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World Health Fertility Between 1950 and 1970 women had an average of 4.7 babies; by 1980 the average had declined to 3.7, by 1990 to 3.2, and in mid-decade it is now only 3. In industrialised countries the average is only 1.8 per woman, in developing countries it is 3.1, and in the least developed nations it is 5.6. However, the actual number of births has risen by 12% between 1980 and 1995 because there are more women of childbearing age - in 1995 about 139 million babies were born. About 80% of mothers are estimated to be between 20 and 35 years of age, and birth rates among women aged from 15 to 19years are twice as high in the developing world as in the industrialised nations. Whatever the country, it does seem that the more years of schooling a girl receives the less likely she is to have an early pregnancy.
Child mortality In 1995 the global average child mortality rate (death or the probability of death by age five) was 81.7 per 1000 live births. In industrialised nations the average was 8.5 per 1000, in developing countries 90.6 per 1000, and in the least developed countries 155.5 per 1000. These figures are bad but the last, for example, would have been 287 per I000 in 1955. Globally there has been a decline of 40% in the child mortality rate over the last 25 years. Over the same period the world's infant mortality rate has declined by 37% (infant mortality occurs from four weeks to one year after birth) to 60 per 1000 live births; but it still means that in 1995 8.4million infants failed to see their first birthday. Twenty-four countries (17 in Africa) had rates worse than 100 infant deaths per 1000 live births. The World Health Organization (WHO) estimates that during 1995 there were about 5 million neonatal deaths (deaths during the first four weeks of life), most of them in developing countries, and perinatal mortality (death during late pregnancy or the first week of life) was the outcome of 53 in every 1000 live births. N e w reproductive health programme Reproductive health has been recognised as Midwifery (1996) 12, 207-209 © 1996PearsonProfessionalLtd
central to health in general and the burden of reproductive ill-health falls predominantly upon women. WHO's activities advocate 'a more integrated approach that addresses people' s reproductive health needs throughout life and reaches a wider audience women, young people, service providers, policy-makers, and community groups. WHO has therefore set up a new reproductive health programme that brings into a more coherent framework programmes dealing with different aspects of the subject, to ensure better co-ordination of research and technical support activities. The new programme will draw up a comprehensive strategy, define norms and standards, and develop technical tools for addressing reproductive health concerns in countries'. The World Health Report 1996. Fighting Disease, Fostering Development; Report of the Director-General. Geneva: WHO, 1996:11, 14-15, 77.
Gender Roles: How do they affect the child? It has been well documented that women's work and their productive contribution to family welfare is less understood than women's fertility and mothering to the age of 50. Male fertility and parenthood have been virtually untouched by research in developing countries, therefore the general concept of men and their roles has not included fatherhood. Some trends are now emerging from the limited data which has been collected. These include positive factors, such as: sex-role development; socialadjustment; cognitive development; nutrition and health; care for children in early years; warmth and nurturing effects; and negative factors. These all have a profound influence on the physical, emotional and financial welfare of children. When fathers are not in residence with their children their role is viewed as that of provider, and this diminishes as respect for the roIe of father can no longer be demanded. Studies have indicated that father and child become emotionally attached when contact is as little as five or ten minutes a day, although evidence suggests that they are not as widely involved or influential as mothers in caring for the child's personal needs. The father's participation in child care seems to be more equitable when both parents co-operate in economic activities, although this is hampered in some countries by cultural beliefs which deny an appropriate role for fathers in a caring capacity. Achieving Gender Equality in Families: the Role of Males Innocenti Global Seminar, Summary Report, UNICEF 1995
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Breast feeding news Breast feeding in Armenia In 1993 the Ministry of Health in Armenia imported 900 metric tons of infant formulae because it believed that women would be unable to breast feed because of the socioeconomic changes occurring there. But in 1994 USAID decided to cease all shipments to the region and, to avert a crisis, funded a research study into infant feeding practices to help the ministry implement action to support breast feeding. This study discovered amongst other things that health care providers and mothers were not aware of the benefits of breast feeding, so the ministry sought assistance in preparing health care providers to help mothers to breast feed successfully. It collaborated with Wellstart International and UNICEF to formulate a policy and develop a programme to promote breast feeding and create an environment sympathetic to it. As a result, Armenia now has a national breast feeding promotion policy, a national breast feeding co-ordinator, and a national breast feeding committee. Health care providers are more knowledgeable about the best practices of breast feeding and lactation management and are better able to pass their knowledge on to the mothers, whose use of breast feeding is now increasing. Breastfeeding promotion in Armenia. Mothers and Children 1966; 14 (3): 7
Research shows that fathers help breast feeding succeed Remarkably few studies explore how fathers feel about breast feeding. Similar findings have emerged from a study undertaken by Pamela Jordan, a researcher from the USA and Joanne Chadwick, a midwife from the UK. Fathers have a great deal of influence on the duration of breast feeding; from a position of being highly supportive of it during pregnancy they become frustrated and perceive themselves as excluded by the bond between mother and baby. The fathers felt that they were deprived of a relationship with the baby, inadequate as parents, and distanced from the mother. In a survey Ms Chadwick found that midwives agreed that it was important that men were involved and appropriately educated but that the midwives were too busy with providing the essential care for mother and baby to provide this. BFHI News, March/April 1996
The Code in India In 1993 India passed an Act on the regulation of the marketing of infant formulae and the promotion of breast feeding; it included
World Health Fertility Between 1950 and 1970 women had an average of 4.7 babies; by 1980 the average had declined to 3.7, by 1990 to 3.2, and in mid-decade it is now only 3. In industrialised countries the average is only 1.8 per woman, in developing countries it is 3.1, and in the least developed nations it is 5.6. However, the actual number of births has risen by 12% between 1980 and 1995 because there are more women of childbearing age - in 1995 about 139 million babies were born. About 80% of mothers are estimated to be between 20 and 35 years of age, and birth rates among women aged from 15 to 19years are twice as high in the developing world as in the industrialised nations. Whatever the country, it does seem that the more years of schooling a girl receives the less likely she is to have an early pregnancy.
