe most
    womon . obvious marn feslallon In a whoIo range 0 1 oevetoomOl\taJ
    £_ rJ M (}eM_ \'Iwnn IIN'........,.; W ~" \1olrtl'
    ceeocs prevalenl In gottrous COfT1mUfU!lCS - exceesscd as
    1 _ (b:;JIw rSM. combina1JQnS of retarded menlal dell8lopmcnf, heam'lg esa
    b4llties . spooch disorders. rlOUI'OrtlUSCUIOI abno,mall t~ , COOl
    uesoes moascres 111 5upPlern0l1llng and OI'lllCtnllg jcccs dm alJon detects. and poor pI'1ysJcal growlh I he 111010 severe
    {fOltlfica lIOO1, IllS Irld ispcos.1t'l e to ocvcioo general measures tile coro dcfic:~lCy, the mo re froqlJt:1l1 IS endemic crano
    ;'limo<! at lI n~u mlQ a neunooatecn Sllpply, such as Ism ,"
    • llugrncn1ing lhe availab ility ::If pro teins 0 18fl(m..11 o rig in,
    '/ r",,, lHk'ICmK: UOi'rt1t h' ocrinI' <fI!"""'~ _o1V~ l,lII<'d'
    IrlCroos lng the ccoecmcnon of vege table tocos rich Irl(ron, ""~ 1 2 ~ 1 983
    such as groon leafy \'CQCtables and beans:
    Illl prOVlng the llulr,tlOfl ooliCllfion 01 lhe popolatlOfl and , " It sooms tha I In severely core-ocrceot area s lhe IOdlr1ll
    0001/8 All, loo ming to mOKe bcl1er use 0 1 avwlable re- stores 01 It1e mother's thyrOId bccoee more doplof@(J Wllh
    sources; each sccceseve prOQlllJrocy and laCtalloo , and I"oOf lhyrOld
    • lmPICWlIl!,} lhe distriblJlIon of food If! the farrnly gtoup so thaI accumulates IOdItlC more avid ly It IS a n ol d exoeoooce that
    high fISk subtects fpa rllQJlar!y prog nall! worneoJ gain ac · the scccessee ch lldrCfl are usuaDy more relardod and l.-lalty
    onI'I' c rc Uns are born: ·
    C8S$ 10 l1Iltma l prolclns WIti' 1I high IfOfl conlon t
    ~ .loom S ~ _
    _
    C Rou-.«l
    . 0IahIt ...... , _ no 13.1 IN r
    ""'*-"'11 JllIMt~
    _....-...-. .
    ~ _ "'* __ .'"<.t_Of'''
    AmoIllt lll:Mcw'of~"" J . 'Bl3

    Recofding the 'esullS of it piIol prc,x;1 In rural lndta, the PREVALENCE OF IDD
    au1t'lotS observed
    [f" Poor 10 the usc oi oommunl ly hea llh workers for Thollgb fIIOltly limited to fIICMl.llta iDOU' rcJioas, Iodi ne
    dtlide~y affects lUKe oumkn of people; .
    anaemia SCfcelllrlg and nOfl and 10I1C aCId dlSlllblJllOfl,
    anacfflla was VE!fY commo n 1'1 prog na ncy , bClllg present In " In 1960 , Kol ly and Snel;lclcfl estimated lhal tnere wefe
    66,*, of 6 4 1 womon deh\l6flOY belween AUOusl 19 77 1100 200 million gOl11QUs P6fSOOS work.1wlde Twenly year s later
    January 19 78 FollowlOO thll lnlr(X:Iuc boo of screening and Mat ovlnov ic 's flOure lor tho less de'lC\op(l(:l wglons 01 tll0
    treatmen t by l hc community hoalth workers, the prev olenco uf world was 329 mi llion, and IhlS IS probably an unc!e restlmato
    811a8111111 fell drama tica lly, being pra~nt in on ly 20 % of As lor ondomlC c retrnism , it Is 1I11poss ibie 10 m ake even nn
    women dellv~n n{l betwoon MarCh find Augu st 19 / 8 illlcJ hgc nl guess Thoro m o said 10 be 1-<' million cro W1S Irl
    " Thus, the result !! 0'
    using c om m unlly l .ealth workers lo r
    screening and treatmen t were hlg lli)l satlsl ac:tory Tho cost 0/
    Cnina alorllt III some Soutll-fas t Asian tocal ltles , up 10 a thlld
    01 the population may be hypothyrOId ..
    e.1c:tlscreening test wor ked au f alless tha n one US CClll (0 .06 "'It>'>' enrur"" g<WtI lQ . . . - llL"","OO ~ ' <MICAH
    '-I ~r;J~I 9tl J

    108
    CONTRO LLING !DO
    "'~., "'_v_",
    - - " " " . _ _ ~ ~ _I .........
    lo4lM 4<l!<wo<, """'"... .... ... _ _ .. low - " """" _
    _
    onon. _ . ....
    "'1, III " -
    _ _ ",., """""' 1O<:IIatS _ _ n ",
    -vlo """" 01 _
    8<1_
    - _... _.... _-
    "~ "" can 00000 ....... _
    ~""3-~ _ _ 0 0 1 - ' 8 _
    _ ._ 'M\I'l_"""""
    .,"'" - . . . FO'
    __ ~. .~ ........
    A. """"" outlOOlvIO

    -
    """"lO)al(l _ . 10< Il'*'II/rj C/lIC $IlI'YIOOS ..,.. ...... "'_--.ngloo<l .. .. _ _
    ___ ........d'>II<l.,.... .
    =_cn.. _
    _~

    -'.
    ~_ .......... taI\l>O"""""'IlOO. T "' ~ <n<la­
    ...,01 0lIlIr.. _ q OS ",......... _ """" 50 '0
    lbo'S ,
    ~ .-..,,- - ,
    I 1'"\'...",.. A ~I .. .......-. "' """" _ ~
    .....,_ .... "'""I _ S . - . -.-. <:!liIInn may """"'*'P
    I J " IOOn! <lOlI<.w>cy ,, ~ _ lO ~ llI' _
    "'"" ... _ _.. - _ '00 """ 000 mo::o 1M' ...W".,.. ...., _ eno-- 01 - . ... " ....... .,.., _ol-..
    <la, ."..". !<at..,.....,.
    at Peto3oc---.
    _ _ _ _ . . . comooI ; , , _..

    _.-..'-,._ ....
    _ , PO<

    ~
    _
    .
    <II • - . . . . . . - ~ ., 11'''''"' moot .. ,,",, , .

