THE STATE

OF THEWORLD'S
CHILDREN
1985

United Nations Ch ild ren's Fund

(UNICEF)
THE S'OO'E OF THE WORLD'S CHILDREN
1985

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 THE STATE
OF THE WORLD'S
CHILDREN
1985

"
James P. Grant
jExecuuve Director of the
United Nations Childre n's Fund
(UNICEF )

P llI'L ISH ~ I' FO ~ UNICF.F

Oxford Uni versity Press

I THE STATE
OF THE WORLD'S
CHILDREN 1'985

A Revolution A «"01", ;" child ...,.;..1 ;. boaiooinc I. Marketing The ,. . ""'" ......., pt«N<nl> lot
I'> ' . '0 0« lk _ . Ilut H .. pIl.......... knuwlcda< 0<><1
or
'«"" ...
Beginning low..."., ,<dl.bq..,. ""' , . fullil,"'" Survival .. ,h< diq...-I Ill< "';""':'1 'Il< (i,...
,I>< <IIIII'oiI~ 'Q r-o
1'0"."" t. om: nliUioM or <biIIl. ...'. U
,..... ,II< r""" or ""..til .... _
.... ll......' ..,
r.m>ly plan Suo.'<COl .. b<>t~ ~
f""" ..... ~UI ..... I . r_
II< >hift«i
f_~ ..... "" poIilio."OI """""' "''''~ I, 110<mol>iJ""'"
... _ ..b <>f "'lJI'<lr'.1IId ,lie: ... at......w
d
..,..city to ....,h ...,d '"1'1*' ,....., 10 "- ~ioll· .
io _ .. ..- ,...
-......, ",.Id. A ~ i< ""rr<>"<I"<1I1 i.
~.. 'lO" or tl>< .. wid ', clW<1r<n' ;' ,badon:
poailN. _lf ,I>< "'>rid ..... d .

Woh I'd,"my link ,,,'.;,, I. basi<

A Health kdWoo_ ......1"'1' -.I ,...........-y ....hh
_ «M.Ild b<lp ~ ,....... . _ •
Service ICWII <lblol """';ft! -.I
Protection Tbr """"'" ......'" ..... <!Iild.... """ ,. , .
,h< bruOl of ,II< ,OrlJ I<'<'<>Iioa. f or , _ for All <k<~~I. 0:;, 11 ",alIo<oI_
at,..,...... toaR!< twillW'J' l><llth <v<,
in Poverty ......... OIl
,.".. ..... ~
,1'101 ,I>rio
poor
........u". ~ ""'_
minimum
ph.. , .....-... ,..;,h I~ ..ol,..;....
lbt id<I at. ,~ b<illb ..,..... """ "'"<f)'
'1ok1Y of
ncl" _~b _ ",,""... .. o<edN. ........oairy io ....... ;" """'!Il< d"'.....
TIo< _ io ~, lew ,.... I,....al bo
~ " .. oIl'o«!_b booi< J"OlO< S1
po<Il«ti<la .. d .

Women's "-II at ,i>< dliid """..lll<Y<lluuoa

_ ""'t'S'"
...... at ..,."..,.. ,; <D<1'lY. lUkl
Time ~I<da<. Mol...... ,lI«<f _ ptl<U<ll
Going into "'r""'! .. ... H.. "'I if Ib<f or< '"
Action ...... lbiI 'Iwi.!:' ."'"".
Ilalic _
_ h .. ....crt w Pf'ly IIId ... _ _ -.ld
_ 1o<lI' f.... ta '" uk< II>IIf< "'.l1m at
I""" ""'" h<>IIh.

Changing no ...... " p<t«p<..... 01 "hit io .--I.

;;;;j1,.-~bk,lCkl""'""'" Oldi,.;.s "'"
Ika... or ,lor .,......v.o"'..,....." b<t__ Perceptions <10 t. imptow [...,;)y hk, it boch lho ....
The Dis- ......'m
f"'l.....
... ..... ;:nf<a;""
__
, a.- is
.....
"'" the -.r01,ho ....,....... .. child
, .~ i~ ...m ft!uol~ , .
proportionate ......." .. . "ukl·••NW'I~ ,bnTI<>f< "OIn<
<lU"ubt;"" II)' ,io, >Om< ,okm. • r<loti<d1
Benefit ............... ol ~" _ ,....
<7<1<. allo. , ...... - ,. , ~
~dy

!><all".
_r;"w
;.,(""...", froqu<f"'l'.",", ,b<r<tot<!Iaw.
df«1 ... <hiI<J
II LIFELINES III STATISTICS
E~tllll:tS and su mmaries from recent research and Economic an d social statistics "n the nalions o r
wriling on cost-effective S\falt gics for protecting the world, with pan i' lilar I'(:ftrence III children's
the livcs and normal development of the world's wd l. being.
child ren. Gu.,mo. ... ,...,.jo iD d>Iu, """'aIil)' .,..cliO
o'.l""'~iclI ""'" '0 """'lM _111

-"'til"'...·. .... y "".In

IIll< Jf""'Ilo
Basic
Growth """,,_......-h I , I>< inw>lY<CO<O' of
monitoring IIlOlbtn ,b< ."""h""""If'!>
_ t<. indicators
~, n

_ HI

Oral
rehydration Nutrition
therapy

Breast- _./<0>,11.. ,ad ,....

d. ...... of boo,I<·1t<diaI 1 ,1o<1int of
of """"'·millr.
feeding "_.
1 - " ' " 0II<l """" r 'be"'~ Health """" t o _", bm",;",' - 01' <bil.lt<~
;mm.....' ... 01 """hot< ~ hi<
""I',."a,,,..y

.....-cia< 1"""'. ." ..... <!""- '1_

Immun- ~""!I«l_ ..... ,_...'! .oJ<. Education
ization df",u n
prot>I<mo
<'"",.,...'i
. oJ ~ _ .,_ ..""",
II
;" min' fOi...., h....'h ...... _ II ~
1'"1' 9)

,.... .,.j duW ~ JIUl'U_

Female
education
...,<m>l nloal'" lDIl d....1 ~ I
<01""".... IS an
~o&., ~
"f'bu<iom of ,I>< lillk _ ...... 1_
N_"',
n . -'hI.
Demo-
graphic
indicators ---
......... b r lof.., onol ,hiI.,I -..ol;'y l
.... 11oWI .." r""MY ," ,
d<,,~

. - II G

Economic USP I'<' " rOo. _ b ~< ..Il.u....

rfk<:.. of !>in'" 100 <100< ' ''I:<1b<r 1 h<aItll f'U""" yr P"""'..... ....,..t;.... _b.
F amily _~" of l...... r pWlai". r IIUlIIIC< _ indicators «1....._ <1<1,,,,,, I "'" ) d<bt ....-.icio.l
(,or f...oly ,........,. - . -.
spacing _ I ll
1'IlI, 100

Basic ("fan' ......o1i<, .... ""al PfIrI"W'"

............ 01' 'oM1oo ..... ,,"Id <1<.... r
indicators "sl· I"" ....... rl hl« .<pa.u~,. y adlll,
Food
supplements for less U""";Y l
""'~bu1'"
of""" ... roltllro, I .""""'"

populous 1'flI,ll'
_JOl countries
Sip>
F_
'""""'...... ~ ........ II>< <1>..
"' ... lObi<>
-'"
_ Il~
P<fmi,.... - ,"
MoiD """'<>
1'1 .., ... ..,;", ..... Ia IMIl will»......,n.. -'"
1'Ol'< I.lCl
PANELS

CoIombioa :
~800.000 1 IIktllltl:
POO'Oo'O Ihe proof 14
E/ Tiempo report.,
2
.. _-
Chi.:
A lr~ lor aJ CoiombI<I 15
A~: - 3-
a genIfa\lOl'l

Delhi:
ahead

ITlOlhet$ 1llOf\l101 grOWlh 16

- - -
lnella :
reach,ng 10 rrulholl 4 Prot..::l lng Slrowth :
a graphic presentation 17
Blnglad . .h:
$Ur"iIYJ:'OQ lI1e allWrt'fl 5- T~lnz .nl.:
a kleraey f8YOlUIJOn 18
MIi"" and the SUd.n:
lrrlTll.ll'llDnQ mcrlI lor . . 6 , BangladHll:
ho 19 two rnIion 19
0-_
-
chlct dIIiIlhs _ 60'\1 7- _ O R T
a.mbl. and HondIlf8,:

-
20-
1 M A.c:8 .lion:
women ana children Iasl 8 TheHlnd:
PHC goes nallOOill
-
21-
DlNbillt ln:
tile preventable llu'dell 9 Ta nnnls:
savtng on esseouer drugs 22
-
Popul.tlon growth:
SUI'VIV81 ~ PS slow.oown 10- Ol,rrllea,l dIMa-a:
bnel'J)(l tho Pl'ofessKlrlals 23
w..t:
Tile
a eewm to :JIeast-teeding 11 11'-'- -
Rural PG¥erty:
b)' 5e8$Ol ~ 24
Tile Cod.:
adIOn on 130 naxns 12 .Or..- ,en ydr. tlon:
story 01 • breakllYougn 25
Indllo:
CtNbI'IQ \he oemard 13 ..onro
Bhuttn;
\he 00 trage(ly 26
TEXT FIGURES

'. Developong cccoe-cs produclog oral 'ehydrallOn sens

..
F. , Global supply ot coral ,(!flydralion sailS (WHO/ UNicef lormulaj
Fill. 3 Elfecl 01 borth sp;lo Cll1(l on lorant aOCl ctuld survrval. Bangladesh

' Impact of malnul" '''''' dv<Lng pregnancy on pe"natal mortality

N\lffiOOf anc.l pI1fCll' 11age unablc to moo! baSIC reec s. , 97 4-82
'. s
re 6 Hoal1h and wealth
Fig. 7 Imp;tc t on PQPUIatoon growth 01 a reductooo ,n chlld deaths
F. e Impae\ of OAT on IlOSO<IaI l1eatment of eenroea
F. 9 Average duratlOO '01brcast·l ee(lLllg
Fig.! 0 DuratlOl1 ot breast-reeding ,n rural and urban areas or Bangladesh
by age aoo edUCO,lion ot moltler

Fill 1 T tortucno::e of breaS1:·1eeding llfl interval between births

fig 12 Percoolage ot preo~r.an l women imm\InIt:ed ag<!,ru;t mtanos
~og. 13 Percemage ot Ch1l d,eo :rrunullized ", the t~SI Yt'at 01 ,Ie
Fog. H Coverage and (1I0p-ou\ rates In OPT voccmation Plogrammes
Fill 15 Number at deaths from selected vaoc>ne-prevcntable diseases
F'Il 16 Impact oll\ano-washlog on Ifansmisslon of doa,rhooallnlec1lMS
F>g.11 Chid growth to <lI;1e SIx
Flg 18 Chok! death 'lites lIM nine months loIlowIng aCUlI! phase ot «cases. \he Gambia
Ftg19 EIIOCl 01ORT on 'Nl)IQhl1jain aoo on durallOO 01 di31fhoeal uoess
rig 20 Heal1h expenditurns and popu!abOO seoec
Fig 21 AV/ltlablhly 01 cloclOlS and UadillQMl midwiVes
Fill 22 scescoa pallorn (ll diarrtloeal lntecnone in fU,al Gamboa
Fig 23 Prevaeocc 01 ana.en1IlI amortg women 011rM:! <leveioPing world
FI\l.24 Eltecl of ~'ly C>l1 Wlllghl.ga,n in pregoancy
FIg.25 Impact of lmpIoved water supply on health and nuU,bon
- -
-_ _. _'._,. -.._--
UNCl~,
- .A note on fam ine In Africa -
""_ __ • _ .......
-
~
-
lII>OlI

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_---_
__
_ .. $lb
''li a ..c, ...... m '-"_IorOnIIOI
. _..... '3

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.. _

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.........
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...

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.
_" ' •• _ ---., .IlOOO..- __ dor _ _
_"' • . , . _ , 40 _

_...... ,. '- ... -.;..,---

..
~
_ _ 10000 .... _ . _

_n..." ............... _ ......_, _

n. _ ~ 1gIO<lr._....o
_ _'0 _
"' f_,UI...::F.F
~ 10<'19__
_. _ _ ..-
.. ...-...-..-l_
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~ ..... ""' ..... ,G _'lI .... _ _ ~ _ _ ..
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(hill . _.,.,.
... _ _
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"""'IJII,)OIOI

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. . . . _oaD -..._
"""'" """'" no . . . - II. _ _ """'" _ "" _ _ "'....., '"' _ . . , .

-- _-_ _........ ..
... _ ... C/'Il""" .. _ _ .......... Do
_ _._ """ .. _ _ <l>Y _ _ oloo

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- - --1----
THE STATE
OF THE WORLD'S
CHILDREN
1985
James P. Grant

A Revolution Beginning

Protection in Poverty
Going into Action
The Disproportionate Benefit
Marketing Survival
A Health Service for All
Women's Time

Changi ng Perce ptions

I THE STATE OF THE WORLD'S CHILDREN 1985

llIfaal Mort'lli,y Rale

The infant mor'lOJity nil. ( I M R) is the number
of death. before the ~g. of one ynr -p... 1,000
I".., binhs.
Figur"1 g;"on fOllh. infanl man. lily ta,,,,, of
putirulor COUntries. in boIh ,he 101 and
, m iotic. l t. bles of 'his tepon, ......,inu.'Q
prepan:d by Ih. United Notions j' opulnt;oo
Divisio n on an int ern ationally comparable buis,
using nrious sources. In so= case:<, th..., may
differ from nation>ll'Slimales.
MClIII. nationlllMR figurt$, being for 1982, do
001 1"1 rcO. " th. impact of any of 'he ....,en,
campaign. and child survival PnlllramnleS
meotloned in 'he ,n,.
 A Revolution Beginning
In !.be Iw l..eh~ lIHllllhs, Ih. IivCll of liD
Q'limalcd IWf a millioo <lwd ..... han bttn ... vod
by oral rehydra tion lhenpy ( ORT). YC1 .. 1M
year I:OIIIeli to an end, Jess than 15'; ohhe world'.
familia llte uUn,g 1M tt\'oIu.ion.o.ry low<olSl
technique for preventing and IlUling dittrhoeal
dchydntion -lb. b~l ,~,,&lc kill.,. of clliJdretl
;n the modem world."
BUI this pkt urc: is rapidly ch.o.nsina: .. ORT
beginsto eajxure the imaIlinalion both of govern-
ments aile! of I WOlld-widc pUbl;';, In lD1al, 38
""tion. blu bqun IIJl :e--xal. prodllClion of
the Ol'll ",hydnllioll saltl (fill. I ) and national
ORT campai gnl ha"" t><",,, Loun<hcd in more
than 20 CO"",ries, including Pal<4lan, Thai./alld,
the Philippines, Irnlootllia, Bangladesh, Laos.
ViC'! Nam, Niseria, T.",zania, the Gambia,
A1iem. Egypl:, MOl<IC«l, Colombia, Hood ......
Haili, Nicaragua, Jama.ica, Brazil, IllelMex.ko. ln
<.be past ~ar, UN ICE F itself h...... pplicd 78
""tio... with app rtlJima,eJ:y 65 million sachets <If
the ",IS and tQtal an nual production by dcvdop.
illl countries tbcnRlY.. i. now estimated at 100
millioD packm ( fig. 2).
Previously, dehydration could only be llUted
inlfavenowJy by medicall penonn"l in dinies.
N ow, it ClUI be preven t"" ~y by ~lIU in lb.
.!tild'. own bome_laing ih~ ma.D-produa:d 10-
• 0Pl .. h ~
I'f<ft''''''
,~
..... lnaIi<IIth< t1th,.-;oo _ raul<_r..
( ORT! io • ""hoiq..
"'"
diur!>o<al ; 0 1 _
_ ill"<"f<1l1A, or< 0I~, oppI'OlIioqt<. Tho,......
Ealimol.. ,i,lo<_oI0RT.oo>doltk
... illdlldc CIlilIa. - . . . . c( th< iofl«lUOD<\' 01 <la..
~ iI will he IOIIIC ,;_ hdor< tk ~ 01ORT "'"
he J«lI io ..,;ocw _ , . . clOid lIIOtU1i'r IUliscla..
"'Ill $AChru of pre-padccd Wti or ih~ "ell
dl~apcr homc-mad~ toI U.iollS of sugu, sail, IlId
... (~ r. ·* Eiihcr way, i. is ORr,cheapness IlId iu
IllIllI8n.bility-by-pue1Iu which ho ld:s oul th~
hope: of it! being mad~ UDiversally ,vail.ble.
~/~ 'M ... "r few 'J"'I, " sa'jl ,h~ Din:alll of 1M
InrcrMtiooal Cen tre flll' Diarrhoeal Disease Re.
IUl'Ch, Blnglldcsh, "ORT lids 'M !"'feltl;,,/ u> ......
1M I..... 11[""""""" n~",,,,," IIf r-pk "",,,lid !At
fJJDTld. Ir U ' rillyQ~ jllCmli6k amapr /luu I<IIM/~int
t4 Ii",pk, j"",pe.uiot ..lid .fftt: /irJe Iw ~ tr-
,hi lahonz,Dry ;'1l1I r-Pk 'l """'" <III n..:~ a Jar,t
5aI"'~_
GiVeD the mobiliultio.ll of aU possible resowws
.o.support parellts in th~ use of this Icclmi'luc,
UNICEF believes lhal ORT can Wcome avail-
able 10 half the world', families wilhin lh~ nul
five yeaB. Iu>d al thai poin l, it will sa"" th~ li_
of ~ tWO tnilliOll young childn:Jl a year .
A low-eoot ,.,volutinn
ORT is the """" dn.nuolic in 'lIllg~ of Iow-tll$l
mnhods nOW availabl e fur protec ting the ~¥cS IIld
bWth of children in low_income co mm UDil ico.
For 1M I..t ( we> yean, the SUIU of rM w....ld~
C~jldm' ~port, wilb th o h~lp of Ih~ ~ media,
.. f .. ~ ...., .. rDO<tift MIl
he ~ .. th< _ ............,oolt,
"m..... 001"';'" "'"
,he II"""" f_
either ill -...
......_
~ , 001
"""h• .-.lo ouch .. ric< .. """""
,..... '" ~ F.. tk"""-' 01
_ 1toIIIIft"poo.:kod _ 01 >alII
. - "" , . th< p<e<ioo WlIOIIIS1CEf """"'-10 """"'-I he
00«1 ..._ Pl*iblo,
[ THE STATE OF THE WORLD'S CHILDREN 1985

Colombia:
immunizing 800,000
"' 1hIt1Ml Iewmcnlhs .~_ ............... IlOa/lIIl' ~ c!*l - ..... llOm . . ... ~
~ 01 it! roung cI'oldtton IQMlI1 !Mt 01 EJ r"""J,lllR _ lOan IllopIell b'f 20 0/tIeI
n'IlI/OI' 0'9USes .... ft\lIO:SIVe c.lI/JllllIIl" 6l)'ead newspapero One ol 111& can..,'I larges! 1l'M1"
_ wee ~ 1.<lnaI Vaetlll8llOll Oays _ . lhI! Banco lleI r ueoc, dislllDuled mllI'Jy

__ _ _ '" ~ SIlO>WIg Ihe figure 01 """'

_.
The ~ ....,, !I'e ae-w>Illl'lol I"lltle_
~ ~ Ccklmt>oI ' . _ ,.., 10 "'" daMI 01 the NaIIonol VaeonalO1
08y!I- 23td, .My 2 811 _ ""-9JSI 2~
den! Be\Ina.If llItliII!r 1M -,- CCIng (..., 'lIIlYdI.
1IOI'l
_
_11'1'.
~lNPI
_.-.g..... .............:: .....
~ "'Oi~'iQ On !he oalioi. dItys eoo",_
_ _ bnowiwI I>aurty "* .. __
POIlUlIr

':' ' 10e.-.- _

:_;;,;~;;,;It"e - '~'" 'lI_
o.g.,.,..... ..
of <:'lIIa<1!n ... <» _ .... aua
.~

w.-:lby...,.,g"..-.. 1 ~ 1lI
It"e "'!lor scc.. .. ,.. Snel VerJO:n • •
.. III lO.I 10 _ . . .,....., III I'KU:>I _ _ Don _OUl .. __ ..... ~ "'roe
"0_,
.. _
l'f' ........
01 ~ .OOO
_'*".....
"'*"".,.. -V _of~ kUI'tlI pr,c:Illel _
_-.~_lt!Of:.
~

On _ ~ ~ roe "-'" VKor.-

'" I • m on t>e ~ '" ....... nros ....
Don ~ ~ II .... '" ~·s2.280

eo_ _!he_
PI ' • .............a IN Iirtl t;Hd .. WQ PI .. ,,"' ""_-"a.l~_roe
. . " , * " ... 1logoQ. ~ 1 P m _ - - ' I I ....
800.000 ~ '-I - . ...... ' tIgIFoIl '''m.... of -.0 - . . , ~ n..
_ poloo, ckJhllielOll. - . . . . , """""''0 -.eoe lOl)t(lO' _ ' " aIed
- - , of
CIO!,
Of! , . 200 .000

--
eo<qI ""'" N .....- .... , MlIl ~
_ ......., ~ 1rI 111&PIOO8Sf.,1II&eatrll*O"_ lry 01 1118 _ I ' M ) ~_lllI

_ Ill..""... ........ ~ -Ul.ogll""

~ofISO~.lO_lhIl_1I

'"II "" WIVI'U'IIlA\lOn llySlem I\SIIII

TO enIIIJIll 3UPlll'I. Ihe IIN!Il1 _ _ tnlosIfIll
To .chIlMIIh<l resull. OWl! , 20.000 -oU'oleers
_ lII(lllIiolecl an<l rNef 1Dr o o O .._ 100" IhlI SUPPOII 01 "" Colomtw>r! AM Ctooss Sociely,
IlOIIS _ MIt.
0 $Ot uP .. 8CI>OOII. perI<a, 10WtI
lr""*'
IIo'I\ith more lroan 13,000 oj tI$ """ ,bIoe lo
De vacc:lnaIote ifill 1_ _ 16,OOO vollno
mllII<lI·piDcoI ard healm clrocII OflOerej I' "'j teets 10 hO/p _ 01_ _ ano ,_.>.eep.
Itylif. lIIlt ~ _ . brC*lCall - . y fWO ~
.... 90 fadIo _ Allhll ~lIIIOn"" "'Il The Un-.:t _ oe. 1.·' PlU\I"''" ,oe
U'IICEF IlI<l'Oded !he
r.,.1... gn-.
WHO, _ _

_.n_ .,..,
CIn<Iy S13lI5. _ InC
SVfl'IOII .., ,..., ~ ,.. ' COId e/'Iao>'
....."'.......-. com¥al 8ll'e>cA ... Ower SOD "'*'- _ limy meoX:s pnorl ....
...... mea aIUIlIrIIlS 01 .<Ill
. "" , - 'II .oork1. m,C$Qi' _ ,..,....., <A 0 11 ..-
CoIarrOI'.
-.:t> .. ... _ ~
naI _
$
...
~

pler-._,
.....-..........-.
e. ' 1 1:1_
01 _
1:1
_ b _ To....OO ... NII'Ub-
. . . ~tG . ~ .. u......,. E--.. _ lIIr!gO'Ig • cNI:l lor -..........

...
_ -.eo 10 lln:l its ~ 10" .......... ' ... - . """" e grooolII CIWl _ IN cNI:l •
To _ roo - . " .... c:o.rwr"
Ilog;IIlSt ~ oecord· pla IItwlce Of! to r~
~ 'c ..... 0 r-. "'""" Iofoet _ _ f'lI ........... _ IN . _ ,• • of . .,, _
_ l> • III ~_ c._ 10 "*""'
.. IlI** -.... .... ..... _ V _ _,
0iIyI On A(lnI QIl lI>e Cl'uC_9' . - - . /See 1.-1 ~ too Ihe EI r __
l*toon ct...... _ ~ ~ .... co '",. . ...on _ 0." .-0' I

,
h# dnwn world-wide anen,Wa '0 ' he fact ' hal
jUSl fOUl nolJlively sin:lple and iIIe.pensive
nle, hoo. could no'" enab~, parenl! !he msclves '0
halve ' he n le of ohild dealh' and save lhe li.esof
up 10 20,000 child ren each day.
In brief, 'hose mclbodJ are-
o GroWlh mOll;lo riq - ...hich could belp
"""he" 10 pn'V<:n, _ "t<ildmalnulrition before
il begins. Wilh Ihe help of a 100000, gnlWlh "h an,
and basic advice on wn nin g, mosl lIIOIhen oouk!
maintai n lheir dUJd'. healthy growth _e ven
within their limi..d <esOW'CeS.
othe more
Oral nh,dratiorl _ which could saW: lIlOSI of
by ,.,....,.,......u and """"''''';1» <a<';"" ,..,.."" wi'h
IIv <~riI»t tlf ,,v Mill andDIJur famtJ Df .......
"""mN" ic4';"". In spill of tM """iIlN'''' and terio>w
ttnU"",nu tlf _14"",""", ud ....'ion it />I'<If'i"I
J>fl>Iibh olld Wlr~ff",iw.."
SalIX ocamples or this child suevival revolution
as it begins '0 go mlO lClioa IIOIInd the world:·
Fig .1 Developing countries
produc ing o ra l rehydration salts
-,
~
~

-
,han . mii.lioIl }'C""'i children ...ho 00'" trsono
die ""'h yar from dianhoal debydnlion. ..",."..,.
~ ;~
o Bn ast-fm ;"I _ whic b CI.ll ensure w, ;,,-
fanl! have the bt$t possibl:e food aIld a ooosider.
able degrn: of iounu ni,y from OOmmon infec1ioDS
durio& the lil'$l sis; """'tm' of life.
o A fuU $5 oourse of l...... uo;zalioa _ ...hiclI
can Prolec1a child a,gai.n;11 measles, dipbtheria,
whooP;lIlI rouab, ,nanus. "ubcm.>losi$, and polio.
A, p1Uen" , hese disease. kill an estimated 5
millioo )'OIlI!ll childJTn I )'CU, la ve 5 million
more dislbled, aIld ~ a "",jor cousc of "h ild
malno'ri'ion.
10 !his year'. repan, h is possibl¢ '0 begin
repan,n, on ,he progress of ,hr:sc sualegies.· 10
lI.e wordli of the Sa:nn"y .(rtneral of 'he Uni ,ed
Nalio.... Javier Perez de Cuellar:_
.. ,~.....,.,Id-wide m"",,,,, Iuu htm R ttnm'ti",.
°
TIurt o~ wn..it",koblt sWu 'ko' ..,,;,oblt <~;Id
,w,..,;...1 mo>Ju,,,,,, "'" ,,",un'" f/'W1d """" ,It<
Wllrld ond offm 'M Mpt 'h", 1M "'In of infon' olld
<Mid "",,"'olily, ,rill '" dtpl«ably ~,.,.. ""'Y lit
mfllUd lhw'ic4/1y in 'M f",...-bIt "',un."
Cili", !he four low-om ..... ho<b outli ned
above, the Seaetllry-Gertenl concludes:-
"Et'idthl:t lJ/XlUJl wlo,n lito ' IMst ond o,hn- ,...~
simple ~I ;nterun,ioIu 0 .. bting n Ulflhd """~

.Iu.._ ... . . """.. . """

oo1l«tIo<l1
,~ __
boowa .. 006' _ f« Growlh _ ilOri<ll, 0n.I
..
rdlydn..... _
IIlUlli>aliol>.
·ffflliotl; mol """"'""" -"'a:, ~ lID- _
_a~~
............. ~_,_
o :al'
0S0n _
,
... r I
-
PU~lilb ~IWI[H~iHh II >!!! ~
ihjHh~l ll ~iha'i~~lu h [. ~
"~' "m W'T,I ~Wi ~~ 3 :3 ~
iHihl~:l liIHihi~ih jl ~~ IiJ
HI'l~,Uj ~" •. UlUU!·1 _ ...
~
~h!ilim 1~i!HJiir:in Ii ;~
! H!lhlll .b~~.hH.• ~ i!: = a-
!~~~31fi~.gll·ii~. i'!~I~~11 ~ .. I
,h.! pH.~t~[~. '1IH"! 0
[iJ~.~.hli~~pl! hiH!!I> 3
. .• . .·~I!.I·!l ·i~i'~I[ ·
ll.II;IIIII!llili! lfi'!:;~ .
!11~:lllli"f·.jl!~ rJ.!~!11
'~'i<II'11Ii "."S . ·.~,il· ~
Ilii;I.I!;~!~ili;1 ~I!I!;:I
!~~~§~~i~ ,~aiq~!~ ~ S 8 ~ ~ g ~ ~
 In Indon..... ' he lif'h ~ ""lion in the
world, 400,000 voluJlIl!m in tlver 31,000 villilg..
a~ rnanilging I llatiooal prt'lramme including lhe
monthly growth lIl<IlI;tlKi.q tlf childrm, tlra!
~hyd ralioo lherapy, lhe promotion of breasl '
fccdini and safe weani ng, the use nf immwtiza-
tiwl services, and birth spacing_ The lim is to
reduce the ownll infant death rale by appro';.
malCly half- frtllll 90 10 Ie.. than 50 deaths pcr
1,000 live bin.h._ovcr the OUI fif' .... yean.
Fig.2 Global supply of oral
rehydratio n salts (WKO/ UNICEF formula,)
170
160
I::il T""
160
II
]a Pakistan - where half a millioo childrell have
been dying every year from diatr"'-l ,uhydn-
titlll and 'immun.i.uble· diselSCl alooe - an Ac«l-
erated Heal l h Programme has lifled the imm uni_
wit>o rale fro m 5~ to almost 50', prod~ 30
millitlll ....h.... nf onJ rehydratioo sallll in 1984,
IIId lrained ""er 12,000 tnlditiooal birth atl m_
daJlu in 10w«llR techni q ues for pnxecting Ihe
lives and growth nf Pakiuan'. childr<:o.
III India, l he programme fllf Inlegra led Child
Deve lop men l Services-using" simil... raIlge nf
low""", lechniqueo - is operating in (lI\e-liflb tlf
India', 5,000 de,,.loproenl 'blocb' and ",..h;ng
almost 10 milli<l<l young childr<:n (.... pmel 4).
/
, III Dquio Cil y, Ihe Philippin.., a campaigll
centred tlo growth 1IIQIl;I<lring, lhe prolttCllitln of
breasl_feeding, immuniu.til)/l, onJ rchydr.ll;on

- '
- lm KOEF lhenpy, an d binh .~ hIS helped 10 reduce
" 0 ....... COUl1lfiHS infllli IIld child death rales by 50'1. ""er the Lat
130
I .~ -
Broken lines indicate best In Colombia this year, over 800,000 young
•
•
120
110
avaiable estimate
I child~n have been immuniud 00 each of three
N.,iwl al Vaa:i""til)/l Da ys IS pan of a campaiJo

~ 100
"§ so
I!
I i
ttl bring abon< a t'tVOIUliCln ill child . urn",,1(...
panel I ).
III Bnzil, 19S4 has abo seee 2 milliOll UJldtt..

a OJ If tW<lll vacci nated lQlain51 melUl.., 1.5 million im_

muniud lQlainst diphth<ria, wl>oopiol cough and

,
B 6070
50
i i
/!
:'
tCWIlI', and I!m(lII. aU th e na ti<!o'. children
protected 1Qlain<1 poli<> _ll>rough , he lIl<Ibiliu.tWn
C>f over <100,000 ""Iunt een tnaIlJlini ove. 90,000
vaccillatiol:l I'llIts OIltWilsepan.le Natiooal Vacci,
nation Da }/1
:'
40 In Tanwtia, a cam paiJo based on on! rehyd ra.
lion therapy and &roWlh llIOJtil<»ing hal been
30 lauoched as , he fi... s'oge of • OUtriti<m pr0-
gramme which aimslo halve the dealh rale among
2<J th e 50,000 children living in 161 vil1a&es nf lringa
10 p"""nce.

0'" '~'~'""5--"L7:7:::'8~ y-
:"79 80 81 82 83 84
10 Ethiopia, the city of Addi s Ababa has taken
lhe fim "CPS in • campaign 1<1 balve illlinflllllDd
child dealh rales over th e oe~ three yeln.
Nelle: FVno _ w", . . .1 ~ I n - ' I<> In Nileril, ,, WIlpIian !tao jlll l hem bunched
l!Io""'" ~ .. _ 0I8Cl 10 ..."., f*O'o'Il3 ..-&
10 Uy 10 repeat on " national !ICllle the succe:ues

- ,~
...-
~ llI'_ .......,.,'*~-.l.,
nf the n......yle vaccioatitln campaign in t be
Own am -where immunization COVCrl/le hall

s
[ THE mE OF THE WORLD'S CHlLDREN 1985

Africa:
the permanent crisis
&acrly one IlU/ldred yeats alter 1M colooial ~ OIl this PIlr.em IS Ie.. dmug~l
_ . dm<:led uP II>e CCO'l\ItlOnt 1l1l!>e !Angtess 01 _ aflec;lS a lrnrd 01 A/rJea 's POllItabOO
I'W;)W
Ber1in, Air"", f,r-Cl; ....... In a S1a1e 01 PfIfIl"'fW', and 1t>e _ ~ ""ViI
rumed Clops in Swazi..
C<1$IS T~ 01 !he ""O'kl'. :, 6 00QI'e51 Iarld a"d MotllmboC!Ull, in 1983, P\!I' ClIPliI lood
Ml00ns are 10 be _ south 01 1M Sa/>ala _ Ploductoon was 00..., by a dlsast""'" 1 ~'l> 0!1111a
2~ oIl1lem ate"""" "IlPI!00ng lor llfIurgency ilId 1981 l......e as ~ CfOP5 at rriIIa1 ar>::l sorglUTl
10 Wliltl off Iamioe p.vd>ed in lh8 I~ 11>1$ yea< lila 8IJIJ$aI has
gone COJI \01 rrOIIons at _ 01_IIef'lCYkloo
The en... goes Cleeller Ihao ll<8Slll" QrougIlt
Alrica 1$ Ihe 00'111oeo1 ..Ill the lowes! IrOOOt'llM. Il\e a" aod child deall>!l ll<e IISitIll '" r:ornlrlSS SUCh as
_ ecooomoc I1 OWT ~ 'aleS. and me -'1
Mall , Chad . no f1llioPia
......... of,Ie "xpec\llncy en(lllle<acy It .. a*> me Maa~ _ , ICIIIl la ~ br,ltIe and MIfI by <:llQUQ/l1
COIl\W'le01I ""\11 !he I\Ighe$l Mes 01 IlOIl'J\ilIJOO
gt<>WIh. !he leas! poIo!"",1 SIabkIy, an<l 1.... /IlDIl
aM 0'Vl>r'Olal''''ll a'e heonQ ~ _ bv wind
aod ""'.... Eve<)' ""'" now, tile SaM,a e><PaMS dS
seve-e """"""""""laI llI'oblems. ffO!1I>CrS bv aoot""" 1 !> _ _ ...
As a rlllllo::tlon of Ihese lis . AttICa alSO !las me
I"oghesl rales 01 d>ild deaths TIlIt V'l''' nearty ~ Not 181he COOQ.....I s llOi'lo:':a! QnII....., ... ~ ""'I
. . - li,hocan c!ldllt"" MI'll (loe(l and IflO!I'IeI 5 more stable , In !he IaSl 25 '1"'..... more ll>an 10
""ViI _ Iloo.>roo-
,-
,....", ...."" Deet1 a _ by malrUIII!""" and ~ "' 29 ATncan natlOll!l
_ by ~hO<\ or C<>.JP
""" d<''''''' by colonial 'IIle<!l n<lYe not ~ and
d '~1
~.

T", OPt....... _ ~ 1I"CePt<>denl:e lor IOO3Y !he cont>nelll as a _ has 5 "....".,

so ~ AI''''''' f'Ia!IO<'I boI/3t11Q _""ate .,"'"
1970$ Wl>en a. POnS _ed. t!le'\' hac! lal<e"
OUI lOanS to ffleSI on ~1 8Jl1t18o Jl.IIlI
_ '<)$0 _ Ihe Pnc89 pad ta ~ ,lroca S raw
rrt:olenals JtIlI
New loons beo (0 be Illkcr' 0IJl - llul lI\IS lime III
mp<ll1 lood aro fuel ana to &e<VICe pasl llebts
10<lIl1, fu(O """"'" COSl 40':10 at OM ...', ~
letugees. halt oIlham dlokl,.,n
Finally Al'oca IS IIIe r;o"IIy con1""""t _ 8 !he
ra,e 01 POIlIIIatioo 0I0Wl~ """ v-et to slow down
w,,,.., 25 year . lIS POPUlabOn .. e...,.,."ed to
aouble to o.er 1 tlIlloOn MeanwhIle 11M! pe<cont"lJll
01 Ali1Carl$lni"'U ", aDsollJte P<I"W1y n,.. """" Ir<><,.
S2 ~ In 1974 to 91 ~ in 1982

";'''''''9''.
debt r$IlIIY" ....." dam 8 thor(! 01 lt1e lnuvllably II os !he mOlds aod bodies 01 Affca 's
r~_ 01 Burl<iM.fasc. anll 100cl ~ npo/1 S cosl
NlQella MOrllIt1M 52 DoIoOO 8 ~r cIlIIdren wl'llCn a<e f'rlO&l a, nsI< ArId ~ ""
"''''''.1''1 may t>ecoma "'J.QarlleMltln\l by llInJ<I-
TO cam \l1li '*' ry loreogn 8l<C"il/lQIl mosI "'ll1t>e l&OCl 01 SOli klr KlmOrfOw'I ll9"eulluru lICl
'"I/!OCllIurai .",...tmottt 110M Ie cas/1 crops lot tM da""'ll" """" '" to<Iay', enil"'"" o a n _
exPOll But 09v0t"'lllhe best 13M 10 a .POI! Clops nenlly emde "", canacny ot tomorr<W/"s P31entll In
f\lOS me3<II g,OWWlg too<I OIl m<118 ana mole At"",, ', IlGiu< ot need a re.<ilutoon "' CI1IId ~
milIgonai _ ll1e result IS """"'.' .T••"talllllUlI· 11011 os ltII!Ie\()te mora ,w
S""'Y II'Ian ever lI8k><e
ooratoorl, grNICt "_abl!4Y ot "'" POQ( and CMIn Pll!Se'\I ad'¥;onI;as '" ~, • 18 BIsel
PIt$IOraLsI$ and W'iCteMong dOP8OOII!1Ce on .". more POS5IIlle man """ Del"'" Oral 'a!l)'<lra'"",
POt1«l looa l00a, Atoca Dateii' gruws t\lIIl 'IS and """..... ;r.al1011. It>' (I:Oa ",,*, could K>pa~
own !l)Q(lllll(llla$ to """"" ~ ~O"..IIion_ _ Ilia _ 01 perhaps tl,)Il "'" AIncio<l _ " "
oIg",,,,a"""Jdy _ ,..,... a", eac:I1 year

•
been tif.ed from less lila" I~ ' " Sl~ in Lbe
Iwd ve mondll $inc.- the QllIpaign began (_
panel 6) ,
In T urkey, Lbe 11~1 of I Jive-year Turki:lb
Child Souvival and Devd opmen . R...., luuoo is
planned for 19S5 '0 uy 10 repea., lII.uoo·wide, l b.
IOC' M achieved in Vor, provin"" wb= .b.
--
~ combinatioP of 10. '-<;01•• ecbll iqt>ell Iw
re:dum infanl dcatbl by 6S~ in the last fQllf
In Cbn'q:1 di.U'ia, AII ':ril, lb . infml monal-
i.y ... 1. bu already been ..,1 by 60'- (from 103 '0
41 per 1,(00) io only Jiv. years, lI$ing I wmbilll-
tioP of lllW-<oR .echniques ;ndudina- th. promo-
tioll of btuIt-feeding, eene- wemiq, growth
lIIOniloriDl , oral ...hydral;"", lherapy, and immu·
oizatioo (_ panel 7) ,
In Algierl ,...If, . be coumry'. oowly IppOin .ed
Health Minis.er hal pledg.d llllWve .h. nltioll'l
inbal dealil ..... in . be O"lll live ye.... Th.
......paiall orill he spearhea ded by I ... tioI>-wide
ORT prIlInlIlltIO ' 0 combll the di&rrltoeal dehy-
dration "'hkb ...... IC<:llWlU for ""orly ~ of all
child d..tbs io Algeria.
No. all of these ......pail;Q$ will IOIXftd. Some
wiU fail.ll main'lin t.be ini,tiIl .n.husiasm. Some
will mI ron,Oll' .0 hove n:ached m iollead of
mobilizini all pclSIibll: mllUl'CQ '0 reach m In<!
90'- of ,he pnpnb Ullll. Son.. will fail '0 ruch ,he
p<><>reII fl..<llilic. Some will flil vktim 10 rect:ISillll
Iltd cu,·backs in govern_a, ,pendin&. BUI ""me
Qrt lUCCftdina- io achieving high er levels of
chi JdreIl" beallh aDd ,...U_hoi",. The child tuM·
val m'Oiulion Q; IlO Jon.1" I th ootY. MillY
tbou$andtof chiJdrtn', Ii""', ....
bci", ..ved. And
th= iollOWI realistic twis fill" bnpe lho., over th e
nUl lO 10 I S yean, in flltl -d"l.b ra'a will fall by
as lIlucb as 5'lli or lIIO... . year in COUtllrie& lucb
.. T o..,,";., Nileri&, Alll m., T ur key, India,
Pakistan, Indonesia, Haiu, Nican&:ua. Brazil and
Colombia.
SeIf-bWtb
Brcak.broll.llbs in J<.n<r;o'ledge and .echnique:
have b«n made bd"nrt. UlUaIly, tb ty b..e
reacbed ooly • minori.y of . be d"""loping 1V011d',
people.: ei.b..- they " ..... 00 e>:penJive, or .hey
could llllly he made availa bl. vii th. hllSpila!s,
docmn ....d cli.n.ia wh ich .... just IIOI lnilibl• •o
. be lDIjDri.y. Bu. th e four basic IlrIlqi.. of the
child survival revoluuon represent ad\'JJIces of an
allOSeth..- dirr nt order. !I.od who. I i.... Ib...,
Lbcir uniq"" ""' tiIl iJ .ru",_
o They cae be: diltilJed d"""" . 0 III ...."CC of
tim pl. pnctiable illformluOil IIId Idvice whicb
aImosi ill pareo.. CIII lIIIderstand and .... on.
They .....hem..... nOi depend..... OIIly llll th.
estaWOII of bnlth service$.
o They are III inex pensiv e that a11t105t any
family IlId .... y GlUOII can offord .0 pOi th.... in.o
pnctice. For III four, th e I vcrq:e additiolUll COIl.
would probobly IlOl be: lllOIl' than $10 per child.
o Th ey are 10 univmal ill Lbcir ...IOV1Jlce, and
to ,ynergilti<: in their ...lItioJ:1Jhip wilb each
other, th ll thty """'Id stri ke I. the bean of th e
cbild heallh and mainU.riUllll pro blem io almost
evny poor communi.y in the dcvdop iog world.
o They are lI ot dependenl OIl profound
chml" in valu.. Olll" do they 10 qainJI th'lrain
of people', OW'll priDriUn. Ral ber, .bey off... a
meanJ hy which Plf""'It C.III reaIiu their """"
wishes for bealthy 5W"Oiving children.
DraniaUy improved child health and 5W"Oival
is thcmo«: mad e realistic by lhiftillj i" opera-
UOIla! em.... of lravity from bcallil inltiluUom
the family itself And in .b3l sense, the child
.0
IUrvival revnluuotl an be: oeen as port of III ....."
broid er dobol trend lowards m uru.i.og th. pIi -
tIlIIJ rc$pon sibiliry for bealtb .0Lb. individual.
In the indUllrialized world hself, the invest-
menl of U1 ra billi..... of dollll"l in mcdicaI
, echnolO(lY is yie lding ever tDll<'I: IIlII'JinaISIi.... in
hlltlllll bealth. Lnw-<oo dtanges witbiII Ihe
pow« of t.be indiridual, 011 lbe "'he< baod, cnuId
lever beal th .0 0..... levels. It iJ oow knowli, for
UIIIlplo:, Ib3l an /ulIctiCID tIlIk COlI add .ppnui-
ma.ely II yean .0 M life a pecuncy by llOI
IIllOking, driDl<ina: only io mnd...lion, e.otinS
wisely, IIld lilting res ulu u ercile. III tell"'ll.I" ' O
lbe pn:"r' ''; 00 of 1M kitld of blowlfd S" liletally
PIillionJ of people io the indus.rialiud world 113....
impmved th eir OW'll bealth by their own ICIioOI
,
I THE SOOE OF THE WORLD'S CHILDREN 1985

