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    The State of the World's Children 1988 constitutes a direct appeal for the involvement of all possible resources in the cause of child survival and development. It argues that what is needed is a Grand Alliance – of governments and peoples, education systems and religious leaders, mass media and voluntary agencies, business and labour, professional associations and conventional health services – to create a universal demand for, and practical knowledge of, those methods which could bring about a revolution in child survival and development. To learn more, please visit: http://www.unicef.org

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    The State of the World's Children 1988 constitutes a direct appeal for the involvement of all possible resources in the cause of child survival and development. It argues that what is needed is a Grand Alliance – of governments and peoples, education systems and religious leaders, mass media and voluntary agencies, business and labour, professional associations and conventional health services – to create a universal demand for, and practical knowledge of, those methods which could bring about a revolution in child survival and development. To learn more, please visit: http://www.unicef.org

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    227 views98 pages

    UNICEF: The State of The World's Children 1988

    Uploaded by

    UNICEF
    The State of the World's Children 1988 constitutes a direct appeal for the involvement of all possible resources in the cause of child survival and development. It argues that what is needed is a Grand Alliance – of governments and peoples, education systems and religious leaders, mass media and voluntary agencies, business and labour, professional associations and conventional health services – to create a universal demand for, and practical knowledge of, those methods which could bring about a revolution in child survival and development. To learn more, please visit: http://www.unicef.org

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    of 98

    THE STATE

    OF THEWORLD'S
    CHILDREN
    1988

    ,
    ,~

    United Nations Ch ikl ren's Fund


    (UNICEF)
    THE STATE OF THE WORLD'S CHILDREN
    1988
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    /'rt$1 ., P 6' L
    AII._ s.- 0>10""''''
    U,K..
    THE STATE
    OF THE WORLD'S
    CHILDREN
    1988
    @
    James P. Grant
    Executive Director of the
    United Nations Children's Fund
    (UNICEF)

    1'\18USHtl> FOR IIS ICH '

    Oxford University Press


    CONTENTS

    ~) ~

    THE srATE C*'


    THEWORLD'S CHILDIU';N

    A grand alliance Ilo<F"'X""""", '" _' l>< 1_ of _ ", "l" 0( I'<O'«''''C WIdr.. ~ IivnlllollfO""\ll
    ,tIy I m1lIioO cIlilol_, """, yt><. n... "'~ •
    for children
    d _ "...._
    til< muk or.
    II tb<
    _.0,(
    Wor-I of \<>Joy'> "' ...
    ...,.."""""' hi< _1OolIy'J ........ ~

    Alliances ll'ooI.Inlt,'h< ........ boi><for _ ........ blo<1 J'P"'tU'I"'" _ 1'"


    acncn
    ~ ""'" .. oI.....ty b>oom. I. do:-...... _ld. di.< .-q....-so for
    In .... _..,do, '" ,.,., hoot ben me r--'" '" _ _ OKT. ~
    lon. en o«d<nI< J""S"'" -...J> """'"'" boahII aft.

    Childr en T"'" _"';, w-l ~ - . : """"""' ~ l"l' _ ,...," pot;<;<>_

    and recession .....p ..... """"" Ill< 1""" - ........... -.... ·Ad '""'. hu r...'
    .... o.I<poood .. . ...........s """'"""""" ,., 'Il< .......... _ .-....l """"'" r ,0.
    ~.....nl.

    Family
    knowledge

    Partners ,..,. oJtion<" 01 _ .. ........, <an '"" ""b ~ md "'I'l""" at ,lit d~ or


    til< """"'" ... I'=iboo ~ tb< !>nItI:l _
    ,....
    ... tb< IdIooI 'l"l_ tJo.- Md
    in (he alliance !>b<>4, ..,..;>«1 '"'-' to. ...... -.. ... """"l>ry _ 0IId ""lIli><n ol. '",

    Support
    for women

    Conclusion
    srATIsrICS

    l"l.\Ut D l MR o 6I '
    D _ ... __ ... .w .bdoo
    Table 1
    basic indicators
    []0 _ _,' ..
    G~"'~_ , c _ -...,.o _ ... ,

    7Qbk Z
    nUlnlJo n
    --
    a-_ ...... o _ ...... o

    --
    Twbit]
    hcahh
    _
    _ _ O p'
    0 __
    __ 0

    _ ..Ie.-"""" [] .....""-
    of(m O _ _
    0

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

    --
    Tablt 4 =' .... ' _ lJ ' , __ '
    education

    Table 5 c:Jroa<I ""'""""'" [] ~ '* [] _ [] mol<


    bon ~ . - [] . . .."""_ [] _ , .... (l _ [] -.r
    demographic indicators
    ~-

    GNPp«_ O _ ..- O _ _ 0 _ 0 _
    Tablt 6 _npmIolR D ooJ 0 ...

    -"
    economic indicalon

    ....., =.
    Tablt 7
    - 0 __ ' .._
    , O"""" []m' _ 00_...-,.
    _ U

    --
    women

    T"'" 8
    less populous cccmnes
    -_ ...... ,...-
    .. __ .... "
    _n
    NOtes
    --
    ~-_

    _u

    -"
    PANElS

    Immunization:
    a Pfogress report 1 India:
    the tIYashold 01 irnmunrty 10
    BreliH eecDng,
    Sen81181:
    stlowing it can be done 2 a progress !epor\ 11
    ,,..
    mobilizing to plan 3 Hondlll'U:
    leaching hospitals 12
    United Stales:
    knowledge for health 4 Japan :
    lewe< deaths. fewer births 13
    CoIom bi. :
    pupil power 5 Self hNlth:
    tile tobacco res' 14
    AIDS:
    a work!·wide effOrl 6 SMR C:
    chldren first 15
    OAT:
    a progress 'I!IX"'t 7 T1Ie Convention:
    righlS 01 fhe cl>ld 16
    Bangladesh:
    rea!il;es of people's lives 8 Southern Alrk:ll:
    hidden casuallies 17
    Turkey:
    sustaining an achievement 9 ,,~ :
    \he Bamako ;"i tialMl 18
    TEXT FIGURES

    F. ,
    ''.. •
    AnnUal undef-Iive deaths. de\felopirlg countries, 1967
    2 Percentage or daily smokers. lIldusl'ialized c«mlries . 1965-1985
    a Increase In 100 supply 01 veeeres by UNICEF, 1982-1966
    Fig. ImmunizatJon cove<age. by geog<ap/lic legioo1s. 1986
    Fig. S Esl;maled m"limum OAT use fales to( children under 5. 1964-1965
    Fig. 6 ReoUCIOn in oeetne lrom acute lespifstOl'y in1ectlons (ARI), ThaP<lthali,

    Fig. , Nepal,I984-1985
    Economic growth In the developing woOd. 1976-1986
    Fig. 8 Percentage of the developing world's populalion living in ccomees \¥llh
    zero or ""9ative growth in per capita GOP, 1979-1965
    Fig. 9 Decline in net l'ansfer ot 'eSQUfOOS 10 the capital-importing de'i&loping
    countries, 1900- 1965
    Fig. 10 In/ani deaths by ~Ih in\efVilI. selected surveys
    F. u Numbef 01 teleVision sets 8tld radio receivers in the developing world
    per t,OO'J inhabitants, 1965-1983

    "" lnc:fease in molhen ' knowledge 01 l,ealfng diarrhoeal disease. Egjlpt,

    '.
    1984-1965
    ra Avaifabi~ty of healTh care lor pregnanl women and infants. 1986
    - - -1-- - -
    THE STATE
    OF THE WORLD'S
    CHILDREN
    1988
    James P. Grant

    A grand alliance for children


    Alliances in action
    Children and recession
    Family knowledge
    Partners in the alliance
    Suppo rt for women
    Conclusion
    Sources
    THE SfATE OF THE WORLD'S CHILDREN 1988

    Tlu: under·five monality me (USMR) is lh.


    number of ch~dr.n who die ~rQre 1M lip' of 5
    for every 1,000 born ali~. This yeu, illS the
    USMR figure which governs the order in which
    the oountries ue listed in the 5l1,islical ublH of
    1M Stile of the World', Children report.
    Figures giVC1l for the under·five monalily rate.
    of p:anicull.r (Oonton, in beth lh. lex! and
    SlatisliClil table'S of this report, are cstim.tes
    pr .t'.~ by 1M United Nations Population
    Division on an imemuiooilly comparable nasi!,
    using vanous SOUl"r:es. In some casu, lh= may
    differ from n. ,klna! HtimUH.
    Agrand alliance for children
    Ont dead, in ~. ~ ia 1M world is 1M Amid alIlht maD)' ot!ltr dif6c1Iltits bo::iDg lhr
    dm~ .. I d:.ild UltIlotf 1M• or 6>" .•'\Dd CIIdl 1O'Orld'$ dIiIdrm, a<Id amid aD Iho am.r
    issws

    .....,..................-:::=
    -.I< dw goes by, ~ lIwl • quanti" tI.

    wwid, from ~ Illf«tMa md


    lIJ>dcnwuioclIL Y01 III the: 19lIOs to far, dapft
    with . "bidI UNICEF ;" aaiody _mtd in Oft'r
    100 lWiom of the de..~ worid, tile qutI-
    IiDDs of dtild SlU'fJ\'aI and child dr .clupcnui,
    I!lerfton n::c:Wa panmou!It, lICIt "'" bec::IIM ,,(
    rho diIIiculI E' ow io; djn,"'C', Ibo: Iimil~ ~
    _ or _ Iow-lml _ 01 pnIlCCIiac dIil-
    lilt Ilbftr oc-. mel ~ ollbo: ploNem but
    bte:aw< fIE dw:' emattOO!. '" .... timc:s, ol
    drt:ll's lifts :md JfOWlh il3mdy rmdtinc in tM dfallDllC Iofr.alst po!$ibililies for lIS Jdutiou.
    ,n... or PeatIy 40,000
    bas tberd"on be«! ~IN
    !iva nell Wffk. II
    )'OWl«
    dw it is __ 1'1Ios.. _ -flCIi$ibaitltl.riK from lWO CO:lnTt-
    poNiblc IV pm'Cnl IllOll dlild lkalhs aDd _ mg ptm....-.:·
    child malnutntlOQ by me""" "'1lic:h aDy ~Iap­ V"'" it is now known 1IU.11M ....1O\' thrn l. '0
    ing "'lion em .fford IV bfIgin implementing .lId 1M lives IIlld tile llOflll ai Rf'OWIh of children can be
    "'hith ev'"')' indusl.i.lilC<l n. tion can afford [0 der.a red, in large mnlU~, b)' informinjl' and
    suppon ,' M1pponi ng parents 1I1fmse hfl m wc:h bask and
    Theoe art ,be (><:1. whicb lOIft r over .ny inexpensive aclions IS gening IMir ch~dn:n
    rolUideRlion of the ilile of the world's dikln:n immunized, usinlj: oral lh=p;es for diarrhoeal
    as ee 19801 draw 10001lnlJ.~. And tbey are disease, maimailllng w:lul;~ brnsl·f~ in
    fxu .. bicb h.1n :Ill mild 10 say ,bout tbt ljUllily the early monlhs, .ppIyinj;: ~ knowlrdgt about
    of cIIildrm'J Iiws OJ .bout lhl' quantIl)" of ..bea and " - to mlf'Oll1Kf: orhft foods, recognia.
    chiId,cu" dull.s.. For l!ll:: ......,bi o...... of ~ IIIi lbe dall,gfr signs ollCUlf mpinfOf)' ink<.
    DI* iDfKriofts and IIIldmJutrition which is lht non, sp.Killg births at Ieal:r l1O'O ~an :opan.
    lIWlI ...... of dIiId dnlbs, aIIo IOUCbn me. li¥a
    PDf1llIiqg .... ~ftIQJ <:aU ,[ f":'"'iblf, aod
    pI/Iliac imo pnaa tlIf eMCIltiab of bome
    of neD brJP lIIIIIIMn of <:hiIdrm ...too lift ""
    1l'ltII ill bnItlI md poor growth, ltDal* <Oday rD
    d... ,1up 1<1 me. fuD mrtItal oDd plr)U:Il pGfnI-
    b'::;
    1
    (ore paga 31 10
    J7). If applifd, tbnf
    0fS .and this ~ I . c::auId drutiaIIy
    tial, unabk _ ,ow 10 fully ~ 10 !be rNIa - by at 10ml Sl* -dM: qain .... aagc oIa
    ~ oIa mil60a dIikl dnlhs eadI Wftk.
    fiUl\iDe$ tbty will ~ or Ibo: mmntlm;';'" in
    .tIicII tbry dIM. Socond, tlIf ~ ID tIw ~
    apKily 01 virnIIIIy aD oaliom am tlIf IISI Ira
    )'Un has mD it pouiblf, for 1br fin( rime, to
    pill lhal ~ .and 1bcw lfdIoi<pes II lilt
    diapoAl of !he greal maJOrity or lbe woOd',
    peopIe:. Sixty po1" eml of tM drwJopiog world~
    THE S=E OF THE WORLD'S CIllLDREN 1988

    adult' m nOVo' read and write. liiJIhty per "" "1 of year «JUld hi ve beensaved if I Up;irems had been
    in children now enrol in ""hoo!.' Radio reaches empowered 10 use: lhe IOW-COSl bru kllu-wgh
    inl<.1 • malQTity of i15 homes, rejcvislcn inm • known as or:ll rchydm ion Iher:lpy Or ORT."
    majority ,,(i'Hommuni,ies (fig. II ). Govem mem
    sclVicc. IIO W rea<:h, with ....tying dc~ras of
    o More than 3 million cbildreohave been k~led
    cffooiveness, imo almost e-.. 'Y communlly. TW9 in the lasl tw<:h" momhs by mrl>JJn, ttla~,.., ",,<I
    million doctors, 6 million nor$CS, and many mOre rrAo>op'''1 (aUl A, and another 200,000 have botn
    millions of community health Wllr1et'$ are now 1\ permlnently disabled by poiiQ. Ycr Ihe effon. of
    w<lrk. And 'c"s ofthousands of non.governmental Ihe wIlen ~a ... ha,·c m:KIe irnmuni'.ation widely
    OllI"niUl ion l., peasant co-oper11ivea, lobour un- a""i1.ble .nd the lives . nd limbs of .llnO$l oil
    ions, employers' associations, poliliC3l cadres, Ihose children cou1d have been spMed by a ecerse
    youth organizations. wo,""o', ~m.Ols, and of vaccinalion cosling .ppl'Ollimalely SS per child.
    neighbourhood associations now add up to • Whit is lacking is an equivalent (ffon (0 use
    breadth and depth of o' g.nized rewurU$ which loiIay's <:ommunicllions capaciry 10 inform par-
    could be the means of informing and supporting ems e'·erywhere of lhe urgenl need for I full
    the majority of the developiJJK world's ramilillS in roIlI"se of v:lccinalioo. during pregnancy Ind Ihe
    using tooay'o b1ow1ttlg<'. first ~31 of I child's life.
    MoM izinJ "'is nOW tllp.ci,y therefo re repre- o If"'/r m piNlJ(I1J ;"[«!ia,,s, mainly pJ\Cllm<>-
    scms • majOr opportunity for the .dvanct of nias, have killed I further 2 10 3 million under·
    primary h~a!!h care.' And IT the nert !lre!dy fives Ihis year, MOS! of those: children could allIO
    made can be Iccd enlllld, then the g<W Gf'Hcal!h h...e be<:n saved, by SO cenls' worth of aOlibiOl ics
    for All by the yc., 2000'nuy still be wilhin reach. adminiSlered by . rommuniryheallh worker wilh
    only I few momhl ' tnining. And most of tbeir
    parents could b,ve lIOught oul lh.t lcw-cosr help if
    Ihey had known bow10 diSlinguilh her>o""n I bad
    The kilo_ led,., road to bnlt1:l cough and a lire-I hrealening lUIlg infcerion and if
    the medio:al establishment in mOR countries we re
    A g1mce down rite list of !he major cau"". nf willing 10 relinquish ils u d usive righl to admin-
    childdealhs Ind child mllnulrilion in lhe l'o'Orld of iSler antibiotics {"'" p;ig<! H }.
    1987 (fig, I) shows iusr how far Ihe world'.
    children could now Iflvel dQv,"I\ lhal 'knowledge o U"Jmrurriria" ....s • contribuling cause in
    P<'rMJ>$ one Ihird of Ihe t4 million child dealhs in
    !'Old 10 bealth';·
    Ihe " 'Q rld lnl year. And although nOl having
    o Diarrllou is Ihe lelding cause of rhild dealb. enough to eat is stlll I fundamemal problem in
    But approx.im..uely 70M of Ihe mOre !han 4 some of the world's very pooresa communities,
    million children kiDed by diarrhoeal diselse Ihis the m.jor couse: of undemutritlon in the world

    • 19l1lI ,.... 10> til< ....... """"'''''1 of ... ~ _ ,"" <iOilJ pin.,. Ill " ' li<pJ>J< .. dNIll. _ .. ill,
    CoIIlm "", "" I'NnoI)" l1<ohh c.r< """"....l by ,Ik 'l"..ld
    ll nlth o.~,_ (Ill'llOl ... UNtcn '" .-..i.o-A" .. th<
    ""'dUI.l .... to< ~ "'''''*.,;"" oolInioa m h_,
    .... . . . opfrOOl q>, onol ..""' .. .... ..... ~
    Son« u..o:.... ".. "",r<t<o>« didlod do<odn of •.".....-
    .... .. __ ."''l'1 fO< ' lkahh Jo< /\II br Ih<
    S<v«>I "odi....... rc<oed'"oocl> .. ~ '" """,oI _
    Ii« _ _ "" . .... df«tioe '" ~ .... _
    MId
    III
    "1"" 100lr >nd .. r<~ h:o
    _ "'" _
    pdod UNtl:El' .. ..
    ... wN<q opfIticd>Io _ht>.b Ill po_lillc "'~ If th< .liI,,_ """'" It>Il tk dIild b<aim ..
    " ' - "'~ '!I<fI .oprci>lIy ~ on! t<hydmo:cl
    'Ik 1iveJ ... dl< I'""'"' h of"'" -W~ ..... "I>io<nl>l< dIil4mI. sal« ~ 1M.\1 ..... ""all)' Ik "'......0IlS _ "'" to< ><bi. ",rnd
    br f"'<nb, .Ji<, _ """" """""... frOOl • "'1lI:h ,.",.."..
    1...........,..ruloN< ~ _ h_ ... p/Iulnoo...... IlRs
    _ . 0IIl) • f<w «1IQ " , ' " . . . . <II«tm ..-....or lot
    ~ rJnl "'" (0 ;,._ - . . 0<Illd>n! I'f"'<dur< ill ,'" ""'"
    "f'"ooobo. w hoopiWoj. t• • Y<"1 ....:II ro-- III
    .-,.. .., ",,,,,*,,_ """P\I will . ;a '" --.ry.
    ,
    Fig. 1 Annual under-five deaths, today is nOI a shonage of food in the home. It is
    developing cou ntries, 1987' rather a lack of ba.ic services and a shoMage of
    infonnolion aboul prcveming infection and lUing
    " ,- DiorJ'IloMl &,"" Ol
    __~H
    _ _ '*-" tl\I food to promote growth.' Moking ISIIre lh l ill
    p,l rm ls know lhol they co..n Pl'lll«i their dl~·

    '-
    ~ _CCllMl""'"
    ra lIIIoo . mejoo ........ ".,." _ 0< _ 1lI' dren'. nult'itional heallh by such means :IS birth
    ~.a.;Jrl "'"'9 0Rf Ip,lCing, care in pregnancy,brcast·fe<>ding, immu-
    nization, p,,"..enling iUness, lpCCiaI fe<>ding duro
    in~ and arter iUncss, rcgularly dll:eking their
    " child', weight gain- md 5Upponing parents in
    pulling Iho, knowledge into odion- an over-
    " ceme most, lhough nOI aU, <;UeS of malnutrition
    md poor growth in the world today.
    to a It conlribuling fOClor in at IeUt One quaner of

    i-, -9

    a
    0Irl ""'~~ r«lD<f ll\'
    tJw.<:o:\t~ . f* _1<now
    ~ In<!""" gol ~
    all loday's child deaths is the ti",iJrg
    Binhs which are 'too many or roo close' to
    of bittm.
    mOlhm ,,·ho ore eilher '100 young or 100 old'
    a ll)' a vel)' murh higher ri~ for bolh mother
    and child (!ICC poge 33). Using lhis knowledge,
    Q

    i '-
    •
    -- - u_
    7 lIIIoo. mejoo ~
    Qn""' _ _ !JIr"""
    ""lIUI'._'"
    _ ....<:tIIil._I1\tO_, •
    """". ~ ""'.'"
    and loday'J 10\1.' <05\ mean. of liming births, ;.
    therefore one of the mOft po",erful and leasl
    expensive of aUleven; for raiSIng the level of bolh

    --
    child survival and dlild devdop menl,
    a
    -"
    ..
    6
    ;,_ ()6 _ ""-""II t:<>uI1' Similarly, more: lhan half of all illn«s and

    i
    d.ath among children is associalc<l with inade-

    5
    ,.- _ """ "" ~t7t B U
    00I.r.l0 CIl OPT _ _ morI CIl
    h lllSltm t l e _ lly lcw·
    quale /rygiDr•. In communiTiu wilOOuI safe WIler
    suppl)' and sanitation, it is obviously""l)' difficult
    ""'" .. 1IIt.>UI<:<I ~ - . " - 10 prevent the com.minalion of food and water.
    , ~ $ii1IS '"'" con IIJIII "'$ BUllhcre an' 10Il'<051 melhods ,,·hieh co..n help ro
    reduct: tho spread of germs, And all families have

    .-- --
    II righl 10 know ",hl l lhose methods are l"'"
    a ,- - - . . . ........ _ 0 8 _
    c.."",_~
    page 37).

    --, ~ CIl -...."" In sum, moo! child mlll"utritio", as well i1SmosI


    child d~ks, could nO"l'o' be pre_cnled by parenlal
    2 2·4 _ .....
    MIJoIo Cll""""" ... too ~t>r
    _~..., aCli"n. whieh "'" almost univonaIly affordable
    based On kn<>w1e<lge ..... hich is already available.

    , Ol"" "
    ........ """"""""_ """"_~

    .-._ ... 10_


    =

    -
    _

    'For h
    _
    ""'_ _ t>r ~ ,,""' '''''....._

    ~". . . thIOl, """ClUeCll_NII".,."


    lcJr"""" _ _ ........... lIlcl......"., ""' ".
    ..utIpIr,,*-..., ~ •• C<JnIICluIory COlOIB "
    ......._ '.....""" ItJirU "' .. _ _•
    _ ",<,-..--

    •
    THE STATE OF THE WORLD'S CHILDREN 1988

    Immunization:
    a progress report
    The """""sa cl tho SIT'IIPoo ..1dIcI1lDn lIfO"
    gr... Yne on l!le ,,*1970. ","""lid "'" _
    to .......
    ~ 40l1l.1
    "*' &~ lO<l"Y (lI'IOugl'I_ ~ ...
    f!o.1lU' Orl)rltlllll1JDll10 OUt "" - . moru ombotlOUS
    0Ill0e1... M l!le tunao ~ - ",,"......auon <Jl Egypt: .... ....,..,oon _ "- ""'" """"
    or<;IUIId ~ ttl _1lO" '" 1987 a1t.. PI_ I
    .. ch/dren '9W'S1 . . dis•••• ""-:k _e then
    ~_ 46 "...",..,~ .... _ _ Mwoor. elIIId on II-. ...,.... lO oct- me ...gtl
    n..l gcNI_IOt. ...._I>I'IN_d 1990 · bV me IIlffl-6hh . - u : y at "'" f1M;IlIIal
    A progreso "'llII"I - c..v. Anwa: 1he IleQ 01 _ (II _
    . - ....,. . . . . . . , . - . . . . pIC 1010 _ .
    l _ llwtIs ol lllollO' 9, 'lI~Ie:t"*"" . . _ _ .. ApnI l98110 _ _ " - o..r
    ...... .- . g e " " ~ d OPT - . . . . . , ......... _ k'IlJ ...... lI'Inl _ """"'II.
    SOl. _ ~ ,.. U CQ.oM d _
    . ........ IW _ _
    an.
    _ INOudl .. e s - ,. ' I low
    ~
    PQloo"":JlIl' _ _ ....... no. _ ..... boa ea' _ "... ..., _ _ so .,.. ""

    --
    _ 'I _ c:culiS tIoI .....,.,......
    -"!! <II ...._, 1 4 " ' " -..g _

    ...
    1

    _~.......-.w 200 "' ....


    . __ _
    '• •S15O_
    20 _ _
    -......--. -,,,,_,,_ _01,,,,,_-•
    _~

    ~
    . . . 1990 ... _ . . . . . . . . . - _. . . . .
    ,. ' ; ... _ _ · 4 _ ~ b OPl ctIbwl-"lO!
    _ .......-s fIIpe _
    _ _ 7OlII. tor
    OlntJ n.. ..~ .. u...... - " , _ 10< . .
    """""" 01 de' ,' », '0 ((llO'IIhII -_ ceUllle
    '..,r>ed 1>1' .. ~ 01 It'.- IOI'lor1 ...... "'"
    ne>l II.-ee_.

    NIl """"1rY ,"""" .--1_ I....... !(I meel .....


    la/Ofll NJ\IOf1S III:e CtiomboI If>C! T ........
    rooonw""""" I!l.ot Ot'nm......"'oon _ '*' be
    <I'_OCit,' , _ '" . $hor\ Sl*:lI pi MIlt ' !I'oe
    ..... o l _ .. _ " ' _ ........
    ~ 1>1' ouch ~ 80 natlOftS ' -
    ~ 11•• _ _ 10 1990 lJO"II ..,

    - ....
    ~_ "- 10 """"'" • """'-
    . . . . . . - _ ... 30 1""1" '"
    ... clt ' . _ ", _ Some m, ? Ill ...
    -
    S. E' COioEi...,e NIt _1tIecl1raft -v _
    _ 10 _ _ . . . JOll," _ _ lPInoI2I
    ~ : IN"' __

    ~ *" 3IIlW<:I Irl;I"'I

    ..-...:........._-I'lcgt.. . . .-
    1 • ""'

    25'!lo on 1985 10 7OlII. .. 1981 ~ )

    _ ~ _. ~"'" 31lo .. 1981

    •
    Informing and faciliming sucb parental acrion ORT, which ".. s lafgely unknown outside lhe
    u Ib~,erore Ibe maJOr ,b.U~ nge of d1Ud bealrb scicolific communiry al the beginning of this
    roday, deade, is now heinl; uS«! by approximalely 20M
    of the world's famtlies and plc"eoring an esu-
    maled 600,000 dehydralion d~albs each year
    .mong lbe world'. young children,
    A revoluUOll bq:Inn1rlJ Taun togt'the" immunization and ORT are
    Fi,-e )"e.n ago, wben UNIC..EF 6/'S1 an iculal~d therdon:: now saving tbe lives of .pproxim.tely 2
    lhis poI~nt ial fo, a revolution in ,bUd survival and milliOfl cbildren eacb yur. As Ihe Secre,.ry.
    d~vrlopmrnl, il ".. s argued Ibal the use made of Gcneral of the United NarioO$ has said: "'(1
    n.....· knowl'ldgr d"~nded almost enlirely nn omrable c~;ld ,"<WiN! ,CT>OI"tio~ ~ot /lepn ' Q
    soci.aI ofg. niz3Iion. Heihh promolion is Ihe great spreruJ ",ross ,ke "",rlr/".
    nerd and lbe great opponuniry of ourtimes. Bm Ilul it is only a beginning. And Ihe essenli.l
    it is nol Ibe ClldWiive rnponsibUily of, and ..nnol luk nOW i. 10 broaden .nd de"!"n Ih31 Grand
    be a<:romplisbed by, lhe beallb serviers aJon~. By Alliance for Children in order 10 fully realize lbe
    and large, lhnse healtb services cannol ",ach QUI pctemial which has ~n SO dearly demonstrated.
    far e"""ib or of..n enough 10 bring aboul cbange
    in knov..ledge and behaviour on Ihe nc<:C»lIf)' Sadly, the 1980s h. ..... also seen counter-
    sale. Norare lhey ~ithe, staffed ortruMd fo, the currents running agoinst S\>Ch progress for Ihe
    ,ask of empowl'fing mmions of people 10 protect wor ld's cbildren. The weight of wars and conl\icr
    their (IVo'n and their families' heallb. Tbe expcrtilll' in many pans of Afric. (p. nd 171, and of armed
    and guida~ of Ibe medical p,nftssion is usen· conflicr in Cenlral America and be"''Ccn Iraq and
    lia~ bill it ,emains a p,ofesston wbich is befit> Iran, has fallen mosl Ileavily on lbe d1Ud,en of
    equipped to rnpond 10 Ulnns ralber lban In Ihose regions. Less visible bUI jll$l as Ingic has
    promote bullb. ~n Ibe economic recession which, in ~ot
    years, has eroded beth famUy incomCl and
    The,efo,e if Ihe cballenge is to be mel, il "i ll l«I'"rnm<:nt services in so m.ny nalions of lhe
    be mel by iI social movemem rahcr Ihan by a
    developing wo rld. Pages 2l to 31 of lhis "pon
    medical mevemem alone. Andwh.ol is needed is a summarize Ibe impact of Ihal recesssm on
    «>ciety.wide alliance of all lhose who cou.Id ch ildr~n .nd oudine UNICEFs response- the
    communiCll" "i lb ilnd suppon I"'r~ms in doing call for 'idiustrncm "i lh a human faec'.
    wh.1 can now bt done_Iearbers and 'eligious
    leaders, mass media. U1d gcvernmem lIgencies, Briel!)', lbe challenge is one of idjuSlilljl
    "olunl3ry organizotions .nd people's OIOl'ellH'n's, econom,cs 10 """,,,ion and res,oring economic
    bu<iness .nd labour unions, professional associa· growth "'hile al the same tillH' shielding lhe most
    lions and convemional heallh Sl'rvices. Only weh l'U1nerable famU; ~s, and especially the growing
    a Grand AllianC\' fnr Cbildren ClIn CT~", e 'M mindsand bodiesof lhei, children, from Ihe WOl'St
    informed public demand for, and pracrical knowl· effrets of a necessary economic , uslenry. And
    edge of, lhose methods which could b,ing aboul paradoxically, that COOlext of crisis p,ovid~. a
    Ihe ,evolutiOfl in child survival and developmem. l pecial opportunily 10 promOle, on a massive
    To<!.y Ihat Grand AlliallCe has begun 10 scale, such measures as immunization and ORT,
    galber. ....nd the child survival and dcvelopmem breall·feeding and binh spacing, bener wcaning
    revolution is nOW under way. and ,egular growtb monitoring. For lbeso are the
    '''!)' measures which can offer the mosl pretec-
    Immunization oo v~""l:" , for ~umpl e, b.. ~I· lion for Ihe le" l cost 10 Ihe lo~sl numbo, of
    tended irs reach from less than 10M to approxi· children. Yel they are alsoffiCasures which can be
    malely S09l of lhe developing "w id's child,en .fforded e" en in difficull economic times-if a
    during lbe 19805 (6g. 4). As3 result,vatrines are nOlion 's le3de,. make a cle.. political commil'
    now estimated 10 be saving the lives of apploli· mcm to Ihal goal and if a nation's crganlzcd
    mately 1.4 mUlion children ~acb )" ar. Similarly, resources form • grand aIIi.nce to achi""" il.

    •
    THE SIl\TE OF THE WORLD'S CHILDREN 1988

    Senegal:
    showing it can be done
    In 19l!5. Io,we' tIIlIO 10%01 5et~·s c/'IIl(Iren But ee (lI$m::!~ leaunt oI5enega1", ~
    wet.. ~ ..-.d vac<>no-p""""tabIo_..... """" was tNI ...-..... use <II tr ado'...... 0<lI'J'IrtUl0.-
    """,ell:illlng 30,000 c/'IIl(Iret1 It vea, T~. "ClO/OX' 10 ""''''''S

    --
    caoons IIlIotmand lW:QlIIage Thtoogt>.
    ,,,,,,,""'" 10% ..... pro\8Cllld "9"""'1 TR. <l>pi1thena . out 1M CO<.o'IlrV. ~ .... lIdo ..... lOCal
    ~ """Ifo. "'l<nJ$. POIoo. me...... . """ ~.........-. held meeongs or _ ted par...,"
    II nome. ..
    lTlI>SQI.OeI , ..,..... ....ged patll'IIO 10
    _ u- C!>Ik!ten Va<:co:IlIled Thousan<IsCJl {JfJtJIS
    Th'l lact ~ ~ .. omong "'" 30 POOle$l
    rial""'" til lt1e me.... wI 0\1 ew:npIo to . .
    -lr8d<\lonal '1ll'\'"t_ . and """'ooogerS- belll
    ihe dI'''''''' to........"..,. me ........ at ,til ..............
    ""P"'lon1 , . ""'... . i1 . .,, F<If Seneg.oI haS I.... learns
    shown that filet.. .. no n&IIO<! _ ca<YlOl
    IfmlU1Ill! "'" greII l m ap lll' 01 III <::fl'(lren try l/Ie WomM', o'll"""""'' '''' tIIklll'llle\f"lllS to e<I$I,JIl
    UN t.or~ <lol. <JI 1990-~ paflIICaI1eaclo<$ .... .NII _~ _e tIrOuD'J. '0 ...,.,..,.""" ..,.,.
    COI'I\Il"OIte<l 10 " """ d $<lCIII I\I\d 0(;0<'I0M0:: , .- r....,. of '"'<>.J""""" 0I~. 801' Scoots
    sour<: .. "'.. . . - 10 _ " ..., c.I GuodM eIIo - ' , Ir<>m ........ 1 0 _ ,

    Seoeval .... ""'" Amcan <;<JOrl\JlII', '*""'" '.....


    """""0 1IJ'N"JU'IIlII1.... ~.. and oIla-'Q CJl
    ttII nme and place CJl Ihe neares, " " " " " ,t",,
    pat..,,,
    .", ,............,., 10 '""" "..... ..... 209l. 01 .... - .. y""",..., opoIt, "'0"""'.,...... ""'"
    eM-
    papo"j.lon u terllCY IS Io'w """ _ , ..
    read by criv .. smaI . "'-"'v urban....-.::.
    os lI>e <>riIl'modem mc<lourn c.P8bIe 01 ,eactwlgthe
    A_ matctII<. Wlth 1""_
    cens , fool!:lal QM'lIS. and o adl~ Wles~
    ot <:I'IIldr.., -.ng T-shot'
    ""Ill !he sIoO"f" ' V.tC(WI I"", b' 1111 ctWdrtJt(
    mopIOV 01 per..,11
    Ilui merely eteannO me <lettIn:I v.oJld OOt have
    To ....eo:om.lhe... _ _. ll verv_
    01 _
    fango
    COIl'verlI""" etJanneb - ~ t,8lllt"""'"
    me.... 01 comm\l!'IIC.!IlJOn- ......... moboIirod
    been 0fl0UIIh
    'omo<tabIe Iwllry mabng._
    The he8lth .......ce. aIoO ~ •
    av&l!ablo on
    • """"'" bao<5 •• .. 1M """,,,,'s 6 50 I'leaflh
    In Oc_ 19813. P, .. -..J 0t<Ju1 soke<l """'Y 0....0........ I'lellllh pOIl$ MoboIo , _ n ~
    ~ l JIWlISlJV lIld III secuons 01 iOOOlY 10
    ".., .. ., effor1 10 ............,., 75% 01 So>rIeQal".
    grea,
    p&r1l'l1
    O!$~ ~ t<.>\Igh ""lW' ""
    !hsI IlQ
    WIMJld heve 10 brw1g S o:I>rId more !/\In 5
    <Jk:m!IU....
    bo<Iv,. _u
    """"'G C/'oldren by Worid HeaI1h [Mv- 7 ApnI
    too 7 ' ' V llCOI>a1on,"" he _nce<l. .. .. .........,.
    To malre 'I«:orIlIoon even more aoxesSOble,
    oomrnun<l>e$ sa, uP ,_ -V PDItS ., m(>IqLlll.
    Soon .~erwa<d. " .$l><IOaI ""oono! _
    ,_ ,,""'lIng .. """"""""'0(lf'I
    oe,
    01 aocMIty. tool<
    odIooIs . Pi'N31l1 lIOmee. or """" • oI\a(Iy tree ..
    me VIIoge _e. T,_ ..--.. _ p<*0CIl
    cha<ge 01 Ihe ",.." _ 1""'.>$ ~ rm- _ or~ va<:co:IlI'>OI1 .....""'" ., o/IIces,
    1" , , _. _ horn,,,,,
    ~ ""'" mounlO(1 '" Alnc.l In eoch 'V9'O".
    ~ ,. and \Ift>On ~ . _
    corr-nollees _ .. ~ AI ,.....,. 01 l!>e cfI/II SeneQal'. tnumpIl demorIot"'1I how • _
    If'ICOmIl coutI "Y <:an ~ ' II ................... ces
    seMC<I wore """"""e<l
    10 norl.... demand klt, end etX:UIlO, 1IIlITUl\tI.
    flaooo pIayW .. I:<rv role "' ",bmong "",onl$ llOfI It abo opons uP ,..... hor\>otIo lor ot!"et ohrkI
    ol>oul , fie bo<>elIts 01 ..............1"'" - lI'm\.IglI """'" h8a1th otr3l9(lm, ouch IS 1lIe control 01 malina ,
    '..-ts. _ _ $iX>l'."''''''''''''". 1......... rm- _ "''''I' .,1«: """', ..., ..._ dIsUse, as
    go............ oM ~ ~ pIey$. - . wei "" t:wth soa<:ot'IO, _ Ilf'O"'Ih l>'Of'I\OllO<l
    """ otor_ The P't'" """ ,.........", """""'d It
    .......u llU1 nlluenll.lll au<li<l<I<:e, • The ' I<gm," BO% lry Wor1d liellllh DII' ,988