    ---
    ...""'n - --~--­
    _....,_ ol..- <vIgO ,has_~

    In IOmt .................
    __"'
    \IOO<l -..to. tIul • ;0 • _
    ..
    ala"lIIlP'I' ' ' '_"=".I ponocI_
    A_ _ /I'e
    ........ <II .. " ~<QllIy '"
    10 odd - . . 10 • I0o<I• .,
    ~

    _ _ _ lor '''' 1>1.. &-" _ or ... "" ........ A


    """"'."..,... l'»s ' - ' <lono""" _
    - . . .. !'1M 0<01<> .". _ mosl ~ _
    . ~ sail .
    """ """"""' .. ""'''_ "*. ""*' ... .....
    _ _ ... "'" """"""" cIlolIl·. _
    _ - .., .lIe!.".. ..
    . -, ....
    .. "'_11'_ _.
    .... _ o l _ A _ in .... _ _ • . -
    ~-""""--""-"'llOO"Ig
    "'-' . . - _ .- • " JIy """"lor _al
    8ol!*-...
    .-,g _ _ .. _ _ AJ _ _ l ~ " " "

    . - . " '_ " ' " ' _ """_ <II _ '" ""I, o-e

    -- .... _.--_.
    ... .-. -
    """'" " . - ..._ lor heO 10 IcIU' __• ""'"""'" ___ ...\to' I , , - * , , _ ' * S l AlIor 8

    . .._---,
    ""'"" . ,,,..- No> -.g _ 10 .... . """ ..... .......,. '" "'" .... d'oICI _ _ , ",, ~ !<>ollongO ""'"
    _ _ lPI3l • l>O """" '"<>dy _
    - - . 01 soli .. "'" _
    ~ In _.
    <It _
    ~

    "'" ,...,. ... ,.....,.,


    - - "'-"""'1:<"'-" ".,
    llOCOuIO or lI1e ocalle<"" """" _ IIiCI _ DlC 01 \till

    -"-~.
    "" "*-~ ~,,,­
    New Ooonoa
    _ _ onbOO1l$X1
    • _ ..,. """'d) :_i n ,
    " Z...... • II INCREASED MORTALITY RISK

    -""-,-
    r........ k<nal reteaI<~ _ ........, ..... 1Ill1il ..~ .... 1alo
    .. _iol04. oriIII _~, - . . . . . ..... ..- " " _
    tn.......... - . . - - . doildfoo:
    "~ p"""" _ nuor-, •""""" _ In 1982 I " """'" 01 3,.81 _ . CIIob.. " ~
    .. _
    _
    ""'*'
    "" -.co
    01 _
    Ihe ago ol 9 jMfS
    _ " " " " 01
    _ ...... ..trMy
    ...." .. _ _ """ _ .... -..... _ _ 1rDm
    __ " 1... """'""" ,_ ..,.,.... ~ ..... ""'"
    ....... ,. ... ... ._ "" _ . _
    ...,... _ 11'.... 8 10 '2 _
    .... _ • ..-.1 ..
    ~

    ... .... ..,.,....-..


    1912
    In,",,,,- - . CO"Ilt<'le<l ....... 16-_
    ........, .."""_ r.lMoIoII _ ._ """"""'.
    WIll> "'" ........ '" ""'" , . _ . MolII ....",., A
    woo """ _ sail _ev woo ~ '<Olh """" 'e'lo "' ..
    _.-.-.Ilo., "'" ...
    _ 10<16 - . "

    __
    _ ..... _ _ Irom'10

    _8_ ",_, , __,


    ... ,_......., _--'-, _,_ _\:IlII<O... .......
    " ....,.... ,....,... ""'" - . . . " " " " _ . . . .0 ... '
    ~ _ in g<llli'lll,l(! ~,.,

    _ _ "1'"" ._010 1 _ " 131' "'Il """"" ,-,.- '~--­


    ---~---

    -
    -...oTralOlol . ........ _

    --
    ~ ? mon" -

    I ~ IIbOIound

    .. """..... ...-. . _------


    _ I l1'ho
    _ _W IlI_.""" r_ _ ,1'01" - ' " "''''
    ,"""""""" _
    d1or_ OJ lW<>I on! ..... _ "" _ . 'u « ' ...... ol
    .....".
    _.--r__.. ..
    "Thete .. I _
    _111_'''..... _
    e--_
    ---- ~--_
    - ,~
    OW,"
    "it~~1
    ~ _ I _ _ A """'*""I
    SonousII'_ .....
    _- ... ..

    Vitamin A Deficiency
    ~f&_Iee<J_.,..

    • boot _ tritiDo _o. . ~


    _
    _ "' _ _
    ... _ol_... <II.. _ _ "'" _ A _
    _ _ -.... ... do"",","", _
    ~

    «IIanI.... _ ~I1aI"-' _ _ ......


    _,
    -,- -- - - ~-
    _ r_ _ '_'H'
    DoOr
    .. _ _

    PRE VALENCE
    PREVENTION
    " ~ - from "'" Co\xJll
    \IOfIOl - . , . _
    "'" -...
    tl\'."'"
    lor ''''' "" -
    01~ ' la "" A.. ,..
    ""'*' 01 _ _ - - . """'"'9 ~
    .......
    " ..
    _ -. diorri""""
    £11_ ..-;-. 100- riwoWo A"''''1..", Ii< .. 1oRil1i..
    ri...... A copoooln 10 pte-

    .... "'" or "'" _01 ... ",_"" ,.. _


    _ ....... ' . .. ""'"'*;00, ........ ..,.. IOt~,.
    .. _
    "'_ - . . . . . ...... _ _ , do .1ioo_.U ..101;. .1,-
    ....peoo;.. _ -

    ,.
    II LIFELINES: ACUTE RESPIRATORY INFECTIONS

    " Vitam!n A rontcauon has begun more recenuv In Onate- "A year 's supply of vitamin A in capsu le form coots only
    mala (sugar), India (tea), and Ihn Philippines (monosodium USS 0. 15 ucweve : the COSI 01 dc1ivcrirlg capsules and of
    glutamate), Previously, several ccunues werc torhfylng cereal any I(.'quired mtormanoe support must <lISO bo taken into
    products . c.q., bread in India and corn flour in Guatemala. consc crauco III programmes in Bangladcstl aoo Indonesia.
    Miu garinc IS fortified in most developed countries and in total costs of dcl lvDrlrlg vitarmnconcentrates 10l; tl lJdrOll ill riSk
    severer dovclopna nat'c ns. Including Arazn, Colombia . Chilo, are less than $0 .20 a year tor each protected child
    Mo~ ico . Peru, me Phillpomes. and Turkey." "Even less cxooneve. In areas with tavccrabc growing
    ccoouioos. IS the addition of dark green loary ~t.>yetables arid
    othor foods containing vnamm A 10 the child's diot This call
    casily be l.lCCOmpllshed et minimal extra cost, "
    ;(e<nnI'""..n'" " ,">POOl rK l >JI_ '" 2 /IlCIW),NI.1I"" , lrH"" ",
    1."..-.lJ !.91l1

    Acute Respiratory Infections


    Children in lhe developing world get coughs, colds, about 20 per ce nt of in fants tern III dc \lOioPlflQcountries fail 10
    influenza and bronchitis as often as children in sUNi~e their fifth birthday, 3n<1 that ono-tourm to one-third of
    lhe Child mortality is attrlbuted 10 ARI as an undertYIIIQ or a
    industrialised countries- but their chances of dying comri bUllflg cause.'
    from ehe infection are up to 70 limes greftler. The ~ lOt COt' I/(Jl
    H<u;r; gf ",:uIto 1/t5j)/(,11c>'y " '<lC~ If! a>rIdrCn
    deadly alliance of malnutrition and acuterespiratory ", ~ .""" 1/"'"
    T 9~ ~
    II pr.1 lJNlCCr/WHO ~~l rmnT', WHO.