India:
reaching 10 miillion
IrIOta tI39 fI'IO/e C/WOretlll\an .:lillie . 6 e<u1tlNl!; "'" local POi/l1 for C/ldClren's mm ...-zaloons and lor
o! AIr.o;:a pul lOgOI!let The rnlIIDf'Ily ot U><>sol ,ogtkr C/'IftCI<-<.IP$ on Irt$tr Ileatu>. """ as a centre
CI'IiIdt"" 8/e Ivlng in ~ . one .. lt ~oe III born to< l ter acy. I>eaI1h Oncl nutril"'" """""'" lor molt>-
\II'loOetWeogl1l, one in seven dl8lI D9!onl !he ilglI or CIS Along Wtlt\ VIllagIlllllallll 1)UIde9, !he at>g;l{l-
Irte , """ lin 1lSbm8te<l 3 moIloc.'o1 Ole OCh year 1"",,, waaiWOll<e<1 ""Ofnen recru~OCllrom !he comml>-
rontIillOn!5 INIIICt1 could be preroo\o!ll D\' (Wal "''Y and lrBJoeIl !OI _ >II mol1!llll. ate lhu
lflI¥lIal'Ol1 0<lCI ...........,..at<w'.,o,ne CQII'II'rUIIIy' s ptI/I1IIr)' '"'" _ IIle heal l~ """nIlS
Md .. ol!'Iet ~ for j'OUr'IQ c:I'idren
Over "'" yurs ." ' 0$ In ""I"""""llIIIe
Ma im OI lndiat'1 c/Iildr«l _ been cl1 aiked UP 11'1 From exper.nen181 begiIvwngs ten yeaI' IIQO .,
poI(>I Jl'QIeoClS anc ~le (lOYfln'lllle<l1 pro- 33 01 """"'s 5,000 lIdmonIsIr,'''''
'block. ' (""""
lI''''''''''''''
&1 there are '""" 89'S INI! l'lC Wlill "', _ ..... 01 100,000 peopIo), ltle lGDS
govetMleIll ~ set\JrIll '" eeee a mall'" ce besc ptC(lt. 'nme will toy mo<:I-1985 be S<:lM> " 1 ,000
blCCkS ccntannQ tome c/1nI;M' S pCOrOS1 ..._
Chkl Illlallh Sb1II"I)'e' (1(1 a $CallI 001>mer4Ur81O
Wltn me probII:im IlSe!! • 8Illl skims AI lfla1 pr.xol1ha ~ _I<e<s.
opanel)FoIowJno suc:cessIul local
'oOIIIC/I ne"" _
camp;!IIgI1S (see
enola .............:abOll_
W<,enlly """"" 60,000 Sll eng, WoII be OIgaroWog
""""-""Za1ocns arc! checl<-ucs lcf 10 3 moaocn
cnol(llen, eI8sse:I lor 3 4 _ me>\I1a<'s, and
10 _ SO'*' several Slate~;ts ar. nqo, SIJllIlIemcnl8lY fJoad"'lllor 6 1 milIicn cIuldren and
"""""51 to ...........'" illI tnoIdIen ~1CEF', ,,,. I 1 IIliIIICtl womoo Another 1,000 bIock5 wilIoe
II'O"l'I Olr« "' New DeIni eslim.;l'" ma l .1 allllate C<M!I"ad by 1990 RlId Ille progt..,..... lIS. w!'ICle
oove,.,vnenlS fOllow WOIJOIl or> tM lXlmtnJlmeOl, IS d-.e 1<1 reac ~ --.. POOl d'oId &geCI $0> ana
""'" Indi:l can - . . . lis goal 01....:or"'l"'1!85' oo:>c1eo' ~1 Ille ' ...n 01 "'" oenIUIy
oj all inlaotl I:rt "'" \"I"lI' 1990
Atroooy. "'" """"""'allcn 141et" IIave <lcubIe<l
o A 11I1....-.1 codesoor>on "'"I>e<><Wl'Ill
. - lUb;tiMes lIS
~ '" 1><_.
10 law
""" tnpled ., lCOS _ A SU<Yeyoll1>a cnolOrCll
In I 5 cI "'" cngtIIiII ptc,ecl blocks I\aS - . 11\111
o A nal.oDnal P'OlI'atm'IIl '" _,t llOoaDII!y haS ......... malnullll!On Jell ~cm 21.9'h 10 5 4 'W> CIIeI"
been Iauncl1e<l - 1IlCIu<Iing m_"" dislnbulD" ot 21 mentns. Among chilcIreIlllP to iIIl"". W.oaI!'/
"laflWl A to p"......., bkndness '" chrido'en It>a 118'_ grOuP 1<1 JeiOC/l Matnuu,_ t.o ~ cm
29 2... to 6... E....... ~ ihoo children In !Ul"aI
o GoYerroneoI 0IIIIBys"" _ _ """ _ ~ a­
!COS bIccl<s are """""d me mosl d<optlv«l In Itle
,...
\IOf'l ""l toile <l!tI>o61 quadruplecl <N8 U", _ , 1M! COUfllry Il1eir .,lam mOl"'.""fate IS 5/elIdII:1 JaJIing
a SlL<!y III 200 lCDS b/oc;k. toond
II'OIlal.l'/ mle In 19 82·1 983 o! 89 _
en 1I11&'1l
per
Al 1he Ilear1 01 lIIeSe lICllVIIies lies he IOIlSIII'll \ .0 00 live oortns ., I'Ut8I blockS. as cotrIll8Ied W!\Il
P/OIlI""""" "" Inlegreled CIliId DeveIo:pment s",.
VICeS (!COS), eer*ea or> the lIIlg8f1W8o:ll- ileIaIIV•
me .... 1oOna11 ~ 0! 12 4 per 1 ,0 00 ., rural."""
• ~ kw et»Id """'. The """""~_ ~ , It>e CUllen! 1,000 !COS ptqects
C(MlI e pop<AatJon o! lIbOu1 1,000 """ _ COSl cut ., only 0 1 J'h c1 me COOn1",,'S grQA.
$IITO,lIliIneo\l$I'yes a PI~ lor o;I1IlI;l<en UP to <lcmeS1lC prO<lu<:l Ar<,I IIlc <;0$1 Wli stil be wei
sue , as .""""""""lSIy lMCl!IIII ""'"l'e lot preg.
nan! an<l rllJl9fl\l WOIfll'Il an<l lei DOOI (:toId!tlfl, as
DeIcw 1'J> even wt>eIl aJ _
have been rllac/l8d
's cNklten ., r'lIl8<l

•
-<lOpecioJly in giving up cigan:l1es and ' aking
daily exerdse,
In the "cry differenl drclllllllUlDCCS of ,he
devo:lopUt,g world, .. here bo:..lth has oJ.. "'oded 10
becnmc uoncia'<:d only 'wilh ..hile coolS and
hospitals, a oew pcrccpuon of the family", ,he
prime guaniWI of ilS own health is also lht pre-
rnndhioo for .. d"'-"'lUc :advan~. And in mosl
developing nauons ,ada)', tIN: fl'OJlUers '0 ,
hoaIthier.oony CaD also be, croosed by knowl"",e
..ltich ....bla familia 1I,cll:I$OlV<$ 1o pr<)\0C\ Ihe
li.... and the hclollh of !heir cl>ild"'" by changes
which an: ..i,hin lheir o"n power 10 realize.
Bu, if this potenLial is 10 !befuLfiUt<!, , hen , VCfy
much lI>OI'" difficull breaklhrough rnllSl 00" be:
made _a breal<~h nOi in knowledge, bul in
w, ys of pulli"i ..ha, is "kcady known 1.1 Ih e
dispoaJ of mmy millions of families. How thaI
lask is hci"i aUCInp'lN in. ltWIy na,;ODI of the
world will be one of the p!"incipol subjc(u of ,his
y""" SlQlt IJ/ lilt World\ GJrildml rcpon.
Hul'" scnriccs
Clurly, the bealth SI:rvica Ire a:scmial,
Equally ~l ...tly, ,hey an: nOi coougb. In 1M
de""loping world loday, IWn-thUd. oC the populo-
uon has no rquw _esa 10 modcro health
facilil ies. If ,he child . Ul'Yi" al revoluuon is In be.
rcvnIuLioo fnr ,h. majori,y, il moot ,be:reforc
depend more no nrdinary f'miliel,han on medical
insulu'ions.
This, ill lUI'l1, means that our lIIClI,al map of
~hiId heal... care need. In he radic:llI.ly .. vistd. 10
'be ""o"coLioooJ 'circ le of heal, h' , i, is 'he
pacdi.ui~ian" ,he doc 'or. and Ihe hoopi,aIo
which arc littD as 'the cenu,",'. lt:ss w. U-q ualified
heaI'h wo,kC/S and viIIagc "olu",,,,," an: known
.. 'wotkftl.1 <he periph.,y'. MOlhcrs and chil-
dreo, needless 10 say, arc lh e pciphery i13c1f.
To further tIN: p''''''' potenLiaI, il ..ill be
OCCC1Sllry '0 turD 'his ci rcle lnside OUI. The
mOIher n«d, '0be: scm ,.. the ttn,re of child
bealth ~. II is Ut. who' is 'he higllesl-le""l
health worker _nO{ in lJ'ai.ni"i 0' in qualifianioo.
bul in lime and 10''', in lh<, .pccial knowledg. of
h... own chi ldr=, in the b ..adth of 'inlcg"lt<!
.. rYiCCl' .... provides, and in the pe11lWlCO'
p~ ohe bring. to her child ', life.
The cmp""'erin,g of ,h e \DO'her, and the
building of rnacenuic cirdeo of SUppotl around
b..., is thcrd_ Ih. only apPfOKh which <:aD
reali$lically bope 1o btini the b<:nWI1 of a thild
surv:i"a1 revoJulion 10 the majori,y of lb e develop-
i"i world'. cltildr=, For il is ,he moth er who ;'
owally mponsibl. for deciding .. hether or n<K
she will be immunized q:ainst ,etanus during her
pregnancy, whe'ber or nOl' , trained penon will
he pr...n, at ,he birlh i whet he, onJ rehyd",Lioo
Ihel1lpy ..m he uocd '0 JIf'l'vcn, dehyd..,ion i
whelher tc bl"Casl·feed and for bow long; when to
.....n and wi'h .. ha, roodo; wbet her blond. and
coolr.ing ourfac:a an: freq ue" lly wasbed; wheth.r
boul1 of diurlloca will be treated by willlholding
food or by condnut<! feeding; wheth... . child will
be IU.n for a full COWIC of inunurU2:ation; and
wba her Ihcrc will be an adequal. inlerval before
,h. neal child is born,
Empowering mothers with prt:ICn' knowledge
and ledmiqnca of child prO\cetioll iatherefore l he
key to unloclr.iJlg the p~ ' potential for'
..""Iutioo in chi ld heal'h. Bu, ,he rcoponsibili,y
for lurning l bat key rest. with the whol. of
society . Fo' Ih. IllOlh... cannO\ act oJone, should
001 bear the reoponsibility a1""", and cannO\ be
empowered by inf011DllU01l alone .
To use oew Ir..nowledge and Ie<:hru'lues, 1M
IllOlher ottdo tb e moral enoouraaemen, and
pra<"lieal .uppo<1 of aU the ""flcc une circ la
around her. She needs the partn.nhip of her
b...band and , he C<H>pCnIlion of her parents-in--
Law; she Jleeds th e $Olidarily and _ pie of her
frieJl<b and neigbbourl; she needs 'he advitt of.
uaint<! and UU1tt<! pellOO in her own IJtcaIiIYi she
needs '0 f~ lhat .be h.. 'he sanclloO of her
spi ri'ual and polilical leadOJl.; and she necds the
confidcncc of kn owm, that wbat we is dcing hal
the blessing of those whnm she UU111 'lid
~-
On anolhcr plane, w e needs more acr:eslI to
t<!uc:auoo and incomc-nming o ppo<1uruties; ohe
nttdo • lillie more say in ,he a1IO<:lllioo of lhe
family'l food, money and worlr.; and We need.
buic tccl>nol<\lia 10 relieve ber of drudgery and
gi ,e her mote e,,""IY and ume.
•
I THE STATE OF THE WORLD'S CHILDREN 1985

Bangladesh:
surviving the autumn
Extr3Cll !rom II .speech made ll\Il~
HealItl Mri<IeI Map-Genetal Snams.l HaQ 10 "'"
ConsuMlMl G"'OIl ot !hit InIemarion<; Gen U" k:w
~ oseee Rese8rc:I\.
(ICooR.B)
Oral rehjtlrll1 .... therapylOATl ~ In Us
pt~!Olm al trle CODA.B on Barr,/IlId6$h, CiItI
ognlly lie calle<! "'" rne<IICII ""'a ele of 1M
ctlnII.Oy FOI U has flt<7'o'801lo be the ",ost ,.."
l ui i0oi lor combalirlg a cur se lllal irI8S 51_
ma olulld from MI!oesI ' ''''" dOwn to the _
In ~ . _ a _ _ cor..tlnullS 10 lie
T'~ h las! tvoorea ~"" 10 II lleal/net1\
cl,,"" .
In WI' OOIJntry. _ """0 IS oriy one
<lOeIor Ie< 20 ,000 per"""", the only _ _ Iof
~ successtul t'eal ment of do....mo..al oseese IS \1:1
tellcIl ~ \1:1 treat n- tar'..... at home
ConYnuroty stWies ~ , BIIngIadesh haIte !Ihown
thaI _ ORT C¥I _ 'r be t.>ught 10 a
taliiii)' memIler The lidI~ of Il'_
a
lem$ III also c:rl>Cli!l OilCkgIOUOl:llor me
oevelOI>-
ment ef e!leclMl """""'" Mattn ca,e
Thera .. anc\ her DeneM 10 _ ORT
ItIlIt IS the releaSe et scarce tI()sp~ laco/IiIlles
I _ _ _ WC<Ml t>e cceupoer;l by do,"'_
_ PEltienl!l

""""""". ... r.a.., an OIlll'<l8\Jlt "" you """""'"
one ...m.m. you ... """""" ""'OIher \'Ow. ' " llus is
tleC.....e "'" lI'O:ItIO<:e 01 OilrillOe;ilI dIse&es
Peal<s "" lIood _ tern ,eeeae on alE! lMumn
However. """ MW M¥e !he IeChnoIoI/)' ....I h _
w,m ;II 1!IeSe 8dl"lnlag<lS, there IS. _ ,
st.. a Il'CbIem Ch i 'et'rvdo"auen salls are usuaJy
tn.)(le av3l4lble in plasue pac~eI!I - 10 t>e """eo
woth ...,Iet Such ~ets, lhwgII """y 10 use, lIflI

.- _II
... nc\ ,ealiiy ....... Ialta ., Mat areas cl deveIcp-
10 combat " " " _ This leCIV'IOIOg/ IS $lmpIe,
efIec1Ne aflCl cl'Ieap. on::I WI!h ~s lone!'; almnstra· ..... cwrnroes ThcugIlll'l8)l ateC!>eaP, tr.ev
a,esM
botycncl "'" ~ _ cI IOOSl POCf
00I'I, mosl D1!alh5 due 10 OI3ImOlla can De pecpIoo, C&COle ...no",e SlJUIJOIing lei _ -..
~
Lest llle<e t>e " " " _ about I!le IIl'porIan<:e 01
OAT let me POO/ll OUI llI.1.1 on many ",ea. 01 tl-..~ , ~.B """""'"
te cve<come
~ me ~ lla scolatxl!... lIStSh"'" Clevefoped a ~ SlIIlPI<fle<l oral
t lVll pmgt""""""'l .... 1Il the lCOOI'l,e, cl<..1hs Due 10 sdu\Jcn, wnoen
t 8" be P<O<lu<:f!<l Bl II>e towesl
_ a, Itle mosl d'eMeO of "'" (liar_I
pos$IIlII! <:ost This new SO Ul.... IS base<! en
d ! • have ~ redI.<:e<I by <>'<el 5 0 \lb <:fI(eals . and uses 'O..w.'1!1 ~ avadabl!l .,
all _ ., lKlOoUcn , l!1e """"'~".. .
McIrMYeI, I am 1lI0Ud 10 say !hal belore !hoi 'nay tXIt~nbuIe te fl'4lICWl<I nuIr'\lCIl8I SlalUS ct
<le\11~ item 01 OAT, It was "'" lOiXJR,B !hal II1CSe mcsl ......... !1b18 10 dwtllcoa - ll<ICI . young
elIectMt onUo!MiIIlOU$ lIuod
<le'Villope<l Ire fiIsl
prepa"ltons M08II' llS8d IQ prtlVlllll <!Iar'1IOOaI -~
Cleh1d<aIlOl1 cleall1s Yel "'1ra ~ l Mll1aw was ror ~try I>!IOPIeo .. A$Ia. Ahoca
nor "'" _ lot II COIJf\lry suet> as E08/'ogIa<lesI'l ancl Lal.f1 AAlerICl, ORT IlO1ds IhI! Il'CI1ll$tI cI
heSl\II,.,. cIloIClIocexlS ana mere Il'CCIUCt"'" adu/l
~ ''''''''''''' qll3l<tll'lCl me<IoCaI p/lI'$O<'II'I<l and !I"OJS1
l>8 Mmonos""ec", . 'a'<: l>eI!"'" rae .. wes A co"mry ""'h a s ~, . - pnmIl
- ' IS'IS hu.rt\8oll """""""'. _ ~ t M a t!oo:1 10
To rMCll suc/l laPMOl1l. Oiarrho 1 _SOl _ dlattllcea Ie sap \/Ie V>IabIy cI ilS pI)ll<Jatlcn
OIC!ImO I1<Ml IQ be "'''en long C;st illlCOO, """'II To deliver a nat.... hem "'" curse et lldarrncea wd
I>'lIl"flille 0 ........ of lIansPOfl Altoo olton d<atrh<>- truly be " "'*"" Slep _lis that M""""S
eaI oenvcwalooo kMs ""'ttl'; - and • • :lim. oIIen doe 9COO IC/l"IIC em8!1C1Pl1tocn

"
 Wid.... :nill, lb. motb.... also needs lb. support
of lb. _ modilIlUId COJ:IIl"lunications industria,
of .u d.panmoO l' of sov....nmc m , of linlUlcial and
dowlo pmeIll policia, and of aid, lnldo, and
fiJw>cial pulici.. inlhe iDd.usuWizod wo rld ilSOlf.
In paniclLW, = t r<:$l2rCb in the d.vdopinS
wor ld has b.igbliJhled ,bn", ki.nd, of Oupport for
womm whicb are of IUCb pulC1Itial sitllliliaz«<
fur lhoir OWl! and Iheir cbildmJ 's heallh lhlllhry
musl alIo nn w be coun,ed arDOl\i th e bruk-
IhrouSIu in kno...l0d3e ..:hicb oould chang. ,b .
rati o bet....." a 00UlIuy'. boalth and ,,·oaIl b.
Tb.... clwlsa on ,ometif"a known IS lh e thrtt
Fs:-
o Fem.a1e education: e\'CO wil bio 1/lW_iDoome
oommunitics, • child btln" 10 • IIIOIher with nn
ed """tion has been shoWl! 10 be lWice aliJr.ely 10
die in infancy II a child bom 10 I JnOl.bcr with
....n four yean nf ochonlinS.
o F"",Uy Ip;lclns: iDf""r and child d..lb$ h. ...
been found 10 be, on avera s ., lwic. IS bigb whC1l
the inlerval between binlu, is 1m th a.n lWO yean
( lig. l) ,
o Food tIIppl.m. nll: . handful of "",ra food
each day for II -risk prtg"am ...."linen has been
shOIVll 10 rcd Utt the risk ,J! 10'" birth-weiShl _ a
risk which curia wilh il • lWO nr Ihrtt liJllQ
Sreller ~ k.libood of death iD inf'""ry (Iii. 4) ,
Although more difficult and COJ<ly 10 brinS
Fig.3 Effect of birth Ilpacing o n infa nt a nd child au rvival, Banglade ah
~~
58
89
185
'-'-'-
- -,_.......-
In!~ deaths 0- 1$1 birthday
(per 1,000 Ii1I9 births) \ \
, ~
abtlul, , ueb chansa wou ld nol only slnw popula_
lion SroWlh and impro ... lite hoallh and ...,U-
bc:in/l of million . of Ihe world'. childmJ, Iltey
would alilO uprCSCflI • 11"1' forwud in junicc and
human righu for the majOrily of the world's
~.
Th. cap;lcilJ 10 rucb
Like all 'lulowledge breakthroughs', th e cur-
reruJy availahle l«hIli"ua for lmprovins child
hoallh depend upon cqui'lllcn, 'social bruJr.-
lMn U/lIu' in th. Clpacily 10 orpniu and commu_
nica, e. Low<olll ,«hoi"ua on, in lhemselves,
1101 eooU/lb; thm' mUSl also be mechanisms and
cb""n.b for rachinJ: oul 10 inform and support
p;trenls in lb. manag.menl nf th""" lcchniqUC$.
By diln nf tnmcndou. dJOlU nv.r lh. Lasl
t"""IY yurt, _ nalion, of lh. d....lnp;"II
world h..·• ooW lMd. lbal '*'ciIJ breaklhrough' ,
TWC1lIY YClf$ ago, for .nmple, Ib e proportion of
Jitb wbo h.ad th e chance 10 go to school "'.. lea
thin on e-third: tod ay il ia ~ 80'.11. T wenty yean
ago, the radio was • rarily: lOday thet. on 0 ....
S,ooo radio Oli lion. broadcasti"llIO over I billion
transislors. Twenly ynn ago, the prin led mass
media wuc tdatinly undC\'doped: tod ay the
devcloJlinll wotId .... S,OOO daily 1l~W$p;lpm and
OlIe-third of th e world', rcadmhip ( exclud ing
Chin.), Twenty yun ago, th m' Wm' hudly any
trained paramedics or co mmUlliIY d"".loptllC1ll
0- ' _ 37
1-
,-4_ 90
123
Child d&aths 1SI-4th tllrthdaY
(per 1,(0))
"
I THE STATE OF THE 'M)RLJ)'S CHILDREN 1985

Nigeria and the Sudan:

immunizing more for less
v_ 01 e>.Perience wilh ~te\lOI'1 ,... . 'CUSIOO,e ,' on ...........:Zllt on dil Vi. wet e bell I~
_ _ IIIal ~ maJur>g ~ lWIIIiWlle is rooI b'f II'oOltlon 8Ild ehklten More llIIfenIS krw:w
"""""""ton ...,
.-
lIflOUOh 0lIen. orIy ,..It
o! ,.. Ctloldren II' alXllll 1.... ~ lor
eee "'"
beca...
llIQlJgo'11 aIono 10 theYlICCIlllltoon eeotre and 0I1ly ............aJ\lOI! IlOIIS _ _ up .. II\lIfI<eI.
tlIIIl cr IhC:*e ,eIum lor tho IIlCCnI arcl lhnl places, _ /If'ld ~ . more par.,ts_
_ 10 IJmIl _ <;:tlIIcIren ",. • IIIlI """""ll 01
~
Fer .......... <dion 10 -*,
PIlI"''' . - 10
Two "' ... oI.Ml1o.
sw.. ...... ii.'
~
.. ""'. .Ol _ _ "'" 10oller ......, """ mull _
t. ... 10 get _ <::I'oben .........."'" 'MlI'Ioul .:omg .....

..-
_
"""'-'" _
_
......
- . _ .. IN lime a'ld e/Iof1
Ie> CClllI - . ... ~ 0 . - of

n. _ _fwO<~_'''''''''~,"'''' Al'a ~ _
cr- t:. ~ -. _ ffI<> coo_.
•

_
AIIIr

III _
oI.la ,_dell...........,.
101 progo...... .....,. _
CWy 8... CI ... c:.y'l
"""..
no. """"""............
'.-d 10
__
....
n_ · Imu1IzfId _ cnIr 4~ 01 h _
9¥ .Mr 1983 ............ _ r - I _ _ --~_. '.
_ b_~ .. _J3S,OOO_'" 1'hR1'\do; Doo:i&a,ea _ ~..,.

-
0000-.:l"'0rld0_ ..... &.I1"9"'ol
_ '_....-.g .. h~-.;I<;II
... o;:foiIr;lwINd ' - " _
Ow<>. 1S elna Ia::l<b:l <eIoIllIe
$ ' . 1*11\' , . _
"*"'_ at -""
R __.'"
.....,..,.".. ......... IuoIIIO
Delow~ i

lhO '*'
".'lllhlll*_~
.. a _ ~

t roct.r;long me Deparlmenl <;II Y_

IO"., ln
, _ ... _041983 ... 11111>-.00.....
......-.:tIle! • new Ion:l 01 irnmInra\lOll _ and SDor1s. _III ~ orQarol•
bonS lW'oIl IhII ............ - . 01 KaIOl dof!nd
W....... . rnonth nearty30'lloola--.nt..o_
!lSe/I Ne:<l Itle ~ '. ftl<len$IOfl \flOl)(\<ers _ _
~I«l WIlhOI twe/Ye man!P'oa. Iho, CI/I'CllIIIgn
IIllO SUI~ lis tatoeI 01 8 Cl'l1i jlnd as Ihe
II<""" amon,,", ;n......ce 1'''''"''11 WI ~
~oon laIly fO:'It, IN CCII per , :hila _
ca liotls, ~1IItu'lI ... IOw-CO$l and If&dolionll

.. _ __ ..,"-' . .---
lU!:lhCJlJS lIUCh lIS 5IOIY-lelW1Q. clrllOlll ana ll'OI.CI
"'""".~~"~".~"'*'~ll\IItJ
tJI'I "'" ... 01 ~ _ PIrt.
0 - . '-III.
~
ll<>cI.-on 8od<ed I)y - , . . . - progr...........
aroc:les .. IIle /'M/I UIfror. 3Ild • lOunf'oO loud-
liQl'lI, -.l _ 10 _ _ CIXII lao .......... - . g -V _
..... _~
.... ~---­
IO~
~_!:I...alO
_IOtlMlI

..-.:l 0Ul ~ , ..... _ .....o;wlif <;II.Ucanoool.; 1 •

IllI IiCICIell ~ __ . - . _
" " _ _ ., __ "'.......... , III lta:ll's
~ ee--..g ........ ,cay··r-.covoroz· ~ IOOO po'*'llIdl)y_
... _ ~ &q:ICI\
01 II . . """"""""' '- _ l O'lolO_ . . . ~ "
~ fICll cnIr
...... So. . . .'...." _ lnboll'>01 _ _ .. _ . ~

bJ ... _ _ tulll' .... _ _ .......

.,.. s.-c..-....y
llNlo' ... .l.C6 _ ••;;.;,
.......... a'IlIIs.. ee kJ
.......... c.ae bJ
_ ._or
'W ' !I'll o..e
bJ ........"'" IIiIlIetI
_ _ _ _ do ......
~ _ .. a.:- ,~
'*,_, 10"'''-
,......... HIId al
• """".'OJ_ 10'"10
__011._"'*_...· "'.. .
e
n
c
l
~
... "IT'. __ Ii:lutWIg ... ~ SlaI8 ........,

Soon .... CWla. . - III Or"r • InCI<IJ 01 0000'*'.....'

u
 *<IrMlS: loday lhe govctDl:nenu of lhe d.....eloping upon its 230,000 primzry~honl lradlers 1<> pro-
Wilrld ba,-e trained over j mill ion paramedics and lI10te knowledg e ahDul O RT and imm unizati on 10
unknown num bers of co:n:iDlunily workers, WIlIer many miJlio... of <hildrt:o and Ibeir pataltL
engin((JS, extr nllion wo r' ;en, an d vilIqr volun- The exislence of 5tVcraI Lbousaod family
, ~~
planni~ workers in Indo neJia h.oJ made il
N never befo"" lhesr IIl:Ld ether mechaniams by pgRible - with "'tnining - to carty ebild i wvival
wble h patt1l11 mighl be informed, involved and n n t"",,,," int o million. of homa.
supported in bringing •.boul a child survival n. <raining of 86,000 viJJqe hand-pump
n:voIuti OllIn: no w in place in mosl n.ti1lfU mthe camakers in Karnatalr.a, India, bill; mean t Ihat the
world. T on numet'llllS 10 lin, some examples of ...,te gllVfl'llmetlt can nnw all on g6,OOO mote
these mcclwUsms can be ""'''''' from IUttnng village 'promoters' ill its campaign 1<> mal<e ORT
lhose already working in t be servia: nf child avlil;lble to famili~ .
•urv ivaJ 'lrategico:. In IIdd ition to tbese government l'eSIII1J'CeJ,
The rapid expansion of primzry....,bool ed"",_ people'. movementl in Lbedeveloping ..orld bave
lioo h.oJ enabled. counl\}' Jik N igeria 10 call g rown in both n umber and organizati<>na1 eapa-
ci lYov¢r the lll$l 1*<1 dc:eades. T.o )/<'In lilt>, Ihe
New Naam lI11IvaDellt in Ihe 1I0rtb of Burkin a_
Fig.4 Im pact of maln utrition d uring Faso {rotll'lUly Upper Volta} wlS only reaching
pragnancy o n pe rlnatat monality oullo a few Mossi aenlementJ: loday it ~ 45,000
Tho _ 01 1~ 5 _ olJ(:lM looU·M>:lr\IIgII mem bmo in 700 villqeo and volunteer Num
i1 , . _ Tho o;IIar1 td l ~ lItO e1lea 01
\Il'Q1kcrs an: being trained to make: O RT and OIher
""""- on bmI. _ 11"""'" CCII"I(lO/,e<l. <lumg
ehi ld prote<:tion 1Uategies available 1<> III famili es.
_ '1 'lU'l\iO' :
70 T wonry Y.ln 1110, <.he Saz-vodaya nt(W~mctn _ a
handful of teuhm in I work-amp jwt outsid~
ioo CnIombo, Sri Lanka: loday it hIS 6,000 voIoll-
leers, mostly you"l womm, ..110 an: oow m0biliz-
§50 ing to carry the ,hlld lurvival n:voIution to 0VC'1
4,000 oiI1ages throughoul the island.
AI... in Lbe Iut ,..onlY yeara, I"" capacity and
ou treacb o r organiud tdigjon has grow n 10 uie
poim where il haa be<:ome a majDr development

f 30

20
raDlU'CC IS well a a .plrituaJ (00:. in l1IIDy
d.vdol'inl!naliollt;. Today, thousands of imam! in
Indonesi.a an: pronlOting Ih e lId""nlages of breaot·

I
r....ung and gmwLh lI11Inhoring. And in the
10 M ald ivC!, child survival lTtCSSIi" an: llOW regu-
larly ,,,duded in I"" national F riday ,",""""
c, bmadast by radio to Lbe main mosques on every
0 inltabitrd Wand. III BruiJ, the GaLbolk Cbuteh
1944 1045 1946 nOW b.. o ver 14,000 heaJLb \Il'Q1Mn and 1"'=
Mooth o! birth National Confer=« or Bnzilian Bishop" has

___
,..
---
... __
-----_
_ _-_
D Bom during rood shortage
_--"'-_
CMceived during 1000 shortage

'_ __... _.....

",. _.'_... .,...- ......
.... r.~ _ "'

_-- ~
derided to pu' Lbe child lurvival ~ utinn in,o
a<tiOll in ai_I <:Vt:\}' diocese within tb e next
three yeaN. ( Ear ly indicatio ns ee that Lb. infan t
mDrtaJily rale has a1rndy been reduced by m in
Ihe Plio< ...... of Flouslopolis.)
Similarly, i" Col ombia, priests an: bct!:inning 10
_ 'H' inform all rotlplcs who ",me for p""mari lal an d

"
I THE STATE OF THE WORLD'S CHILDREN 1985

Cheraga:
child deaths down 60%
... CIlold ~.....,.,."" "'" altMcr, come!O peI;o. dllllUllelia. """""WIll lXl<4> and IeIa_.
IN! c .....lJOI diSInCl 01 Aigerio TNt ",.. 01 .,tanl and 1S'lb 1oI,la_ mea~.
_ among !he I>OIlI-Calion 01 t!tl.OOO hM
_ N pr(IgI'_ be<,;on, 13'llo of Cher.
lIOell aJl by 60'10 on ~ 1M! yeats ~~ lOw- gil'S CholdrfII> __ . _ by _ _ I t>:ne
COIl..-... -tue:!l as_·_1U ............
l3l1CWl a'Id ~ D lU¢IllIIi.eo II> Il'-.t llI5eaSec:aused by WImn DllI:IlueIq '" 198 I
""'"' ,..., 6S I'IlId _ -... D ~
~ .......... _ "'~ CfWlI_
to : 1 =n -...<IflII ,""Jo) ..... . . . . , , - _
11*11. ......,aty IJI'*' lie _
_ ' " '"'-It """,lIWy me ~ 103 ID 43 Men .... ~ "' .-.:1_ _
_ 1*1 .000 .... _ ~ lDr by ,,_ __
TN ..., 1II_",o.-_d. _ non To _ _ ~ ca,_s _
_ ., ....... _ ....... lOe.....'
,..., ~ .....,dl...a ,'''',• •1lll"-' ana; 1_'•• III " .." •. - F_ _
"' ..... _ ""-'u_to'n". .....
l&q( - .. cIIsIies .-.;I .. , . . _
_ ",.,...... _ *'
- ' - ' .,
llWO ~ ~ .... 0WI0I1'lMIIh . .
~."
~ '4ICl'_dla
_ II> . . _ <II IN _ PlllO"UO".
- .., .",.
~ ...
CQI ,...".,.. . ., -
0\1 b; '11 - '11
• on . . a.ag.,
do.... 11>. _ __ .... - . . hy c:o.llllll'O'l"'k " ...-wr
lor ......... ~ (:OI'"'I0" ..
_o, Dr EmileGaWoo'''' . .
~
_lh''.I.
c..e .. u . . -. s...u_ .. _-""" PUCl.-
'_ '__ 0"'_
lMcIrCrllllled ..... ....." !laS !hi IiIl'IItJIagI III ."010, 10 IN ell,I'M'" ..."". ........ n.
~_
et>io<en - . ~ '" --.. _ . - . ; I
every lime !hey - . tJtougIlllO l!le t>MllIl ......
01 _ Cl\oIOItIn"' AI '" ........ 11m" !he .....
IlllllfOICII "'" ..... IlfOIeC1e<l _ """ ~ n $0 lI\a! _ NItf $IQf'lt 1)1 maInul'i!>Ol'l or
gt owm cor.olO be _ OIl ~
'_"'II
grOWI!l c/I8ttS
tile dIsIncI ' frgm lHIong .........-..., l>'f lIlrgoe
I1IKl'Itl8<I 01 C/lolOten .. .-J 01 or_. eare and T~ lhe cent res _ _ I1ilIlea by I team ot
~we _ : ' l<eeor>g ~ III ell. 101' "'-
more _ . , III DJmg!he IM!-yUf , _ IrOtI' Il'"fT'lI"/ -... _ _ -n
m..." rne<loclII-..eI. _1t1e
local _more_
Ih;Jn ~
noO
1916 to ,", , CQI'lSUIlalJons '" !he IWMJIIh conlI'. .
"*' lram 28 111 ID !H .662. V-Il l-""1'iOICliIlO
PliMOUS non.>g .. nursonu - wno Iladllle lOll 01
~ dor«lt1 wan
Ille _ 10 bnng Ib<iUI
""'" .... Ir<lm 2 4 346 ID 35. 713 . ,..""'",.... .. d>ld~ n-lIIlons..-
_ClloraQa_
e.._.,.....IO_CCIIQCI.... __

_l_
1'hIbMIC"~_1O ~"~'" ona:eIy 9(}00 01 lie _ ..
IN Cf'IIcnn _ _ he .. . . .-.0. So . .
__ ...-.e llegiIn. meoaI - 0 b
_ C .'11...., '_1 <11_ ..... .,_
llCi' . ..... '
- . , lSO.000 _
__
d)Wlg .. ~ - " . , .
onlfo he . . _
The .....-,.,•••
....... ..., _01 .... "'*-"
___....,_."""."'_10 LO"","
l l l ' _ o-".-..l"'~~
_ •__ _ .. """
.......,. -.
,PI""""·. a:d ...