    •
    As Ihe 1990s app rO:lch, thaI commitmem 10 Survival Fun<l - incllldi~g apProJlimalcly $90 m~ ·
    children i. beginning 10 be made. lion for rhe promotion of immuni. ation and
    ORT.' The govemmenlll of C<:nlUia and Sw dtJr,
    wilh widespread public support, have also allo-
    ca r~ d S\ OO million . nd S50 million respect ively to
    The pIMM, .m.nee help acccl~nll~ Ih~ spread ofimmuniution cover·
    age across Ihe developing world. In support or
    A, previcus cdilion' of Ibis repon have ce-
    UNICEF's child lUrvivai efforts, Ihe governmems
    scribed in more delail, n.,ions such as Colombia
    of Nomay and filt/and have also lignificamly
    and Turkey, Sym and Scncpl, Paki$ian and incren ed lheir financial commi,men,s.·
    Ind ia, Bmil and Holivia, f;gypl and Ecuador,
    Th ailand Ind Bangladesh, hIve saved ~terally On. non-go.... mment.l orga nizalion _ Rotary
    million. of young Ii.·"" durin~ rhe 19805 by Interna tional_was among the Jim 10 lrt3 kr: a
    doubling or lrebling irnmun~non roveroge , b). major rommi,me01 to this CluSt and is now
    making ORT aVl ilable 10 p.rents, by prom01ing drawing d~ 10 ill tllget of raising SI21) mi l~o n
    breasl ·feeding, and by monilori ng child growth. for polio vaccination programmes wol ld-wid•.
    In eoch of Ihc~ examples, the rapK! sprnd of
    basic oeallh ltn.....iwR!' and 10"',051 tc<:hniques
    has been made possible by conlinuing $O<MoI)·.
    Accel.... tina 1M mODKnNm
    " w e alliances involving some combin.,ion of
    po~licaI and re~gious leaders, tc.chers and litU· With suppon from many leaders ofthe world's
    dents, mass media and uadilional informalion lC~gioU$ or ders, international non·govemmemal
    channel!, trade unions and emplnyers, village organiz,nion" 1.3ding usoc;atinOl or medical
    I. ad.n and local councils, )'OUtb nrg.nizalions profeSlional", and lb. media of many natinn" Ihe
    iUld women's morcme nu, profession.l associa· Grand AUlancc for Childcen is beginning to
    tinns and ,""Iunrary organir.u ions. coalesce . roun d lhe cau"" of putting today'sl.....··
    (/)$1 child pro rection met hods ar rhe disposal of
    [nleroalionlll)' Ilw, an informal allionce for
    Ihe v:1lI majorit)' of parents. Two million lives a
    children is begrnning 10 CO:I1=c. In \ 987, for
    year are already being saved by Ihis prottSS, and
    ex.mple, leVen heads of ,!ale in ~0l ...1 Amerie.
    the gl),lJ nf reducing Ih. 1980 levels of child
    have mlde an unprecedented joi01 t.kvision dealbs . nd child roalnurririon by at le.sr half in
    appeal for tItc immunl2alion of ill rhildren as part
    ,he relrt3ining yean of this ""mul)' is ""'"
    of a new programme to halve child de., h ralcs in
    demonstrably achievable.
    rhe region, In Alia, Ihe >even heldJ nf SIl t. of the
    Sourh Asiln A$$DCiation for Regional Co-opcr· No'" is nOl rhe lim., lhe refor. , to change the
    ation (SAARq bJ.vc joinrlj' SlI,ed thll "cJlildrnr goal or diffu>e the effort. Many orher problems of
    sIIow/d !It giM! Ih, lrilllnl priDriIy ;~ lUlJi(»lal
    cln><I""",,1U planlt""" (piUle! 15). SimiIorly, Afri-
    Qn htllds of ,, "te meeling in Addi. Ababa h.....
    declared 1988 a JRr [or Ihe prottedo", JwroiNl,
    OM dnIt/opmw <iflheA[riu", chilli" and urged all
    ._ .. *"'" .... .. P''''''P'/It, Iloo lI od " ......... """
    _"",. «U<W <OII.m..ioo 10 ....
    <0lIO< , r _ , Ik ~ ""'"

    ,urican nalions 10 . chie.... universal immuniu·


    ......lW)'oI lb< u_ "•
    . - ill tns, mol .. _ _ .. ....
    ~......... <Ill, <N<t 70 ..,. " . .K' ,""" 0/lQ
    tioo by 1990 as • slep toward prim al)' healrh care. ~ orpolUuom _ 0..'<10,., of ,.....-.d
    Grow ing 5Uppon i, abo coming from """'rill
    """"""'" ..,Ik ~ of ; _ fot ~ by ltIr
    rnr 19'10. ~ ~ ,_ , 0111 0.1 "" o,:<o<in, ,lit
    industrialized n.rions. Th e govem"",111 of I ra/y , 1l'orlol Il001<. mol ItMr R_ _ 1otM«l ....
    for example, has allocated over $ 130 millio~ 10 .....,..,...... TOIolc for« b Olild Somnl, _ No __
    pi>y<>J .. _ pan .. _ ..""'............. 01....
    misl 35 nations (26 of Ih~ro in Afrie. ) i~
    reaching the larget or univenal imrounizalio~ by lio>ir dlilol P'O'taion ""-.. ill .... ~ _ Ml, " ...
    l"or (I 'lli'!) oi>‫ס‬oioi ‫ס‬I0o ,Ik p"'......,ioo '" ,lit lJl< G«I<tol
    1990. Similarly, the U~;ltd $i1U.. Con~e$S has ~ 0/ , Coo "" ,lit RiJbu 0/ ,Ik a.ild,
    allocated over $ lS(J millio~ 10 a spcclal Child <Intioa ooidI . '"1& O/<IoiJoIml.. ~ ~ 161.
    ,
    THE STATE OF THE WORLD'S CHILDREN 1988

    ch~drcn cry OIlt for a1\cmi<)n and acrlon. BUI • Thai alliance for lbal goal is mercrcre lite
    world·...idc consensus if grllWing that the groat..t ccntrallheme of tbis year's SI"u a/1M Won'J',
    of human tragedies-du: frequent infeclion, poor Child",,, report. And nOl by coincidence, it is a
    growt h, and carly deaTh aho many ofthe,,'ofld'J theme summed ul;' by the slogan " 'hieb the \'(Iorld
    cbildrCTl -can be dl1lma,ioUy reduced in our Health Organi>.allOn (W HO) ba. dlO$Cn for it.
    rimes. And praeucal progress towards thar goal is fortieth annivcmt)· year in 19S5- ' Health for
    ll"tbering mnmcntum. All-AU for Healm'.
    As I ",nmbulion 10 thaI cause, lhi. report
    Therefor. the 'ask of the hour is [0 a=lenrc CllIISliNleSI direct I ppeal for the ;nvul""mcnl of
    11m momentum. And iflhcgreat go. l ofensuring all p<mibk' resources in I n .Ui.~ for child
    these, tb. mo5r basic of our ch~drC1l's rights, can he. lIh. For loW.y, the re is hu d!)' an individual or
    I)(' .cb~vtd by....:11 an .mance, then it may be
    organization, in eilher induSlrialized 01 develop-
    ing world.. that canner help 10 fighl for lhe
    thaI a poI\'crful force will :l1so have been created
    survival .nd heallhy development of all lhe
    for Kh;.oving other right. and mOre d Teaively
    ...."Orld's child"'n by informing and suppo ni ng
    tackling other probleJTlll -the problems of eM·
    parents in applying whal is now known .
    Ir.
    dren who .r' dl$llblcd or ,ctank<!, children who
    ablndoncd or negl«ltd, child"'n who live in
    refug<'<' a mI;'! Or on [he IlreelS of cities, children
    Ther~ is therefore h.rdIy an individual or
    orga nizlti<>tlthat will net find, io the pages ohhis
    " 'M ore , ;cu m;.od by war or ""ploiled at W<lrk, ~...r'~ S!tM[ 'l{ 1J,t W1WfI~ ('Jril!l~ rtp'Xl, ~
    children in the grip of drugs Or alcohol, c~ildr.n chall~nge 10 prxtic:al involv~menl, a bonom line:
    ,,'110 suffer vWl .n~ (It "l'xual abu$e, and children of action, a partm play in thc Grand AlliallCC for
    "'110 lack cducarion, water, or food. Child"'n.

    Alliances in action
    The galhering illi.tnc~ for children is abo pan llrly, a1cobol-rellled accidems and illnesses are
    nf a wider Itruggl~ for primary health care. And I/JKIng the leading causes of prtnt.a1llJe M oth in
    !lIcuy, nn~ of th~ common slrllnd. in lhal struggle most nation.. yel tbe solution 10 this maior heallh
    ;llhal for alll(C$, and in all notion.. lhe broad~'l problem also ~ .. in lhe bands of lhe informed
    w:ay ful\\'ard lies in informing and supporting individual rather lhan the med ical professional.
    families e",rywhere in pulling a1",ady available And 10 Ihi.list of major ltealth tb"'",1 mus' nnw
    knowledge inlo practice. be IddC1.l A[DS. For although the number of
    AIDS-related <lealhs in the lall lWei"" months is
    A brief look. al the rnaj<>r threalS 10 lhe life and probably less lhan the number of deallts from
    heallh of adWlll, world-wide, will illustrate that diar rhoeal deh~'drllion in lbe l.~t 4g h(lUrs, the
    world-wid~ lbeme. A[DS viru~ could claim the lin. of anywhe",
    beN·...n S and 30 million adullund .hild",n over
    Th e leadin g causes of serious illness and death the decade ahead.' And at this Jtagr, the most
    among adult. arc canCer and heart disease. Yet elTeeti.... w""-pon lhe world bas against Ihis new
    th~ir loll could nOW be CUI by perhaps .. much .. thre al is public cdue:ation 10 empower people with
    509t or mo re t h~b ~I~'s own ~U·informed the I:nowledge to defend tltemselvelO and tbeir
    decisions on smolting, d~t, :sod .,.~rcise. Simi· famili., by their own decisinn.:sod action•.

    •
    In the industrialized world, there is growing Mallb knowledge. Overall, il is ekar !hat 1M
    evid.n"" that this opportuniTY may ~ " ken at potential of !hi. app roach is much p ater Ihm
    tile flood . DespiTe the expenditure of approxi- th>l of any conceivable scientific advance.' It is
    mately 52 billion a year in advertising by lhe now eS!inmed, for example, that i' ..wld ' Ike the
    rot>a(C(t indomy, for example, SOme 33 million ",,~nditure of moy biUiollli of doUars a yeor 00
    American. a/'C now u ·smokl'$ (fig. 2). The 'csull 0 "" mcdie>l techoology 10 add iuS! one more
    has beflI • 3"'" r.u in hean d~ between 1963 )'1:ar 10 the avera~ human life ex pect ancy of
    and 1984. Simaarly, lhe Soviet Union has J't'Cently Europe or North Ameria. By COO1nlSI, a full u..
    launched a S500 million pubtic education earn- yron could now hi! added 10 tM life·spsn nf the
    ~ dcsigntd 10 ..ise ~,,,,b or human b.allb a'.... ;oge m:ole, a\ low or even on COSt, by
    and productivity by 'self·lleallh' action (0 impro,,<, indr:idual decioi"", 00 ealing ..,Mih ly, exerrising
    diets and reduce alcohol consumption. hnd In tile regularly, $JII(Iking nnlstal~ and drin king alcohol
    two ~U! since lh. Soviet leadersllip decidlXl to nol)" in mcderatien,
    mobilize rommuniatio"" ..,<1 legis/.live capaciTY
    .gtins! .Icohol abu.e, co....umplion is repo ned to In 1M very difTerenl circu!IWances nf the
    have drop~ by . ppfOJ<im.,ely 5090,' developing world, the polenlll! for sdfMahb
    action IS even pater. No eoncei,·able increase in
    Panel. 4 and 14 briefly summ. ,uc lhe ,'eps ""eendilUre on medie>1 ,echoology, no amounl of
    which can "" and arc lleing taken in lh. building of more bospitals or m ining nf mere
    industriali.." world 10 empower pe<>ple with self. dOClOfl, coold IlOW offer a healtb ",'urn On
    investment which. eveo begins to compare wi'b
    lhe btndils of primary health care arategiee
    Fig. 2 Percentage of daily smokers , designed 10 inform and 5Upport the deveJoping
    indusbialized countries, 1965-1 985 wnrld 's parentt in using today's knowled~ about
    - l.JniIed Kngdom Sweden binh ' !'King, breut·rccding, immUnlZlllOn, u fe
    "~aning, fcedinll after illnes.s, oral rehydnlUon
    LlNted steiee - Norwa)o
    therapy, domesiic bygiene, coping with respira-
    lOry infC'Clions, and promoting regular weigbl

    --
    gam.-

    --
    Both indUSlrialiu-d and developing worlell

    .... therefore nOW stand al clearly muW cross.roads


    on Ibe road 10 health. If the road ch"",n is the
    road of primary reliaoce on medical lechoology,
    Ihen the palh will beeome steeper and more
    difficult, requiring Ihc expenditure of more and
    mere resources for leSli and k 5ll forward progress,

    • t. lilt I>Itl " *""<I...nJ. tho r- _ ;.....,..... .,... I\It


    - . . . ~ lo<a1Lll ...- ... ............. _I>,- ,ho

    _.of
    """"l"" SJ\l' ~ -to< "" - . . ., AI<olool, food, ...J

    ""*"»-
    PotpIM .....
    to 75
    _._to_
    .--OI_1:
    . . _w>M.. . . __
    l B5

    ,,,,._n
    F.x<mt<. t. ......

    pott«1IOO O(, b< ~


    - . UnI ,.,~
    ~-'d, tlN IClF...J it>
    f'!d'. .... _ tho """""" GOKI kw ,be """ I<indo 01 .........

    """ - ' " of_..


    IlIOiIy.-J h<>lU """'" ~'toa bY. .. ~ J'OW<';' tho

    1Ioo>-"I'l'_ B
    _ G f'IIW! ~ ........
    ~. """ I .........

    .. _-", ..-
    ~-"1'_
    ' g' .. .-.r.g .. _. T. lilt.. 1ft _ _ oddod

    -'-.....,_....",-,-
    ~_ fI' oll'>IIiIill'
    -..:;og ,_,
    ,, ~":, _ . I'o«l ~ .. t _ . ....... F NoaUoo. ~
    10 riUlg bit"""" .....,~ • _ . .~ ...........,....""" _ _ ,, _,kn-< \o<ft>

    . ,_ ... ........ .. ho _
    aod _ <I< .. t i
    !lot _ """""'" io8urooo. .. !lot ......,...
    .. of dOlJml io:- """""'. - .

    •
    s I I
    ~
    <l~l: l~mH! i:UP~ HHHWf h ~Hh !HJ!H~ ~ ~
    H !' ,',l "'1 f< n~~ ,'ji! >'\ i~'o f· ,i- a C'" - ' ~;J
    iil '~hg~ im!!' h~~![!~i~ ji! ;1'; iH!;~~~
    ~!l!
    1'; f -••,{ I["I! P!li.I~P tl _.
    !,!i "'ll~l iOJ
    ~i! " n i ~: j U[!i-~ *~hi~!1 i! ~!j' ~j~llifi cE
    .a e .
    ,pg bll~~ ;",11I
    !~I!!H
    ~ H ..
    ~:il~hi'
    i!~ ~! 1 05.
    tUi
    ~! . 'r*,~~
    ~;Ilo.
    S' ~
    II} !"fll', ',i!H! h~m.p~ ;1 h!~ i1f!!§1 ¥- :§
    III ~~[H. .l~m lHlll,H :! !I.! ,huh ~
    uni Ii! ~ ifr~j i!~ i Hg~ ~ll r; HlHII i iI:I~; H
    ~
    _j.n!.llil ".ljH 1"1' <-.I,I;IlI'B'~H
    !Iift ~lij!:h;II~Hii~i4;,nl;U~!U~H' &§t
    '11 '·~.~hHhHi ",h '!i! Jul!ii Ll t
    ~
    I
    II Iii If I !j",H' I!'n·' ,"[ 'r
    ~~H ~h dh IHh~~iJ h~H!i ~ih~i!
    la
    and ~Uowing f""'''r and f('\l,'Cr people to pass of boIh nalions and ramilies to protect the lives
    tlll"Ollgh a narrowing valler of e""r·incrc..ing and Ihe nnmlal grIl"111 of their Children, But a
    =I. If, On lhe D1hCf hand, we choose the road of constaO ' Iheme of the development stof}' over the
    primary reliance on empowcring people with the liSl forry )'t'ars is that tbe«' is nO fixed relatinn'
    knowledge to lake more control over tMir own ship belVl'ttn a gi,'co level of development and
    heahh and facilim ing the use of that knowledge, the " -eU.\>eing of the poorest seainll$ ofa $OCiet}'.
    then the "" )' will broaden nullo allow tile gnat At any level of developmcnt, if the poorest and
    majorit}' of the human fam~y 10 move fo",'a rd mcst vulnerable are to bcnefil in times of
    rewards the goal of healtll for all. economic progress or to be prolWt;<,! in limes of
    economic bardship, theo thete hn 10 be •
    conscinu' naticeal effort to fubion available
    r($(lurCn into a shieldagainst ,"" worst a.pe<lS of
    Knowled~ ao d pcroerly poveny and ill health.
    For all the now horizon' it may lead to, lbe Gi""" today's new kno"..ledge and nev.' com·
    koovMd ge road to health will be neither smo(llh munication cap:rcity, rhe pottn tial for protCCling
    nor downhill, Nor will progrcu along ;t be in any tile poorest i. now greater Ihan ..'or before, And
    war automalic. mnbilizing to prnmotc available knowledge, and
    to facilkatc its usc, now offers what arnounu to a
    In p~ice, knowl<"<lge U onlr one mand in !he change of gear fur d.....lopmelll,an improvement
    pattern of human bellaviour, And in many in the ratio between a".,lable rCSllUrccs and social
    rommunilie, today, the ~r of the inforIIl<.'d progress,
    indj"idtW to lake more controlover family healtll
    U • power often circumscribed by poverty, The major responsibility fot 1Iti. process rests
    dimm<"<l b)' lack of <"<lucaMn, frustrat<"<l by the "'itb notional governments, And in the not tOO
    uoequal SlatuS of women, moddied br the prcpa- dislam future, those governments ""ill 'urely
    ganda of ro mmcrcial vested intcrests, and limiled come to be judged by wherher Or not thO)' b..-e
    by the availability of such basic pbysical pre~ui. c1iminaled mass child dea'bs from mrb ba.sic ill.
    sues as de ao water, safe sanitation, and adequate as diarrbotal debydtalion and vacrjnc-prevema-
    housing, bIe diKascl, and whel her Of not lhcy have
    emflO\''''rctI tbeir cilizenswith loday's knowledge
    Th., is why lhe empowering of individual! to and provided them witb the basic services whi<;b
    pr",'ide for their 0Wl1 hea1tll can never be a aUow !hem to pol tllat knowledge into l'f"C\icc,
    ",bstitute for govemmem acrion to facilitate tbat
    plOC¢SS b~' providing ba.sic community services, Thert i, ac conffict here, no 'either/or'
    guaronlcc'ng a fair return for a family's labour, betweenIhe muggle to change tile economicand
    enaCting land reforms, and building up tile viral social SlaIllS quo and the stNggle to improve
    infnsuUClure of primary health ca«', Nor should buman well·being wil hin the SII1US quo, Bnrb arc
    the cnrourag."ment of individ ual rcsponsibilit}' for alwa), nectswy, N(I.OM would ~k 10 deny that
    health be aUO'N<'d to detl'X! in any way from Ibc po"ert)' is a major C'II$C of malnulrition and ill
    international ro mmunity's responsibility for belp- "" 31th among Ihe world's cllildren and ,h.,
    ing to end the poverty and iniuslice whicb remain fundamental soci.al and tl:onomicchange is nCC6'
    tile fundamental cause Df most illoe.. and prema' sary to end th31 poven)',
    tllJ'<! deatb in the world todar,
    Bot nei!her docs lhe an.lysis of the soci<>-
    ~r lime, of COUI$C, advon«. on both these economic callSC'l of ill health lletraCI for One
    froo" are mutually reinforcing, Any improve' minute from tlte rigbt of aU familiCll to today'l
    ment in the mental and physical develnpmelll of scientific inform.lion ,,·bicll could help tbem '0
    children contriOOICS fundamenraUy 10 the .sociaJ protect the lives and health of their children by
    lool! CWnQmic developmem of nations, Similarly, method' tbey can act on ""'" and at. coat they
    any tl:onomicdevelopment increasesthe capacit}' can afford INa)',

    "
    THE STATE OF THE WORLD'S CHILDREN 1988

    United States:
    knowledge for health
    """""' ....-. " - b LO : ........ " . _ o_81'_
    1990. IlCII' of "'ll" IC:tlOOI - . _

    -n__dI
    of PI.dt ..s..-III_'
    I'lOl • SlI'lIItOY b ,.. do
    "., _ \1'_ noI: ......... IN
    _ " ..... 1_ _ $ ..

    """*"'ll•........- _. ~ _ . " "_


    _ '*' _ .... "'"'"
    ~e..l",,_""bl"""'_
    ......... to lO _
    o Ilrt 1990.
    _1095"ClOOOM_.......,._...-·
    ........, til
    cI....,....., III ~_
    I\t lilt bego .... 01 IN 19l1Os• • _ _
    Pf<IlII'...... _ .......".., .. 1hol' 1J''''od S\.01. . 10 ....a lilt "' ...-.g. oi<:<t"d. ~
    I""""'OM "*""'-' _ 1hII P"" ''''''' CCII'>- tal "'_ ..., _ drugs dumlI ~
    - . .. al-.o ougtll lO _ Dv!hl """ 1990
    Do:,._
    --
    c..ng on ..~..., ~ people IIloI<e 10
    O Ilrt 19~ ... mo:nhero 01 ,"
    Ide .. K> IlI<lu<>o _ ,_
    ~ ~

    , _ ..."""' - on ............... ,"'" ...--tor


    do_ ...., dIM...··. !tie US ~l 01 Hea/ll'l
    ~ MUd me ~ """"""'"'IV '0 sum LIP 1hIl\
    o llYl ', 990.
    .....
    ~ lot .... by _ . """ maso Jl'I9lH.
    _

    o
    .. 01.... IIlIoIma1o<o:l - . Some o!

    ItI' 1990. tNpo<cen' . of_"l<>ll~' o


    m.. _

    .,.
    1hIII"op<l/1JOl,IlI""""'" ""'cl breHl-
    - _ _ be 10 7MI, II
    O'ICfeMell
    ~ .. doscII8t;oI ..., LC 35" 0' ... mQtl!hll '"

    l!le P . ........ .... rac lO'l lot' 0lIf0f\rp"


    __ lly 1990. -v h9>-schooI .,..-.. .. me
    _ ..",... lllogtl _ 1nAlft. a;otetnl stI'IOl<. UMed SIll.. _ ,~ IICQ.O".... ~

    ...
    "'II, _fOOl _

    ....o ,ew
    ... 1_ _• ' " ' _
    I

    belMl _ _ """" I ' '' lIN 19 791ogon1"' •


    _ - . . - . . . . ......",tMt' ••
    o &t 1990... _
    _
    ...
    " allO' _
    ........-.rw "..
    _ ""-'-_
    75"", _ _ "",,-
    be . . lOdesoibi ...........
    ~oodo.~v-

    _
    1990. ,.. _ . oIll'ol1 MlA lQakm
    ".~ ....... ofll'>e_ ......r_

    1or~_-..c:be.iO
    M'Il. lind ............... 01 _ _ . . -
    - . : I be f-.c.I trv> _'I 3.2',(,
    '1ID_
    0 ._ ~
    1I'l.-.....-oI.."""_-.-e-
    . .. II. IN us _ _ Sea.., b HNIIh
    ·Vfteatlbit _ . ,. . ~ .....
    ..." _ 01 Po.dc, .. _ - . . ~

    "'"
    o ItI' 1990 ,505 "' . . _ - V I _ ......
    _ _ _ _ me ' - . .. t - . . J I d _
    ~_''''''''''lDaUln
    _ " ' - _ _ bwogo.
    ol~
    ". ......
    ....
    ...... ..
    .,.,.,..,. - - I gIw ' .......
    "'doel_~
    <:em:
    ... aI _ _ ~ _ "_ _ ''''..".,.
    ~ "'" - . . . . l*sonoI " ' - ...
    o 8¥ 1990. • _ 7~ _ be _ \I;>
    a",,_
    .. _ ~
    o « 111'""
    _
    ........
    , _ , , , , _ AIr.."
    ~ llf"'ClPII ....., ,.,.... 01 _ _ ~IO _ _Ircm:-.ao.

    ....
    ~
    lI;JIcJwng_ases

    o
    -.."....-~
    b e _ ..
    h9'_oIll'>e

    8¥" l li9O, "'" .. 0\>01"" of _ _ "'" em-. _ .._


    __ "~l* __
    _ol..-'
    00 I ...
    _ _ IfItlu:ed Gealh mes toom _ .
    ~
    ~_'"
    ~ _

    Or> 1hII QIhor_.


    aca.mf\o dIo'llt( b
    =..... It'cughlIOP'<lI"D!• .,.OO
    _ .", o..noon
    _"-
    01 ~1111_""
    on =_1Ud'I. .. ~huIlhoIr_
    weogIII CQnI!tIl. _ ~ .- . rei
    ..-. . Hoa,..... I1'o;IuId be 70'Jl, c:ontral 01"""""" _ _ ••

    "
    Tb e allian<:e of rc5O\Irces which rlID achieve Fig. 3 Increase in the supply of
    th,t golIl is potenli.lly .be m,.>$1 important social
    vaccines by UNICEF, 1982-1986'
    mo~ment uf O.l< time." And u the next sect ion
    ",ill shO'o", this movement is now beginning to
    500
    come IOgtlbcr, in ..,me nations of the world, \li th
    SOme dram atic early results,

    Ullivenal immunization by 1990


    So f. r, tbe main teSling grou nds of tb. G~nd
    Alliance for Children h.". been the attempts 10
    provide immuniu tion . nd 0",,1 rehyd ....rion.
    Th ef( are th.... \I'ho have . rgIJoo .hat this
    fecus is too narrow and th>! ORT and vaccines
    have ~n over-cmphnilN in UN ICEf's advo-
    100
    cacy IWer rCCem yean.. The reply musr be tba'
    when tb. lI'tlrld h.. at in disp0$31 lWO of the lem
    expens.i'·, and most efTtctive public bealtb t...h·
    niques of aU time, t...hniqucs which af( capable of
    defeating both of the greatest tbr.ats 10 tbe lives
    and the norma l gr0ll1h of the world'. cbildrcn,
    then it $Ordy m.kes $Cnsc to give them tb.
    highest prior ity UlItil that job is dOfl<!. And ifwc
    Tho _
    _
    0-

    rse
    - -

    83
    - -

    . --

    as
    lIoWI' o l _ l'l' .......::u .... _
    ·_Io fou"- .
    ee
    cannot moMizc the will to put these most basic •n. ct.-r or-. tho lOloI_ '" II 8'1 ..,.,.... .
    clements of child ('rotcetion into :K'tion for th. ElCG. OPT, Dl, pelc,,,-. tn:I n v.",...., ~ I:¥
    sake of saving tbe ~v.s of up to 7 million children
    each year, . t a COSI wbicb is negli~ble for such a
    cause, then wbat chance do II'C rcairstiaJly bay. of
    _IHCU_"""_
    l.NICS'--" .",..,..,....,
    ....".... "'"""'"" 10 thodo' • ..-.
    '" II EPI

    mwng $ignificant progress against the ple'hor.


    of other, often more difficult, probl em. which faa.
    ch~drcn against sis moin dise.... by 1990.' And
    tbe world's cbildren?
    with \l'b.,ev" ten3City .nd single-mindedn... is
    In rhe la.t fi~ )''''TS, immuniu tion ha. gath · nCCC'SSU)', rhat target mu.t be achieved. If ony
    ered a new momrntum (fi~ . 3). It is nOll' '';t,ltb.t funhe r incomiv" were nccesply, il should also be
    this momentum be maint.med. In tb. 1980s, iust mentioned tb.tthe cre.uon of a universals)'SIem
    thrre vaccine·pr..".nllOble infcctions- messl"" for immuniution will be essential to the delivery
    whooping cou~b, and tc•• nu.-have killed ap" of n..........ccine.- for example againS1 m. b'" . nd
    pr~mat.ly 25 million young cbildren -mor" AIDS - \l·hich may well be developed over tbe
    than the cntir. und<'r·five population of the
    'iX'.
    United States or Western Europe. luiY, the
    Iow-cmt mean . to stop that uneonsciol\3bl. car·
    nage and to c op it wirbin the next f..... )""rs. If we
    do not now use mose means, then our pretensions
    • l'lo ..._ ... .... _
    ~ """'nie> or< ""
    t__
    im=Imwoioo .....,.._
    """ .... , _wiIb
    _ "''"II - . - . " X«PUIII< ...-.l ( ;.,
    1011'srds ci. ili>.ation .nd OUr hopes of hum.n
    tIi< - . _ W«td;, "'" """ 101< Jo< UPT 00.1 .-.
    progress will not stand up to any funher examino· _ for ...... ....t polio). 1nIoo - . . . ,.._ _.,.
    rion. ",K!l<> _ Of _t, ....._ ............... pon_ ... Jrort«l
    mJ . . . ... ~ 1'fOl~ io "",ko«<l.. _ _ aiIdteo
    Th rough the Unite<! Notions, lhe world ho. SCt ~ IIwy If< <Iiatibo:<d .......,. mil ... .-co....... ill
    the lorget of imm unizing the grn' mojo"ty of ........... "'1 "" ..............., ~~
    u
    THE SI'ATE OF THE WORLD'S CHILDREN1988

    courx or 1M DeXI <kadt. Ma1ari:lI CUfmltIy kills dlilclrca Ked • /ttIl ~ of ' a:Uuu brioR the
    lIIlOft tUn alllilliorl p<'OPIe ncb. )'Qr. UlldIedc:d, . of _ .·
    AIDS may iIlaImf 1ft e¥m grnrer thrnt to
    UDlftnl1 dIid """'IIllia:u tkRfont df.

    _............
    bum.m tiflL 't"1lt KtuaI IDe! patmtial bmt:&n., to
    ~ wlIoW -id. of I ~ alld pmmnaIl
    pmdJ oa ,""",Ijzjng III ~ of all ~ 1':
    l noutCft 10 tnda auI to • ~ wllh inronn.
    IlllIIIUlllDllOCI I}'lml ~ lllertfue iDakLbbk.
    TlIt DOlI oi _mj,v_ ID ~ dt,dopuIc
    ..uId, 01\ 1M Oilon' haIId, hal btnI akulmd I t
    :oppr<lSUlUlldy SSOO lIliIIioa pn )'tW -iboul 11M:
    u.eo.r,
    In ~ IS~' _10 1M
    gulr IlIIJOllIY of JleIlI*. 8m clinIC! an be far
    ArlIe u _ Ilh _ d F-U ¥,u W'Cfafl . away, tr'ItiSjAlfI an he l'ITaIic and ~,
    "''; k1i ne llul j'ImlUMDl immwUmion 1}'Slt1II ~ ean be Joo&, na:inatioa limea an be
    mm,1On rtpfnt'nu OM of !be grnleSl in.-· IlIll'ftUllI, Olhet m.embc~ or rM family may Ny
    mclll oppomulIIi6 ClpftI IO humanity. iI's IlOI orortb ii, JWfllI$ may lIOI J<no.o !hI1
    fC"o~rn ~rinns I~ DeUSAr}' and rut the
    o.-er the '"' twO ynn, the proportion or die limlll,ll is imponllll, tbr child may IlOI be " -eU,
    dcY.1opinj; world's children COI'ffed by OPT Ind thr WGtk in rile fields, especially It barvm
    ncciM bas increased by 7 p<:rmll'IgC poinu I rime, ID3lll«knn wilb mem: urgcnty. Unlns rM
    )~Ir (fig. 4}. Apiml musics, me aYCngC' in· relsons or <lVrl'C(lllllng aU rh_ obstacles I.r
    crease bas teen 8 perCl'nlage points I )'I'U. m.de lbund.ndy clear, I nd unless !he rimn Ind
    ASSIIJTlinS lh.t thll avenge ..:n. of i"""'u.. i. pl.acu or . accinu ion el.!! be !!m!~ lOOfr C9llVI:-
    maimlined in ta<h nil ion O\lff ,he Ih= yeus ~irnl, rum-OUl rarrs will eonrinur 10 be low Ind
    beiween !be end of Imind theend of 1m,hI' drop-oul rates wiD conrinur 10 be high.'
    ove.. U picture will bo thlt 7096 or mort of ,he
    IrMluni::nioo in the developing world is
    devdoplllll world" children will be immunized rhr~rOA: "mply llOI IS easy or auromaric If il is
    ~1lSI d,scucs which lea Ibm I decade ago
    ..= ~ four to li~ million child...., • you.
    lOr mOIl p.i=tI in rM iadusrriaJiled -wid. Alld
    if thry :orr ro ~ rM r/for< 10 lII<r I child...ho is
    In lICbor.....us, oltbe ..ffons"'r=!:DIynn~ llOI W 10 I diNe on thrrr or four sopInlr
    be lUSIiIlIed mil ~mcd, .ben is lIClW ~ occuionsIII rM lint: ynr of tbr child's life," Ibm
    ctwx .. of ~ one of 11M: lDOSl. imporwll all pareOl$ Plll$l be frrqIIrndy inronncd, rrom aD
    ~ wblCh •• world rommulIiry b.u ~ SoeI for poqil* IOUrCrS, tlw a I'uII 0lIIIt1C' of nmn.nons
    II ~illiailO prcI(<<t lbr IMs :IlId tIlIl'IlIaI rtV"flIl
    '"""
    PraCII lrftIdI aIIo IllgeII W t opprmimaldy
    34 ~ UlIollS .... flll sbon or tbe 1990
    of TbI:1t d'iIdrr1l rrom _
    OIlS dIsusi:s of rhildJvood.
    of tho __ .......

    ~ umc-.. I IlJIlffllle rfIOn il1DCIWIIN brin


    11M: ....t 01 11M: deade. 8Ia lrftIdI aM _
    iDMlbililift.. hnd all lWioos uJJ Rill ~
    md ~ tbt 1990 l~ Dr. EWpb H<:adcr-
    - . lbr Doroctvr of WHQ's E-po"""cl PJo.
    ..,
    .... ' 0
    ..
    11TlllT' 1"'DI_ is lbrrdOrr I penlWle'DI am-
    dlaIlr<>cr- ADd rbrrr II Rill I ......

    JmIIlllt on IIIlIIIlIIIlUtlO (EPl), bas rqlUledIy ., ......., - I

    _ _,_ _1"1... _-. T.. ,


    ~ ttw " .. r _IIIt' totIM11 Inl.l • ~
    rMIIlIl€ £PI f'I- • ~_ -a UI « c.- ,,- ....
    IlnlIllU ., • ud. NCOIIItI, rItU-dIGiJI~. ph ...,
    _ _ _ lor •
    t _ WI _
    •• • • _ ......
    .... _ _ dilol
    or ..pplon.... '!'k IDIia poblem is lbcRfon: DOt
    lindmg I~ YICQlIft or llw: ~ Of 1M
    refngemon. h is IindinJ lilt po!ilial commil· " Tlooll'llO " _ _• _
    mml, 6ndu.,tilt ~I and <l<pniu. _ _100. t
    ""'~

    I tl _
    tiolUl skiIh, and finding 1M Wo'lI~'I and mellll te ~' I~ ... _ . "" .- fl l ' w' : ..
    inf<ltl1l all puemf Ihll all prqrwll . 'O"",n ~ <OlO t l _ lUP'Tl) aaol 0I"V1; . .
    (W\'J. " " " - u _llf'Tl aaolOl'\" ;
    _ -TlI'n
    _
    tl
    10 be vaexinlled againSl IClInllf and Ihll aU

    "
    _ ..
    Fig. 4 Immunization coverage, by geographic regions, 1986

    "
    "
    Wool ......

    " "
    " "
    T8 OCGI CPr Polio " Measles' 'lI. of pregnant
    % 0( 12 mooth-okl ctik:lren irroTl.rized agailst women irrmurOlea
    agMlsl letill1lJS
    ............. . 'll _'_"'_IloO'lI_ _

    _-
    lICG. , .. , _ _ 'l'I oomoOl:l<.mM 0Pr ..., POlo _ ...... .... _
    _""' __ lZ "" 2
    -:/1"",, - _ . ..
    _ ....... 'a_ ;_ .. t>Wog ............ oo>i>ot ' C<> . ~ . "

    ............
    _ .......UIIIClF_"'" _ _
    I, "' _ _

    DUI, in the l151lWO yean, tbe 'Integy of wriaI has mad. tUt possible in ~ n"ion with low 1...."'1s
    mobUiulion has agll in shown that il can achi."e of litm"}' and mass· media covenge.
    remarubl. resulls CVl"Il in the fxe: of previO<tS
    JICS'Iimi.m and prescnt econ<Imic probltms:_ o TM'*ty hal mere IUn trebled its immuniu·
    lion coverage since: 19B5 in an offon ".. hidl has
    o Svria has more than dQll~ ils immuniza· a1real1y saved the Ii""" of more than 20,000
    Turkish children. Almasl every possible nrga·
    tion COverage between the beginning of 1985 Ind
    lb. end of \986, so 5'lv;nij: ~ than 5,000 young =
    ni.ed ""..... in Turl:isb society played its part,
    Ii,," .>eh )'l'U . Tha[ oc!lW;e_nt would ncr have including lhe m.u. medi~, over 50,000 Islamic
    ~n possible wilhoul lh<: health services. But lndm, and 200,000 schoolteachers. (panel 9).
    neither " 'OIllJ it have been possible without 1M In e~ch of these cues, dramnk achievemenl
    comminmnt of the o.[lon's poUtialleade" and a hal ~ made pnssible by a nalional po~tical
    oociely·wide . Uiana: involvmg ihe mass media le~de .. h;p which h.. publicly commincd itselftn
    and tens of thousand. of schoolteachers, ~ligiO\1S universal immuniulioa and called upon the
    leaders, and campaign ,'Olumeer. (panel 3). whnle nalion tn pmicipatc in achic.ing it,
    "VOUcilUlt;"N," declared ~nepl's President Di·
    D SnKgaI, on. of th. thiny poorest ruUiollS nuf at the npening of hi$ nauon's immunization
    in the wurld, wilb 30,000 nccin~prevenuble
    a mpaign, "if rwrybody'f 1nui1mS."
    deaths each YUt, has lifted irs measles, DPT and
    TB immunization l... el. from very low level. to That same political commitment, that ..me
    ~pp'oxim~tely 70lt by mid-I987. Panel Z 11.- 50CiaJ rQpGllSC:, U; the ' iNC q>Ul
    IIQN of every
    Kribes the remarkable 50CiaJ movement which .~ elfon to pul tooay's health knowledge

    "
    THE STATE OF THE WORLD'S CHILDREN 1988

    Colombia:
    pupil power

    . In CoIor'nr>a. me whOle ll<b;at>Or>Oi $YS,ern IS


    ntYN be.ng ~ 10 promote !lie I\eeItrly
    "",.Iop",." of IN .....,.,.. 4 II'IIIloon vwng Cf1ol.
    ~

    '" utban oreM. 700.000 1Iogh-$CllOOl p..iPOI$ are


    llet'lg b _ .. 0d>0aI as ' Mallh """""" s'
    '"""'''''''. from the mass rne<\llt to
    $)'$'8"'. from ~t orgaroo.oor.o.
    ~ '0 ,"" _lIlY
    _ _ _ 00f'T0(TUjnrly

    The new ~ at Health Mentors IIdrawn kom


    the ,anb ot I>!gt>--sdIool pupoIs (0WIt ~ at the
    t<mIl. Red Cross """"'~ . SCouIo. ttio ""00i'lM
    ,no. ecluce100ll

    50.000 or them .... tJJ..~ ~ ,...... \Cl POke. _gan"" 'eacners. .........-. '1OQ',,'8d
    ..a..s.o pat_ on """""'III aond c:nilcI_ , """ '0 by l!le CoIomb<an 1n!\IlIJ1. of Famoly weII"'e. OS
    ref.. moIhots and <!>Il<lrtm "' ~ of CMtI 10 It>o ".".. .. !<om l1li C _ CI'Iun:II , Theor 1I~"
    h8aIll'I _ . At 5dlIIOb '" nnI "'00. lead1Irl l>ased "" B "ll'!C"" ma-l\lIIl C<lIICllOlnI\Illg on ...