    infections (A R I) underlies a thirdofall child deaths, Chitdrerl under nve account for most of tho deaths from flR I
    and weakens the suroivol'$' chances of healthy growth {11'le elderly are also ~ulnerable}'
    and development, U A review Of da ta nom 86 cou nmes on five connnems
    Few developing countriescan provide sophisticated concluded that about 2.2 mlltion deilths are caused by ARI
    every year
    diagnosis and care for the 300 or so dIfferent 1'110 mortality rates III UOb'BS under a year Old are highest in
    infections that make up AR I. Yet the lOll of deaths M,ddlu Amcnca (rww ly 1,500 per 100,000 population),
    tollowed by Africa ( ' ,454), the develOPIng countries of Asia
    can be brought down, and at very low con. (1.2 112), and South Amellca (1,110) In child ren between coe
    Immunization proteus againsl diphtheria. whooping and four years old, mOltality is tllghost 111 Africa (467 per
    cough, tuberculosis and tbe respirawry complications 100 ,000) and the developing coootnos of ASia (;.>U4),
    followed by Middle Arnenca (149) and South America (113) .
    of measles, Most ARI can be treated at home Mortality rates are lowest In Norlh America (8 per 100 ,000).
    provided the child's momer understands the need to In AmerlCtI, Furcpe arid Oceania Ihe reiauve Importance ot
    An i as a cause of detl1h dec lines as children reach school
    continue giving liquids and f ood, and especially the age; but II,,:; Is 110t true 01 o ne-to-tour-vear-olos In Africa and
    need to continue breast-feeding. And both mothers Asia , where ARI contmues to cause 30 % of deaths This i~
    and community workers can learn to recognize the cooetstent WIth the faCl that malnutrition mtroocal ccunmo s is
    most common around the age of two
    warning signs that Ihe child needs antibiotics or more
    S/Jmm,1l11C<f /rom A lluI<> <Jrd !( I I'O IiC " c'We' I""I"I ~ ' '''~
    specialized care. in J.,cfJt><J:< ~ ' 1Ml,'W ' I" ."'" <IIJho MK>. t'I)! .~6 '"' 3 , 1918

    ARI: The Problem Child Sickness


    ARI is one of the leading causes of child death in the modern Children in deve loped countries contract ARI as often as
    world; children in developing countries;
    O " Acuto respiratory lnfccucns (Ani), diarrhoeal dlseases I r'Accu rere data on the rncdcnce 01 ARI areuroneo. but
    and manrutntlon are Ihe prmcjpat causes of lnness and death ccm munay-based lonlJltudlnal studies Indicate that It is very
    Ir1 children in developing countries.. high ever-were On the average, a child If1 an urb<!narea has
    " MoItalitjl trom Ani In developing countries IS3 0-70 times from live to eight attacks of ARI annually, WItha mean duration
    higher man In oeveiccec countnee. It has been esnroated Ihilt of 7·9 days Most of thL"SC are me less ecnoos upper

    110
    _
    - _... ... _..............
    ...... " _ "'". .... '* '960s '"'" '*" 'ltlOs. .. - . . . ....,
    _._...-.._._=_.- -
    lIocillt.
    &IW,""""" " r'. tm>s ..... ,-. ~
    _
    " n.,_ ~ 01 .... l>I0bI0m" -.0 _
    " _ _ iOJ1I_1ho ~
    .ep_"'"'
    _1Dr . .
    .... .e. ~, ~

    Oo.oo!>oe. ear-...., ~ lISA 1ltopo•• IOty_


    -.010 *'<1
    ..
    ... of _......,. IrIO'y _ 30 '" CIl """'""'" !>O'" _ .. ~ " ' .. _ c . . - _ 5 ( l .
    _ _ ......... ..., 101030'4 01"""" ""' ,...... . '" _ o l .. _ .. - . . . boIow5 __ oIO.. "" ' . ...
    """""_ 1.... _,_only ,e.z,,, "'" <Ie "" :'
    ~,~
    -_ .- ,""""-...., •'WJoOoo • "'" ...- . .. ."..".., out!<on(,J ' ''''' """'""""
    ""' ' ' ' _ ' ' ' ' '.. ''''" 0'IId _ ,....
    U " '" _ _ 01 _...".,. _ . . , .... ~ 'onou ""'" ~ Ie> , 0'\ '" II<><QIIaIo "' ... go \S(t<JI>Onl: lrMt
    "'. . . . . ..... \.hIo<I~, • _......., " * 1 _ "'''''' . "......, ..... Z. ~I ....01 _ - . . . "'"""""II
    _ """",",""'b _ _ IlIioI;InoIio. ..., lI8a~ - . . . ttl! ..... lIlaIiIV ..... _
    _ one-<>olI
    " " " _ ......."90.
    "'01...-. l.\JI>cf_""" ol o l ~.

    ttacl_ _'.1OaPal>ua _
    ~,
    le>1lI_ ' 0" '"
    Gur>oa
    ~ _ ,"""ol
    """" atoiI'Y "" _ _
    .. ........oM....,_
    """I' · ~IIOI ~

    """" .. _ . . . . , bOlO,,",," . . . ~ " - " """'" '''''1IIOrY .,"".... _


    .. """ '"' _ or>cI ... Old. " .... 2 ~'l,. llIl "'.. reailTJetll ~ .. "" ,... otloOI_-

    _.. . . . . .
    ~ 1O\ on O<l """- • _

    - _._.-. . . -
    "" _ _ ... <1 _ _ ... .., ...., ..... '" flo _ . .... <;aOO
    ,- t:>l/lllly ~ Ie> lIS .,..., . " ..•
    ..... , ' G .. _ .... _ .. _
    ~ _ """" IWO ~ ~ _ .....
    _~""

    __ _ n,.. hOd """ .. mD<O _


    _fllt_
    -....". .......-llQ'lO oI_'*""
    .......". _
    ~
    ... _
    -...
    ._

    "" 15... ol .. r IO

    ....... _ _
    .,_M._

    ....
    ' HJ ....,......,.... "I

    ..._-
    _ , f\eopo'OlCO'y _ _ """" W'1'I\l
    <:<lI'I'I'n(II\
    Causes of ARI
    ,,-- --_
    "." """"<lrt _ . _ --._ """"~ ..",,

    _.. ._.
    hOl 'lWfI'_

    .=. -_.
    ... ._
    - - -~ ---.
    " .... _~­
    Over JOI " , , - <.... AIt,
    _ It' _ ol
    1110 lICUlI"'"""""'" .;,;_~".,,'-._
    n- _ ""'" 300 "....