0 . - _._It.
_ IboUI . . "_110. . d - . as II;-. _ . . . . !he _ ca,_, • IN
_1D ...... 0INn _ _...cc. _ _ _ """'11""'" __ toe dOSe III ~

. ..
~
90""''''_'''''_
"'I~l
lOIJlIIRlIII ~ eoil ~
of . .
d'IIare1 ........... be YMlIM!IY
INi _ of 7S 000
~

"
pre-baptism classQ Ih.al ~""'-<:oJt l«bnillU.. '""' <:lid..... ), by the ",<J!ri/a _ tWlI of Itl<1i.a, and by
oow avail>.ble for protectiDa the live. and the <he Saemaul Undona Villase Women', Move-
beallh of thoi. childreo. 10 1984, on the Sundlly meot which counts ImOlIg iu memben ,b~
Won: each of 'M th= National Vaccinatioo -.omen of 0_ 2,000 villt(l;es throughout the
In)'$, Ihe sennon in 1DOl~ of Colombia's 2,230 Rcpubb<; of Korea.
parishes was devoted 10 til,e Uup(ll'Wl<:<: of taking
)'OIlll8 children 10 be: immunized ( 1IfC' plOd I ) .
In some: COUJIlries, intcml1ional voluntary
t(l;coOa alto represent I powerful and oraaniud
In the Philippiocs, <he If'm:ideol of <he Catbo- l'eIOUI'Ce.· This year, for ~JlImple, <he Lu,ue of
Ii<: Bishops' Conftte1lCl: has also launcbed a Red Cross and Red' Crescent Societies bas
campaign 10 bc:gi.o a child .su<vival n:volution, launched ill ""rld·wide 'Child Alive' campa.;gn
startiDg with <he ...ample of his owo diOCl:lt. baed on pnIDIO\io& ORT, breast.fcedins, inun,,-
III Rome, the Holy Sed,u InflOIlJ>O!lIi th.,
~14<
nization and o<her Iow-<Olt lIlClhod.! of protecting
cbi1<ln:Q in poo, communities. Alread y, , he poten -
",tin Callu>Jic " id lit,"",,". in ' M ",na... """ 01.....
of,Iu W/JI'Id, " nd ~lIy in 'M dn>tlopi"g NZ' i.lJu, tial imporuooc of the Red Cross commitmenl to I
<h~d survival n:voIution !tal bc:m dnmatktJly
will ~ irs """,i"M" "'I>/JM' '0 ,1Ittt i",par,,," , d~moom..tod in Colombia', immuni.>.atioo C:I.m-
si1J4pte ~h to im"."." 14< heollh of Auotduds of
", ilIiM1' ''f <.ildmr:~. paian (see panel I ). For ee three Nation'"
VlI<:ci.ol tion Inys, the ColombilU Red C,,*
In Q>.loy oalion.. volunt ary Oraaniz'llions bove mobilized 7,000 of ill IiRt-lid ......1:"'" $,000 of ill
also now af01lm in numbn' IUdcapacity to a poiot youth leadeR, and 1,600 of ill 'grey ladies' to be
whm: 1hcy '""' tmOna the, most imporllU' of all trtinod IS vacciollOl'$ aod orpniz<n in the t:asI: of
OIItoizcd resourc.. for <h" national devel""""",t immunitiog :almost tl1 of CoIOOlbi.'s cbildn:n. 10
effort. India alone now bt:1 IZ,OOO prin te volun- Idditio o, • lOlal of 16,000 Red Cross voIun'<m
tary "'lltniz:atio01-oflen workintl wi,h intI<>V1- b.lped tVi<h tho promotion IUd :adminit'l'Ition of
tive ideas lO>OOa the vc;<y Jl<)OtUt people. In tbe campaign.
neiahbourilla Ba.o.a1adcsb there are more tlwl
6,(100 separate vohuuary t(l;eocieo wo. kina for 10 all of thi.. ' be hetl <h ",rvices ,heouel_
developllleot -1mOJIll <heD' the Banaladcsb Rural have 1M crucia1 role of providing traillina, n:fernl
Ad"",,Cl:DIeIlt Comm.iUcc ·.. lticb, by bus, bi~le, services, IUd esoeot.i.ol mcdi£l! skilb; to bxl: up
,be work of III 'be mLOy other teIOUrces wltich
IUd rickshlw, h.os t1km 'be ORT messagetoova
CIO be: mobiliud in support of the child survival
2 milliOll homes 0_ rbe' la, Ibm: )'ant (I«
paoelI9) . ln Zaire thm: " '" over 1,(100 hospi,01I
ru o by voluntary IUd n:lillious orxtniz:atiOlll. In
""~' Sa.. ,be CIliIdtN Fuaa ""......_ ;",
Uaanda, <hey provide bet"'ftn ~ and 60'1. of aU •~_ ( 1UoI>l& """"j, S......,. (1l.<d<I _ 1. tlIot Uao..o
mod...." heallb services. I\od io""",," all'llllioru, ~ ood 'Ix Uoi,<d Slat.., .... _ """'1~ .
"""""o's orstniz:ation, ha" e oithu bc:m fOWldod ...... ..,... ~ 10.<001 .""eaieo lot dliIO _ _ _
or rapidly exp,anded in the lut decade. Today, '" Gamu Gafu, IOIItbato ~ ......... 0xfsIn iI ia'to4ucinI tlIot
ora! rdI ydnttion , henpy .,1<1 otherlow-<:oJt child ~ .... >dI,dnoioIo ''''b.iq"" <ii, ' : ' in BallI'"
d<Ih. '" L>odoI>, tb< T....:biq """' .. Low Colt (T ALC)
suMvll stntcgies Il'C be.ing promotod by ,be ......,....... ;,. -lUoot •..wbl< toiIlioclI oflfOWl.b dwtI"""
Orsa.oiz.ation of I\oaolan 'iIlI\lll>ell, by the Patriotic ..... ~ pIJotiI; _ sp«islIy deIipod to ......... 011I
WOlllen'SAssociItioo of '-'~ by <he Revolution' , be ",b' ~ . ..Iitla. of ..... """ .... lot oW tdIydmio1o
uy Ethiopian Women', AII""iation, by tbe Indo- ooIutioos. O<hot "'' ' '11')"
orptUmloos o<tioeI1-.. ,.
boiot . - ............. in cbiId owm" indllO< z.....
nesian Nl tionti Villaae Women', Movement, by Lo'. ............ ~ lot ClIiJd... l.,mwioo'" I.,et-
tbe BotswIOI Council of ';Il10tDC0, by Ihe NW'Sing .......,.. CuboIi< ClIiJd aur. B.I!>.o'; '., R...,
MOIhcn' Asoocillioo of th e Philippines, by tbe Oub "',............ s-.,.o I.' Ca,!>oIic Rt6cf
Women', UoiOJU and Camminees for Mothcn s.mo... CARE, tlIo Olrio<ioo OoIloIn'1l', F","" WO<\d
V...., 'Ix 'l'0<\d v.... "'............. F_ _ tlIo
and Childn:n in Viol Ntm, by the ' Women of ,he _ _ ...oni....... 01 tlIot Girl GWoIn .".; _ ~ J.
$Qutb' in the Dominican R<,pub[i(" by the Fodera. , - . . IG IOiIlioo So:au<I ..., _ Ix io Iio< fot ......
lion of Cubao Women (\Vi<h iu 48,000 'heaJ<h lIodoteolor I"o:o&k>ot, ia .... tdIydmio1o """"",

"
I THE STATE OF THE WORLD'S CHILDREN 1985
revolu tion. And ",j, b g rowing ICCe pWlCC of the
idea of primary health <:lOR, the profmiGnal
heahh leriices in R .-mlI llllions ~ bq;inni"i IG
U:Sp<lJld to .hit challenge by dcplOjllng thcit
""penise tllIougb channels lind OI8aniz:nions - be
they plr8Jnedia or Inlditional birth am",dOJl ts or
'be masll mNla _which ruch OU110 lUuch qt,
numbel's of people than the heali b ~rvices
themselves.
In lDOS1 na tions, the steady development of
,hese waY' of ~1Ill: people mean. ,b'" lIJIoth. ,
pric:dm ~ has moved Lolli place. PJ:rhaps for
,he 6J$1 time, liU1lCareas oflb. developing world
have lb. organizational ""d communka,ioo in_
rrull1K1 u~ 10 rcK h eui 10 inform an<li IUppott
,he majority in bring ing abou t <baDge. And il is
Protection in Poverty
The (ront linc in the ]Ollj war OD povmy and
undcrd""ck>p=m is an<l remains the st ruu~ for
economic jllOdce and growth. And lh. fundamen-
tal issUCI of women'. righlS, land reform , <fuarma.
""'01, income distribution, job en.tiM" fair..- aid
and tnd. policies, and . IJIoDl'e equitable in.. ml_
tiona! ard" remain fundamemal dtlcrminaol& of
child",n'. su rviV'll, hcahh and well-being (_
68S. S I.Ild 6 ) . BUI wh.iJ. 1M, " TUggl!, is bein g
w"Sed , an tll,raordinary nppnn unilY has nnw
ari~n 10 Il ",ng'h... lite 'ICCOnd fM Ol'. MOSI
paretllS in poor o:nmmunities oould DO'" be gi"""
lite I<nnwl0d3e an d lhe . u ppnn ' 0 enab.'lo ,h= In
protoct ,hoi, child"'n from lbe worst effeelS of
,hal p"v..,y in l heir MOSI vulnera ble, ,;j, al years
nf VOWl h. An d in SO do ing , a 1000g-a~j led blow
could be .uuek again" de..lop me111', ~nemy
wi,bin' _ lite self.pcrpelU.ting cycle of iIl.bealllt,
poor g rowth, and lo wered pcuential by "'bich lite
pov..,y of o ne gen enn ion casl' ill'hado'" on lbe
nt ll.
Ironically, llti:i poIenlial for qnifi<:anlly in>-
provi"llhe "lale oft he world's childrell ' arists al
• tim< ",ht;fl lite l'CCIIIomic poo;liOll of many of lhe
world', poorest families is b«ominl: ll ead ily
"
litis n.... capaci,y, lIS mucb lIS , be 10"'<051
lechniques themsel..... whicb nOW mak es possible:
• ~Iolion in cb~d health and survival.
In mD$1 "'lliortS of ,be developin g wnrld,
l hm'fore, eo oogh of ,he elusive pre-c:ooditioos for
.""h a revolution .... IIDw in place. The lechnolo-
gies and ,he kno wledge are avaib ble. The idea of
primaL')' healllt care and the empoweri"l of
parenlS ralher than inlti'Utionl has been widely
KCe]>led, APd , he Of1l:anization al capaci, y In pu,
lhcsc Iccb.niques and these idea. II lite disposal of
lite majori,y, ODd ,n achi eve a chi ld survival an d
de. elopmem ~ I Ulion, is gmler ,han ever
eerere. In short , il no
1I0.. ee
dOlle-if lite world
wanl l il.
wont (WI! p<lI1el8) .
Larte arus of lite developing world are suffer-
ing from lite bo<:k1as1t or
the world', longest
CCOIIOrni<: m'CSSion ome.lIt. 193(h.. Rising prot....
tionism, falling imports, arid bi3her iIlte mt rala
in 'ho indllStrialiud n.,ions have eroded l he ,hird
world'. earnings and deeptned ill debts. The
resul' is a rau in "'al incomeo foc lhe majorily or
nations in Latin A.menc.( whe re a" ra&e per
capi l. incomes f.lI in 11 nu, uf 19 countries
during 1983 and GNP in lit. rqioo as a whol.
dropped hy over ~ ~ ) and in Arricl ( wh ~
drought nuw adds 10 lb. bwtlm of a rcc$on
which has <tduc<:<l already Inw average incomes
by 2. 4 ~ a year ill 19S1 and 19S2) ( ~ p a n el l) . "
This y..... , UNICEF hu published a specia lly
commissioned slUlly of lhe rcc$on -from lhe
poinl of .iew nf , he ehildmi of the world'.
poor esl COntmu.nitics. The !ludy poinlS ou,
,hI!
Ihe poore r . family is, ,he higher lhe pe rccnlqe of
• I. low-< K Asia. , Ii oh< _ ~
..""'" lit - . """"' It<a Ill< dJ«u Ii «msiID .. Ill<
'1'«1 , ,....,. i""""" Jf<'W b1 .... l1wIl~ . }'<at" I'lliI·
1'112 - """" _ , ,!uti ill tlK 1'1Os.
its iJoaIale"P"" em DlCat'itia -lOod, ......, flld,
aDd I>taltIl ~ NJr f.IIl ia dw iDooo:Do tlootef_
....,-
Vuy kw bn;l r- *"'
koowollbou.l tIw df~
......... fall ia tht capo.bilily '0 susu.iJl tif~ itd.
of all WI OD 1llt' .hildmI of tbr: clcYdopiq
ADd iD IlId:I cim' _ ..oo.... ;. is .be deYcIcIpiDa
minds and bodi es of )'OU1lI childml ..bleb are
worId-1Dd that ia ilXlr is ~ how link or
moll at .uk.
thq are ,aken uno ICCilUIlI whal akuIatina
~"" 'I~. Bu, from lIIlo1l.kuowp, Ii'CO do
To compou nd ,he hanMu p of fallilll ill<'Ol1llS, MOW ,hli "vtTI&C h"' h,-rOHll ~ h.aa dedill~
l he oociaJ ...mas hlY<! " f ,tIl b«n ,b~ Iirrt 10 ItIlOtIIlhc.hildrm of oonhcm Zambil, th i llow
luffer from cu,-bad" in , ovuntnenl IpendiJlj bitt h-~ hfl ( lit ind icalor of mal nu ,rition even
whicb =ioo, deb,l, or in .....nal ional lllOOnary before th~ child is bont) are on Ihe InCfQSC in
polley IDly enforn.. Aod i, II qaill the pDOI'C:R cmai.a pam of Brazil, ,hi,
the lIumber of
who are lIIOSI dcprodm, OIl llx soc:i&I KrVias. chiIclrm btioI unt~ for ttYCfT lIIIbtutritiotl !til
'I'M coodlllioa of 1Ma lldy _ ""cfuo:. l1w. urllIed ia e-.. Rica O'IU tIw t- thto!r )'Utt
tIw m.oill imI*"I of ...-joe" iD the dc.do\linI (dcopile I ODCItitllICd ......UDnII '0 beahh and
soc:i&I ....icQ ), md dw aUlriliorW '1nIstiaI' baa
_uirs, is """" boroc by . - . a. al* 10
....... i1_simpl'f b<auao Ihey 1Ia.... ocithct 1llt'
political ....... 10 ~I il oor 1llt'
to at.IrtI i:L
. fat "" ,.....
iaa_c1-. the dWd.ml of Sri laob c1urio1;

A -wid whidI t..-pracmioM towardlci'rili2a-

_ ....... ioDa; aJ:Ioor tIw .,oea .
bIoora 10 be bono!: by iD poot'QI .......... IDd
Fig. S Number .nd p.n;:.-nt.ge ulUllbl. dlild.n:<l. ADd. it is llOI III imlIIaublc II_ thai llx
to m..t bnie nMdt, 1914-82 poor _ II..,. ...lfcr _ whcoo hIni u.....
btIcomc hanIcr. SeYual u..... WI ....1iU)". _
~~
IIa"f'C littII " I m p!eo or _/w 'O¥mIIIlCIIU CUI
-~ runb8fs unabllI to rftB 1 clo_whcoo tht will is tbcrc -1O Pf'OIeti ,be_
blIsie r»eds ~ ,.... 1Sl vuloetabIe ","",ben or hWDltl aodrly r..... llx
_ ocriouI COtISfqumta or mltIIlItIic bmbhip.
Ou, of Ille cccmomic <:01111* 0( 1M 1930$, for
""ampl~ , ...... th~ 'N ew Dt-al' ill ,h ~ Uni,~
StitUi lItd lb. nfCltllben illl 0( ,h. "elf....
1)'I'C1DI ia lItItIy Eumpelll COIIo,ri... Apill m,lle
194Oa, wu bl'Ollght cleslnlC1ion ond Ibon. ..
whje b couJd ha Y<! pushed ......y lIIOfC EUJ'OPCI"I
iolO dati.utioo.. But b<auao .0"f'Cf'DtII£'l1l ma<k
opUmlUtl .... of I YIiIabIc ratIUrta, IIlcI maclc it I
...m.a. prQirr to UIItIfC • ~ Ictd of food
IIlcI bcah.Il ClIft for lhcir posx" " iom, IU:VaIioa
aDd dcsIilutioa . . kepi; III I ~ 1tI the-
Ullil~ Kill,dun" fuo: cnmplc, tIw CJIIt:rIIIIcw::I. of
I>taltIlIDd IIII1Um.:. - . the- - - " , cbiIcl:ca
. . .,..;"tIincd aI .. hi&b<r Ictd iD the ocan:ilr
pears of 1940-1945 thaa. ill tbc iml'"C"til,~ pc'C'"wv

..""',."
or P*-.... pcriodo _ hcoo .................. ""'"'

Siocc ee 19301, I aafny DClItas thcrd"_ been

--- ~
_ _Plil* "O'UII,L> ill pIa<:c in tIw iodl:llrialized -.....ld. And bo . ....
0'*"_ .... impt>'fetl i, .lilly be, i, pnxetll ee mojol'i.y of llx
VII1o cnbl~ from falIitI, m,o clc::Ri,ulioD. Now , the

"
I THE STATE OF THE WORLD'S CIDLDREN 1985

The Recession:
women and children last
Till! SO«<a! SlllC!)o PUbI<she<l l1l' UNi CEF earlie< in """""'..... niOfe lhn QIJlldtIJllled in IlaIMa
/hIS year on 11><> 1"'POICl oj me WOII<l " """"""" on tnpIed ., 1lIazi1 and more !han <lOlIrlI9<l "' Peru "'
"'" ....od's chIIdr"" UIICOYele(l """"lI 9''''' tacl$ Me>co:c IIIey rose by BO~ an<l ., Ec_ ana
at>ou1 TaIlo1ll T8IMy . _ ' ... ItlCI CUI~ ., lJrugu;]1 by more than 50"
llO'Y""'me'lt e><DIlO<llture on _ 8e'\IW • ANt-
Iyslng It'oO!if.! facIs. 1he st""Y also 1:1 _that lnougn MtISllCS are nar d 10 come 0\'. _
'''''''"''''''' """",. ll(Ogtesswely MtOi:. at It>)5EI
0C00"I0mlC
choIdret> -
Str_
M_ been ~ Iol "" "*'
", m IIle _ to faA Mel< on-me develOpIng
courun ll1e poo<est popula\lOn 0'0IJ1lS " eeee
COU1tr IWl lI"ally me mosI ... lr\efat ll!l arOlfI (II
ostale$I<dam BraZIl
01
morl" lny .. JlSIIlg 8/latpIy .,
. in somo Pl'ttS 01 l!le
I/lIIl POO<l!f
nottl'l-aaSl.
all - !he poto'l!Sl mothelS ell(! tnerr 'Ioung d'okl''''' one In hve d>ildten J$ ~ beIo<e reacIlIrog ~
seee :no SlUCJV was ~ the ' 1IOIl& "1/11 01 """ 'I<"'"
SlOt'
hoes -
'* begun IIIto EurOPll.
rrooest~
IdI .. IIldIIslralozea coun- o In BoIMa
\he
more wolllJlY In "'"
1000 PI__ rose ten!ol<l ., Il>e _
fII'l(long ........ 1984 aod <l'ougIll lIaS reduced me
NofIh Amenc"" economy The _opong C'O<I/>- 198 4 M/V'IlSI 10 "" 8S1"""'1ld 60'll 01 normiiI
1neS. too. 1\11\1& begun to st'<lw SIlI"S , ~ """'"""" In!anl n'\oJrl.SIJ!)' 'aleo hlr... . - stabie'. lhlrr"l<s
IMr GNP pe< <:all'la . ~ IeiI by 2 5"'0 "' 1983 .
WM dUO I<> '''''' 111' 0 5\10 Of 1'l> in \ 98 ' 1 llut so tar
to JlIllIOI O'MlUtllZal00n and <l/a1 'ehl'<lra""" earn-
P31QJ'I$. l>ul CI'I«l mal'l\JlnbOn M s ..-.creased
the ~0\IllmIttll IS <;<.lI"OC8f1tral!l'd .. It " relallvely
S1~ '" ltl8 dr<lllglll "$aS
welkin couolIles 01 """' ItlCI ~"-easl .......
Iod<a. few ~arocll . _ Pegaonecl "'>me 01 ,1$
s.
rnomemum. largely bee... of 0rnt;1f0'I'Il<l ~
a14 '1.In '"Peru.19 83GNPandperC<lnllt"OJed 10 lall inII\'1984 I/IIItl
capIa "'''"'''''' mote
The

,--
tural prod""""" In me RePubIoc ot ~ OI ea , GNP
nes g own rapodly """" lhe I;J$I lWQ years iItJ.l
on,...., mo<laJ, ly has _ to "'" lowesl_ ever
SuI ~ PfOSI'OCTs a,e bIe<il< There"no
"'Il" 01 ' '''''''''''Y ill " Inca , me POOI"'~ oj alIlha
com.."s, ",,:n llO"""""'lS lleSeI 1)01 _ (latt>-
ongs an<l n.gn dell! ana ""'" un est''Mle<l 1 50
moIIon peOQle al ..... "om II\tl ellectsot lIIreel'l'ltrS
01 OtOlJllhl ill Nigerlll . b example, { ~I
r~ lias (lr(lJ)De(lb\' more ItIan Itill! <M!f !hoi
"""' IWO y&1n TtJe,........oer1 ot _ e!l' ma!tlour.
_ Cllildren are 1lSIng. an(! hunger 1'IllS" t>e<l<1 a
d30ty IMmIII ln ~ « h _ """''1/
In laM AmItt>ca. _ C8P/tII """"""" IeiI III 1 7
1984
FOOd and AgrlCUllure Or\;arualiCn 01 me Unnell
NiI100s julloes lIlal 63 % 01 rlOuSeI1OIlls <lo IIOl
earn etI<IIIgtI to 1M' liven an 8<leQu81$ dtel
Outt>reaks 01 M>erC\Aosls, mJIana, and 0I!le<
onIe<:b<IUI <loseases ..e 1I'1Cr""""'9l\l common
o in Sn Lanka, inIIoloon an<l CIII-DacI<s ., govern--
rnen1 5!W1dinll till... erO<le<l !he foo<l.Slamp ......
gtiIItWTlIl ana eo 10 un ~ '" malnJUi1lorJ
among I!IO C/IiI<lrfIn oj the poor
At !he "',M 01 198 4 Il>e UNlCt:F Slu<lY PI"""'1ed
!hal Il>e """$1 was l"ll lO c:ome The pre<bctoon
tIOlds 101 u-.. ceunlnes ......a. nave been unabIo
"""*'
l<) """''''''' trI8Il """""""" pertormance - <l/ to

01
!tl4IIr
reoessoon
~n,' !rom 1Me """$I ~
<>.II of 19 COU/ltties dunIIg \ 9113. and C NP .. me
. - - . .... wt'IOIe <lrOppo<l t>y o - 5 ~ , Cr~
• 1"" SlulII' """"" cr.- (V "' . . . NlI<lbad\ . . . . -
dIleI ~ NWe lor,*, maSSllle ,elrencll- 01 rh<>SUIoocl""" wtri:f'.""","" '9~ ~by
menIS. w m """"" wel!are prQIJramm(l!' lI\tI hrst to Ot""Olkwonoly _ _ ........ - ... ""QIlp(...
",I!e< lAItong 1983. PlICelI mote than QU.,1upIed ~"'" UNlCl'F ""_

"
 n- hal 0lI0IIe '0 bsILioo d'" linIlUUdI ol-=b •
affty lle'l for 1M poomt aDd _ ~ '""" low ooa 10 the -.id~.
("milja ol the ~ ~ romilift wbo Ii....,
ill I"" permao"'l bu, silal l aDftJm<y ol poo'Crly
aDd ~" r;llDilies wbo eadI year
.ufftr the deathl ol l S millioo ol lb.... dUldreD.
Monlly, r.... people wo uld Itttpl W I a unall
Pl'llII'n ll&e dowlllum in an $8 lrillion world
econom y should llIWI an incrusc ill low birth-
woilbl, malDulri tico:l, r.... ,umcy of illnaa, and
poor n",,".IJ ""d physQI r.l'O""-h. amollB lbe"*'
YU1Ac:",blc chiJdrm ill ,he pooml qlW1tr of
hWDIJI -=ifty. Aad ir .~ do MIl ae:ttpl that
motalIy, dltrl tbc _ . . ....., to ask wha, f;m
be dolW :abou.1 it pnr;tiaIlIy. For IboK familia
wboK IUDdard ol IiYiat doa _ allow for tbc
Il«IIlAl dndopmca, ollhtir obiIdft:n _wllttbcr
tbc (:IUlO! be ec:--= reo • or 1ft . ip iol
po.my - a minill"'m pm«tioa JlIould be pw-
rided apimt tbc __ caeca ol . momll in pb)"lic:al
ckprin-' Aad 1haI _ _ be d ' ,cd .. a
Tb.t CBt ror mch a AftIy ot'I iJ a t:IIt which
ma DOl 0Dly ... CiliDiDUil hllDWlity but aho ...
com_ _. The arowth of a hWDIJI bnin iI
9l1' complete by the time a dIild iI foor yean old.
Poor Il'OW1b durina thoK vilo! vulnerable yean
UI UIUy lI\tII\I Ihl ' the child will n~r ful6J the
mcQlaJ ""d pbf$i<:al p<)lential wilb whlcb be or
W _ born. Man y timea it hal hem .... ucd and
dtmonwatcd W I it ia a oati...•• hWDIJI raoun:a
...bleb are tllc key to iu aoc:i&I llld .......,.".,jc
pnlIraI aDd WI ioftIUDC:IIl m people ...u.s
, , _... ........ la iu 1980 IF...W Dtotl<tt>-.
RqiIn, ror cump'r tbc World B&ak toDdllllal
that tbc ri&ht kiDd ol -w In--... ill mch
tlaiap I I priawy cd_ _ ..... beaIt.II an: till
yXid lUI " - - ' ec:,- . ft'IUl1I 01 up 10 2S~ I
yaJ: - w hi&ha" 1lwI f;m be Cl}lOCtlId rr- _
aoocb-It tbcrtl"ort makes

..... ....,
FIg.S H••lth.nd wealth

1Per 1,(XXI r.ebol' ~ ~ It

.....
Ule 8'<P«'Iancr

~~
2.!IOO g or more
..
, .-:I.,...

t.lilhh
v.lW'CIU5 0tt1ef de'oalopotg ~ (total pqUalJOn 3.001 ~
ncticalors beMeeli c:u. ' ~ "'" OOU"dries (Iotal popU!llJOn 1.131 rr6:lnI
_""~_~ o C _ m _ t o r lll8O .. _
_ " ' " " ' _..,_ UIIl .."

..
[ THE SfATE OF THE WORLD'S CHILDREN 1985

Disabilities:
the preventable burden
On! n len of 1ho _ l'$ I>'!OIllo -- 1OITlOI 450 Wlm ~
"""" .. nogro nsI< 01 <1001/> l.-.;lpOor grOWTh",
I"OIion - suI!« from metlIaI 0< o/ly$i(:al dubdily .,fancy Ot the 11 _ _ low ~1 baoocs
fOUl 0Ul of five We in ~ 0""""'"
And t:<lm fN"'Y year ",. '9 ...-.on l>f<l bOrn .,
one-thrd are clIilOren urcIIlf !lit""" The Iow-cosl ~ COlIIU'I$$. _e two 001 01 Ihree
c;llold ~ leC/'IroQUIlr lbcusse<l . , 11\1$ rep(ltl pregtl8Ill WQmen ee anaerroc IlIICl nlll'l' atll
..ou4d also f(I<lu(:e "'" l.<llK:<:tIlIIaDle l oll· _ Even 8 r.alJ(llu4 Ol ,,><Ira nC" I!3d1

owIIOCh(~ In'm,IIl<letion woukI PI''''''''! POlto

d;l~ on ll'Ie las! 1/1",,,
'''''''1M Ol lY"I1W'CY can OD a
Ionr; wa~ 10WarUS pr..-'l"'ll lew bot\h.weog/lt
~ lIllIl I II1IlIoo d1jkl,,,,, year
I!:I8fY In
some oe'eIoi>o'll countnes bel-. ~ Y(I and ....... BellO< Doc! '" .......per\St'/lI .on SUllJlIemenlll can
of lMlt'I I ,I)()(l ~ arelattl!l wart! 011 """"""" Once ...."on. """" a fiIIategy
couIO pI""""l d"",boIol'" as _ as savong loves
oma!nu1Ol,on
He ?!",", a map 1<6.11. C811 "'liO
ana _ tl<IolY In lIllOutJO'J(, 01
10IQad
C8$8$
chilCIren tlOn1 ""OO'''''''Il!lt ar" four 10 ... Tones
more ..........ablll 10 menTIl '" physocaj ""'_
Iho cllold<m WIIO """""" 1M _ 1<" 10\1$
pr~ than I>a'- oJ normal b/l"...""gtn
<XIIT1Pl'ca1>OnS CCII1I'JIlCI"'T.., WI1IcI> ClIn ClIlI5Il
_ , _ , ;,,1""1I0n ....., subs8Ql.oenI 0II>er <I<sabotites, too , can be IYlM!rlIed al low
oeatoess . etlCe\IIla:IIbs, wNct1 can tlI llS11 PI"J'l3o cost• • 10Il0ugh suppIytng t~ ,amed.... can PftlYlI
nen, br.l.. da mage. and ........... maJnul r;ooo rllSUll· COIf1PIe>< Io<lIne <la!CllIt'CY. wrct1 "' some".,...,.
tan:lI.<S PfII1S 011M WQrId lIOlS 11<11.8 PO$lUIaIIClOS 1I1
"'Il from loss ot lIllPe1.!e and doarrl1oe•.
"'" Ol all,",lOd grOWth. deal.....,,1SR\ and rnantlIl
osPO'Iall ub«~ean _ltUaIy leao Ie>me""""'O'liS.
lIeIomMIy, _ c1vMo;
"""IS, 8M
~'da6on. can bII P''''''''''Uld tor • lew cen\$ by
a<XI'rI\I oodioe 10 &alt and Olliei' """"""" k>o<ls '"
n::apac ty 01 ~ IUberculOslS l>/ """":1,,,,,,,
of OOBte<l QII Lad< of VI\aITIJl A
blind!I an estmltc<l 500,000 GrMklreo every year
NoIl1l1 drsabiIibllS ate as otMIlus 8$ (laa fneosll or
lameress MaIl'1 ........... of ~ l oll YICllm 10
....., <:an be ''''' 0ld0ld b'/ "la"""supoleme,oIS

--
me II1VJSlble llISablloly of POOl merna! " l(l pf\y:IICaI COS\IIIQ 20 Cer'll5 CI less a year per peffiC/l. '" Dy
le3<:l1onll """herS 10 1e8d t!leir <:IWd<"" green
deYek>p "nen1. eeeee by IIle l<eQI.IeIlC)' oJIInes5es

or ltIIee yearn _lIM

llnd ;os.sautts on ""'" gt(7Wth dunng T~M 10Sl1wO
mosI VItal10< h e oMliubon
01 b" ." ancl bo<ly Once IhaT growth owortunrlY
Mas ~ . ~ <:all ...... be C<l'JghI yP Bg3II>
So IlO\Il grOWlll ., chiIllI>lxld IS lh11 m<lGl _ .
sPread - t!>ough tr>e .... Sl noloCeal>l. ~ Iotm 01
dosabolity III l/'Ill world IO<lay All !he maIl1 tIo;l>.
ruqu8S o!lM choI<l Sl6VIV3I revoIU\lOn - <Ql ,.,.,.,..
drtltlM ~ , _ .1eedInO anti IO"J1)n)Y«l
_
l'.'r."n"'"
..........-.g. .... and lI"""l/l n.......
1Or>tlg -
....es by pr oteebng grcw\I'I TMy ........tc!
eeesee alSCI sa'o'lI mlIII)' miIIooIls 01 chld'en Inn
physlcal lOfl<l menial handoc;1p
AtlotI>e< kev"""""l in the cIWd sur...... ,~
lIOt' IS IlIlMWll"'ll low ~l. ~'lICh cames
WI>en dosaboklV "as
rlO1 t-n prllYenllKl. dJiI.
a"", wt>o l!eveIop irnparmer"" """'" ear!I' doagrn-
,.s ""a 'eMbWoIal"'" 1<1 IlIllp """" ,eaklf! l/Ieor
PO!enllal Yel 98,., ot the 0CveIclIlrrlI workl s
Cl<SlIbled """" no access t<> tr"""'"
I'Ielp
One sdu1ion .. C(Irl"JI'I"Url<!)"blIsea ~"'"
proorilRWll8S. WIIidlCII"" tlIlI ~ 01 ~
_ worIcers lIr><l ." bge<s Ihemselves _
oommut'''Y heallh IIt<lI'I<ers '" ToIuc3. Me:>oco. Iw:I
!>eM ~ ),aoned. 1""Y 5UbS~ IfTClfO'ml
lr'lfl Ww>g C(lrl<;hl""" 0110,*, of!tle dtSlIl>Iea '" ~
cI\iWge edt 10" t'Ill8deoj ~ed 'Chabdlla·
[lQI'I servIcos Sue!' proo,,,,",,,,," <:OS! .nv $9 8
j'88I" lor 99C/l dlsallled petSCM'1
nrilber (C(lnIJnUc nor poli tic:IJ $(Il~ In all"'"
child rrn-Ihe human l'eWl.ll't'el of 1M funue _10
grow up with an impaired I bility 10COOlribu le 10
""d belldil from thrir naDioJ>'l de~lopmenl.
A.a achienblc Ii",
A sal""Iy net WOVCII froID tbe stnnds of lIIini-
mum wqcs, Illlemployttltttl pay, sickn".. benefit,
""d family allowances i$, unfonUII.Ildy, SOJ1l( way
into Ibe future for Il>OSl pc:ople in Ihe de~loping
,."nd. BUI I more et.",elllary safety net of
minimll1ll food ctltillontol:J, primary hcaI!h cue,
eletnClltlry education, oaf<: unitllion, and cJean
...ter, cou ld be pill in pb ee by _ deve:lopi",
nltions - if!hey can . wpe nd one comer of tllal
nel o n bir and ",Ible pcolkia of inlernational
lrade and aid.
Th e subject of this l'C'pOrt -aa of ill two
predecCSlJOrs- il an C'lC:D DIme basiI:, more modrzt,
and IIlOn immedi ale goal: -
Even in difficull economic times, il can be seen
!hat I wmbinltion of , p ngin g knowledge and
circ umslInce hIS ope ned up the pos&ibilily of
providing a minimll1ll ",feey nee of !he moll. basic
prol:cetioo for the growinH mi.ndt and bodiCll of
lhe world's lIlOSI vulnerable chilm o. The lech-
ni'l.UClIIrC known. Th e OflIanizalional capacity is,
broadly . peaking, in pillCe'. The COlts, bolh
politicaUy and fin""cially, ,uc absolutely minimal
Going into Action
Iu lbe basic lechnlq ues of 1M child sllfVival
rtvolulion hqin to go into ICllon arou nd Ihe
world, . body of cap"riellC<=is beginn;", to build
op around tbcm. But befort looking at that
UPl'rience in I Jinle mort detail, il is wonh
recording an impnnant ilem of news which baa
cmcllled from the arta of Baogladtsh where m uch
of Ihe pionccri nll work on ORT lias been done.
In the M atl l b area , wbert child deatba ba".
in rclJ.tiOll to e e benefiu IUch prolcctioll would
bring.
In shon , we are faced 1101 wilb I grllldiooc
long-term plan depen denl UpoJl a thousand
doublfui premises, but wi!h I few spc<:i6c lasks
which lDOSr n"ions could rcalistic:ll.ly n~ 10
achieve within !he """l few yean. Spcci6caUy, all
fam.iliQ wuld be C11l blcd to ..... ORT, all childrtn
w uld be Unm\l.Oizcd, all molhers C(lU.ld ~
alll'UC of tbc impnnance of brcast-fccdina and
proper weaning, and aImosr all parcnucould have:
the melllllllld the kno wledge 10 P"C"'C111 nulnu-
lriuon tlu'ouBb !h. monitnn", of !heir chiJdrcn'.
gro wth. It it ClltrtlOt'dirwy thaI four such appar-
enr.ly simple ptVposilions coul d SO dnmaticaUy
improve child health as 10 haI"e Ihe rale of dea r.lu,
disabilities, $lid maltIuuilion. BUI tM is Ihe
oppnnunity whicb present kn owleds e h.u n"",
opened up. And we arc IhtrefOtC' left with I stark
question _ha~ we !he will 10 do il?
In th e de~lopi", world, it is clear tMI the
tcaliution of tM prcsctlt potential depends, more
!han an ythinJ d$(, on the poIilicaJ COIlUllitmenl
of a natioo's ll'ldership "'d the mobiliution of all
iu 0JPDizcd raoutea. Bu, many n.ation. wiU ......
still require Mlllcial IIQd praWcaI help _ apeci_
ally in the f01l1l of fOTciin achu.ge. The ind umi-
a1iud world Iherefore abo has an oppo rtunily 10
demonstrate illt COIlUllitlllC1l1 10 the world' .
chilm ll.
altndy been drasticllily rcduad by O RT I1Id
orber child survi"a1 strategies, tb e avCl'l3e size of
familiQ bas hqun ' 0 fall (ott panc114 l . With
, rowinll ccnaimy thattheir cb.ild rcn will mrvive,
and with 8rowing confid ence in !heir own ability
10 take dccisiwu which iml"'ll"l' their o wn ~vcs,
the parrllUi of MaHab an: now ma1<ing more u,e of
family pLon.nina; acrvica. On average, the number
of children per famil y is llOW lWO 1m Ihan il wu
o nly I f(W years agO-I m ull bener lhan Ihl!
"
I THE STATE OF THE WORLD'S CIllLDREN 1985

Population gr,owth:
survival helps slow-down
l~ _ _ now r.ave me OOIenllal 10

...... 1"" !MIs ot "l'>PI~ 1 moIlOrI cl>Od",n

o AI$II"IQ leoiets O!temaIe liducltIJon - anoIher o.ev
cl'*l ..."'""" SII"'"Vr - are . , strongly Il$SOCI-
eacI> yea, B.. 'MlUId lI1e roll 'esu!l be ar>ollW al"" _ Ia llong _ 'ales
-oe ... ...,...., PO(IUIabon? ParildO ><>eaIIy, the otilePrObal>!y tI\tIoIlamo1V
most ""IlQrlllnl I>'",_a lor
~.~
acx:ap\a"lCtl ~ IS tl\tl reallzalOCW1
If reclucn;l cl10Id <lea.,.. oy NIIt ~"" no et!e<:llll Oy pe._ 1hIIl lI>e)' have tile POW8I 10 Ial<e
... 00 !tie rumbeI' oIllorl1lS, !hen populaliDn WOUld omoo<tan1 decisoono lo ompr<>Yll ~ own illes, Any
1IlCf""",, lleClluse more dllkJren lOQIJI~ ~ 10 ~ wIIIch f8IIllorces parents' ronloOenCe III
....emu..,,\' """" dltldren of _ ""'" • Bul aIIl1>e l/'oe<I own alliIiIy 10 ompr""'l tI'>OW own C>t~
~ ~ Ih&t a re<luc:Iu1 .. !he runbeI .. _ .. ltwe/QIe e cM"08 wtokh mal<es tile
of clIikl _ """'-'Id aISO!leIP to br'''O abOul a """"'l'l....-.:8 or lerrWy ~ """e .~ II!I
greater,..;lu(:bOn .. !he flI.OJOof of cn lcl borIhs - almos! altho """" Slra\egl(lS of tI\tI CIIil<l ~
oof bre".Heecng
Tne <leam ot ar> "'lant nalUlaWy me._
-_
the 8fXl
of Il>e CM\I"'>epWII PI"
rllVOluDoo oller P61'ents """e rontml. !IO they are
oil Slrategoea _ 0I>CIfIaS(l " ' " ht<eIi/IOOd 01

lec _ _ breasl·leedIng pr<M<l8!I So aavo'Q " pafO!tl!S 0Pbf'ig lor smaller tam:Iies
o;hjld'$ 14 may al:lo help to postpone !tie 01.>:.1 for alI1tlese ..asons, r9ClUCl!lll chid ooaths IS
Dim\. S<Ir\IeyIng many l-..l SIud,", Pr!rxJIaIi(Jn lIkeJy 10 c:aose PQII<lIation growIIll0 _ """'" ar<l
Repons ~ lh3l " breasH eed,nll makes a slatliUe at "" """"" datlt and al a"""" _ than
:sut>sIanhlll 00I1tnt>.rtion to bort!>-spacong _ 19110. ""llUd b8e<1 Iho case
~ \' con~oI., manyareas"
8r~ IlYi<leI>ce lor \/'lIS ~ al-
o rile gr8aler IIIe chaoc:e of a c1Wl' s su:vrval , ready e><SIS: tnose
COO,Ifltroes aM regoons wIIoCn
!he '= ee patents need 10 flSU/e agellllSl loss 0, _ atreacIV achie'V!ld a revoIu1OCW1 III <;hIkl SUM-
t>eanncl n>:;If$ C/'OII(lren l!lan lheV 8C'1IIa!Iy wan' ..... suct\ as Dw>a, SrI lanl<a. the RepIbloc 01
SlalJSlJCalIV, Pil/enlS who sullef !!>ElIDIlS 01a cI'oId Ko<ea, Cuba. Ca;Ia RIca. SIngago{e. aroj the
lfII'MllO ha ... 0 5 more 'llItWII' lI\iII1 PIIrents whoise stale 01 1<:e<a1a row _ Dorth 'ales arnorog "'"
children all survive Savng a cIl<kl'!, lila mog!ll ~ in Il\e (1e'VIljoping wOOd "rwery(Ieveloping
""""'lore be saoo 108ISO pt~ . ~ ,~ I)irItl ' Buf ""lIOn mod nfat>1 <leath 'ales aM _ rales as low

---
as Sn l lltll<8'.. lor e"'«IIlIe. IfIe<1l1leffl WOUld tie
over lome . "". - 'MOOnd ...,. QnIy to IIIeir own
a.ee1 e>.per....... llul lO laDing cflIIl:I ~:aItl ,ates., 7 5 mIIion r - etW:j oeaths sad> yeat - 8/>(/ 35
!he tommun111 81 large So In pr3C1a'. t.... e flec1
'ate WO<IId PlOllab/)' bIl ......,., 1I'''''1l!t
0<'1 !lie llir\I'l
• E_ ' I ,""""""" ., <:fI*:l 0I>Ih...., no tll<l<l ""
o 00lI o11he ~ey S!ta19glllS I", DnngIllQ 3t>::Jy1 a lhe lid> 'Ole. lhe ~ .. ~ _ WQI,/(l nor be
"*'Y g<ea1 _ .. ~ ......... - . . . . _
cI1Ild............. """"""'" IS bIIltI sp3CII'IQ ~ . lIIIICe
~ IS now clear IMI ............. clIIId Jl'Qr18lif)r is .... ~ III ""'"' oarli 01 lhe _ . Ihe ~

IypicaIy ~ _"" M lf10 lwO _ t oigher _ DOPl'IlIiCItI _ . , . . . . , "'" _ • """"-.... ""'""

II ~ ........ _ """ .. IN 19~0s or 196Gs E_ .
IIIe " - ' ."orvol between bor1hs .. loss \han I'M> CIIIIl .,...... _ • ......., """""'" lc:f e _,,...
~ man WIlen ee 8ve<llQe rIlervaI ~ ,two 10!our _ I<ld '1f'IV 10 10'" I0 ~ _ PI"lIllO """ ...
years BottMpac"'ll SlraIllQ""l wiI oI>~ Iea(l f<\8ly _ "'" _ ? 110 - ""' _ _
d""""Y 10 ' - boclh$ as wei -'" ~ orowtl.. " - 10"-
~ by bmil)' pIa=inc pracrammos ill my 0taI rdydnt* tIoenn
lItboel' rvral U'Q 01 Benl lw1es" 0.. .....,.e, tloc chiJd Ii",", ia • ~ _
~ Wbl ~ ,.,." -J Malld ..... .-...~ D)'lI llify in 1M ~ worid willlllfJl!:r ... I1I.1CI:.
I btc DUenor of u.. IIItIlfft" jonod Q.I1t'¢ for 01 diarrbneaI infcctioa _ _ tim: bnW«:ll r-o
Diarrhoeal Diseuo 1lcIean:b, Bualadab., "'1:1''''1 and .... timca per ya<. ETa}" epDocIo of di.mboQ
a dnI.... ric rt,u,,,iort ill rliiJJ dIIIlh./., ftc- r.a1lfiJr.r Io-m tM child'i nuuitionll \eftl, and ney
• JIOP"u"itm ap/tlfiort, ... 11 ftlfJIllUl'//y modI i~ cpiIod( o:uM .;th i l U1( rill:. of duth frnon
It>wtr Mia 0/ JKlPftJ<Jritm "..""Ii" ( ICC I*Id 10 and dchydno,;OJ\. In • <:oUJIlry like BuJlAdtsh, for
fig. 7). eUlll pl(, diarrboeaI d(h)'tlnlion Ilills IIIl101l 10'l
of aU dliJd«:n.
Ild'on: het lr1gic del lh, litis rulldametlill COD-
n«tion belWttll child SUI";. . and fmill,)' de- The caus< 01 diurbnea .. pclftf1)'. po« "'1<1"
cliM _ also "",It OWl by IIlIijI'1 Prime Minisfer, IUpply. ~ IllJIituioo, ~ belith educaUoa.
1Ddita Gmdhi, _bo DOled llw:- poO< Musinl , CRT will _ cbaJlli: lhIl po'mt)'.
alii it .m pmrid< • mnarlIablo: dqru <L
"1WnuI
_WI..ama
<Iff _ _ , . . " •
,Illy . . . _ W r . -JIW jaiIia if
"., ..It! uti proIIeaioa frnon lID< 01 ,,,,, a i, '. __ df<,;:a
- and it .. ... CllUltiai RnDd in tbl-IIfClJ KI 01
........ -1 rW_c~.. min;"""" beI!tb and nlluma. rot dtiIdraI in tbl-
T-.dI tbl- end 01 1914, ill MoDco Citr, tbl- -td'i ~ .........pirJos.
World Pnpdorion CooIf~ "-' ..... raOl!I- In at- .u caa, ddl,dmioo CUI b<- krpt ..
DoD 10 thia Am< dIca:: _
~ by • J*1:IlI . . . ~ Dow 10 1lWlII( III
"'nrnorc.ll ---J-li-I. _..- ....m.;., d.. <Pitock cI di..,,1w>r::L U u.. J*1:Il ' ~ thai
_/Il", ;.....;.n.- ..........
...J rdyIhn. f«dina sbouId lXllI:inlJ(, llm an ani rUiydmjoa
...."" uti ....... .,.,• • t1<nwJ ,"*"n... ;" ...utina ahouItI II< ....... 10 tho: child from tho:
cliili .........., ~ .. 'dined. n. u.,.c.-U Iqinai"l of th< ~ and that <l>OQIb abouId
k mlItIUk Ur .a.-iI.o>riP .l1li /frriJiry ...." ~ b<- cil'ell 10 It'p1ac< IlK IIllid1 loll durinl the