    -_.
    ... " ' _ O""'PS 01 10-1<>-15 1*""'''
    1OS1Ud'1 pnonty ar.... _ cIis<Iase and oarl ~ a­

    ---,
    ~ <Ii promotIIIg ,Me'tI C!>l<II"erl"s ne.m _ llOllllle!opy; v~tBbIo diseases; maInu-
    ""'010p"'8'" By 1990. IlOtal at 300.000 Pll'on" tnlJO<>. 1OCUl1I ,_storY ;moel""". corr>Qhcat>ono
    w;I havol ~od .. _ "-lW'lgS,", 10.000 01 pregMl>Cy end ~. and "'" _ ' . em<>-

    AI all _ of me educa~ SyStem-from Itlllogh scIlooIB, l1li _ ... ..-. PBI1 0I1!>e
    """l3rV !/-tough to """"""SIt and II"doding Mull. _ WtlCub'ft. All 1u6,wIg <he _ " , ....-
    oducl""" cIassM-cllolcl """",,01 and "'" ,'. ,..,,, .... "' l1li 9th .... all> ",ad... , pupiIs.pend B lOIaI
    e,.,
    ' 0l'0C'" <>nW beong ."""l' o<.ted ."0 "'"CUI1ocu. 01 30 t-oo.n I VOfIJI WlIO>g _ l!>eV ~............,
    Ium f<lllKe ~.""'"" 01 pat..... • e lo"""""tg. as
    .,udies. Pt<>'I'IC'.
    .,llle d:spouI of POll' ccrmlIn1....,

    -,
    ~ 01 " - base ~ 10 d>Od
    1M<aIIy. """"" pupoIs CIOubIM w!>ell>et !My
    .....,... be _ 10 QMo<m "'" """' "",*,'8d of
    These 'oocent ~ .. are .. ~ at • tllml. • SCIllffiCllm sllereel by mBffl o! ""'"
    ....-.111 progr......... -caIIed S_ _ - whd 1'-' and ....... _ P>Hlth BUI_. Paret\,.
    IIn\S 10 - . ChIld mor1aIny by """ tl1n:l beloit .....e also worrlQd abDuI _ -..n·1 wo....
    _,o-ho<ll8 . . .
    1990 TlIoprog<......... ·ssPl'Cll;c~..... 1O
    tIJlv~llIlea.,8O%oIurlCUi<.fM!s.
    c:nilcI de<l1hs from d l _ dehvdrelion.
    de.1lho from _"10<'1' inlOdlOnl t>,o lit INst ~.
    to_ _IS ""
    10r.-
    """- malot>g
    Bu' so I",. "'" PlOQr""""" II ..-brog _
    'IS

    EQI..OIlPed ""'" ~ 01 oral rllhydr.""".... on<!


    n,,,,,,,, .., _lop-
    '0 cu, .......'m"'" by ""'" 20%. and to 'e<I\lctI
    ltI8 II< ma.n d>iicl
    "",,1-0$ ' Om tile comploceoons of pregNnCy and '""'" lCPIC'O. 0""" JX4lO ~ \II$IlS """"

    co-or_
    ollildtllJlh by """" ltlan 26~.
    The prtIgr........... by 1hot MnItrv 01
    Healm. otJQI"31ed .. !he """'" of !Nt suxesslul
    II....,... oocomp6n08d {8111.., "" ""''''''._'l by
    o oornmtnlI' I8ad8< By 1990. ne.aI'" """"",,,,0 WIll
    """" ""\ed ~ one mAon Cok:mbo¥t t"",,",.
    '~100n ou..-· 01 1$84 8uiIclong on the M001 t...- ...... 10 ~ ""JO'I'O'd ar1<loppr_
    ..... .,.... """""'" ll0us.0d by INt C8I'Y\PII9l. !til 81ed "'" _IS F", "'" ".,.,.. _ •• _~
    ...... 1$ III <kMlIoP • sustaonlld ....,...."..", ,0 I........ "' th8I" _ hal 011"" been B deePY
    ptOf'OO i.not,.,., lhe """""oIl>Jllt>e _ """,,01
    _BbOtl
    mow>g B>:peflBnCB , An<l no1 l1li la...\ of ilia
    ber>elilS os 1lIa\ I new 01 C<Aomban
    and 8I"I"IOIl<II\aI d8>"lopme,,, 01 the ColombIan
    cnIIo And., tllatCMlSe. 1IIe _ ......... _11>0 \OUth os ~ upw.th """" tIOC'aI ""......... .,..
    ~ "'-«lOf'l 01 • WIlle ' ' ';11 01 o<gamed ",.,.; GOI"".''''''''
    ro. ltI8 _ 01
    CoIonba'o POOl

    "
    at the disposal of the m~)Oril)'. Wilh Ib~t ro show parenu how 10 use ORT and lbe message
    rommirmenl, al'p.nendy insuperable diflklihies has been reinforced with m...ive television and
    can be .nd h.V(! been overcome. Every year for ..dio CQ\"erage {fig. 12). The result, aerording 1O
    the IoSI wee l'e~ rl, the civil wu in iii Sih'ador the ~hairman of rhe Egypria n Ph)'l;iciaJls Associa-
    has be-en Sl~ for rhl"«"days ofnnquillil)" 10 tion, i, rh.. child dealhs from diarrhoealdehyd..·
    th.1 the n~l1on's children could be immunize<:!. lion, whicb used 10 ex<=<! 100,000 . year, have
    And in ~plember 1987, rhe eil)' of Bcirur . Iso be<'n ~""prl1ri",aJtty nit iN hal! by the ORT
    S:ilw rhe firsr of three planned 'd~y!I of lnnquillil)" t/forr n.,
    <IS leaders on :ill sides cOo<lperated rc allow rhe
    cil)''s children ro be ,.mnated. Similarly, in UanliNrtU, "",ial marketing and
    mass-media effon, to promote QRT appear 10
    For immunizarion, in panicular, rhcse rcanr havc reduced diarrboeal dealhs in SOme areas of
    ochie''''men ts show rhr rMre is lKI narion which the coumry by .pproltimuely 50%. AIgm.r is olIO
    annOl nOW meet rhe 1990 lug<>r no metter how nOW on <;QIIfSC for ao:hieving irs owo liUgcl of
    f~r behind tho! narion maynow appear 1O be.lbe mal:.ing OIU l vailable ro evCT)' hnu...hold before
    strategy of social mobil.ilation brings universal rbe end of 1988. Orina h3S 1 long bistory of using
    immunization wilkin reach. ftuid. for oral r~hydl;ll ion Ind ORT i~ now in use
    in the maionly "f Chin>.'s hospilals. Et" l>Jlor and
    Pm., despile severe ecooomic problems, are now
    0 ..... I'thydratiO!1 tlIeraPJ making na,ion·wide anemp.. ro 1"'1 QRT ar rhe
    disposal of C'o'ery family. And in BangiadnJr, on~
    Social mobilizarion is alSCI now beginning 10 pul oon·g",,,,mm.nla! organizalion blS now orga·
    ee bruJuhrough known as or:aI rehydn.rion ar nue<! almost 9 million home visi.. ro leach the
    the disposal of many millions of parenlS (panel 7). ORT Ic<:bniquc to the nalion's motheR (paneI 8}.
    And ag.in , th. imponan« of Ihis brealahrough
    cannOi be w er-emphasued. Diarrhoed okhyd...· It i, nOl nearlyenougb. Progre.. is far rOO slow.
    rion is responsible for no Ie.. !ban One quaner of Three million children should no, still be dying
    the more than 250,000 child dcalhs each wed:.: each year from rhe dehydration wbich any parem
    Yer il ..n now ee prevemed bya rhe...py which is ca.n prevent at a c:osl which any parent can afford.
    10 simple thaI all parenlll can use it, SO inellpC1l' Yel rhe WHO largelll lo be acbieved by 1989
    sive lhar all famili\o$ can afford it, and so effe<:live (5CM of I"'f"nrs using ORT, aod 1.5 million
    rhal il is npidly becomil18 • rrearmenr of cho"", children's bYes bein¥ " "ed by it) are not going 10
    in rhe mosr . dvanced haspiral, of rhe indusrrial· be mel unleu rbere IS • sudden attelerarion of rhe
    ized Wl)rld. \\'Odd·...·ide effon to promote the ORT m~ge
    The health services alone cannol empo">'1:r a over rhe nCXI IWO yea.. (fig. 5). DncIor. and
    norion'l pareml with ORT. In mO$l roomries, rhe healt h "m kers o«<l ro be trained lOcommunicare
    majoril)' of docrors have themselves nm been rbal message Fila 10 face with parents. Schools
    rrained in its use. Relraining heolrb profeSlionm, and mass media and org.nized r~l~n need 10
    ar aU levels, to use and rc reacb ol1ll thcn py, is be ISke.! to reinforce it. And all poUliealleaders
    therefore a necessary bur nOI a sumcienr ccndi- not rei aW:lfC of rhe ORT porenria! need 10 be
    rion for irs promOlinn rn a wider public. And in ccnfrcnted with rbe focr rhl! rbe main eoemy of
    !he cnunroo now seriously anempling '0 pill lheir nation's ch~dren can now be defeated, ar an
    ORT at !be dispo:sal of aU parents, it is an alliance .ff"rd .b1e COSt, if lhe nation'. organited res<>urcco
    bclWeen the: heolth servicn and I wide nnge of sre mobili2ed 10 mcCl !bar ch:illeoge.
    ne.... resourccs for healrb, including rhe schools,
    rna.. media, religiou' Ieoders, mher governmen,
    services, and non-$O""mmemal org;anizations,
    wbich is demonsuauJlg rhr rhis ""r be~. Bi"", and be alth
    In £Cpt, for eumple, rena of IhOll$3.nd. of Although immunization and ORT have been
    medical pel$Onncl ar . UleV(!11 have been Il;lined rlIe major rallyi ng poinrs of Ih~ allian"" for

    "
    THE srATE OF THE WORLD'S CHILDREN 1988

    AIDS:
    a world-wide effort
    TIIs op<eed of AIDS""", "'" _ , 'on
    YO"'" cooA<l pr010CI _ 1...-' _ by " - ""'" 1Cl.....
    be f8ducId by !lO'.4-90'4. thlll<,tlIic _ . already And IIhoJ _e to t>appen ""'" !hili ~ l!oIcaOO.
    _ ..,formed Iboul "'" ....... .,.; l8kn(I 1M """" " rnogIlt be l!Iot ...... ,t. d¥It c:lD<Id 01 AIDS
    otMous Sl OPS 10 _ " If> me ~ '" could t-e . ...... fnng 01 hope
    ~01 cl'>aI>9o. \he d _ IS IM/y 10 O'I!ect
    BOI £el\lJ'lQ AIDS ", \/loS cent""t cloos not mean
    ~e be""""'l 5 and 30 million '*'PI<! (Mlr
    mat AlOS n$4l~ '" not ............. for_""-,,..·
    tile ""'" <lee....
    liCI.ot.Iv WI Alnea No! tri; "'/fIaI"IO mo<e ~
    AIDS tM<eIor<I Nos somethong "' common ",m bolo:"II (Ifflhar\<!<l t>v !he _ ..... WI Al fCI "'""
    ethel leadng """",. 10 tIUITla1 _ _ "",""", onywher...... wt m(O"' d>oI<ireo .... also CCII"lU1C1-
    beet eeeee. ceeeee deh','l!l'~=. re-..p::am:"j :n; :rn: ~..l: lit: =: ee ;:';(!:;;Ulmcd w:.:r'.:l,
    ..,!eel"",. _ .... lnull...", Ag""l!" 01 w..... the Afnco ties as monv women worn AIDS as ""'"
    IIIDSt ell""''''''
    wupon IS edUClIlion . Tho, IS why Mosl... "' t/'IIIM" cJWO.t>earng years """ neaFly floII
    ""Oriel _ S , meeting .t "'" Veroo:e SInImi1 "' of "'" _ they be.. 8100 b<lcome W1Ie<;1ed
    .lU'llI 198 7, spell n 0<11 ,t111l ..'" "'" absence 01 e OoctOl'l WI bmboa. tor~ . fe.. Nl 6.000
    ..e:cne or • ""'... the _ hoQe for "'" pr......"t<>r\ .m0ll1S may ,...... """" Al OS. ""_ _ es "'""'"
    01AIDS re.IS on • S1fa,egy based on oducltt"'ll as "'" URt"" Stat...

    "*"
    " '" puI)Oc
    c.. to _
    Iboul "'" pr""""
    SlBPS n c I l _
    contracting or ~ n .. AlDS coUd aIoo po,lU OIl v<l.EICl tll<&;I1 to
    ......,.. more cIoilIr"" d ".. _ matOtl 1IDOu. me
    In ' hoi ....... ~ na\lI:W1s. boIooM of doh' ..... drse<I$4I .. eIowed 10 .fkoct. .............. _ end
    """" -.g -., on
    hom _
    inloImo'.,.,.and - . co
    .. eolia. onc:Iu:lWlg l.ondor> _ San
    breas'·feeding ~1IlW11e"
    1"tl8Ofel>Cely , n .. POUlbIe lMt br_,·I_g
    Fl_rsoo, "'<lICat~ 1/'IIt the spread of AIDS II
    COIl It......... t..... AlOS ....... . . - - """. ...
    .....lI<1y ~ Illowed
    """ CISO'O ""'ete If\IO IS tl>wgh11O _ h~

    ftI "'" <IevtIopng world, I'ld ~ '" 8u1 "'" """ IS .......,. - _ _ the-.x.nment
    AlIJCa... rnau"'" purMIc oducat"" elkin ~ 01 t>reast.looo<Mg. "' pOoI'~, COIl_
    ..." ~ "'" r.<IJlth _ but "'" och<XlIs. tile arid _ "'" nok of _ end dent>
    mass ........ Md "'" """"uar¥ agenQ8S 1$ elso now Tho """" CIIJ> Ills<> 00 tr...,.,te<l .. . .....,_
    b"O"·'" ....-. Or' ¥"'(l(lS 8u1 "'" ~ Prograrnmoo
    AtOS .. _ " " " "l"Jr'l'IQ ...... of "'"
    health !IducII'' ' '
    ef!orts the wor'.d hlIl$ eve< seen.
    0'''''''''' "'" lmo'no,.nzatOtl!EPll .. ,...... ,.. ,f".",,'11 SIll",""
    non proceduresWQI1(I->M(Io """ tf>e<e IS nofo>own
    But" " P' eose!VlM I:fI<lMdICal<l 01 eIIon who::tl .",... 01 . <:tlIkl """"1C1O'l\I the AIOS ......... r!lrougIl
    .. also needod to ""'lll'N'l< parents "'th flfor .... OIl EPl lI1ICt"'"
    lor> &gU\S1 _ "'....... ~. II«>-
    C _table _ . one! '_'0<'/
    ..r..,. MisII1Ior<NnQn must no< rnrea'.... llle buo4lng of
    • per"...".." """""""''''''' ..... ,om _ ..
    1IIreO<ty
    lIClIll -lhe "lfell'<lUlI 01 Malt ~ problema W!lItI'I ...

    -_.
    SIYf1II , 4 moIoon chtId<• •f . !Nell fICh ~a' ....,
    the gr,,",es, thlNIS to IIIe we IInIl Marth 01 "'" could _ 3 .....", """" NOr' _ n bIl.
    _ n forTillV. end BSPIlCIOlIV 01 its d*lren
    ""om'""'''"' Iht$ IS . svs""".....t.:n...... benefit 'Ile
    AIDS ecIuc.""" CCIUkI ,.......10<. be pan 01 .. .....,.",., wotId ......... vac(:1I'I/llll.....' AlOS """'" II
    ___ "nort to emp<;lW$t ;>o<>p:" ~. to

    "
    Fig. 5 Estimat ed ORT usa rates children, there j uve also been etherexamples, in
    for children under fiYe, 1984-1985· 'teen! yo..., to .bow lb. power of mobilizing a
    ",id. rang<' of soci:al rt'SOUlU' in ,h. ClUSf; of child
    as hCallb. Throughoul Latin Amelka, for cumple,

    .'"
    ,b. Mul. 10 r.ach lcnl of million. of parents "; lh
    ~ 0 1984 32 today" information about the Mncfiu ofb .t,u !·
    milk ond 1M da'W'tlO of anificial fttding Iw be<:n
    o "85 w'gM through Ibe hospitals aDd dinia, the
    < ldC'Vision and radio Sla,inn., the nl".ltSf'llpen and
    'j 25 maguincs, the ",omcn's movcmem~ and sports
    R lU ln$. P. ncl II brings together the resul,. of
    such cOmmuniCltwns cffons in sewraI n'lion. of
    ~ 20
    lhe d.....eloping world and p.nel 12 illustr.tcs the

    I"
    vital role of hospital st.ITs in lhe promotion of
    breast·feeding.
    e , , But perh. p!1 the gre otCSl cnmple in recent
    of the .ncmpt to mobilize communications
    )-e....

    "" co!»,i!)' to empower the m.jority ...~th . ...ib-blc

    i• 5
    hc.hb ktIowlcdge and t«bniques, i. thc r.lpid
    sprc.d of f.mily planning a<:tW$ tbe developIng
    ..-orld.
    Planning binhs has usually ~n vitwtd pri·
    o marily '" means of limiting population growth.
    B~l tn recent years, ...w ld-wide research ha~
    shOYoll that pr.....enting binhs "' bich <'(KOC 'too
    many, tOO dase, tOO young, tOO old' can do more
    to improve mother . nd child health than a1mosl
    .ny other singlc intcrvcnt ion (fig. 10). Even if
    there were no :1I.,,; h thing as a population problem,

    i
    o.ao _ _.... IOOTI'*" "' _ '" a>rNCI
    therefore, the decision of .so many millions of
    f.maics to begin timing the binbs of their
    children, by vuiOlll method. and acconl ing to
    their own tr.Iditionsand values, would still r.lnk ..
    .... _ """"",,*,,_ 10 couso at
    _ " ' _- ...... , _ "'_ _Ol one of thii ",nrury'. grea tcst COlltribtltions to the
    """ _, _lORSI. '" "'" - - . '" ""'"' well_being of the buman famay.
    _01'""
    _ "'
    _ooOjdo..... - .
    ...",<iI .... _ •• f*
    _
    _
    .......
    .. In Ibe 1960;, fzmay planning "..u the provlnu
    ..w.c", _ iOO,OCIO _ . _ .
    ~

    of the <!lite . Tod.y, almOS! all aduhs in the


    • u.. _ _ "' POt'*""llt ol ___
    dl;Vl:1QPing "'Orld know about, over one half are in
    "cttien Lrder __ "' . _ """ 0llT OAT.
    """'" _
    l<9" to _
    """'"'" _ ..., r'fIt'¥lo""'"_
    M!mOIM b
    _lOASI.'""'" on!
    _ 1WoliIIlIo lOt.
    favour of, . nd lI'o"Cr one thinl are using, famay
    planning methods.
    _ . h m<l<JoO"O _ ~ ....., .... .... 1"'Ql.. ol1l'e

    ---
    _ _ _ """, _ Ih/lORT ... - . N _ _
    And again, this . t:hi.....emcm ii a result of a
    ..... ' ~ ro ""' al Ol'IT " """' '''' _ '''' ron",,;ous decision, in counl')' .fter rountry, to
    r(J
    _ OI. "1hO """ "0I'lS.""_. arrl
    .• _ lyPII avo< ..........
    N _
    usc tod.y's nc'" communications co~ty to
    break f.mily planning 1<n00000edge and tcchniques
    _ _ _ 'iPo:l to"- _ 101'IOl bm"012<'(Ql!Io " _
    -----,.-_--
    """ ..... .-.. a9ObOl _
    of OIlt from behind thc ...·.lls of the dinia .nd begin
    ~
    pIltling them at the diiposal of the public vi.
    lk.cI " ""'" , _ eetses.
    schools . nd .duIt education da ...... television and
    _ ...e..- .. _ _ """""""'...... r.ldio, n.......paper1" . nd balboanll, cm.mas . nd

    "
    THE STATE OF THE WORLD'S CHILDREN 1988

    ORT:
    a progress report
    Two tIec.odes IlOO, coenbl ls If\ c.Icu1t. and 01"" oJ 1M IaocI< 01 docl<lrs. .......e•. _ cll'>o! health

    _S
    Dl>oI<a <ltIn"o:)nO".ted thot _ . pa_ 1O oouId be "'I:l'te<s who _ - . ll<OI*IY "wed .. llIe
    sUI>>>u lullv InIsled USl<>g • ..,..,oon at gk.ocose. c:lInicaI ~1 d d...._ ~ ORT Ac-
    ....... and wat.. ,"""" ""lillyThe"""", 1'. _' _,h
    co<dIrIg to WHO. """"&boo.s1 25%01_ fool"'e_
    OIlS Ood 0I"i'I' ObO<Jt 6% 01

    _h
    _ . """' . - " to be ~ .~_ _ .. .lOCI:
    Ia<rm at acute dIatrhoeaI ~.toon -, condrIlDn _ been futy u<Voed .. "S use E_ """'" OAT os
    """'" k>!lI <Ml< J million V<U>g <:noidren """" ""01 offIoaIIy , ~ . """t ",01-.1_
    The IomUa soon b8ellme Ii;nQwn as or81 ~ do no! _any d"""" hands 0/1' e~ ollhe
    (ORSI.
    lIOn nits me t~ ... <>tal ~oon t1....~ one! .. 0 thern>M unttw_ 01 >IS ,eel
    the<_ (OllTI PQle<lllal "'..... doetc.. Ood ""aI'Ih
    ~ con-
    In>e to ..,... end to p<escnbe o n n _ drugs
    Bu1 • decado WlII. ¥IllY lew OocllltS .. the
    ~ _ """'. """" ....,. 01 ORr, ""'-">... aImosl all caNIS. Ole "'the< u _ ...
    ~po!erl\JOII_ Verylewl'lulttl 0001"" k&d
    h.erm!tlI. And """"I ... act.1se jl/ll'enl3 \Q "'tItloId
    I<lOd ~om" _,.,.,., has _ _ - thO .....-st
    .to<:ksoiORS ..aUbIe. _ vetyf_~,"
    were """" _ .... """ onvmono had Cf\IIrlgo<l. So bot
    paso O<iv>ce
    !he 101. 1970.. 1 _ \hft1 ," 01 tile develoQong T'''''''''''I/ .. d1orrflOtl manogemenl os ""'tho<
    _ os children _ betng ..... ,8Il W'th • the<1IP\' COSI1'l' f"(lr ~ d&:uIt. boot n .. no, ..... 01
    ..,
    wl-.:l>CCIUId MY. t.en UYWIII some 10.000 kYes . the ""bl OCts trad'\IOt'IIiIy lIUQhl to &l'-'*'ts (II
    _ . nu<afI\j. rnctwI!eIy """' 0","" POI"""""
    cal ~. W,'h tuppOf\ /rom the Ur>led
    In \he pas, decaclo.!I'>IIt <>O:1J,Irs '- changed ,.
    S.."'. Agency lor IrltemallOnol DlNolopo, ,,,,,t.
    o A "'tal 01 90 countr>n now " - no,"'"
    PfOlllm5 to po'QtnOlI "'" __ ot OA T
    WHO os now "",.Iop> .. ""'teliels I", ''''''''"""Il
    . . - . . """""''' ol>oul OIIT ~ lor ... tOb-
    o GIor>aI
    moh:>n ktre> •
    Cl<0<lu(;t>I)n
    _
    01 DRS has "'_
    ond 47 ~
    270
    counl_
    IisIwlg weoooI <loa'fhoeo """""'II """" I\avtI olreo<ty
    been compIeled And .. the 19805. WHO III.
    oISo helped to !loon 8.450 _ ll<Oies........
    IIaYI begur1 mass p<O<lOC;>orl 01 !hi) ...,.(58" ol
    /rom 1:lO coumnes on the suPOM""'V .
    - """""I """<led to .............., dootrhoeal - . . . CQ/I!lol
    o A,ppr""""",,,,,, 20% <li <:IJoki".., I.""dla-rhc>ea ~
    ..... new betng trea ted WtIh .. tile< ORS Of _
    ..- Of" '~r.""" .".." ...... (1985 f'O'''') 8V the Slltl 01 !fie 19901. _
    _ _• world-wide WIll ' - been ' ",,'''' ,,
    • QWJ\81 01

    o UNICEF now . . ...... ,•• !hat OAT IN\' be """t<XIote molllods 01 dfloing WIth ~
    P'""""ong mote U- &10.000 de .nhs . ..... <lisease. 0"dtxl0<I0 1M use 01 OAT TI>oo .CtI\lClII
    os betng CC><lId<natM by WHO'.
    T/'lOS global eIfon
    rna..' 01 tr"'"'ld
    OAT. _
    per""""" oI>o<Od ...,sur. 11111
    WI\h oonlll'llJe<l feedng. rapdly
    Oi.."""".. Disease C"(,,m' PtOO'ar'lIm& whoch haoI _ _ thO 0(lUI"'" tr... tn...-ll lor choIdron ""lh
    la<get 01 50'4 ORT ..... by !he
    ..., the _
    "'... 19 89 " _ . 1haI. W(I<Ad
    ....:eIy I 5 molIon choIcI ooaltls from ~
    1'"_'
    8llflr(l>:.. """"'.
    tI otho< '-""""-n:Iu<lir>g thO schoc>Io. me-
    0 _ lid> \lfIar ",. . _ ~t.oI "'gortolOt.... -con
    Bill ''''''''''''g ouch • target .... , _ .... olsobe moll*l9d. thorl" shoUd be pOsII/)lo 10_
    e>U..,..d...-y etlorl to o.ercome • runbeI 01
    or..... all "a,.",.. to pr'M,m Of ""ot .......,....
    (lBhydrabO/l And tIIaI wW<:l btono I!>e ""ClfId close
    ......... problems wnhin • V""f"""" """'_ to \OCIO/V ""'" lhe """" ~ , oongle cause 01
    PIIIhooo "",~. "'" """" 1en<lU$ prot>Iem <lOath ~ t'_ .Jlm.,.. ~ 'ts VOI'"'ll - . . . .
    SI~ lions, W(>r~·plxe and mar~el-pl~ce, \'nlunwy w:lS n peered 10 reacb 8m-. before tbe end of
    organiulions ~ nd W(>men's groups, n well :as 1987.
    Ibrougb Ibe bc~lrb $/:rvi<:es lbemsel,·".
    10 /JrJo>rt>jQ, SUCC<:51 in mobilizing bundreds of
    tbouS'lnd. of mem~ or lhe family welfare
    movement as active nutrition cadres has led In tbe
    TIle Fan! $lep SCIling up of 133,000 fH1SYa1I JI4, or village health
    post.. "'bich nO"" support more tha~ balf nf the
    The ~ruggle 10 empower all p>renll witb the nat;on'$ parents in providing ~n inregr' lcd pack-
    knowledge . nd Ihe means In protect tbeir chilo age of Iow-cO$t method. for p1VlCC'ling lheir
    dren by sIKb means as immuniulinn, oral children's normal health and growtb.' By meaos
    rebydr:nion, liming births, . nd bre:ast-focding is of immunizalion, oral rehydration, family pl.an_
    therdo", well under u'~y. And lhe strategy of ning, lhe promotion of bll'ast-focding, pre-nalal
    weial mobiliz~tion is alre ~dy showing what it a n care, ~nd monlhlygrowtb moniloring, tbe POSY""-
    acbieve on Ihese major b:mlegrounds of child dl4 may succccd in empowering parents to
    beallb. reduce the 1980 child dealh rare by SOft (II' more
    by the end of the decade.
    But Ihe involvement of large numbers of
    pcopl~ and a wide variety of orgonizaliom in the In B"r~;nQ Fwo, the t984 immuni13tion
    plomntion of immunizalion and ORT has also Cl.mpa;gn u·hich pTOlecred 70'6 uf the narion's
    shwll lbal il can be a 'thin cnd nf IM wedge' for under-l..-year.m:ls again.1 three maior diSCUC$
    primary bcillh core i!$elf. Sod al mobilization has (yellow fever, meningitis and meules) has led to
    sh""l1 Ihat il can put child health onto ,he the 'one village, one hciltb pooal' programme
    poliuc.l agenda. h has shown lhl it can I;>oo$t which is oow well on the way toward. ill goal of
    bealth services by giving lbem tbe lead role in a pulling a communiI)' beallb worker in each oflhe
    major national achievement, It has demonJlralw nalion's 7,500 villages.
    a Str:llegy wbich CIZI nnw be ~ agoinst Olber
    bealrh ~nd development prnblc m.. It has shnwn In Algeria, an allilUlCe between the mass media,
    th~t it can bd p to create a mo'" informed demand Ihe schouls, and lhe health services. ims In halve
    amnng cnmmunilitl for ba.ic servi<:es. And il bss lhe na!ion's child death rate, SO ... ving the lives of
    Sb""l1that it ca n help people themselves to !lain. ..0,000 Algerian children a year, by achieving
    linle more confidence in lbeir own ability tn universal immunization befnre Ibe end of 1989
    I"'rticipate in improving their own lives, and univ..... ll:nowl~ ofORT befnre ,be end
    of 1990. ReinfoTcing thaI effon, Algeria is also
    In Colomb,'", fnr example, lhe successful immu- rapidly ' pprmching ill goal of providing clean
    nization effon of the mid-I'J8()s is nnw being "",Ier IIllllon·wide by the end nf 1988_
    follOl'"Cd up by a Nalional Child Survival and
    De""lopment Plan wbich aims to Involve. wide In "~lUldqr and Pm., despite gr....e cconnmic
    range of RWUJ'CC5, and ..peciaIly Ibe nslion's problem.. childsurvival projects are nOWallempc-
    schools, in enabling puents 10 reduce de ~1hs iog, wilb considerable succcu, to .uppon all
    from diarrhoeal dehydration by balf and from pall'nts in using gro-..1h promotion, ORT, immu-
    ICUle respiralory infections by over One third nization, and family planning :IS • meanl of
    (pand Sl. dr:rstically rffiucing child deaths and child malnu-
    trition.
    In Eg)'/l/, lhe succe", of tbe ORT programme
    b~. encouraged tbe nation 10 tal<e on tbe
    challen/le of univcrul immuniulion - and with
    l>Ilu:illy rem>rk.tble resulls. This year, with mas-
    sive televi.. on coverag<: and the p>niciJl"-uon of
    the !'r.,idem, lhe Fint Lady,and Islamic leaders,
    lim-round YlICCinatinn. bave reached almo~n 90tII
    of the nation's infams and full immuniulion
    THE STATE OF THE WORLD'S CHILDREN 1988

    All of these are nalion-widc t ITan s. In many Fig. 6 Reduct ion in deaths from acute
    othtr nOlions, smaller-scale pro jKrs art showing
    respir atory infections (ARQ, Thapathall,
    over and O\'(Cf again that the maiof eeuses of
    dUlb, di$.lbijiry. and poor growlb among the Nepa l,1 984-1 985
    " " rid'. <hUd, en <::I n be trrceti~ly tackled, even a,
    nry I"", !t\"t ls of ""anomie developme nt, by
    200
    ,OJ
    1111" o Total dealtts
    per 1.0);)
    informing .nd suppon ing ~ rcn" 'btnueh'e1 in
    the US< of boIh •.Jid existing knOlOiedge Ind the '00 o PflI deaths
    per 1.000
    no:w knowl ~ wbich tht wolld hIS accumulated
    in recent yu rs. Every momh brings new repom
    §140
    _ ' 20 ,~
    of pilot proje.::lS which eeve lowert'd child death
    r:lle. by educating I"',ents in oral rehydration ~ ' 00
    theraI')' in one or otller of the 90 dc,-clopiog , OJ
    ~
    ccenmes where diarrhoeal disease control p"" ~,

    -
    gnmmes ha"" now '-n bllQC~. Similarly, 00
    11131$ are new showing thai the distribution of
    vit.min t\ ""psule$, or the informing of I"',eolll
    so
    20 '''''
    ~~..,
    about l h. chUd'li daily need for the vegetables
    o.~
    -,..""
    "'bien provide vir:unin A, <:In have dram. tie
    .rr...,IS nOI onl}' on pfe ventinff blindnrss bill al",
    on disease rcdoction gcncn lly. I\nd ovCr tbe last
    eigbt~n montb", reporu bave :olw bl:en coming
    1
    -,..
    ,,., ,
    ,
    in from many loul pilO' programme. whicb have
    lUa:CCded in balving cbild death. from """te
    n:s.pir:l1ory infection, by educating parents about
    the danger signs and making antibiotics availabk
    through inexpensively trained communiry health
    ___
    _ ,__. _1"_ _1" """,
    _0. __'__
    _
    _ .In _lIf'Oio<Io._.
    ~ 2....",..-..

    : ~_

    _ ..........._1Ilt1 _
    tho _

    _,_.eo..
    lIf¥O. --.......
    ~ . _ --

    worker. (fig. 6).


    AI the moment, the lCllie on which many of
    _ ''''-._l _''''
    thcose solutions are being applied .. l imply nOt
    rommellJUr:ue withthe $Clle of the problemsthey In both the scale and efTCClivcness of these
    are dw gned to tadle. And as Dr. Vulimiri efTons, there ;, stiU a long road ll> travel. But the
    Rama~ngaswam~ fnrmer Direaor-General of thc
    achiC\"tments of the last few yean have demon·
    Indian Medical Rouarch Council, has laid:-
    llfated beyond doubt that so::i:ol mobilimion, the
    " w, """" h"w fro.. .
    10 .....t Iilr /fl'''''l l1rp "",11- dynamic :a1Iiance of a wide rangt' of • sociely's
    rralr ",pni..nm 10 rhe ...... oppliall;011 of trnIl orllaniud resources, is II<IW a new and powerful
    Ird,,,iquu in 0 tim .inJ of O~u.Ol;onaJ Jramr- "'"tapon in Ihc St~lc for buman de,"<,lopmcnt.
    ""'*. TIIiJ PI'/K'U irrw/nrs cO..lIIlIni!y fl'1'lriripa- It i. a strategy wblch can help in the essemial
    rUnt, " f1iJ/IJgt-IMlII "pproiU!I, lilt lUI' of li..pIy developtnem process of giving ptnpl. more
    trY"",J FH=nlUl ;nd;gnrollJ 10 Ih, '''''''''''';0/, control O>" r their own Ii...... and enabling them 10
    l"ftlltlr ",i,iI " trUed rtfrrrol 'Yilt"" ""d Ihr panicip;tte in, and to organize for, the impro" '"
    pnlfIilWn of sntIU:ts III ,," iRlrgmrrd P"-(.agc r"IMr mem in basic ~vin8 conditions which is so long
    11r"" in "frlJPlrnltd. tpisodic !<'<Iy.... ovenlue.

    "
    Children and recession
    Despite ~U paSl f.,lurel and present frusU3- ment in the years ahead would in fact rontribule
    ,ion.. cbildde.!h "ues have been halved in 31l1l<I$( loward. Ihe eventu. 1S1.biliz:lllon of "tlrld popu.
    C1Icry region of lhe d""e!opmg world. Now, our llliGn al au earlier dale and at a lower Ie-'el lhan
    genc"'tion is = ing, for the lim time in human would Glbrrwi$r be the~.
    hisl0l)',3 faU nOI only in lhe rate bul also in the
    ol=lu!o n=br.. of child duths. In 1950, for
    "".rople, lhe .nnual roU of under-five dearhs
    exceeded 2 S million. By 1980, tht figure h 3d The rout advance
    been CUI 10 jUil under 16 miUiuo . Tod.y, it has Such progress in reducing both child del.IM
    almost « n.inl)· been broughT down lowards,and wd child bi n h~ ha~ been one of Ihe greal.,.t
    poWbJy even below, the 14 mill;"" m"k.. 't And hum.n acbievements nf thi, O' any mhercentury.
    this has beoen aChieved d~pile a 25" ;n=ase, Yet there are Jlin an estimated 3&,000 young
    .in", 1950, in the ' bool"," n"robr. of binhl per children dying every day-yellerda)', IOday, and
    yoar. romorrew-from the cGmbinlllion of rommoo
    It is sometimes argued [11.1.[ funner reductions infecticns lind poor nUlrilional health.
    in child dealh. will n lCerW.tc the problems of Whll we are nO'" suing il the beginning Gf tile
    r:lpid population gTO\'1h. BUl lhe imuj{;~ logk of nell plu... of Ihi, ,t ory, the beginning Gf another
    this ' rgwm'ot does nOI 3urvi,~ closer cumin. · great heahh revolution which could re-accrlente
    lion. The psnern of dem~phic chl nge in aU progreu, contribule to a continued decline in the
    ""tio"" .h...... th.. [h."" lin never been a Steep rate Gf population growth, and again halve tbe
    and ""sto;oN fill in dild binh~ which has nOI rale ofdeath and malnutrition among the world',
    been preceded by a Sleep and .u~tainoo fo.ll in )tlung children.
    child del.lh$ ((mid 13). Aner a certain poin t
    (when Ihe under·fiV(' momli!)' rare has fallen The way in wbich lhis <:oUId be achieved is
    bel"'" about 100 dealM ""r 1,000 hi nh~ l ihe becoming dearer as the 1980s drow to an end.
    roou",ion in tile number of births i~ lI5uo.Ily even Primary health care is inching along the road
    more rapid Ihan Ihe ,educrion in child dealM. from .hcIGfic '0 realiry. BUI if i' a precess which
    The ,easons for Ihi$, and the human variable' al can be accelerared by mobilizing today's capacilY
    pl.)·, are many and complex, hu' one rcnsrant to .uppon the ,ast majority Gf familte, in
    f.ClOT is Ihar f. milies lend to haV(' fewer childr01l knGWiog more, doing more, and demanding
    when they become mol'C' confidenl that their more as theyIlruggleto apply IbeknGWIedge lhal
    rxi"inR rhildl'C'n " ill ~Ul"'ive. i, now lvailabl. for protocttng th.ir own and th.ir
    children's health.
    In addilion, Ihe new opportunities n"'" avail·
    allk for funher redllClng child de'lh, ClIn them. That stmeg)" hasalready beguo rc be tested in
    Ihe 1980.. And tile resulu 50 far suggest that tile
    :;elves helll to reduce the me of population child survi,.. 1 and developmenl breaklhrough of
    gro'NIh in ""tl imponam wa.j' . fim, ~ey child Ihe lale twemjerh cenlury has already begun•
    ....nival 'trategies, ,uch as the promotion of
    brelSl·feeding (a 'nal\lTl.l comraceptive') and Ihe .~ driving force behind Ihis Oe>:l ad\"ll1ce in
    spacing ofbinh. al lcasl "'" ye. .. al'"n, ""crt an child ,,-ell-being will nm be medical Or scientific.
    obviou' and direct d"",nwifd pressure on binh II will be political and social. For itdepends upon
    roUe.. Second, em~ring parent' IG prOICCl • polilic.1 commilmeOl, . 1 all levels of nalional
    rheir children's lives and groWlh help. 10 incruoe life, '0 mobilize aU possible organittd resour<ro
    their sense Gf control ever their own ~fe and behind the la",- of informing and supponing
    destiny, and Ihat I<:n~ Gf increa.inR control is parenu in applying looay's ~nowledge. T haI i'
    perhap" the one f.",or, ahove all otherl, which why the nen chapter of this report will <:onecn·
    ma~es Ihe acceptance cf family planning more tnle GO wbll eu crly Ihal 1:o000·ledge i., and On
    likely. s.x,aose of these many differenl ~nks lhe details of tbe Grand Alliance which must be
    berween redocing child de.ths lind reducing child forged if thi, Il.nowledge is tn be put ar tbe
    binh., a reVQluuGn in child ....mv al and develop. disposal of aU.