    .... -- -- "" . . . """""""


    1lI _ _ """ ..... • .....,. . . -

    ._aoy.-... - ---_
    ...., ...... 11>0 "I'PO' ___

    ...... _ -,
    1)' -1.10.. _ "" ..... """"""" ol _
    ~ _ _ - , ~

    .,. """"" 01 <5....."" "'...,_


    fl< _ """ _ _ Iron...., "'
    C8u<p"o v....,.
    .-.01_. In _ nets _ """" aIIt!clOId ~ '" ~,.,..",
    00aMMI _ _ "" _3 ""' aonI 0 1 . - _ ._ _ "'~ ....",
    ............

    _
    Ie> ~_ _~

    casoIol _ _ .... 0CUIIl 35


    PO' oonl 0... ."..._ _, _ _ 8 £ 1 _
    oI_M<Ity tIIf<:lIOftI,""" 5 44 _
    . _--_.- - - ytyW, - , - , ~~-,

    -- ..
    lIOt chCl _ _
    DteOOI_""'. _ ........ 0CUlet!<""""'" _
    ........-.
    ~. '
    Tho _ , . . , . . . " . , . _
    ~lla<l ..._ _
    .

    . ..........
    ,_ Ill ..._"'... . ........ . . .. ''
    ...-
    '1 "" ""_ "'_.. chlt>on _ 1>,..,'......... I 1·'Uor<l _ (pnourncn;oj _ 1hOSl "-cause'"

    _
    _ _ "'" ........... """ _ . _ _ lIllO'~ I5 _01<l<Y _ ~ .,...,. ......-. .... Old
    <lel'S • a>oIOre" "'""" 1IlP''''"''''1I!!r "" .lIa<:M PO< _.........
    _ JlMo _ . ...... ~ .. I/:ftAolI_~ _

    ..... - .
    .... IO <>lII't

    - ..... ... _.. -


    ...... • 1>lOI_
    """""""
    _•," _ d
    _
    _
    _
    _ _ ol _"' ...
    "' ... _
    ol ... . -
    " ' _ Cl'ilb'cn1IfC • .-.:I ....
    ~

    ,.-
    , . """,."""
    • _

    "
    - , """,
    --- ~_
    '
    Risk Factors
    Child Deaths 10/.0
    lui:>
    _
    _ ..' MIy _
    .,;0,,0. . . . . . ..
    1ope4. a..
    w.'" ".1
    _,_bee
    !he
    k
    ..
    ~. Oft . . fat 1""'" ,w. '" 4JloI I.... AI. l ill
    cliIolro.·. _ ."" ........ ...... ol'-ARt:
    -.mao ..,j h.oc-t _
    rio.... <7<1. 01
    .....10' ;0.,
    U'"t
    ..... "" _ '" _
    pnoo.<no<"oa lIa1> 01_
    "'I/'SIl>'811 _"'"
    .... ""'11 .._l orn n_
    l\len1..
    MALNUTRITION
    lI>t ~and~de'> r .)tI"~ on <:neSfLO:tll.. I ro-n.. ._ ... ol ,~ 0lIo<;..,.."
    ... 1'toI!opnoo... """""'" '.... .. _and '" _ \~
    ,... oiO _ 2' and 13 _ "'llI* , ~ . INn """"" ..".,...,.. 101 """'Ol ... ".,....". "" All• • '" """""'"'
    IfllPOi'la/lOO fl ~I\l COLIlIrleS: looo twIl ~ _
    """"''' .........
    , ~ can bu _ _ ""'" do .. ""'" """"'"
    "-_"_d_=_._
    - - . ... asoocir.... _.".,..,. ""'" -*'Y .... ..

    ...... _ ..
    .......... """'"as ... ....... "" _1'1OIIOOly con<OJtIO<I
    ll\< ... Pan ~ _ ~ " " "
    n _
    ,~
    _ . _ .,.... , _ " " ,

    '"
    II LIFELINES' ACUTE RESPIRATORY INFECTIONS

    " 1 10. CI10IcI .. 1"""" .. at


    .... ~, ~ ~_
    fI'IiYIj' . . -
    ,_at<Ity on"""""" .....
    . . - .. ....... """""'-
    1<:C<U1l 1<:r _ , NII""' _ a>ry ~_
    _, _...
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    --
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    -----,"'--
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    LOW BIRT H-WEIG HT


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    ID / --=_., AIlI """'-"'Y
    IS II'IC IaCI
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    __ ",........ - .... . - 2. .. ~""
    AH . . \110M .......
    1~ .,...""""'lI
    f OOll So.«M> )

    Preventing ARI Treating ARI


    _ .... . - uoI ""'.... rotdiD& ""''' .Iaoc .... .....-

    _....... - .......
    ~ .... ioopocl 01 A IlI:

    ._-
    IMM UNIZATION
    1!'I(Irif, _
    ~
    .- ""'" - -"",,"
    /WI_", eo.ogI» _ ....... . - -....
    .....cncaotr P'I-_ l>J .............., _..-.."" HOME CARE
    n" ~ I .._ ~ ... .., ~ _ .. tile
    _ _ .. .oR _ _ chOIHn .-. _l>e",",-,
    WOO1<ert...,

    -
    oJ ~ hi
    ~ _ _
    MEASLES VACCI NATION _ om _ I> _ """,0Ilf\lI" _ _. .I-
    M ....... .~b iI , 1oo _ _ b, .......·". . .,..m..
    ........., ............pit •...,. ..... pIi<oOo"" '.a.oa.a. _ /oJ1I "lOy ........ .....,..,......, ~
    II flooc:w....,..,.~ ..."' .. _ _ "'9'" _ ~ .. """"-9 ..... 10 bIocI<od
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    ..taI .. ... _ _ •
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    ot ol>::>ul 10'0 _
    flI<!Ut:lIon .. All """,",IV""""'II.,r_
    ' 970 _ ' 980 - . . . . .
    _ ot_ ..- . __ .. .,.,....;oon).
    (COIIOClII\' _ _ . . . . . .,
    ... .... _ ... ClOlIQI'Il
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    HEALTH WORKERS ANDPENICILLIN
    _
    _"'---- ~­

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    rant!)' . _
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    .. p..
    ........ - . Eqorioo_ III "'" N_ o.l """"'" III
    \aoolia ............... ...;tlo niaiq. die, .........1;e,I "'"

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    an:! .., 10 ..., ........ t>. ~ D<J(lt;l"""""
    HEALTH WO RKE RS h(T""l _ _ " , _ O I ~ 10<1 .. " . . _
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    \ooe. <Ira"" 'II' . li< ~ kJ _~ '" Alii .. plok _ "'" 10<1 tIl.>1 """"" _ """""""" _ lei
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    01 ".. ....... dIilogf'>OM ..... ...
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    ""*" ......._ ... lobar
    _ ----
    PENICILLIN RESISTANCE
    "--'- ...
    I ,"rn """"" -.. "'II'!CIIMI ,.., _ _
    ,
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    'llI'.." ,..,.,
    _

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    CCIfMU'<I\' _ _ • ""
    ~"