Child mortality In 1995 the global average child mortality rate (death or the probability of death by age five) was 81.7 per 1000 live births. In industrialised nations the average was 8.5 per 1000, in developing countries 90.6 per 1000, and in the least developed countries 155.5 per 1000. These figures are bad but the last, for example, would have been 287 per I000 in 1955. Globally there has been a decline of 40% in the child mortality rate over the last 25 years. Over the same period the world's infant mortality rate has declined by 37% (infant mortality occurs from four weeks to one year after birth) to 60 per 1000 live births; but it still means that in 1995 8.4million infants failed to see their first birthday. Twenty-four countries (17 in Africa) had rates worse than 100 infant deaths per 1000 live births. The World Health Organization (WHO) estimates that during 1995 there were about 5 million neonatal deaths (deaths during the first four weeks of life), most of them in developing countries, and perinatal mortality (death during late pregnancy or the first week of life) was the outcome of 53 in every 1000 live births. N e w reproductive health programme Reproductive health has been recognised as Midwifery (1996) 12, 207-209 © 1996PearsonProfessionalLtd
central to health in general and the burden of reproductive ill-health falls predominantly upon women. WHO's activities advocate 'a more integrated approach that addresses people' s reproductive health needs throughout life and reaches a wider audience women, young people, service providers, policy-makers, and community groups. WHO has therefore set up a new reproductive health programme that brings into a more coherent framework programmes dealing with different aspects of the subject, to ensure better co-ordination of research and technical support activities. The new programme will draw up a comprehensive strategy, define norms and standards, and develop technical tools for addressing reproductive health concerns in countries'. The World Health Report 1996. Fighting Disease, Fostering Development; Report of the Director-General. Geneva: WHO, 1996:11, 14-15, 77.
Gender Roles: How do they affect the child? It has been well documented that women's work and their productive contribution to family welfare is less understood than women's fertility and mothering to the age of 50. Male fertility and parenthood have been virtually untouched by research in developing countries, therefore the general concept of men and their roles has not included fatherhood. Some trends are now emerging from the limited data which has been collected. These include positive factors, such as: sex-role development; socialadjustment; cognitive development; nutrition and health; care for children in early years; warmth and nurturing effects; and negative factors. These all have a profound influence on the physical, emotional and financial welfare of children. When fathers are not in residence with their children their role is viewed as that of provider, and this diminishes as respect for the roIe of father can no longer be demanded. Studies have indicated that father and child become emotionally attached when contact is as little as five or ten minutes a day, although evidence suggests that they are not as widely involved or influential as mothers in caring for the child's personal needs. The father's participation in child care seems to be more equitable when both parents co-operate in economic activities, although this is hampered in some countries by cultural beliefs which deny an appropriate role for fathers in a caring capacity. Achieving Gender Equality in Families: the Role of Males Innocenti Global Seminar, Summary Report, UNICEF 1995
iml
I
Breast feeding news Breast feeding in Armenia In 1993 the Ministry of Health in Armenia imported 900 metric tons of infant formulae because it believed that women would be unable to breast feed because of the socioeconomic changes occurring there. But in 1994 USAID decided to cease all shipments to the region and, to avert a crisis, funded a research study into infant feeding practices to help the ministry implement action to support breast feeding. This study discovered amongst other things that health care providers and mothers were not aware of the benefits of breast feeding, so the ministry sought assistance in preparing health care providers to help mothers to breast feed successfully. It collaborated with Wellstart International and UNICEF to formulate a policy and develop a programme to promote breast feeding and create an environment sympathetic to it. As a result, Armenia now has a national breast feeding promotion policy, a national breast feeding co-ordinator, and a national breast feeding committee. Health care providers are more knowledgeable about the best practices of breast feeding and lactation management and are better able to pass their knowledge on to the mothers, whose use of breast feeding is now increasing. Breastfeeding promotion in Armenia. Mothers and Children 1966; 14 (3): 7
Research shows that fathers help breast feeding succeed Remarkably few studies explore how fathers feel about breast feeding. Similar findings have emerged from a study undertaken by Pamela Jordan, a researcher from the USA and Joanne Chadwick, a midwife from the UK. Fathers have a great deal of influence on the duration of breast feeding; from a position of being highly supportive of it during pregnancy they become frustrated and perceive themselves as excluded by the bond between mother and baby. The fathers felt that they were deprived of a relationship with the baby, inadequate as parents, and distanced from the mother. In a survey Ms Chadwick found that midwives agreed that it was important that men were involved and appropriately educated but that the midwives were too busy with providing the essential care for mother and baby to provide this. BFHI News, March/April 1996
The Code in India In 1993 India passed an Act on the regulation of the marketing of infant formulae and the promotion of breast feeding; it included