Impact on population growth of. reduct ion In ehild d."h,

.---_
---
_
l
". 1l'OI""ecl _

-_. . ___---..
l lb . ~

ol _ _ ....-rioy
11'-"' _ , ojo.... ~

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

. __ .. _--
--"'
_ol
_ _.._ _ __ ..
____I:...., T_ _

•__
• __..._rJ-.
Iht _.- ...
- .. _--...
-----
...
__ol

_.-
____ Fa ....
_ _ _ 10
---il,""'" - - - - - -- - -- -'4,,
--- """'. u
I THE STATE OF THE WORLD'S ClULDREN 1985

~ iudf, ODd tIw IIdp IbDuId be • •t if the
diarttloft pmisu: or if dd1ydmior1. 1IItlI m, thnl
thooli_ 01 ~ IIlillioIl J'OWI& cllil41'l:ft. l'U"
could _ be uYfd. AI !be ...... Ii-, 1M lIM' of
oral reb)'d n.tion salu: can mitiptr \"" impKI of
1M U1_ on tbe clilld', lfOWIb.
BUI whllcvn 1M pcKC'lIual of tM lcc:lmique
;",olf, lb. 8lUtes' brei klhroulh , cll\ljns 10 be
madt: lh. knowleqe of h"" and .. heo _0 u" oral
ldlydnlioo thcnpy mUll now be PUI It the
dilIpouI of millions of paralU 1M ...o,U _.
lJI 8o.''''=h , 1)00 worbr$ &OIllIM 8&a&Ia-
dalI R.... Adnn I Commin~ ha~ pmo.
...u,. "'IN U millioa boma 1(1 leacII pImlU
how .0 make ani rdIJ(balioa -.lutiolll f..-
otdilIuy bolIsdloId inJ redieDts (_ pIMl I9).
In Tllailand, Iblnb 101Mwork of O¥tt~,ooo
viUllle-baxd heahb worken, .....Uover bllf of III
famili.. now hayt 1IXtII 10 the new 1M"",,, (_
panel 21).
In the Philippinto, production of oral ",hydra-
tioa MIll hal OOW rnclxd 5 millioa Me MoI •
yar _ .nilablc: nltino-wick l1u'<Mlab 1M btlllh

maio< co_
1\ Jimilu b<etklhtou&h ....- ...,. of Lb"
01 iIlDca and dath ill 11M: iDdlMlrial-
iud world ~ have br<:oa:or IYIiIIbk llmJu&b-
_ Ewope md North America ;., I 1ll111l'f.
IDDIIIlhL Goad ...... lOr lK __ uud. - . .
llowty.8vI thiIlp . . hqinni,. 10 1llOft:-
111 . - ........ of ~lU-., 1,200 OIlTdmoaa-
SUMan, bIdlcd by I nodio ..,mpaip, blm lauchl
9)'!l of mMhcn bow 10 ..... 1Kbcu ol 'Uuc.r for
ani rdlydntioa I!>trapy <_ ~ 10) .
1D Miabbollri"l N ~ 360 oral rdlydn.-
tioa JlOIU Moe bml set liP Il:1UI Ih ('OI,IfI\l'J'
( 011< r... conry 2,000 younl childml ) and S.ooo
IJri,Uimn, backed by Pf/(Ipk', Hahh Counci1s,
... tutyin. tbc ORT lllCSSalc 10 people', homes
ill I nllion.wide O RT camJlAiin.
10 H,,;I;, the JIf'lpllltioo of motbm II'linr ORT
wbm IMit dlildnn ~ diurbon ("'1mb iI
rapoouible far a ' - half or all child d.. th, ill
Haiti ) hal ,*0 frorn 2'\ 10 34'4 aria only sill
_ tilt of. campaip- ind llllia& iatmoi..., ndio
ad,utioUl, _IO ltadl pIfftltlltow 10 .... u......-
tbaapJ . lo~ lmIIlcr~takeao IftUOlX
scrvKu, YilIaIt bcallh ~unl=s, &nd YilIqt
dr1l&M(ft$. lJI toW, IJ~ or llil rq>onN CUllS or
diarrboeo in dlildml llfld<r li ... "'" _ bcm,
ua1td witI:l ORT . AI • l'eIlI1t:-
~__ <..ISdnol 1w,....., .. ~ ... /«
&mltttJaJ ,'0" f ~", IIw
Pi",. _ -f.u _t1IIalmloo..Wt .. 1M.. ' .....
• faJh ripifit-I'" _ dtt dtrliaI .. 4..., '
....................... _..,. u- dtt",....
tltdi. ill -.lilY":. '
III L-. tM: ~I pbns to make ORT
.vail:obk 10 75~ of llil fomilieo by lht tad ol 19l5.
In Maico, • Notiooll 0rIl Rthydnllion ~
jca b. btal 1a"",,1ttd- aDd "'PI'l"'ltd by lht
JoxIl prodllCtion of 14 llIi.l.Iion IICMII of IlIIII 1
"".
I" the Gambio Iwo-lllitd. of aU mol,,"," hove
btcome oware ol ORT Ibl'llllib an inlensive rld io
campaip and IJmoI,I 411.10 have SlutN 10 UK llle:
ItChniq ( Itt pa>d lO l.
lJI Nil , .,000 \'iIlq:e bcaltb workm have
btal tniDed lo . -b ORT ia ....UtlllPl IOmaM
it • ....u.bk to half tbt tlatioa'ii clliIdml_ the

.....
:rut. tlot
jW"""' ...... had iacr..-d 10 IllCIllI' IiwI nal Ibrft )'ftfI.

lJI £&rpt, • NItioDroI 0rIl Reb""'" e.-

r. Bmil, 14 millioa IKbcu 01. oW -= pUp iii \lOW tIlld...- -,. _baKd ........ Itanood
from piIul C1lmpei. " IDd bct<d by $26 millioa
prodllCCd illl9IJ lAd 10 lIIilIaI lIIOR ;11 1# fint
lId....... tho ol lft4 10 '*k liP ORT~;" ill . .... {rom tbe UMtd Stat ,.. Att1lI:1 for
16 0IIl <:L 1M utioe'. 23 _ .. ...t ro. elpm 1(1 lJIlmlational O... i.,'....
"1 ( USAtO).
Soli..... ~ aIld ~ Willi thn>t laban-
laria _ manllfact..,;",,; onI rdIydntioa 1lIIu., ·......of...
."".
.,. _of'\l< T_-,~
prcdllCtioa (apKity h.aI; risal 10 16 millioxI..ebeu ~ - . c."", PI... w_ _ Or-
,.,"_,an..... _ 1914.
 In Tan.zam., an inilial S.5 million _helS of
oral uhydratiOIl lilts hl,'e besun In be distri-
bu.<:d in Ihe las! lwelve "":>nih$, as pan ef I new
coxntiallirup PfOlI~' which reacbes nUl 'e
C'V<:IJI clink and heallb POIl1 (set panel 22).
Nel all of Ibcse campaig;"" will succeed. Peo ple
do n()l suddenly begin In _ O RT jusl bea_
tb e facts abool j • ...., made avaiJable to lbem _any
more lhan JlClIple sudd"'l1y $Iep l/IlClking, OJ
f1u.nse lheir <:atinS harnrs, iUSl boc•...., n..... flCtS
Fig.S Impact of ORT on
hoapital treatment of di.rrhoe.
~a __ a
- 55 -6%~' -=P!t:I OAT 1&8%
~DAT 5'3%
Ad missiorl rate
Pre DATO·8%
- 47·1% change '
Post OAT 0·2%
o.-eraI hospital ca::;e-Iatality rate
P!t:I ORT2'9%
Inpatient case- fatality rate
~ """"'tIC ila lre<S\ln ,_ ~ .. >sllll •
b«o<ne widely kn DWn. And before O RT,in all ill
different forms, b<:co....... the standard WlIy of
1,..,111"1 the mnst <:olI\IIlCIn of III cbildbood
iUnc:sscs, partnll VI'ill need to hear a dear and
romislenlmessaa:e lboullht! n...... th<:l'llpy from all
sides-from lhc media, by WIlrd of nlOUlh, from
h<:ahh professionals, from lbe IllCl.l imam. or
priesl, from communily and gGVC'ltUIlC1Il l<:aden,
and from lheir o wn friends and neigbbours and
'1\lSI<:d sources ef inf<>l"D:lation. In most cas<:s I!so,
a IOOIbcr will need 10 be siven a ptXtical
dcmonstrlltion of O RT _ and Ie htve lhe informed
wppon of lhose lII'OUnd bcr _befor<' bttomin.s
ctIlIfidenl enougb 10 act ually use the new lhcnpy
when her ewn child has dWl"hoca. Of Ih. mothers
who now know about O RT in H o nd llJWl or tho
GlllIbia, for cnmple, 'only' abolll lull an: llCIU-
ally min,lhe lb erllpy whorl lb oir chi ldml h.ve an
att",k ef dilrrhuca. Simil arly in
'only' II>oUI 35" of mnthers who have btto
Ban.lad""'.
Ilushllbe 'seven pnlnl$ ' 0 remember' for making
and uti.nS bnmc-lII3de oral reh ydral io n IIllS arc
ctIlIfidenl enousb _J(} far -lO p UI wha l lbey know
into pnctice whorl Ibe time con>es.. A& Jl"l()ftc and
lIII>I'l' lD(I!hcn arc seen 10 use O RT Illl:CeSSfully,
mot<! and more mothers w ill be mcourqcd 10 Iry
;1 -1 proccs$ whic b can be eccelerated by using all
possihle channels of COIllIIlunication and support.
Home risi1.'l and radio campaigns, volunlary
actien and S0vcrttml!OI backio" arc likely to ICl
S)'Il('1ialically SO lhll lhe impacr of lbe campaign
as a whole is consid..... bly 8fCItcr than lb e sum of
i\l parts..
O RT demand. time and patien.,. lIS well lIS
Itnowlcdse. Molben, of.... O\'C1W\l1"k<:d and Wi..-
rolle 11l()Ihcrs, htvc 10 knDW wh at proportions of
$&II and sug... ro u.e, Wha l '1w.ntities o f wiler 10
dissolve lbem in, bow frequeotly I frt$h solmioo
sbnuld be made up, bo w much lltould be givelllO
lhe child, and 110'11' oflen, and for 110... lOOi. Fe...
motbers in the indUSlrializcd ..."id _ 1I'i. h all lh<:
advlII .qes ef lilen<:y , ""'te'·"''''ap, meuurins
iugs IIld refrigmnol'1- arcasked '11 undmake any
U'Cllun(nt u l!eman<Iif<I lI ORT 10 ptOlCC1 lbeir
d l.iJd 's h<:allb.
BUI as lh e mtII1>crs of lIllllIy nilions arc now
$bowing , lbe be"'" US< of ORT is »OSlihlc ...d
does open lbe WIly for I drastic reductioo in dtild
dcallta IIId child malnulritilln.
zs
I THE SIl\TE OF THE WORLD'S CHILDREN 1985
The West:
a return to breast-feeding
u.... two generaliOnS ago, 8ImOS1 ... human
lIlIaolS were ~· led [ """ lIS Iale lIS 1 911
two-tno,os 01 /I.meI.ca's "",,"year«1s _e ll1lI
tleo'IO fed on tlreasl-flllll< EIo! t>v 1973. <)Ny.
"""rte< cI AmencaI1 In!anlS _ . brea'M ed tmm
Dorth. and or>ly 10'llo beyond Ih"'" nl<>ntnI
EUJ<llIlI soon ~ In Swe<len, 11>8 P<OPO!-
POll 01 "!aOls ~ Dreasl·led a'l1WO monlh:s
<lrOPPed from 8S'I> on 1944 10 3 5'1. on 1970 In
Itlll !'Ieltlt!<laOOs. I/lI! 1975 figure loo" llXdusrvely
l;IIeasl·1ecl " faol8 (at ltv" rnorlll>S) "' !IS oni'11 I ..
The <lriYJng torce tIeIlinCl l!lI$ Ctl"''IIl' ..,..
m<Ill9rrolll1iOn Mole WOII'Iel' Degan .""kM'iQ.
many saw I!'e bonIeas a SymI)<Il oj .....'" ~_.l>On
and
In ,esponse. infanl·foNooIa C<JO:IlIlllr'''''' brOUgt1!
__ ptOd<>ClS onto the mar1<$! and t:>eI",, _Of-
ng lhem And In "" """ ...."'" ...... _
....-eserl9Clll' EII1t1'iu61aSlo: alloul a Atnongs rraleIn
an(! 'SCM/flblIC', ltle 0lIatl1 kwrn.>Jlos llI )Qealed to a
\jfOWII1g _ 01 $Ollhi&lIClPon bellh '" _
IIIICl ... !he lI'IBCloCaI ptotewon As ' no«t babieS
we«! wn ., ~ laIs. the empt>a,.. on SIfICI
hygiene and $IXIIIiISS DrlIeI .-Ie to<"'5l.teedIng
.-n messy or ''-"'CleM' Moo! t _ _ 1lOlicY" - WIth me am 01 '8>SI'1ll to 1$'10 me
separa!<.td I,om 1M< mol",," ., brth ... tho
"'leresIS oIl1OSPtTal eHIQIlI'>:::y, anclll'olIy _ fed
on S<;I'>e(lule ,,,tiler lhlIr' on PerI\IIn<t
BIll In !he I85l <leC!Ide. bI t.!eMng lIaS
S!age<l " ,-'<able <:om8-l>Ild< l!le Waslem
~ In No<w3y. flt'Wld aM S_ /of
1lXamJ,lIe, 95" 01 ba/:lie$ Ole now blust-*, from
tIIItn In "" lkIol... SillIeS. the P"~'I\"'" (II
moIiIers-wi><) tlegttI_.leed"'ll t!'e. lJaboes has
""""!han doubIeC D8IWl!en 19 73 .. ", 1980. In
tt>e F _ fIello,.obbc 01 Gem.....,..
alrnOll/ 10 "" O!
baOoes are .s1ill bleasHed 81 two nmlM
The lfend t>aO< to bteast.IeOOort\l_ .... tt>e
_ Uencl _ ~om ~ _nas been ~,,; by lletl..•
eduCated molhet$ A 1980 ~ in me \hied
S1a1eS. Ie< eJ<amQIe. stcwecllMl ....._ 70 ,," ot
O'O!lua18 <mlIws bt eMl ·!ed !ho>Ir child'en as
-""""" 10 onlY 25 '1(, 01 moIhw!l ""Ill ""'" '" less
yea~ of SC!'lOoIioII
What C<llIJSed tne tel"'" to bleasHell(lng ., me
_ m""
F~SI 01 All, a """"""'" alXlUl Dreasr..n .'.fS
"31U1a1 SlJDl/flQ/l1V led "'0UllSof ""JITle'11O SIanlCl
Df9'IIIlla llOrlS to suPPo<l brfist-leeclIn<; moll>-
ers _ I"" La LBCIle Leao<>Il l/l Ame"ca . """"""'"
""'" in Norway, !he Nu<$ir1g MotI'le<$ ~\lCIf>"
Auslr lll'"
AI !he ..."'" lime mooem teeI\rIoIogHls _ e
CClrTlItlO to tie looI<ed at m::te C1\toeaJ/y 8Ol,l resPed
was ~ to grew ag"", laIlhe ""tural WOII<l
In II'Ie 1910$. lIClefl1dic 'eseatcn l""""""'d!los
nend by dl$C'OY8nfl\l e
r>JlI\llOO8I, ~
Il''''''
end
deal abou1
emoICMI _
I""
Iall"S 01 DrOOSl·feed1ng . Soon I"" mecltcal PrOI_
.... and ~1S began 10 18... no1JCll,
Swe<:Ien set uP a ble.lSl·!0060O\l las1<·!orce at
~!eYe TI>o l./nle<l SlaleS govet nIIWIl.
In 1984. Ms ' se! mep<omobOn ol_.iee<lIr>g
as a prW1Cipa4 l'lInon Q! un,l\!d $ti\tC$ neal\l1
proponlQll 01 t>abills " 110 arebleaSl-lea 110m bi<lh
., IIle oeveloclong world . ffle<lI! a,e OO¥/ SIQOS 018
_ <lnII ~ !ran breasI·!eedlroIl - 19"'" Ie<!
by IIIIl ....... modem and urbM moltws 901POD<
mo1hers "" ely ""m me orcome needeD 10 OIly
........,;,h ...... ~ . and Iaci< no! onlY I"" c-.
waler 10 <llIl\ ,t Wllh llu1 !he lIll'JJllffiIlflt to .tetolila
oow... end 1f>e ""'3C'/ 10 .ea<l !he _
inS\rUCIII::InS A latge-scate ~ ~ kom Dreasl·
I~ In l/le pool WOIIO wouIcl'l.. aly mean It>e
_
inlent.
and malnJlrJIb:l at man~ ........... more
TI>& ,ap<l ....eM 01 onI<Y"",'''''' "" - """ SlIP"
pan "" _ DreaSl·1ee<lir>g IS meeloraessenblll ,I me
Thirll Wo1d IS to a'o'OOll ltle lr8p alll,l fake IeSII lime
l!1an ltle Wesl lO ",ah,e IMI bre8sl......., IS lhe beSl
!tie world can oller ilB ",!a nts
B~a'I-f«dinl
Almost unnOlk«t, maIl]/ n.tiOll$ an: also no..
movi"i 10 ptaaVe anmher ~ital clemetll of cbild
ptOlCCtiOll _ b<nst_fe<dinl (figs. 9 and 10).
Brcut-feedinl is • n.tund 'safety net' apinK
the W<>nt efTCCQ of POYCJ1Y. If tM child $11rIiva
the lim month of life ( l be ll1OIIt.daD8CtO\l$ period
of childh ood) , then for the n""t four monthl or
.... cxclusi~e brcut-feed;''''8 lOCI • Ion8 ".y
towards Clnccllin8 out 1thc bealth diffCt'Cltcc
bet ...... borin8 born into povcny and bcini born
in lo afllu...... Unlcsl the ,:lIOIbcr is in cxlfClllCly
poor nUlritional health, lhe brcut-milk of I
"""hn in an MricaD villq:c is IS 800d .. lhe
hreast-milk of I motber i n I MllOhluln lput-
ltICnl. So even under lhe ponlCOl roof, I child ..ho
is brcaI1-fcd in lItiI period '$ likely 10 M .. hcalthy
and to 8row .. well IS I baby born into I
European or North Amrrit:IJI bomc. 11 is a\mol;l
IS if bre ..l-feeding lUes IhIe infan, oul of poverty
for rncse lint frw villi tt101],\!Ia in order to 8i"" the
child I fairer $Ian in lire Ind compensale for tbe
injlllil;ce of the world intO which it .... born.
10 recenl yean, there ha"" been si.&ns thaI tbis
strand of child protection is beginnin8 to fray. In
many cili" of lhe de""loping WOlld, the incideoce
and duration of brust-feedin8 has bquo to fall
prccipitOU$ly_
Often cocottraicd by the e%lm ple of bospit ....
by lbe IICQWactocc of doctors, by the adve:rtUc-
menll of infanl-formula manuflClurcrs, by lhe
demands of ""'8. employmenl ouuid. lb. bome,
and by Ibcir own belief thaI bottl...feedin8 is IllOlC
5Ol'lIiKiatcd, many lIIOtbcn hi"" c:ithcr 0 01
bqun to bl"Catt-feed at all er ha"" 0<)1 pcnistcd
beyond the 6111 frw ,,<!tit$.. BUI "'lw.lly ofton ,
motbcrs in poor communities IfC unlble 10Ifford
$ufficient quantiti" of infant formula, unlble 10
read thc inJtnlcUOWi on the back of th e COJ>lo.incr,
unable tn obtain dean Wlter, or tn 'leriliz.c botlles
and telllS, or to keep lbe lIOIution cool. They are
therefore lnlpped in,o 'f'Cndi"i money they
cannOl I fford on feedin g lbeir children witb 0""'-
diluled milk powder from nnclcm milk botlles.
The result can be I douhq Of treblin8 of
malnutrition, infection, and infanl dc:aths.

Fig.9 Avel1lge du rllt i'n n of brent-feeding

~~

~,~ "~
".,,,,
~­

-
~,

~-~

~
......
""""
DOMlNIQI,N REPUElUC
~­
=-
'''''''''
cos= I--~--

--,-_ _.._-'
- - - - - - ---::0 5 10 15 20 25 30
Mean duration 01 breast·feeding (rro"llhs)
..... ....
........ '
"
I THE STATE OF THE WORLD'S CHILDREN 1985
The Code:
action in 130 nations
In II POO< c<:>rrmlI'< ly Dl IOO 0IMlI0P "9 WOtIC:I. ~
t«ry Who IS l>OIlIe-fecl lS IWO or lhroe '...... more
W<.ely to de on onJaneoi IlliIIl a tlaDy wh O IS btllllSl·
too Tile $I""" _ cI breasl-....ding In l/Ie
cdles 01 !he ~ _ !>as It...e/Orll be-
come II """'" """"" lot """"em
One ot tte mosI .,SIllIe forceI ,*,",0 l!l<I ,".e 0 1
_ reedong Ms lIefJ<1 \hit """""'"""Ill of 0'Itar>1
l<>rmul!ls Dy l/Ie OCl"""I'e<crlll llaby-·looa <;;Qfl\"
_ , In May 01 196 \ a ll.. II lef>.ye<II campeigI1
try roeahh prOIOOSlOnas . IIllI'\.tJOI'<.nITI!O'IT8I ~
i a bOOS and .,""""'....... BgeOC oes l/Ie World
Hea!m AosembIy ocloptea IIIe internatIOnal Cooe
of _ '''Q '" !lIea:iI.~ SubslI1"l«'
l ne """ at IIIe Cooe 1$ .'!too PfQVI:IlOn 01 sale
IIrxl a<leQuaW! nuIrJ100n lot .,fam$. by the ""'tee-
ItOI' ar<l promol lO 01 br\lilSl.leeortg ana tly
ensur"'lllhe p<epet use oIl1fB3Sl·moIIc $II!)Sl,luleS.
wnen eose 3111 ~ 011 the tIa8IS 01
~" .,klrmo>1.,., ar<l lMlugtl IIpptOllr"'1I
rMrIletn;J lII'od d,SIIobuUan
By "",l-19 84 !hftJe \'8¥S all... lho Code s
8dOPlJOn. tfle _ IieaIIn Orglln""b:>n 'E'4X"'w
lMl IIle Oodft r>ad l:>een lIaroslah!<l .,to 17
~ and ltla1 130 «Ultloes IIllOtaken»TlI!
form 01 "':l,"", "" ~ Mote I""" 18 " OUS1,"""ed
111l1ielollor>:l coontoes nave enacre<l tIIlloO<lal
_ WOI'I< VI/ll NaO\ tor "'Stanoe. now allows an l>our
cooes Of _ " " .. , ost"'ll legl$lallon lO ,_1tJe
ceee's PfOV\SI<JnS on ll lll Ieas1 3 4 e<l<lfllnes III..
OJ"emIV tli'all O\jle<pslalKln
Some 33 1JO""IM>erl\S M.,",a'n>;l 11'183,"'er-
, _ o! ll<aaSl· .........l>Sl 'TuleS \0 ,"" PlJDIo<: . _
17 tIave aetiWlIy llOOO lt1e mass meo<a III ~II
llIe.osl·leeoon\I In ""'~. lot II~. "'"
M_ try ot IieaIIn OS ~ II M/IOMI b!eut-
!eedonlI ~ ""uch vses rad'" "" 0 1elevisoo<l
sPOtS . poslerS. """ manuals and tw<lll<l<;ll<$ lor
t>eattn DClscwv>eI; tIOlllD-kltIlltng ~ ,I'/ IS baffC(J
!I'(lm flOoSPrI.-r. . ,.., Meallh ter1t""l In Bralll
te!evlsioIl l>elwOrI<s rtaVl'l doniIlOO mo re !har' S '
"
mOliorl a yea<11'1 ~ lillie 10 Q<OmOIe
b<8iI$I'~ ' ""'Ih leao''''ll a<;lre5$8S ana cetebII-
Ires ~ IIIeot ume boo at chat(ll'
Mo:sI II'IfanHormula rnarulacl",,,,,, !lave now
ac<;epIe(! 1he Cocle' , mall'l ~ ana tIaw
aoroed 10 :>bode !:I'y fI'Ietn wtIen seIWJg !tleor
prOCluClf; "' ~ coonlr.... Nesllll. wnicn
conuols ""'" so.. 01 1NI ,nI8nt.formu!o mar'<el ,
tlIIS BgleB;I 10 o;orrdy ""'fIl Ir>lI Code's baSIC
~ ana !he .1lemabO/lal !lOyCOll 01 Nes1lil
prO(luClS lias ('fI7N been lon\ld
BUI 5<lIne manulaClUf"'" ~ fegaro ftlO:I ceee as
. . Unlusl~oed _ 1CllOtl "" I!lIl rna_no 01 I"""
0t0<2tJ(:1s . and .,fnngolments ~Ilv PIl'Sl5l
In OlIO IN _ _ penooj du"ng 1984 . Ihe Inter,...
loonal RabV Fooa AcbOn Ne!work 10WIl0<! more
man 100 _ 1lOfOl oI1r>l1 Code by 22 CO/l1PIlI1IGS
Il'lle1I dliler..... ceunt"es
Ac."", 10 ...courage bo'easI''-''ng ne",," 10 De
'IUPllOI1l!C Ily a _ range01 measu<es, M many
coumnes hav8 f<lOOOl'(eo:1 Wotl<Jng niOIh8r. '"
1l'lIl<:Ulat. fequl<B SPe(:IaI errangemerna if Ihey .....
to De atlIe 10 DrOOSl·1eBcl !MIl _ _ SUCli as
\lU3Iantelld ~!. end IuIy I"'Id ma l""'l)'
"""'" "''''''Il''''nents lot !lOme help OlIy<Ne
cenlres near !he wor k·oIece. 1IIlCl ..... :\II'lO bt<laI<s 111
01 b<e<ok lor r>J1'SIOg moll,er. dUlIng file wor lung
day ""fol Ihe oaby .. a _ <IIa . flC! \.eMlIIIo
r8eel'lV'f /flIIod..ced 1egIsIa""" pr<I"Iidoog Io! 90
<lays "" n",r"'1 lea "" end """"''Il laololieS al or
near me WOII<-plOOe
Many orllDf"~ lIalJorlDl a ncl I/llelhallOllal
N1"" pneo torces 10 llUIlloale Ihe <\BrI!P$ 01 rr-.IIl
S>Jbsblu1(!S NaIlotoai coaI,lIQr'IS to ..Olecl blea.~
ICOO"'ll tlave beer> esIabIi:Y>ed ... Costa Il.::a
Iod.. , Kenya. Malays>a Peru 1hfl_ppones. Iln<I
01"'" develoPing c:ounm"" AM 1IICSe orgalllla !lClRJ
"''' COIliu>Jrrg to play a " ,al role "' """"""..... Ihe
maf ket.-.g oIlnfanl lormuIa
 10 19SI , I I""-year campaign opiDst tM
promotitm of boule-fealins culminated in lhe
adop!.ioo, by ll>e World Heallh Aaembly, of tbt
I nlem otion al Codt of Mar uliq of B....._milk
SUbslilUl"l ( _ panel 11) . Sin,", Ibtn, IS nltioos
hoyt brougbl in leg,1 Ur volunl&/)' coda 10
P~I 1M public prolflOtiOD of b'easl.millr.
lUbsUlules and :H CO\Inlri,:s are cutTelItly drafting
logWloon. M ue b of the lIlOS1 blalanl advutising
hal DOW disoppcam:l and fDOISt COJll ainon of
iofanl formula now grry i bo: n>essage t haI 'brtZfl-
milk is besT' . Nest le, wlU.:b co nl!'Ok 50" of lbt
inflDl -fon:oula marI<e1 WOfld·wide, has 111-
llOOnud ill in lention 10 =ply wilh 1I11 Iht
Code's JI\:l.in provisions lind, in Ille 1984, ' bt
im em ationa! Nestle boyeolt ampaiSII bas bee.o
t""cd.
Dapile <his proems, Ihe infanl formu," code ,
II il hIS come 10 be knr""n, is st~1 nOi beinS
observed by 1I11 companilOl in aU COWllrics.ln 1M
lasl year, for CllIIIIple, (b e Inlemation ll1 Baby
Food Action Network b,as ~poned o ver 100
Fig.l0 Ou r.t lon of bre••t -feedlng In rurel e nd urb.n ere.. of Be ngl. desh
by Ig. Ind .dueltionl ot mo t her
ac
Mothers IlQEId 15-24 Mothers aged 25-34
_ Rural molhers
£>,.,. _ _ L..J_
s-. _ _.. Urban
_mothers
,...... _
violations by 22 comp,anies in ten differen'
counlries during on. IbKe-week period.
Sto pping ee irmponsible advertising of
breast·milk substi l ules is not co ouSh. In Ih.
pr=nl elima lt o f contIictina: aocW p tQ:Sllt<:l an d
BlOwing uncmainties, brcast-fccdina also needs
10 be promoted. For 01 Ibis poinl of balanu,
J'l'CSCnl kn owledge I bo OI the protection o ffered
by bmst· feeding -aad the d lllgen limIle oed by
bottle-fccdin& _ sho uld sord y be made Ivail,blt
10 III mot hon who my be in doubt _and lu all
IhOl" whu are in a posilion 10 influence the
llIOthtt's decision.
World ·wid., lb. promotiOIl of that kn owledge
""" now bq:un 10 plh... _nlUD\:-
In Ih. Uoiled Stat .., Ihe percenlag. of OIOthen
who breast ·feed Iheir babies from birth hal
doubled from 26'; to 54'; in the lUI d ecadt.- In
Norway, Sweden an d Finland , 9'5'; of an blbies
are now breast·fed from birth (0« pond II ) .
Mothers aged 35-39
"
[ THE STATE OF THE WORLD'S CHILDREN 1985
III tile Pllilippillos, "'" MiloiIay cI HealtlI II.-.
mm-l its pmllCllld aad is bLtiDa a utiaIlaI
a mpN, D ....... ..tio, .ek.isi<&, aad .poIlaI 1O
pu~ ~.~ 'J IIlpaiol'iIY. P'l~
or ..,pplyiq Will. formWa ill...,.. baDllCd br lbc
Ministry ia aU aovamaa>' bospilab I.IId balth
~-
In Brazil, over 100,000 health .....·k. n and
other ofliciala have an ...dcd tnininS ..:qj<mll 011
the promoI,on 01 brust-f«dilll Illd M,ioftal
~lnisioa Illd radio flttworb,. wdJ III; admtil-
.... ODd "O"'m"n;"",ion profo:nJonl k, ban do.
"',ed air u- and .....m wonh well over $1
milliaa UI the a mp"iIn in 1M II*'"' 0I _)'tU.
In 13 _ ... edlJl:al:icm abou. tn.l:.f..w., ill
lIO'W put 01 the IWIdard ICbooI auricII lam.
III lDdia, 1M l ooaumeDl hal ~ aD anti-
DaDa:011 tbr IIIIdftia& cI~.miJklUbotit lil a
aDd _ bit .,' ' ;' e radr 10 PI ll bcfm:
I
PwIj·uwo'
hi Sri l.atlb, . ..... ~ <;-. poip 10
pramIIIC ~ . r«diJla aad . bu .. aU 1dfttW.
iq vi iuflW fonaula ha bc:Ipalto • • 1M Itcq>
.... ia baI~fetdina: IDlI ..... !be: IN'idmor or
lnu!.foatiD& l'CIDll'WU 10 Oft< Jll'l' ill art..........
II lI udy of thik\rtft ban> iDto tIM: poom. l«'liofta
of oocicly ill Sri l..aab hal; shown thI, 7~" of the
tm.>.fed bo ~ .rnieYed ~ 01 norm al weiah.
gain after lh. lint ei&hl mon,ba of lir• . f ......he
b1biQ: ...110 had been fed on infant fonnuLr., Ih.
fil llt'l' waf oat y ~ III)' Ol'llWlionl in 0_ 60 counuin of lh.
In Papul N,.... Guinea, OlIO of the piOftCft'l of
\ePlI,ioo '0 pnM<Cl bfast-fccdin&. 1M iArideoa:
of lMlclk-fcedia& in PorI MOI'Qby has IxaI
rull11ClO<lrr- US ' 0 1n;.iIl rOUt 1ftI1o. Owr llw.
..... pcriacl, tht Ilwnber 01 .... 01 ~
lDIIaut ritioa bnJqb. to Pon M - o (,.mcraI
IIoaopiuIIlIJ bcea ""'"' daaa IaaIYal
b all oltbac: am . "1' -' hnopitolo ond _cr·
lIitJ UDils IInr: ... im.paruDco: w!UdI it om of aU
~lCl tbc " n ~t _ tIlaIl .Mod<n
.....
boIpiulo art aft... '.... dod . liIriDaof 1M bat
and blea __ in dlild ~ and ~ at III
<DIIIpk nidi jId ........ a ~ 10 mi n' '"
II>OdIcn wbo will nne<..., iDD<k I hoIpiIlI. The
fa Ihlt _ r IDIIcmitJ wtits IIXd 10 ifPU11.
-u.m and ilIf.llllS II binll IIld .llCOItnI.
•
batde.-fcatiIo& r.- tile lint doy hili ....... I .......
fI<tor in tile dodinr: of brast-f«dina: iII _r of
tbc
boopitah
de\tl,,_,.
ill
1OOrid'i citio:s. Mott ap-co-cbt.
mtJly roull lriel - both iaduarilliled
ODd dch::lopiq - hlw becua cblftpna: thoir $1_
dIrd roulinoo ta nlCOIlf'Ill. 'toomiaa:-ia ' and
breal-f....una: from birth. M Olt of II", kldina:
!toIIpiw. in Indio, China, lho: Phi.lippine, BnziJ,
IlOdooelia, aod Nicatqul, for UltIIpl., hi •• DOW
. b.ana:od 10 Ib£K pro-bl'£Ul-f....una: paUda. Aad
<It<: Con« ol lbo illl£!1ll00nal CoofClkntioa
of Mi<lwi 1OMiq; ill Sydney in III. 19",1w
affirmod -'" ....i , 4 .tl.bin '" N
rici, ./ .II -.vr. '"~...mu. __.._
"'-,-/oJ;
toW
IDIII - I/ilc ad '" ,;,i, ./ .u J-ma ,.
-""~"-
Lo Id"itjoo 10 tho: bnlth Ki ' Lts, lDIlly other
_ 0- - UC abo ..,pportiq: tlw . . . .ic.·
miaiRria vi acl_ m, odIooI prilM"ipoh , aad
lm::bon .., iaduIliq tbc subioa in lhoCllfrio:1ab;
~ IDd Inde vaianips .., ......... Vl
i11901~ in ... - ! Ib:w:It Ioa&er _ a-olIy
lava mel bella fIcilitiel for brasI..fccdiD&: • tbc
wuI<_pIIa; mditiauI binl:I utmdaolS aDd pu.-
gwodica! gff uc lod pina .-hen; 10 perW witb
bfaII-feodiq; tad ta <X!f'" witb t'OCIImOIl prob-
IaDI; DDaIRlunltJ cqlnintu'l, priau and 10-
I.lIttk IeIdm an Itndina: their l ulhority 10 the
campaip; OOlt-joYmtO>eltloi O<1anizltiool hi".
It1 up lit. I nl~ltionoi Bob)' Faod Action
NelWOl'k, 1tIId. up of huodrecb of pri""I. voIun-
worid ;.IIId -.amm', lrou~bay. Itt liP nllioaol
~ for ~-ftedioa: in !be Pbilipptnn,
M ohylia, K t2lr-, Triai<Iad and. T obqo, Pent and.
e-. ...
'!"be nen f,... run will 1dI ..bnber pramt
"'mpI;11II will 1 iD baltiDa; !be .....a of
battJe.fcoediq. But • ~ IDd ~ . uolicI
.... tbl tile dt.aap from brast ta bot:lk .,...
dolIIblot aod ud* tile rU. ta tile dlil4'1 1i!c aod
~.,.I M dear tbatho: 0 10
pn:!IIIOt.IlId prolIOC! brast-fcediac . . . YilaI •
_ y vi !be Olba Iow_ ...qin _ IYIi\IbIe
1O prolIOC! W IwIItb aod oonaol IJ'OWI.b of
dtildmI iD poor n:mmwoitia.
la IOclltioo, tn.t-fecdina: h2s obo been sbotm
10 be oa. or the _ imparunl cleI...miJunu cL
lhoI: ll'f'IlrIIe iIlla'n1 bft_c:a births, aperiotty ill
poor IDll nmII """,,,,,,nitia ( lia, II ). As aa
Ideq_e iIltel'Ylll bft_ birtllo .. .a, k-.. 10
be aucial 10 lhe wdl-beillll; 01 both moIber aDd
child (fit. i ), bIeaR·f~.IlI may be ~ tDOft
imponiUlt to hlLllllll health thaD .. cum:otly
l'eCOI nizcd .
But liu the campm l n to promote oral rehyd. .
tioD tbmpy, tlIl: Wllpai,sa to proI«I breUt-
f....un,: mU5l abo l'eCOIlli:a= thlt • 1""'1 dal iI;
apitI beinI aked of the tll':lCMr, Brnst·f....un,: iI;
nOl tiora)'l QI)'. FOI - . 1I\OIhen, it CUI be .
ptiftful, tirina, iJoooftveluent, IDllloOlDC'time:J em-
~ proo;oa II d II ncb IItW deal 01 the
lllOIMt'I n-, 1*....... ud frel>;lc:m of ___
.....11 IDll iI .a, I ',,1Wi1ioaal K1aI' .... tho:
_ bell' to caawI lhoI: pnlIecUaB vi bleaR·
f«diq; to all thilo1rea,
Im",uiuu..
Earlier th.iI year in Bd baio, Italy , I <mall
lDtCIia& was bcld under tlIl: lilk 'To Prolca the
World'i Childrm'. ConveMd by the necutive
hnda of t"" World H allh Org... iDtioa , the
World Bank, the United Nl tion l DcvclopllIClU
Prct:nlII1DIe, "'" UNICEF, itl pwtici panll ia-
duded tlIl: heads of llWIy of tlIl: ww\d'l .... jor lid
proIf&IDltICI, lcprcxtll.llivel from oktdoplaa: 111-
tiDol in AIrio:a, AliI ..... l.atill ~ plus
fOf1DCf World Bmk Praidc:a t Rolxn MeN........
Rodd"dJa' F..lN'Nion Pt ' ;la ll Ridla:d Ly-
maa, Uld: ~ ~ 6t;1U'CI froca lhoI:

"""""""""
OtaCO\llilia& tbac problCllll .. IIOIl a talk ror
-..at aIooe.. iDcRae ia .......-. sbare vi
-'dol ........"
A _".
"--,
or lhoI: I""$"'ll -.. 01 jnymmin..
• ooorId---' JlftlIUU1 r", the BdJ _ .
r-iIy food, ~ vi her W<ril.-.cl iac. <Old 1M IIOl"J 01 tho..,lf bel __ ' ni. .
chariII.& paiodI vi Ph i ......,. aDd braR-feaIiq, . '1 poIc:atilllDlllallll CJOlllribllliollllO c:hiId
art lhoI: •_ _ "" '1" " ) ' I by whido. tho
oammtIllity • a wIaoIo: _1Dd ""P""ially ita ...... -
MaI,h md chiJd IUI"l'iftll ;" the do; ' . '1II1Ollrid.
f oe I 'oW "- vi ~ $S, • c.hild QJ:l
_ be immtltliw .,aitlIt Iix 01 <Ix . -
A S .l l Influ.ne. 01 h r. .at -flNding C PO Illd dana:~ d' 01 child hood -
on int . rval betw1I.n birth. mcadea, lelmUl, pcnllllil ( whoopilll """'Ih) ,
dipluberia, polimtlyditillDli tuherculolil. But ill
19S4, Ita tllaa ~ of the okveIopina world',
childrttl Wffi: protected "IrU",t aU Of most of
Women not breast·faedWlg these infoctio", (fiB. 12), Tht mull il lhlt

"'! chaply pm-tntl hle did &n: bei"l tilowtd to

lliJJ 5 million )'OUDI children . )'ttl" ...d to luve S

~
millioa.tnll'" _ntl.lly '" ph)'liaJly dislhled (_
Wttrrl&'l bre<!st·faading puId 9 and fill. IS) .