    '. ._,"",,''''''_''''' TREATMENT COSTS


    Il" lhe ""-'II"'" 01 '--.0' ......."'""' Alit "'.. _ _ _
    . . . - '" _ ."",..,.,.. '" _ • __ CW 12~

    -_
    ~ . 0 ..... _ 8 "",*, ."""",lM>Iy. lor • ~

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    ".,... '" .....,.,." "' 1_ l.folK:Ef _ l • "'" ~
    Antibiotics ........, INl '" ~ ""'""'""" ony _ . ~ '" 10...
    01 _

    "-"_
    ........ ~ _ aiel.... _
    .. _ ---~­
    ._l"'U"~-... _
    ""'" U" " "

    '"
    II LIFELINES' COMBATING MALARIA

    Combating Malaria
    Malari4, r,alUmi,ud by LV A""P.vU$ """'I~il",
    pf I~'ddnl ,,,04 ....., ikbi/i/aring diwua Impact of Ma laria
    *_
    ;, lift<
    /1/ "",dilld. l~ """'Y dntloping "'"~'''''''
    u.._,... ......'; .........,., _ _ ..
    t<ptril>/Iy til ''''fli<:al Afrj(", il iJ """ oj 1Mfiw "", j~
    U1UIl of illjlllt, oltd I hil4 1IliJrt.21ity. l'rt1fM"1
    MaIaRo 10 ~Iy

    =
    '' ... - io 1aI uoI . ~;\olna, rio

    ir_. """
    _ "'" abo t<peci<J11y "",lflmIbk, Jl<lll il:~Ia ,ly if
    ._10
    ... _ ...IIlrir
    _ .. duioc
    . _0<1. Ma lulritioo
    alrNdy ....1"""risW 11" MaInl in """'-'" .. ,."".,....,. ............... by ... """ .. .
    OMri", 1M Wit I9SOJ /wpn r/11lltiglt "1<1, ....1aM _ ~ - " " ..... II 01 """
    _ 0 1 .... _ " ' _ _ - P _ . P..-...
    ll""'1J ...... bo wmpk",/y muJwui. BIl' lilt dism# P _.orP ....... . _
    ~ by _ . _ , _
    _.~
    ...-ing Tho.....,..
    Jw rillU IIlDdI: a .p.nae..".. _Iocrtlt, t"rgrly

    _.
    -..... .. _ ......,. h""" ...., ., _ . oooor<lol\l '" Iho
    I«lIlUt of 1M uptJ\Sl 0/ ""'''aUlia'", COIIrroJ p- _ 0 1 _ 11'...... ""' _ '$_01 ............ ....
    ,...111 .... ,'ndt filliuly, f7"lJ'i"l milra,,", '" ......., ;.. """""'" 01 lhO inIoclion. _ .,."
    "", idllKM .oo..d1 - .01"
    or _1>1_ <:oncomo\rI
    ciJn " _ ,Itt """'1"i_ witH carry rlu diseim,
    and ;rr<real;", Ii"" itrollu in lilt /MI' "" porIon. ,~
    _-~-_ .... ~- ""'"
    of , Iu _ /aria fK'r<I$i,...
    lAltr-urm ""or"" of .... !.:Ina dqJtlrJlt "" d,z _( I""ano.......
    _ .. _""'*""
    """Y~ ol N
    _,"Ion!
    _ f'!oananI - . .. _
    _... _
    ~
    _
    ..... _...
    .

    ,>tI« I;" lIA' oj ilUtfliddls, ,fUrl,,",,i,., 1M ..osqwiro'J


    />mdi.., ,..,"....... au ",i", """'I"i,o lit'"
    MTot1U
    ,,!III rrfiflk10lS /II p.oI<e1 b""'.... fr- , /111, 11</ wi/It
    _ ~ • ....,. 1t-cy
    _ _ .. ,.... . 10 12 _
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    hir ,
    01:1 """'" ~
    _ "'"'""""'"

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    "''.<l,' _ .. .....
    --._. ~ _

    ",...,,,iUltS. NI,ti.. '''~ _.~ _


    ..., Do"' OI'lIIn'IOIOriOl ..... opy I.bw llIrIl ....grd
    'I1uu _ m 0 . . • i,Mr u l'<'!Ji..., whically .. c:r...".,..., <II _ ""'" lEI _ _ , ....
    diffi(fd~ or Mtrlr. In lilt _ II,i-. Ilrnvglt, ",,,,11m
    OM cltildmt can lit ptolt<uJ _kin.., 0'00
    ""I, il IIwy ,II. ziWII ,...,.,.,"" d"'l ImlllMlO' '"
    j>(lT1 oj W1Ilml/nil)'-bcIud pniMry /willi ca.. aflitoi·
    ria _ _
    -._-----
    ~ _io orlOlCa1lOn <:am<:aIQno _

    - ,-
    1 1' '\.Jllo mony _ ~
    _

    ..... "'.. _
    .. _
    .- "
    _to: .... '''' .. 1OCOtdO<l . . . . ...., ,.,..;gr,..."
    _
    _
    ... <>, ' ....
    _ ......
    sc.._ ....-..;_

    _-,- _---
    ......... .. " .. ' "'10 ..... tnlocI><>no rd...."
    ....... WJlnMCII_... tIIiCl<.. _ _ ~

    <II J cia,. <II taocl lOr "" od<.IIt Tho oHocl '" ""'" 01
    _ lOr fl'IIlnCu' _ _ ..,." low _ ....., low
    ......"""'" -
    • ..
    ..., ...." .. _
    - -
    . _ <fl!I<Tm . . , """"'*"
    .......... . """"""'" <lion-

    ...... . . ... """""' ''''.


    Resurgence of Malaria
    so.:. .... . ort,,_IUloril .... .... _.,.0 . ......
    . . - lId..l ......... 10....., dn'ol<IPo& ..-..I<., __ DEVELOPMENT OF IMMUNITY

    - _.. _.
    <ioIlr .. '"'Pi<a1 AI,,",", 11"'" or .. ...-...:• ......- pXlpIo
    _""" - _
    """"""""" .
    U ~ 2.<00 _1'<'>IlIo -)uol

    ....." .... '"


    M .. oounlI . . '"
    <N«

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    nail "'" -'<I"

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    .. wI'I<> ..... ..."

    . . . .. .
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    ",->-.." _IO ~ ' ''''''

    ........., -..
    T h i I _ < I I ~ ~

    ""'"

    - ---_... _. _.-
    _ ........... '" _01 "'" lOP ~
    Tho Wo<\O _ _'"_.
    ontInI.""" cniIIl
    f"oal....
    ~

    """'" """'" .. .,.., _


    _
    ~.

    ., 01 "'" "'ClOt .. l!>O.ooo ..-..