    "
    THE STATE OF THE WORLD'S CHILDREN 1988

    Bangladesh:
    realities of people's lives
    TM ~ Rvr81 AdV_r CO<M>IlH "'" mass n'llI<b. USInO ,............. ~ to 11"1
    (BRAC) is 11l8n1>loOl9 ro uI<e DIIT '" 8VOIrY /lOme., across nulr>\lOll " " " ' _ We I<roOw 1M, "'" pOQr
    • rill""" _
    !tom _
    250.CI'Xl d>i/df""
    delfydtatJOfl, So
    o.e /Well' r<""
    'IN. 9 """""
    dorft l>a'Ye ,-.on But~. "'" mos,
    IflIutnI>lll poeopIe '" 11>0 c:cmrnumy do ArId_
    mo</lda II6VfI '""'" _ n,., IN<<ror 01 !hey 0CCfIPl ,.... ~. !he """""" 01 tho
    BRAe. F~ /UIsItflAb«!. ~ Ihs l!ssan:r poor ~mg It are -... rTllI';tl redo.Jced.
    ~: .
    ~ ee
    QCM'IYI"OII'IIIII _~. OU' wOO:trs
    -and _ . ate now 2.500 01 t ~ _ 1I" _ to
    Atlet OUI holt r_ """'..... '" "'" ~ •. IQlIow.
    up """"'YS $ll<lwed !hAl onIv 10%of !hose reocted hcu$fl. spending h.. an """" WI\tI ead1 rM1lleI.
    _~ ~~.~ '.~ Ql!T So:! ~ ~ Jon.: ~ t....-.g IIbout ORT ancl othar WBVO 01 ll«>tec1lr1g
    01 ~ Abou' !hIl ",,'1l)nl/>1p _
    1lOIl and beh~" ~
    O>!<>rrn.-
    """"
    ~ jI. yOU I'\3Ye to bE;Jr .. """" the ,I!allOOs
    Out fntle5sorl ....... ""n
    tucllo<llll'klS'-""'"
    wnal !Ny 8<. lea<:llotlg I dIsctMtr.,. !Nt our e-J
    01 poooflIII' . _ _ R...... tel people to boll wate<1or
    ORT. lin ""'" ",.,.., Ihol 50% WII not use tile
    ..."..... _ e not usong ORT 11"+1'$"""" . """,.111 tl'e"8l>V So.,.,....- to .....- • Jlf&gmatlC <loc>-
    _ more .. Polls and,eb""•. EIu1 ah... hospotJll ""'" - llhooAd boiWJg wator bfI pan olltlo ~
    .~,
    llMlonsllOlJOm. !My _ . corrwoceo:I aboul !he
    .... an<l "'-VAl '8ClP<I WIIetlIMy t>eoan 1 0 _ . *........... """"'WJ'III _ 1alowIIbout I!w>lls lIl:.o
    tho$e """"" Il\Qy lAuQ/l1 oIS(I beoan 10 believe' an<l ORT onc:I """","",at>Dn. bIrtt\ 0l>K":IlJ onc:I _
    lila usage ,.,e
    began to rise
    ""'""'""Q. Thtn we will "" • S'f'I'O'IP'II b.Ilweor,
    We ...., le8med thaI !he . . . - c:ornrrunorv /laS Ihne _ 1 0 . ~ to • ,.. on ll>e
    to be PftIparM /or ""w ~. ~ "'"INl" have <ire«llul deiOlh rile ~ OIK ChIld,.., i(I lin
    not t16a'<l 01 CRT. 1heV ....... "'""""'"II" _ ..- _. we """ buold Pn"*Y heollh eate .. ead1
    !tom was'''ll wne ...,m iI. 0...-"'<11 "..,"1$
    _ ancl " .eeh houl;e/'IoId TI\oI 10 _ . 1M
    ...-, WIth me ""'" _ ...... ,..,;, """' , ,adoo t>etrlo has 10 boo won ,
    ORT 1>0. bec<Jme f _
    .....Ilag$$ It> b-:k ... up,
    lO 80% 01 adull males ., Bangladesh They now But CO'MUntJII. ""'"' ol3CI (lfJmOI><I. ancl IP""
    _, "* """'"
    ORT IS ICC8Ilted ~
    10 blow -'>ou1 " . SnoIarIY,
    !hIl sehooIleacner. WId !he
    ~
    ...,..,.,.,,'" ,."..,., ptOYICSo. basIC huaIth _
    _
    No
    corr>'l'lUI"OfV .. """" lleit to do lin Nod
    an ..!oIm<l<l govao-nmem b<>r-..:Ji>C'/1O """" IiI:olv
    _ ... people '" IN comt'TlInlV. I!\t<l """,*,wiII
    to 'espcond So ltIele ... Job ot ~ co do on
    be ..."..lQIV lO we It.
    -~~
    TO crwte lhl: tim¥.e 01 a:xep(iI<ICe me¥l$
    Some"",","1 _ booen(\ls(:(l<JrOl/OO. The~
    """'9 ew<y CI\IlrWIeI 01 ~ We """"
    8090 rQiOCl'o~ .. not usy We""," relICl>e<l 9
    "'" up lc:..d$po...... ..-.;l demon;traoon . ,. "' ''''' "..", women 01 those. a!><;MJ' 40% n.", ~
    m ¥ b l ~. _ .... onpotllll'll ~
    to uso OR T AM 01 trese. hall or" ll$II'lg It
    tl1IOn CIItIttM '" ",,81 BangIedesh We mal:.o ..... oonec1lV But d ... _ ......... lmeet> "'.... I.m
    .. t " - ' u... t/Ieir pupil. '" ORT and oncouroge <:en... !hot ORT onc:I _ ",'aI Marth ~
    lMm 10 _ hea:Ih me"ogeo IIOINI
    ..... nol ""~ bfI _ to 100% 01 800'98de'"
    motheB-lheV wilt OISO bfI pan 01 our cul:<,o-•

    .
    But befo~ dilroMing fun htr Ihe p<)$Sibijity for JlO""ers slruult wilh the nK t5UlY rtllrucruring
    anolher greaJ adv. nce for cbild~1l, ;, muSl be of lheir """" economies.
    ad,nowlt<!ged ,ba, both pa" achi....t mtnl and
    pr•..,nt polenlial .re IWW Ihreatened from behind Wilh raw maleria! prices at Iheir 10"= levels
    by .nothor of tht ~al force. affcaing lhe daily for th;rt}· ~..... dtb, Sto!\'iti ng claiming approxi.
    Ii"". of millions of pc<IpIe '" the dewloping world mately 25% ofthe third world's revenues, a 609i
    of Ibe 19805. drop in bank lending, a long period of 'lOgnalion
    in overseas aid, and a fa~urt 10 solve international
    ecooomic problems affca"'$ both rich and poor
    worlds, lhe nIt of per "pll' economic ~~b
    AdjuHaKD t tD recnolaa b31 been negative or negligible for rwo thu ds of
    the developing narion. in the 1980. (~. 7).
    Tha I Ihreat com.,. from tM lingering rKcssion
    which still rt$IS its crushing .... eight on much of Because Stoveril of 1M mOO populou. countries
    the developing ,,'orld and which appoars unlikely of Ali., including Chin••nd India, h. ve ~n
    10 lift in Iht )"t.rs immodialtly ahud n lhe able 10 insulaJe IhemStolvcs from 1M 1I"t1f1l of the
    Unitt<! SlOlC$, Japan, and OI""r major indum ial rK....wn, the number of pc<Iple living in nalion.
    wi,b zero or neglll;"e economic growlh in the
    1980. is estimated at ever 700 million or jusl
    Fig, 7 Economic growth in the unckr 30% of the dev.loping wo,W's popul.tion
    (fig. 8). Bu, three quaners of ,he rounuies in
    developing wortd, 1976-1986 AfriCl and Latin Am. rica h""e seen their av<:ngc

    ~
    ~ 3
    : ii" om.... faU by lS% . nd 10% ~~ptCI;v.ly during
    Ibis decade." And in Afri~ -from Ethiopil in
    ,he e3Sllo ,he ale d' ivoirc in "'" WUI, Ind from
    Ihe Sudan in the nortb to Moumbiquc in Ibe
    sou,b - rhc ph)"ical and linancial droughls of
    2 recent )..,.... combined w;lh r.gionaland internal
    t confticrs, h. ve wilhered I ",bcon,ineol almo.tlo
    the bone.
    In I(l.'neral, lhe ones who have ,uffered 'OC
    mo" from thi~ ,«usion are the young children of
    poor communi,i.... in .1TC'C,ed munui..... They "e
    Ihe ones whose famili"" h.ve least scope for
    mlking economics and have therefore had 10 CUI
    hack On necessities. And Ihey 3~ the ones who
    arc mOSI del"'n denl on ,he govemmenl ""rvice.
    and ",bsidic:. whk h so many government. have
    fell obliged to cut back a. I "" y of Idjusling 10
    economic rK es.sion,

    .-. _...., h canner be messed 100 enen Ih.. ,h. young

    ---_
    t976-80
    " 82 83
    ~--"' .... '"
    I'-" In .... ' teO 0-
    .-..,
    ~-
    85" ee- cbild (lnnO! just 'ri ck OIIt' ouch period. of
    l usteriry. Ninery per o;eot of the Ktowrh of a
    human bnin and mtlCh of 'be growlh of Ih.
    hum~n body is cempleied in the firsl live yearsof

    . ._-<>'-
    ---- - --
    life. A child who has 10 go wilhou, adequll' food

    -
    •• UN Sect-.ol ~ or heallh care in IhOSl: years will nOi ~ow 10 hi!;
    or het phY1ical or memal porential. There i~ no
    ..... SC«Ind chance.

    "
    THE SI'ATE OF THE WORLD'S CHILDREN1988

    In the 1980s so far, morethan 70 gcvcrnmems Imournoo to. And whll it means '0 millions or
    bave had to adopt «<loOJrnic 'adjuilmcDt policies' small ch~d ,en, "'hen ali lhe fin.ncial euphemisOlJl
    in order[0 reduC<! hmnc""r'p"ymcnrs deAci,s., of 'Kossion and adjuSlmeOt are sn ipped away, is
    honour debr repayments, reduct- iollarion, and try thaI !he once·io·a·lifetime chance for nonoal
    to gC1 th. ir Slalkd «<lnom;• • going again . In growth musl be forgone.
    most clt hose nalions, such pol icies have inoclved
    cuI·backs in government ClIpend;rUf(! on rill' Allowing this to hapl"'n is I di,g;race 10 the
    present .nd • threat to r11~ future'. II is the
    social .. rviCfl and on .., bsidi. , for ' l.7.pl. food.. 3Otithl/$is of civiliu,ion. h ;s a process which
    Si""" 1983, UNICEF h... breD gleaning ..... i· shamos .nd diminishes us all.
    o;kn~ of the im~l..,f these proxcssn on the weU-
    bfing of lh. del'l'loping world's children.' The Thece are pr""tical al[em3lives. And the guid-
    ing principle fo, those . hemati,·cs is rooted in Ihe
    need for such. special $lUdy, and rhe paucity of
    W dara . vail. ble, i. in it$<'I(. pointtr to ,h.
    lack
    of priant)' gi"cn to lh. protection of children in
    de,·t1opmem esperience of ,he posl·....r era. For
    ill$! a$ ;1 was ne.:essary 10 fight for 'basie needs'
    policies in the 19705 ' 0 Ify 10 ensure ,hat food,
    dillkllh economic time.. 1IU1 the r~hs to date
    health care, Nutation and housing for !he poor
    UIow thai rh. " 'l'U·being of the youn~ h... been we,c given some priority in a time of economic
    mc..untbly del.noming in at I... t thirty notion< gl"O\\1h, so ;1 is now necessary to lighl fo, a policy
    llf the de velOping world. In many African COlIn·
    [rica, for example, malnuuirion is knOWll lo have which protects what h3s been ""hie~ and makes
    ~J~ In!! !~ p!!'x d9OO! !'Jff~r !!~!'!.IpQ"km!!~!y
    increalled. in a period of eronomic decline.
    Heahh care and edoollion h.tve ilio mFrer<'d. Tile specific . ltemat" ..,s to currem adjuslment
    The number of qu.tlified Ie"""",, Io:n ro Ihe stralcgies hal'e been set nul in a special UNICEF
    edu<::llion SYSlem in the enly 1980s " '3S4,000 in report published in 1987 under tho litle Adj~lJ·
    Ghan. and 7,000 in Zaire. ,,"~I uilh " 1r~"",~ f<U:t.' Al tneir co,o ;., ,he idea
    This yen, in . ..mple of ,en roumries sele<:1ed tn3t lhe offccr of adjusnnem policies on the most
    by UNI CE F for moll' dmiled s'udy, malnurrition vulnerable seaors of $OCiety, and particularly its
    1''"35 found 10 have risen in five, child death niles children, should be studied in advance, ,ha, such
    hod ri",n in ,h,,,,,, :rnd school .nend:rnce was policies should seek to imp,o"e Iho productivity
    falJjng in eighl. and incomos of ,he poor, and Ih.l lUbsldies I nd
    services which form part of the fabric of $UrvivaJ
    $hould he rdnfor«d ....[hcr than discutled."
    A bener .. ay
    So il ;,. th.t the greatest burden of ,ceessKIO is • ,l'iwU_ _ ..... . _ j.<,• . . - I')" m"...... Conw,
    being; I»~ on ,0 Ihe w urn, and m~1 lUdwd }olly.U>J F" .... $I....... "I"'tubod .. Ena\iIb .. _
    . . - I')" <lo!<>ol U _ y ,..... .,.j _ " . """"'1'
    '"Illnerahk m=bers of 'M world community. .... Il..Jio<-1loJmrma, BruiI ISiD hulo l. lJIal.. C
    -.
    No[ even on economic grounds can .<U<h a 1 _ !'<no. <k I'M.. <k 1t<potIIi<~ """''' Sri t,uob,
    process be fus,ified . S3crificing ,he gTO\'1h of IOI! :t.imbabo• • I· 1 " . . . - io F........
    1.'' '_ _ _ I F . - !'mol. .,.j I>o<lI
    I«by's children for the growth of ,omorrnv.·'s ........... tvIibbI< io SraDIIII .. " 1'"" _ """" ~
    economy mal<cs neitMI =nomi< "",nse nor I~ XXI. ~ >ih/l.
    human sense.
    .. MOIl 0"''''''1« """""""" W-""'" poloQoo _ -"'
    Yet that is wh31 present 'adjuslment po~ciu', fIN_I IIdp . 114 " *",, · ~l· "Nil fr... til< I. " "",OCII\>I
    M-.ry Fuo.I (IMn I.oj_ .I1 \117, tMF M,....... Il>t<uo<
    with not. ble este'pllons in some t:OIIOtries, ha'''' .Iloilo<!
    '!dId NCamiI<sMn[.......
    told "'" "'-'< nl SocoaI C.<IlIICiI 01 "'"
    111>I __ ..
    ~I'..u ~ • .IIa
    ".,...'" " -" ,..."..._ ..... dto "'fI/<'IId " . _ _
    """"'?'- " , _ ..... II.< _ _ '" bophf_ '"
    • ([Nlt:J;t""$.8nIlI"'<I>I w.!y .. d1~ I ~• .,.., ~ . , _ ...."'••" .. _ " " .. - _f« ,. _ ... .,--.
    "tt,... ... ,1nIJ_ ..... poI:obJbod io 10IcI. .... ....... ..
    ~ ~ .. '".lm.... ,. _ _~

    "
    To the argument 11m mese services simplY primary schools, city hosrnals or rural primary
    ""nnol be afforded, Ihe an,wer must be rhall h,,;, hl'IJrh care dinics, card..c research or child
    again a quesl'Oll not of in""irab~ili~'S but o( lmmuni.alwn prognmmes.
    priorities. 1:,"Cn it" a government has ro nuke II is It thi. poinr rhal the ",hole issue of
    .....p 5pMlding cuts, t/ll>~ is a choice 10 be mlde
    idjultment 10 eccncmk reecnion joins hands
    l bout "" "<:l ly wbere those run . hould be made. In
    ddence 01 in rhe bullb of ilS ptOplo, In ""Midi... " i lh the main theme of tbis report. For ' adiust·
    ment witb a humIn (:l<:f:> <lorsnOl jusl mun lbat
    ro narioml1 airlines oe"ing rhe licheol 2,. Or 10 =nomic eonSlra;nts an be dlSt'Cguded. It
    n>lional food progr.ll1llM S srlViog rhe pooresr
    melns, rather , thar the maximum prOlC<:l ion for
    20"1 Aod even iF $JM:oding on hel llh I nd the most vulnerable hilS ro be oquceZN from
    ooduc:llion does hl~e to take in share of Ihe every dolla.r " ..il:lble for health c>rt, edllCltion,
    financial s1l.io, lbere still remain, a choice .il1xM11 or social "·elf..e. And tbe re il nO queSlion at all
    whetber 10 CUt ioto Ihl' budg<'u of unjvemlies 01 Ibal lbe maior opponuniti.. for :Khie~~ that
    aim now lie in mobilu,ng eltiSl'ng ""pacl')" IU
    mform and suppon parents in applying roday's
    Fig. 8 Perc&ntage of the developing Itoowledge aboul ....h b""ic heallh ><lion. ..
    world's population living in countries immwWal,on, ol':lJ rehydn rion rhenpy, binh
    with zero or negative growth in per s""cing, brtUl·f~ing> safe we~oing> growth
    capita GOP. 1979-1985 moniroring, rontrolef rcspinllul)' ,nf«tions, safe
    ascc mothe rhood, Ind b..ic hygiene.
    ThC$e art Iht m ~j o r M rrlegrounds u( c h~d
    D T01al 1965 poJ,Uat'oo helllh. These .,.~ lhe orelS of mico which could
    cur child dealhs I nd ch~d malnurririon by half.
    2 .000
    D 1985 poputaliotl WI The~ are rbe areas where pre sent ltnowlC<lge
    g Cl.1UI1trie$ WJIh zero
    Of negatiYe growth
    rouId ~ mJlO"..r plre nrsr h~ m ..h·cs to prolcellhe
    lives and g"""h o( their children. The se are Ihe
    ~ 1.500 , ~,
    l rel ' where ><:l ion is possible 11 such low cosr lh~ 1
    ,t can be afforded by a111111Sl I ny nltion and by
    i"
    J t ceo
    a1mO$l any fm ily even in such diflicuJl ecencrnic
    limes.
    To mobilize I oociory's niJting ~SOIlr<:eS in
    order rc in(urm and support parent. in rhis way iJ
    sec Ihe key ic 'adjuslment with a human flce'. It
    make, il po5$ible lO prOIC<:l the vulner.lble, e"on
    under ecencmic pressure. It demonstrates a
    pnelical concern for lhe "·ell·being of the maiur.
    iry and nOl iust the wte. It i. Ihl'rtfore nOl only
    more civilized and mure humane. II else makes
    murt economic .nd politi",,1seuse.
    Some coumri<:'S art al1empring to pic neert hi.
    response to reussion. /1rdownia, (ur example,
    faced wilh the need to cut """r.ill 5pOnding .. s

    a
    _
    rcsull of falli ng oil revenues, has CUI back ilS
    hoopiro i","Cllmenl COSts by 75,.. Al Ihe sa me
    rime, funding hIS aCl\l.OUy b«n incrtaocd 10
    W1ltI " " ' . . . - 01 "'" t9llOs. "'"'11 _ _
    _ 1,,,:<._ """""........ 'o:zt1llt '" "'"d. ' . ~ o """"lel'llle the de~clopmcm o( lhe ~1fdl4
    "----"'----
    ," ,'. - (200,000 of them by Mareh 1988) which art
    providing immuniuriuu and fl mily plan ning
    THE STATE OF THE WORLD'S CHILDREN 1988

    sc rvic~ and assisting p1.tcnl. with oral rehydra- not ,,·idely appreciated in rhe industrialized
    lion [hen l')' and grOWl h monitoring, in Over nalinn.. perhaps because irs a uotS <::I.JIhOi be S<l
    .17,000 villag... I~dj" is . too ,..l....ining cspendi· ",adily Ilndersrood or ils consequences so eas~y
    tun: 00 hospitals while s'''J'ping up prognmmes phologr.lphro ., thc delerioralion in the physical
    10 pro'ide immunization and other vilal l"",..,.",! d im, le which ~ !lKome pan of oot sllndard
    services 10 lhe majority. Oil, h.s m-reued its imagery of the developing world in this deade.
    spending 00 social ..,rv~. ,• •gt'IW 10 the l:Illllhe change from the 70s 10 Ihe 80s hu been
    poore.. ,,''''0 ,hough nvo F.l1J g<Wernment eIpcndi · such thai Ihe nel tIo\\. of financi. l resoo rces
    tur.. have been CUI back. And in tf/grritl, wnu" between rich and poor worlds has been almosr
    spt'nding cuI! h.ve ~n made lhi. yo", in every romplelely reversed in lhe la.1 fivt y..... FigIlll'
    mift istry exC<'pl the Mini. try of Health, hDSp;,.t 9 show. ,hn whcn aU the calcula,ion. lie done,
    sprnding has.tw been MId back while lht n.tion u king in,o acroum aid and loans, inreres' and
    ancmprs ,OJ pul 0 ",1 rehyd....tion the....p)', imrnu- amon;zauon paymenls, m"'Slmenrs and l'l'IUrns,
    n~lion, and dean ,,,;uor at the disposal ofevery IhI' oollom line is lhal lhe del'eloping world
    r.mil), in the 03';00 . lranSferred ever n o billion 10 Ihe induslfialized
    world in 1985. Thor is a dramatic aboul·face. ln
    1980, lbe net transfer was ever S40 billion from
    Ihc rich '0 lhe poo,. Even the World Ban): and
    1'Ia ioteraational rapolllibilltr lhe Inlernarional Mone1ary Fund Ihemselvts.,..,
    !!!!W W,! recipj~n~ Qf moolm:! from Latin
    BUI 3S ee new UNICeF report pointS O<lI, "for America and Afrin. They havt been sin«: 191>4.
    1<>"" co" nrri", nlU;l»Ial INtiDo at"", .........". lit
    And, ",ilh currenl polides, lhey ,,·~I be for the rest
    nif!id(lll, """ wif~ Ih, OWl hnvic po/iliad IfItd of Ihis decade." And ail lhis has been happening
    «OIfO"'~ tlJGTlJ~." IfloDg.tCrm economic grOWlh al a rime when world priCl:$ for primary prodU;CI"
    i. to be re' torn!, and if ,h. mOSI 'o'Ulnenble on whil:h moo developing nolian. are srill sc
    members of society are 10 be prou'eted in ,he heavily dependem, are ar lheir 10....,.1 level. of
    proce~ then Ibe indwnrializcdwolld will have 10
    modem time•.
    offer fai~r aid and trade policies and MM'
    financial help. Withoul it, '~joSlmenl wil h a This financial famine has 10 be ended if~h
    buman f3~' will be a sIcguI wbich wiUnever be is 10 be reSlored. And il h., 10 be cnded qUlCkly jf
    ~fleaed on Ihe face of. child. lbe mosl vulnerable groups, and e5p«i.illy Ih.ir
    ch~dren, are nOI I" suITer III the: meanrime.Ir will
    In many nallom loday, ch~dren lIl"e gein!!: mean Ihal many debrs "'ill ha"e 10 be wrinen off
    "ilh\l\l1 food or heallb care or "hooling bI:elllSe or reSlruetlued. h ",iD mean rhar levels of !'eal sid
    of a financial droughl ,,·hich emnOI easily be and w ncusion. ry loans wiU have 10 rise again.
    caplluro by lelevWon camenu . Yel the lack of And il wiUmean Ibal privare e<>mmerciallending
    financial rl'SOUfCl:$ n n be jusl u harrowing .. at reasonable interest r.le. wlll have 10 be
    lack of r.infaU for thme who an: ilS victims. In resumed, Only increased co-openrion among Ihe
    l:Imil alone, for example, an estimated 60,000 iodumialized coonrries n o achien thi..
    chiWren haw: died as a 'esul! of recession in Ihe
    19l1Os.ll In the oIigbtly longer term, the re'lOrarion of
    economicgrowth ro la,~ areas of the developing
    ThiJ oUis is nOi only of the pool world's "'Orld ,,'ill depend, moll of all, on an e. p.nding
    making. Despite aU j»s' mi"altes in policy or "'Orld economy .ccompanied by • redunion in
    priority, me facI i. Ibal many of Ihe d emem. ;n
    inreresl rales, a range of commodity agreemenrs
    lbe economie Slonn_ falling rommodily prices,
    bigb in<erm rale.. In unstable dollar, fluetll3ling 10 secure fair and S1able price. for raw malerials,
    and a rolling ha. k of the prOlCClionism which i.
    oil ~rs, falling aid levell- bave been beyond
    the mftuence of lhose who han been bardesl hit, gn.duaUy slifting lhe Ihird worW's abdily 10 seU
    10, and buy from, Ibe industrialized world .
    S~h a dramatic delerlontion in the economic Difficult as these measures mighl be 10 agree on
    dimale for the developing world in lhe 1980$ i. and c:<.>-ord inate, r~y a« in lbe long·l.rm pollli·

    "
    Fig.9 Decline in net transfer of tal and «<Ioomi. 'merell. Qf :ill nation s, the only
    resources to the capital-importing sur. foundation for sUSlsined prosperity, 5lab~;,y,
    developing countries, 1980-1985 and peace.
    r7l lndUstnalized to r7l ~ 10 As • practical beginn ing for !Ius prlXf'$S, any
    I!:.....JcleYetlpillll LJ IrOJstri<*led governmeQl which now demon,mlle. a will.ing-
    countries countries nciS 10 p UI lh. poor first, to U2 ill power as •
    shock ab$orber for the mosl vulnenblf on the
    rough lVlId of ~$lion, . hould nOW have the
    gen erous w ppon of me, in dosui1 li ~ed world. f or
    n lhe Director of Oxfam UK has Slid: "Eight
    hu.lirtli ",j//1M proplt U'lro spt"d /'lin of t<d yr"
    "'abwlnUk,d "",I ),tlp loJay. nIH in 0 /ltlI<rt lilt
    ll'hm - ~ltr ji{r rm ~rs of «OlIO"';! K'W'II, - Ihn r

    ......
    ..._,. .".
    flMM"''''tIIlS art btll... pla.td for rrspo1ldillg 10 rke
    "ttds of Ike /WOr"
    Butfor lh. indmlri:ilized world to play its pan,
    to Ih06e "'ho r~ and sh~p" puhlic opinion also
    """~ have a difficult and urg<:nt job 10 do. Somehow, a
    °1960 81 82 83 84 85 1980 81 82 83 84 85
    new elhos has 10 be crealed, a new etbos whkb
    sees the 'silent emergency' of froqt1<'nl infection
    and widespuad malDuuil ion 3$ being jull as
    unacceptable as lhe loud emergency of sudden
    Net transIer of rescoces between induslrlalizad lIam llian. The former AdminiSlr.IlOT of the
    and develapilg WOt'ds United Nalions Devdopmenl Programme, Brad·
    50 ford Morse, has called fOT that new elhos in lllMe
    words;·
    "WIJ"" 01U. IMy ltd M fi</Iy inlOTmld. Ilr.
    fIlOpll l utid 'No! ' 10 Ilr. Jptrtrl! of .auUlroplr<

    , Jf'mu/i/lf a""'/If 15 miliUm of Ilrri' "'I"",ed family


    in Ajricll. If Ih. proplll al lh. Un;I" Nllloo art
    ",abi/iu d I" U1y 'No!' 10 11r, prmrnuu fKnJl"Y in
    ft hid 800 ",illitm of IIr< k>t",on pUffily liw, "nd
    dellUUld Ilr. ft41 lIfObil;salwn al Ilrrir gom'1ImtnlJ
    IUId of Ihe UlfiJeJ Natilm. ')"1m! lUI" 01,,"

    /
    IIIolrilauNl ,'IUI",IIItllllliiIillIO Illiad ;1, limo il con
    I>r dOU, "'1I
    finall y, if lhe principle of prDlCC'l ing lhe mOJ1
    vulne",ble ;SlO be 1~l<cn $C1'iou<ly, lhen il musl be
    a precess which can be mooilored and mnsuml.
    And lhe 1m is 'h OI w"" reas mosl nllions can and
    do produce u!"lo-dale quarterly statisti" on the
    0,,.,
    _ 01 ".". . _"",
    at

    ----_. .__._--
    TIIo.Ir>R """
    _ _
    ... 1 ••_ ,. " _ .... """ p<Imo ~
    huhh of lb.it <OOI1Qmies, f"'" nariens can
    produce e' -e n annual sL:ltistics on lhe heallh of
    lheir children. This failure 10 moniterrbe elTCC'IS

    - -,-
    ref· of economic and social thange1 on lh. lWU·bcing
    _ _ " """ ..,., .... no . ... _ "' .... _ of lhe mOSI vuinel1lble, ~nd particularJr. on lbe
    growing minds and bodies of young children, i1
    bolh a esuse and ~ symplom of lhe lack of polilical
    THE STATE OF THE WORLD'S ClllLDREN 1988

    Turkey:
    sustaining an achievement

    _
    In la,,, 1985, Tlrtey maunie<! one ol lhll most
    """"eo...... ~""" cam~ ..... .--.
    o.e. 4 moIooo cIW*en were WICOt'oted _
    tot IhII """" .....:one-
    ..... to ...... IlO%
    toveI'-
    _.-
    new

    o TheeaInlI
    acllOtI pOaslblo CIUmg ,tie 1" 1

    ~I """ ,,,,,,,,,,,-,, "" oppeal 10 tho


    ~

    "'lJOO, on all paI""lS ~ tt- 1(1


    P''''''''''- """'...... kJ • 'esull. """" 3 """"""
    cases 01 me...... wI'I<lOpo'lI cOUl1' . _ polio ~"" ..... "'~ . . "'_ _ 1(1 help
    - an<l ..., O$tu1ia1ed
    _'00
    22.000 ell... """"lS-W8Ie o All 67 P'<lW"OaI ~ _ _ " ' _
    lMl. lI'f'It'l'lU!'Iatoon COI'eI'og,e IS expoc'ed lO ra l"",
    AI lho; _ mMM 1Xl't_ by SOCiIII rno<>oo:OlOOll '0 IlICl% '" 8\t<lry _ e t>v 1988
    on " gr_ ""... _bnngIng lOgett>et the Matm o NI 67 ptll'o'WlC<el _ (lorlO<:t(n " - mel ""'"
    servo<:e!i••ee eese media, lMIr 200.000 tud>el5,
    """" t'*' 5O.0lXl onamo. ..., _ Q/
    on. CCl'JmIlfPa''" '" lI(Iocaoon. lot lho Inll""". 1(1
    _ , "'" per"'-'! support 01 250.00Cl pnm&r'f-
    ,.,."",...... !mm the Iknarv 0Jbs. 1M Red C.....•
    co'''. IN ~ "
    .-
    _ , . . - ... PfQT>Olltl(j """"""""'''''' .....
    Il'''''PS. _ the lions Clubs
    ether ~l:!l!: "".;-~
    9ul M>CG ""', 'IINI. 3 _ ' - b-.
    boon bom or> Tur'o<ey And (lY(lI 1 5 ......... more WII
    ~
    o T~ "'" 'adio",omo"", ' 01 ............_
    hao "",,1If'Iued, ..,., &>;>aMed ",to 01l>er _
    be born ., 1988 Ate!ll8V 100 t>tonu ~1
    And .. ..... P<QgIess beong made _ d s more t1ea/ttl "-,agee. ""lit "'" $UPPPIl or ~
    CQITIpr-""'" prm"'Y _ carel !lgure1 ""'" tho enl..,........, _

    In .... ...",,'" foIcw,ong IhII eampaogII. ",• . - . . o N_ ...........,a11Ot1 mu:>d1 h..... bOen tel<! '"
    Mal and pOor", lIl1>.-I are...
    W8$ dI$QI.oIl"'O The heallh _ . &00 .. who
    hall helped on !he great _"""'1.tao\;s.
    3I1ee!JOll1O otne<
    ",st"" or
    $row
    The rnoJl IS 1IIal omtrrI.If'IIlation ClMIfage. ncm .
    lo.rl'ed _ "' ~1 r.gr, PI'<Vlll' .. "'" pa<manant """""" _
    , . - m...,. ~ ~ _ HoOclfvs. C¥I- ",0(11""""". hils ,,"en "9H' 10 75% lot OPT Ini
    ceIIecl d<n>g IN campllIgf'I. were lIII<MI. And IhII POk>. ..... to 50% tor me.sle1 (Augusl 1997
    Ollle<em gowrnrJ"oMt ",....1<,.... 'MlK:tI htd....oote<l !IgIns) NlI'W !XIlIcles. ondo.cl"'O ~l rnmu-
    t<>ge1her ... . ~. began to 00 b8ct '0 m- nil"",," t~... II at OUI-po""", """"'s...... 1>8ll>
    own tU'l
    bOrn , and """","""anon cove<_""""",Jed I"
    "1_. child,,,,, t>eoan 10 fill
    be 'II $U118;ft 1I>Ose rnprl'lSS<Vfl _

    TurkeV·. new comnlI1menl has abo ca~


    Thft Mnol<y 01_ \:mw t~a1 .....,., tIad liMn 00- "'"""""" _ care aetoon ~ I>os<>o"'" Mw
    won was "b,"le
    not. _ The campIlIgII"&d ...... /)fill te/Iy(Va_ l!IeraI>v ".lMldard Pracuc..
    ""'wed 1hIIl&r1l" booCklog 01 ~ ctokI"", The MC\OfS 01 .. n
    medcaI jaa.lt>e. and !he
    _ ""'ted T..-I:ev WI on~, which ~ t..lOd\l o! ~I"C clel>a"lmenll ..... ""~

    of """1WIong \tIo. _.mel" .t. ",n'l,'' ''''' ""*'


    become • 1Mlte< 01 nauonoo' pncle The NldeI 10K

    BuTIhII ~ hi<! olso H1 chid ""aim


    _ ........... S".61"ljl1il1 ., ... medotal ..... ""'......
    eumcu!' A81r- . g ptOVlll'fltrleS "'" bHIg _ '-"
    for all plOCUSd\ll 00Ct0lJ and "'"""
    on "'" na,.,..,",
    8g<I<l<liI And lhII..tabhslvnenl of" Tile -0'1' ..... (:(lrnIfatmerU _ ., ~e
    ""'.......,.,." _ 10 ...........,., .. ~ en ., ""'" 1985 os n-fIIote h6IIlIf'IU to __ tho ~ tow.... os
    "'., 1'1''' of 1<1. NIl t>ecome IIUCI> on •• '~ more ~l and COfTIPIahe. &O'll prmary
    gooI IMI" WIiI ~" ..._ ~ In .. tie""" COfIt lot T..... oIl r;hIIdr "" 9u1lho au--
    not _ I:Jy 1990 ThI CIU'Ill'I . lIS leaders.
    and 01$ fleaIm -,em. are conwntled 10 lIIat
    menl at a .......... sat ¥id WS~ """"""".,1OtI
    PIOO''''''''' Ily 1990 .,. stands as bolt> !tie
    '¥O"l. And WI CO<l\fI'Wr>enl IS """ hils made Ivmt>oI and lho t..., 01 tha, COlr ",ri,."

    •
    priority afforded 10 lhis u sk.. Yet there could be more ~nsil ively moniloring the nutritional health
    no more irnponam tcst for any governmenl l/Illn of I nation's children so Ihal, IS with nalional
    Ihe 1"'1 of "'helher or n01 il is prOlccring Ihe economic indicalOrs, Up-to-d.tC qu.ncrly figure,.
    o.tion's vulnerable .nd whelher or nOI it is an be pllxlurnl for politicians, press, and public.
    proto:<:fiog the n. tion's fUlure - . nd its children
    sre both. Progress IS measured by such indicators shoukl
    become both an . im and a mealilre of develop-
    Today, the indiclors for mearouring the ""r· ment policy. In timl'S of ecenomk gr""1h, lhey
    f"rmam" of that dUty -lhe quanerl y ""'asur~ could re"ea! whelher or nol Ihc peeress groups
    mcnl of, for eumple, challg"'S in child nutrition, were sharing equally in 'he be~6lS of tbat
    immwtization ecvctagc, and me prevalen~ of gr<lI01b . In leaner years, lhcy WOlIld reveal
    low bin h·""ighls- arc nor even in plare. [ndud "'helher lhe poor and the '11lnerable were MIlTcr-
    we know far more about ch. n~s in the " " ather ing disproponionately from the elfects of reces·
    or in viewing 6gurrs for telCVlsion shows, or in sion and adjuStmem policy. l1lcy "'OIl ld also
    consumer preferences .nd Ihe mon'hly sales of sern .s • guide 10 lbe fulfilment of Ih. pr.sent
    video r«ordCl'l, th.n " " OO IOOuI chl nges in Ibe potential for significanl low-OOSl progress in
    outritional huhh of the under·fives. plotccring the lives and Ihe norma! growth of the
    UN ICEF, W HO, Ind Ihe Food and AgricuI· developing wurld's children.
    lUre Organizalion of the Uniled Nalio", (FAD) And it is 10 Ihe question of h"", Ihl polential
    ..... now co-<Jper.ni ng 10 find wa)'l . nd mu ns of mighl be l'eal.ized that lhis repon now rerums .

    Family knowledge
    The polenli.l for making rapid progress in of the 'green revolution'. In both C3Sl'S, many
    reducing child del ths Ind ch~d malnutrition, millions of families ba'~ tlnn empov..ert<.! to
    even aglin s' the uphiU gradient of reassion, improve lheir own Ii,"" thl'O\lgh the dissemina-
    ari.es . 1 ,his time because mere is nOW I greater lion of available knowledge and affordable lech·
    ga p Iban ever before in history betwet:n what bas nologies.
    been di$WVer\'d .nd wh. t is being .pplied,
    ThaI same strategy is now beginning 10 he
    be",'CCn whll is known to health professiona.b
    Ind Whl l is being m. de tno,,'11 10 p. ren1$, used to PUI twO of Ihe most ~rfuI of aU public
    health Icchnologies., immulU2Ilion and ORT, It
    between wh'l could be done and wbal is being Ihe disposal of. signi6a.nl pem'nlage of the
    done. wo rld's parents.
    Tod. y, in aU nllioos, organized social reo BUI IS yet, the surface of this 'social mob~iu·
    have reached the le',, 1of developmenl It
    SO\I1'tt1 tion' po1em ial has hardly been Kt'3lched. And the
    which it is possible to inform and suppon the elfon to usc loday's rommwtia.tions ",,!'Xiry to
    grcal majority of flm~ics in u king advantage of empower people with led.y's knowledge cann(lt
    loday's knowledge. But th.1 n.... capacity has 10 be limiled 10 .hon ·lerm campaigns.
    be conKious.ly mohili!ed.
    Social mobilillation could also be used 10
    So far, Ihe masl significanl eJlllltlpl., of social empo"'er .P""l:'le wilh the knowlcdlle 10 improve
    mObilillation for dcvd opmenl objectives have other basic dimensions of tbcir uve. II could
    been the spread of family planning Ind Ihe sp rel d briog improvcmcnts in housing and ""let supply,

    "
    THE STATE OF THE WORLD'S CIllLDREN 1988

    India:
    the threshold of immunity
    A mockooJ'SlI ' ''''- 01 india", m-ntnlItlOn re\ngefaled dlstrJbubDn. ond ll>e U......... 01nealm
    etltIt1, tt>o ....ges, ~Q. oug.ges.. . <:au1JOUS """"",,", "",,-,",u. tots and • 1lM to bol
    0IIl0lT"0Sm , A ~Nt...-ge II ~ ~ JI""OG<l as r~ In 1986 , for ~,
    tOWar<lll 11>0 ~ <>! 0/NIVI0I'IQ .. onl..,.. ...... 4.800 <:lOC'"",. 12.000 ~omedocI. ond 30.000
    pregnant women by 1990 8Ill ltoIIe IS equally no 01h9r comrn.nty wo<I<ers.-e Ir _ to Mip ...
    doubt tt>a1 ori( l!le ~ ngorous local plannwIg "'" etton S<ler<I_ of oil . .... _Ttl tIo!P¥t.
    _ progr.........e monagement can ' OIM """",,,",a- men.. _ I<e'I' people ... ""'" Stal<llHlrranatrlll "'"
    1100 _ III trMt 'egoons whoch ,!Ill I.-g behn:l iltO r\OW beng trllllled evary _ " ~POl1
    The.t_ _ 1>ogI1 Inll'oeearly \980&. v........... Bul rM<:hlnll_ .....,"""'11 . ..."""""""" rnmu-
    pr......,_ doseases we", "''''.:$<1 10 be cJaom. ""suon coY8Ioge of 80% or mor. "'" 6Sp!In(l JUSI
    "'II lhtIlIves of 1 miIIOn chOd<eo olM\I3Iy as much on ClHIlnU !he demiltld os on enounng
    1"" ~~-"Z\' ~~ .. tho suPPiV. And ,I .. the tlemsr>cl SO<Ie whd1 ...
    ~ !!f'l ~ ~
    1965 """'" IN I'nme M....."" <:<)<ro(J>Ue<! !he
    natlDn to llr1I'\'O'fUI ~llOn ., . "1Mng memo-
    ,"'-
    In 8V9fY dllilllCl . ,'''' plsn os to rnol>*te ...
    .... 10 1lIe mem<l!'/ at o;ha ~. """'a
    Gen<I1i An ~ convn.ncalJonS resources to faIM pubk
    E>::>anded Progr......... of I..........,.,.,.,
    was lllrNttf ~ 01. 1M demiltld lor. tI>e J.- WCCIII8IJCln
    '" epe<0lI0rl "' .. of """,,". 420 <lIS" ", .. . Wit"'" ot "II"II_ M~ol~,_r~
    lIIIl StfuOUl>. !lie plan w ilt to """'" OO\nC1 by Ioodenr. asSQCll!lOflS ot huh/> proIOOOS>onIIs _
    doslnC110 "cIeepen" ............_ """"'_ ftam ""
    _ _ _. pSnC/\Sy.t1 ",..".,.. _ cocromu-
    _ _ at _ 30% to 80% 0< more
    roly eIder"o. SCh<>OIlO""'*" ..-..I c/>IId COfS wo<I<ers.