"' ~
ClanJ. if lhoI: lult hctwem pOIential aDd
paf<Irmmtt could be brid&ed, tha< immunin..
Iioa cauId tW ill ripthll plM>t • IDOIlIer

J powerful ....... 01 pnlIiIC'lUtc crowina doildrm

apiQsl the won:! d!ma 01 po¥mJ.
A IfUI do:al 01 tuonn. -.do ... 11...
COOCUltmed 'WI I""" ••_1 wtlidI C:u< help 10
""fuc.
m:ab ...:cin£ItDOft widdy .....u.ble. ADd 'WI tIIiI
&..u, tlxre .. oJ.:>......-1O rqoon.. Man: heal·
Rabie """';"""', btner UId d1apeo- mahods 01

_.."--_...._._-_
- ----_ .
" -'..
_- ....
1Ic:rililiDa: eqoipmm., imp O",tllllDU ill Cllld-
chlio ttrl"">kcY, md 1M do;,dopmr:II.t 01 cc/our.
clsante indic:llllR to tDOlIi.'"
!he p<l(C1ICJ' of
.-..:dna, have aU matk it more polISible to mu.e

"
I THE STATE OF THE WORLD'S CHILDREN 1985

India:
creating the demand
In lhl! IaslIWO yea",. ~ III toJncIr_ o!
lrld"'" Wlagss _ _, lIIal irMl,on il ati(ln 'ata
~. ee lITIITlU'IIZallOn r81eS I'Iad I:/OIIOl
UIl more '!'Ian "'!oId, ...., Ina campeogn oroan<Z·
eat! be p.JSIwId uP from ...-.:let 1O~ 10 80" l>' ersIl8d Ieemed some ~ n, 1osaooII. New IIle
JlIOI8 al tll!aUYely low COSl and '" a ,ej8tlYel'l' """" Matf1ya PrllCleSl1 S\Ir.e _rtoenI !las t>egIXl
""'" "nd III _ ~, $l.I<X:flS$. r.a. ~1I"I)lld ...te«I"'Il t,.., ~ 10 COVlIf none more
on ~ Ina1 Pll/en15l11'1de1Slarod the oeec 101 Cll5tricts in ee <Xltl1InO year and tile entire stete by
"acdnatlor!, 8M on 0/QBI'"llng IIIe "",:eInal>orts 10 1986
llOYmiI WIlh !IlIl JI'ltJ!JI'IeS of daiI)' 1iYn ~
A si<nilar ~ lIaS t>een "..,..,led in 60 0
In Dewas d;Slrd 01Madtlya f'la(lesr ., imrnurvza.
hC>:l had been _ ' b _ yen. 8ul """"'" 01 ~ stale. where imm.n.:t.olM
...., afSQ ' 8\0_ ' bill only 15 % 01chilclren_8
rd'I 2% oA CI'!dO, et' were P'OIecled i IQ8H'ISl POho
""" orIv 3 5'1> II;)(!,~ d lptl""" .... perlu$$I$ PlOleCled. The campaign """" based "" !he
8M tel""'" (OPT) """,,.nation W,tlli n a yeat , a
l!XlSbn\l hea/Ih oen~es. But ~ <!Ill I'll! stoo \here .
~ .. 600 WIlIgeI" tlad ,_ ~_1'9'Jl'e$
NtIO ~ - . . """WI 01 ~t . looaI
lO 75 % lor POho 8M ~ 1'10 lor lui opr ptO\8CPon
famitY planning llSSOCI8tions, non-goverronental
"'lI"'lizaoont. !tie Me!floclt$I chlxcMs. ~yll
M '" N;geJ", lsee panoI6), ~'was IOChie- (locBl 1/Ol'. " ' Ol!i ~l memberS, IIle ~lr_
I'll<l lXll~ by 1O'lCI""""'ll "'" iII<:erIINe and ,~ nul! olticer), the mallila mar>dal (village women·s
1M <lifticulliBs. Fnt. PQfenlO _e enlllowered WllI'l ~lions) . sc.Mo:~. arcl ll>e _ _
ee ~ 01 wha l llllll1l.<lllll cOO /lC:tloo!'o'e wadi "Ulcers 01 thII programme b inlll(lr811!d
Newspapers, 'adio. posl...... _ , O....-.elS, pro- ChId: ClevolI<>PmMt semces 1_ II'IIIeI 4). Films,
ce$! <)C iS. car~. and <IoOI·_lOf"';'S by ~1IIl'i, sII<llI _""""""'" ., local
COITI/Tllnty ~ lYOIIg!tI tho " " _ 10 all cinemas , l""""ll public """'esssys1eml- ". .......
~ Pl"l"l BOOUI ............. lJOn were per- used to ink:>'m pare<ll$ of ll>e ca<T¥><llgrl and its
tormed on ma'~el-daj'$. Ano;l '"
ever,. viIage , IIIe t>ene!jlS b c:t1ib'0l'n eoe IWO. The daY DeIore
~ or '<iIlIOB crietli beat ...., ~~ each Immunizal>On 'c&rl¥I., ~ hOme was
_ to ~ IIIe message AlmclSl evetYO'lII
Decame invoIvIl<l - _ ptOIessoorillll;, drsl<icl
VISIted by s _hh _If.
0< la-rily Illanrinll
_ ... or rnah/le _ I member. or !ICIIClOl-
ault"oriues, WIage leaoer"s. _ ~_ . schoof.- 1_ . or ~_ . 10 remn:l parents
leac1"o11f1, Rotary CluO memtlerS, vIlIag a volunlOOfl1 IfIal 'tomorrow was ee daY'
8M par""ts _
Four Jrtn./IlllltlOO dayS were lleIO Iletween
To fecluaIlIIe 0'" _ , a.... 25U otI'i<'J'IInZa. 0IIcernber 198 3 ancl MatCfl 1984 The """llI Ms
1"'" post. were set uP In sctIooIs. le<nP1eS ano
POilinII _ "" _ as '>eaIIIl ~~"' , so I"'" been IIle p<OIecllOn 01 95% oj children "O"'nsl
1Ubet'CuIO$IS, (1IpI1lh6r1a. ~ oougn and
lew m(Ilher.; had lI,I tra"'ll mO/ll!han 000 ~ oIDme l , e
~~
Wltll l!-. cIIoIcl rOl1he h<sl JIlOIr"O:l l!'to. o<gan<llltll
a-POCte<! M ,OOO cnilaren: H ,900 t" ' ne:l UP s.maa. stralegieS !>ave abO _tid "' Delro,
8uI a map ~ lIn!I<>t was WBllil1g III the _ 8 pupoet stlOwS, barlllefS POSlers and ~
""'" year only 11 ,.00 cNd< "" _e to'OUgI'l1 lor .....alr»:l an ifmU'lilallor1 eatrIllllign _ US«l
IIIe Thold :sllOl 01 ~T vJCCine Ooe l<lasClll tun'IOll the a~' ~ and other stafl oj the
0Ul1O ee lIIe~ 011 oj pubI"""t al!<lll!l. And PlOO'amme for WiI'9"'le<l CIolc! ~ s..
tl>c organ ",_ IIa<1 aI$O OV<lIlOO'<ed • ""Y lact <>l """'" in p(lOr corntrIU<'lt... to!aIling nearly a
l<Ia ", lJI:wil5 In FeIl<U<Iry. Ina monlh ~ ,.... QUelteI 01 8 moIion people, in'lmt.<slaOOn rate:!
!he I!\Ird .........""at"'" KIUIICl. mar»' 1>e<lPle _ have been PUSI>I!d korn 20'1\ 10 <WeI' W %, and
_ seckJnQ eeaaonaI empjOyrnen1.n t/T<I sugaI the suategy I$l>ElIng llJD/lClllod "''''''''' ....... Breas
,~ -by~

"
 jm",,'n;";'" .nillobk 10 IIIOl't JI'<IOI'k. But bof...., IonItiJIa • l.hiII daDml of lbc dliId
BIll 1M *"p bn_ .""°im;"'1 potaltilll surri'l\ll ft'VOIlI1;" • it bePns 10 J O ial0 tctioa, iI
~ be unjust _ 10 pal ialO C'OIIlal the lo'w
ad pcrfOf1D&DClf wilI_ rbe bridaod by.cduwl-
lou Ill....e. For <h= is II-.lua. ~ lhIt lum -out ad .blell ~ riles ni ......r iaImJ>.
e¥aI widertiq 1M 8'i'&ibhility of YICcilIes . . . oiutioo ampaiallS in 1M d~1opiuJ 1IJllrid.
illd f, lIOC ea<Ml&b. In moll indUSlriaiiud oounuin, a baby is
Bluntly llaled, lhe Ill ... ..,niIican,bra"· pBCtiaUy born onln. tonveyor belt of immuni·
lhrou, h ;n knowl<dl e .boll. ;mmllnW.l;oa illhe lIllon. E_o:ry birth is rqiste l'ed IllId Cl'ery child',
realiDtioo thaI prcKal lmmunwnioo "'1I:.oouJd yacc:inalion record isOIl fik. Heallb viIi,on call on
,=- .bou.
be doubled, IDd ;n maar mbl<d, if pum ll
loa!< Id natlle of tritri.., immuniDcion ~
IDd if tbos<: .. ho bto<iI.b. tlK:ir dliId for the fint
immuniAtioa oren: Il1o 10 lum up for the ICalOd
Ihe n mo<b"" 1\ II"" home 10 mrW>d her
nccina md 10 mlkc hct .ppoin!lDCrll! It
bealth cIiniQ. f vcry .ppgiptmenl cndt
tppOiOI....' for lbe MIl.IUIC of imm" "i..rion
in._
Illd third in~ 1Il III Ua.mllo'"rion am-
...... in Arm U>d Asia ~ by WHO
bel:-.m 1979 Illd 1913, lOr ..... mpk.IM .......
drap-auI: n1e bn _CUi lbr 6nt U>d third 'Iboa' of
OPT.,.,.,me _ ~ . C!'J' (fit.. 1"4 ).
' Ill _ OW ... .. """dOte _ ........ questimI
of ........nd • ni a pply. And if 'the ...nd"1
I'Ula! public ball1. IOOf .. 10 ploy ito ~ •
lo'w _ pruectioa ...........uuitio-. IDd _
~ - ad fttlfiJ ito pcMmtial for briD&i"I '~'
redactiorl of up 10 -.bird ill 1M !lie of dQlll
aDd diIabi1ilf """"& !be - ' d ' i chiIdrut _1bm
""",,,II mllSl be mlpow'm'd .nth 1M inf(lmllltioo
10 nIIb: "'"' 1M Iheir cll ;~ ~ immulliud. NlA
And by mealll of o........rk immunizatioo CIfD+
paialll, that is " hal rowllriies like PUislan, Indi.. TETANUS II
Niaeril. Colombi. IllId Bn~ J ~ oow bC'ginninB
10 do.

- ,".
Frg,1 3 Percente ge ot c hil dren imm un lu d In t he ti...t vee r of lite

~-"
." I·

." .
... __
-_--"".,
63

_
_OPf _~PIo

- ----
BCG
-
,
- ...
....
Ilpn
_~"''''''V1_ 1 _ _
POUQ .
Co ""_
-.....- b <nIIriII
_ ..... 11:_ 1 "
_
i ii.ido
MEASlES·
1IO _

0 \£0. ....
_
'"

"
I THE STATE OF THE WORLD'S CHILDREN 1985

Matlab:
providing the proof
In lI>e Iow-lying, /b:Ickl<one dislnc:'l 01 Mallab. Wheo1 lmrTII.nZalu1 8fll ",al >9hydralJon _
ElarIgIades/I. 9CWIt1SlS al lM lnternalionar cent,,, ~ e<:llogetner, lIIey carrie(! the IXIIennallot
"" Diarthoeal 00seaM Re$eareh hSvol been pre-
_ung dealhs from 0!¥fIl08a lor more {11M
curong ",tant morta,1V by as much as .0"',"""
mo<IilI"Y amongunoer·1rYes l7V more ll\Nl a ll1ii'O
!wen"" I'M"! 81 trIeIr l,eatmam cen~., "' Manao
E....oenca KI SUPPOI1 some 01 _ hvpon_
Bazar They have also !leefI SIIJ(lying e/langM III
IXIQ<JIahon growth sn::e 1966 Tho, name 01 was coh::le(l oYe< me ~ l/l<ee years. !rom
.... tlab ., tl\ere!ora """"""' lltJ"(lng """'~ II>e ~ 1917 to 1981, wI•.,., . t>ultfland famoly
I'I<lIkl rNeI as one at lt1e most cloo;eIy SI\IdiOO ~ programme was .....-..:tIl')( " one ar....oj
ar8a3 olll>e ~ W(lII(l , Ma~ wil~ • popu!aloon 01 9 (1.00 0 A _
Foekl clata cde<:1e<l lrom '97 5 10 "' 977 to.R:l
POQlIIaUOtl was usee kw" c;cwTQ<I'loot\
lila! Cl\j(Jren uroer IMI '8lXeseI1ll1d onlya SIll'" at Tile progtllmme's field-wor1<er.l readied 80% oj
Mallatl'S ~lJO<1 oJ 260 ,000 tlul aceournec lor women 01 choIcl-bear "'ll age The ",Ie
oj corwa-
mote I!IlIn hall01 aI oe<IlhS . One Child in f!Ne<'I foul ceptt,oe ......, otigonaIIy 7~, rose WlI /lin eogt>leen
was (lying ll8fore lI>e _ olllYtl
monthS lu " Sle3CV 33% T8\ar'IuS irronon4a_
WMI cIkl Itoe l;!ltldIen <lie ot1 Oooe the , _. 10' P"»lnan1 women was "'fOdI.<:ed Ie"" on, "
chers hOO W<en If\Io a<:<XIUr'l tile livEs saved by Jun8 19 78, b\II made sIOwIlt nea<lwav l.>8C<l\IS8 01
lI>e Mal.a O 6al:ar trea m-I <*ltnl. 1he1r '9Jres me ~ . _ . '" """,,,lion dumg Plegnancy
'......1IIC 'Nn 1r>1_ on I!leo' hrsl year d;1<l pnmariIy lle'o e,rtiG/8&s, by me erd ofd'lutudy period one in
at naooatalletar>JS. wIloCl1llmlUrl1fl<llor 26 \, 01 tmoe ptagnanl women M<:l btlen V8Cci'18ted ,
deathS D>arrmea. lever lIJICl _8I01y .,1ect>ons
TtIB eIIec:lS 01_ two measures <licl noIlaI<e
eaUS8CI anolller 26%
lonll lO ¥>ow l.l'I By lele 19 18 and !hfoJglloul
Atnortg !he one-lo-!oot.yeaI-okls, oormooa 1919 _ 8 _e consG~ tewerdMtt>s in the
~ U 'li o! deallls. Measles. """"'" also sMIy papuIa,oon lIS e _ , me cn.Ce <l8a1h "'18
e<n:enlraTed ~s ravages in """ ago 1II'OUl'. DC- kID by 2 1'*' The tIinh r&lUISO 1eII, tJv 21 %, 1036
COI..O>1ed tor" _ 13 % 01 <l<ralhS F""",. """ llo'ths pet 1, 0 0{) llOPi.Aation eeeeeee 1'0111 46 pet
,_alOJy ..!ectlons koloa a ~ " 3% 1,0 00 .. the compatoson lItea
FtQm mese grim logures, 1he _ C"'ltllmcweol
on 1Q ~ ""<11 moasvres o;ould 00 _ to Mo5l "'Il"'hcam '" all, the ,,1at1l ~ 'alll
began 10 lltOll1lY8t'1 beIote the teIaooS sho1:S I'lIld
red""", tile <lealh 101 Clea<Iy,........,;z,ng moth-
_ inlt<X1uCed By 'roe end 01 me SIUOy ~ ""'"
9l&-(().OO aog:ai:'lsllet>nlJS. WOI.lO:l have llle O'OOtes1
irrIlll>Cl . toIowo<l try meaSleS vacona;oon, Wtler\ lallen by tl 'lb. a""'8QIIIll 103 "",""" per 1,000
~ .00 IUberculosis . "",, :ina lion II8d
m birlll:l " the p<OI"Cf lItll8 " CQI1l1llSl to 116 pet
1 ,00 0 in me cot,UoI at"" wten ,he mot:hets MIl
~ IIOded 10 lh11 Ii$l,!tIe r~,ooncl\IClIld
r>a<:1 war<l!; shots du'ing pregnancy. imam
Ih3T a ba= ..........-.zolJor> P«l9'''''''''''' cooJId pr. II)' was 'S'lio .... IlIan for " lam. _
111M.
moIhe<$
><en! 25.., 01 allc!Wdren's oeaths DeklIe ,tie llQe 01 ""'" .......... _ immunil8<l _ in tile yeats """"
~
thaI h~ ~ 01 me~~ h $rid ta<Nly pIar'ring
They also ca4Cula1ed !hal _build orlll prograrrmo in MaIlaO. yeatS in wI'Iic!1 parents have
re/IyOIaloon l!lefapy, tlaCked up by J1Uaveno<JS grown mote CQI1k1enl mal II1eot c'"klr8n ...
«even! ,_ /rom
,-
8""""""'1. COUf(l 75,*, 01 ctlid SUM-e. _aoa !a"",! StU is now two "",""on
less mar> when the P10\1'arm>& began

•
 Fig.14 Coverage and drop-out rate& A missed .ppointmeOI D>UlU I postal mninder
In OPT vaccination p rog ra mmes and rq>c:lted Ibsence IDCIDI I fum" visil fro",
16<""'" _ _ :lO ~"" pogo.,..... """"l lhe hc:oJth ICJVicca. In the N<'IhcrlIllds, for
HXl cu.mple, I compulerized syltml lnCQ eva)"
11 ., child'. immllll.iz.otiDII ITIIUI frDll1 birth and lUll)-

l:
"",ticalIy SCIld' 'he I ppro prille mninder to all
par...... until all childrcllltC fully immunized . A
hiah level of ~Icn.cy, &ood roads and chco.p
lflImpon, lwarcncso of the value of vaccines - all
!60 1m. llIIOOlItt inununiulWn', patb. Even $0, the
proponion of dliJ drcn immunized llIaillSl. measlco
~ 60 in New YDrkSllle, fDrcu<ople, did not rise l bove
0"
~ 30
the 6S'll. INrk lUltillhe 19701 wben lCflislalion ""'"
iDlroduecd to Ihe dfCCi that unvaceirmed rhll-
drcII would 1>01: be rqislCl$l i.rJ primary leboo!.
- 20
~ 1O In 'he developing world , immwtizatioo is I
diffel'Cllt story. And I, is not bcauoc of any
~ 0 gl'elller cardcssocss thl l I child is Dot nccinaled
tst 2:nd 3m wbco immuniulion is lhcorcticaJly Ivailable.
A UI """"'" '" 11'0'00 0Pf """,","," .. ~ ' .. ,
b <mUll)' aglIi-osl ~ f,,",-- twnooI>o'9 ~. Pcrhllpl the mother h.a alrudy taJr.co lhe child
~,- for three iotmllll.iz.olions.. But whCII lhe bohy is
...... '!E,"' <hI<Yef1 ~ nine IllDIllbs old, she hao 10 decide ..hether 10go
- ""'"*"'-
,'" f.,..._ "'..,""'......
~.,; __ _ - $ back yet again ( usually foe mea&lco vlll:cioe). She
,..,. S ..........:» •• _ ' ... _ has hcco told ' be OIIlIht to go. But ohe docs nOl
WI __ 3,." moo ,,... '" kno w why. There wil.'l a not,,,,, in the clinic, but
wo , _ ............. _

-
,.., _ SiIIO _ '" _ obc could DO< read it. No-one II'OWId he. is
' ......_.. . ' ''' '"' _ T~ encouraging ber 10 go, bca\IIC no-on e _ 10

-
'toO --... ."" .... ,... ....
Jr.now anything more lboul illblln she d-.. Her
' .T
,.,
, .,
,.,
'...
'..
_....
~ o:-~_
~
t~

., ...
UA(J... ..,
" ' ' - - .'"
S:JO, ,...; .... ,,...
.,..,.,,,
.""
"""
_
_
"'"
,....
wo.Jr.ing d.ay ,,"m .t he in , he mornirlg and docs
not end until ohe gocs 10 sleep II nine or 'co
o'clock I I nigbl. Going 10 tIM: dirti<: willlllW1

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

finding _body else 10 do her I'I'Ol'k in 'he bome
'w _ """ _ ""' '""" and missing I whole d.ay irt the fields, perhlPS It
'..
,..,.
Go
,
_..
_ ..
~ ''''
~lI\
.... _
6"lO .... . .
"!'I'
the busiesl time of the yur. At nine IIIDlUbs, tb.

..... ""'"--
..'" """ child is jUli '~lIirtg 10 the Iwkward "Ie wben it is
'w __ ..'"
". 100 old 10 cary I.Ild '00 young 10 walk. The d irtJc

_.... -
/OIl. ",", ...

..
,_ ..l'II. ,... -, ." ....
is 4 kilometl'Cl .... y, IfId there is 00 lIlDI1CY fDrI
'. _.. 30111. ..... .... ....
bus fltC. Besides, last rime she walked alllhe way
,.,
''oo:!
'W3
-._
~
_
..
~ ...
30'" '...
,,"".... """
,,"" . . . . . .....
.....
,
to Ihe clinic she had 10 wail in line fo.... hoo, and
I half in the IUn with oowhere 10,; , down . When
,toO
,_
lloo 1" , _..
,__
.."" :1601 ...._
. -' ""'" il"I
,he finally got to the f"lo" the yono, doctOl" had
'.. 0'."_'' ) I""
hcco rude I.Ild snapped II her wbCII she "'Jr.cd
,........... ..,'IIi __ ....
_ lboul the baby' . rough. She had felt humi..lilted.
tW3 " It~ ... That evening, after she got back, the baby bcgl.ll
Tho.....
Nola: cI 00M ~OO ~ "1lI tu CI"1I
SlI!lllII sil&.....
_~ ,A1"' .,..,_ l'IlIlIling • fever I.Ild cried a1ll101l the wbole nig:hL
They bad said thll thaI mighl happen of, e. the
_ l'*"
_.., _..-
_ _in _ _ cl ile.
ottn_InOII' ,_ "'_ _ iojectio n, hUI all of 'hcln uccp in one roo", I.Ild
_
'"".,.. '
_ ot _ ,~

<l,'-
...""...._ ber bwband had lOll! his Imlpcr I I being Ir.cpt

"
I THE STATE OF THE WORLD'S CHILDREN 1985

.WIIke. Now, the child IleeIJlI pcrl«:tly ",cU, and Taking I<!van'llIe of IMsc: IW<l main lesson. of
'UR'ly lhl'tt in;«tion. is cllOllgh? m:et" ""pen"""" immUDiuliem COVUIlIe CUI ~
dras,icaUy inaeaxd in a vuy slIon time, and al
And $0 th" dlY l ots by, Lb. IpPO~~lment is
misled ..,d uoth« child locs unprole<ted. wry littl e ex,ra C<JSf.

If yllOCio~ an! 10 play Ibm . ita.1 pan in Fi~ .15 Nu mber of deaths from
,"''''ival

.-........
bringing lbout a ,,",oIutioo in child and s e ected vecci ne- preve nt e ble d iseesas
d~JO}Jl"""nt, then immunizauGII must be lD3d.
l vaiu.hk in pranice and not just in th.""'Y. And Eslima1ed IInmla! dealha
,h.a' means t aking into aa:ount the p'O.eJ1y of
circumsU.IlCl:, Ih. lad. of infonn.ilioll, and the -.....". ,~

,~
unfli . burden of wo,k whi.oh dfrnivcly deprive
many women of th. power '0 pM)ll!C'l their
childrm by immunization.
In Pf2CIice, this 'slICk' between I va.iIable ,,,, .
-
,_m
~

"""""
.,
~
,~

"
=,~
,ro
".
' 00
00
00
ea
,~
~,
~,

'"
--........,
manlution sern.:os and ,b. proponio:o of chiJ- ~ ~ 00 ~
dna anuaUv immunized can be taken 'Up in \ 10'0
em.powmng """" "re '""eo "
~ '"
ways. Firsl , JW'toll with in:fonnation ~
'"ea00
""
~
>I:'OUI what immunization off"" _.
~~uction of
"za" ~
eo
""t.ar
"' least I quarter in the risk of child d eath _ ""0 ~
~ ~ ~ ~
inrn:... ,h. distance which ""rents an ' '''p'''mJ JQ
"aut. Second, making immuni7.lltion ."ailable II
limr:1 and places lOOn: convcnicnl 10 wtlrkin g
~
~
....
,
eewr
"'",
er
00

"
sa
.. .
""
"
n
""ec
""•
I'fOplc <:10 ud= .he di.tana w hich parents IIMI
as

- •
m """,
Jo t"""l. Both bring immunization nearer.
A' ~1La&io, th~ u... tegics Weff .ummed up
~
_ ,m .. ee
" ~

by the . 'pl'ric""ed vok<! of Donald Hendenon ,

"to "" "• •ss ""
_.-
~
nnW Dean of Ihe Jnhnl Hopkins School of
""'" ce
••s ."r
sceocco
Hl'gim e and Public HeoJlh and formerly dlreclOf ~ " " ~
of WHO', . utt<:Sd"ul smailI"»' camp aig,,:-
~Nol "'rfirisUII is 1M foci 11141 1ll<UUp,/ llIrtWfllioPr
COl 0'>0/1
,~ ,,• ~

""
,- " ,...
--...-
prtIfTlI1fI' 114"" ~~;rd II difftmfl "p,fI'Qold i~
~ 2.1117 ~
prwidi"lltrllica 'M~ l1unt rorrarneJ teil'h cM"" i""
;n'....... 'itnu. Sud prtIfTlllfU ou CM ' IJCIniud by
""" pri",ipk" (l ) 1~ of 'M ....".", 0 1 II ,~

"""""''''", itJ<lIrion IItOT 'M raitk1tC~ of ".~ >«ipi- ~ '" '" '"
OIlI 11M " ' 0 """""ien, Ii....; (2) A<I;""
fq.ns ""'*"'" ow.
pm""'limo of 'M «rna Ni"l off-11.

--------"""'
kWII... ;1'''"IIIfW'iorr, f01u llmph, ir /mnlfhllo 'M ._ 0-""......,._"'.. _ .. _ ...... _ _
,esiIfnI" 0'11 Ii"", 0/ tilly "'.... fli ll4gm " .. "'" in
.........
lill ~IJJ '" "I'M """_4 "cu p", ,,,. by \lOS 01Il1O..
__ ""-"",__ , , . . _n__
• _"".......- O>l:JWIt<)._
if <II"'........ Cmrrf1/lrobh mIIllf "" ,,/;/0;1ld if
"""'''n rion is offtmI 01 ""'.....""1 1I...... ~1y
pa;nlf h;"~ ..... ",>I 1010 dirlonl ~i ''''1 ,Ire <_
-----
..",., *"='/Ofil5'll> . . . . . iIC"l> Of _ _ . .

__
"" "'lJVM'O-..ng
__"'..._n_..__
pmVII'" is lOt/I fIr¥IIniwl llM fmNIWlttI.... R'mII'''' -

--,---_
"""'---- ...
....".,. """"'" oj _ ........... '" ""'"""""" _ ...
~ .

bly ifitif kwh of o<Uplll"" ifarJII "-' llLifimtd

",, - oJuco,itmal 11M f>TO'ItIIIiaMl ....rW ......
Iwn i.....,;lfII ri...."
 III th e O wo area of Ondo sm., Nig..m. for
mmpl., the attompt to p UI lhis Iulo..ledgo uno
pra<ti« Iw q uickly doubled 2Ild redoubled Ihe
tlte 01 immlUliution .. hiIe, ocnl2l.ly red ucin g tho
COSI per child immunized <[Ott pano l 6) ,·
In Indil, simiW Stra tegi es = no" being used,
2Dd ",ith reDW"u ble SUO:<:lS niles, in the smos of
KarJlatm 2Dd Madb ya. I'lcadosh, and in th e city
of Delhi itself (Ott pIlld B ) ,
In Dc:wu district of MIldh)'ll Pradesh, three-
quane.. of ill chiJdttn ba... been proIecl.ed
qoinst polin 2Ild oImost hol f q ainst diph.beria ,
"'booping eo UBh and let 2.0us, in I CIllIpaign
", hich is now to be utended ' 0 l.h.. o n li ~ S1.lto by
1986.
In a similar eampaign ICt'OIS 600 viU"IOS of
KamotW tlUl yar, %"' 0'( ill the childrm have
been proI<Cted "loin.. polio, loben:ulosis, di pb·
theria, "'hooping cough DLd tet - savinll apo
proahna lely sao
lives 2Dd p reven liq <'$Ii....ted
30,000 oases of Sl:rious illJ1,:ss or di..biUly.
Also in 1984, similar ste"egios blve l one inlo
action in Dd.hi via lh. Pl'lllITlrDll'l< for lnlegroted
Child o...,lopmonl SerYi<:a (II« pIllel <f l. .In
poo r coaununitles uullin.; n....ly I quarter of I
mi.Llion poop le, imm uniuuon rates have beon
pllSbed from jllSl tll'i to ","er ~ of ill ehildnn.
Similar I mmps .0 ntoI<e immuoiutioa uni..,r~
sally available .... no'" pla;nned by SI:...... I S1.a'es
including HiJ:JlKhai Prade:ob, and by th e «nmJ
govem mem in 30 other dis.trieu.
In tho Kalor district of lubl, Sud..., the
proponion of under-lwo-~ ar-<llds (uUy protected
by immunization Iw ~ from lea l.h2Il 10'10 to
more tbalt ~. In l 2llU:UY 1984, l ubl lown
colUlcil docidod to extend Ibe campaign to th.
other eig b. districts of th. ,city ( w: pattd 6).
10 Zimbabw e, promoting nation-wide ........_
n... of immlUliution through radio advertising
and th roUBh popular folk '1OOi" by rural groops
• em... Ii",d ..,... or< """""'J io "'""""- ","",e;,,,,,,,,
...oiJobl< """""" olo< ~ ot<I1i1,J m>..,oaiIJ 1=......
.. _ .. 1,DOO. tD<ftOliq "'" ~ ' «
"","bk . . -
"'" 1IIcf<f<n mlua: 11>< """ p<: ,:bild . prime--time lell:vision. Eigbl S<pUlIte advert;'"
1m hel ped 10 more Ihan doubl. immlUliutlon
I'Iles from 2S~ in mid-1m 10 S2 ~ tocLay.
.In lesotho, simillll' campaigns run by tbe
ma tern.al 2.Od child health services blve raised the
JIf'Dl'OlIion of childrm protecl.ed by immuniaation
In over m for tho: siI main T.iIrlI<I diRases.
In th e Gambill, more Ib2.0 80!0 of all ehildrcn
~ now immunized "Iainst III sU; diseases eo v_
""'" by WHO', Expand«l Prnsm on Immu-
lliu.ucm.
In I'aIciSlln tho " = Im ll«l Hcolth PfOlll'llt1lJ>e
hal boosl ed tbe SJJ.pply of immuniunlon th,ouSh'
m in= _ in the number of immuniz:uion
ct11t..... ICt'OIS the eountry. At the sam< t;lU(, •
ItWI modia informauon campaign bal I!so in_
etnS<d tbe dcMnd for immunization. " her o n.
yur, tb. proportion of Paltiu Ul', childrtIl fully
immunized Iw riS/:!1 ff'O<11 I... tbalt S"' 10 lDDre
Ihan 2Sllo Ind the eampaign is now ~kdy to go
close 10 ill larget of full proI<etion for SO'Io of Ihe
na.ion" ehild "n by th. end of 19M.
But in l.h.. .lis• • v..d ve lDDrum, l.h..larg<Sl. oflhe
lle_ yle immullizltion cam~n1 bave beon
.soon in Ibe two It>OSI popUJDUS natioos of .he
Soulh American conti n.nl _ Bruil 2Dd Colombil.
Last year, the Stau of t~ W.....Id'1 ChiUl" "
report rocorded Ih. '""""'Sll of BJ'lzil'J National
Vaccin ation Day! ....hich have virt Ol.l.ly wi ped ou,
poliomyelitis IllIOllg Brazil's 19 million under-
lives. Thill year, the campaign has b«n dramati-
roJ.Iy u'onded 10 include vaccination q.oin",
diphtheria, wboo pin g eoUBh, lelan ... and mas1a.
On tbe S2llX ' wo NauOl1ll Vaccina.ion Da)'1~
l lUle 16th and A"illSt IIlb -a l<>tal of 4300,000
volun leers "lain manned OVe, 90,000 immuniza-
tion POOIl ""...... a COUlltry larger th... WQt ern
Europe.
Those 90,000 vaccination p<>SI.I. 5e1 01" in
IIChoob 2Dd eommunily centres as ,,-ell as in ,b.
dinics, d~ly redueed th e disl2l>Ce wh icb
paren ti bad 10 tl'lvel. Al tho wnc 1m.. a m2SSive
public: info rmation campaign mad e sure thaI
o.ImoIl ill parmtl in Brazil kn....."'bero 2Dd wben
:and why their chiJdrrn mould be immunized.
Four man TV videosW<rc distrib1>t«l by "1.I~te
to ill local SlltiOIU IUd . btI"", 12 Ii""", I day on
"
I THE STATE OF THE Vl\}RLD'S CIflLDREN 1985

China:
a generation ahead
In reoom yoars. _81 .1l8rrlalO::naIIy SP(ltl. aenyot"ShOtl Ilul rt ~ be wrOf'lll IOllSSUIIlEllhat
SOfed workshOps No"" _ l>eId Ifl 0 - It> all CIIinolse moIher$ use ORT as a traoil>l)nlll
pr«note coal reh\'Orlllion !tlo<aPY lOAT) in !lie """"ll!y In !<Icllheongln$ ot ORT _ 10 \10 b<IcI<
c<:UllJ'y """'CI\ II<lo.JSIlS a (JI2I1er 01 the WOI'<! 's 10 a _ ale ""I 01 mass·p<omo\O'l _ tl8S
",""'en The workshOps, N!I<l "' hOi!CltalS. 'oI'$rfI naw _ aIrnosl tor\lOllM
alle<ded tlV pae<,llalllQilnS wIIO werey srog I/\lIave-
nous trwBPl'lIllleallloalmOMllle!ly\ltaliO<l The SIOIy bo9ns lIS to.. _ as 19 56. wr>erI a
savem flllo<lerOC 01 "",rrl1ooal dlSi/asa 01'91'-
"'1 IIllOUI lP1aI lime .. 1919 , survey resutls _ cI>*lren's t'csI> lal$ 111 8eo,ng L""krIg
begllfI to come in 110m S/'IaIlQ/'l8l COO"1'1 S/'IClWl"ll me Im" ",enDUll laciI ilJ8S ID coPe, Cnonesa ~
atlhougll d llWrl'108al <Mease was <::<>mmon.
!l'Ja1 ~ ... 0<31 treatmeo1 USIng 1 _. DI
<lealhS I,om de!lj<lralO'l _8 not At me tune no:>- sod,"'" ana PO\aS$IUm _ 0_., wa lel

M_
""" cou:d ac<::<l'J'l1 lor tfl<S Iir<long, wndl flatly
contta<l.cleCl !he , , ~ 01 ff'IO$l de>elopioOS .... "" DIll1 reIl\'Or8l"'" ooIu!lon, II\iS ~ M1
"'ll<1< wilIlOIII glUCOSe 0< sugar Bu1 th9 doc\OI1;
In 1982. me Mrilstty 01 Hea~K beuan ~
found """ ~ mol""'" IOIIWleo"y _ I""",,,
"'" sally solInDn belD1l! g>Wlg II 10 me.r dloI<lr$'\
wllll UMCE f 10 PfQm:>le malemal ancl etWd health
In len 'model coolmes' Dl.o'Ing me 0VlI8I researen "'"' lIS Ih<ly !la<lIIlOf>o~ """'"," ... """""" ...
lor !hft PrQIlIICl, a..naoe t>arekXll (IQcI(l'_ asked ThrOUghDUlIhe lale 1 95~ lII'O 1960$. the $iII1-
h(7w _ WOUld treat e child Wllh diarrhOea AI\IIt was -... Promoled III _
OUQO' SOIuIIOtI
menlIOOIng va"""" lreatmllnlS. """ ao:ldel:l- "IIM e<luca1MJO progranvres ttvOUQ/1 lIIEl schools,
of ooorse we alSO mal<e $1>'8 "'"' l!l e mQlher i$ ,aooo. ona "'" pnnte<l "'8doa _ana !)y lIle_OI
IJM'1lIIhe chid a saIllllld sugar 1dJI...,." j'Ot.flg <Io<;Iots ana tl'ObiIe I'lospotol !<lams who

"was assumed 11131 SIle was 811 e.Cfl)lJOn.llUI

her rePl' prompIecl ~ 10 _ _ !lie
_ t DlJI tD _ III lhe <:o.mttyso<le ""''''lI and
atlel tOe 'Great leap Fawatd' In "'" I'*l' thal
QU<lS\JOII 1ft e Si.J/\I9y 01 ll8Ie tool docK. pr&CflCeg !oIIl:l'M!d, rTlOS1 oarelocl <lDc1<>f$ lII1<l tn3ll'/
Il'IOIhetll rememt>erll(l and cama<l '"' usinU ORT
o.er 100 t>arerool ~ on all Ion COJIl1'" • wt-oI!! the hDsprWs ~ ~ ,averted to
Irom ........ 1l'0"l'II1U .., !lie norm '" v........ in !lie ont'8IIeIIDUS II'Iempy 0Mi tfICI)n1fy N1Wt """'8 ot

_1
00UIh. 110m Guangdong In !he ....110Sichuan ecoj
~

~
.. the _
Ihey a<lVISed
-_ e QUa$1o )nll(l
lor !he lrtlatmen1 <~ <Ur_ 1
M ease Marry llIelerrecl 1nI'8IIef"OJS IherllOY kx
<lehy<jralion SuI ...... OUt 01 len sa", thol they
1"" I'I\Olhe( 10 COill a aM llf\d
IIllOUI

sugar
.-
C/Iona'. t'csI>taIs t>egun USIng ORT as II forst
~ - Wlt!1 a resl.1IJrig fal ., case-li1la1ily

_
Today, MIlliOnS ot j'Ot.flg cr........ moI!lll<s are
-... ORT W1moot C\elllP<""'Ill "" Ihe healt/l
Thai Is lOe uIti/l1ale lU/lI ot the CIIIllPl'Ign
saM"" Some saKllhallhey did 1'101 e""" nee<:l1O
_ Ol'lT, sn:e ~ wasaQ&:;ly COfIlmon _ to Plomote OR! wDtI<l-iNKlll, d II SlOCCee!lS ee Gay
DOge arIIOI1ll~,
W1l """"" """'" n seems $lrango> !IIltt a rnasIIIVe
InternaUonal f,< oo nolionaj aIloo1 ..... "eo ' 'Y for
Cleat:Y. ~T IS be<ng used" C/w'II' and . alon\I something so oodona'Y """ everyday as OOT In
"'1/1 generalty sallSlOoC1OrY ...1fl1oona1 revelo, l>eIps !IIltl _ , C/Iona can be sa><! lD be II _ a _
l<) e.pIa n the rlll1lY 01 deaths lr<X11 'le!ly<h\lCln ahead ol IIli! rest 01 IIli! wortdln U$I/Ig whal !he
~ nclia by contrllSl. lO!lS$ en _ ~ hlIs <:ailed " P01en11al1y tOe g<eatesl mea.-
tnaIed 1.8 mi!Ioof> choklt~ a 1'Ja>' III diaI'l>oeaI cal rlodVanoo tI'!Is C<lt'lUry'"

"
......tI ~ dillribvtal 10 IJ.l ndio aciofts aDd
bi....... 10 tiIIIes. dtJ' iao!.lot web IttdiDa: IIp
10 I~ N atioluol Vl"rillllioP Dol'"- Pollen aDd
pamphlcu _priJllai in lbcir leDI 01milJioDs II. 26
printint cmtml IO'IJIf lb~ ~U1- re:inforad
Ihe llltIS:IC"- Ad~ tI w= publisbal oot
ooIy in lIewspIlpa'l and mapUMS, bul on pu blic
bIlKS, on Ply-slips, t.Jl~ 1lllellltOIl, lau try
lid'ell and d <'<1";';'ilY bilb .. And onoOlln""lIItnl.
_ .., mode oot ooly on rad io bUI 00 almost 4,000
public tddrt$s I)'$WIII ill rural uas, shoppinJ
""lIQ, fOOlblJ.l IItdiWOll. and lll pumarketJ
<hrou&botIl Brvil.
Whom the 6nII mWu 01 19&4'1 Natioa.aI
Vxcinltioa Days an: m:.ded, lbot BraziliuI.
MiftisuT of H cahh a:pectl lO be tblc: 10 .O_'oa
tIlII 2 IIliDioD 1UIdtr. - bI~ bo= wP"u"'ll
apiBsllDtIIb aDd l oS milIioo apiBsl dipluhaia,
-"'oopi"l """'Cb IUld 1t\AO....
fa c ' hie, thit '1':#."
tquIJ.lr IptCUnlItr
DOd ~ _ ~~ ampqll hx
fl " d in ....bili "'" Oftf 120,000 peoplr.
indoodm& ~ )O,IlllO .... ualtal from lbot
CoIolnbiu Red er-. 10 asi1l tht bealtb ~
in ..,-inlliol ......, tbItI ~ UU1'" 01 I
millioa lIOdtt..four..yar~1s 00 tteb 01 three
N. tlolaI VlCcilutioll 0 1)'1 ( K't pIl.Id I ).
It is always poaible lhac entllU3iasm for sueb
amptigns will fide wilh lit<, ded ininll Yilibilily or
lilt laratl ~ Qpt<:w ly ", bert tllq an: oot
)'tI buill int O • ~enl primary btaltb t i f t
l)'Itea>. BUI in IIODIt cues - and lilt Coiom~
amPliln is such I CQe._tM m.ablIWtioa of
=-
coo:nmUJlilito for ;~ ioo eon 1I-«1t - lbe:
OtIlo; nl;"'al inrnItnoctu.., 01 primary bcIItb
fa the....,.. ImIl, it is poblit IlIldmwldina
itId! nidi. illbot btoIIUlnWa: 01""-'n....;...
~ N WHO'I Dinelor-G<rlo:nl _
_ ~y_ ta~ . . , . , tIw ..Ii..... alai
,.,M " ' i '",;_*-4 IIMl,lttWdiUta_
-....,..
GIOWI!I~
E.dtlSi"' braII.. f«dillH; off", ptO«lCtioo
qainot both ;nftCtioa IUId moIDulritioo in 1M
rint . . _tbs of Iir,,- TdWI& I dliId 10 be
; ,,"in oll'cn pnxectiaa II'" . . 01 tbc:
..... daD&a'OUI d- On! rdlydntioa tbcr·
apr prtX<CU opinoI deb" " " BUI it" lbot
lrowina mind and body of tbc: you.ol o;hild il lo be
prtIltcttd from lltt WOI'R dfem or f'Ovcny, lbtfI. .
founh wo.U or prottction mWI bIIbuil l ll'DWld lht
t hUd'. life. Somebo"', malnUlril ion ilKl f mUSl bII
bpi DIl l-
Malnulrition may be: an qo-old ICDUrJt. BUI ;1
ill ..,ll li_ely ""' field ofllCi<ntilic: lIw1y. And in
rctcnl yun, ~ b.a bem l quia. rnolulioD in
our uadtraIaJIdiq l boul ..bli c:aUltl child moJ...
nu lri<ioa -aDd -.lw. aID be cloot.o 10 prnall ic.
o MOIl: 1III1a1ltrilioa ill ill. ....., ..... _
I*UIII uf -'-riobtd daiIdmI 60 Dot illlooP
lhII ~ is 1O)'l1Uua ........
o..tomMolltheftmoJnmtrislterl
is
dWdraI 1m ill \ao:IaoQ
ahIolllle ~ oll1lfti ;. I
DO
food 111 proricIo: ID Ilkqum Ilia for I -U doiId..
oIxt. 01 food •
,~ ""'"""lIIritioa ill a-d Dot 10 IlIlIdl by
by I"tJ't'IItd W«tioos -.hidI bllIu
up ~ deprm: tllt apprIil~ ~ I1QJ
nutric:oll in ¥llCDiIUq or diarrllou., aDd oflll:"
inc!tJ« IIIOIhf:rs 10 flOP fttdiAa wbilo: tbe illn....
I~'
In Ib.iI alIn al, tbt: llll'O _ N UTlI!lon failioli'
of prnt1ll tfl nm to combol t hiJd malnulrition ore
Ibtt thq <:1IoCftll rilt On th e " t1lmelll of malnu-
l rition mbc:r tban ilS ~n tion , IUId thll l bq do
_ ",fficitntly in \'DI"., 1M motb.,. in IeaminI
bow 10 ~t rnalawiliott rrono
f'l:CIIITi.ol.
If 1M early sIa'" of Wlcriaa IfOW1h c:ouId be:
-so. oiIiblI: 10 1M lllDI-bc:r, Illd it" II 1M_ time
slotatWd be: -"= •...", or tht t:p«iaI food -.If
01 tbc ftr'I yoGO& child, tloo:o it ~ be Pl*'llk
10 pnw:oa ~ bolt or Dmf'l: or . . tbe child
"","""UIriIic. ia tbc do: ............ -'d ItW:II wiIbia
aiori"l family fQCIIlIIliS.
Tbt Iow~
lIUmt- . .....,
Ind. """ for
aIrady emu
mWnc lbIl mal-
ill 1M f _ of
powtb dlItu wlti<:b I n _ "'lIBi:oI mlO .... in
__ 10 UIUlltrin.. By wri&1tina tb: child ItIl:b
......,lh ..... eoltri"l tbc rau.ltI OIl lbot dian, the
6.. 1i&1lI or poor growth an: modo: . .bit 10 both
I:Dothm aDd btallh WOIktn. If I 1Ilotl>tr eon ott
•
I THE SI'ATE OF THE WORLD'S CHILDREN 1985