    ..... 1MoI:IIly. IIIOIlOy """'"ll 'J'Ol"'IO ..........
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    COlI

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    .........,. '" _ ..." _ _ . . . - """"""'" ltoD

    rr """'Y
    """'","""'- ......., , gftIO\eIIl lOt .. Ir"r(Irl;:clOy 0Tl(I n'IOIlOIiI' Ii f«Ind
    1l'O'C ",.... .. _ , ... _ _ , ctl!Idron CWO".11>0
    _
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    ~
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    _
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    lite "' 10 .,.,..... _
    S. .,.. ~ II
    10 •I

    -,~

    '"
    ..... ll't>IhiII"'" OIl • ""'" ....... . . . . . .", 1*"'" 01 - .
    Treatment of Malaria lho<lly. _... ~ ~ Jlre'o'(Yll!l>o
    <fIIkl'. __ 10
    do. '~'e~ 01.

    . .
    ~!rom ~ ~_

    WI"'.-. .p,,,
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    Ill _ _ F<>.<IlIy,
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    ~

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    (r l I mop ""'II! at h l*aooII), """ !CW1;-Vm
    ~-- -=-
    "'~ '-">Illy

    _10 __..
    ....,..... fin< ,~_, III
    Or!

    """ _
    olIly '" ~
    _........-. '"
    Ilo:IgnooiI _

    ~
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    ., mal<o _ ,
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    ~

    ._"""".......,
    __ , ., 1MlI'/._"""'"
    _1Il_ ,_ ••
    _ .. on _POtIol.wy ...... CHOIC E OF DRUG
    !r·C»loroqwII _ .......

    _
    fqI " ' - .. _ _
    ,... ...... ,. '" pioriIy n __ ~. _ " ' ......... "'" iI'uyo et "'" """'"""'"' _ . buI .-01 , _ ""'""""
    """",lie _ .. ~""<l"'_""""_""" 1""""'" "'-" "'..-.... _ II """"Il"-"
    IlfO'o'ISOO" III _ ""'11PI ..... "
    ;,::;-;: :-:::,~,_._'.'-~
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    '...
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    __ _ ,,_ ._""CV_CI
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    11"MorIaJoIl< ""'" _ ...... IlIl "4'; I'Q:\"""'" Il>llOsI
    _ _ 01 IIIL. 11>0 ......... ,. _ . '" pr<M<lo _ ,
    _...c,...
    a<loQu;IlO ~""'.llor - . -...-.. • _ _ u '·-..... ~01"'-_ tlII_Qrl ' "

    ~ - 11. ca"I
    -... ..-.
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    _.~

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    .....
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    ...".............. - t.laqll
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    "'....,.,... using .... _ _ lI1I<Iull" - . . . ~10_~.., ~ .....
    ........ 5ho Ia.QtIlI>:All ... 1".-1 _ !llnIIl - ~"II at " ' - Il """'" _ _ ~ _ _

    --
    <a"I Do .... _ ...... ThoPItC _ ~ ..
    Po........, . _ ...... _ _ ""'"' early dI<eeIooo> ....,
    _ '" - . . ~ ... "'" _ . n-. WIl...- _ """," . -......, IV'lOIl
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    ... . ,~
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    " " " " to _._


    .... . _
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    ouopr>nod "'" _ _ 0"Ili:it-....., ~
    ..""'_"'donoeal_,•
    - . .• •
    ptOQt......... 1<1 ....
    ut, _ ...., .~ 01 ....- """""- II!""" '" .... Control of Malaria
    o. "''''''''~'''''''"''_'''''_
    IJiagncois ...., _ _ llW<IP"lOll - . . . . . IIy
    ' -..... -..a _ _
    __ ........... • «"*l be

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    ,,",,100 WlIOglll1M _

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    _ fll/'IPOIIon _ ....
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    .001

    a _ oI ~ _ ..-..
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    ...... bree4i11 ~ Ia . _..

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    r.. ""'"J'"'\I 01 ' - ""'" . - (100
    I ""'" _
    _ _ _ _ """'"01"''''''''- 01

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    '"
    II UFELINES, FEMALE EDUCATION

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    ............... ""_ _
    - ' I .. ""9OiIO'o, - . .." _
    _-,.,
    _OII!!(I.-x>
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    RES ISTANCE TO DRUGS


    n.e _ Iooportu' 01 Iloo _ ... Iou _
    ....
    ~

    ~ ................,
    o " Soncv ~ _ lW1l 00lItI0ll 11> ..... PIll '" _ II _
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    - " - . 01"<1 11'1 ~ P ~ "OlI.O'oI
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    ~ _ Costs
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    ...
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    ~ e . p I~ ..... criI'
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    par_ ...... TREATMENT COSTS
    _....
    _
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    01,
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    Female Education
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    '" 1'oOI . ""'_ _ 0fIK'l CIloIo

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    I . """" cloorIt . . - ""I !hot rroro """'"~. _ _ ...., <:I1Ild " " " ' * ' f _ ..-.....
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    '"
    II LIFELINFB' FOOD SUPPLEMENTS

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    --
    _ IIIlII'lllY do "" _ E ~ .. Wal
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    - _---_... ...-
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    Possible Explanations
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    Girls in School
    01
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    _

    -,
    _ _~---
    r - .. _ _ ,

    -- _ _ _ r- .. _

    '"
    - - -111- - -
    STATISTICS
    Economic and social statistics on the
    nations of the world, with particular
    reference to children's well-being .
    s ... "" lI>t ..... - . of infon' ..... child """,&1iIy
    COUSTIlV (NUO( TO TA l U S
    TABLEs
    !:Ba$jc I"dic~ton
    IMR I I population I I births ""d infan' and child
    a
    dUIM G NP per ""pill ( I life c~pt(:lanCJ I J adull
    lilC~ n IChool enrolment I 1 in"""'" dislribu,ioJ>

    Z:Nut rition
    Low birth.weigh, n b,.ast-fcedil\i n malnutrition
    I 1fwd prod=ion n alorie intake
    3:H.aJl.b
    Aa:ao 10 w.,,,,
    n immuniO<:ltion of child"""
    n immuni:ration of _a.rt
    n life expectancy
    4:Eduutioa
    Mal. and ftmal. ~ l.raq I J radio m:eivcn l1primary
    school cnrolmut ""d t(llI1plotion n occondlll'}' ""boo!
    enrolmem
    S:Delll"l"'phic lad;.lln"
    Child pop w.ati"" n " " or Srowth i.. ram ""d child
    mortality I I tnld. death rate II crude birth rat.
    n fertility rale l l urbanization
    6:Eeonomic lJIdic:alO<S
    GNP pcr C'lpi.. 0 annual Sl'QW\h rales 0 iD601loD
    n po •• rty O s" v<mment upend;,u", U aid I debt.

    -
    1: Iluk Ladicators fot Ie.. poplllOlls CGWltri«
    G«l<taI - .
    ......
    F........ r.. "bioi
    l:I<toi'iom
    />I.IilI __
    4m
    . .1_1.

    S ... 00 nrimom ia u.r..., ••" IOIn,. " I< (";d'; . ""'",....)