    In 198 6 . ltu plan ~ lIllo acl""' .. 92 of tho


    spott'~""" ...... tII/I kllI; _ , W(JtI'>SJ\••
    lJI'OUP$ _ VOU1fl <JrgIIn<UI...,... r\OW bell"'"
    420 <!oo1rW;1S Tho c:<l'<ef.ge _ so f.. IS 63%
    for f6 _ paIoo . 58% fa OPT. and 4D% for ...... (0 SUIlPO" I"" hNl1/l WI\IICeS PIQITIOI!nIi
    ,t>e """"",",suon ........ _ So fw . !of.....-ns>lo.
    mu_ . n- f!IIu'" compare WIlh ....1"'" 500.000 lndIon pnmary-l(1lQOI 'O~ l>M
    average ol 33% b TB. 30% ftI< pCI/Io, 35" fOr been """"ted on ...f..", ...............""" _ pmted
    OPT . ...... !l'J(, for measles
    IN,...... '""'" been dismbJted """"ell' lI1roulI"
    In ottwo" WOf<!l. "","""age h", "...., rougtOy
    doubled (end lor "",osleo ~edl .. ltI8se 92 -~-
    Rolj;o ond televIsoorlOfS ,eactung ",,,. 01 "*">s
    <lIs:ncIll. 'MtIllllmosi ' QUIIr1ftJ olln<;U', [IllIlIM- wnh !he ..............._ ~ . And on "'\WTIlI'ed
    lIOfl. _ _ bee<l1ld<led to <lit• .
    100 _ people .-ng ocMn.....,.,.",. lor
    In \9B7, l!>e prog<""""" " " ~ If'JIO """""",,,liOI'\ 12.700 """"""" .
    .....::.ItIer 90 ,blrJCti to ',,"ClIl IOtol o! 10 miIion
    "". .I S " " 11 ......,.., pregNll' _ I l l M.."tw>- In """" """,d<.
    0UPP0<l _
    ,t>e csp..-;<ly foI """""""'..-..I
    Indoa t>sf buill "" III '''''''''' _ . ..
    '"Illhtl " - ...... oIl'llfrUl1lll!al .. !hoi<IflllINI92 r\OW beIflg ~ to a.::r-- 8 0"" _
    ",O\''''to. _ e><\erdng It to 90 mote , .. ""
    ot'I8cl""" - Ina ~ of • !T"oIIon c;IIildI"o'''' M$
    o!nIln'I>Ouf, ~ ~ the ~ 01.
    v!lSl ...... ~Ied sv>tem rllo co-ordin<I,ed
    _ _ "" 1fl"IOTIUIM.!800n " , QOIII
    8C1oOn across • SIbearn"""" _ in longuage t:an be ICheved ond l8InIId. then !he ..............
    ...... cut1uM. cIomate _ ,,,,,... ''9'' ell,," 01 tII/I 1018 19900 ~ also _
    _red 8 path for po-ogr ">l"""St !he ..........
    0YeralI, I!le _ ....., >ell! on tile supptv _ 01
    ot!>et"'""" probIoms 01""""" ...umoo whd1
    "'" ,~ eQI>MIOIl-v"""'" pnIdl.clJOll. ... ,""""on, !he ..."",,·s ctOldlon.

    "
    food $eCUrity .od education, economic productiv- /fled p,u a lillit Mi IIIOrt hWIII tdllCOIio" It". allda
    ity and ;"romc..,arni!18 oppommil>e•. A5 impor· 1i,,1, bil "'Ort iwUlII ,d~raliOl"Ir".; "" "'til
    nppronrll 10 p~61k It.alilt <u:rimt alll1 "'" lind a
    a,,=
    ram as any of ,hese, ;1 could promote 'oday's
    kn""icdge ond low<o:lil technologies for lighten· 1I/T11lf/ pwblic IIw/1t alliaNet 10 IIlOlll' WI fOrfC4rrf•..,.
    inll ,he "..... k. IOId of IO'Olmn. · In 011 of lbe$<" ''''.s, BUI in order to appreciare rae naNre of that
    new and vit.1 knowledge is now . ,.il.bl• . And in alliance, aod Ihe pm",a11asks il W<RIId face, il is
    all of these ••us, thl' i:nQW\edge ~ould be pili at perMPJ useful rc briefly sum ma ri~e the informa-
    Ihc disposal of the maiori!)'by mobilizing already lion ir could convey.'
    . !listing rommuniclIlions resources.
    ThaI knowledge is Il<>l complicaled and should
    IIU! ;1 is On the plane of child health thaI tM ne"'r be . 1Jowed 10 be m~e so. And "'hal roll""..
    grcllW of all g3inJ could now be made. TodlIy,a is a simple summary of a scientific consensus, a
    solid ""jcnti6c con""nSUl mnd. behind a body of brief puUing TogeTher of a body of knO\\lledgc
    kn""iedgc, Ir:ldilion31 as "'e ll al mO<km, dil" which should nO'\" belong nOl only ro rhe medical
    co"cr«! or re<lisc<>vc,ed," which could enable profession bul 10 all families everywhere:·
    mosl families 10 pre''''m .nd m,OI almoslall of the
    major ,auses of dlild death and child malnutrition o WHAT FAM ILIES HAVE A RIGHT TO
    by methods which they ClIO undcl'$,and and al .. KNOW ABOUT TI MING BIRTHS
    cost ,,-bieh lhcy can afford. 17It lI'allll rilhf 10 1IoI~ IIlq,ltm """ cltild"" art
    ltriMIfly IMcrtllltd by btco",;", prcpaMI btfort lit.
    Pulling Ibn body ofinfomm ion at rhc diJposal
    'I¥ of 18, btrollli"8 P"II"1J1l1 btfort I~C IlUl-I>oNl
    ofaUfamilies is a Usl: ali enormous as!hercw;ud. rllild ;f IWO years old, IJ1lJ hua",;", prlf/IfaN of ler
    ;1 offen . h is the gu" heollb cboU.age of our
    ~avi"l [aIJr ,lIildmo lP" afllT rtodi~1/ 1M agr af ]5.
    times. And to lIICeT Ihal challenge, il will be
    necessary 10 forge a new public heallh alliance, 10 WHY FAMfUEs HA VE A RIOHT TOKNOW
    slimulale a new and "",,,~'ln" ",o/IiIi=i"" of a
    Il«ause research in many nalion. ba. nO\\l sbavm
    wide range of con~m ional and llDcon~OIiOllal
    resccrees in rhe ca~ of heallh. Ibal dead" of ;nfaD1' and molhen could be
    reduced by an estimated 25" Ihrough avoiding
    For as the WHO's Direelor.(ieneraJ , Dr . binhs "'hicb are 'Too many Of 100 close' (fig. 10)
    Halfdan Mahler, has said:· and to moThers ...ho are 'T oo young or roo old'."

    "" TIX> "'aNy of'" still/h id iN ImIIS of mrd"'al rart


    o WHAT FAMiLIES HAVE A RIGHT TO
    K.'<OW AIlOUT PREGNANCY
    lJ'l l"'" or iJUtroeIIrio"J relit,.. IliON rllillki"8 al/l1ll/
    11m' liNtl i" ord,.. 10 NNdml~Nd 1M drlmlli"aNll of INP"II"OIfCy, il u tmll!i/lIIOttl "'OI't [ooi aIII1 rtfl
    II" N= probItI/Il alld 10 grnJP Opf"Jf1NNititl 11101 toclt day; 10 "fUltr fM PtN/MaI cart i[ 01 ai/
    rtlullfar IHyoNiJ 1M htalill Cart >ylItI/I... W. do JII1I po"ihJt; 10 IJt i"'IIl w~iNd ag<li"ll ICIOllIlJ,· 10 tIOOID
    ....1'11 w""l~i", if xoi"l[f<TOIII rriI~ Iht prtpa"'Y;

    -- - - -
    oNd 10 Om/llet fM a Irai",J fIlrJ0~ ID IIl1m d ,It.
    birtk.
    • " f<"'><W or _ t«IlDoIop< _ ... ~

    """""'" .. Wp """""' , ,.... and _'0 "' bod


    pt""""-, JI>J II!>o "'=- >l:iIb aDd .......... hat
    <=oily 1>«. poNi bI' ,!I< IOIrnl>'...... "«"""",n\ TriNoe • 1 _ ,!I< t>tl< IW" /« I.i/<. IDo:lUiF . 0<1 "'no'f< _
    Coo"".
    .._1l>Ji_
    Tn UoiInl N l'Wa, N... yotlt, NY Illilil. USA.
    " .,,-..~ foot ~

    UIJ "'"' """..... .......... IoooJ .. 10<


    IUCIIUCUO>I _

    .w.eu.. - . lOt
    IImpqi: ,1m lulowINp .."....... .. .....,.. IIIld o=ooibi< lono
    _
    -
    .......... !I<>.lUIp or ...........'1 fomil}' "" • rw. to
    ' -"
    !W'.,..;",,: J<\IrJr>tioo. ~, ""'"' _ 1lI<llI<>Io '"
    p t _ ........, fo<:,&, ""k II .... ... of ..... ma<l< _
    ....-.d - . ... ..... k.-. .. io<r<_lh<<'!<'JY<l<noilyor
    . 1'mI ......., of ,....I o< ~ - . ntIl f.<IO<", _ ... ....
    • .....-.. oral> or .... )""'I,< dull

    "
    THE STATE OF THE WORLD'S CHILDREN1988

    wm' fif MIlJES Hff VE A RJGHT TO KNOW ,mllliuea Itt bottk-hd. HI1unlI: till' rnnd '0
    znilioal fecdia« an Ibcrefo« ~ l<'ll$ 01
    F..-dI ynJ, :aa c:stIDlIled soo,ooo lllCltMl"i@in Ihous.anlk 01 (~'s IRon.
    nrrtnUtI<V Of d1iklblrth (karing bobmd oM:r I
    ~--mc..heMs cfliJdrm) and (WfIT S IlIilIion o WHAT FMll llES HAVE A RIGIIT TO
    ;nfanlJ IR! ItiDborn 01 die >lit hin the finI Wffk of KNOW ABOUT PROMOTING GROWTH
    lif•. " MI n>: of ~ IkllhJ could DOW be Aboou J"lf'"Y ,hro"l!' 1M <I, i/J', firu !,ilT of lif.,
    pwo\'nlN if plrents, includll'll fiIMn, ""'~
    ",Irtr fwd, "" ",tdtd ," "" iIUm I~ lIttilJN"ilJl if
    omJlOWl"cJ with loeb )"'s knowledge about ur~ Iii. illju,,' i$ MIlD M il"" ",wJItlumhtd. KUP"'il II
    pugnancy II\tl childhin h.' T" ln~s, for oxample,
    ""''It .liilJ K"l'U'illt INII fro'" flriJ Ii"" 011. rUm
    killl
    ~.r, )~
    'Fpro~inmcly I m~lion
    all of those deaths could'" prevented by
    unmuniullon of lhe motber-tc-....
    As \1'Ofld Ilank ~D1 BarM, Coo~ uid II
    tile t«CnI (1981)W. MotJu.rt-l eoaremlCC In
    n<:\ll·born. tach

    _.
    ill/wi"" 111101 .IIumi IOll IIrt I/IIIlt dll"tffOlU "",/
    _ /ill.I,. IJ _ of IA. _ ;"'fNKT<W MrJlJ of
    JIIImfl/looi 11-' sJl,>ttlJ IIfWht<o boIth _Ittt 11M

    11Irt NAa om tJrjU • tiiJJ -.IJ r" lit fN nna III


    ~3irabi: "'e..- Ikc..q «lis • d¥t il IS
    .fIhrebk tMr 1,400 v - iu tNr1UJ ",1M ..... "" .........".m« ,.,u,o--"
    t-enJ f{ t~ ~ Jtlif1triJtt .... dtiJJrn.
    " _ tdh IlJ IMI dItM _dim *-dtf
    II'" lIt-.cMitftdl-n · " ", ...1.
    /«J_u 'r i' $A"".,.uIl-".<IIIU~fH'
    a4 . , . .-..u lit JIttt rita.
    fib«
    I'll .

    _ -"'Jf , . , 1""'*-' ti,'V ~ fMIII'I! ~


    -~. 1UpW~~.rs,_""'''''''«''.
    oWHAT FAMIU ES HAVE A RIGHT TO eJ!iU~ _ _ «tIllAJ ~.1/ • diU ....
    - ",. - ..",. __ ., ,..._Ir pmt¥.
    ):","0'01' A8Ol.IT BRfAST-FUDING
    .. ,Aor firJl frw
    _Jl,. ....... - ' Itttlp-.ulor ...... tr-.
    8«11~/t(l/•.,
    Ilfr tl ti,..- .. ?- _ __ .....
    " .. i1f/al ~
    1lt n
    IwlrA -*no ., . /iInc.
    Whw r«/lWnl/f frD- /III ilt.m. ~Iy i",...
    pt'<Ilft/1(Ifl
    .If "«,..,;,,,
    fO M.IO
    1/IIl-
    1trr4Jl-fntJUq fr-
    .u ,••""." Ofillr f<»d1 sJundJ I...... "
    "fl"
    bot.. ilIftctil1ll aI u itl"llll/ririo.
    111 1M • af
    dtll.
    '*"'11 .",,4JhJ, • JIIHIJI eftil i ~ "" .%ffll ..-J
    ' iIll:/r d", f<tr""'Y d., 1M illlltU I.mN, A .Ai/II hm
    '.1
    bltl hm!sf·...i!k is 6m joQd" eMJ will tT1trIurw
    II"" /rmul j«J"., vlO" IJ rlJtll;~.t Irtll ;~III tit,
    rwt /lilly m;~ uNil 1ft.". 1M rlllt/rtl up D" DIlY
    rm,hI'I"'It 1~1I duri", I• • il/JInS i"tlj.
    UNJfId >"'" of lift. WHY FAMIUES I fAVF. A R IGH T 7'0 KNOW
    WHY FAAfIU ES HI/ VE A RIGffT TOKNOW
    Undnn ulrition is a fKlQf in '~ldy OM
    In poor communities, rates of infKlion and dnth lItitd 01 aIIloday's dlild dnths. lIS main allH IS
    ue 00llIlll0llly two 10 thrft tuneS 1Iia;Mr !'or till' combiNllOll of r~1 infection and •
    ~red inf:anl& !ban !'or inf:anu ..ho _ ud... faihm: 10 infl.orm p.mlll aboullbc! IptQli r-linc
    simy lnaIf·fcd lOr the: finr few IlIOIIW ollW." n«ds of dw JllUllC child (see pqe J :and
    III puUculu. diur'llon. IS botIl ""'"' _ w.,...." With balK' ~ IIIll JuPPOl't, 'k
    :and IIlO:lP ~ -.txu infanl& III poot CIlIm- rrr.ilnuuilioo IIIll mtlIq! :and physiai
    gr-.h of many J::... of dlildrm o;i.aId be

    -.;-----.,.-_
    IXcocakd by parnmlbcmaclou.. III _ c:IICI,
    bid: of iDl"armJUUlllIIlllOU ~ dcmaDdI OD till'

    -_ . ......._---
    • •n.

    ....... _
    ·n.. 0010
    -,~
    .......
    __
    _ , , . _ r._ ..
    ...... _--,."'--~.

    t
    ... . ..,. .. ..,.., •• _ .
    _.~

    . OW-.("...........~
    $ $ _ I
    _oo:.~.~.;;;;,
    aI . . . . .w, n.
    c ..
    .
    t -...
    IllOlbcn _

    o
    IlDd CllCOl:Y :m a tr"lCl cIif6aIhy
    ThIa 1M bell of food.
    WHAT I:AM llIES HAVE A RIGHT TO
    KNOW ABOUT I.\(MUNIZ....'nos
    All prtpUl ............., 1ft i - "
    1"'_ uJ till clr,limt Mc<dd Itt f ....... [ttr • fun
    .,tur
    course of j",,,,,,";=i0l6 "'Jim IA. ~ aJa,.. )'ta,. ApproKinutely 2 million children die each year
    TIIu ",ill ",.all '" lrost J""r" pa,,,,, wudlliJ1j.." bc<:a~ they are nOt immunized against measles.
    risils. Only one IOW<OSI injection is needed, bul ir is
    WHY FAAI/lJES flAl'E A RfGI-rf TO K.NOW vital that pa.rcms bring their cbildren as SOlID as
    pouibl. afle, lhe age of nine mOflths.·
    Approrim>lely 800,000 infamJ die oach yen of
    n"",alal tetanus, which can bl: provcmed by o \'('H AT FAMI LIES HAVE A RIGHT TO
    immunizing tho: mot""'·lo-bf:. KNOW ABOlIT DIARRHOEA
    Approximately 3(l(4000 child~n die each year of Dial'l'h(J(a if datrpollJ. 11 u IAe ",OIl (0"' '''011
    whooping rough because lhcy did nlll receive a diullSt of (ltildhiliJlJ. 8,,1 il i1 also Ilr. "'all co",,,,,,,,
    full COIIrse of DPT iniK!ioru;. On a'·en ge, ("...n ( iJlISe of ",alllwlrilio" IUId drcllA. TIr. daltg" la 1M
    when vaccination is available, one lhird of all <1t;ld ~ liJ. <0_ 1fro'" lite . ",pcyiltgojIaa ",wAj1"id
    child~n are nOl brou¢1l for the lirst infection /ra'" llr. lJody, W1rt" 0 (lri/d Iras diarrlr«a, ir if
    an<!, of those who are broughl, one quancr do 001 IArrrJf}f't ...."I;alla krrp "" fim"1lJoad au jI"idl.
    complete the courst ." IIdflit:. Ia 'mt ,ht bwtl ' u aoclly lilt 11'll1"11 adtri~
    ItS:d WJl'1d IN ;pared - twrI if i/ tal/lD fro'" a
    'lKlor. If the diiJrrIroriJ lam "'aTI' IIrIlJf Iltree diJVI, or
    1«>111 ",,,,II U'Of"S( Ilia" "'''al, or if IIIt< kiJd ",ill "'"
    Fig, 10 Infant deaths by birth interval,
    selected surveys
    10 Itt.
    t<U or drill!IIJfd fIO",u. frz/jJlmlly, IA." il ist=tlNal
    Irtlp fro'" iJ dime, ltetJIllt r.corirr. or dlKlor.
    SUi ill lltt p<u ",ajorily of ( 1UtJ, all lrt(mtJry
    "':lio" is wi/Ai" IA. ptnNr oj Iltt rct/l·jlt{""'l<d
    parmI.
    D Shorl iUerval,
    less than 2 years
    If lit. ' t'arrlriJ(iJ is 110' 10 ca"st ",~llIulrilfo,., llttll iJIl
    "" t>,ITiJ JltttJI a day i, ",tJed Jor <U ItIU/ a ",../t afm
    Ih. ilb.m is MJn.
    '" II"1J{Y FI/ /lIIUES HA VF. A RIGHT TO K.NOW
    Dehydrol!ioll caused by diarrh~a kills 3 million
    children a yeal. And even though the chances of
    de>th in :my one C3SC of childhood diarrhoea are
    very small, the possibi~ty mu,t be protected
    ag:ltn't.>I
    For the 9lJlt of children for whom d", disease
    docs not become life-thrcateDiDg, the danger i.
    malnuuition. If dw rboe. ",mes four Dr Ii"" or

    zo • ne oJ!l<lll fl<lOr '" IIInileI imlllImWtioa ~ U<Ilinc:


    ....-...._ Iri_ til< """ ~ om. __ b-o """ til< r;,k ~ ....
    o VJrnII< b<uIa rrnil<t..J ""'-tel.... II,- dot . . - . . -
    ~ , ~ til< -"<t. 1__ ", ,, ,,'1' 10,.. IhM ....
    ,"_ ,ioo

    -_'--"""-_.-
    __..._--.-
    _ til" • IIp/ianr II t:lolt= wi)
    <t>D<n<l ,ho: iIot<tv>I 1><0..... ,... ......... olf 01 ........
    ""' ...s "'" _ ~doN<
    _
    ""'.-.c<ioo . TlIo_-....
    '" ,ho: """ ~ __ ,..
    ..... tt poooitIit. t. """"'NlQ>od .&I,,",~ wIl<tt lliI;tIer _
    "",,0-, """""c. ood toIIOWI...._ ...... ..... m<UI<. io ....
    of
    _ _ _ _"""_ .e.-.._
    -~- .... ~ .... 0 ......, rho _I«< W """"""'"'. ...
    ;, tl '" " _It>.

    ss
    THE STATE OF THE WORLD'S CHILDREN 1988

    Breast-feeding:
    a progress report
    Fof sa
    t>8tloe3. bfe /lSt-rTll< IS !le lt.. than bOlt~ In A1nc.a. brea51./eeo)ng UOUI wei . 110 "'" sec·
    leedlng_ !1 .. more nWlllO.... . more 1Yygoenoe, on<Ivear 01 a ctoId'. k1e ... '~""""""""""""
    Cl><>al*, ancl 'rlVnUlWeS' nlants agaor'ISt CIl<TVntIO. rural ...... IIuI bre.w'/Hding noods prntecllOO.,
    "..,\lOn!. But tile POO'"' the h,,""Y. !I"oI ", eater lM r-'f e"l*'Glng ""'-' arus
    tile d¥>g« 01 bon~ Milong ml ~
    A map llfI)OIem for ""'''''''''' -..:l can olrllll<tV
    ""ttl un<::Ieao wa1'" " on " ",,, bottle means bo ....... J1 <:<llIfllr... $UCIl lOS Brad 0fI(I Mexico.
    mer .. _ , more _Int><ln ~

    deW. rate - . . No<> llWds'" lIIl.....,....... '" ~ "II"


    go OUI to - . ~~ '" tlwn find boltlft-Ieedong
    The 11_ ,award< bOltle-l-w>g ", ,.... ~ ......e ~I , espeoooIIy . . " _ _ lila,
    ng _ Il>ere\ofe pY," a t tJslt the ....... aOO ll'ow\!l ri""1. Cllfl be te<l by _ merntNIt. "'!he ,"""'"
    01 ~ ~ ot ""."." The!.. wily me 1961 So WlthOuI ~ leg<>latIOn-_ ornplover
    WOIld HMlttI Assolmblv. """""""''''0 ""'" 150 ~-"" IlUCh .......... mel......IV Ie.....
    lP""'ntl'Wl'llS. adapted 'M i,"emaOOl'lli Code oi R lw",,>i-,~ 'uilco. e<i.tclixInoi ~,ftx ~
    M_liI'I(I 01 Ble as' ........SuDs,oru,eo 10 uv to OIOP Cllfl on!,r llO to I..
    tile n~ P'' 'iOIJOO' 01 ntam !orrrIIUs_ The .l1lJIIgIe no_ - ' tram .. - . •
    oncouragoe lIMO plom,,,,,,,, 01 " " " ' _ IIbool the
    """an,~ of br."",,-mIk Hoopitat. <;en •

    So f,......... 130 I18lJ(1nll have tAi<on $OITIll aeIlOn o 100lell moltlln and _ 10Qe1hur " ""'l""'IV
    on "'" Co<le. _ """"""" " by Of adop!Jl'lll warn. """ """""'''II'' bre,..H-'"'!Ilrom l:xr1Il
    " as IIIMJ1un'ArY me"",. But" '"
    ""V....",...... II>e bl",18 OS t>e"'ll ""'"
    to<> ......... to
    Of los! -
    o refuse ' 1M "'onI lomNIa _ Den leecl<ng-
    bonIes lr<Jl1 "'" ...... <IS.
    In labn Ameoca. $ON$! na:"o'" """" adopt$<! O,e""" \tIo ~ _ \tIo 1ec1nque 01
    "'" Code ... taw and """" hIM!! ~ lXJblo(:
    """"",.", ~s ..s,.,.. mat."'''vhosPn8ls. l>'. ... l · t~ 10 .......... _ rnodocol .".. :1.,,,.
    '''''''''''l;/"' 01 new-t>om _ ""m u- """""'" 00c1O<J. _ _ II> work ",. carl •
    IS ~ standard pra<;lo:;lI an<I mothers ...
    beInII """"",&gild 10 brellSl-!<led ""'" _ At; ..
    o eXf)laon II'Ie _ i to of "'_t.~ to all
    m<>!~ """ Ie.." to IlooIpWI\h lInV prOblems
    bolM
    leW"''''llo'ug.IIv
    riKUl. lhoIlfend
    ,_sed.ThIs...,.. brn'r.1ee<.lono "'"'" ' -
    t>ecome tt>o l..l The tnMlio can •
    lM>n AnwJcan """"lIV 10 "'I'on • ~
    """_ .. bat!> :he ",evWnce _ dlntoon 01 o "lorm III par""," Obout <hi! ilfIPOI'\<In<:< '"
    breasl"!eedo'Ig
    bfeasHeed!nII Suiwys Ole...., SI><r>W1g Joe.
    ~ "' &rId. Ponamo , Co.", Aicoo. and Clile o '&Iuf<> -....ng !or "' ..... t -rnA SlbaUtu t ...

    In ,he ~ !he !fend """" ...., """" __ o 1"llOfl1O<:al_,.,.,. 0/ tIJor 1Il1"", tom-..lo <xxIo
    ' ' -sed as 01 .. ~ .""'' \IS>ng ScI>c><4 '-
    cao'iP8'9" . tlKk:ed..., by . 1<>4' new ~ cocle on
    1M jlfomobClll 01 OIl"'" I............ and the .,lfOCIUt- o ""' e thai no ctoId Ie_ _ ""1I>cxJ\
    IJOI'\ 01 roanong'" I t most srallll'lmllllais IrIOIina• I:no<wog !he J1'IIlOItenCl! 01 breast·feedIng
    ...l>8n hOSp'''' ... ""'" O"lroduc"'ll r~ Me""". who hov. "'NOl·fJd c.n;-
    allo< ~ QY11M1 ~ 2O'l'o '" mothers """", . 111
    llfeM,.te<l<lon\l ""'" b - . at lour """,lhl; (CCIIT>- o _ enccwJIlIlI" I'OU"'lI'" mothJrs on 1'-
    parecl10 9OlIl. " nnl arusl ! and~

    •
    lix timO'i • ye'r -l~king . way the ~iIC, Moldd ,,/wa), IN wllSlIld afttr d'luru ,,,,, IIlUf btflWt
    limiting me 3bsorption of food, burnIng up prtptlri"l lit tllti"l llJOd. F«>d OM U'<IItr lirmJd bt
    c>lorics in fever, draining a.....y nUlricnlS-thcn ~PI ell"...
    the slew wvan,e of malnutrition is \lIUally lhc
    IrI H Y FAMfUES HAVE A RIGHT TO KN OW
    rcsull. Dimhoul dixue i, probably rC'Sc:nsible
    fOI up 10 h31F of ;ill cl1iId undtmutrilion. Plenty MlIIY ch~dhood inn.,..s, and therefore moch
    nf 8uids during tM mneu, and exira food in Ihe childhood m.lnulriti on, could be: prevented by
    r<:<overy period, are the he.t protection. home hygiene , Lark of ba.sic services SIKh as
    o WHAT FAMILIES HAVE A RIGHT TO dean WIlier lind ufe sanilltion means that borne
    hygiene is difficult 10 put inlO pl1laicein poor lIId
    KNOW " a OUT AClITE RESPIRATORY IN- under-scrvcd communifics_ 8~1 this does nor
    FECTIONS
    melll lhal puents do nOl h.ve a righl III know
    A rlfi/4 witlf 0 /xi" r OJlgIf o. cold JIrould K Iftpt why lheir children fall ill so ofien and what needs
    U'II"" Imd wt1lld ond gi"", platty II' "riM. to be: donc-by llleir govCmmenl, by their
    BfflJJll u Ji"l 'M"'J COM,i" lIt. If ,Irt clfild wi'lf 0 community, and by their own efforts _ 10 prevenl
    clluglf frill _ drifllr. o. lJqiru Imrulfi"l ", ,...If I/W.tr if. An informed community is >Iso more likely til
    Ilfon n_o~ (Ifat 11ft clrild ;, itt "fPll(T IUId ttttry dem.nd, :utd to particip.te in, the provision nfthe
    rffrm lir""ld bt "'lIdr '" gtl 1r_lp /{Ifi_My fro'" 0 boUt community services which make home
    elini, o. l>rolllf fMrlttr. hygiene possible.
    WHY FAMIU ES HAVE A R/GHTTO KNOW
    Coughs .nd colds, :oJong with di.rrhoeal disuse,
    arc childhood'. moll common .ilmem. MCKI
    children re<:l'lVCr on lheir own . BUI acute respira- Smokina. a1robol &ad AIDS
    lOry infeaions kill 2 to 3 million 'hild ren a year. Finally, :III f:uniJ,es in both induslriali«d and
    If lhe .unger signs are rc<:ognized in limr , the developi"8 1131;OnS 11>.,,", a righl 10 lodlly'S facrs
    majority of P'l1'ntl toUId gel help from a hea](11 aboul AfllS, and 3bout lhe health risks oftoblcco
    worker or clinic. Andmoll clthcse children toUId smoking . nd aJcohol abuse.
    be: SlIV<Xl by inexpensive lIItibiOlM:s.
    It i, now known thl! '('S! brulhing' (brel lhing It may be: lboughl lhal lhese are chiel!y adull
    more than 50 times a minute) is as reli.tble a ecncems lying beyIlnd lhe mlnd.te of UNICEF.
    guide to the pr....nce of modente and severe But !heir profound clTeat on ch ~dren are now a
    lung infeaion as the mOSt sophisticated di~ow daily leaJity in mll'll .uriom.
    available from lhe moll qll.1lified paed'a!ri<;l.n in
    lhe mOIl modem hospilal. AU parenlS could /lOIV Tobacco smoking . ffeas clIiJdren by polluling
    he empowered with Ih.t knowledge.11 their eovi«lomenl and ex~illg them to higber·
    lhan·nc«mry risks of boIhmpinlo\y infcctioM
    If the medical est. blishment would IIbo empower and cancer. 10 pllnicullll, IIlcohol and rcbacccC'lII
    oommunity he.llb l'I'orkers to prescribe antibiot- Iffea the unborn child IrId illtrc.se lhe risk of
    ic$, thtn anolber major cause of rhild dellhHOUld low binh.....ight. So I'I" U....tablisbcd an: lh=
    now be drulically reduced. risks that Finland has now made it illegal III
    o WHAT FAMILIES HAVE A RIGHT TO smoke tobacco in the presenee oh woman who is
    KNOW ABOlIT HOME HYGIENE prcgnarn. Simil.rly, alcohol abuse is >Iso closely
    associated with accidenls, violence, neglea, Ind
    Motty ,hildlf«>d illnm~.. ""d t:f/'«illily diomll'ttl, increasing po''erly - evems .nd processes 10
    IIrt CQI/S(d by gmru Olltrin, Ihr "'"~Ih. II al all "'hil:h J'IlUng rhildren are al.....ys the most
    /'OUib/r, larri,.n slwvlJ /It wd orIlUctJ dispow 01 eJlposcd. Indirealy. bolh smoking and 1I1oohol
    JO Ilrru 11ft}· ,0nnOl romr ;nlo <onllUl fl'Ilh pcopIt, abuse oflen mean tbat family ll'SQUfa'S are
    Iliad, O' drifllrUrg 1:r'I1Itr. Wrutr fro'" lIJII:lt",. SII~"tJ divencd III the expense of meeting lhe blloic
    liro"'d bt boiltd and coolrd /ltl lm driuing. Hondl needs of cbildren.
    THE Sl'ATE OF THE WORLD'S ClllLDREN 1988

    Honduras:
    teaching hospitals
    In 1982. leading """",lito or> Honcluras. as on _ _ tlIlI -ago!etJllth oj br_t·l--.g
    "'Sl rno1h8rs and _ ""0 ollfl.. en'
    bo'tlI. "IStnbu!Jnll "",,,,.. e<aI .d"" , ~
    w_to "
    ",....,. 0l/'IeI' naPOl\ll lOllay. were to<I1..... upara!'
    e,
    '..... 1rom ,..." """,tho to 0YeI one year
    The$e CI\arJOeS !l'e ll<01ee111>g lhe IIYes end lhe
    new mcnners. and_r~ no, . 000,,_ normal growlh 01 ~ ., the ",an ot Teguo-
    _ .10 gIucOS<l _ "''''.. '" ..,.. firs, few """" 01 ....
    l)aIpo ond San Pedlo su.et ImJo <II no cost to the
    hHtm se<WOea l""" 01 "'" ~ OS atreodv
    MosI_._I'U'S8S-" "'" ~ seYng $ 14.500 " _ on Ollont 1om>uIo.1oe<k>g-
    "'IIb<e. ".r~ Ie mo1hets end VfJlY ,..... _II boItleo, ana gklcose sokl"",,) won !he Ile'p oIl\ltt
    _ Ie offer .... _ . on l/>II sw,ocl. So
    lIIt\'lOogh moo, ""'""'" >llll1<><! breaa t-leedong. f>-
    Uro,ed Sta,es ~ !or In,_ CloM!lop-
    ment, lhe f'ROALMA <IIo,ecl " rt;N< ~ to
    r.." ~ __ lI$UOltV ",'oduce<I
    CluI"'ll "'" CO'o'et . . mat_ .....<10 "' Ilondur...
    In, rr'lQ(Il!l On _age, or.....,4eed1ng NId
    s1OPP8d aIIogoTh<>r l>I 1"" lime " I>alIY was lrve
    ~~~

    By 1982. up-to-dahl Ilellllh profllSSOOrlals were


    bec:o""'lI cOhcerned oboIJl N efffICIS 01 ,nt .....
    wtrUas
    _to
    and ....... well'''"g By Itutt lm8, tt WlIS
    .........."lila! e . - bl'eaaHeed"'ll tn:m
    !eM, !he loge 01""" """"'" IS "'" bes. guaran'....
    lit

    of ""'0'....... _ lor onv ct-. 1M


    Dr ,-

    -
    I.... ng was "'" ~ suPPO"ed '" 1he hos<:Mt'""
    - . . ,...,., 01 tho ~'. c/1OIdf.., _," I>e<>g

    In $@lomb..- 198 2. _
    IPn>,oecto
    . torled '" th"ee (II The
    PIlOAUM Ill""""
    <III Apoyo ... \.actr.(:NI Mat"""'l WItS
    1\0,,,,,',
    hcspo,. . .....tIl t!>I
    llIm 01 o::hIngo:lg StllOClarO ll'8C1JCeS '" tOIIlefM'V
    O ~
    _ "lIgI"_
    4 68H) '2

    _ d...... reu....,g .. <1ocl<n _ "'"""" .. !he


    _ ,_ _ of bre. S!· leeding Il ~ " 01 new- ,,->t"l)e of IleeIIh po ole, , '".-. recoo ..""' ldioog
    ro."..... br_ -'-'"'lI. Hondo.ras. 1982 en<! 1 ~.

    ,-
    bo'l1 _ _ ..,. """hers boo<;:arne
    '00
    Molhetl wete """"""'''''''''' 10 ~ llre351'fee<long
    ... """'" as _ _ ""'wei.
    *m '"""",",, r~ ~ D=*
    bo:_. and _ _ soIYlJOnS. _ e
    70
    00
    o:=:e..
    81' 1965...... rn.mt>er 01 health ~ 00
    ~ br. ... t ·~ from bor1h N1d_ ~
    "om
    ..
    401lIo lO 75'" ThoI Jl<OPO'OO<' 01 _ 00
    ~ "".as'-ll1<1di1>;J on <lotrrIll<><l """" 00
    fram 33'" 10 90%
    '",
    """-'.- --' .,.,-
    ,
    ~ " rvsutl. l/>II prQPClrll<>'1 01 "",Iller, helped \0
    ~ b,easH-.g '" the ""',...... ly WIfd 'ose
    from 10% on 1982 III 70% '" 1985 Tho lJSll 01
    o'Ilan, lMnuI/I .. !he IirsI momh oI llle WU .moo,
    - .... - ~ -'._ ....

    .
    These proble ms "i UnOI simply l/3 nish in the is perceived. h is lherefore especu.1Jy imponanr
    daylight of health jnformation. They arc related thai all responsible chlnnels of communicllion
    to some of lhc moll ingn.inN IIOriaI . nd Kl>- are mobili.ed [0 flIwre lh. l e"el')'f. m;ly is . ware
    nomic evils of our limes. Oflen, for example, or the risk. of tobaccosmokingand alcohol ebuse.
    smolting and . kohol abose are moSI common The ne'" [hrea[ of AIDS is allO beginning [0
    among the poor, not bt<:anse ,he poor love thdr
    children I... or are ....,. ker-wiUed, bY! beco_ it h"'e a m. )or impact on childreo in two principal
    ".~ FiNl, m.any young children arc bemg
    is .m ooR the poor that the uodemandable n«<l
    for esnpism;s greater, beeluse it is among the Ol'phaned by AIDS becauseoflhe .gHangeof;IS
    poor (hal the problems of unemployment and
    vicUnu;. Second, increa.rng numbers cfinfa nu are
    <kmo... ~ ..ri"" 3re moot acute, I>ec._
    among the poor th. t self·image and self-respect
    il ;s new being intected befnre or during bin h. This
    problem is p.nicul.rly .cute aod I~c ;n Arria.
    where, unli ke mosl region. of lhe ,..or ld, lhe:
    are ihn-arened every day by a consu mer so<icty
    from wbieh they an>, 1»-definition, margin.li ~ed . "'lOS vi= 'ppeIT' 10 be lilriking at men and
    women in equal numbers. A. a result, lbere Ire
    The dcep-rootednm of $lIeb problems ;s • now (1987) ellimaloo rc be ovee 6,000 inf.nt.
    fund.mcntol, social, economic and polidcol ch.l. "; Ih AIDS in Zambu. Iione (1$ cpp<>$Cd 10
    kn~. Bu' 'he empov.'ering"hU famdies with the approximately 400 in rhe United SllleS). On lhe
    basIC r.CIS on the health risks oftoWrul, smoking horizon is an add;lional worry -rhe n$ing om of
    and alcohol .bu... has already prO\'oo th.t ;t h,n the AIDS pandenUc whicb m. y lbrea[en esseolial
    major p"fl to play in uducing the ,isla to selVic... for children. In 1987, public educalion is
    $OCiel}' - and its clIild,en. Th. lob.ceo in<!IIStry is the best defence we have againsl lhe AIDS lbreal.
    increasrnidy ,",geling poor and minority groups And informalioo aboul safer ~x musl new be
    in pulicular and the dc\'eloping world in gcnenl added 10 lbe lexicon of what e"ery family should
    - for il is in these IIC<:IOB Ihll room for eXJmlSion knew abool the: prou,crion of family beallb.