Delhi:
mothers monitor growth
A 11000 et IrlC\IllrI moIl>etS from me PO(l<lISl
CCIITWI'OIMIIlS or D8Ir. ~ave l/'IOwn lIlal It>e'y can
dlMlabCallV ,lI(lu(:e malr>J1JJ\1On among II.- c/Iil. Ttle progr..... 01 aa 120 cnkl",., was loIIowed
dl'1lO by usng QI'tlWth monitol'"'ll Charts snd by
leamong hOw 10 rnal<e belt'" ...... 01 ~ .. k>o<llhey
have a.aJI...
No _man
O'tef pe<1Dds IlII'l\IiO\l rrom !rve monlhs leonevear
10301mecrolclten _~O '''tnalelV
SS 't. _ SIlOweI'l a S9"tf"""" """,~I . os de-
The rnoItIlI.. were allencung rile tli"IIC 81l1lC/'1ed f,,*, til' Iheu 'eaet\wlg81 _ SO", 01 ""'_ago
weogI'1T lor ""'" _ CWy 13 s/IooM!d M omor~
to "'" Srlrnali Suc!>eIa Kt.pala" HosI;<IaI '" DeI~
Tt>9Ir d1ilcl'OO _ a 10101 o! 120 unde<--!1Vl!S _ weT" moolllOd 0i"IIy lour fell funtl8f_ .
all maIrloun&Iled, some of lIWn_ely
Accordi>g 10 Dr Sudatsi'lan K""""" ""'" lni-
Normally, tile !real """'l WOUld """. been ow- tialed !he D8/hI ....polImenl •
ple:nen'JIIV 1000000s. a 'outIfl/l che<:l<-I.OI" . and..,...,
- . a<lv><:e lO ll>e mothers I!Il1ln If,i! P<lnOCtMt
case, a gtaup 01 P9<ldJa~ 100m 0"" ot 0-...'$ ' "Th&s8 ,8SUIts show ee $/tol"ng elklcl-. of
mIll,l;caI colleges alter!1l1e(l a <lttle<er~ appm;,tcIl 1h<s aPPI08C/1 " tae1<>.... t"'l ptObI&m 01 ",,"nuIf>.
Tt1e<v .......cot\,,"o::eo,as tr.ev
wr01e lite<. !hal .. ~ toon ... !he most ............aOl8 _ "'OUP, "'I ch<ldtM
U/lClel' tile age o1lwe years TIle r1Illnl...-..!ll1all,l$
Ihol mol'her is d1ar(l111l Wltn me 'llSI:oon!>bOrty or
01 85 S"" 01 _ ely malnO<l"sr>&<l (:10_ ....
~ ~ malnourlohed cllild boj ""'sell.
unde< perior;loc 801<l roguIar ~" her etIoId s Drought to I1CII1llaI co ",ooHlOImaI til' IIUi """1\0(1
ooTfrllOn willlITlpI'QVe, -, Suct1 "'"' approach .. ~. a'lt,. n'Slla1lYely eas y
to cogatlWl _ not ''''!'JWe ... ~ . _
~acn moI!1eI was gM!Il a ' Roar:: to Health' ~ not SO!ll'lC1 iIleSe c/IIItIrllfl arxl ttleil farnoloes
\lIOWIIl cI\aI1 ro keell M ns use was
""""" to """"Y fIoan<:oaI bIIrOerla _ """"'" 1"" IJSl<S oT
e>pI;Wle<.l n . 1I1 ~ ¥ISII . !he d"*l was tI06Pttalol81JOr1 No new ~"'P. as III lhel'. .t"t~
wa.ghll<l an(! !l$ growth CUI'I'Illlloned'lfl Il>e"""". _ talJOrl CMlre, is 'eQUIl«l My WTj>alollflt·
_ <:Inc, e g • on<Mly health cam",. eatI
K lt1e eM" SI'<lwIl(I me C/lllcl ~ welgh1, !IllS
uTiIi.>;e the "l'll'oach e!lflCbYely Nutnoon """"""
was tre<lTed IlQ1 3IS rou\Ifl(I lJuI as ;1 cause !of
~ me _ n1NI C/la/1t"""""'" no loon '"",","5 ;..sT an eIemen13tY . " owle(l'J'O olThe
II"'" Of a fal '" lhechJId's-.ghl. !herI1Ile DIObIem dieIa<y 'eQWemelIlS 01 The Il'O"""ll C/IIld ana lIIty
_ ""111 8 'ttla ""Ira tr.. ~ ClIn De ""'Ol'YeC In
was d...."ss.,.., """ the rno""" In a<l<liIlOI1 It>
ct>e<:lung lof ",!«:loons, IN Slatl cl<1O,ISStI(l tM Itlis plllg,amtnlI , IIg <':COTIlTUIIty health WOlI<or.
sct-co/Ieacher. pullhc Il$aIlh l\Uf$8 _ """""""err
d1ik:rs diel ln del8' - wttat Ihol child ate. haw
muclI, 8tI(! _ Ir ~ - snd , _ It>! sc:!'I<><O r;lloi(lIen As \JllI moIh/Il ""'..... " ~
_ !XIm on mote lreQUetll feell ong and on III me ct>ild's <:are. Ilel r:onhclenoe ~, he<
cMIlIl&<l nultlloOnlll oudooI< heIIlo" 10 ~ a
~. 10 lMdlI<I's<!oet Whlct' "'" mother
COIlld make WIlton her loniIled """"-"OBS 'l!laps8 III The <;IIilO. are "'" outlook !O'W... a~ t""
IamiIIy aoel os IIlso dIanQe<I Nuttinon eduC<luon
"""""'" lIS II\¥IY as I'wO-ltlitds 01 oil mothers 01 t>eco<"es a p.1J\ 01 a P!lCI<age or progr........-a to
rMInouo''''''''' ~ dO n(>I "'"""" lhat It>e<e IS ~ lhel(ll al~011 hechicl r",,_
an~ VI'IQtlg In Ihe 0eII> CIono<, " , "'" mott>ers
WOOl Inuglll :0 leoogntle 1he SIbIl.. Sl\II"I 01
"*' _'IS
<;OmlnI.Illl1'/ n;l<r«\i'/ aor<>e the eHeel
01\ the choId 's nulrr\lOll t~ 00 tmPlDVetl1elll1l
mMlul"liDn _ ondtJ<litJQ ~ lllXl lade 01 I'ltA (110)'1 NlS The e!!eel 01 a .... (loo'OOO IW afoon /of
tile _ C<IlT"mJMy
ener{ly. imIlll:UlV Of IrIlQOMl CIYJ'IO-

•
 her chi ld'. progress beginning ' 0 faller, slK will
lake oon 10 pili Ihe child back 00 <:olIIV.
Somelimeo, slK ntt'ds nO [ul'th.... infOmuliIOn.
1 _ cI _ waofWlg _ _ "" lroOi<IMce III M ore o[len she will oeed. and !lttk, IIdvice on how
2O _ <li _ ln ~ O _ ln Ihe 0r0l 0d S _
10 .IDlI.iotain the child's norm.aJ healthy growth .
18 ·care cerrtres wllh p'OQia ,, ue
!_f 11 16
14
Day-care cewes wittx.oJl
progrIl'I'O'l'Ol
o
That advic e lOighl lnclude.,
Keep on breasr-feeding unlil tlte child is I I
leas! one ye.... old.
,g ~ 12 Q Al lhe ase of four or live mon'hs, begin
"5 -5 10 gIVing Ill<: child Olh.... foods - wh2reveT is in the
family pol, plus. little oil and some skinned and

i
Jt ~
8
-
8
6
~
mashed ve&etlb les.
o Children h2ve anWl stomachs, 10 ftt'd • child
~
4 oflcn- evcn if il is only. mil .mouOl.
2
• "'-''' or
O'-2~,..-":;:c.o"",~~~=-.;;;==-~ o Penist in fteding during urnee or diar•
6 10 14 18 22 26 30 34 38 4 2 rboea _even <hlll!3h Ihe child lw 110 , ppe1i,e.

_ __ -
... _ .-ot_ "" ....
W
'""
tiole: ~ '" Ite lUM8t 01 C!'bo'I prewJllOt' ill
1>00 III <lays .. ~ "'...
~ _ e..- _ l

" ~ ,.. ~ ,.".,

_
o The: rbru ro live d.ys oIter an ~In ... are •
.perill time for Cltching up o n los' growth -
flf>q u""r [eeding in these rew dlI)'1 will belp
roward•• compll:le r«<lvery.

ImpcI c I _ A_Ill _ _......... i'r!ra.'-'"'Y

o Woo.b h.lnd. often , and especiall y afl .... dote-
ClIriog and befo~ p~paring food. Keep food clean
It-.oan or _ l<J1octlOfl In ~ (lig. 16).

-o~E 1_--=:--== = So", e household. Ife IHI deprived of baoic foods

lhar <hi. information wOllld be of limited us.e.
Some lIIOlIten have &0 ~t1lc decision.making
5-91' I power OVer Ihe a.Il..... tion of <he family's food tI•• ,
they would 001 be . ble 10 mk. rhese omall bur
lD-19 P vilal clwtacs. Soote womrn hive 10 linle rime and
=:J 10 many J'CIponlibilitiel <h.t Idvice .hour more

2O- 40f I
flf>queor feedin g of .peci.ally prepu<d weanin,
foods WOIlld be: jU$1 insensirive 10 <hei, circum-
,,-
Bu, ;n 'he mojori,y of cues, • growLb chan
I which mkes rhe problem of lOI!nu, rition vis;bl.,
o to 20 30' 40 50 and IHIIIIe basic: advKc which makes lha' in fonna-
Percentage 01 other !amily IT'OlfT'II)&I$ Wected n ten lion practicable, could .... hl" millioDl of """hers
aa~ loIoIWIg onelamiy meorblr boo:lIl!lg i1Iocted 10 prevenr child malnu lrilion (see p;IOel17 j .
l00 r~ 0 100 !:riies not Ove . 200 different kinds of g rowth chan are
n haI'Id.washing in IW'MJ.~ no w in use. They ClIn be otad" of virtually
poogo..",.. progo" " 'i8 indemllClible plastic-paper, th ey COSI only. f....
_ ~ dull 10_ 011. 1rWl Yog!Ila were lIlso cenlS IOd <hey can abo CIITY other vilalll"ll:lSlges
- .-.-.. _
""""""" by 3n, by "'" .... (J/ toile> "" _
ot_ ... .bou, U:nn:IuniDliOIl, wuning, breast-fecdinl,
,.. w-.'· _
.,..._ """" ,.
""""rot •• _
........ binh spacing, and ""'" 10 make an oral reh yd ra-
lio n ooJurion. In ,""on, Ihey can become I putnt'S
'" TO. le l __

"
1 THE STATE OF THE WORLD'S CHILDREN 1985
,uidc '0 protecting the life :llld normal hftILby
growth of child"", _
GroWlh cham bave been in limiu=d .... for
man y ~ BUI with lh. sprad of a ncw
undt7Standing about malnutrition, X 'IIIC CO\In~
tries are now besinning to usc growthdu.ru on •
scale commcllSlll'1l. wil h tbe problm>.
In Thailand, the Ilumoo of growtb. charts in
..... II.. riom from 400,000 in 1980 to ;!.S million
a, tM btginnjog of 1m. In Uganda, 2 million
charts hav. 800e i,uo service in ,II., IISl 12
month.. In Bou wana, to holp cope wi,h I ... ,e of
nutritional CIIICrgfil <")', 95'" of aU rltiJd,ren under
five now h."" ,"'Wlh chan.. In 2:imbab wc,
soo,OOO b ye j\l$l been printed for UK tbroUShOUI
Lbe health Rrvice. In T anzani2, 700,ooQ are now
loinS into ..... In the Republic: of Kon"', 600,000
bave been dislributed. And in 19M, M"';co,
PakislaIl, BanllJadtsh, Ethiopia, Viet Nam, 1Illd
Zaire have all bee n finalizing l'landAnl nation.rJ
gro wth cham with the intuotion of p..,..idillg nnc
for cach child UDder lb. age of th ree.
There an: vay 8mt difficulties 10 bl: evercome
if growth monitorinl of ch ildren ;" to, fulfil lIS
poI.nlial os I dn.rnaticaJJy .ff'-'Ctivc IOW-«>IiI
technique for ~oting child malnuuition. Th.
n~ for .... aOCUT.llc weijbinll of the d tikl each
II>OIIth, and the need for IIl(lfIthly co,,,act ...ith a
trained p<1'SOII to assisl iD plouinl lh. child',
Sl'OWlh and sivins advi"., arc ocv= limil. lio ns
l>llIM outreoc:h of 1MSrtlWlh moniloril'l id.., In
Ind()JIcsia, a nUlritio n imp",.,..,,,,,,nt PTOll ro.rnn>e
has .""kIcd ,he>< problems by lfll.w 0l ...,..,rol
The Disproportionate Benefit
)ndividwJI y, br••'IAdnl, IrowIh monitor-
i"l, oro! rebydntion, and imm unWlinll th.refore
orr... remarluobly COSI~ffccti ... prol .....i,on ' 0 chil-
dre n in poor communiti es. BUI th.ir oombincd
.rr..... could bc several times IlCIt... lba n uimpl.
addi tiOll of lheir .,;!VlQ IIll<$, To see ...by Ihe
wholt is so much lrelt... than , h. ,"m of lb.
"
bundred lhousand villq. ou,riti"" V(lIUOI~ or
Iuldm who manage lbe monthly sessions where
0"'" 3 lnilli01lIOOIh.n .... igb lh. ir y<llIJ1i "hiIdren
()JI ordi zwy IIIIlrkt< sal.... Th. impact of this
imoginJli... = p:oiHn hIS ~ 10 be measured.
Th. troiniol of more communily beoll h w«k-
en is deuly lh. most import.nl prc-<:ondi Uoo for
,b. spread of l rowth mon ilorinl and lro""h
adviCC' 10 the majority of 1tlOIbtn and cltiJdren ia
the d....lopias world (Ott PIIlles S7-6 l ). BUI the
second mojor obstad•• 0 Il'OWIh moni.orinl i.
0I1llO$l purely l""hniQll. Tb roulhou , the d eve lo~
inl wm ld, lha<' is a desperale nced for . cltcop,
light . nd occu..' e means of wtisltinJ cltildren.
M os' sales an: . ith ... so hcovy ....d txpc:"';v . th.,
they an on ly be found in • f. w fully equipped
clinics; Of IMY ItC SO difficull and ' Wkwatd lo USC
lh., vWlinl communily heallh workers some-
times liv. up in emhortossmcnt; Or , hey an: 00
iaaccurole Ibal lbey caDDO!. d.l ecr a cbanj. in I
child ', weichl from one monlh 10 the ntx'.
So importan. is l rowt.b tnoniloriol 10 Ihe
survi val ....d oormal devel op"",nl of maroy mil-
lions of children , thll lb e inventio n of an sp pro-
priolO _ighins devK:e for usc by community
hcsIth WOtkm would rilbtly bc rqardooi IS one
of the IllOIIt imponan, technical breakthJou.RhI of
recent ycsn. And it it difficuI'lObelieve , bal lhe
inlernational acicntifH: and 1""b.Dia! profcs-
sion~1 profe$$ion which l;I.II llllOCb • 25 -lon
$600 lnillion d.vice int o space in order 10 _ ure
the tJWll of the plan",s _ is inapohLt of d.... l o~
inl I . W<>-JrjJo, $10 d.vK:e for tDCIS1Irinl the
...tiabl of child re n.
pans, demands I more SOjlhisticllltd undtmlDd-
iDS of the prob l.m itsclf.
Until ycry recently, il hIS bee" con ventional
wisd<>m 10 ..y thol 2 million children di. each
yeu of mtI$lcs, th. , I millioo ....d I half die from
whoopln ~ C""8h, , hal IeYtral million die from
di.lrr!ul<'al d~hydralion, an d oewnIllIilliOtl more
from malnutritiOtl. Eyery illovern menl and eYery
inlern atio nal d<"Ydopnl<'nt Ill~ncy, iDdudina UN-
ICEf, lISCI ouch lIatislics '" dra w '!lention 10 lb~
principal danlefl flcilli cllild ren who Ii~ io
pov~ny. BUI OIlly in a ",lllj~ ly . u perfi cial ll<'tlK
' re ouch figu .... true..
V~ry f~w childn::a di~ fn)QI malnutrilion a1on~.
Very f~ di~ from measles alone, or <"Y~n fr<)1J\
rc::spinl1ory inf<Ctionl or d. :hydration alOtl~.
M oo of lhc 4(),ooo YOOII,II chiJ<in:o who an: now
dying ~1ICh dlY an: dy;n, nne bea"", lb ey 100 a
l>o.lll~ hUI bea_lbcy 1oI~ .. war -I. 10tli looilli
war qai.M1 lh~ , hoer fr«[u~ncy of lb~ .... u111 on
lh m II!'OWlh during lb. ;, most vulnerable yean.
Each infection, .. heth~r it ll<' men.I.. or diarrhon
or whooping "'''ll h, 10_" lh~ child ', nutritional
status, lUld leaYe'll the cbild wuker 11101 mon:
sll$Uptibl~ 10 fu" h~r in fection (""" pant! 11).
In lb. iDdusuial.iMd world , 100, in fectiOtl
w~ahn' childn::a, hOI1lJ up calories, red uces lb~
aboorption of nUlrietlls, d~press6 th~ Ippetil~,
IIld oJ...... 1M I!'OWlh, fkll wMo tM inffClioo
i<s<:lf passel and Ippetit~ is rqaiotd, tM cbild
tISU.lUy 'ca lC",," up' the It'"OWlh which has been
Ioal. In other wonb, u.., par, whicb illn... plal" in
the IIOry of the child', d... ~lopmeot is tlUIl of I
l~mporvy X1.back frota . ·hich I. full m:ovety is
nonnally made..
In a poo r community of the dl:vdoping world,
lh~ wbol~ relationship bm.een iIlnca, nulti!ioo,
&Dd I.child's devc:lopmcnl ~l flltldam, malJy diff.r-
.-.
ent. lnalead of beint I t.""porary lI<'!.blck, III
iUD... is often lb~ IirIIIlCP IOWlrds &D (lr ly death
or , for th, survivors, I>t'rman~mly retudo:d
Why is ilIn....uch a diff mm p!'Opositioo for I
child living in po,-my?
Firsl of all, illness is mucb mo", f""lU ml
beau"" lh~ ~n yjron=nt of po vcny is shol
lhrough with n:le<lia of ;nf....tion _ lItld , an d rink_
inl wl.l~r, lItlbYllimi<; SlIlilalion, lack af soap,
inadequalC food "at;tg~, l.d<af knowledg~ I bo UI
hllldwuhing, and oY~....ro...dtd living and oJeep.
inl cond itiOOL
Scc<Ind, tb~ child 's res.l<tIlD« rc this IIlCm
prev lienl iAffCliDll ill UllUI1Jy yery m uch lower _
";t!lu l>eca_ lh~ chi ld is nM adequately nnu t·
iaho:d or ll<'clo"", b. or ah~ has nnt fully ICCOYCred
from I. pn: viaU$ illn....
Eilbc:r ....y, ,hil; combinl.lioo of lOOI"~ p",... I~nt
in fcctioll anll I... robust remtan« means thaI
illo.... &mnll& )'OlItlg child"", ill vtry much lOOn:
freq u~nl. In I poor cammunity in lb~ devc:lopial
ww ld, fn, ~nmpl., I child is likely 10 be ill fa r 16
0' 20 woel<a I yur _ wilb lbree ar faut haulS of
diurbneal iJlftction, pc:rhaps fnur at li~ reapj,r,.
lory in fcclionl, and m.o.yhe In Iltack of measle$, or
mtlw, or ocher commD.II childhood IUo...... In
oo~ sludy of child ",n in an n tl'etll.ly poor""", nf
Blngladesh, yauag childrat we", found 10 be ill
fa< l hrff-q,wonen ofth~ir liytl.
This diffm:noe in. frequtnC)' IUKl\Inl.. in prac_
ti«, 10 I ernereeee nat iUS! in. dog..... bul in kind ,
Incocnpl~l~ l "'O'i ~ry betw een ilIn"lSQ means lhat
.UlX'aSi.~ ilInO$St:S undennin~ lb~ child'. growth,
lnwering railllllCf' 1001 "",king SUbseqlWl' ilia,,"
balh mare 1ik~ly and """" ,...,""'. Far f!'Om beintl:
I tetllporary loCI..blck, i1tn.ss I I this k\.. 1 of
freq uency bccomea cumulative;n ill impact. !t.ad
,h~ child is nnw ani Aeepening d nwnward oJopt'.
In perhaPl 2 millinn af ,hac: casc:s, lbc chi ld
dies wilb tl>< l a,~ aymplnms af mulla, In more
tban a milli"" ...... it is lhe racking caUlh of
pen usais 0 ' lb~ inAl mtd lunp of pnetIJIlOIlis
which linal ly provt" 100 much for I _ abntd
bndy. And in more lh. n 4 millioncaoes I yur, II><
child dies in l b. Slupo r of d.bydr.l.1ion. But ", hat
kiIII most a f thac: children is nnt only ,he
particular illness lhey hl.ppe ntd 10 ha ~ al u..,
lime af lh eir deaths bu t the f""lUC6Cy nf illoas
durill& their Ii"...
Even fa< lb. survivon, lb~ iml'1Cl 00 Il'DWlh
l."&Doften be permIIlenl. Connonl i1ln... and
maln utrilinn, in th~ yt"an ",ben mind and bod y
an: tc hM nled 10 d~~lal' most rlpidJy (til. 18),
moan thaI child ren 1ft smolltr, wuker, and often
la<:ki"l in lhe ~nergy In play , In ""plan: , In
demond ""d receiv~ u.., stim ulus ...bich is 110 vital
la lb. development af mental , pb}"ical and social
sl.iIl..
Protectinn Ill iinat all of ,h~ illMOSCl and
d.lnl~" of I .......m. up in pnvcny wiU OtIly
blppen when povmy iIK lf is a•• t<:OIlll:. BUI
I THE SI'ATE OF THE WORLD'S CHILDREN 1985

Protecting growth
GROWTH OF UNPROTECTED CHIL D.

,--
16 _ , . _ - _ _ ..... _
~binn- - ,0 _ _ . ~ _ WIlh ....
14 '''''''It' on<! ""'" '" _ 10"- . U ,""""",,,
--.;

, ,,ta.. ~-
~

~~-t~··-r-ITl1U
_Jow ,
. poor ....

•
i
• An a~ eNId in a poor community
llIay have six or more weight-1osi1g
Ilnesses a year

o 3

GROWTH OF CHILD WITH LOW.cOST PROTECTION .

-e
"tz
~, "8
E

f, 6
low..,.,., . ......... . al<ft ....", <0<> .

2 '-'11 _ - --"",-, _
~_ .... _ _ "'-,oo'"""""ll
by - . . . --
..IDIactuo , go...." '" - . . y .. _ _ .... """""" 10
_ .. """"'" '" - go"""" ..... _ .
0 1 Age In years 2 3

•
 prolecti"" apinsl a f~w Sfo« ific illn esse!l aD lu lp
UI brtd rlu ryrlt, by mlnc ing the number and
frtquency of illnesses, allo wing long~, periods of
m:upention in between, IlJld so pulling . be child
away from tbe steepenin, : slope. That is why a
limi'M number of basic iluerven,ions can h.v. a
dispropottionOleJy benclkial effect.
This is <.be C<lntcx' in ~Ihich a C<lmbinltio n of
l vaiLabl. Ilnllqia could provide JIIeh I utDU-
kahl. prolection 10 <.be Ii""li and th. growth of
children in <.be poor .....rld. It is <.be .. If_
perpelUlting cycl. of f, eq u.n. illness and malnu-
trition whicb .......be .nain tbrel'. And thOl
cycle can now be brok... by puning low-ooso
,echniqu.. in ,h~ b.ond. of the world' s paren'"
Measles i.mntuniu,ion, for . n m ple, can
..hi. .... ""'Y mu eh mo~ ' han e e PftWntioo of
<nea$I es. In OM S1udy of I measles oUlb,eak in <.be
Gambia, i' .... foW>d. 'ha'
S'" of ,h. d lild"'" with
measl.. died during rhe ou tb,eak ilStlf, But nine
"",ntM Iat.,., Ill':' of tbose wbo bad survived Ihe
measles we... d~ad from o,h ., causes ( fig. 17) .
Measl.. is a major cause of dilITh...... and mal·
nutrition , often causing I serious lou in bod y
_ig bl. Recovering thlt loss of gro wth can ,Ike
anYthin g hcl w«n 6 and 12 wccb - wC'C ks of
molnutri'ion IIld wcalul ... whicb o pen <.be way
for nth.,. infections and f""h.,. molnulrition.
Imm unization against measles might th=fore
hlv. saved not jllSt the S'lL of chi ld.... who died of
......1.. it..lf bu. also ",""y of th. mucb laIller

--
nwn ber who died durinA th. followin g yeu. As
Fig,17 Child growth to age four <.be Wor ld Hcal<.b Orgaoiu.tion haa abo said tm.

is "11ll", " n~rimI Jmlicfl Ott tJJ«tive i" f1ttIJC1ltin,

tp«i!i< diM_ wJ,id ....." pttcipiloU _1,,"lri,....
olld, I!lI /'f'I'Iilli.., ,Irt chiM II ~ I'ffllrJCTy pm.,d
""twte" ' M <WIllS, l"II" p.-rtlfnllhu dUll:nward.pil'll/
" OM e",, "";!nou n,..ijinl"l/y 10 rlu 0fIml1l rtdlKl....
0/dildlu»d IIIOl't/l/il)'.
12 "By pttNIIri", ..._ 0/ tw ....."1.. i",,,, ~,,~r ,,,"
Jmlicfl til" Mlp I'tfl<I1f rhil <y</t, olld IMi, """m'!no-
, ;.", UJ 'M pr<Wllrilm 0/ i,,/o'" OM ellildMod
_ 10
!f '" disllbi/il)' 11M dflJrh e/l" lime/ore nU1llJ bqond rlrt
F<Wll r.... 0/ ,,,. illdivid""II_1 diJu.... "
i ba,..,
is 8
And JUSl IS i.mntuni..tion aD lUI effect
beyond the panicular disease il i¥ aimed at, so all
four of the main 10w-«llSl inra'll:Qtioos discussed
, 6 -7 ;llth" f'CJ'Orl can IChi. .... mucb """" <.blUl .......
6 10 be t h~ ~ when looki ng only at thei, direct
effects.. T ogclbcr, brcast-fccdilli, JrtI wth mWllo-
, n."""" ani ",hydration, I nd i.mntunizotion wnllld,
fa , ""ample, also offer considcn.bk pro!oclion
againu <.be acu ,~ rcspi r.l' o ry infoc.ions ..hic h
nIIlk along.ide diarrhoeal debydr.l'ion IS a moio.
2 ClI""" of iUn and death III>OIIJIlhe d" . klping
wo,ld's chi ld .
Similvly, onJ ~hydr.l,i<m thcn.py itself can do
mucb more than p"",.n, dCOlb {rom dchydn"ion.
0L 3 56 11 1 6-8 t2 2.\ 48
Diarrhoeal inf~iOll is a maio< ClIIlse -ill SOIllC
PHASE IN LITEtO ---l
AQe 01 child (mooths) ..... ,Iu "",jo. ClIuse -nf child mal nutrition .
Srudi .. in G u...:mal.. Baoglad!$b, Uganda, Bra-
til, Ind th. Gam bia, hi ve all ""'wn
th l l )"<lUllg

"
[ THE SrATE OF THE WORLD'S CIflLDREN 1985

children typical ly . pend 12~ 10 W~. <>f Ihcir~ ....
'uff....., from di.rrlIoeaJ inftcliollS. In Doe study
;n Ilangladesh, the .""!'Ii. child was found lO
.uffu almost SO da)'$ of diarrbonl in fection I
yar. Duriog those SO dl)'$, the chi ld'llippetil c is
rtducW and the mot her'. inclina tioo to ' 0 with_
hold food. Even when the child doe. eat, lb.
illness itself scv=Jy rouim the body '. absorp.
lion of nUI';en,... Th . lUuh is the loa or perhaps
I kilo of weiCh' gain 0"" , the ":ai", from
diarrb(lelll di3c1l$C alone.
Given sucb I rat e and frequ ency of nu trie lll
10$$, i' is 001 hw:l tO ~ wh y d iarrhoeal in fo:ctlan.
arc coming 10 be scm III 011. of the lllOlil
import ant Cl. llOCS of child maln utrition. Similar
.. ~ io ,h. Gambia, for enmpJe, 11.1,,,,, shown
that alll105l aU ~ <>f child malnutrition have
been pr«edcd by !ruInen' bou~ of diarrhoea.
0n.I nbydr:llion Iherapy drasticall~, rcduca
the risk <>f death from dehydration. BUI i1 abo
reduces the nutritional impa<lllf the illnm itself.
Stu dies in lhe Phitippin.., &tJgladesh, and Tur-
I<cy have diD_ thai children ,,.,,.,,:<1
wil h <mol
rt hydralion u.hl during bona of diarrhoea
showed ben.... "";8h' pin 'Iwl dli ld<en lowhom
ORT was nOi available (fill. 19).
The full polential of th e 10W-COSl in",... ""tion$
oo w avaiLablc ClIO on ly be $«0 in the rom CJ(l of
this syn CfIWn. F or with. few decisive ,n tnven-
tions like ORT. UnmuniZlltiot>. and practicable
odvicc on infant f«diog , th e downward $piral of
malnutritioo and inftttioo can be bro ken and.. in
its pl=, III upwanl spiral CllII be Ott in motion -
less frequent illness leading '0 tt\OK """,ple tc
recovery ladiol to mote oon:nal gro wth lead,og
to less frequ~ t iUness. ...
Growth ,t$df j, thc aim and thc 1llt&SU1l' of this
PfOCQS, and thc growth monitoring chan is the

Flg.18 Ch ild de. th ... tes fo llo'l'I ing acute phase of measl es, t he Ga mbia

o , 4
Percentage ,:If children with measles who died
6 8 10 12 ts

~===:::5;::=========""l
Child death I'1IIte, during .cute ph as e of menle' infectio n
Measles JT\iIy be ,esQOt1SIbie 10< fa' u.s....
more dealhs thao those atl nboled SfIl..OHtA
10 tile acute phase of meases.
II$CII Often, it is measles which -
PUSIlCS young chdOren "'to the CAAIEROON
00wnwB«l spo-al 01 d<a"IlOea, mal- Gt.Io'oTEMAI..A
nulntron, lowc<ed rosas!ance , fflSl)l-

---_
ll",too

_-
--
_ _'-"'-_..
. _,----
.., """" _,-,..,"'-
.-...
.-,
'_ J _

. ..
~
~

"'"
o 123456
Percentage of cases dyilg
7

•
simple piece of tcchoo!ol:y which can ~a1 to
IDOIhers, and to community bealth wo. kers,
whetbn a child', growth iI faltering or wh<'1her
'he child iI On the way to healthy nonna!
devt:lopmem .
TIw i! wby David Morley, Profeuor ofTropi·
cal Child Health at the Un;"eni,y of London and
ooe of the pioneo:" of low-coot wa~ of protectUtB
th. gro wth of cbildKll , hn concluded:-
'71uI1!f!UfIri4l i"'/'dC1 0/f'O'wtA ....m ;, MlAin,1m
r"'~ ....,IMlitMary .", Mlldm 'lnIdi", rilal il ;,
Marketing Survival
10 ,t1mmarJ1, gfOwth Jt>Ol,itorirtg eharu,_1\eu;
of o<al rehydrat;"" wts, 'l./Jd ,,=;n.., are I.....·
l.'OSl, life-uviog, growrb·protectinS t""bnolosiel
whicb coo cubl. parenti t" prorect their children
again.. tbe wont orfeet' c.r poveny. Similarly , a
mauix of t1p.tOodtre and d own",,~ informa_
lion abou r pregolflcy, br>oul·feed.inS. weanina:,
feedinl duriDJ Ind immedi ...ly ofrer illn.... cbild
.~" and bow to mak,. and use bome-made
oral rebydra tio o solUlioDl, COIIld also .mpower
parenr ,ro proleet the livco and rb. buhh of their
children.
Bur how can these leclmol"llies and rM infor_
madOl\ be pur ir rh. dispo:sal of million. of
familia in the Io..... income world? For .tleasr the
nat qtlUtCf of • ~Ollll)'·. $igoil1cllnt impro~
menr in the hnhb of rbe poor world', ehildl't':ll
will depend on ho" w.ll 'hat quaUO<I c:ao be
an."crerl.
The initial taSk of Ihe cb.lld .\lfVivaJ revolution
io rh• ..,mmunica,ion of "l.. t iI nOW poaaible. Yet
in • world where infonllari"" tccbnolngy hu
bcwmc rb. ncw woodc. <If our qc, Ihamcfully
linle iI known .boul how -ro communicare infor·
mation who$e principal ¥aloe illO the poor.
There are perhaps onl y ,wo larJI:.....ale prccc-
deolS:_
The Iir$t iI th. Grecn :R.....oludon, which , ill
,'Il/«Iilm ",AkA is ' M ""..... ",It
Iud 10 a /1101....
IlNlm,alldi"l r.V /wIIA ..."km' aJWt 0",",' 1M
lIttLUi'J' a/ fadi", '"" dMri", di<>rrlt«tt; 0",",1 llu
.... of "",I rdydnrlilm ""1l1ilmJ; aboul rM im"..,...
Uti"" I>f 1fWU/n i"' ''llllwrimt; lW 1M i1tl!'Odtttno.. I>f
W«I"lti", frxxh.
~/I ;, Ihu infomwl ;nvokJrmnl of 1M "''''hn in rlu
''"'Uk'" ""' .... 'M~ IMI rM <Aild 1"''' "" wri,hl
t",k 11M twr)I ",milA ""'iLk u prrloa". 1M ,..,.lftl
<o1trribvlilm 1M fTI1U!lA <M'" """ IIWcIlt w t hild
drot/o1mrcor I>lId <Mid '-I1 A ~.
ltWIy CI:ICI, fUCCCCded iu pUltin, iuro rhe band.
of th........ds of Illtail IS well .. laJ'I. f~ ,he
r« hniqu.. and the kn.... lodg. which enabled
'bem ,I> double and ,reble rb< yic:lds fl'OfD lbci<
,""'.
U k. the ~n' porential for • I't'V(llurion ill
child health, the Gmrn Revolurion in Il.8ricuJlure
alto began wil b • scriQ of 1«1uticaI break_
tllrouSbs. Bur it "'uld not bay• • ucuedcd Oll''';dc
rb.l.boratory witbout readtins 001 to minion. of
fam><n ro Jiv. ,hem ,b~ knowledge and rhe
..,nlidcrKe '0 'ry 'he Greco R.....oludOIt for
themselves and lb. lcdutical and 6nancial IUp-
pan ro make il work. Somehow, tb.tdiflicultr.....
W2& acbi..... cd in Turhy, in the Punjab of both
WWI and Pal<i$Wt, in the Pbilippioell and lttOIII
recenrly;o lodonesia . nd Sri Lanka.. And io eacb
.u«... rul ....., the keys '0 ,b . acbievemenr can
no w be seen to have bttn : lhe commiUt>cor of.
nation'. poUtical lead.rthip; rhe involvemenr of
all branchell of ,ovcl'lllttl!nr lfId nOl ;u,1 Ibe
ministry of qriculturc; and lhe mobili~tion of.ll
pos!Iible "'lIanized rcsoutt:es ""d cban o. l. of
communication from lbe l,."j farmcn' aaocilIriOf\
'0 ,he nadunal mass media. And in uc:h C*IC,
'1I«CSlI .... achieved by I (:Olltbin.tion of the
rumen' _'II dccisioll$ 10 chans e the WoIy lbey
work ed their land and rhe ,I>vemtllCDl'. commit-
",""r 10 providi", 'he oeceuary IUppott fo.
fill1llCra 10 imp l.ment lhal decision.
I THE SOOE OF THE WORLD'S CHILDREN 1985

Tanzania:
a literacy revolution
-. 197 \ "'" 1"",,,,",,,, gDlfelnIlIIII\I oecraced dS ~ " ""'" P>er_ <leCIOe<l '" _ "'"
" ' _ 01 _ OIJI " de<""Y WI!tlI<' Itve _ S c.aopae<1y o! IIIe exOS/inO SChOOlS by O!*alJ<lg &
WiTh 70'1> 01 <If; POllIAatooo ilIote"'lll IlnQ iIlI sl1m s-,stlirn -1IBlt o lllle ~ N"""'lll!leol SCl>XO
econcwry languts!'ong among the 15 Pooresl ln tne 'd!r;' on I"" momng lWICl t\aIl on l!'ll a ~ ~
WClrkj, Iho& · ~ remcy revoIUIIQrI' seemecl UtIioI<ely was !'I(lI ic!eal- btJl besl was roo! dow9d 10
t>ecome me """"'I' oj _
Bv IIlI! IlOO 01 1915 , I/'Ie lll'OOIl\lld ret Dee!'
mel Bu1 ""'" 5 .....", r",,,enoaos 1\Ilo'
enrOlled '" lhe """I IT\lIIO' problem " as It>e SIlOOa\IlI 01
adult das!;es ""a oIIt"''''''V -.as IlOwn lrom 10""10 leo>CNn AI a Irau'Iing cost ot 30 .000 Tltll:&/lian
. 0 " Ay 1917 d told fallen 10 27 '\0 "''1(1 tl)I19 81 sIKIongs """". "'" ""'"""'Y coukl r'(l( 81lortl '" ~a"
10 21'l> In other """"". IN! last llgeao:lll ~ !IOO<I more 1l\a1' ~.ooo prllTl8f'MJC/>:Xl ~ 8
Tanzarosll!i DrIng down I!>elllilIteIacy rate tl)I more \'eaI- no! nearty eroogIllO meeI tr>e 'leeOS or a
IP\8n 10.., e year- tne &I_ I
.....acy ..- ac/>Ieved by 1liiy na!IoIl
= ..
nea 1" '" !lU'''""" rI'YOI\IIIOn One ,,*,!lO<I ..... 10 0'I0I>0bl8
~ SIJJd8ots. 'elifllC le3CllefS, and oloe<
secondaty-""IIOOI I:lUPIIs 10.cl ... assi$IarIl INCll-
What trI8CI9 thoo ~I P<>ss<b11 ""'"
~ ...... "'" """"""
"'" n!'oelped Bul
fIrsl ana IoremosI ll>e lXIlmelIi <X>/f""'\mef>l o!
"'" lIalon'e ~1fI -a l:<l/TlITlM>en1 """"'II The ~ P'O<Iu:ed '" T8nza<N1 was the
~ om the ~ .. t ilia! I/llt _ JQrT1OOl QI dIStance UaI<W>iI prOg<an"<J'Ie, a lTIfee-yelII' OOl.OSll
'1\um8n resources".. boll> the e:>d ""'lIN mea"" by oo,,~ 8fld rllOOO bac;I".d by !O<IrlnO
of oeveIopmen1 _ A.$ !arIZ",.,." PI_I ..-aoe Moo .IId folbwed b'J "" -.s' fe:sldeooe
N1e<o<e $aid "' fM_raTIOflIo< !hII ""'''''''91 - W> a 1_ ·ItaifW'II colieoa SlUOoll\l$ Sl/Iylld a!
_ ~e8d or
l\8lls oj ,-..c:a and __
ill
" ' l'$I we """$I e<lueale our """,":I. Our chId<"" ~ 150 ~ 8 montn as a studenl llfanl
w.II not """" an II11Il8d on OUt ecor<>nllC <lev9Iop-
men! lor hv9, WI Ot even _ tv
years rroo 01 trI8 45.00 0 men an<! women lIthOe<YOIled "
alt,tJJdes Ql llIe _ . OIl t"" 01"'" haM. """,, en !!WI """MIt(!Iranng P<O\lfl>I'\TJ'I 35 ,000 Pf.$lII!d
!roo llnal """m.nabi)n and wen! 0<11 101MCIl on IlIe
~ ~~
natiOf'I's """"""" Sd\(:<)j$ So Ia< lolltrw-up ,e-
BullO haYo II'QUIl\lId an lId u~ lIteracv C"1llP8IO" """rc/l haS lI8l8CIed lID map" <l1tle<l!/lO!! III D8f'

-
_ regIec.. 'II "'" ......""y scnools WQUkl _ !om'>ar1ce among I _ S _ '" !tie ......
Men . kll nIt8inp/II'lG 10 _ "" a lyre w,,"
a slow "'3Y - and al loss IIIan OO&-Ih.d ot I"" ,!"OIl
punc:rure Ar>:l ""'" lIIat same "'" year... Tar>nlI'"
also tr>ar'aoea to QIJII(l<UIl!e me numtle1 til IHo- FOf Ilo1h """ns iInd _ . lI'J<I Me<acy r"""",,"
I , .year..:llds 01 dS P<imllr'IlId'iOOIlI ~ I""'" lUSl CHef lIOf! has IlDl Doell .., 1ho<II f\SprObleirlS - ~
1_ on 1971 k>jusl""". _ , on l!lc oaIII'
lhe ""'"0!Je 01 b\lol<$ _ , and Sl);lM p;lns l<.>'
1980$ priflhng presses Nor ar.... lIle problems yet
_ _ ~tenK;Y .. I... llegIOnioI;j nor !he cod, ol
ADIlIr Irom ltlIl P<>O\aII CCImllTmenl fron' I/'Ie
100. 'I ""'" T_ _ S "'l/<lf1I.'IIY "' IIl'l(lInQ klw-<:osl Ilduc:aIJO/l Bul. revcluUOfl .. 8OUC8lJO/l has - .