    T.bk of IMII io...-l dilf.......... by """''''' 1970-1980
    New Index of Infant and Child Mortality
    .....-... or coIlolIoIaIIOn ClOt
    !"'o-'" ~ f t tN::U •• !'DOt ~ let
    1."'-"-' NIloonJ 01 . . ..•
    .. . ..,b
    ' ; - . _ ...... ...
    o I _ I . ~ ...
    __

    _ _ • __ .., _ _ my .....c lII$ _ 011 .-..-· I ~ OI'I . . . . . . ~


    _ -.. _ tcr ctiIIl "olaioOl)
    ...... rod chlcI ,"0,*'
    AI . . Ot\r or .. " eo. .,.. _ .... H ' _ o I ... ~ _ .. ChiO~
    ....,-..iII\J
    _
    _
    Mt d .....
    . .., lNC£F '*"led Xl tullI)OI'I . . ~
    "0lIIOI,_ 08llI .. 010.... II III CQ.r.ilI 01,.. --'<. II now
    IllPNft _011I'0Il ' 5 - . n/anlI.., cr-.. "'...
    NtUonI ~ DMIoon II />i1llJtli" .. 1hII .... 'MlIIIS curlenl!y dyWlg ekfl year, allI'IIIly" 5 millen
    ~ .1""'",,,,,,, HI of Inl"'" rnonaJjly . .n· "'" _ 1hII _ 01 1 • • h9"er ~ man " ,.,
    rnaleS In! ~ These _ e ctI'1"ClIereclln 1'82 preyICtISIy - * ' """""*l -" _ rJ/heI lIIarl ,
    ..-<I __ In! 1>_ leO "' Jht SloI.. d . . _ . ...... dtIlI'llor fNf/rJ 2 ) inl.lrll _ _ lIWll1eWllap-

    .,-.., ---
    ~_Iar 19 83 Io_~ol" "'CI- . • PI--'Y ......,. '" IKI ,
    _ _ _• tiel' ..n ....
    _ _•01 • """, IlO\l."-"- lie
    '" <:hill ,,0_ . d'lIkloiNll lor...., 2 ..... _ _
    _ , . "' ..... ' • . , _. . .. _".,1
    '.''''''IQ 1;1

    ""*' _lor...., S .... _


    -"',-.0* /.."''*,-
    In • • 1"'. >. raM, r- _.$ ....
    _ _ - , ......... _ ' ..., o l _ ...

    IlOlIr1O ' - ' ..." ,


    o;IIia " ...
    _1CIltt .. 0lllIh '* _
    prqKIIOn 111M N ICItIl ol
    ""'" ..-.:I d'IIkl oeooh ... 1IlIlrom III <;ut.-.T
    1,000 Ch*:I<tn IIQelI '''' __
    "'"... lIenotJW\aIOI Irom m.l
    ~.
    "'*'
    n. ••
    b' !toe ",1/11'11
    le¥lII or ,) "*'" l;I.-ouncIl 0 "*"" III'IN.-.:I olIN
    c:enIUIy Ol COI.A"IoI. ~ ol !he pufIXIIef O! UNICEF
    mor1AIIty rtIle l,*,\hlI1* 1.000 ~ bIrttlI), TM mutll
    INlI the two _ _ CQJId not be - , . COLP,..;I S<CIlIlIrtIo'll <:OI..O'lIr\'.e~ '" !Ile . . . ol CIwId IIlJMvIlI
    IIICl .. .,secIn -""Don . IIIlI::aLU IN OB"OI . . . .
    . - 101 ,.. C/'OoCl-=ro """.so '-i,_
    Ue." • I'IIIMl
    '*~
    ......._ ..-.:110 - . . . " " ' , .
    ........, QlDOIII «00'''' .............. _
    or
    ..-.:I" I'Cl)II'IOlI~. 1O~" . . P'OIIC"'" mill
    or
    no.
    ~

    ,.,., bIltw 1 ..
    _ _ SIlo"'"
    ....... ..., cHll - - . , _
    ,-now_w'",'
    ~_bNk1l_. I.now_~• •
    ~
    ..a m 1 _ 01 _
    ,.., ......
    ..... torllw '-*IO_• .CO'.... _....,.
    _ l"O _ <II mortality '*""-.
    If>:! .. .....,..0 .
    __ I!
    -_..
    ... . 1 0 _ . _ _ - . . . - . "' _ _
    mid trIOIIIIky l'1,...-.:I ol .... ........, _ _...,
    ......-.:I _ _

    IS _
    ... fill
    w:.., _ _ o l r - _
    ; ~:

    .,--,~
    or inl.lrll _
    las 11 ... ..-.:1 ol~""""''''' • •
    alIIclAta
    .
    • • IIQllO<l lha l ItIOI . - 1000. 01 inlBm aroo CI'IId ro:>w _ lor..,. _
    1OClIY -MlCUI ~ 3 miIIIOtl • year T1'uI "tnc.l. _
    30" or.. "'llllll laro:l ctlIId
    rnonaioI'1 will be liClOPled l:!)' OOU'm_ lor - . . . .., <IeIIltoI, • P/OIllCIll(l, III' !tle .-.I 01 IIlI _ tuty. 10
    ...a._ • ..,_ ..... _ _ <MIl' h _, iCCllUI'Illof ",.. 40.. ot II ontam mel CIlIiCI _ _
    lew ~ so 1IIaIi.,-, _ , . IN _ _ form .... - . ~ _ .. _ 0'U'IlllerS
    _ -l _
    ""-'_ _ChiO
    _ 01_

    --
    . ......,; n....' Fa..., ctU>- ~ II" Aka. N . . . . - IlIiI:n ,... III c:.
    _ ,,_"'~ol_ """_
    ",= 7 ....... rdchlll"... _. _ ..._

    ,.
    Index to countries
    In 1M tollowiog tables. COUIIIlles are llsled In dncet<:ling order ollnlam mortalitl' ,oun<!ed W It>It """,est 5 In
    IIIecase 01 coumries .i th a lal8 01 50 lMaltlSor more per 1,000 rive tw1hs . cocwes with tile same rates are
    IlS1ed alphabellca8t'. The ref9<ence f'\lJITIbers indical"'" !hal order are shown In the alphabeUcal Iisl 01

    ,-""'"
    COOOlroes below
    Al{jharustan , G_ ee Pakistan 30
    Hail; 23
    "es"to
    '".~
    "sa
    ,~~
    es

    .........
    PaPUa New Gulnea
    ......,
    HonOc'as
    Hong Kong "
    '" Paragu ay 80
    -,~
    '"ae """ ..... ea

    -- '" ""' '"OJ"


    Australia

    '"za
    .... -
    "aa ""'"
    AUSlroa

    """""' '""ra ,'"


    Iran (lsIamic Rep, 01}
    so """""
    ....... '"es
    """
    ~

    '"'"
    --
    "'"~ ae ,.,
    "' to
    5aIJdj Aratlia
    BoIi..a
    '""99 '-" "
    -...
    ........
    sa Sierra leone a
    &..
    '""
    """"" Singapore '23
    6<J1ga',"
    .." '""e ""","
    Soulh Ah::a
    s

    "" '"sa"
    '""'" F_

    .....
    &,~ ".m..... ,,"0
    se
    """'"
    Cameroon. U "",.
    ""
    ~~
    Korea, oem. Rep. 01 es
    Sri Lank3

    """" Afrocan
    Central Rep , '"is" ,- ,
    Korsa, Aep . at as
    sa
    5_
    SwlIZe<1and
    as SyMn Arall Rep
    '"'""
    """ lao People's Dem, Rep.