    Partners in the alliance


    This eore of lnsic information addreiiKS major regien 10 rcgioo. Informa[ion aboul the advan-
    child hc:alth problems ;n almosl all nation h is lag... of brelsl·feeding and tbe dangers of bonle-
    information on ,,'hich almo'l . n scienli$l! are nOlI' fceding, for examl'k, is more rrlevanl !O urban
    . grred. II is infonnal;"n on which all parcnlS Lalin AmeriC'l [ban 10 rural Africa. In JOme
    could !lOll' ICI . It ;, Iherefore informalion which moum.inOll' or ftood'l'rone n gions, a lack of
    all familie. now have. rigbl 10 know. iodine in the diel causes mental and pb}'$icaJ
    Thc lim slep io pulling lh. 1informalionallbe r,,"nh[lon .mong a Signifi<:a.nl proponion of
    disposal of [be mllori!}' is Ihe 'tailoring' of wch childrrn; if parcn.. in [htl":' region1 "''CIC fully
    messages [0 n31ional nceds. informe<l abou[ Ibis problem then [hey """"Id be
    morr likely 10 usc and to demand iodized $11[.
    Cemre. of medicll cl pcnile in each country
    need 1<> become involve,J ;n cuslomizing, wilhoul Similorly, lhe nature of tbe JOCial alliance
    ",mp/ielling, Ihis huic informalion. For al· needed [0 promOle heallh injcrmaticn, and [he
    though the knOII1cdgc jusl outlined is universally communications IcchniQllC' employed, .... ill abo
    rel.vam, [he priority of problem......ri... from ....1')' wilh Ibe OODlOllr> of cl<h n'lion's cultun .

    "
    THE STATE OF THE WORLD'S CHILDREN 1988

    Japan:
    fewer deaths, fewer births
    \Vol SIMr'O thIII _ 01 more ~"" loa<I III "'" OO,omallC. In .lapar>. _ .. '" child
    mell e l)(lJ:lJIIIllCWl QIQW'IIl. ~ 1'00110"''' nealltl I na.e IIbo been !he result 0/ •
    ""'9'''''" aM molong n mote d<f!lcult to ~ """""""'" ellon '0 pro,ec, <::t>ldren -rdudong the
    tno:OfIle$. lIeaIltI. IIfl(IlICI.o:;aoQnl ......".tJon of PI"""" .. rl'IOllem rne!ho<ls 01 chid
    P"O" 23 0/ 1M ,epon orgue:IlIlal !he ~e ~
    e/!eo::, .. mo<e loI:.eIv But.. a "'""local e><ll/l'lQlol . n .. l.Je ~ I 'oY<l<tOfS" ('-'su """"""I,

    C<U'1tro _ lw r«IucecI ~ dealho """,e _.we,_,""" _


    wortIIlaoiong at .......1"'" iICllIatf ~ .. !he "" eJ<a'TlPIo, are . neched to - V llO"CUllUlai co-
    on neal'" _ rtuIn1IClI"I

    .'~"'on~_ eclucI,OOIl lies been • fOlIO' flCKlr .. ""'fl'lMnU


    cIIoIcl ...., ~ ,
    In 1940. JOl*\'. .. tan! m008lltv fal l' IlMRI was
    90 de aths per 1,000 bor1lIo -~ 11.-> moo' FOf many """', evetY p<egrlaO'It """""" ..

    ...-
    de>!I :"'\Q COUI'IlI'l/Is lO<lav Todav n .. _ 10 ~ tIM been gwen • ' _ ond chlcIl'lOl&-
    5.!'> - _ Japan ,"""'" ~ F_ .-.<I _ " l _ l """"l - . • l:ep1 . , _ IS •
    s....oen '" t>a\1og 11>0 laweat ,,,Ie <I ."Ian l ""atho ooo.rc.e 01 od\oc.e "" ""'" ""'" _ I>e< eNd's
    P"'II'''" The .... , few _ _ '"""''' the mo1l>er'.
    weoght _ _ bl<>ocI pressose '" prlllN"CY ond
    W Jth ouch • flll'lO <lI"l' '' <:tiki has <10_ .""'"' ..-ge .... '0 corne to 'fIlOll'Ier"s dlIsses' n",
    ~ to J8l>¥I"s '.~. at ~""" gr.......-thl c/as$oo ~ II""" the ...... tl... of cI>oI<l
    As ., .. nalJOnS, It1e onn1.1l 'I'M >I . ,.'ICI'ease n core "'d, b &vel\' CIas. eomIlIete<l. the lecho 15
    1lIlI f1\.OflIbef ot """<!ron wtlo ............ to h&'e C!lIIdren starnpod .01 the lOcal t>unt> C1lflUe W I'" ," ~ Or>1·
    0/ U- """', aM "'n:e • lo<T"4'<''''Y ".,. "' eo.... _-''Toke \lOOd care 01 """ - .
    popUlI..,.., growth r.""'. !Iu, .... ' h grOWll'lg <'Orl!t- unbl yOUr cntI<l ,"",,,,s ..,h<:d ' - 11'>1I l'lOlebookalso
    de<>ce ., Iho """""iii 0/ ~ """,,,on. parer". con ....... the o;:hokf. boo1h-w\llQlIt. """""""'''''''
    Ir>'et'VWh!:<e leod to have smaIIel fomolieJ. In "'" rew«l. IIfOWln chan, • ohect""'" on ~...,.
    - . 0/ 1940. ""' ..... lIgofIlIUIt1beIoI_.... per men,a1 ,x.,e!op,,,,, • . ond """""'.oboo, proIO<'Of'I(I
    eoupIo w<OS moM , _ " 9v 19t1O n was 2 Today !he flII1t'111:.lM1 IIeIIlh 0/ • ctokl un<l<II """ VUf"
    n IS 1 g In demogIaplIC t.."",• .lapar>"s PIlOll.. ~
    • • 001 ""'" mplac"'O U..,_
    Asb """",""",IlIOll'ess. _ ...... _ _
    In 01"'" _ . • CO/'IIOOUll ""Of! IllS _
    "'ll1J\al Japan NlS regos'e<ed • togI>e< _
    or """'''joe Il'owth """ the 1MI loti decI<les
    ,.t. mode to IITlIIDWlIf .JIpAnase PlIf8fl' S 10"1, !he
    ~ ...,. ,!>I me..... to proIlCt ""'" o:IIfI.
    drill'. heoltl1 The suceeu III """ eflon lies bolI1
    than ..... _ Moon on_ conVWe<l to. _ _~ted Irom. Japan',
    _ ........ os .. slowing POPUlI_ growIh and
    ObvoousIv, mony tOClO<S II. ~ '" ouch. accelorlPn\l econornc gr<l"lllh And" 1$ I pattem
    """""" apIw: lind economoc II ansI\lOII Nortetho- _ ClIft ...., be detected on _ _elopoo'll
    less. Japan". ~ ~ conI/adell C<Ultnes _ r - S8ef\ rapocl ". ,"" oj lIf()Wl!> on
    thIII ode. lhat ,-.ang clIild _ ........,.......
    per C8P'tI GNP ourong the 19800-0-, T'-
    lltt<IIe<a1... ~ ll'tM1h ..... _ eco- _ , Songopore. So L_ . ...., the RePUblIc 01
    -~~ Kore. Lok8 "->. II 01 Itl8$e natoOfll have
    FIIItrIg cI'oId de.",. ...., !"""cI _ '",..... ......,ed ho ~ , _ Il "" eorly .tlll", .. the
    boll> te<lte """'Il GNP But .. ""'""""'" ., 01 educa tJOfl ...., _ ot ~ ",*",,-_
    m no"""" _ . "'"' 'onI: .. _.......utlIe _ .",ep fils .. ctokl deltl1 '",..

    •
    The conSiant elemenr ii that any individual c>r t[llning in child heallh. In KtfIJ", ba.sic child
    organizalion lhat tan in any way help IC> inform hcolth messages arc being included in the re-
    and . uPI"'" p>renlS in applying such knc>wle<Jge formed primary·-school curriculum. And in the
    is llC>W a potentially important rescerce for M iddle EIJJI, W HO and UNES<.."O arc re-eperar-
    prnm l>ling the heallh of lhe nalinn'. child~n. ing " i th governments to bunch a joinl Health
    Th at i. rhe under!)ing principle of SC>(~ mobili- EdllCllion Curriculum Development Prog ramme
    m ion. And il is a dynam ic applicaliC>n of primary for IS million primary-school children.
    health care'. most fundamental lenct _ lhat health
    Such e!forlS clearly have a double value. In the
    is the respC>nsibilily not iusl c>f the medial long term, rcaching tlte majority of today's
    professiQo but of society as a whllle.
    schoolchildren means reaching the majority of
    \l'ithin the Iimi.. of genl'l'llizalion ICl"OS$ ,omorrow's parents. Says Ihe Dirmor of W HO's
    countr ies :rnd cultures, it i. theref<>re lime to he Expanded Programme on I mm un~lion {EPlj,
    specific aboot tm pan",," who could now play a
    pon in the Grand AUi:rnce for Ch~dren. .11, ",.
    ~If"" haJ Slatftd;/I all Khools i" 1974 ~ht/l EPf
    collld 1unJc gollhc i",,,,w,,ualw,, nrffl<lgt
    10 "'/lSI of IMst u<hD IIrt bU ll lll i", /'(I.rtII!I tOlhy. ~ In
    tlte shon er lenn, schoolchildren themse lves can
    be a channel for PUlling health knc>wledge al tM
    Edu ea lO" disposal or Iheir mm families and comm unities.
    There are more tbn fi'·e limes as many In somc countries, that pC>lemial is now being
    teachers in the dcvelopmg world as there are inslilUtionaliled. To graduate from s«onda'Y
    health worUrs. Th ey u$WIny see more orramil~ school in CoIolllmo loday, for e>;ample, , rudenl'
    with young children and their conlact with pupils nol c>nly ha~ to M C>W about basie child prcr cc-
    is long-term and regular ralher lhan Reeting and eon melhods, Ihey also have to 'Prod 30 hours in
    infrf<Jllent. Eighty per etnl of the developing community service to pul thaI \;nOlO'ledge at tlte
    world's children nc>w enrol in lIChnol, and 6Im disposal C>f families (panel S).
    complete It least four years. The formal educa-
    Educators and lead>crs know how to communi-
    lio n system is therefore the developiDj: world's cate wilh lheir student s. Will they now usc that
    broadeSi and deepest channel for pun,ng infor_ po;>"1:r 10 communicalc looay', child health
    matinn althe disposal of its citizens. knowl~g. tn tbe ne>;t generalion of parents?
    ElTons have been and are being made to pat
    health odUClltinn onto the syllabus. BUI the te ale
    of thaI e!fon is in DO way proponionate to its
    pC>lential. And Ihe rase should nOlO· be made 10 BUliDen aod l abour
    ministers of education, to scl>ool prin cipals, 10
    Employers and lrade unions arc in r<gulas
    teachers, 10 Ihe head. of lraining colleges, 10 the cootact with ~lerally hundred, of million. or
    publishers of le~lbook.s, lhat IW rlrild MIII/lilIc/ltlt
    parents in the dtvelopiIlg world. The retail,
    x lrooJ wirllllllr loi/lY" ktWlc!(Jf( aNw Prottl:MI tervi~, and advcrti sing profelSinns also COmmu-
    rlrl lnxs tmJ lire..,.",al "mllal ."d pJryriullgrtmrh
    nicate " i th lhe general p"b~e.
    of clrildml.
    Businessmen and labour leaders could there-
    So~ nations.,... alrcady seizing Ibi. oppon u-
    fore make a crucial contribution 10 the empower-
    nity. In fur/ICy Ibis year, the 200,000 leachers
    inll of parenls wjth today" kn""iclgc_
    who helped 10 organize the Dalion" vaccination
    camp3ign are now being lraincl in today', hasic Many employers and union offic ials, world-
    child htalth knoIoiedge. In n.illlJId, similar wide, are :I1rearly involved in imponanr heallh
    ItISOns :m being put hefore 6.3 minic>n children i$$l>I'S such IS the right to maternity leave and the
    Ihrough Ihc standard school curriculum. In frrul,- prlWision or crbcheJ and breast -fccdillll facilities
    dor, 34,000 leaehers :and 150,000 sccondal)·· in the " llrk_place. Those issueJ arc an ideal
    school studems hlv~ Ibis year hun gi~n a week's eome>;t for informing and , upport ing p>renta in
    .,
    THE STATE OF THE WORLD'S CHILDREN 1988

    Self-health:
    the tobacco test
    In tho 1Il<!us!MllleO WQt\O. more ond "..". Io.>:>g CM"<:ef '.,... .. men _ _ lObe dGdo'w>g..
    people 1crIow ""', It>ey can ""'P'OYe U- c:ha'v;es pmpomon lC tile - . . "' ~ And ecco<d·
    of .. lcwlg ond _thy lIf.. by ~ more _ "'II '0 tOO""""""'" HIoart _ IDIl, _PIs from
    boll\" 10< _ .,.." _Ill. The ~ .... he¥1 - . . . om>ng men II<MI alto <le<r. _
    ,",",* -doIft smol<ol. 000"' O"'~. toke ~lty '" u,ce,,, ~. " con;<l<>g ....'" a
    reoulor "-ClH. IIIId ""1 <lOWn on sM, woar. 25% lIeI:fNSe on 1M ~ of $ITICIloI'lg"
    ."""'etO<l 1.,.,
    cholesterol. """ 1Ilc_. But 1$ """
    ~ 1"'11""," ... -\1"'9 on """"' rn..1J>Ol.
    knowleclge CI\aIlgqj tho wil'IlIIlOllIe bIl/llMll
    I<ed "O\lOnS. '" c.o.o., lot """"'P'-. WHO r"POf\ll
    So f¥. IObo<:<:o amoioog has b<lerl tho m"" a ~_ 1Il ' - t ~..-.:I on ncreMe" We
    l1li, !he ""omallQn of
    l<I' lIng gnu>d lor {Me oCN _tlinCY altrbJled 10 ··me 'llCl d"" """" ..-.:I
    ~ CItI iead to """""""''' .. huitn .... mora Can.1odoatls tIMI 5tOllP'ld smobng" '" E....
    c!IlnIIn "' ~ And tile ~ '0 dOl" """'. f"""",, and 8aJIIun .. a ~ me """' ....",
    per.,"....1 P<blic " formatJon .-.d . . . ..... _ , ~ And..
    ....wes/. thol
    lo>o:Ioien ...... ~'. _1M> educaoon can
    gnp ~. !hot>gh 1M ~ 01 mer> ,III smoIo:l
    (>QMll1t. ., me .... t snol' " - - . tite<l """ _
    Th.. "'"""'II" thaI omoI:ng os ~ 101
    ~ ~lS by _
    30% of aII llw1 ~ _. 75%of bI'''''''''''''' "-. .....1/1 1II11'\l1jQt
    and 90% 01 l'"lI C _. has ._
    ltwauQl> tne hNIlt1 _ . the ICtIools. lhII
    promcIed
    1IrnpIoyo;o, ..-.:I <lepar1mem I t",as.
    _ _ counmol. a r>ew " ...' ....... hils coma
    I~
    media. tho wor'<-placo . *'<l by _ on 10> Itom tha lW>Oing d""
    ~ are oloo ., """
    b80;O ptO(luclS ond ~-.us Tho 'erMI "" tI<lm lOtIacoo II'TlOb>g on n- """""*"t•........,...
    slow buI Sle8(ly oedo'>e " IlmCIIonU (see IIg 2l. ... menl US heaflh 0'0IlPS f>UoN CIeom If\II t/lII;
    Swe<lIIn. mepmpomon 01 m.... O<luIt. who.- _ t"", '" .1ICQfI(lMy. """""""0 " r ~ t>lo
    has IllIen from 50% !O under ~ " lhIIlast """"" IOt.t 1e,,'5.txXI d&aw. year GIld on Decembe<
    ~ In ,,,.. Unnt<l King<Iom. lhe PfOPOfllOll has 1986 US SuI~. E_." Koop """"
    IlIIIoon from as% n 1948 10 3S% WI 1982 arod "'
    lhIILlmO<l SlOt.. from 4Oll. .. 1978 10 )US!"""
    I:tmed
    ~ .. 'N" .. ,....,.~ ... ~..,..,., oner• ....,
    30% todav And_ on l1e.......omoI::iI>Il.a-<r. lhII
    ~. Koop·5 a~emem. lhor. h• • been.
    PlQPCf1JOf't 01 men wOO SITlOiCII has 1-. !rom 83'.16
    funtw 8% <In:Ip .. Cl(lorOlle 0lrI<>bng in lho U.. t ecl
    '" 1966 to 63% .. 1986
    Slele• • .-.d, as T..... """'9G'""'" repone<I '" f ........
    oe..p,,, • _
    wom"".
    .. lot>.<;w omoIong
    ond .. llIOvIe 10 ~_ • Slgnficom
    ~ "'" 1981. '.evetY _ ~ bm\lS new..-_.
    lJlIhWrlnlI 01 oI<l ....... .. wtIlIl hils boootne a
    new

    ".....,..".,. of tho""""Il . """"<OIl ,ot>a<:c<>~ ' ·III~~_SIl'ICIlong· · ~

    IS r"ClW Ilec:Iorw'og by 1""' 1'" per ve..


    (MlI
    rodust<,_ _ And """ tIaS 0-. ocr-<! ..
    ",he "'0 IIIQIIS ~_ f>UoN gOne UP .. MI 6.9:)0 US
    ~""""'I ~ 10 """" Iho ... 10< 1 _
    lhIIl8Ce of .. 52 biIoat>+yo.. oavemoong ~ tMe,... ~
    by "'" wtr.cco lndustry In suppoo of wen .Ilons. the World HllaIttl

    -""".
    ~ ~ elapse belo<e lONoea."..,.. O<garo""'" hils ~ !ho t "...,tt>ng .....
    '"ll shows UP .. lung cancer llt hear! 00e3se. the than tIIlI '_III 01 ",.. ~ ""...d _
    be oe~l$ of lhesa changes II. "'" vel ... e ..~ !O be OXlI'l'Ipllllblo ",,111 tIIlI gcel of Healt ~ lot AI. by \he
    fI"ol\MY/ e !lu' '" lhII lJM&d $1/1\. .. ooe-SllllCk
    o,her cruci.l are3S of ohild ,,">l,h action. But in ers, and ,heir membef$. In lhe ~af$ ahead, will
    SOme roun'n.;s, boIh employers:md unions rn.1'e !hey tOO join an aUi.n« to defend the lives and
    gone mllCh funher, 'he normal dCI'Clopmem of ,heir nalion'$ chilo
    dren/
    In Tlraila"d, Sri Ltllllla . nd B~,*i"a raw, for
    enmple, Ir.Ide unions hal·e started ,heir own
    ohild heaI,h seminars for ,beir members. 10 ,he
    P~iJippj..,., wo,""n'$ ,..de unions ha.... begun
    their own cbiId health educalion programmes. In OrpDized. reliJion
    tII,n eD, sixry of tile Iargeo, fac!Crics h.:tve in'.... The \'Oi... of organized religion regularly
    duced family pl.nniog prognmmes fo, Iheir reach<-s OUI 10 hundred, of milliollS of the
    work·fora:s. In Nka rQ(flJ4, union leaders are 'x developing world's parents bolh direaIy and via
    r1f1(io members of 10caI he>lth commi",""s .nd the p, im IlDd elecrronic mas! medi•. And ,he
    ,ake responsibilitY beth fOr educaling their own respect in which ,hal \'Oke is held gi.... , i, a
    membef$ in health matters and for enJi!ling their special pl.... in 'he alliance for child health.
    help wi,h commuoity health proietti such 31 the
    organi2ation of >'accinulon :md malaria control, Soon ofler ,he announcemem by UNICeF in
    and the !l.lling of oral rehydmion units. December 1982 of the potential fOf a rel'OlutiOll
    in child survival and developm.nt, lhe Holy ~
    BUI in most nations, what il; being done is only aMoum:ed Ihat ""1M nui" Qulto/i, Ifill tItIwo'* i~
    • !.bodew of what could be done. AIl m1ployrn 1M ""riOk' '''''~Irit< oj 1Ir, trorld ... toiJllmJ;/J
    . nd all trade union lead. ... could be .sked to lIUUi",w", JIIP/JOI1 10 ,~tJt ;",pcrta~l, ,implt pro-
    make • loog·term commhmem 10 the lask of posal, 10 j ",prou 'M 1Wll,Ir of kJ,"drtol' of 1lli//Wiu
    ensuring th., all or lheir employ,",,'! and aU of of ,lri/Jr,"". The World Council ofCbur<b.. bas
    ,heir members will be empowered wilh basi••hild also \'Oiced irs support, and Islamic and Buddhist
    healtb knowll'dge within ,h. next r("A' }'ears. leadef$ h.w bewme dirCClly involved in promOl ·
    The me'nS at tb. ir di.posaI Ire many ~ po11ers, ing child survival. In EtJ'fJ/, for eumple, the
    videos, and public addre» il1lnounetm.nlS in prestigious Uni...... i!)' of AI Azar has rese.rched
    w1lrk-pl.... . nd eatl,'""ns; regolar mcssages in messages from lbe Kora.n i~ suppon of immuni·
    pay p3ckels or On time·sheers; company m.il zatien and child prcrecucn, and tbe Grand S~eik
    S)'1,.ms, h.a1th wo rker vi' ilS, worker education has askedthat ,hey be dis,riooted 10 all ~ian
    ~~
    families via 'M mDsqllt$ in each COmmUDl!)'.

    In addition, Ihose businessH which communi· In CAloMa, Ca,hulie pri.SIt in more than
    ca,e dirccrl}'wilha large public cccld also use thai 2,000 parish.. hue pr<!ached ,he need for
    opponuniry 10 prcmere .hild health messages.. In immunization on national vaccin.liOll d.ys. In
    Brazil and CAll1m/lia, for example, information 7ilrkty, lhe nalion', 54,000 imams reached aJ·
    lDO$I all parcnt. wilh immuninlion messages in
    about lhe need for . full course of vaccines has
    r... hed millions of parem, b~ being printed 0lI '0
    ,hal counuy'$ roeen, campaigo immunize g(l!ol,
    bank statements and el~ncity bills, lollery 1lf i" children (~nel 'i}. I~ Sri Ltllllla, Buddhist
    liekelS and ..Trier hags, ccmmerrial calend'rJ prieslS are bringi~g child survival messages 10
    . nd , ponsored newspaper advertisements. This lhousands of villages. In bufMlniil, Islam IC texIS
    year, Dhab Malch industries of ~wJn/r has Ire reinforcing lbe elTon 10 promo.. bRast·
    put immunila,ion messages 00 250 mil~OlI of iu rttding, improved child feeding, and growth
    m'lChbox~ Th. s:lme could be done On till
    moni'ering. In Larin America, priests in seme
    receiplS and food packaging, advcnlsemems and nation. an! beginning 10 use lhe 'ra.di!ional pre-
    ra.,ion coupons, cinema scr,""IU and billboards. marital and pre.Jlap,ism counseUing ...siOM to
    informcoupleJ about immun~lioll, oral rehydra.-
    Employers and ,rule uni1lDS, advenising agen- ,inn, and the \'llue of bre...·(et'<.l ing and gJ<>'><1h
    cie, and marketing companies, know how 10 monilOring. In BrlJZil, the con'iderable power of
    communicale with ,heir employee., 'heir cuSlom· ,he Ca,holie Church, wilh its 7,000 pries" and
    .,
    THE STATE OF THE WORLD'S CHILDREN 1988

    many (rained healTh wllrkers, ils 120 radio w l as such as th. A COMjXl811t1rt series have won
    stations a nd hundred, of paris.h newspapen ;lnd wide acd aim for the integration of family plan-
    m~gllZine$, !u.s ~'$l. bJished • 'Pastorate of ,he ning and cbild heahb messages inre their nigh tly ·
    Child' programme 10 brin~ today's child prctec- dnunas. In Pllkuul1I, prim e-time tel. vi";on pic-
    lion slrlltegics to the f:unil,es of 1 million young tu,el of ohildr"" ""fT.ring from ' "KCine·pr.n n, a-
    children nalion·",ide. In HI Si>lfll'd01', the Church ble discucs lun b.lpc<lto sigllificantly incre ase
    has played a COIlngt<lUS role in helping 10 K. rachi'. immunization cov.~. In Nic"r<JglOtl
    organize th e tll= 'days of tranquillity' each year and NtjXJI, t.n. of thousands of rom;" books,
    on which the fighting SlOp, and the nation', songs and poems b,,·e eeea produced On topics
    children are immunized . .uch as immuninlion, hygiene, and tb. prev.n·
    tion and trcatm .nt of diarrboeal disc. ... In
    BUI over and .bove tbe support rhey can give
    lA!0",1M, leading newspapers and t. levi<ion and
    to p31liClllat campaigns, religious leaden are in
    ~;o SIalions have cc..... cd the ancmpt to
    regula r COflt.Cl with proh>bly • ma jority of the
    immoniz.the nation'$ children not iust .l. n. ....s
    "w id's parents. And they 100 COIlld mIke a long- slory but as a <lUlU, monitoring and rel.ying the
    term oommilffiem III 1M (ask (If empl)\\o"ering
    reSlllts 10 the nation ,,; th an urgency u""ally
    th= ~nls with IMy's hcihh Itnnwle<J~.
    reserved for the cm·enge of general elections.
    Religious leaders know how TOcommunicate 10
    But ag;lin, the contribution ~ the p,int and
    their l>\lIO wn~ptions. Will they now xctpt
    electronic mass media to an alliance for child
    the ch:!!le!!gl' ':If k!m!ng a J)'J!:!lk he! !!!:! ejlimce 11) h.a1th rouid go far beyond this suppon (or
    hd p protoo lod3)"" children, and tomorrow's individual campaigns. A majority of the dc,·.lop-
    world? ing world's parents rouId now M regularly
    reached with vital child h.alth "'"§lilt'S- And
    wh~t is now needed is a /olfl-It"" rQI/I"'lJ M<'ItI by
    proprietors and editor s, journalists and broarkast-
    TKmul medii ers, film-mok.rs and cin.ma chains, to the t.sk of
    ensuring that . majority of their r..dm . nd
    Willi f>O'j Iileracy, a1mOSl 4,000 daily newspa- listeners and viewers y,; 11 be .mpovvered with
    pers, 400 million lransislOr ~ios (6ve times tod.y'. child llcalth knOlO·ledge .
    more lhm twenty years ago), 92 million television
    sets (eighl limes mere tMn rwcnry years ago), the .I"hoic who own and th06C ....ho lUI1 the
    develo ping wolld can now communiale with llIe Id.vision nC1\VOrks, the radio station .. tb. cinema
    us
    majori!)' of families via the print and electronic and video chains, lh. .......papcrs ond magazines,
    kno w bow to communicat. witb tb.ir aud iences.
    mass mffii a (fig. 11).)'
    As a tangible expr~ion of their social responsi-
    In tilt 1980s. lhi< now communications musd. bUily, will they tOO nOW use th.l power 10 h.lp
    has strengthened virtually every su«cssfuI at- p.OmOI. lh. hnllh of their narions' children ?
    tempt to pul loday.. child lIt allh mewges at the
    dispos.al of lh. lIUiorily of paronls.
    In Syritl and in Egypl, nalional lelov:i,,;on Voluotary age...,iCl
    personalilies have brought the messa g. abou t
    llnmunUation and ORT into millions of homes. lnt. matiooally, over 3,000 non·governmental
    In B=il. S6 miDion in air time has helped 10 0.gan;1I1;DnI are nOW " "Orking to improve the
    promote inform ation aboll! brt:3.Sl-f~ing to quality of life in th. dev.loping world. T oget her,
    virtually ""cry urban family. In 1"rtrluy, child lbey spend approxim. tely $3.5 billion a )·ou,
    heallh messages are I permanent feature on MIWceO a third and a half of il 0 0 health.'"
    national radio and lelevision and, so far, an Nation ally, Ib..... are now <ountle.. numM rs of
    estimated SS million in air time bas h<'lped >"Oiuma ry agencies (an cstimated 12,000 in India
    parenu to bring lllO$l of tbe nation'. childr.n In
    be: immuni7.cd. 10 Merico, soap operal or 'elnl(>-
    alone) and m.ny of them ar. ,"'Orking in comm u-
    nities .... here the n~ i< greatest.
    F"tg. 11 Number 01 television sets and daya mcseeear arc working wiTh mothers'
    groop' (IOUI't'M hatrlj!lU) in 3,500 vill.gt's TO
    radio receivers in the developing world
    poplllarize health knowled~, including knowl·
    per 1,000 Inhabitants, 1965-1983 edge of ORT, and TO h.lporgani ~. immuni~tion
    ''0 programme.. Another medical volUnTary ageocy,
    '' 0 Tbe S:lnkyad...a lIlO\'I'IIlent, has ~nli$led the:
    sappcrt of I,ooe Buddh;'t prieslS and tnirled
    o\'~r 2,000 volumeers to advise communities on
    "'00" immunil alion, coping wiTh diarrhoeal distue,
    improving hygiene, and monitoring childgrOWlh,
    •
    i: In I"JiII, the Voluntary Health A>sociat;on of
    Indio works wiTb a.....r 3,000 argo.ni~aTiOll ' to
    provide training and health care '0 some nf th~
    poore" cammuniti.. on th~ sub:ominenT,

    j: Major international non-goveTOm~nTal organi·


    zations haee also been in the va.nguard of this
    mcvcmeru, Since 1984, the Red Crou and Red
    ~'"
    eo
    Crescent Societies, with a global ne""ark af 230
    million members, have b«n Wl,Irking under The
    >logan of 'Child alive' to pul today', knowl~ge
    20 about llral rehydration therapy and diarrhoeal
    dise... conTrol aT the disposal of millions of
    to parents. Similarly, the Seoul and Guide mcve-
    m~nt, WiTb 25 miUion mfmbl'rs in over 150

    ° eoon,ri.., has bunch.-d a ' Help ~bildren graw'


    programm ~ by wbich Scouts and Guides boTb
    eo sa learn and ' uch Ihe techniques af ORT and the
    '"",,,, ' In _
    "'_'_IO ~ _""",, importance of immuoizaTion, br~a$l ·fcNillg, and
    __
    _lIb"lOd
    S:v<r .
    ....... _
    ~ a l~
    _
    """ _ 'mojoriIJo al grov.'Ih monitoring. In wpport of polio immuo;·
    Utian, ROlary In..rnatinnal has launched iTs
    massive world·wide ' Polio PIllS' campaign "'hieh
    alms to raise $120 million to belp eradicate
    poIiom~~IiI;s ,
    Volunl3ly organizations could th~re fore re.c h The various notional family pbnning organiza-
    imo a majority of communities with th~ ~hikt tions, the Save the Ch~dren Fedt ....tion, the
    health informaTion which every family nOW has a ChrisTian Medital Commissions, the Ago. Khan
    right to know, And in recent )~ars, many of those FOlIndalion, Catholic Re~ef Services, CARE. Ibe
    organiu tions have been involvC!d in plQfK'ering Oxfams of various nations, and many more
    both the knowledge itselfand the: waysand means \'Oluntary arganizaTions are involved in $Ome of
    of pulling it 3T the disposal of the majoriTY, today's mo»l , uctes$ful child health programmes.
    In flfdo"tsiu, fOT ~umple,.1 2 religi01l$ organ:;· ThOllgh su<:h arganilaTions, members of the
    utions ha\~ launched a joint communitatiOfls pnblic in \>nTh indu>lrializ<"d and dC'V~loping
    progr1lmme, u.ing l'<'gul:ll' religious ~hanne ls countries have an opportuoity to playa part in the
    including "udy groups, prayer meeTings, and alliwce for child health. \l'ill ihey now use that
    bome vi.i", in order to enhance the cbikt surviv.aJ OPPOl'lUniTY 10 invest their 'ime, their ..lents, and
    knowledge of 10 minion moThe,. by Tbe end of the:ir money in h~lping parents ta use today'.
    1988, knowledge to protect tb~ lives and Th~ normal
    In Sri IAUQ, 4,000 voluntcers of th~ ~ de'elopm~m of 'heir cbildren?

    .
    TIfE STATE OF THE WORLD'S CHILDREN 1988

    SAARC:
    children first
    T,lI<lo~. ~ . IOI*og ~l' oes _ fo<med ""!II lI>e ~""" 01 UNICEF• . . - OOtatlo<l
    f~>QntI ~1~ ..".,.,. !or tr_ _ IICO- "'''0",11_'''''''' on how ,nose obJect"," "'"11'1
    tlO<"1IC ~ Bu1 .. lI>o Pld-1geOs. '.. t>e_ Altl>e.u"'"'n '.... tlWlhe0d801.to1.
    QIOIIIlI "'ll"'""Ut>OI\$ in AIro:a.cenull Arneoca. and set UP ••11<1/l1ng CQITfTOI"'" DI the ....... 03uor"f
    5au1t> As" '-" t>egun Ill--.g & C\>tICem lor "'- 10<"9' sect.t..... ··IO<nlertal<e _ "" ••,.. (II
    '*It"",", <:/'wId>"on onto",- ~ egendao tl>e ..1<>It"", (II me - . . . . '" SAARC c<:U1t_.
    ~o< p<ogt _ _ e><dIarIge _ _. '
    The SlI\'8O ""lJOIl$ or the lecen!ly torrned SotIIh lr> _ """,d••• mecIIerdm .. now ", ~whIch
    AsoIn As.soc....,., !or Aogo<lnIII C<x>I>e<8\IOn
    (SAAACl-IlangIodesh. Ill>u!..... I~. M _. bolt> rrwror. on<! "-'le<ll lhe ....... ~ttC"l)I"",l\'
    N epool. ~_..., . ...... St, lotlu - ... tootno to 400 000>II ~ 10 c!loidter\.• needs
    miIkJn cIIoIdren '-""'8t lI>o "0" 01 rr... each ve• . To gtVII lectncal SWPO'l • • """'It..... 10<
    ~ 3" '!!!!':W1 !!"~ ee eem, O! ~. 4 s......_~ C ~~ ~ '"" ~ :n r.e'J)(l'~J . see -
    ....,"'" cIo nol ........... 10 'each _ firs' bonhday ...., CO<M>n_ toearth on<! pc)Il<III.lI011. on<!
    011
    IOd 8OOl/ler 2 _ die before lI1IIy "'. frye Not 011 """""'" ""'" ~ nave 0'lCkl<led chtI-

    ....
    .. of lI"oM wi"<> ......... _
    POleo nal _
    up to IuW ""'"
    10 becomQ 1,,"'llt.... Il'DWclMl

    E>e~ - . g fo< Il1o v..... l...... ""lIWl IIId


    cit..,.. CO<ICfII'nS '" thflo' IOC_ Othe< """""'1·
    lees are also b\Wlg !lS\:fId to IlI,okl the _
    _ "'10 _ I"OtI: 011 SAARC's _
    .os co-opera,,,,,, '" agncUt",e1 ~1 ond '"
    !I<>'OI\Ce.-.:l lec:IlooloG"
    01 "'"
    (IOIIIS"""

    belWMO 1IIe OSlO'lS 01 !IloS vasl 1118_ '''Il'''''.


    pn)\lIornt
    ~ - .....t..
    Iaell<! by "" _ .... I¥get'f COI1 """',
    oo:we cluster at onf«bC.... _
    To deepen SUPllM 101 SAAIlC. """s.\l'(lUplIcI
    ..,;."",al".. 8"l(l1OC1M'''' 10< <:IliId<en .... also betng
    """""\r11lO1>. lIo,eroev ""'" ""Pb18,.,., '" l/>e 10<""'" arncw>g POlfliemMtanarIS. prolQSSoOflal as-
    SAAllC """",," """ ltlerelor<l ""'" bV shamg _ sooa1l0 'n and ""..... llYSlM$I "" ........
    _ ....... .. """""""lll>o"" of ""'" ~en, _ ''lll1101l ...-.ong (he '''Il'O''.• "'"""
    ...,.,." 01_"",,"
    IIuI 0<1lI' d 11 'onks Ilogh on IlOOllCaI ~ .....
    oucn <:o-oPIKotor> be el!«lNI In _ ~ """ ~ _teo """e ..... 1O<)ay twO
    198 6 . SAAflC'. In, """'""" "'"'"'II .. sued the ,.,., """"" 01 ""'" hope 10< Soul!1 AI,,,·,
    ~ . O«:Iaroton , .. wIJd> "the l'1eacll 01 cMdren F"'I , 1here . . . COttIOIl.... _ ....
    stale '" ~ 1 IeCOgnIled \tIII l tho meet"", ,tlQIO'l•• POIrJeal "''''''',. IhlII 8CIlf'IOITlIC PfOQfI$$
    01 tho IllI/Od$ 01 .. _ ... was !he pnnc;IpooI means l>aI ....gely r.eglec1ed _ de> o l _ t _!I>ot
    oIlluman 'esoute:e~! ChoId'en $1'IoIAd ......lment'" It>e p/1I'sIcaItfld mental tleveIl>pmenl
    ltler<li<l<. tMo 0""'" the hoQI\e.. ptIDrTIy "' r'I/Itl<ln.iII 01 c/'IIl<lf"" .. an • ......,ttallong-lem> ......'lmonl '"
    ~ ~ .. !he oooaI and econ<IfT"OC dItweIopmenl 01 nat>or\S.
    S«:ond. !he prOQf'" ~ Soulh ...... has ~
    .t.t.comInI'' ,d
    Mailing till; mol. &PectIc. 1lllI - - . r.eadl; ol
    It..., , _ '" lI>o goalS ",~.
    0lIl "" mun".I"'" by 1900 and . by !he _ 2OXl.
    in 50 many other ~ e<:l""" '" fK«\1 VHII _ _
    IhlIt 11 now till. !he ,eSOllf<".. -rN1<lf\lIl. 1ed'n::1I.
    <tfld "'",, 101"""- t<> _ pr8Cl>CeI IUbslr>c<1 10
    '.n........ pnmaoy 8<luC.O"on, -..ole"""",naI
    lI<!'/ ~ oet>sJoo 10 ~lMl the PfO«l<ron
    IIrKl chikl ""llll.O
    ". sal. dr01loro(,j wale, _ _
    QUble shell.. lor til al!orlllld t<> lhe '1QIOI1'.
    ~on " _ "'$0<"'"''
    are mot>l:nI<l '" thll.....-.!he<> the year 1995
    T,.. sutnn'liI was p<eoodold by. SAAAC-.- cooIil .... 1"""""0 or tl>e 1985 ctol:l death ,ItI '"
    liOfe<:l Sou1fl ~ Conference on C!>iI<lren _ • .. <:ooJr'1U,... (II the ,egoon