--
soIu1lOOS lItI<l ,IS SI.<:<:e!IS on ~"'" an PO$SiIlIe
rOll<lUrt:<lll wnid\ mooe !tl.'l Ioleriq' 'evoIoJllOn
" was t.o1locoally auT 0 1 lroe lIueSl "'"
"""1TIIlIe 10 socl<lenIy _ me..... mIle< of scIIOOI
brtIughl obotJI III 8 rel;>1MlIy .... cost and on a
'eIlIweIy ShOn 'I/I'le In OISCU$SlOf'tll """ ~ oro the
p r _ 0llCl0fIUr0l'f l<.>' """lher ~ _
lJO/l - . Jow.oosI ,evo)Jbi)n on <;I\Ild SlJMViII .""
101 00M:l0pr11l!l~ -Pfesooenl ~ere haS ;ogall1 sa<l
'We will 00 d ,.

•
 !I.D independent evalUal; ntI nf th e Green Revo<-
Iutinn in Turkey, fornampl. , paid lhis uibule to
11>0 Turkish fannor,_
~11v "•.,., ;"'porla. t ,,,,,d,,,;"" ... U 'MI II..
T~,.u~ ftmlU" ' 1tmt,td....1l'f load '" <oW..,. ~ iJ sud
/wi fl"JItlrullo. flrll£lim, IIdrJpI """ fmiJ~..,
l«hiq"", ruul""'l'l, pla. , ,.u " a i. al " /oIDrT .... It.
arrd "" lOP Df ,,1I 1.u, bom/Iw- . ,...... /., load twr
iJomJwtd btfDlt. IDIl£«/fJIpliJllI~iJ IInII f lu"'fIt ".
But thor<: i$ a KCllDd and . n D larg.,."",aIo
aample ofJ~. numbers (Or people being ""'IX"'-
em! In UK now ,ocbniqu=o for improving ihdr
own circums,ancO$ Ihrough ,heir nwn decisions.
T wenty)UlS ago,,~ b<:glln a campaign In put
the kn owledg.1UId tho .... an. of family plann;ng
a' t he disposal of many m~UonJ o f I'«'I'le in the
low·income world. And ' bat too was a campaign
10 promoIe low<OA technolosies; with tho poIeD -
tiaJ '0 g;~ people more p",wn ' 0 Unprove ,h~r
OWl! and Ibeir childno'~ lha.
At Ii.." lite o ffid aJ bw,h Krvices-..: though,
' 0 be the o nly proper ch annd for pu ltilll ilIe
Fig.19 Effect of ORT OlD weight-ge in and on d urat ion of diarrhoeal iIIne..
n " SIUtl\' d OAT at!rr...sterud at hcn1e by tr.'WlEld
rJlIdw/';es 11 a nsallII'C8 al Tuflwy, a 100ai al l.237
cNdr8n aged D-5 years _ t' !T'IOl'OICIf1ld CMlf a 16
Dt.ration 01 d larmoe.d m"""",
'Nitti and without 1M use at ORT
I
[ ,,~'--
, !.
ft
f f<,
knowledse and ",""nJ of contraception at people'~
disposal . M a result , the pl'at'~ of family
planning .p~ only $lowly in th e late 1950s and
ear ly l%Os.. Bu' in the 191Os, OOIIntri... like
Thailand and Indonesia bes:m 10 pion.... ways of
hreaking famiJy p1u ning nu' of ,b.
medical ches,
and tuming i, inlo a people" lechnol"llY. Soon,
pilb ud condoms we.., !loins sold in phmnacies
and baznn, co m er-stOlCl lUId cigaret'e IUoaIr.i,
vendillll II\llChin.. and ,.. .. ations. Ad""",, in
cinemas and neW>ipapcJ5, phnne-in advi.. ..moes
and mall-.ord.,. con t raceptives, 'lu... ion.l.lld-
on~""'" ~bows on radio lUId TV, 'pol adveniK-
mentl repeated dOUDS of times a day - ail wuc
used to pu' the knowledge and the meanI of binI!
eo,nrol inlo ihc buds of the pmplc.
D<mystified and deprofcssionali.ud, family
plwniog beslll to salher pace. World-wide, a
uuojorit y of paren u now hove lICCeSI 10 modern
means o f c",n rolling th e number I.IId .pacing of
ihcir births,
~ .... tWO Brell lessons to be le>mcd from
monm penocI . 746woro in ltlil OAT traalmElnl group
and ee rest S'1 a control group. The n:sA!s,-
Monthly aver89t weig ht gain io children wit h
diarrhoea, with and without 1M use 01 OAT
Treatmant group
D Conlrol group
_so.- ",.. "...
•
1 THE STATE OF THEWORW'S CHILDREN 1985

Bangladesh:
teaching two million
In Banglaaesll, alm<iGt 10... of all IIIe C/IIII:lIeI'I f"""'Y (lOQ<·teKIOOI , ~ the ·....,pOinlSlO
born <kI be/oM ,eacI>ing !he • 01 ~ .... \Il)m !he ,.. ,.tibet ' 10 molhBn;, ohDwJ'lg !hem t>ow 10
'"""rO'allon and _PoIlCIII Drougl1l on lly daat· p<epare Ihe ~ mo " and WlOIChingwtol!:!he
_ _ ICI! ttlOSO \lotIO _ . llIaI,noeal _ . make d.
lliseasIl IS a Ill/IlOI ClIllStl oj II'IalruUI1l"n
A m)nlh lal"'. • ""'_ .10 team QUeSl""," 50\,
Mosl of Ine (le/JlfI$COOJId tlII prevoII<"Ied by !he ot ee on
l/I!l .~ poul1S ' IlIlll ..........
'1"lCIlI1lss
.....,pe mea.... at pacl<.eIs 01 ...... ml¥lIatioo sal1s rnem 10 prepa<e 1I>e """ The _ are
rnxed WlI/I Wlltel SuI coeap ltlouc,jh It1Il PK-kl'\S
ar1I . sucplylng Il'oem Ie II>e 1~ _ mottws oj
9'_ and It>n 01'" "'''yd,ation _ I<M paol
~ to hOw rrlI>C/l me motrwn n-
_ childten .. Saf'IQbdesh $<)IS llIrnosl ........ leaIned - 16 cents !of a per1ee1 aoore, Sand.
n\OUnllIbIe pr()l)Iems The country wctlld_1O <:fW\IS b' lOwer SCOles, IlOd rlOIhl'l'l ~ (!Ie molholt
pr<>tluc8 90 "..."" pacj<elS a \'MI II"l$Ie<ld o! has forl/Ollll'l hOw (0 mal<e Il1e mix . (ven aber SJ<
Klday'a 10 million. <Tief 80'1> of E\al~
...,....., ate lItlerlllu and <:anr'O:lI read !he onsInIC-
1J<Y\S. heabh _ teacll c:INy 20' ol Ihe
-,,,
>Tn1l1\$, 9S'll oj n'Olner-s can &NI prepate ll1e moe

ooouIabon: and many ",.." IM'wlies (\0 nol earn The IIlOIIIt<ltII'9 tearm Blso t8$l hOw ol1en !he
en<MlQI\ to toJy the P9Ckets rtlCllhers ilC1~ \1M' ltle ..... 10 theit c/IKI'en
........ theY II;I "Il
<hal""*,, Tile irr\IilI 'e5IlOI'5'lS
The Ilangladesh RLdlII ~n1 C<:wrw'm. ..-ere <l~ , _ rales -... ,.. k>w ,..
''''' (SflAC) <eeogno.ZecllfIal a soIlJton '""s .-led 8~ W,t1l diallhoea suctl an ellelY'l3y evenl , mlIl;I
ooflicI> """"" ....-at _ COOId alford Aller a
~ 's _ l l n l l ~ carne l.Cl "'11'1 Ihe MSWel -
artael<s ,~ no 1<.... ' ' ' '11
af ...
a seI 01 SlIT1PkI m ge' calM '.....'" pooI\lS 10 All. lII1Jdy!ng Itle I>'oblem, 8AAC ccnclu<led
,til,'" Ibe< . wI1dll8.1CMsmo\hIlo'S how 10ward011 INII OIal 'eIlyd<at"" """""'" mor" ~ I,orn
<lI!Il)'d<a11Olll>y """""il a ...' ..........,. ot"""",,"'In a ~ lnl mille COIMlUOiIy Ieader&, So BRAC
mr-1ingeI1WICtl ot sail 1.I>Qott and " !ou<.flo\let ncIuded ""'" more men ... elICI\ moro1<><ing le3m to
.lICOOP 01 gut. IIIlllcQll(Vl!troea sug;I' weak 10 1IlI! ""'" oll!lfl >'Illa\l8!l - lOdi'wolually and
BRAe Iaunche<I its oral fet!ydratoo programme "' "'Will , at ltle rn<>sQUll5 ar<l """"el1lla<:es -
in ffid. 1980 _ JuUod - . . . , """. ""93' lnl 10 hold sPIloaI _ $ lor the trad,toonal
roZlld 10 learns o1lllr1 - 5e¥8Ilwomefl oOll JeItydIot- _ I, whO at"
aI50 usua.... men
non WO<l<etS. two nlllie TearTl C'H"I~>ill(W$ and a The resun was ~ in ttoe ......OI/O(lO<1.
eooI< -1avoBd oul ttvough I... ot B""g~'. 11"". oIlh:JuQh !he ,ate has yelle ' .... above 60 ",
20 0i$Irl:;1S W,TlIon Ihree \"'I8IS me I~ I\a(l But BRAC is conhOenllllal I\Ie talas Will contll'lUl!
'augI1t 2,5 million WOflWl In 20.700 ,iIages ""'"
10 PrePare me !IXJaIl.1p moe
10 fI«JW as the " ' Jill';' 1$ _'e<'!\'
brougnl
home hough !tI!I SC/IOOb And t' ad/honal lle3ler$
The leanl co-otllonalC>CB ......1 Ihe via<.ges 10Sl, 10 on<! t>I' , meclIe ~ 'II" \'Klich . - PQat.....
P"Wlllle ", ay WlII'1 \IO'I~ officIllt! and " " - Ieatl"l8. -...00 ancl tad"' spoI$
leiIOe<s; Ihlly Me meel WI\h Ihe men 0 Ilhe 'IliIage
and "'l)IlT"IZfl ~ C'lIIIm eatI'IlllIi gt'I5 III local
1.$ ~ ""l8r$ >IS (,fth year Itle pmgrammll !laS
"",eased I1le tII.fI'Ibef 01lIS toeld-wQ<l<eoo 10 I ,20 0
""'"'"
The 0/1.1 rehyd!lIbon 1II'QI1<llrs men clll on e&ch
ana lIaS "'"lI)' c!larlC8 01 ~ its O'\te<im
largel 01 ,eactmg 6.S molIio!I tI'(lmers t'I' 1986

•
bot h of the$<: prtted~m .. Fim, Ih~y h av~ ahown
that th~ way 10 promote a ~oe-opJ~'1 technol"llYand
to put iofortNtion al the disposal of th~ majorit y
is hy mobilizing all poosibl~ ruou.n:es and work_
illi thl'Ollih all possible db annell both 10 = te
the Jnr4N1 and to lI:lffi it. Second, hindsigbt
dearly shows tbat neith..,. th~ G reen R...oIution
nor the: family planning mUVell1tllt rt'lI1ly took off
until thc:y Wtn' S«n OS political and CC01Iomic
priorities LOd giv~n th~ full b&cl<illi of a nation'.
polilical lead..,-w p. Whe:~ tile we;,ht of the:
prtSicknt or prime minisu" ... put bdtind the
ampa;gn, when the ministric$ of labou r and
financc and cd\lQtioo as well u the ministries of
healtb or agriculture boa""" in volved, il theo
became possibl ~ to mobilizo, IM~ of the resou.....
of government and of S«ic~y,
Nowh.,.., ~ thac lwo l....,ns """'" d eody
iIIustra,ed Ihan in preseot·day Indon csiL Beaux
the campai gn for family planning was giv~o ltijh
poM nai and political priority by ,he Pr$d~nI,
and beaux g5'1. of aU f:ullily plaonilli services
were mad. availabl. DIIm4c the formal healt h
$Orvi=, llmotI oil lndOllcs:ian parmll ' oda y bav.
ac<:aII to the Itoowltdg~ and ,b . IIIClI OS of
rontrJCrpliolt, A similar COII1bination of pn:sid~n­
,ialleadcnhip and the usc of aU availahle ~haoncl.
was ... ponsibl~ for Indon...ia' s oucccssful G reco
Revolutioo of the Lat. 1970. and early 198O:t.
In stark "'ntrast, oral ,d1 ydntion sallll have
been 'passi vely' available: :For the l:l$\ ten ~rs
through health dinics which lICl'Ve only abou t 20'1.
of Ih~ l""'l'k. lk1w..o 1974 and 1179, .pprolli-
lII<Ildy 10 miI~on sachClS wtR: used and, un-
doubtedly, llWly ~vt:s _ "" SlIvtlC1, But in thaI
same period 110 las than J million l ndon~
childl'l'o died of dehydratio,n.
The.. ia nOconvincing ,.ocdial reason why oral
l'I'hyllratioll sallS shoul d only 1M: amiable through
clinics or healtb ccnU't$. J o.od if 'he aalt:s ~ to
become availa ble '0 'M majority th t'Il lb. time h..
come ror mass informatinn campaigns to OKate
the deman d and for the prod u.. itsrlf 10 1M:
availabk _ as easily IS mltdlCS, lOOp, razor blad..,
soft drinks, cia= ttes, tea, cooiWtg oil, or batt..,.-
i.. _ from groceI)' un ndlng mrhio","reel
hawkers, Jari_Jari " t >U.all'S, SUptnlLlrkcts,
barber', shops, tea stills, gI>I smions, and han.
Although ,h o ,as/< of maltin g the Itnowlcdg<:
and the lIlCIm of family plannin g- uni versally
a"liJabJe is fa< from completed, tbe story orr:otniJy
plann;o, over the last to" yun is allory of Brat
hllpl! for th~ ehild sum"ll rf\'OIution . Enetly a
decado.,o,al the lim World Population en"r..,.-
eDee io Bucharal, it was rosolwd by the intema·
tinol! ",mmu nity that "1111 NllpIa 11M i"'irNilUlu
IunJt ,100 b<me rig.' 10 d«Uk J-ly oNl m p"nui6ly
'M nu..lwr 11M fPI1d"i of ,10. cltildttn" .
In 1914, as the second World Popula,ion
Confen:na: IDC1 in Muico City, it could look
bac k on a decade of rapid pr<lg/'aS in translating
t~t human rigbt into a human rc:aJity. The:
majori t)' of parmt. now have lb. kDow ltdge and
the means of bin.h control, Now, the time has
come 10 also er.. parma the: ltoowltdg. and Ibe
means of dellth coatrol.
Soc ial .fIII.fbtUll
Inasmuch :Ill the: prospect, for a revolution in
child swvival d.~nd on the rn mmunieation of
prw:tiCll.h1. infnrtnlltio n '0 millions of pamtt.. the
mod..,.n lIlUS media ~ d early a powerful to-
JDUrtt for hel pilli to bring- that revolution abou t.
And it is pcrhapa in this specific aru of ' lOCiai
0iU k«ing' 'hat the Pl'CSCllt Cllllpa;gn has II>06I to
leam from Ih. fomily pIao.ninl aperiencc.
l)y..,. the IBSl twenly yurs, the developi 1l8
wnrld has lran,formod. its clpacity to communi·
elite with ilS own people. The ",lI5Ol.idltion of
natinn al Iaoguqes, the iou allin.g: of oati ODl! road
and rail net worlts, the inausi.ng ~""tiooof
peoples in to...... and citiQ, and the dramatic rise:
in Ol;hool enrolment bo.. """"ed a n.... potential
for lIlUS commu nicat ions. Radio r emains of pan-
mount importao<">l! for ,""hing the majority . But
the printed media arc importIJI t in urban areas
and lCln-isioo and vidoo have sPTUd more quickly
than anyone ....ould hay. imagined: by the end of
tbe present decade, for en mpk, almou th......
qlLU1~rs 0; lod;,,', 700 millio n people ...ul ha..
aa:eslI 10 lelevision,
10 the industri&liud world, the modem media'.
apacity for tIIIIS cocnmwtica tion is inaoasinaly
being d<ployed to briag abou t <haoges io behav·
iour and improvements in society , Th. Nltional
"
I THE STATE OF THE WORLD'S CHILDREN 1985

The Gambia and Honduras:

marketing OR:T
Am100 WlU'I trIG I<rlOWliIOQoo 01 OIal JOOy(lI3!lDf1 l:'ly "1981 Less IfIan a vmr jaie. 93'1> 0I1t'<l
It>ef3P'I' lOA'}. PllrE<llslhemselv<lS C80'" now_' POPUI/lTOO knew l>bOu1l.11'08OI and ~ 8~ IIlId usoo
11>0 d~dBhyural "" _os"'" '""'" cause ~ a! _ once. litter oogt,lWr, meltu.... B ..........,.
01 cI\lI<l <lOa". ..-.l e """'" ca.rle ot ehoIO
malr<l\ril.... - .. me ~I\I wool<! Al ltIo
~ ,""",aI<erI in _
wll&r8<l from s (lIBl_
_ e s ctIIO:I Noel
,,,1"'' ",000, .. ,tie IWO
momem. less I!Illl'I , ~ '" Ollli'fents I<ro.lw lIbOu1 _ PlO tu lt1G SUIWy AhlDsI 4 0 ,., Nod been
OAT So "'" QUBSloon marl< ""'" IhIs """'" n&all!d wUh OAT The CO$! 01 me Cllrnpaq1 _
medoclIl !lreaklllroogl1 . 00wcan ~ bo put onto \tie 25 cents per mother '~hlIrl
M",,. '" tM WI" """""'Y olll>e world " "",r_~
~, IIIe Gamllta d ""'" <Iecided lt1111 iltll-t>ael<e<l
a....
~ _ ..... os SOCIal "" "ke\lng sacntII$ <>! 0/11I ' MY'l'. t"'" _ """"<l t>lI ~
Plomol"'ll OAT Dy 1IIe same meltlO<lS _ na,e tI>Il 1",,1\CWI 'll3CI'l 01 lOr> rtWlY 01 tnfI nalo, "
PU' _ IJl<e ~ nlQ almOsl •...ery ~ eeees So ItIII ~ $01 O\Jt 10 \&adl
.. .... "~<l worItl mothCtS 10 IO/eSlaII r1eI1\'drat"'" ~ malung UlII1>eo'

.'1*_
Ow" \dolO'! kom (II_V I1OOOOI><*l r r v - '
To IIy "'" It\II ""'" "'" ~n""....1S QI fWO caretuI ,,,,,,,s,ct1 tUlne<l ~ B ootlle \01 a soil toe,.
CCUI1'... !hII CamDla IIOCl Hgoaufl", eoIIsIlIll
lI>e tlIIIp 01an sooaI """'"JbnlIIeam-
100 Amoocan """",,,of" AcaOOmv "" fdl.c:al""""
._biB
<It.... - -"-I ona nocasunog <leVJCe
lI$ "'"
Ie aImOS1 eve<yone "' ,roe <»un1lY E'll"1
Julpearl tIOUl<H:3pS 01 $V<}!If ""'" O/>e 01 SaIl
De'oE ' ....'_' IIOOeO 10 IflrM.Mpeat1 DoIlies 01 .... ,e<.
W/ISfoul..,
T~ lI'ie$Il """'ll8IOI'<!W<!8Cfll 11>0 worItl'. 10 """'" s ..~ustaClOtV Prill .... vdm''''''
~.
10000 "'lle<lenCe ot mass-ma'k!>lng ORT ThIlS10ry
.., far • ltI " ~'Q8Iy illteraw POJ)UIa.toOll. _ W3SllQBo"
selec:led as 1"'" """" rnodIum "" ,eacllong the
In Ib>clu<as. IN <:atI1Pil9" cote<! 10 PtOmOIC nal""" . _ . r_ a ~ \!me was gI"e'110 "'"
LJnosol - 0".'"
name of l/III ~
_10 01 WHO/UNlClT 0<111 <e/lydrat"'" lo<
"'' ' ' '.\Clured c ~ tly RaclIoGamboa ilsl<!ned to tly 75
01 motherS in 98 'll 01 V\II,1Oll5
mW! , ... aa,1I"! POIlUIahOn ...as 400 00<1 S/lv(IrI
monlllli 01 caretul aw.ence ,eseaOCh llIaduatl Soon facliO lld'ier1_1$ _e e.1llalninII llP-
SIIIlj>e<lltli! mar~&\J<"t9 DIM
Rad.. """, selecte<l "" iT..,.outSf!I1 ORI Altho sarno \>"no all PI tnfI
It<> one mod!um whlct1 'oor:hos rnosl 'noltw. aM COUf'lIt)' S hNIl/1 wo<l<ers!>rod ....'scs e """"""'"
several 6O-sea>n<I ORT _ ' _e OI~ lo<
use on 30 ""'''''''0/11
roo., JltIWOtks
'" lI"N'Il <lemonsIta1OPnS "' VJUBgeS""'"
lile facliO """""'JI' A t<>Ial 01 1 T 000 WOIt>IlI'l
"""""""'9
emered 1l>ll H.:lppy Bally IClIIl:nc! I'<l1lCIl o"arM
W,*"" a few """""" II>e ant Ihe.ne _ was pl,osIlC rne'lSUt"'!ll\lll5 .... 1 mrs OIaoop as Pl'01es
nalienal"! P<>P'-W IIn<l _ Ih< fl&<ll la~"" ol all
mo1tIefs lu>ew 1M _llS
lor .kiIage molhers whO COUll! alrswot basic
01Ie$Il0I'l$ on ORI C<Yr'm.>r>1y 1"010.01 ""II'" """
'_ K<'
Ilul " was also ""-"'d mal rn:>sl
• we.1O·o"e oemonsmu.... 01 OAT So lloI'lln
o'lee<lO<l nee weol to "'" ~ whete II'lIl ~1QI>aSl
O/\>PO'!"'"01 tnQl!lers knew how 10Plo:pare "" ornj
_ _ _ eenloSlod10 I""n I zoo '00_ "" 'Y'l'StoPn IIOliJI_
00. - ~ Ge!l101lSlfalOlS kom """Oil! t>omes
W,,,,," 8I\l"! .-,ma 1W<>lf\d'~ ot mo ""lIOn s
n".. IIags tIear"'ll me c.omP<19" • symbol of a ret!
rroII'ICIs IU'Iew hOw 10 f'I\I< ItIe SOI<MlO a<ld alJroSl
~~
40" ""<l SIan"" 10 use _maoc CRT...t"""
Thol CO/I1Po>ofJ'l (Il)l!Otld anod n""o.,-oo PUbl_ '""" ch<k/I... had lloItll'looo

"
HiP Blood ~ Edu.:aioa Pqn.m ill tK
V. 1ed Swes, lor ramplr , "- helped 10 redore
1Irob datht by a.er S' I yar, IadiII,r; to &II
cwcra1I rullK'1ioo of 4M ill tK ...... of «lOU
datbs d~ 1M 191Ol. Othn media ampai,os
io 1M intIUllrW world hI,'t llelpal. 10 IIdk IIIe
probI.ms ofhr-...t: CII><tt, <!nit .h_, road $Il'l:IY,
onol'lY ~nsavation, .nd home-accid.m prncn.
UOII. loml.bly, IlII'h maM mtdil camP'igllJ 113"0
adopt ed and adlpled man:1 or the lechniq ues o(
11K ~ mukctin, world and h3vc there-
(ore Illraeted tlu: lahel 01 ' lOdaI mumillll'.
10 the dcvdopi", worid , 1M oew apocity for
1IlISII communiatioos 1111 abo opeood up •
poI••ll ial ror $Ocial _ ltni ", _paipa. And ill
lhe .... few l'ft", IIWdI h. hem Ieamcd aboul
l!lc plXUlliaf _ md the 1iaIi~ -ol sac::iaI mar·
mille II ......... of brinI:iIIt obovt ~
-'l~ • I"" lidd of bc:olm.-l lI11ltibo:JA.
Mea 01. 1M ...... imot ol -=ial lllalhtiltc •
the dc:n:Jo:>piq -'d basltalmll1ated auuncI 1M
... " ;'00 of family plalI.IIiIIc. BIn P.,.....,....
_ P'ia;... have ... hem p:aNd 10 othn soaJs. ill
Eaiador" ampNSo 10 pn:ft:Ol.oiw-tmcd ..
limca , day for ,_I"" _1"'_hIlI
, ......mUtlll. radio ..r"an••,m...1 rq><Ilcd onuaI
illCl"<lXd tho
lIwobcr of boI1xboklI ua:in.I icdiml Ali from S~
10 ,., . ill the: PhilippiMS, 2SO radio sutionr
hroadcasliol daily llI<IAIa (or lh= mOlllm
. bolll iml'l'O"ed IlIricuh un l lcchniq ua ha". ';8-
ni/kllldy iII."..ascd both ,h. ric< yi.lds and , h.
illCOlllell of ,h . SO.ooo pani cilllti", farmm.. Also
in Ih. PhilippiJles., I radio ....... pailll ' 0 pn-sllldc
_has 10 <Dricb ......;... fDlllh bas NIXftdal in
inansiq the p<r(Ul"".
10 oM usuall'Ofridll. rr- ...
01 WOIDnI ", ho odd oil
tbatl I' t o _
..... ZOll; ill oM tint .ia!l1 .....'bs of tb<
amp";';o
Today, oM _ of lh< __ tD<diI _ud
oM Icdutiques 01 sac::iaI ...tctillI -....., ~
boci:o"iIIe 10 lot UII!Id 10 p.sl 1M udWqlll:S ol.
dilld ll.U"rioai ~ " tb< ditprAl ol mil-
liOIIs ol !'Cans:_
ill HOIld_ md tho G.. ~ __ marknin&
ampaicns ~ promoted ORT 10 blUldmls of
thousmds of_ben (_ PIl>d 20). W"nbilt ...
)'<11", aJmop I ~ or
lIIIOUo<n IuIew ,boul O RT
ud aImoa balf of thmt It,d used it.
surioIt ill puutmbip with • _.ci.ol
Similarly ill l';~ , JO"U"ID"'fI' radio
..r\'Utis.
.... "<DC)' bas "uabl 1O/1CIJ _has WI "Super
Ii........·",. (th . IWD< a"m 10 on! reltydratioo
salts ) will p<nml dchydntioa. o-qllUtU of
the tDOlb<rs - . . repaned 10 be salWly WI ' M
sahl and Ih. 0011 of lhe campaiJo is bet ween 65
eenu and $l75 per moIlt•• rnchcd.
In Bmil, lit. <lIlIiYllml of 51 million I)'W" ill
ndio ,nd ldevisiuo Idymisinl li mc ha be<u PIll
lothind • n. Uort-wid. CIlIIpaiJn 10 promoc.
brcat-fCfdinl. Virtually .... a ' OIl. in Bruil is llI'nI'
..... WI 1IlOIb<r'. mill< pn>ridcs oM b<sl;
poIIibl«o nillritioa aod pnXcctioo for babies,
tbouIh it iI . . knoon> wb<tlllll" the C&Illpaip bas
~ .coa ad tK r<eatl ..... alirk lootVds baltk-
rftdio&: ill III many of s-i/', dtia
1:0 IDdia, dIiId IIl"inl -.-OS II'< han&
prodaiIlIed by ad"''''",.maIlS.. bolsa ud bID-
......... Iso :>:;,;..... IJ"lIlP 01 doaon .... lit...uy
'mIlUtiDl' health by amin& lip health IlIDI ill
tllIIItet.pxa.. lo Gbma, • ,1tNP 01. JDUD&
doxton bas n>t:tI bqtoo am... dIiId surviYlol
iaronutioao talks .. e-ouy buIo=I. ln IlIOooaia,
~~'~Idaf IIlIfk<tiDt tcehDiq\lCl were IlKd to
mwds IIld dai&o tho IJVWIb 0"," wltidl iIQW
lDOIIilDnl the ouuilional IUIIP of DYa" J rni.lIioa
childftn Uld isCl1mm.ly beinl adapted for _ in
Elhiopia. III Haiti, d.mand for on! reltydn,ion
sahlla beillS ere. IO(! by ' lI. tio n-wid. ld vtnisinll
ClJDpai,lI aod lh. sachet. th....I... II'< br:illll
supplied l.lifOllgh comu-1llo1'I md IfOCffY Slora
pi.... 2,(100 'l'ilIq. ou~
In 1Ddia, maaaziD. IdYUtisftllcDts _ _ i",
infonnl tioo .... brnst-fHdilll btou&h' 4.000 l<!.
1m , <DODlb inlO UNICE.F, New Delhi of5ca
ud dIild "'""'I l'e1'Olulioo m "'I" ..
ndio
......
.... rcadtio& ."dia>oca III up 10 200 milIioa
11>< p>lUltill of $Ocial marI«tiot iI DILIr just
!lqin";'" ' 0 be aplooul. Bul Ibady, th<rt- iJ I
bodr of upt:timz .ni!atrk 10 auid< fOlt =
dJom. F" U'SI, it iJ dear that pcopk's Ii_ :tlId
b<hrriottr ........ be tramf........ simply by ......
ioI tho: mqir: wmd of __ DW"kftiD&. Mzss
medii........,. .bow the lICed to boll ...'u or '0
brnst.fead or 10 fead • child _ frcqualuy
CIIlDOI 101"" the pntbkms of ~ sIloru&< or
"
I THE = OF THE WORLD'S CHILDREN 1985
malemity Jeave or li~. lIIOIM' mot<: "'''''IY llt
~ hours in l b. day. R~. winB several11lcmpIS
'0 "'" social marketing f"" nutri,ion.J inIprove-
menl, for example, Richard K. M""off" has
wrincn: .
uTM ~~rril""'-ed""IlUlr- r~mtd-<Jdwrri"u., ""'..
CDfIIiztl~1 of 11r;'_1<111114 pawtr !till "" ""fiol of in
!j",ira'iq,u, .... 1M m(JtnUibiliry 0/..."" pmo irli"ll
ill IISI' al a nlblri'al.e lIlT II«t:SJary 1<>001
;n;/;",itJe."
Se<:<>ndJy, it hal pro~ imporWll 10 recognize
Ib" dirr....... ea M wen ll$ ' be similari,;es ~we<1l
COQUI>rI'cili and social marketing_ MOll' C<>JnJI'Ief-
ciaI ad""rtisinj aims to pro""". b rand_name
<'(In,.,;<'lII$Ilt:l:S in . ....mpet.itiv. marh, and I"
0$:l0cia,< prndl>CU wh h moocIs add ."",tionf,. Sl><'h
advertising is often del iberately devcoid of IUbo
$Ian"" or rationality. By contrast , social marbling
U$Ually dtp¢nds on ' he .... bs'...,."
of i13 lDeSSage
Ind tb" ration ality of itl preoent ation. A campaign
designed to bdp • COllUDUO;\y and iu panDl!I
leam b"w [0 make I.Ild II!IC oral ~.hydnlion
$Qlution.. {or ""am ple, is • diff=t mar keting
proposition from I campaign to per&uade I
community to drink Coke rath er <.ban Pcp<i.
Because social marketing cam paig ns Uilwlly
w:<:k I mot<: ,mponan' clutlg" in belu ';ou< ud
all;,uda thiIJI I chaDge in loyalties 10 I' particular
Im.nd name , masiI media lIIeUai<S in ,hemsd...,.
are usually no, mllU&h. In ' he prolrlO1ion of I
1110'" compleJI process 'uch os ORT, fc" example,
mass medii campaians caa be In imponal"
eomplemc n, '0, bu, nlll. IJI adequile I ubstilu't
for, practkaI facc-'o-faoe d<111oOnSu.. Ii01lS by
heall h wo, ken or ' mned vnlumee....
So far, ,he oomm<lI1c:st mWake of ""'ial mark.. _
ing campligl1S _ 1I1S IG be I CII""""tntion oa lhe:
superliciaJ SSpec1ll of commercial mar keting '«h_
,,;ques "' ,he eJlpe<IX of Its deeper disdp~nes.
Reoeueb IGW 11<1,., I targe' ludie,"", perceives its
llWn pmblrn>s IIId nted.. ,n'n ,.,bll $llI.llCU of
• Ri<1wd M _ hoo _ -......., ,. ...., - .
~ 0I0l .._ _ 1'fC'it<1."'
Lotio fuo<ric&,
...... _ AIri<a. II< hu _ 1<10<1 .. ~ ..Moer 10"'110
.... UNIClW '" th< <l<
.\I......... 0( 8-.. 1k s.
c"",l\neI
o( th< In' ............ CooJo o(
(I« pu>eIl ll).
infntmllioo hive cr edi bili. y, in,o wbl ' Ir.inds of
p"""nllliGn K«p1lble IIId wha, Ir.inds nf
inf()fmllinn prac1ia1bl. , .... all CSXfIUal ' 0
campoUgni whic h ,.,.k '0 briog lboul C<lmpleJI
eh:mges in hllIlWl bthlvioUl". In devclopillj sueb
campaigns, Clldside"'ble r<$C)UI'tt$ of 'ime, m(lncy,
IIId aa,ivi,y need '0
be in"""ed in "'""'IKe
selectioo, medii planning, onoll'lis of lllCSS3g.
ruistonce lUld moni'oring of "'"""'lIe response. A
poi~
lICk of professionalism in any ..... of th...
disciplines em eui.ly au in b.aU Lb. effcclivcncss
of I oocial marlr.etillj campaian.
Cord uJ marlr.e' n:scarc h in 'be c:ampaian ' 0
promote brust-feedinll ill Brazil, for example,
sugges,ed ,ha, "would be wrollg for lhe cam-
pai.... '0 dwell on 'be idyllic ISpecII of b,",,_
feed ing 01 011 'he idea , hal bttUl-ftedlng is the
symbol of 'love , nu,ri,ion and prolection>. From
careful .<amp~"3 IIId in,erviewing, i' ..... .<bown
,ba"_
"S"". an ",.pluJsiJ Mlld In'i<>wsly du-y <I """lin
ItmJjnl """i... /"'1hI.... wi,. liwul-/udi"" ~
""""irtt in lin inun.. a,oo"ry "....., lin """",,;"/
iMbi/iry 10 prorNk '1mJt, nlllri,,,,,, tmd prol«';o,, '. If
- . rimp /y '~IOIIi"l bfflJ,,·judi"l ctJllld ..,.,,,_
ally ""' lriboou 1<1 lMlfJnl in, """""I allritry au
ca>Utq ..... ,ly di",;nil. ,1st "",, 1ItT ~ oll- i"'1'<"'on'
lot,,,,,,,,, rt/kuJ."
Similar raea",b . Iso proved imponon, in 'be
CIID~a 10 pmmo1e O RT in Hondul'I$, wbefl'
.,u,ude I UrYeyo lhowed Lba' IDI>Ihm w.... very
$IlOJ1BJy ptWispo5ed ,OW01dS tIl'alD>tn lS wi,b •
snp!Us,iClltd, Ul han IJll.lie . It was IMfl'f<m de-
cided l ha" 011 ""lance, Ihe promo<ion of ORT
WO\lld be si3ni6caatly more lil<eJy ' 0 su"Ceed if
,he oampaiao were '0 p"""",e 'M foil_wn pped
oachet. of 01"11 ",bydn,ioa .. hs n llt... 'hili Ihe
use of hGlllC-mad e call and fUgar solulions.
COImam mooi,orinB of ,he campaign's effect
qukllly revealed lUlClhel polmlially d iAstrcus
problem. The CUnei Ih~l_- Gn who'" ' he
'1'IinIn g of riIlage WOIDCn de~nded - "'e", ....
unm,husilS,i<: . bou , ORT 'ha' many un_
willing '0 BO OU' aIId rflCOmmtod lite Lb py '0
lIIOtben.. The reasons given were Uluall y vague .
Bu, penislen, raean:b revelled the problem. The
collllOOn..' Iccal measure of • Jitll' of wll........ .
oof, -<!";nk boltle wi' b I Vet"Y n:>I1OW nec k. MOIh-
.rs always rinsed ,h. bot.I·. Wore h....din g i, ' 0
,h. nUrse '0 domonstnll. 'u uoool'. Wbm <h.
nWl<" .ried '0 ,h.
I'<l\lf Con' m" from ,b. foil
uchet in'o <h. bolll., ,he ,lain ClOked on ,he Wft
narro .... n.d.. So g.lling lb. sal" in.o lb. bottle
...... di llicuh and f....y p~ XCOlI wbicb ,b. nllrses
found . mbarrassi ngly difficuh 10 ~onn in fron'
of the mo<hen.
On lhn 00. dftail, the o mpaign could hl v.
found .red. Bu, once ,h . problem .... os kn own, lh.
SOIU'lon ..... DOl far."""y. A. Hoodwan Ilbonlol1'
ledmician suggellll:d ch. nniog <he .upe of the
foi l SKh•• 10 lh., 00•• nd ....OS loog and poinled:
....hen opened II th. poin.ed end, lh. fnil sach.l
beam< . funnd for pourin ,g the sallS dmly inl O
'M bollle. As • bonus, mothen are also I.fl with •
"..ful ilem of k.il. hen ,.quipmenl. Says <he
. e<hnicaJ 1'<'(>011 on ,he HOlldum programme: ";1
u perjtrtiy . kilr ' Q "'" IODW Ihl ;f tlu ~M"'" <mr<....
W tMU M~""trt<J, t1r 1uuJ .Iwrr ip(mJ, I~ whol<
p"',"'' 'rr_ W M/d Mw IwII ,..w...,...J" ,
It is already pooosible In lOy ,h., 50cial rnlf kel-
ing is on. of <he mos, impmunl lools for liling
child prolection m alqies Dol of lh. mnlicaJChesl
and Pouin,'hem ;nlo the bands of paron", BUI
lhlo-e is a greal dang., ,hat lhis polmlial will be
sqlLlJld.m:l in facile imi. ation oflb. more viuble
' llChniques of commercial "'iUk",ing, ....hil. ;anor-
ing . he pains,aking research, Ihe professionalism,
and the an.mion (0 d.laiI , which succwful
mar k•• ing dC11LlJllk
Th. iftd...lri.lIliud world
RilI;htly Or wrongly, lhe ind us,ria/izcd n.,ions
also J'I'"l$S rrIDlO,kable Pl,....., (0 promo,. new
norms and n.w 'lliludes ~e<pecialJy ift ,h. field of
health. It was lbe induSl.....lizcd world ....hicb seI
Ih•••amp l. of boule-fttding and <h. " JlM3tin g
of mo,h ... and habi"" into diff.,..,n, nx>DlS in
hosp;,"l ma'ernily Unil•. On a more g. n. n l l.....l,
" i. ,be indusuuliud "~,,.Id "'hich has mad.
h.al<h care almnIt synonyulOU' wil h dependence
On medical profnsioolls Ind apenu,'. cun1;v.
=.
In promooing ,h e mnhlxls and I ll ilud"" ....hich
could hdp 10 bring IIK'UI a child survival
rtvoluuoo , lherefo re, Ih. in clumialiKtl world has
I .... ponsib~ ity ....hicb II"'" funher tluut lh.
financill FCSOu.rees which i. could m&ke .vailabl•.
And ,heR are sume dolinil. sig;". lhll I ben.r
mod.1 of h.a1lh Cart is oow beginning '0 emag• .
To begift wi'h, lhe basic lenft ofth. child heallh
revolution _the id... lhll primary .... pon sibil;,y
for heal<h can be laken by lh. individual- is an
idea 1M ' is now gl<hering momenlum in many
iftdusuialized n.tioOl. Tbe I Uppon of prof. .
sianal belhb ..",ices is of coune ts5«Dlial, bUl 1M
mlllions of individual. in lh. rich world .... ho are
taking up regul ar ."ercise, stoppiftg smoltinll, and
beinll Cartful wi. h food and drin k, are =laiminll
Ihe primary resporWbilily for lh~r o....n physical
w.ll.being.
MGt<: specifically, man y induSlrillized natio".
It<:tbermelva usin g some of ,he In.... -<''"
melhods discuwd ift !his repot"! , In recenl yoars,
for ."am pl., lb.,.., h", bre n I vn y protlOllnced
lrrnd back 'owards brtast·feoding, wi<h over 90'10
of babies being hrta$t·fed f!'Dln binh in wme
nonhem coun, ri"" (see panel II ). This prac1 ical
demon$lralion of the fro lhl' breast· milk is besl
for III hahi"" and <hll hreut_feeding is nol ' just
for th. poor' will undoubtedly fortify lh. cam-
paigns 10 promolO breasl _feedin g in lhe develop..
inI world .
The indus"ialized world is nOl q uilt 10 ad-
vanced in lh..... of ORT . P roba bly I lnljori,y of
b05pilab an: lIill using Intravenous th.rapy for
dehydn,ion, . ...0 lhOlllh ORT hIS bren ahown
10 be more .ffecti... in mos, ~ Sev.n! maior
I\o$pilab: h«... mad. the chang., inclUding lh.
East Binningbam Hospilal in Eniliand wh.re a
..nior paediatrician h,.. comJ1Itn,ed ,h'l " ;M
Bi""i",iltl"" <oJ irr &",gltJdr./r, 1M "'" of IInlI f1MitJ
Iw ret!Dluritmiud 1M ""''''',."..", of IU MI( i"fo~1
goJlmml(';Iir'. 1f all moth ." and flIJlily dOd O"
in the industrialized world a1", kne.... . bout ORT,
lhen most cases of d.bydration could be pre-
vented, nndtring hQl;pital admia:sion unnecessary.
In lb. lrain ing of h...h h profttSionall, <h.
publishing of Itandard 1<>l1S, and ,b. seI,ing of
stlndards for ~jalric and hospital prac1ice, Ih.
indu!lriali=l world's medical lnstituticru also
It.."", I direct iftJluen"" 00 Ipproaches,o bealrb in
,h. developing world. Y.l on ly in lh. 19l1Os have
<he main paedialriC,n lbooks ift <he United Sllles
"
I THE STATE OF THE WORLD'S CHILDREN 1985
IoCttPled IJId promoIed ORT 11 1M bc:51 method
of P~linl, or l reatirlll. lDllII asn ~f dtbydn-
lioD. Similuly in _mUty IUliIS, 'K!omiD.I ",,'
aDd lIM: .mve, ~ l of bmoIl-r....w.,
we $lill1lCll SWId.atd ~ iD 1IIlIIIl)' olibe lIXft
md-f~ bln.un idllC:lltiai hoopi_
III Idditioa 10 tho: power .. alImp1c, ibe
~u aracI OI'I"" izaliMs ,,It_ industrial-
Iud ......L:l COIIld olMoutly play I maJor fI*tl ...
,1>0 ch.ild MlrYinJ rnalutioll by Dl&kiq IIlIOn
ll>OOoy anillblc 10 .ownu:tlta ll aDd OfJanizI-
tio M in the d~loJtin. world whicll an Iryi... 10
brilll ' hal "",oIlIlion about . Aid P"'I,:amma in
putieuJar could bC' IJ>croKd In ' M in ternlliou-
ally ..Iftd WJfl (If 0.71. of 1be dOllut utic>nJ.
GSPs. Today, m. I\cun for tbc f.-marUt
iDdllJtria1iza1 IIalioas "PIdS .. O.J~ 01 tbcir
GS,* -abouI 11M: _
abtr ' - t:lwI ill 19M .
. in 1974 * ',".
Wilhia me- aid ptlIIrammcs, partic:1lIar .n.....
l ioa f;OUld abo ... a"'m 10 >lnl ePs which ~
btndil both tbo: ~ C'OWltrics aDd ,"" ~
people wilhill OO<IJIlriu. At 1M momolllt,alipifi-
cant pt=tage of lh. indufl rialUed world'uid ill
dl'VOled to a p;lll-a b&orbin8 hi8h-l:irch pro-
Ifammn which confn IM i. benefit. 00 &fI urban
millOrity and l1,lQ .0"""0
In u.. ida! of maItiDa:
IoW-aIR bGc: IltIIth care I'tailablc to all Simi-
Wi,., the mu:rnafioa·l hoo t ifastilutioDacoaJd
abo play !heir fI*tl by odoprin. tbr ndio::al ideo of
takillI lbt Deeds of tbo: plllftIl _ aad
dIiIdrno ;"10 accouat who:rl ~ OM'dir;....
cI fiQ'ncW IUpparL III putiaaIar, iI i l eIIaI U.
that Ii nand., llTaIlI.......u should .aiftlY ltd
to pI'OlOCl m..alIIl .,,,itaaDd pr<JI""""'"
",hich bmm, 11.. poorm - . . *"d cllild rm. By
Illy IID bliDltcm1 a lalJatioa, such Krvi<:a ere not
' uu!ford.ble COIIlllDlplion' but essentiIJ and
b.ilhly CCIIt-dfcai"" itlY"""",,,.. in Ih~ ptCKtll
llId fu,un hWDall rnoun:a of I lII,iOfl.
build bail: P""t'Ctioa for ,h~ pl:IOn$I is bqinnilll
_ . lbe . 000mulIt1Il:I of Ibt iDdllSlria/i%ed
-.rorld.. TM. ~opmm . aid ,.mcia .... Car<ada
lAd Swedm, f« rnmpk:, .... a 'O'dy l""C""'iol
kJW<lS tt'C!llJjq1lel lib ORT. 111 WII!WlItOll,
tbo Ulliud S<a<.. A,1tDCJ lOr 1111 1I:JototD.
oplII£JIt ( USAlD)
_
_".-k
10tbo ~ioo 01on! rdt}d ruioo therapy
CUlIUl:lit-
.....-Id-;rio;k. 'Iluo\IaII il:l Joq.u-",-~ p'"
the ItlltnIIlioo.oI Caltre for DiarTboeaI Dixarc
Rl:$eIJ'Cb ill 8anI1IOesh. Ihn>u&b ill ilIitiati'"t ill
callin. 1M biahly 'lI':CCSSful lJuema,ional Con-
f~n<:l: 0tI Oral RehydrauOtl Thera", ia 1983,
IltId IhroUllb I rapid iDausc. in ill filWlcial
IUppor! ' 0 lDIIIy ' ovet'ftDIII'(lli it> IlulIChina ORT
campa;'M, USAID io doinI • IJU' tka!lo briq
wI,hilt rndI the "'1miYuslI ...-ailabilil)' .... ORT
witltilt Iftl yan~ wIIicb AtD's Mm;a iuruor
bdifftI to be III uuUtabIo: aoaI.
By !be 'I'OIItDWJ tqmim..... 01 tbo illdustri-
aIiIIOd wurId, llId by aU !be m i n;,.", .... iDdmdualt
who IUppon thna wilb !heir IaOIICJ md !heir
timr. I major alOulblttioa io aIrad,- beiIlI made
to !be prtllpe(U for I ~baoJe ill chiJd 'Ol'e lJ.-bein,.
ThIOlllh finlDcial w ppon of COIItllerpuI ....oni.
Zltion. weh ... 'he CoIOtllbilll Red CroM ( tee
pln~l I ) . Ihousand. of Ii...,. have already been
lived by Iow-«ICl. teebni<luCl bWI. l'lIl in,o
aetioo oa • 1:IIIMi"" acaIc. ADd ia II1moI< nt!rf
illduIlrializcd <oOUllttJ• ......, .... ~
IUCh .. omm.. SIft tbo QiJdml FIII'd, • . . -
_ r ehurcl>-l:l 1 1 "'P""im...... md UNt_
CEf"1 NIlioclaI CcIalmiuoa. ..hidI W<d:i.na
to lIIIb ITIilabIc bcIllI ~e ami ~
.....ca for, tbo child ........... lUll wIIicb ..
lDIIIr vohmWJ ....Ioi..riom butc hdpai 10
pioneer Ol'el reno! Jnn. It io oraaniutiolll au<.:h
II 1" - .. ho ore doilll _ 10 put into pnoc:tk.o
Swedish Prim<: Minist.... Ollf Pal"",'. <:ommenl
on lb. prosp(CtI for I child IUI'\"ival tc'YOlulion:-
,M,...,..,.,._
. ... ill 1M 4f1iclftl _ rria; _ -I"
"lUs""';biliO'd«s "'" 00I{y ral "';1.
M a..balrri-
allUlJ .. riDllS-_lIJl au' Wrn lid ~Itiluy. H
 A Health Service for All
So far, ~"Je moo';"" hu bow made of tb.
health sc:nrices u.elIlS<'lvu. BUI if h5hh services
could real'h OUt <0 lll}'lhing ~k. a majority of the
world ', poor, then tbey wou ld eJeuly be one of
Ih. Sll'llllJlest Jarm in th,e laminate of support
which mo'h<11 p~ to improve their child.....,',
chances of survival and lI.ahby growth.
In puticular,;\ is th e community_bucd health
workc1- who, ... en wil h "",Iy • few IMnths of
uaining and I minim um of oq.upmea t, ClIo be tb.
moth"",,' lI1OS! importlDl soum! of infortnlltioJl
ond pnctK:aI wppon, In ooctce, sucb halLb
work.", ..... ofle.. volunteer village women.
Most mothm Wanl and need lone·!....",.
demallSlnuiOfl on bow 10 '....k. up oral rehyd...•
lioo sailS and wbe.. 10 UK thtm. Similarly, lIIOlSI
mot he.. need someone to tum to for rtmindttf
aboul immunization .,;1I.dull!$; for 1Idvic<: and
,uppon 00 'M qUtstion of binb spicing; for
rcassutlJlce about hreast·f ffdinil (and for htlp
wilh problems wlli<:h may ari#); fM belp wilh
weiglti"i and growth """"toring; for adm on
preglWlCY; and for help in . ettinB to IIlOtt
qualified ICn'iccs sho uld rho, be o"""lS01Y.
As. pan of the procO$S of empowering moth. ...
the • ....u.bility of Iocol, qualilied, t....te<! advice is
therefore =ci.t A mother may hear .bout ORT
OIl the nldio, or even he IIngh t th e IKhniq ue in
her own home. BUI when , """"" weeks l~,e" he,
0"'0 clilld Iucldemy become!. ill with llCu'e d i.,..
thoell , she needl someone in her neiJhbo urhood
- al 'he time-tO mnfon:e boih her kn owledje
of 'he th erapy I1\d h. , Conlid.llCe '0 ..... it.
Similarly, I lI"IOIher ",ho may be living in thelllll1e
hou.. as he' pareot.. in .l~w may need ,h. mo.,.]
I1\d pnttic&I I UPport of a respected <:ommunity
health " "Ofker if she ill to make chan in the .....y
her childreo an: an:d for _chJ..n suc h as
bre;lS,-feeding fro m binh ( n ther than d isarding
th. rolO$UWlI which preced.. bn:~-milk in the
~ •.
lint f.... dl)" ) 0' chang .. $uch as beginninl'o
wean the chil d II five mntl'M n ther ,han One