    "'"
    """ -
    e ""ts
    "
    ,-~
    Leeoeo

    "'""
    n Tanzarna. U. Rep
    ae Tho..,
    ....
    " '''''
    es ,
    oJ
    .."
    "
    as

    se
    ""'" "• ,.""
    tibyan Arall Jamafllnya Triruclad a'ld TobaQo
    CosIa Rica
    '" -,..., .,
    sa
    """ '" "'"-
    CledlosloYal"a

    """"'"
    """'
    ,.-""'" "",.
    '"ss
    '"ee
    ""-
    _.
    ""Malllitan<8
    sc '-'","
    z ussa

    _
    is United Arab E"",ales
    ..
    sa United Krlgdom
    .'"
    as
    as

    ,--
    MaUT'WS

    "'''''...... ,.
    ra
    ,,- ""r Me.ico "'" '"sea
    t

    F""'
    rreee"
    German Dem. Rep.
    Germany, Fed. Rep. at
    ""=
    '"'" ... ""'--
    ..".,

    '" Noca'aQua
    '" -,~ '"
    ",
    "
    '""
    ,-
    Viet Nam

    Yemen.
    ,-~
    Dem.
    sa
    ac
    ar
    er
    G",~
    G,_
    ""',-
    ""'"
    '""sa5 "'"
    " """"
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    aa
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    "m
    ..
    Zamee

    .- .
    ,"''''"
    ec
    50

    "
    Guonea.a.ssau
    """"

    '"
    TABLE l' BASIC INDICATORS

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    ' lIIlS' 11111
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    "
    lOO fl~ 35/" " 111

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    TABLE 2: NUTRffiON

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    TABLE 7' BASIC INDICATORS ON LESS POPULOUS COUNTRIES

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    General Note on the Data
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    Signs and explanations


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    _ I)I """ ..... ~ Inc-._..

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    Table 3:
    ~ --...._. ---
    = ,0<011 ~,
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    N/1J
    ~"
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    -~
    ---- -- ~,
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    ",...,... """'"'" ........_ '980
    N/1J'-~

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    ~_. ~_ .............. 'No ..... ' _5
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    ..... '_5...
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    ""'" r-e

    ---
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    Table 4:
    Educatoon
    ---
    e,:._'
    _.- --~

    --
    --~

    "--
    ~'.';::::=::'"
    , Y79
    '916
    "11
    '911

    -'- ---
    Smlo_._ '979
    ,91g

    --~
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    --
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    :l:; '916
    ~

    --- ,. --
    Soror<Iary .....hO . ' 975
    -~-
    '979
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    ' 913
    '97<
    llHS
    --~ '976

    -- --
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    ""
    ''''= ,., ~
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    '91g
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    '9111
    '9/8

    ...
    5 .... , _ '978
    ~~"""''''

    --
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    '916
    ,c.....,. :;:&:,;';",0'

    ---- - --
    ReI> '"
    U 19'9
    Ig ' 6

    _.-
    I_Al",,_ '913
    ~
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    '910
    ~--
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    ,-- ---
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    .u Sow _ , ImllO:T"O'II ""


    ""
    '918
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    s.cadory _ _ ,9n

    --
    '9/7

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    ---- . ":W--
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    ' liS

    Table 5: ,_ ... ",, _., _~


    _. .
    Cos • __
    'liS
    "" 'IS4
    " ..
    .... '0·

    DeoliOQi'-.c: if1dI(:aTDr.i

    --
    Table 6:
    EOOllOllliC
    -----
    -=
    --
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    --
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    -=
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    --
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    --
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    ....9.....,...
    Table 7: ,--
    ---
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    --
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    ----
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    ....
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    ---
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    ---
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    '40 _

    ,.
    Definitions
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    _ """, . . l OOO """ l>n1O ""',.,. I....- _ - . GNP
    POI . . .lIIl1"M'!' , .......
    _ _ \1'' ''''''' , l1l3I _ -.

    -,
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    L....: <lioI "... _ l"<I<>lo<><l


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    at ". ..... 01 _ bof\

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    SIIat"' . - " , . . . I'I9'aIlQ'lI oro
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    _ _ ' N5
    _..-_'OU
    THE STATE OF THE WORLD'S CHILDREN 1986

    Demand for vllCcine5 lLal trebled in the tau (0 drastically improve their children's
    tWO)utl as many nations aa:dml!C tbcir chan«t: of $UrvivailUld nonnal healthy
    vaccination PI'OlIramrntS luwarcb the United .rowm.
    Nations loa! of univasal child immunization Pan II of the report brings tOllCUler, in
    by the year 1990 ,
    IttUSible nOla; and qUCMts form, I
    In 1985, vaccines are eiUmaled to have distillation of filtU and mmplt$, =01
    prevented the de:llhs of alll105( • million raean:h lindillgs and current ezpcn npinion,
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    MUllwhilc, IM.pread of on.! rehydratioll available ror pt(lltctlng ell1ld.f'tll'a iJl/tIllId
    l.henpy (ORT ) bas prevented an cs,ilNled devd opment- including ICCtions on: growth
    SOO,OOO cbiJdll:o from dyiol of dillThoeal monitoring; on.! rehydration therapy; breast -
    dehydration in the lasl I~ln months. f..eding rwd 'llUl1ing ; immunizaoor:l;
    ralpiratory infectionJ; iron, iodine: rwd
    laununizalion and ORT ate tbm:foll: vilUlin A; rnaWUo; female education; food
    beaionmg 10 bd the wlY mwan;l$ the supplements; and family .~. This
    rcvolutioa in child . UfVival and lkYdopmem ' Ufelines'section is rolled from an
    wllkb has mil the main theme of this or
    international colltttion seven! hundred
    report for the lUI three: )Iran. publicatiolll and is intended IS; short cut to
    the key evi<knce ..,d cond usioJU in each of
    Pan I of the 1986 rt"pOrtloob It me
    recent surge forward in immuniutiolland
    these fields.
    describes how 11K SU1Ilqy of 'mal Finally, the report includes ;
    mobiliDtion'ilI being used (0 pili tbis and compn::hcmivt: statistical :lttl.ion with all-
    other low-c<.lSl child proleWOO tec:bniques at n;tion figUral on nutrition, hc;Jth, education,
    Ihe di ,po$IJ of. million. of paren!$. The popubtion and economic JlI'tlllresl. I.Il
    report also includes $llIlllIW'its, from (wenty keeping with the ftll(lfl'1 central message,
    nations, of the attcmpl ln inform and the Illtistical tables list the nations of the
    suppan paR'lllS in usina today', knowl~ world in order of theiT child l urvival ra t<$.

    OXFORD UNIVERSITY PRESS


    ISBN o-l9-a28 5*"1

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