    •
    That 1.1Iil.nce of peoples and voluntary orpni. IHuit Ihiltgs TJ:hich 0 part,,/ . ..... d~ 10 /H'D1MIt ~
    u rions i, also capablc of cromng polltic:a.l . hi/d·s ltOTJfIallItoIllry fMC/h. ~
    chums. In September 1986, for eumpk, youth
    Hut by and large, thai opportunity is beiog
    delegales from Eau lDd West, including repre-
    ~nmi .", of the Boy Scout. and tl!<: Young
    missed.
    Pioneers, nm at Erc,·an in tl!<: SoviCl Union. 11 is beiog missed because Ihe medical esl.b-
    Th ere, in the 'spirit ofEr.",n', they emphasiz<:<! lishmen r in mmt ""t ion. i. stl'\lCl1lr<:<! .~~ tram"ll
    tl!<:ir agJ""menl<, ••" aside lheir dilTerences, lDd and slIffed for dealing wilh illness "lher lhac
    made known their views on thc major problems promoUng heahh.
    facing tl!<: "w Id'. children.
    11 is being missed because a majoriTY of heallb
    professionals arc behind th. time. in their
    kllowl~ of oraJ l'I'hydration or· btust·fee<!ing
    Or grOWlh monitoring_
    Medical ""....ie,."
    It is being missed beausc mml medical
    There are nllW approximalely 2 million dlXt1lrs profelSion"'" reai.... 0 0 muoingful lniniog in
    and 6 million lnincd nUTKS snd mid..·ives in the communicatio ns skills, despite lhe facttha t effec·
    developing nations, mon: tban dOIlble the num· li'·e communi<:Ilion is probably the mo,1 impor·
    eee of ten Or fifteen yu n ago. And since lhe tanl conlriblnion they con m. ke to public health.
    Intem.tional Conference on Primuy Heallh
    Dore held 3t A1ma·Ata in the Soviel Union in II i. being missed beaU51' of the p•..rnling
    1978, many mil~ollt of <:ommu nity health wort:.· nOlion that heallb is SOmelhing to he actively
    cn ha.... been lrainw to serve in the viUap and deli"erod by experts and ~ively .....eived hy the
    neighbourhoods of lhe poor world. In Inw. alone, publi<:. The ba.ic delerrrun.nt. of a child'. heallh
    .pproximately 200.000 ollf'll"lMdi worke.. h."" are in the bands of parems, nOl dooors. Andonly
    been trained 10 inform and suppon parents in if Iheft' is an aboul-f.~ in anitudes and training,
    child care.'" As I resull, some lr.ind of modem only if medical profe"ionals see lheir lask as 0Ill'
    h. alth care i. now a.....il.bl. 10 Ihe m.iority of of demystifying Iheir medial knov.'icdge and
    parents, Ilbeil wilh VlIr)ing degrffS of expo::niac emp"""'ring 011.." .. 10 usc it, " ill tbey m. ke lheir
    and accessibility (fig. 13). polential conrrjbuticn 10 the advance in child
    health ,,-hieh is nOW possible.
    More will be said in a momem about lbe
    anchor role of lhe community heal'h worl<cr. But lndircaly. also. all health prof.wonal. rom-
    dooors and clinks, by Ibe scale of their OIlueach municalc 10 a Il.rgcr public thao lhey will "VCr
    and the inftueno;e of lheir sratus, abo h.ve a major meet. If pae<li;uriQans in matemiry- ward. insti·
    pan 10 play in infOlllling and supponing parems nne rooming·in of n.....·bom babies wilh Iheir
    in using today's knowledge. mothers, banish fcNing·bon1cs, and cocoot3se
    mOl he.. to hrea" .feed, lhen lhey arc making a
    E'"Cr)· contact belWeCn din ic or health ..'O,ker stalCment "'hich wiU be beard well beyond the
    and parent and child, nO matter ...hal the walIJ of Ihe hospilal (panel 12). If doctors beth
    immediate reason for the consult.tion, i. an usc . od teach oral rehydnuion therapy, n lher
    opponuniry 10 inform and to reassure parents lhao prescribillJj: .nti-diarrhoeal drugs, then lhey
    .bout such ,·ilal llIld !>;asic Ihings as breasl' will be reioforang rath"r t!>;an comradioing the
    fee<iing, binh _pacing, immuni>:alion, ....aning, effon s of schools, or ma$$ med;', or re~gious
    gl"O"1h checking, and onl rehydralion. "'I:'wry leaders, to promote a IhcT3PY which is nOl only
    Ii"" 0 IfIwh" onJ d iU t o.... 10 0 eli"i<: or htollh the cl!<:ape5t way of dealing "ilh childhood'. mosl
    ( (1/1"," "y' Or. Ralpb HendeNOn, Director of commoo ,""ess, 001 also Ihe best.
    Ihe W HO b randed Programme on Immuniza·
    lion, "0 do<:lrn or h.allh ~" JlrOllld10Ihrowg/l ~ There ii now iocrea. ing .,.idence that lhe
    boric htollh ond growl• • W. 0 I{Illflumi"l atlJ ~ medial profession, ...bose expertise must guide
    SI" " glhMing vj lh. lIlOlh.... ·s I/<sQwltdge /lbolil Ih. Ihis ..'Orld·wide aUi. nco, i. beginning 10 bring its

    "
    THE STATE OF THE WORLD'S CHILDREN 1988

    ....eight behind Ihe idea of empowering parents Meminn has alrn dy bten made of the suppan
    " i th [<lday'. hcallh knowledge. The International from the g""~rnments nf....,b rountri... as haly,
    PilCdi. tnc Association, for example, hu an - the United States, S" 'eden and Canda. In all of
    nounced I h~l it i, now pomiblc '" reduce disease these Cl ses, public concern, expre»ed in IbO\lJ-
    and death among Ihe world's childre n by half ands of nOW'p"per editari:ili, letters to tbe eeli lor,
    within the nelt dend••00 ClIl~ upon all iu and responses to appeal s, h3S p13Y1'd ae impor-
    member orgoniz,";ons, .nd all individu;1 paedia- tam pan . But there is In ever bl'Olld~r rolt>, in all
    tricians, to join in the elTon . The Indian Medial indu,trialized n.tinl\$, {or .n informed public
    AloSOciation has made 3 romm; Umnt to retrain its qocuioning of government policies on lid and
    members hip of 70,000 <locum in tbe UR of oral trade and dcbts. Page, H to I I of this ....P?"
    therapy. The Nigeri.n Medical Associat;on ba. have describe<! how pre&CO! eronom,C policies
    abo '",endy issued. statement <>II the imper- thre.ten both p'st progre.. and present potential
    lIncc of "'-di,,,,,,inatint nif7t'" illf_IUiOt/ DtI rhrst for 3dva.nccs in child he.ltb. T o ward off that
    I/llIIrgin 10 IllI dlKtors, "111M, phQmuu ;l/J, ond thre.t , lhere is a neal for stead~' publir pr... surc
    OIlrtr ru m of IrWIIr uil/[ IU wdl IU '0 1M to ensure that all COIIntries now mal:ing gMIuine
    I".,,".
    <""''''Ilnil)' III efforts ro pro'ect the living stimdlrds of the
    poon'Sl families arc helped lither than hindered
    Simil:!.dy,.,he Imemar;onal Counc ~ of Nurse. in lhl t struggle by tM int~rn.tional rommunity.
    and the Internat ional Confeder-Ilion of Midwivn
    h3VC given their mor:LI and pr.etka! $lIppon. And That suppan mly "'metimes tal«: a fonn
    under the auspice; of the United Smcs Agency which seems a long Wly removed from tilt subje<:l
    for Intm \Ol;onal ~,~Iop mcm (USAID), two nf rhild b~llth. It m.y mu n suppan for deb'
    maior inte rnation al confor~lICC'S on oral ....byd ... relief and tell1UCloring, Or fot inc....ases in .....1
    tion th~rapy have broughr log~lber medical l id and I renewal of loans, or for restrictioos 011
    re&c.reben .nd pTXlitloneu from all r~jtion. of .rms sale. and a lifting of tralk b:arri~rs against
    Ibe world to sb.re ~XperifllO<'S :uld pl.n ,be manufactured goods. Bu' these ~ .... matters of
    promotion oftbe new Ibe.. py. legitim.!e ron«om for UNICEF and ~Il wOO " ish
    to sec .n ~nd to unnecessary suffering among tile
    The b<:.lth profession, from th. medical eol·
    " oorld'. young children. For in ils day-lo-day
    leges to Ibe ru ral clinics, directly Of indir~lly work, UNICE F sees tOO often !lovo' shon I step it
    ionuenres the he.lth srrhud... and behwieur nf can be from a b....nce--of.p.ymenI5 cri. is; ' 0 a
    . Imos, aU parents. And its koowlcdge and
    shnnage or essential drugs, from a rise in nil
    ptt$l ige can be used .ither 10 promote depcn. prires to • mobile vKcin.tion unit withool fu..J,
    dena: nn the rnedkal mystique or In empower from a debt falling due to I clinie being clo.cd,
    people " i t b Ihe kn""i e<lge and confidence 10 lake from the withdrawal of . fond subo.idy to the
    more re~paR$ibmty fOf their own .nd their "Wlting of I cltild.
    families' health (fig. 12).

    The .~al 10 aU
    The public role
    This sketch of lhe rang<' of wcial "''SOIlrc~
    In both developing I nd industrialized nations, wbieh could be mobilized to infonn and suppan
    members of the pobtic can also playa pur by pm·m. is; intended to l;Iimubte ralber than to
    suppartirl g the many volunlllry agencies whirh limit th. imagin.tion " 'hirh now needs ' 0 be
    ar. nOW involved in the Ilrugglc to ....alizc alda y's brought to be.r on this tuk. Q,-ganiled sports,
    potential for saving the lives and protCCliog the \tisute, and ~ntcnainmcnt, for u3mpl~, c.n.1so
    growth of children. But there is also a broader reach 001 to millioR$ of famiU es. People' s own
    role to be: played in inftuencing the pa tiries of org.nizations, whe-tber they be peasem co--opera-
    governments ..-hieb provide tbe frame"oork for li\-eS, neighbourhood associations, ccasurner c r-
    that struggle. ganiZlltions, wnmen'. gr oups, or professional

    "
    USOC'~I'onS, ~lso h~ve a pan to pl~y,· And In sum, il ,. nO! only the 1ul0001cd~ 10 impro,·.
    government emplO}'ffS ~nd a~nc ies of all kinds, bmily heol'h 'hIT is nOUI available. The stlCial
    be ,hey dt'pan mC1l's of f~mijy l;'!~nning, w;Uer resourcn 10 pilI lh~1 knOUllcdg<.> ~I 'he di.posal of
    and sanil~tion, ~griC\lllunl enenscn, or even the the maiority are illso in place. BUI ror Ihe one 10
    police 3Jld lax oollecrion forces, reach out regu· serve lhe olher, 'he whole of socieIy muS! accepl •
    Iarly 10 I~'lle numbersof prople and are lherefore lar~r shue of mponl,ibility for the heallh of irs
    also a ccmmunicnicns rcsourn. children. For it is nOlhing less ,h. n a pmnQIUII/
    JOCjlJ! lII (}bjlbl1iQ ~ which coWd now lIansfoml
    what ro~ nOUI be done into what rcill now be
    don<.
    I. -.:r y<>'" ... ~ .. """l" "", _ _

    ,0< II"~ 11"_ "


    1II<t<..,.,.Jy _!»N< ''''''''olh
    f"""" .. M><lr.. (SIll#! _ "'"
    5..f.f pIoyo.l1l"........ .-.-.." ... J ~ Ils.DOO .....
    """ .. h is a 101 10 • .k. And aU of these possible
    ponicipanls already have lh" r own a~ndu and
    ...".~ G"....., Ibol; .....,. .. ~ Iloo.ooo priOlili",. \l01 lhe basis of 'he apl"'01 10 all
    "'"""""I. >D<I "" ll"oo\Inc 11""""",.. So~ 001>0 .. 7....· secncos of 00<;"1)1 is simply lhal there iJ nO
    """"' (200.000 """"""). gNater cause in which 10 march.

    Fig. 12 Increase in mothef's' knowledge of treating diarrhoeal disease.


    Egypt, 1984-1 985
    "x>
    90 Ill,.

    eo 8-
    ro

    i
    'e
    eo
    so ~ ••-
    .'"eo
    20
    to

    ... . -
    0

    % who kn:m the


    _ORr ImporIanc:e of
    ccomee """"
    lho ""'"'. ' fvwI" __ ..... . - _
    ..
    _ " _ .... .. 00, -
    , "
    ' " ....
    . .","""",,"
    - . .... _ EQIo<h
    _

    ._
    """" ant~
    ...-..,.."
    ..dot>t.. otioo
    _ _ •.0-.._ ..
    to
    - . .... _ .. "" .. '30,000 ( 0l'PI"'n _ OKI\_,

    ..
    THE srATE OF THE WORLD'S CHILDREN 1988

    Nw II nIII .......... ~ IItttpllllM, . . . whidt mlUl _how be OOc,,:c..... ADd II ..


    -tidif'kl..,pm_ .. mod.--. ,... bccurnt"l ilocrtulTY dear dw politit:aI <llll1IfI1I'
    » ..., ...tJ_; cJIilImI .-.u it ~ _ lD<'P' «Iff Ill: me;,~ ill VIl)inc dell' ..... j(
    , . ,.. .wn:J ,.;u""", ...... 1III1tt/, .. StlfIl(tJ uti bllllWlilinan appeab an: framed in IUCIII '1'2)' IS
    MItdd IIJfII """.~ 1«. - 1M U'«IJ ..... 10 also mike financial and pollia ........ I'.. lptm
    *t'«uJ 10 fiIlly j"f- . '" l"tp«1lwrf oMJin ill "nllil and 01,," fields of aoc:ial devl:lopmtni
    i" '''''''1~ p_ritllJ I",J gffimf..Nt INyf '" /Wl'f«l' need to shape and simplify their ~penise illlo
    ,'", t Mld" . ~ /m., 4tU/ gr=' ~. plans "'hich Ire pl'Xl iCllJ and affordable, wi, h
    AnOThe r child will die in the lime ;1 tl~ to obvioul il.nillll·pl>ints .nd oll. in. bIt: objroivc..
    "'~ th" semencc. And 1M de:lth of that child, :I
    and '0 present ,hi- p1.n. in 5UCh I ....Y. , 10
    child who b3d • !LIme and I "" l'IOIWity,:I f&mily

    --
    and :I fulUll:, is I ~bIlltC 1O.u h\llllllltlf' It is DO
    Ionjr:r llKUAry. II ~ lil~rOft 110 IoniC1' be
    FIQ. 13 Availability of health care t or
    pregnant women and infants , 1986·

    PoUtkaI will
    ~ 9' =r...::=! r=..~ = :z.....r....
    01. ll'llI tit 1II111riplitd if thr). ~ pan 01'1 1:0-
    on1ia.Irfli n....... l ~. Aaws 1M whoIo
    ranr of QOIDDIIlI' . . . . . . . . di->plines, fromedlX:l-
    1101I to ,domising, thr pnnapk of frtqUtDl,
    ,~ teJlCtltioll of ee wnc ~ (1'l.lI1I man)'
    .oFNCA
    ,
    I<JUt«I is ~rJmOUDI. And 1M SlIm. ol public

    !:~~~~~~~~~~~~~
    brightly jf those who comributt tht oXYgt' n of
    in form~tion were all 10 blow on the P ille lire.
    Usually,
    hnllh knowlfdgt' pIl~til.Oldnrly
    h is the'll/'OUld «Immiuncnl of :I
    bum mon Sf
    n:llion.. leadership which an mobilize I wbole
    society, prClCll« tht ~ tetOW'tn, ee-
    ordinl~ ....ppIy and demand, and pili tbe weight
    of ptllIlallml ~l .. mea behind I
    ....wiled ruotioaal drort.
    A1tbcJuP lbe~ are ourmndinc ..... "'pIn of
    t
    IlIIth ClXIlftIitJnmt, • lIlUSI be AId WI !be

    _.._..- -
    . , IZFD CCIUf1'MS
    poliric:aI dIG an oa bdIaI( of !be poor IDd 1M
    ..,.ANT CAAE""
    nIblrnbII! is IlOl ~'S ~ And lalla lbe
    . . . spo:ctrum al 1M do; .cl, til C'/fon, tilt c.. ... p '01_..- '....... _
    ~ 10 trmIfotta pam imo pl"'C"" IDd

    ...
    potntlll 11IIO ~ is _ alia DUI
    do-'n 1C 1M 1Il.IUi:nc....p- incrodimt -~
    ..._ ........ _ _
    ........_D1.. _ _ ..-....
    -..
    '-\01 _ .= t ..
    1>0_....._
    _ ~

    _--.....,..-
    O""'~.... lloou lW' ..
    or ." n_-.o>go..... ..... lh<i.h:liol. ....
    This lack is IlOI udusivdy tbe fwl,
    po!i,iria;u;, aDd oetds 10 be ~ 110( . . _
    insupel1lble hurdle bul IS ~ IIlOlMr obsude
    _Boo."....,
    ,-_ ....
    ,0_""",-
    •
    rapture the imagination of both polilician, aoo Involving a wide variety of communication.
    public, To realizc the presem polemial, nation- reiOUrces in achieving great nalional goal. which
    ,,'ide aClion ror <hildren tin be, and must be seen are d"", to the hean. of lhe maiori,y is a
    to be, good poIilh CQntribuuon 10 society which docs nuke polirical
    The ....e:tkne.., indefll somerimcs the laele_ of sense. It can bring meu ul1lhle resulT. in the
    commilment among ruling Bites to Ihe weU·being immtdiate future wilhout m.king impossible
    of the majority h3.'l bef,n and still is a m jOf dem30d. on aVllihble ~C1!S- II is by far 'he
    obstacle to dewlapment in mony nations. And mOSt cost-c!Tccri" e in"esunem which tlln be made
    <he 5!ruggle for leadership in the intere... of the in the nllion's social and econo mic future. And it
    poor malority ;s and should be a permanent improves Ihe lives of ,hildren tod",_
    feature of the <!e"elopmem proce.., But all The q"" .. ion mus, tbe'efore also be put to a
    improvement ClInnot wait upon political utopia. nation's leaders. In the y<:UI immediale ly ahead,
    And lide by Lide with that 5!~Ie, lhere is also a "' ill tbey lead an alliance for healTh by makinll a
    n~ to formula!e proposa l. "'hleh arc capable of perso na] 30d political rommirment to redoong
    QplUring political will and trlInslaling it into child dC3lhs and child malnutrition on Ihe scale
    "",ial impronmen l, lhat is now possi ble?

    Support for women


    Even with !he political will 10 do wbal (lin now putting m:w I:nQ"'ledge into action, Those "'bo
    be done, the knowledge road to healtb !ll.ill bas are nol edlr.lted tllnnot easily read It'lIIindel'$
    many pilfall., about the time md place of immunization , Those
    The wide variely of communication. channels who live without water supply or sanimicn do net
    alrcad)' decussed will 1101 euily reach those who find it easy 10 keep din and Biesaway from bo=
    and food and waler, Th"", who must work all day
    are illiterate and unemployed, Ihose who do 1\01
    O\\Tl a television or a radio, Ihose "'h<.ae cbild"'n
    in fields or fmories cannot alwa)'1 hreuI·feed an
    do n01 go to scbool and whose "", iaJ .. a!US infant or provide freshly cooked food four or live
    e!Too;""ly preventSlheir pan icip,n ion in many of limes a day for a )'Ollllg child.
    Ihe organizatio n. Ihrougb which they mig ht be Yet it i. among the pccresr that the eeed is
    "'ached, And ...'en if this problem of o,,,reacb can gteare.., The poorer the family, tbc grelter the
    be soh'ed, by using I U po.sib lc ~nujty and lih:lihood 30d the rllks of low bin h-we igbt and
    eve'}' possible cbannel, there rcmalOs the leiS malnutrilion, of diarrhoeal disease 30d respira-
    tangtble problem of Ihe poor $Olf·im'ge, lhe lad 101)' infection, of poor grOWT h and early de atb.
    of confidence in change, tbe sense of power- Therefore the obstacles must, 5Omehow, be
    leWless, wbich is hom of long yem of poverty owreome,
    and opp ression. [n recenl }'Cars, it has been sbown tbat '-cry
    T hese t"-o problem. arc fun bcr compounded poor and often uned utllted parent. can and will
    by the fact w.t it is also the vel)' poorest who face f"o'l tooay', child h<:alth information into ktion-
    the greatest pl1lcticaland external difficultie. in If aU possible channels arc used to infonn and

    "
    TIfE STATE OF THE WORLD'S CHILDREN 1988

    The Convention:
    rights of the child
    As I", baclc ll$ Roman urnes. tho law lI. atllll The drm C<lI>.>enbOll CMSI$l< 01 ]5 "'llCI8<
    e:tIoIdl"" as _ .. - ~ Plt_ -PIOP«tl' co-enng 0YIl. ;dIocol. «",""moe:, IIOtial _ eu.
    Not un,. tho 19m "*'''''V dod chIdI"" begon 10be
    ~ ... ~ speoool P'Olocoon 10 .....,
    ' ho <U<Pblauon 01 chokI ~ . '0 P'll'lOde bll$lC
    O<leQ.... te t>eaflh
    _'81. 10 rogtIt. 01
    c....P'OIecUOll _WI''',
    ,..... ''''''" 'arIfII'IIl from ·.........01· "9h'". ....", as
    klod. cine
    , _ .
    _
    ~'I"' . to ......" """" lo<m 01 ~ _ nog!e<;' _ ... plOotauon. tOO <9>1 1<> ule and
    POI'I foI l/MI """" ~. _
    e>:UEli'IIIl cases 01 neglect 8Ild _
    10 P'TV"'" proper <le';eIoprnenlltv'ougt> _ edI.ocallOn. and
    ffeedom to panoapal8 .. 100 SOOIII. 1lC<lnOmIC.
    rt/Igocl<.os. and pCIIo1ocoIlIle 01 _ cu!M1l
    ree 2O:h ="..lrl r:= =
    tr:e ~ ex-
    1~ "1"'''''~ '" 19 24. tho e;.,..,.,.,." ~ TOO Cotwe<lt"'" and tOO rogtI" ~ setS OUI In
    t.aotl StBle(! lhft "me cIWl ~ the b8:0t based on II..." onr<:JIIieo . lhat d1Idr.... r>eed
    ~ 1'lal1O ~ " - _ 1<><I""'1IIe<. we mote SQ8COaI safeguards beyood tI>OSe prO\lOded 10
    lIIan 80 "'''''''''llONl llPNs. aM!IIaI'1lS. . . . , _ . _ : ",It u...
    beSl _ _ t lor I ckllcI"1
    """"' "''''''ll OVI '~ ngtnl lot" chkIren' ............ _ ~ ..""""" ."""ec,..... _
    ....-n.onng f..-rWv ..It'"!l, ond that IJO""rments" ond
    Si<lce 1960 . e IoOtbng group 01 the Iivmon
    FbghIll C<>,.,lIS$IIJi' t>as!leer' drattfOg a Convennon "'" aduI1 WOfl<I .. 11"""'111. sllouId r.. """'""'''00 10
    <J<' tho Ibghts
    ""'''1Y1g
    "'the .""""".",,11 d!J'. _
    ChId. dr"""'lltogOtt- !hose
    on! SOOT.. ,..,
    """"II .. Ih/t 1>0$, "'t ..... to of rNdr....
    Gove<.................,., lormaily -.::0001 _ s.gn the
    oty!ll><lS """ D <:omp<""""""" legal .........,.,.., eon.en""" would _ Ih/t f ~ t y 01 IM>g
    In,ended 1<> bit bondonII on .. ......... ........"._ "" IO ~' D<0'I'IS0DnS _ rellectJng - . . .. , ...... own
    t...... _ r~. M_ ."... lor mon>tonng
    " GM!n an "",,_dinaIy etfoo1 01\ HIIlIl, l/MI Cot\- _ ,~ D<\ IN omo&emeo 'II'1D<\ 01 _
    pmI'lSIllI1O 111 llIe flaWnIO _ IIl1I S1lI ~
    _lJQn <:<>Jl<l be ~ .. ,JIM to be """""" <lISCUSWd IlV the WoII:w>g Q lII.(l One PI\lP058I IS
    pr-,'ed to tho GenetaI ~ 01 the Unrte<l lor • t8dvloclll lI55IS,once """,,,,,,,,",,, 10 hGIp
    ~ . t>onS .. 1989 _ !Ilol """h ....-s.ary 01 the
    ltITer oaoonal Year of l/MI ChoId ........mg "...."... "",ngt~ tr- own leg<sl8Ioon
    end p!lySoCaI C8PICf'i IOCOO'r\IlIy_ ,tie """"""'"
    r~ '*If.." """ .. <he bo:'IOong ,." "',, "'e C«Ml<l - oIttle ~
    lIOn"" p<oYISIOtlS or>" '''"f,onQ
    !he extS ~ o»:unenlS lte not~
    N'''''''. M..... 01
    e<>loroeat.>Ie.
    Concern 8bou1, _ SIJOPOfllor, Ih/t ogIlUoittle
    c:hoId h8s boIen gr""""ll "...ely .. 1hts C8t>lU/Y -
    """""..,.,py" <l8da< amn 01 pnn<::>ple n.s .... be n.,oonafy _ .. t.................. - . . ond\.iot....A11D<\
    1'" ,"I pme ~ ~ nghlS _ _ br0U\111
    loge""" .. ..,.. C<:o'lvenuon _ . once ooccept..... rei _ AtoD<\ " - out ~lIOnIl 0C0Ii fllbr>cs
    and c8MU<le. """'r oncre&SlnO _ oh~ .. tole!.
    lias tho Io<c<> ol " bo>dong oI*ga""" _ str.... - ""lh rfIOffI' .......... 01 <:/lII<i"8<1 r>(I
    ~ IS this "lJ'U ""'"'" maI<es 110'_'
    DO !he lonoet be 10 coun, on 1hGO' f...-.loK lor .,. !lie
    ~ 01 a eor-non ouch " """.".,.,.. SIJOPOfl1heY.-:I Ttle ConYoI<IIon on ltIe Ilogtl..
    l-.cooSUl1'W\ll p<ocfl& Ment>e<s oI l/M1 ~ 01 u... CJ>kl .. tOO mos' - ' u l ..""""""",*
    Gmull rep....,! Ihw c",""""" ...., tIlus U- reJe<:""" 01 tm <:cnc8rn and ,r.e mos, <ldtemuoed
    r\&I....... os wei as ..,.......lIO<>aI co"ce",. Ilflort ve: 10 do tome1IonO IIIJI)IJ' "
    suppon tbem in doinll' so.· But ,\>OCtSS in The C<I!l of troining such • pel'5On - and peopl~
    reaching the pOI"esl - both ""ilh information and witb linl. fonnal r<!1JI."I,ion M"" bttn r.ught 10
    " "lh practical and OIHhe-tpot suppon in ul.ing give rhi, kind of support with great suC<:eSS - can
    il_ is m1lk mU<;h more likely with lhe suppon of be I.... lhan one ftftteth of the cost oftraining and
    one gre'l reSOUK(! wltich hat nOt sa far mn equipping a fuUy qualifted doctOr_ II is lherefore
    discussed -lbe communi!)' hcoJlh WOlker, not inconeeiv.ble rhal, within the neXl few yun,
    every village and neighbourbood could be served
    by such a heahh worker. Some nOlion' are a"".1Iy
    ne.ring lMr goal. And !hi, gl'OlO-;ng army of
    CollUDunity halm worken communily health worke", could become lhe
    With .pproximately!ll"", month,' lraining, a force for kta/III p..,,,,<>rio~ which has been so
    communiry he.lIh ...cner an gn-e advice and bclting in rhe m. ke-up of mosl beallh services to
    help "ilh bin h ,p acing and pre-not.l care, safe dale.
    del,..el1' .nd breost-feeding, disuse prevemion
    Tod. y', knOl" ledge equips heallhworkers with
    .nd immuniulion services, oral r.hydrat ion tber-
    ~rfuI w.apo", . gain.. mo:st of lb. m.in caUSC'S
    apy and roping with dinrhoe. l disease:, basie
    hom. hygii:n. and _adequate fealinJl, knowing of ill health and poor groW1b. llthcrcfore helpsro
    establish their credihilil)' in !he eye, of the
    "'luI to do aboutlcule respiratory inl«tion, and
    malari. , diSlr;OOllng 'itamtn A apsulcs and iron communities lhey scrv•• ,\ nd ir properly tnlined
    or iodine supplements, and hdping with the .nd sUPPOl'led, «>mmoniry heallh " 'OTkers con
    regul.. gro"1h monitoring of )lOUng children_ In refer mOre difficult que,ti"n, to more qualified
    o!h.. words, . communiI)' health wo,ker can help levels of the health service, so lCiing as the
    mc<:hanism by which limiled reSO\lrces are de-
    10 root today', basic child health care knowledge
    in • communiI)'. plo)'ed mOS! efliciendy in bringing lbe .ppropri-
    ale level of hcalth care 10 each healrh problem.
    If that health ...,,,ker is . 1$0 a pan of lhe
    community and its culture, then be or SM islikely The village or neighbourhood he.llh wOlker i$
    to knOl" how best 10 adapt and communico", rherefore a key 10 unlocking rhe JIOIemial of
    health informalion. Th.1 kno"'ledge is vilal. The roday, beal!ll knOWledr,' Bur h. or she C<lnnOt
    " ",k in a vacuum. An lbe more the infrntruc·
    peer are not empry "csscls imo which informa·
    tion an simply be poured. They have their o....n rure or primal)' be.lth Clre is strengthenr<! 10
    suppcn such workers, ihe more 5O= SIIfol lind
    knmr.'ltdge and thelt OWn beliefs aboOl I.ickneS$,
    and 'b' knowledge is oflen inseparable from lhe dUl'3blc will be the effon 10 put roday's vilal child
    cultural and '""lnomic life of lhe common ily. health infomlllion al the dispMal nf all p.rents.
    Sensitive, respectful and effccrive commonication More public and politic:lll recognirion and
    is one of tbe mosl needed Inll m.... neglected of suppon i, lbcn-ror~ lhe due of alllb..... ...ho IIOW
    sI:ills in development and lhe mosl important pan workto improve the health of rhe poor al alll""els
    of tbe communi!)' healtb ....o rker's la.lk. of rod.y's prc<:.rioos primary heal!ll care Struc·
    lUr«, whe'her tbey be norses, midwiv«, doc1ors,
    water and sanimion workers, organizers of \'aCti-
    nalioo and diarrhoeal ditclSe programmC'S, em-
    pIoy<.~ of J:O""mmenl and n>tional and in,ema-
    . 5«, '" ....., pood to" I"lI< ..... 1l< ,o;,,,,, .,~ W.,.I./', tional orga.nizaliom, or eny Ol ber individuals or
    (;kim., 1m Ild>r>l Uoi.....y _

    1'0'"
    my _
    ~ "' .... ~ • _01_"""""""",
    , If "'" h«I.. -<>lll>m>lin
    boc>l ... onI .. 1Iydr._ "''Pl' ,
    ,
    Abo. • oloouI.I ... h< S>rpIrIl ,!.oo ....""'" .... ..._
    ..a.... If .,.;"h_
    ...
    ,h<disp>oaI til ....
    .
    ......
    org. nizations who h."" made it their prioriI)' rc
    help proteer lhe health of the poor.
    It is lhe)' 11-1>0 Iu nlc nn, oflen "i!ll linle in tbe
    """y "f reward or .cclaim, in ,h~ foce olthe non-
    ...... """,,,,·r..-.i "d••• ,~ .. """~fe<,d, "",01 lOr _~ <Ire arrinl of supplies,or !lie non'p")ment of..I.ric..
    >o>d pWI ""'.. r... &., -..... tlleir <lIiIdteo ....t ........,.
    ...... ~ ,"'" ,hoy ore ~
    10 olI ...... r.mi6o-o .. , ~ _
    """""'.1<aIirIc ,_
    ........
    or the fnarrations of bure.uen.tic incni.. or th•
    _ mund.ne detail' of day·lo-day diflicullies. It is

    "
    THE srnTE OF THE WORLD'S CHILDREN 1988

    Southern Africa:
    hidden casualties
    Th" cllrec1 elfects '" IParTI>eod 0Il11le chiIaI... at Heallt> ~, ",*"",,",lICherS and /lUPIIlI.
    S(Mh AInu IlwYe t'I'I8do lhlll1<'Wll .,
    " 1987 Loss Ila$ " - ' _ d 01 !he ondlfect
    moo,""lIOnS 1"""ll1'1 aid
    medicfII
    ""rmmet. ona .ehlcle!l ,,~
    0UPP0es .,.; Iood IIaYe all be(In "'ta<:bId
    elite' S oIl118 -meod conllocl 0Il 1!'ie 15 r'I'OIoo<I
    """g "'ok....., ot Iho ...... r'IIlIQhI><Junn stat ... -
    Arqolo" llol_ _. l8soI,",>, Mal_ . Mola<rb-
    r.....,
    ""1Il the 81m 01 malong I.. go ...".. ~
    Power pIoor>l., PDtl. 0I'ld
    been larll":ed, oIong ",,'h 1&3
    IIaYe .....
    ,a,es. _.
    _ . S"""'"""". T_ _ . Zarnbia_ Znt>abwo- cemen' Qlonl...... 1l"lr<Hum ..Ol"'t>ons
    In !he moo l ~ afflICted CO<.011'.... ~
    nomoc dlstupl"l1'l tond """,,..., &elMliH /\ave ",. _
    The 00111 O!"
    lhoIlIaYe iii<> rlflIPed 10
    lot """""" ond cIW<t.., S__ 1990.
    _ ,ogo
    cteMtd _ _ ,,,,,,$try an ",,,,,.'ood 75" Iosse. ~ bI' !Ile moOlory and """"""'" ""UO"
    MOlamboQue """ Angelo. In ~"l>CUlar. I>avlt ....., gle O'<m" ~ 1<8 "''''''''ed 01 $ 17 boIoon lot
    :he l.l~! ~ '..re!!:!t! !e ~ me
    ~1 =" A.~. S5 5t=:;o., IG' ~"~-r~. w.;lS 5 t;;::;o."
    ~'MlIIe
    -drOl.lgtl t, lot "'" other _n ...,•• of l/'Iol regoon
    dornto$,,,,
    ftoods. llllo-lg u.II. _ _ 1
    ~ !'lave 011 contrtlul.fKl '" !IJq; CfISIS ,
    The ,,",0le1 hI.on.1n cos1l otw"'... ornoum 10 II
    leM' 100.000 de.lhs ... AngoIo ard Moz8lllblqu8
    .. 1997 ' OPOI'I kY l/NICEF _ tNol "l!>o ~ 1M moo, 01 "'" 'ogoO!1'. _ ... no!
    ""'" ~ ~ .. W/JJ/ ancl economIC PlO$$l,>"i . ·· r;aosed bI' Wll3IlOf'I$. 1Nr; or. Ca<J<8Il by mahnn-
    Hal _ ' t>I1 .... AngolI and Mo<8mboque E_ 1 and ",",moel , by untI.a,ed responllOly ... ft<:.
    ....,.. lICIlIeYIi'lg ~ .. from PM ...gaI "'
    , and bI' dI$e_ whoc:h could h.,>., !><len
    1975, t>olh CCU"\tI'''''have _ beset try ontern-' prevenled by ....................
    fogllt"'ll """ .. . tomel " ,,"".., Nooetheiess. l>01h Iioll!ll POk>os .. AngoIo a"ICl ~ .
    CX>.J'1U- tIad rN<!e an onpress"" slM1 ., moIIw dI.mg !Ilo late 1970.. looled IoUIV 10 reduc<t
    """ th<Id car., ............. """. ........~ lINgS, unoer·bYe """'" '. 'es 10 _ 200 _ 1.000
    dnnl:,,~ ......,.. ~ . _ tood _ I V to' lt1e _ (T.........••presen l level. lor e><aYIl>lo...
    -~ , 185 _ 1.0001 ","1Nd. "'" ' 111.... bolll COUll-
    8<J1 W!tI1 !he ~ o! tile 1990s c:.m<I " If " .. has now ,..." 10 "' ....., 32 5 per 1.000 t1
    S' ''I>P'I'!l up 01 ~5I/IlI'lOrI"" dtsrupttor1. end can It\flfehn be esoo>a1ed 111111 appr~ 8IV
    """"""'\l the c.suoltte. _ bee<11ho1r. ouucwr.. 140.0XI VO'Jflll - . . , h.,>., "'""' .. Angola """
    eeve."""

    _
    01 _ _ In MolamboQoe. fOI Molornboqw !hoi toll ..... ""'ply • I ' , 01
    e.ampIo. S85 h. .. m POSlS _ Ileo/ttl ce<l1reS- me """"'" otn.oggle "E ""'Y Iovr "-,,e.:' ....
    almost IIII/f lINllOuoI-1IawI bee<1 <l&s1fO'\"ed sonce the UNICEF ~. "I omalI AngoIoo '" Mo>am-
    _ ..chid WI ' 1011 wtlo otl"4lr'Mle _ hlMl
    196 2 . 0.... • Itwd 0I1lII """""'" """" IIlso been
    wr fICI:e<l '" _ ode> lIod,luwig """,,1Nrl 500,000
    prrmEIIy-SChooI d'loI<lr.., .....1hDu1 educa1"'"
    Peace,"'" an """,10~ , I<8 meflf_
    •.""" '" !he ""ad\leS' WlI"1l'J'lS 01 11>8 Waf: ' .SVS s<tes lot bO!Il heoIlI1lfld ~ 1 .. _ lham
    It>o ,~. " . the n-. ' ''''''''"''' come<! 01.11 l"< AIrJco In!lle meantJme, mAons 01 cMtren coulcl
    forces ~ !law bI.med l70PS _ l~ . be ~ hom ee .....nt ~ 01 !he
    ptI.og8d...-..l </e'' ''t7V'ld oohoOo. clom;:a .~. """lIoc l ~ to", .","'''''....... """"""'" to
    ............... ",,,,.. and ...._ . wO<Wled WOlIs by Pf<Md& VllJll'ltly ""'>ded ilr>an<:e. Iood. •.
    1hi'\lwIr>,j \lodo&s """'" lhem. and ."oclod 1/10 V""""""". OIlf\St»l'1. WIll'" supphes Ind IlIlp lot
    lfonsPOfl avo''''''. _ .. . "'tal POf1 of "".. i!io .. ""llf"""'ll foocl """"->C1lOfI
    lllcy who em y on doing what they can when world, A significanl improvemenl lO Ihe SUle of
    politi<:1.1 "hange disrupts the Slcodyprogreu that Ihe world's childreo therefore depeods mOSI of aU
    hn been mildc Of when the nOli~ arrives from on the SUle of Ihe world's mOlhers -on Iheir
    the minim)' of finance 10 s.ay lhal all budgc'lS I re physical heallh and menial well·being, on their
    bting cui b)' 25% bca"", oh r.ll in oil rev.n"", lime and Iheir energy, on their access 10 infonna-
    Or I rise in jllter.st rates, or I lJump in raw lion .nd income, on Iheir stalUS and Iheir moral<>.
    maleri.l price•. And it is they who deal wilb the
    logistics of supply and rranspon, the problems of 11 is Iherefore the mOlhers wbo will normally
    management and rommunicalion, the $honagos be Ihe focus enne inform3lion and scppcn whiCh
    of kef....,n. or cub. a ,socieTY can 5Ummoo ~ from bushands and
    fam~ies, from neighbours and communirics, from
    And when lhe excilement and the publicity heallh "" Oturs and c~nia, from The media aod
    ilCXomp:mying 3 national vaccination cam~ign the schools, from employers and labour unions,
    bl. died <Wwn, " 'hen Ihe memory ofthceoCOUf- from religious aDd communiry leaders, from
    agi ng ...'Oros (, om ,h. head of SI"te i. fading like go\"Cmmen! servic<:s . nd developmeol planners,
    the posterson lhe walls, it is they who must gel on and, 1I<)I[c.st, from lhe intem' lion.l community.
    wilh Ihe perma nent job of mainu;n;ng ,h . ' oold
    chain' and ,he: sll'l"ilizalion equiprnem, the vee- Al The momenl, Ih. 1 suppon is often ,,"eak or
    non~xiS1enl.· And Ihe e"",yd. y hardship and
    cine supplies and rhe information ftow, so mal discrimination which women f""" ~ in food, in
    imm uniu tion kveI. can be! .",n,inN for child.en
    education, ;n health me, in work, and in
    001yet born. rewards - is loday Ihe single most impon.O!
    The suengihening of primary health ta re harricr 10 'b e improvemtnl cf't heirown and their
    Slructurn, .1 all levels, is lhuefore I crucial I"" of childrtn '. h... hh. Wilh leu cduc3don and SlIIUS,
    a nalion's polilical co mmil11~m 10 the heallh of leu occess 10 lechnology or lraioing, and few<:r
    lhe majoriTY. resourccs of either cash or c ern, women in
    . 1100$1 all commuoil;" are expected To be om
    f1ut in wnduding this report, a report which only wivcs and mOlhers bul dUliful daughlCfS and
    has laken as ils single lheme The mobiliution of
    aU possible resources 10 do Whol can oow be done daughters·in·law, farmers and income~amers,
    10 pro'''''1 the lins aod gtO"lh ofthe;r children, ;1
    home·makers and healTh ",. .,rurs, fuelit'lhe",rs
    musl be said That lbe olher crucial rest of lI.al and. •nimal·feeders, food·providcrs 3~d water-
    .."",rs.
    commiuncm ;s Ibe SIIppon wltich is gil'eo to ils
    mnsl important h... hh workers of all- Ihc na· IL is tOO much. And lhal is why lhe greatest
    lion'. mOlhers. communicalioo$ chaUengc, for The wide l'IIngc of
    aim$ and 5UCiil n:wurcC$ diKU$W.\ in lhi$ repcn,
    is the ' haUcnge of promOli>\$ the ide> Lhal socieTY
    musr give mere suppon 10 11$ women, that Iheir
    knowledge and skills should be alTorded more
    Enryday hardlhip recognilion, and lha' meo should a1!1O share lOon:
    In pnnire, il will usu.illy be ec mmhcr who fuUy in Ihe task of prOlecting the lives and the
    ",·m decide soch ma" ers as whelher 10 brU$I·fced nonnal ph).. i' al, memal . nd emolional growth of
    and for how long, when 10 inlrodllCe olher foods their children.
    and how 10 prepare lhem, whelber 10 add oij 10
    gruel or gi". fluids when Ihe eh~d has ruarrhoc.,
    wheTber 10 I. ke a child LO be immuoized 0' to
    rqrllorly check irs grOWlh.
    The realization of loo.y's polential Iberefore • no. ~ .-. .. ..... jft<'.<;ton "*11""""', rJt;Um,
    '"f'OCl _ .... _ 0( 1IIIlic>_ 011
    femalo ~Il' III.l
    comes down LO a thousand SlOan, everyday, - """"co <lotum<m"'C _ &non. .. funol< .._ ,_
    aimOSI unnmim:l actions by many millions of .. . J>«""'l" 0( ...... . . . . . - - .,r"", ... >lktMlnlby_
    mOlhers io poor communilics Ihl'Ollghoul lhe
    ~-~

    "
    THE STATE OF THE WORLD'S CHILDREN 1988

    Africa:
    the Bamako initiative
    A1ncan health rt'lO'llSlerS meelJIII ., ~. The! ~ ol • rw:'1Wlg !Yn<l "" esMtn lral
    M.... "' 5ep1...-me< 1987. and ,.,.-.cd by tho """""""(,,,,eo
    dr\ogs lin lIioo be.-1 pro- by _
    DfectOt-GMellll 01 WHO ond me ExOCUlrVe [)roe-
    "" of UNICEF........ lIg'ee<! on • map MN
    lOCI" '" one ar" 01 80lIwl (wI1h I POPIi._
    15.000111'1'*'<' ""*' are bo<>gI!l tm>ugIl
    oj
    f1lema-
    .......... !of ~ ...........,g """'aIV""Ih care .-..I
    , ,,..... tltgaI"<>_...... under commIJI>OlY
    ~.
    tOl won-..n 11M c:l'IiId<on ThIt mIIInS(lnI'Ig 01 ' hu _ 9hI> """ """"01. 81 • subslen,-.I .......up
    """"""" .. . IlIIW W"I oIlundr,g and ...... agong
    (1lu1 11.""' _ _ ,e,aIIpnces) The~

    essenual <)'l,JOI lor each COIMUIfI'/ n.<Iruys, """ IIlIlI ,e<l1lOl* to maklI preymlNll lim-
    bough1 "' _ '" ........ lXlSI. woo'd l>o ooI<l .t pnc;eo "*" Ir <Ond e><emp,ed 1ho POOOlI' ,_ from
    wtIoCI'>. ...... ...-...::h lower Ihan thlIlocal rllt" COSI . payment W<1lwl h "" \'OOfS. n:<lmIl <tug j,,,,,,
    ~ ....-.:e rlO1 orIy !hoI ,~
    bot o,lIl;':;:.." , 10 . - w ,," nol """, , ~ 1ho "'-'QQIv 01 Or",,"
    ~ .. ,oaelws bu1 lIIso tt.
    ........., 01 1M drugs but .... Iund<ng 85 pete.." 0I1ho local _""'1/
    ~'01 <101""" _ """"""" to Iho poonl """'" fa !"1ITla"\' _ """,,_ ..<:iud,,,!! ~
    .1 """""" ma,"""" _ chi<! twalh car. .. __ _Ill """"'""'". .......... end ......-.g a>6,.
    U The 'Bamako 1rowolNe' _ the lP'ead 01
    "",,,,,,,III lOll<! <:hokI
    DcoDna ""'""'"""l """""""" ~. "'"'" ........ ~ _~
    Alne.... _ . _ """""" .... <l<I1_ 00n to ""01'" car' ~ ..,..,... YIr\UIIlIy the _ 01
    man"." progt_1o< C!'o\dr..., 80 _
    1984_ SoJO.SMa<"" JIlra tIV ,t>e rno<I-199OJ E>lemoI
    1987. ~ 40 """""" "' AI""" ~ "" cekl<m9Cl _ llInCe fa "'" nIlIlNe W!O "" nee<lfI<!, """'II l<,
    t ~ .,.......,.._ progr_ ,<>Ward ............ perhaps S IUO _ . VMI, ~ III <:QUnlr>Cllpn ,
    ....."'' ' ".,101'\ by \990 before beong phasea <10M! ., 11>0 II'" 1990s II
    Atnca1 lJO"'l'Ml'l"ls. lI>emseMls begtn 1<> """'"
    M ....... Afncan """"....... t..... 8ISO G ~ theo'
    men 0I1ho I<>!eql ~ bill
    ""rworts d hMl\h cel1l'ell and..a..ue Ilesth JIO$t$ ,
    &, WIth CM"""'"'Il Manool <MbcuIues. healtI> The t>eau:y 011.... P'OP<>SII .... ., maionll """""""
    _ ohen IacI< llVel' the """'t bllSIC "*"""""" hcalth<:ll/e I..."""e se!l.IU$I.....-.g8\ 1ho COfM\I.O'lIlv
    .... IIIolIun<l<l '0 mee, __ and """"'" ~ _ leooddol""'IO\he oI""'dNgIm..,.........
    OO!Il. h . ,.....,. ,tall !>lo<:omo _ .. ted _ relolble curSINe"",e ,M oonfKlonc:"oI per"",.
    """ OM! CMfoclence 01 "'" """""""lY ., 1ho heahh ......., _<><>0'' "' ',' ' ". _ I S 10
    P''''''''''' _ dIokl heaI1tl mea.......
    ~
    ~e<l 10 _
    """""" lila! ""'" """"'" .. e "'..-
    for mcdI<;In... Moot ""Ill ~ The """",,,,",1Iso llf(IW;1es. """"'" b 1In1ll'W;ing
    """"""" _ f.. mora ""'" !I'<Iv _ fo< ~ • e<>nl_ _ 01 YlOCO"lII. SVfI'llI"I, and.,.....
    """'"" <II or",,,"' ~,. drugs, Tho prOblem 11..... OQUO!,me", ' <> """"!lin .............. <:!'oI<I1I'M'IU-
    .. _ no P * I _t system h. 0...., ..._ ""a"",,'" 1ho 1990s SVengl l""""IIOlIlOo:1_"
    f<lI bnlQli'lg I)OOll ~dnJgs 10 ,tie corrrron" '" _ ............ help ., CCIll"'g ""Ill 11>0 ....DS
    low (XlI' That IS """,,I!Y wnat lto! "6amallo
    . .110.....• ...... 10<10
    ...-
    Ie J~ 1987 AInc.. Heads 01 Sme. """'''''II at
    Progr............ I>JPPO"f8'I by UNIC£F ond WHO !he OAU s..mr..t ., AddiI_. oeda"ed 1988
    and fuMed by _aI dor>o< ageroos ...uc!l lhe 1"'' ' fa '"" 1l'<>1l!COCIn, """",01 and deYeI<>p-
    """""'''''''' ... Kenvo. Moto<r(loQv<l .... T_ _ """" 01 A1fJcan _ " " Dt$<;u.,..",.., "''' now
    N';(I shown m.l some 30 _,,'"" drugs can l>o urodeIw"" wnt1 .............. <b:><>fs ""'" ..... 1he
    revu!lI<Iv ouppIoOd ,,, ""'" cam>urobeS '" • cos, 01 'llarnai<Q lno,",II"" as • _ 1<> ll"'" 1l'000otlll
    .... _ 50 US _1/1 per _ "'" vnar """""'IQ 1<> moo lI8CIaor<ttJ<>n
    With the information and supPOn "'hich Ol)- lifetime Spenl workingfor diAdvanl~ childl'('n
    could nO\1l put at the dispouJ of parents, tbe
    cicl}' in the i:lduslriolized wo rld, felt mo.'C<110 say:-
    death, of million. of childl'('n eadl year, and the "If I haw ""y rtgrtt, it il 'hill / did Mat t",pllarizt
    malnutrition of many million. mol'(', could be ,"jficimtly lire dif/iclliry which pamllJ flJCt. I SQUt
    avoided. But aU wnc march in that cause might Illy IllIk la he rJr, ttdfNXtl!t ofIII, clrild. Bill I INlierx
    beu in mind the word. of the diOliogui'hed child IWW 111m u t1JW/hrr ''''fJO'10MI IllIk - 10 IN 1M
    p,yChulogiOi Bruno Benolheim who, after a !l<hJ«lllt af lire "'INlrrr.""

    Conclusion
    In conclusion, the essentiaL! of [he present fives was approximately 43,000 per day. In 1987,
    lIppunWlily ,hould not be Io.[ in the diSCtIMioo of rhal figure has been reduced [0 appro. imll . ly
    it, many complexities.. The handful of ma;"r 38,000 per day. And by 1990, it could and ""ould
    thrcm 10 Ihe live. and grcl\'1h of !he world'. be reduced to 33,000 per day or leu. In other
    childrenrould now be defealN, io luge me..OI'(', ....·urds, the potential of [he child sufVival and
    by [he emergence of. body of scientific inform.- dfielopmenl revolurion, over ,h. dt<:adl' of the
    lion "'hicb alnlO$t all upellS Ir c agreed upon, 1980s, i. the daily sa";ng of oV<:r 1(l,000 young
    "'hich almO!! oUpo"'ml Can :lCl upon, and which lives.
    all gcvernmcms could afford to facilitate even in
    [he difficult ecol>Omic time. of the I>.[e twentieth The world i, ......1I "aned on [he way [0
    century. At the Arne lime, it hIS also become reolizing this e~lraordinary pereeual. Imic low·
    c1eu that pulling this information.[ 1111:: disposal COSt me....r.... such as ORT and immunization arc
    of aU parents, aod sopponing them in O,inl': it, alfCad)' savillJl the U.'cs of opproximat. ly 5,000
    can only be achieved if a Grand Alliance of aU young children each day. But protecting th.lives
    possible social reooure.. is mob~j.ed to do it, and the normal physi",,1 00<1 menral {'OWI h of
    man)' millions of rhe world's children will remaio
    Five yea... ago, UNICEF said that if 'his 'social a prIom)' [u k for [be remainder of this Un[u<y.
    breakth,ough' could be added [0 [he 'knowledge And borh lbe fa~urCl and [he Sl>CCC-. to date
    breakthroughs' which " 'tre already """ilable, have sho\l,'O that the cracial elemem, if we are to
    tben it would be possible [0 drutirnly reduce soccted, is the panicipllioo of all possible re-
    child de.th. and child malno[rition throughout sources in 0 Grand AlIianC(! for Ch~dr.n.
    the wo,ld over the next decade!. The scale of that
    potemial may be broadly grasped by looking II AU tan therefore share in [hal task. t\lI can pilly
    [he tr.Igic fi£utes with which this ",pon hr- a pm in the grear gain for humanity which could
    gan_ the world-wide numbers of child death.. 10 lIQW be mad•. ,\ lI can DOW h.lp 10 tal<c thi, Ilcp
    1980, the dealh toll among the wo,ld's under- [award• • more gcnuincly civil,~ed worid.O
    THE STATE OF THE WORLD'S CHILDREN 1988

    Sources
    I ~

    ,- '100_ !<o
    ,"" _ .
    ... e.a".. ~ MftSOOl

    2 ""'" _ _ • """"""
    _._ - ., __. ;00_
    e-
    '3 G<>o'omo
    r - fl<o
    ..,..,
    fo< ...
    "' _
    ~"'AA-...~
    r r _ .. _ _
    '1'
    "1100 e- .......
    •• _

    _.o::.:. c. ",_ I\l8lI.


    _
    _
    __
    ' "" _
    _

    -...-.'!Ill'
    _ _ ol ...........
    " . _. ' 978--'M3"
    II>- IJNlCI.r. _
    ,." .. I>tfICL1 _

    -
    ~ ","'A.IO

    -
    w_

    _
    -'
    _._1_-. """',....
    ",,_0 '" ,.. .. " W>tO I'r<>g<_ .. ~ .. U-

    .. _.....
    """", DC 1')81 _ O ' -.T...... " - _
    s-.

    --'.
    ,. Goo> _ ...-
    )_'_~loel
    ..... ,... _ '983---HII,<
    -0. Illa!i

    ._............,.,.,.
    ... ~._"'
    ..... _ e -, ,....,- ". , _
    ~
    ~ ':JI
    _

    _~ l
    .........._

    ",, 2.
    See _
    lOIf' l .. cN<l

    ,,-.,. """"'
    'Dfl'"
    USSll. 31 M 19111 , , _ s",""", a-. ....-....,
    _ 1118' , _ 271 22 ~ M.... '-co.,... _ _
    b W H " , - ... _ , " Ooong .... _d _ _ ."'_
    Goo
    _ ...,.. <II Tho
    _ Con1<.O<.-" c..w
    ,_ConW
    d 1~ a ........ " ~ con ""'JlN"""''', _ _ _ ". _ _ 01 " ,

    h~_"'?~~
    _ _ 11lIlS. ... 2!., ... m
    ...... """"'- ....
    198&. _ ' 0
    ... b .......
    --~
    0<01 _ _. - Tl>o<-_, W«ohoov
    ,gr., ,lo<NI
    ...
    ""'*" .... Oec ,... Soo

    - --.. . ---".--
    _ _ '35!>-':.SIl _ _ lJ<»n lhtn
    'S H _ " .y , -.

    - ....
    _ , ,_ _ " '"""lI
    8......, H II'...... .. ,

    -.......,.,
    _ "lloIoDo
    .-~
    .. I -
    • " , -,
    . . . ...
    - etww ""

    11 " _
    T_. . .
    :.,....,..., ~';;;;'

    """"""
    ,::;:.,
    r.

    .., ........,
    rho
    1':<:7 il;;i;:-_ "". ... ;\"........- -,-, "' 0:....
    .- """,..."
    _
    _
    -...; _
    "" 32. _
    ~ d
    , _. _

    __ ......... ..._.... _ . ._
    . . . -....-"'"*_._,
    . - ---""""""'
    ~ rho T", f""" Ie> O*l
    _ , 0cl0I>0r 1965, """" 11 ,_
    - . . .Soo "" "r_
    _ _J ._ _.
    • ....-...- (10-8'

    !I>o»t<l_ . --."
    '--- -
    ,~" _""""_ .. uo ...... _ S_ _ • tQ$ol. 21 - . .. "'!QIl"f!QO' ,_
    ...... "
    ... ...-. .. ...........,.,..-"1' """"""'-'
    "'ll'''''''''''''' '_._3
    "" .,. Soa.....
    _ . ._
    . . .......,
    ""'.
    ""'17 _ . '~ 7! ,_" _.....",.. '''''--'''_
    _ ............ 0,;0..,
    _ . . - ... UNOClf_
    _......"dO,' 0;......-.
    ....."""..,"__ ""'"
    6__.
    _ . _a.
    . . . . . . .-. _
    'lIS'. ..._ bfUNO.f_
    ".... 1!J& . _~< "'lllO
    ,-"""",,-" .. --

    -
    " " " " _ 'lllli _ _ 2.
    ~. ',Y>;O.
    '_._'81 _",.... ......
    t~

    . _"
    ........ _~o..-..ol

    ...,."""" ....... ....


    , _ _ See _ M " ' -• • 1. ..... TilG. _ '985 ...

    - " -_ 0>, .,_". rPw"",,_'iIII'


    _ ~
    c...o u.-...,
    " GR. CI1Io<Trw>,
    ,."""'" """"""'- ....
    _
    _ '-' \'IMO """""'"

    -.....-..-
    f I1l'P!. Moor 1911' 1993-- '\184 ,.... .-:EF-WHO
    -~"
    9"'_
    -___
    ' ...... ,'"""

    ,-
    _S, , .",. '_- 19 " _·
    J .... 2' . _ _0 "'"
    , ......... ,_
    ........,
    1,,_ fIIt!I
    ..
    "'" .. """'" , _ ""0<
    _
    .-...

    -, --_
    l (1'-Noo<..._~'" 1118' s.o_JooO "_
    Uro<loI! _ SO.._ 0IIa
    N1 -....,.,,~
    _ _. .. W ....... _ l o d l
    ""...
    11 ~ __ eon.. ..
    '"!<»rIo<nc:
    ---~ -.
    N R 00-
    ............. '9lR _

    - - -_-._..
    ...."'
    ......... ,_,lI!OI",''*'' , _ ..
    , _ .. -..c...
    ,.. _ _
    _ o.loo< u.-
    f,_
    _.
    "" ""
    -'-""'d"-"_",,," .......-.'2l\.

    -- _,._.
    ~ l!lll' _HG , - .
    1lMlJ . _ "_"
    " ..............
    ..... ~
    "",,,"" . _
    on..:- Soc·
    ......_
    ... ... ~A_ "lCDS __ ..... ~

    "eo...
    hlho '-..
    _ ... "..,..-. "*" .._ . __ ._
    ...... -0'1 . _
    ....... . .
    ......" ..., ,,,,,
    _ . _ ...
    ___
    """ " " 'n__
    "~ w-..,......
    0.. .--.
    ~.. "..",..,.,...l_
    " ....
    .. _
    ........ - _
    s.. G:-...

    0C\lS ... .... _


    •
    ...
    ~ eo.-. _ -,--~ r...._ .. ""' _ '. _
    r,_ s_. 0>0:I0nl ............ "" ~H ,... _""', . , _ .. l'...... 0>dI"<l - . . . "'_. 'DIll. .......
    _ 19111, _ , ,, ... _ al .............. _ ~

    "
    - - - I I- - -
    STATISTICS
    Economic and social statistics on the
    nations of the world. with particular
    reference to children's well-being.
    COUNTRY INDEX TO n I LES
    m~

    I' BQk 14d.l.,.lon


    tlSMR 0 JMR 0 population 0 binlu and ;"f"", and child
    do.,h, 0 GNP per capito 0 tife el<peolncy 0 . dull hll'r:l"Y
    o "'boo! onmlmon' 0 incnme di"rib,";on
    2, Nutrllloll
    1_ ' birtlt-weighl 0 brew·feeding 0 malnutrition 0 food
    producrion 0 caloric u""ke
    31HnJtlI
    Ac«u 10 """ or 0 :t«ffi 10 heihh ~",i<;n 0 imrnunizotioo of
    cltildKn ood pngnant ..'Om..n 0 pro<h><1ion of ORS 0 'rained
    . "...,dlllU ., hinh 0 mOl"m al monoliry
    4: Ed"".tion
    ~blt rod r.mal.liter1CY 0 r&dio and lclcviloion r«eivtlS 0 primary school
    cnrolmcru :and almplnion 0 Ka>Jldary ",boo! enrolment
    J: ne.........pll.l. lnd1cJIton
    Child population 0 poplILllion gl'OI'1b me 0 crude de. rh nu
    o crud. binll ",Ie 0 ~f. ""pc:cI '"")' 0 r.nilily rate
    o urboni:.,ion 0 ronll-I'tp1iw u..
    6: EconOllti. Ind,;••w..
    GNP por rap;l> 0 anou.al grOWlb raid 0 ,oII' lion 0 poverty
    o go~m m.o, ""J""IdilU<e 0 l id 0 d.bl.

    7,Wollltll
    Life n pKt. ncy 0 li,cncy 0 enrelmenr in Kbool 0 CI,In~ i .,. _
    o le' .nu, immuniuIKm 0 mined meadance . 1binha
    o mOlem:d mon.~'Y
    8: Buie taolu..w" ror leu populouo couatri...
    G<DottI ...... I!Ic di ll
    Sip md .. ~
    "-",,,.. Ii>< ...... HI
    ~w_
    .1I.Uo_

    "
    General note on the data
    Il¥ "
    _1uulI _ _ . .

    . _-- _--
    ..

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    ""-Il¥"
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    ....... '0.
    ...-_
    "lOCI" "" _ItItr_. UMood"""" ~ 0-00..
    ~ 0>1"0l;ll ~ ""'r _>0 01 . . <lAO ......

    --Q
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    _ 'lF9t 01 _ I \ ' g<>... ,,,... doll , .
    ()!IIaoj _ Tn>m _......., .. _ _ UNm PullIo;:atJonI In

    ----poa">lIt
    '** bY !Ill ,~l,.\'IQe<l N"... IlIO"'V ' - '

    1htI. II' no ,eI",,", o/fIc.-I hgur. .,


    u-..
    1
    r~ l)ro'll<I N OlIQnII' - ' : y ' - - . ..sed
    '.. modo I7V
    !lie caw of GNP 1* ~ ro:l OOA, !til c... II. lII.I
    r-.II 01 I 0"'''..........
    bY 1M WOf1d Bo<Iio: ond
    01 ......-.g _
    ptOCI'SI
    OECD _ _
    UlldIT"'Cl

    .....".,.., ~<lNi' or,_l11_

    ._...
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    UNCl:f W I ' " M <1m !rom UNlCH ""'" olloct IM)Io on ' 'WM1JtIO . ..... .... _ _....
    _ •• Il'\II'\eIl \Mil> . ... Y Whore 11>1 ~ ,.,. ~ lII'fIt~ pan at..... 0l:UIlrV. Il'Ol
    ~

    Signs and explanations

    ..... _-"' .. .i.'.._.•


    u...0II" •• - . .... -......_ .... IN<a''!!"ofn_._ _ _ ......
    . . b.o" U5Mll ~_ ~ ' . ~ 01
    ....'.10.. ....
    .... ..- _ ........ l1""'li TN
    "'t'" ••. Dec.- _ _ - . g ..._ _ of ...-"' -.

    --_ _
    ..- . . - - . . " ' . _ _ . .....,0 ..
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    OWl ....,.. gr.- '''''0". _ • ,.. c-. .. _ -. _"'IM_IO~


    _ " " " IN _-...go 01_ *'II _ t>t III
    ...., IlmII '" " veo:y • _ In,,.._ ................ U!>MA ~

    0111""'''_
    UNiceF 1lekl """'-1OlI«oe
    11 Leo. tI,... II.n IN .....1"""""

    ,r TOW (_ 0"»1 0 1 0 1 _ )
    Sea IooIrote • Itle end olIN IIOln

    ,.....tkoft
    ~t
    DMsiofton .. 1Meo .. 1luo.
    of the USM A l\gtnt; _ ~ ba..t ... tw..,.... ItSdmates Pf8IMred b'f' the UN
    m , r -th baiI. ........... _
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    In_c.lI-.
    Index to countries
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    ,ale
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    •
    TABLES' BASIC INDICATORS ON LESS POPULOUS COUNTRIES

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


    -,
    ,. •
    • .-••--
    -.. - -.,. -
    "
    - '--
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    ,,,• ", ..
    ~

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    10'"
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    llZ/T!O

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    --
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    ...••
    ...." ...
    ~
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    '"
    '"
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    ..... . ,
    •
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    ........ ."..
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    ..-..... • ,, ,,
    • ... .
    "'
    'Ii'"... ,,~"O

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    ~ " 1110
    "'M
    ." ... ,,
    "

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    .. ,,' ""
    n- "
    .... -, .:..-,. .,-
    "so-

    --
    1071,02'
    E' se
    " .." ,. ,
    ,JIl

    ........ ,.. .,,:. .-


    es ' w -~
    W!"'l'

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    "" , ".. , " ~I
    ""I .....

    ""
    'O'iDlI

    _ ."._ _ /imJdi'l do_ "dolO _ d _ 19815 .....·1000 ~,."",


    '01'~
    "'"
    Footnotes to Tables

    ....
    Table 1 :
    --
    ---
    --- ,,-,-,-,.,-
    InOoealorl
    --
    --
    -- ,-,-,-,-
    '.,

    --
    -~~

    -- --
    .... ~­ ,-,-
    ,t1~

    '"1

    ---
    It.

    --
    -~~

    ---
    --
    .......
    __

    ,-..
    "n
    lin

    --
    .. .-
    --
    -----
    "
    "
    ,-,-,-,-
    "n
    "n
    "n

    --
    --
    -~~

    -----
    "n

    ,-,-,-
    I'"
    ---
    .... 1113-4
    r". ... _
    I.' .'0'
    ....... "n
    Table 2:
    Nutn\1On _..
    lU I
    1111
    -~
    , II.
    ,I,.
    li le ............ _

    --
    .-...
    :=
    III'

    '.,.
    III.

    ""
    'III

    ".
    1110
    'II'
    -- 1111

    ---
    ".
    ""
    . . _101;_
    -----
    ---
    ""
    ,,~

    ""
    '.11
    ".
    It"
    ,.11. '

    -
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    "...."" .....
    ---
    ,-
    r

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    "n
    ... .,~
    .... 0-11

    ".
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    =-. . .
    ,,' , m
    ' III
    '''1
    "n
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    ".
    ".
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    I •
    II
    ., II..,
    II
    I
    i. 1
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    i
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    t .I•. I ,I, . , ',II., I'
    I"
    '1'1
    ~;~g~~;~~~;;i~~ ~"'F-_,_h• ,--
    '_'fl'li .0"-'1'1
    '1'-- ,~i!,.,. __ >-'h.-,-j-"i'I'- ,I-II'·, - i'Oi''
    "., ii'fh,..'_'''f.",_,_,j!,.f""fF-f~_'
    l
    luifflff II'l'lili
    f1IlJfffHf l! "l'l'IlJblll
    UlI.I,H lin I"',rll
    mI.UIIIIIlium
    Ihlll,hdd I '1'1 111
    hlimllllil"dhmur
    .-t I J'
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    ! Hil III JdJi lIml j, !! flu JJIII , I i llhl! Idih lit J!I I dill!
    ..,
    •
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    ,
    f
    I
    "I ",t".. "1 t !-;- "I "I f.. j
    ii~-=i-i~;~-~~"'~iii~~-~- i ~ii-~ i~iil~~MM~{ ~mN~~~NNi~NmaamNaNaN~i a~~~I~ ~i~a"'"'~"'ii ·~
    __ Ef; _INle~~E ;~ __ N!~~f _ ~ __ J;_~ __ N~~ !_O !;!!;;!! _;!!!;;!;;;!~ _;~;!_;; _;;;;!; __ ;!
    ii i. i fUll III ii/Ii III 1I1HilflimmllhUIIlniMMunii
    I.fllll!,!!!!!lff.il.ilil.l!i.!1lll
    I. ,I,. , JIIJiJJIIIlllIIJJfl11111111lJ111111111Il
    ~ I
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    lhd J iI lllilil,! i hhllh~ WI I I J '
    j fMJ ll!l!l;i II
    Ii ! 11 I
    'l!lldU ,dl1dll
    .
    ~ g
    .0 ;
    ~ Jl
    Table 5:
    :=- .,a,.·a _
    ..... ".,,-~

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

    --- ".
    ~

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    ~

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    --
    «

    Table 6:
    -- --- ,.".--
    ,,.

    --
    e ... . _
    ,-
    [COlD,'"
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    -- -
    " la
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    la'.

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    .~

    1115
    -.
    1::..._
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    -- ....
    ---.....-
    CHI' ........

    ---
    c::::.
    ..-..-"--.
    'a'~

    19/1

    "
    -- ..-.--
    C,
    -~-
    - ---
    C"'_"=-
    ---
    Co a... .~

    Table 7:
    Wu,.,
    -- '- ...
    31=. --
    --
    e-_

    --
    , •. - ..
    .---
    ".-
    11 11_1

    .,

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    _•.....--..
    -- ..-.-".-
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    .~

    -.....-
    ~
    ,

    ---
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    ...... • •

    --
    QIoa

    --
    - u

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

    '-
    ,_ .u.u _"
    ... .. -
    ell

    ..--
    ,.1&-.. _ .....

    -...,-
    '_ •1113- n
    a
    f !
    I ! I 0
    1111.
    ~~~~
    .t.
    !~~~! ~~~!~ie~~~! ~~~e~!~e!~e~~~~~!~,~~~i~~~!~eee!~ee~
    ~ ~~~ ~ ~ ~~c~ ~~ ~~ ~~~~~~~N~ ~~~ ~~~ ~~~~-~K~~~~~
    ~~~~~e
    ~~
    ~!~~~ !!~;!~i~; ~;i
    I
    III I!ll I 1I1 I1 III II III I,! !Il I I Ill! IIIIII!!!!
    I!"lj!j!iIjI!lj1lj!lj!.!!!jl!I!j'j!!I,l!!I!'ll!!!II!!!!I!!I!! !!II!!III!II!!!I!
    1111. I ,1 l! ! .1 !.l!l !.l! ll;,!!l!! ll!!!l!.!l!!!!!! iill!!lll,l" llil
    I• I n
    !lllll!
    II!,.-
    t i l III ~ I J i I I
    !!!,ilHlllHl lli] 11ldH! Wid Jllll jll
    UHIJ!ldrJl Il lIU I !bflJ u
    .
    -
    Ql
    .c u"" ,.
    !'! "' '''
    .QE
    III OI !o' .2 ~ C
    I- 8l ~ l5 8. 8
    Definitions
    u.-·tiv<o _.....-ot_oIchi1<bn ,.,...._ '" Iho ~
    _ti"ll ....., ....... """ . _ _,.".. '"""
    '" _ .... Wtlh _ ,.
    ..-..11<'1 ....,." 5 ,un. '" """ 1>4' UXXl ......

    _.
    ..,.: l>o1/l. I.. u" .....
    5011> pet~ 01 t/lt ~.fo<.

    _
    I",,"nt ........ . . - 01 ...."" 01 "". .,. ur>dO<
    lltV """ _ olIgO 1* 1,000 W. _
    '.'.:
    ....Im''''''...,): ho9"
    ~ _II!
    _ _ 77'.11. of t" _"""",,,1./01,
    ,""""""" """""',.,.,. ,.. ""-'Q/W
    '" ..... lkol<l<l
    e..t.. lao flu lm 51
    s
    ,......u

    GNP; _ ""'_l>'0diJC1 . _
    c.IJt. . . _ ..... n """"" ~
    S,.,.. - . GNP"...,..," Il"""'"
    GN'" PO'
    _ '"""_ ,.Icc.__
    _ :...,.... . _IOCIII_
    AcceH lO ~''''''' at l/'II llQlIUlr_
    of
    !IIaI..'" i:>I
    lr""""'" '" no
    ' Il.. ............ _191 "'....." 'at..
    """ MYo _ """"""0<1 ... It"'li
    ..... to IN IoQaIlWroc _ of GNP
    uond """ .......
    "'-'
    ""' """,,,, .. cons _ IlfIC<lS !Of
    • .ctI ""'" 01 """"'"

    _ney
    •• _
    lito ,.... _ _ 01 VI.... -com .".,.,.,."
    """'*l .....
    to ",. ........... """"
    : ~ IOfltlol ~ 01
    _nlNltwnoof _ _
    ~ ~

    -
    ........Ilfy P'''9''''''''Y , _
    ~: .....
    <_
    Mot.....1 ......... .......- 01 <III. .... 01 _

    . Pe< 100,000
    Ir<wn

    _c.on .
    " OUR DCWcen;8!J'l <>i per"""" ogeO i 5 OlIO """
    Uw.acy
    ctoIldroo~ _ _ Of "'"
    """,ple1i"ll n l gr_ 01
    _OIl ""'""""
    OMG "'"

    -IV __".
    p,h".ry
    _ 0UCCfl01.-v <OfI'II)IWl
    , cwrM .....t ........ """
    ,et.:

    p M"'*Y ..... ..... go'OSI ... _ d ,,.,., ....... Mol Cn>do.... th ......... .....- of . . . - .,.,. T.ooo
    ~ "'. ..... : ~ .

    _
    ...roIment ldiOOloog _~_ '" not ,......
    , _, Il<llon; '" "'" _ .., """ _ ""'I
    __ _"'_
    ItS ."..
    ~
    "",,,,_ '"
    ........... -... tho
    t:....... bi rth ......... '"""""'" '" ........ per 1,000
    "II" II""'" lor mo' _ Tho no' ..-to : <lOriUooon
    ... ~
    cI'ooId«ItI _ _ In • """""""" _ '"_
    .. " ""10" .... lIlUIno.mt>er
    ~" .... . -.., Ol/O_. T otol "'" runt>or 01 _ . . , !hot woukIlIO
    __ " .I*~oI l "'_ r.... lity , ••'" 110m .,.,. """,.... ~ ..,., ....... 10 .... '"
    ........- '" """"'.... .. ""', ago 11'''''''' "'"
    bNron<!
    _ .'".hoi'_ "Og/I
    , .. eo<:J' "".. vo-s """
    o<:<:<IrdonCe

    ""'. -
    I""""" "'" P4I'UOIlIII' '" ~.,. """"'"
    ohare: """"""" W "'" 1'>og/'ooM1 20lli ...... !Owl"

    low birth· 2.500 gr _


    ~ ~I:
    or '"'
    _
    ~ ........."
    _P'~~_"I"""

    --
    IN" """""" _ bOIow """'" •
    """,,.,,...,.-....
    ......: .......... 1'l(In-!oo<l roour
    ,-
    "'"

    B~t· _ ......... Otpo<llvDr..., · ~ c:or.u-tiorl PO'con~ 01 "(lO

    _'R" ~ 15-4< """"""'" '*'\I conuocept"'"


    ,. ~

    Chlld "*l '" """"". ,. - - - . llO'llo ...,.


    ....lnutr!lion: 8OlIo '" It1e _ _ WOI\IM''''''• . ODA: o/fII:>;II .... I ..... ll_~
    _ .......... 60\10 '" ".. _ _
    wagII'-W-"l)O Oobt _ _: ""' ....... 01 .,tor .... .,..,....,.... """
    '~
    IIUI>O< """d pnne>pIo"" oxtomol
    t>ubi<:II' _
    OHS, crill '"'¥Ir''''''' 001..
    Main Sources
    U_ ·1iv<o Utvlod N........ PopuIo_ 0......... rod Acc.u to World HIlaIt" ~ .",,"
    ..... lnlan1 UnoI... 'I..""", S,"'.......
    ~ driMIng (WIl()l
    .-taliTy: wo...:

    In!otI ' " nd um... NMoDn< ~ DM<oor1 iII'(l


    ....Id _ "'": UNICU

    GNP _ Wo<tI Ew1I.


    Ml t.....1 _ _ 0<_ """ (WHO)
    rTaUllly;
    eopito:
    Rodlo I nd U...,...
    , _ _ ...., CLCl",OI
    ~ ""'" ~ $coon,,,,,,
    Or\IInIi. t"" (UNESCOI
    ...,.........,
    Adutt URI ... 'I. """, ~_.

    -..".: oro Cul\u';O OrvatmwnlUNESCOI


    E_.sc.rn.IIc
    Soc>e,,,,<:

    --..
    Crude _Ill UM Ml
    , ...,
    'I.,.,.... Populo, ..... o...a.on

    ..,..,.,
    Sc_ llowutO 'I
    ~t _ C""
    11"01
    "
    Or_"", (UNfSCOI

    -
    Hou. ,h<>Id """"""_
    ~ lJr"cl0Cl 'I. """, h.nj !<w
    pr_ . - : ktM_ /UNFPAl
    1'ol><H'' '

    B....'- _ 1_ OrIl""'8lal
    _ I,., (WHO'

    -
    CIIlkI _ ........ 0<_ (WHO) """ Upenditurfl WOII<l 80nll
    ....rnuttltlon: UNtcrF f,,*, 0If.,.. on _ItIl,

    ond " ,_ :

    de"lopmem
    . u i o _:
    C<>opow"""".....,
    ~ 100eO)

    "
    IISICl!1' I' '. ._
    USJCEl'-' 1 UN ..... So- T..... NT Ito'1, USA

    IINlCIEI' GMmo'"
    _ " S - O l. ' l ' I ~ tt,S
    =&
    - _

    L"SJaJ' ........ CIftI<o _ '"" ... e..-


    ......- A_ n H, ~

    lno"1CU om.. .. &. _ '"" ~


    roO. . . ;l-I~
    IISJCEF ........ e:-.
    I GlOll,- r -

    r.Q. ... ' uJll. " ' - .....


    _ &01 '"" _.u-o
    tn."lC£F ....... 0lI<. .. - . e-.I """
    n LM u.-, N... DoAi " 000), . . .

    lno'lC£l' otIcc lor N......


    roO. _ 1212, ~ N.,.

    •
    THE STATE OF THE WORLD'S CHILDREN 1988

    Evny Wftt I qtlirttr of I million )'OUlII But if thai dlaIIeage is 10 be 111ft, it WI be


    childR1l ItiII die, III ~ ~ "'Ofld, in 11M: metby I JOci:al mo'cmrm mbcr than by •
    ~ camI(e oIl1lreaioa and imdmwuitioa. pIlfdy medial ODe. Wha. ill ncNcd II I Gnod
    'IbM r.a IOOm1 ilIlY mnu'tnllOll 0( tbc
    (WU ~ 01 pmImmu md ptt1Iti,
    ~.1lK worid't dwdlCll II Ilw 19301 etn-- tdac:al1OIl I)'SWIIS and ~ Inden, mua
    .-udt I dow. Yn III tlus doade 110 l'Ir, IDCdia -t ...tuawy . - - . "'. I I and
    lkspitc I diffialII: ~ dinwe, lM bbour, ~ asYKHrions IfId
    ~ olJo.<aa child bnhh _ _ iI co" ...riwal iaaIIl:l an ' 10 crnte •
    alrudy ~ ia 1M snmg of onrly 40,000 IIIln'UWIl &mand for, ancllWKlia!~
    )WlIC !iva act! fttk. of. t!lOJC 1llCdlods.tllC!l COIIId _ bnq .boot
    I ~ in dIiId - . I and dt.dopmtm.
    AllUd d 1M om.r iMues with .tIicII.
    UNICEF;' cwwllfd, tM gral If...... of Toc;by that Gnnd AlIiaatt hu bq'IllllO
    dIiId ~ and Ii'" ' . wN thombc
    mDIiM JNf'l'llOWU-- ~ ~ of 1M
    .... teaIt and KftriIy 0( tM poblcm buI
    lIe<:IIlK oIlbe '_,Iem;, ill 0Uf rima, 0(
    dnllmic Iow-«JA pr-ibilitin for ita 101" 00,,,
    .....
    _~.ADdiQ~lO~t
    _ _ !hat ~ .. no pam a_ III wludl

    "T'M 1988 Sutt f{ w w...u ~ QiJIrr., rqlOI1


    10

    Ib«don: COftJrituIes I direct lJIptai for ik


    For it bu !lOW btu shoom in plxm tbIt i~Q' of all pOIS;" I, mouron in thiJ
    _ child deaths, and _ child malnutrition, Cll\llOt. ADd ~ is hlfdly an indmdual Of
    coukl be ~t~ by paua!lll KtionI ..bid! Ofgln iu.ion tllll wilInoc lind, in thtx p~ I
    Ire a11l'1OS1 un~na1Iy I ffOfdlbk, based on cNJlcnr: to ptKlical invol... IMDt, I bonom
    knowl~ which ;1 already In ibl*. Informinsl line or Krion, • pan 10 play in 1M Grmd
    and fte:i1itl tinl Sl>Cb ~rental ICtion i$ therefore Alliance forOlildren.
    the milO' chaleng, of child hellm loday.

    OXFORD UNIVERSrIT PRESS

    f.2.9S net in UK $6.25 USA ISBN 0- 19-261723-0

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