Such community heal'h workers .... 001 e:lpell-

how and wll.... to begin ",,,"n inl ; for chec kina on
'tUnUS immunization anel lO'eight gain during
Fig.20 Health expe nditures
and population served
~ ....NicarqWl il'mning villq:e health ...... ken
for I&; than $100 ~h. Colo mbia lives th ree
rnontht' tniningtO village prqrtr<!l<>T<Il for lOSlIthlll
$1,000 each. Haiti is trainin l health agen.. for lea
than SJOO •.,h. Wor ld.wide, the cost of basic

"..
tr:aining for I community health worker is usuall y
in the "",ge of SIOO to S5OO. 1l>e<:ost of training I
fully q ualili ed doctor, by conttast, is .1 INII
S60,000, and, in some CO\l.O lri veT)' much~.
Yet eq ui pped with only I f Wttks' traininl,
IItd a few inupenli... ite"'" of eq ui pment, a
85% •o.. primary heallh can: worker CIII DOW bring to •
comm uni ty the know ledje IItd lhe technol"IY to
hclp parma hal ... lho ,~tc of dea tht and maln u-
trition I1l>OJlI 'hoir cttildl'l'tl .
If tha' community health worke, iI also selected

--
IItd lupponed by the community'. owo "'llanizl>.

.... _--
~ '"" MOtlEY
(eo ._c.o"'g '"
HOW .....-..N 1'E0PI.E

lao '
~:~
poo_'_'"
AAE $(RV(O

til" Q
lion , I1\d hllCUd by efficient ...ferral servi<:el
offering more speci.oliW tlln: when JI"""IS01Y,
Ihen tho basic clemen.. of primary heal lh an:
(P HC) an: in place.

--_._,-""',_ __ .....
PRIMARY HEALTH CARE Primary health CII'l' is brginnin. to be put intO
prsaice. Out of 122 u~tioos n:ttntly IUrv~ by
D HOSPITAL CARE
_ d- " __ ... the Wor ld Health 0l'Jlltization, P HC is oow
official politY in 7g, Nor is the tommiulltm to the

"
I THE SI'ATE OF THE WORLD'S CHILDREN 1985
Thailand:
PHC goes national
IrI a 1983 SI.WY8Y '" 12 2 MloON;. lr1e World
_Il ~ Orga<llm100n foo..<ld l/la1 78 hall """""," lid
1!Iefl1S8/Yes to allaining 'heaItt1 lor alll)' ~ vear
2000' ".,. ~~JIg Plmary 1\$aIII' ClWe
'" many 01 Ir'IOse 18 .... bOn!I. aclio<llags a long
VM'/ DeInn:l Il>e WOtdS. Bul sorm ~
COulll"es a,,, PUIOOIl PI""lIIY hea/II' care O1to
."""'"
Ilf3C IIce ~ _ on a scaJe eotr<n8I"lSI.Wll'a """ "'"
1'<- ' " rt Is <lesogneclIC tael<Je o,e 9.J¢ll OOllKln
Pnmaty IHlaItrI CIlIa beclIJTl8 Thatta<od s " " _
Ileallll policy in 1977, hnclinll naMai foots ..
111;1113"'1'$ "'". ~a<li\JOf> of v"Ullat'/ """" "" "'"
<:omrnJ'lIIy By m.(H 9S. , almosl 40.000 ""'-
- . " YQIun\Mrs (VtN.1. _ by over a Il>Ifd
oj a mil.,., ViIaQe _
_
comm.rooaIlOIs (VHC.~
in piau IrI almosI l ~ n g/ Tha-
Jancu 55 .172 .... 1l\I$S Toda)I, I,,", IIHVs are
ITlOIIIl<;M' f(lll>e g<QWIh or 0\IeI a trnrd c,r Thai;and'.
6 5 n>iAIon under-fives. oncI a _ 1 ot 0Yf!I( a
"..,., children lias sIIown • 60" 1111: ... acule
n\il l'lulollon 11M a 30'10 tall., lI"ollder"le ~
lion over the P8Sl loor yOOr$ Also ltl3rb 10 Il>e
~, ~ lIgaIIISI dlllhlr>etlil ,
-M ........ '11 cough. le i,,",," Bnd 'lJOeICUIOSIS h85
""~ from 35% ttweroge in \ 97 8 to mots
lI"iarI 50'" ., \ 982 The PlO9'lItmIe " """ rducles
orol polIO MIl _ ~ "rei I,., 19 66 thll
lI\MI'flII'lI!llllXPllC\S 61)':\1 ol TMilalld'. CIl*lJlllllO
be!lPv ........., ed
The 36 4.000 \JIlI8gII llMIlh oo,nmun'calors
(VHCsl lila seectec trv The clusl8' (If 15 or so
~ y,he<e \/ley Iiw ar<l_ 1M! <layS 01
in!ormal h...-.ing Atl..--.<Is,ItIe)I _a 00 10 IIIeIr
""'QIlI>OuI'l _ !!ley 1'18'" .......nell - especially
~ atl<>J l fllJl"lI<ln ond nygIerMl'. lhead\ian-
l8ge5 ar<l ee mean:. ol TamNy p1.......-.g. Ihe
Il1'IIXI<lanCe 01 IlOll"'ll cIliklrun mmlnzed. and
W3y$ to Ill_I oncI CO<\uol _
Gr<lups at *' IIHCs - "'" I'IOIm Jor on - "II'l
"
WIage - !hen ct>oose """ of """, I'lUf'I"Ibe< 1000 on
lor 15 <layS' IuMeI U""""l'l 11$ a ~ I'>ealIl1
VOIUn_ (VtfVl ., lIlkl,bOn 10 lOOl1ltoong ~
dref>'s 1l'0000h and "'lll"'V"'IIlfM'I\Jr'II<t3\lOfl cam-
P39"S. !he Vl-iVs g.ve ~ klod to
""'*' gr<>WItllS fa/I""'lIl anal(>
chde'ren
women \OtIc ar" at nsI< 01 Dor\tI
gMng
PCegnanl
..neIer. I(>
"""'9ht eeeee, The VHVs abO ad rnnsl.. hfst IUd.
distnllula t~ plarY"'II polls III'ld ...... OCb'... """
oseese eese o:rUQS b' (:Ol"'iOI'
*-
The Vl-iVs a'e 1'allllll! lO 0l!aI "'th an esIlmated
601Ij,·6~'I(,o! .....1Ie lIrol!sslIs ltIey ,ew """"
"""""" eases 10 !lie nea,es1 l'>eaht1 oen1'e pc
dislnc:t ha;pUaI. Eae/l ratn!>OI'I. 0< grouping o! so.
to ten viQage$ , has a t\elItIh """I", S1at!e<l by a
Jro<ne<.l """""!e ar<I a SllllIl3l'Jlltl. The healln
"""1'''' in tlIr~ ar" ba<:1<ed !Iy llOeIOrS arol hognet_
JeveI medIcIII _ based ... !!Ie OJUIltry·_
ne/'OoOI'~ 01 d.,met ana P'0'N!C>8I/lO!1l)ota.
Thol l)r(:IbIem 01 access 10 b<nle drug< 81CI'Iflap
_ - a llIot1lem .... I'oeh Iaees P' lIIIllry hea/IIl
e",,, prograrnme$ tt>rougt>ou1 tI>e ll8'>"Iopo'l
world - has lIlso been taeklecl Of) 8 rnassM:I $CaJe
,n TI'IaIIancl- arol by an .......... metho<l ~
0\11 !he c:oo.rntOY. over 16.000 -.iIIage 0tUg t>sni<s
have betln set 00 l>'lOeI tile SIJl)8IVISIOf) 01 trill
Vl-iVs, VilIage _ _ lluV SI'IarfIS ~ 45 III
90 US ee<IISl '" 1M drug bani< Wtlt\ "'" rnor>8\'
(In)gS ara bought ffom "'" 1l"""""""""1 at "
dOSCCJUnl lW1d sold at an oIborIl tel.. "'''''' Thol
PCol~S 00 to Du'I'OQ Ou1iler SIIPPiIe:s _ lIll)Sldll'
II'I(l _ lor the p()<IleSI ~
8u11dll'l(l8 natoon-wwle P'tmMy heatIh cara
~ trYougn !tle peopIII'S ownJl8!'l0P81i01l has
""""tore . . - an Imi><IlSSMl stan In ThaJlanc:I
And this _ . ""'.- ot luhJ'a JI'lf'\iCtpallO wiI
tie $OWn "' T- . : l·, sclIcloIs' allet a mas5M'I
C3ITIP<I'll" '" 1fam _~ by 'lIod!O. or>-
fI'Ialy he8ltl1 care !:l now III bec:oo'ne pari 01 II1e
tegU\lt ~ ... IIIe flmI8IY SCIlOoI8. wt'Iit:h
are al!Mded by 96" ot T.-no's c/lIIdrerl
ilk" pu""ly rhel o rical: lod i. bas 'rainod 340,000
bealth g uid es and V(liunwers, for enmple, aDd
Thai.land has 11'"in"" 114,000 hnl. h rommooico-
'0"' (lI(e ,*,eI 21 ). In T an unia, a1mosI e....ry
village 110.... has 0"" heallb 1'051 mended by •
train"" person; ;11 Ilou....." ", ~ of 1M vill"ll"
have vill"lle hnI.b commintoa; illlhe R.pub~c of
Korea , 2,000 community beal.b praetitionms ....ill
~ Ivailable tI' lwo-thirds oft~ populalinn by l b.
end of 1915. In Bouma, 1).,(100 communily-based
bealtb worken"", bcinll (l'.io"" in 6ve yean.
"The idOl lbl t every viUijje l.Dd ncigbbt>urb ood
UIould Iulve " u~in"" colNl ,ullily b.al,b ....()J"k.,. is
lhcrd"orc by no meaJl1 UI ,'mpoaibl. dream. BUI
~Ierally milliolll of loch heahb worltm ntcd 10
be " .in"" lU>d suppcm"" i.n <.h. _ U1d promo-
tion of low.alSl child PfOll/l::tiort ltra .egies l ucb 01
immunlzalion and onJ rehydration tb..... py. And
lh"", is lod .y Ii.ll. sig n " lull the financial .....
SO\Iree& an: aoin.s IG be m"de available Gil • real.
eommelllunl. wi<.h lbe 0 ..:<1.
lD pan, ,he lack of money fOf primary hcal<.h
care is a rosull of in l.rruliona! fot<:es _ follinl
expons, deelioiog ICI1Ill of lrad., big b im . r<$
"" es, and i.olem.alillJ:lal lclldinll policies ....hicb
lc:nd 10 diserlmioate "llw ot JOciaI spending IIJ:I
P'VIlntmJllCl of primary im]iKlnanee 10 lb. poor.
BUI .... h. lh.r !h. IIIOIlcy is mad e available .0
lrain and equip rolllllluni,y bWlh worltel"5 is abo
a queslion of how osinin!: hcaI<.h resources .....
used. ( fig. 20), Al lb. momeo" <.h. World Healtb
OrJ;anizatillll estimales , hal: apprctti ma.e1y thl'Ce+
qlWl. rs of all buhh speoClioa in lb . d...eloping
world is bring used 10 """,id . rel. lively u pens.ive
mcdka.I ...... f()J" a ,dauvell' ""'"Uminorily in ,he
,owns aDd cilies, 0..,. balf of lb e III.lillllol beal,b
budgel io SenCial or tb. Pb.i/ippines or Tan>ania,
for aantplc, is openl o n u rban bospi,a1s. I" the
Coogo, ClD.ly lSI, of the Ministry of Healtb'l
anoual bud.get is being spent l1li prevcnliv.
l\ICdicine. In Ghan. , 4O'A. "f the national beal.h
u pcndi lu.rc iJ dcvot"" to l,pecialist bOlipitai ea..
for less <.han I" of <.h. po pulation; a fUMb.,. 45"
of the budaet is allocaled 1o ordinary boopital CIf'C
,,"rviuS ~ of the poplllaUUlI; and the remaining
I $'1> is a1loea.l"" to the ronunuoily beal<.h worlters
and related p!'I'l8rammc:s ,,"rvinl 90'\ of tb.
populat;CID..
At the llIOmeIIl, th...., ""' r"", signs of a
li g nificant cbang e ill litis paUtrrl. Dc:spile lh. flC1
lb•• as many as SO 10 100 eonununity heal.b
worlte... <:an be trai ned and equipped for <.h. "'ft
of lIIIe doct or, th e majority of rouolries, aecordin.g
10 WHO, ",rill fall ;~/a ,''' ""'1n1t df g ''''' ' r;;
pyra ",id wi/~ "" ." """'J>I'Wn 6ci" , df IIv ~ithn
prof~1 Cflltl/ll'riK'.
Oft.n , I relati vely $lIIaU shirt in this P/lucm of
spend ing rould rei.... <.he mourees 10 train l"'i.
nUlll~" of rommuu;ly health wor ktn. In Latin
Am<riea, for e""",ple, l b. medical sebools arc
sehcduled to produec an additional 200,000 fully
qllllified dot1ors by 1990. F or lb....... COIl', il
would be possible to ,rain a f. .... less doctors - say a
toto! of 150,000 - pIllS on. miIlinn primary heal th
ClU1: work en 10 ~ •• in poor comm unities aod belp
msk. amiable tbe Mo....INg. lU>d the IcchoiqutS
fot drastically mludnl chi ld illlless and deat b
among the majorily of the po pu lat;lIII.
From its IIt<Vq of I II natioo", W HO ron-
dudcs tMt there is II yet ~t1lc ideoc e of Ibis
shifl . nd thai primary heal th , ;n lII051
counlries, slilll.nd> 10 be i.olerpretcd not $Q moc h
as a cb""g. of priorities III a 'g rafting OIl ' oI lo....r_
le..l health workers to existing syst.ms _ if th. re
is anyd>inB left afler lh. bills fnr hiBh· 'eeh.oology
b""pi tals aDd IOpltis'iea,cd mcdieIl eoUeges hav.
been paid,
Al lbe lJlWtIenl, .pproximatel y th=-qUinen
of tbe developUi,g world', bealth budgets - .nd a
simil... proportion of th. indllSlrializcd world 's
hcalth-rell1cd aid- is devoted 10 capilal expe ndi .
l ure o n modem hospilals and eostly medial
teebnolll\l;'" wit h aU the loog_t.rm =Um'Ut
u penditurcs whie.b sucb spendin g pan.1UI die -
1 11 ~.
Wi <.h a llIOre detcnnioed oommiulIe," 1o pri-
mary heahh care thao tbese figures sug gesl, il
....o uld be by no means im possible .0 thinlt of
.very eommunily Iulving aecas to. train"" beal<.h
work.,. within lb. OUt f"'" years. And few
measures rould do 10 much 10 em power and
,uppon parents ill dnt$lieaUy mluciog th e inc;-
deoec of child dealh, the frequency of chi ld
illo.... and tb. soYCrity of """eny's grip l1li lhe
Browin.g minds and bodies or the risiogllOn. ...
tioo .
"
I THE STATE OF THE WORLD'S CHILDREN 1985
Tanzania:
saving on essential drugs
In many ~ coon1lt8s. 60% III 8O'I!> 01
IllEr IlOIlUIarion a,e <IePnY«I of I)asic "'''lIS V1TallIl
I"imary IlOOIm care Al !he !lBrn" lime . ro'lICh
money .. """" .....teo;l on _ _,. """",I......
danget'QUS <ltUgS , iIIOoClaQIlalely """VDIed ar<l
OVIlf'pre$C'ibo<l, or on useless I"""," In some
C<UIIIies. 8 0 11 of me heaIm tIo.oCIOel is S(>e<>l on
onarmaceutJCals <!esbne<l1Tllllll!'l !o< C:>1'; i'losPtals
In Tanzaria. wnece ~ 10 75" ot 1II1<l8all>s lila
alln bul«l to ~ dO: . ", ItlEr ~
",om haS long Sl'\lSWd the irlll)Or\antt! 01 vilaQe-
........ PfIIMIY heahn~, The ....u$ll3 Dedara1 .".,
wtoch was adop\lld In 1%1 ...., haS Iormed The
_ ot 9OY""nmenl policy _ sn; e. SPell 00:
!he ~ O1 l1>e _ _,
••All oor Dog llOSOdals .'11III t<>wns an,! tneY benefit
0<'1'18 small seelJOn of Tanza,,",: tt IS 1M _
sale 01 peasanll' PI<ll!uclI wtIocn pfOYldel Ihe
IQrfIign e><cMnge 10 feP3)' loans "."led to l>uIId
l/lem Il>ose """ do nol gel IIIe bl.netd o! !he
i"IoISl:oIals IIlU5 CJJI"i tile major res;xlllSibikly lor
P"Y'/lll Iot !rIllm ••
Oes!>te ~ "'lenIJOn!l. 1I'iOu9Il. TanLlIlIa's
urtlan t>ospo1als. $tIIWIg ori'I 14% 01 Ihe llOPUI3-
toon. <:<JorlIiJ>Jed 10 <Ira., 60'.11'0 01 tne .....1_ heMh
budgel . In 1919 the """" nascnllI III me "'1aI.
Dat ... salaam, was allOCated 1( 'II> 01 ee l\iIboIIal
....
dr ug Do.o::lQe1. _ III ltlIl village <llSllMS3/leS
lO\)l:lItlIlI '8CeIVlId arty 15% . IIIIlJly "1llI'1l Wllhou1
9ul now a new essoot.al drugs Il«ll/'''''''''',
bad<.ecl l7i tho IQr\l!lOlilll and DantSll govern-
menlS. UNICEF, ..., ltle _ _ Or\lMlll<t-
von (WtiOl. I ons Ie 11M' Tama",,,ns "'(X'" neallh
~--
F~slty . me pmgIMmlI!I (:<I(lC(Onl,ale" on IJ'tWICI-
"'II !uol 35 <ltug!l- _ tlO<lkom me WliO _ _
lIall!rulP 1iSI. and ~ oral rel1y(l T8100n 511!1S,
J)llJlOCIb1, and am...""tanals All .... llOughl as
basic genenc drugs ,all1el than llll, !lie more
•
expeo5IVe ' tlraOOfl8lTll!' ~lS Further SlI'<-
ingS .'C made til' UNICEF llI/)'II'lg' Ille <1<"""
,n but<
on <'3llOUS eo<.w1!MS on a system 01 <n1ematlOMI
comceUIMI I)od(brIg
5econcliy, Ihe 1ltO\I'llmIne PUIS pr ior 4~ on gel,
lIrlg • ouppIy 01 the drugs """n monm 10 Ihe
CCI.fllr{s 2,55 7 rurai dispemarl8S am 239 hoeiIllh
cenues, ~ l!le hosIl<1als. OsUibubon is •
malO' protl/em .. a COi.O'I\ry 01 360.000 SQUBle
rnoIol$ (945,000 $Q ~ kibnelres) ""II> lew good
rolI<l$. Wher. tner8 llf8 WII'IicIes, ollon It>ere is no
"'"" or __ PllI1S 10 keep Ihem 1Uf'IlWlg. Buses,
bCycles an<! """" _ llf8 1>el11g used 10 ensure
!hII CInlgS . rr"", rllQUIafty
rr... pmbl,rr'15 loe roOt Oi"ly .., shol\aoeS 01 dtll\)S
llU1 on Itle W&/ ltIeY aM used b\'neahl> workers lIlId
I!le Oi"'ll'al PUbIoC· One 01 tile Iegacooe 01tne NgI>.
~ C\.O"lIlrve appIOllCIl 10tleeltn nas been
on '''''TIDIOIIC """,Iai ly', IMtn nealth worI<8rs and
patlOOts IIIik9 '1lQlI"1II111 on h/)lO/lCS as 'cur . oaTls'
Ollen " IS pressuTe 110m pat""'lS. who l)eiieye l!Iat
streng ~ IIrft !TIO$\ elk1ctw9 lQ< 8V8flI eolnlen1,
_ """"', WIIM;h (IrlI;Q\O!iIg8$ health WOIketS
10 TnISpreSCI"rbe or "",",-pre3CIibe
So:> the (llIw IwC S1rale\ll8S 01 the <lS$8I'l\oII drugs
prograrmlll Ilava adllTessed tile anllu:lei an<!
urcleTsIanD<rlll 01 ll<lI/l ~ an<! neann WQrI<.
'" Bet-! Oc!obe< 1983 an<! APnl 1964
3,700 _tI1 ~ """"I lIV<lugt> a _ 's
lfaonong '" tne """ end :\lCW"lJ'Il 01 essen_ drugs
For Ihe gentlal pubII(; • 0CUl1lY·~ "'1olma\Jon
~ is lITInOIII'Dng tile MW ~ lind
proper use of !he aeIecled essenbal drugs
In COSl-saWIg 1I!mlS. Ta........'. lIS88TlIJ8I dtl.9S
prOgramma i$ 8IreaCy • nug.e success, II>e D3rosII
9CM""",ann conlnbYIlon 01 S30 miIIon ontend«l
to SlQXI/l IIIB PfOI!lCl for "..e reers. is lII<.8ly to
$lt9Icl1 lO lMo, as ma COSl 01 ""IlCfl;ng drugs lIaS
tv::1N been rflduced b\' almost 50'},
 Pri.tnary heall b care ""d !he traillm, of commu_
nily health ......tcn is fSsetltially a simple aIId
obviOU!l idea for improvi.llS lhe heallh of the
majorilY, BUI U I.M. Keyn es said ;11 <.he illuoduc-
tio.a (0 his revoJutio.aory .. ork 011 cr:cnomics: "nr.
diffin-Iry lin, "'" i~ ,'" " ,'\(I idros, boll i~ t>alri"l
Jr- 'uolJ .........
T nditiouJ birth ancadaJ,ts
The fllCl <.hat twlHhir d. of the dcwlopioS
world', poor do IlOl hi·... ..xess to mod=
medical wYices dOOll not mean thaI !hey have
no..here aod QO.OOe (0 lum III whell lhey aeed
help. And for the sral maiority of UlOIhe.. ill Ihe
devclopills world, it is the local midwife 01
uaditioo.il binh atlell daut who is the IIlOSt
i", porUIIllOlln:c of I Upp"'rt in prq:oaocy, ehild-
Fig.2 1 AVlnl bility of doctors Ind
trlditionlll midwiYI.
,~
w
''''''''m 'M
aaa
"""""'" ,~
0 To .unplify, the traditional binh an ...d""u Or<
nw.N<> t. ,
binh , OIId early child care.
KnOWll in dillerelll paru of the world as lhe
dIl)'Il ( Middle East), doi (India, Bangladesh,
PalUstOll) , '"0''''''' ( West Africa), d~hn ilDyi
( Iodollcsia), ~ilM ( Philippines) , ""'~ '0'" y<II
(11t.oibod) , (>Qr/OO tIIIpWo ( Latin !uncrkI), or
..,riooo ( Bruil} , !he One WOUllOtl chantctcristic of
uaditioo&l midwh-cs, amid a weal!h of dillerftl'
cultural practices, il lhal lhey are the ones 10
whom poOl people lurn in times of need.
In India, fill mmple, an eslimaled 600,000 dois
allmd m of all binh ... III Thail""d, 17,000 ...,~
l4III )'IIC auend 80" of birthi; ill Nicarqua, the
ptJrutIU deli..... 68'" of &II babies.. hi 101&1, bcl w~n
IlK LIld SO" of all moth... ill the de... lopills
world 1lll1l Ill'radition&l midwi.... fill help with
the process of bcariIlS IIId anna for childlen.
Un like mod=l>eahh pnailion ..... traditiOllaJ
midwives are concentrated am008 the poor IlI\d in
!he IIIU1 or-. Ove, 9l),; of Ibe JB,ooo ~il<>n in
lhe Philippin.. Ii,.. ill !he tural ...-. [n Haiti,
almooIl &II of the rounUy'1 11,000 wgn-/mt1Mllive
in !he counllylidc. Ln ESYlYl, ]0,000 doyo< iCrvc
mainly lhe tural and urban poor. In 1nd000Clia,
thf 70,000 10 80,000 duh~ boyU anen<! over m
of births 10 poor moth.....
tile molheT and child health iCrvicca for the VIII
majorily of !hf poor (.68. 21). In tnlLDy poor
COlIIDtunilia, they III'C !heref"'" one of 'he SICOI'

""''' c.•'"
CI1 of all poIen tiaJ l'CIOIll'CCS for empowering
" tOOt"",, wilb lutowleds e and practical OQ·Ihe-
!poI help in tile luI< of prolcctin& !heir children',

,.
"""""S'm lives and heal!h .

' 0
" ExperieOl:e bas shown that DIOIIIt tnoditional

"""" ..,
binh allend"" ll welcome traininS in new leeluli-
ques- wben it is offeml. Moo= health iCMces
ClJl provid e thaI lraining. BUI ill the modem
"'-""'" 0 hca.I!h "lablMlunerll , !here bas b«n a pro-
nounced tendency ' 0 look down 011 lhe lnditionaJ
binh allendlll~ • is noranl aIId IUpemitiOllli
pnaition... of unlcientific ""d W1hygieni<:
D Nurnber of doctors per1 O,CXXl population melhodl for deal.ioS wi!h prqn:mcy and child-

-
Nl..mber of ~ midwives per binh. Commonly, ,hey hue been attused of
10,000 population perlonnina danaeTOlll abdominal lIllSIl80s dUl_
___ _ ""..-.M_'O _ _ inS prqnancy, or of IIdvising 1l'IOIhe.. 10 disani
- -- - ,- ~-"' .... ,....
i,6A.
tile enIoruum whkh pnad.. !he brca$l-nillk

"
[ THE SOO'E OF THE WORLD'S CHILDREN 1985

Diarrhoeal disease:
briefing the professionals
WOJId· _. II '" probiIbI'y uue 10 say lhal a ,*,tTaI Londo'l, l/IIlI team ot dodofs lJ/ld ' e5eIlI:
"'lIlOIol'i ot _ •. """"'''''''''' 1\OlI~ '/IO'I<et$ ancl cheri btogan iIII.IOiQ • slom """'*!'t _
1ll'*"*"SIS do no! yel i<nl;lw aboul - 01 00 nol
_ . !lie llf1I8I<lIltoug aI .... ~ Iw-
..,. (ORr) ~ ... ~ <Irl,ogt
II'IOII*S 10 ,,0lil._
lood<bng ~_...­
Md_ _ !III ..-..,. lJtIe ell /Mtrl'Io:>!Y ~ .. lis ....
was 10 /NIktI "''0. ' iI' aI>Oul OA T .. ;
1

"""'-'. ...-deW . . . . . . - """' 10 _

al ~ c;ormvwtf _ ..orion. 00CI0fS.
. -..... " . _ _ 01 _ ............,
.

In[lJI'Pl.ll''''W.''! I t211or .... n_ORl

...,"*". _itMS.
-_II*.....,... . . -
c:r:w..-
~ rliIl oe8'Ir cne" .... II'IOfe's

_ _" ........
jlt.a....... _

lnh~~_

..... ...u III aI'-""\rClOCbS.... ..

~
..... ~ ,.,

ibo...
one'-
d .l".....

.. EtogIIIn
pI'Ia"~

"r. tOi .. ,
r_
11'
_

_ ....,
~,
,'Ill, 'IllS _1Il - ' --",
~
0' '" _10 _ _
Feu,en .... 000". . ""*'9". CliO"'O O<.C
~
la". ..., ~ b dilldl iOUCl _ _
e..-
..... 1110 46 .000 ~ .. _
_ 11)0 1M 0-1(1
In..- _ _ <II
_ _ .-!>O<Wy~Oi_"'ol'"
o:-e 00 , ' . 9 WO'll:l """"""
The". $"_~
~ lib,.. ' . 1tft ........ 06 ,,,,
lot ........... ..rw::to _
,
10 d " - a ...
_ _ _ _ 01,.._':1 e1'
_ _ _ _ _ 10 $lUOJO"IIl_ lOJ*:"
~

"-"'" One ol llle ....... _ l o r ,

• ' - " ~ 10 onlrOducII ORT '"'" .....,. 01
ol delllh For. . . .. _ _ " ' ~ o n ....
[!l\'IlI1 _ 0eIIa. lor e:<aIllIIlo. _ r... IKI lI'lIl rtlII OI llrea5l.-.o .. pes. aOIll llI3imooa ana
........-- . - . - _ hiOS """ , ....
l!lI looIl 00CI0fS _e nul ~ .and <lcl 1lOll 'r.Ik.e 01 .............lIllOII .... .., _ _ 0._
_ Ihlorllaio:::klng 1O !hll ClO ' .
~ORT 1110 IuIf,l ~. 00Ier1 antl_, me _ot At INI sa me lime. cwmoe.. DI<oIogue Mol
lTIIiQns ot d1Il(I'en men ~ II _ '1II11011<J"oowio Uanslates ~'dl
llM~n " _ i/eI
on\OrmiI'' ' ' """ !he "'""'"
"-"'" b'/ COfl"O'IlI.l'"Olei. l\IlCl
odgolI _ I 1t>I ' - It>erllll'/ 10 pem'ellW every P'~ I IorI.Ol1lof ,_ _ ..-:l f:flC t>CaI
po<e at"'" P'ol .. I heaIII> .-vIceI, - Irtm Ihe adYoaI or ""'" CII'I oI\ef • from !heir own ..pen.
~ ancllNl _1I<:l'>OOlI1O II"OCI patI(»II~
~
"*" ancl II'ICI 1lOC:Oors, ""'" 11'>1 1VlI. ancl INI
_ _ 10 II"e Dlltirnlldla _ lIle '*'lIe
_T~_ _ •.'''_1lI'I KIOfiS
...,... " 9_0. IIIe ~ Il _
pI'Ia"-
8IlI '" 0Rl _ _ <II ClIMIt:iP- ana 1IJ'81 de ' "",.. ~ worI<ers. As IN I'leMsIII
~
.Ie " _ _ O'-A,....,.., ....
lIW'IlS W<e IN tH:ilI<lrJ'wgll ..... _ t 1

.....,....... co......... 1983 ""l'U"I_

-'*-:uw , • ......,....,.
h _ .. •
" ',fted...
,.,..,.. 1
__ Da,_ """"".. _ . _ -
_ _lI'IlII ...._ ... ....-.,g ..

-
_ .. ~£i ; . .~ ~ I(lI'QlllnI a ' 1lfllIIICI_ . . lot" •
~..,. _ _ 10_""'"", asIN.-.a I • .....,~

'"', _•• _ . .&tI,ocl .... c n l ~. .

_ _ _.. "00 ........
In ".." 01 19&0, ore ~ 10 _ ....
~ tJy .......... grOUl) (II
0 . . - /looiIoopw c .. • 44-""'1' llo AHlTAG
lJIIfrl'" _ _ SO " f Jll'll ottr.:. .. U ........... . . S1 ~ W' ... Do

•
( aDd _bidI CDIl1iD1 n luabk iaIm '" " p . 1 for ..... pk, iI has ta:a W'rin"","
proputies) , or • fIilin& 10 CIIt oad drs the wVW.". _ J-l ,..... II.. • is otmi.l.olW
"mbilica' eoni bypmi<:alil', or • lid
, " ' Deal . . . . . . ~')'.or
_ h-
~ ........,'" ,....,. .-J"".
ntI ,''', .Ito •
fi"'"
is aW.
MIl ,, ~ _ "It.lr~
II ....'" ...,.Ir ,..... •IIN
.luIt 10 do in 1M I~ III 20'1 of binhs .hen
~ ariMc In _ eases, theoe a<XIIa- i"fl a..J .....-. _f«t> awl ""i., •.. I'rrpmo,
......1 on: well-r....nd<d. Some lraditional binh """*lIIIIJ.Ir /<K adviu "" ....", 1!tII·, balM 1m diu
ntI"",,1ton ..... Itolp ...' • •!wi, Sltoisn~
allendlllllli do protIlOIe Illld pra;iitt lI\IlllY danltf- ;..por....., "",ru ~f _ a..J /tI",.. i~ , turd ..
ow and ill-f....nded id.... durins PrtllllllnC1,
deUvcry and infancy_ diutfll i""wr tlf i~fonPlllr;"~ "" ptl"lOMl /1M pd lic
ftWftU'·.
ClcvIY. mod...... hea.llh p rxtiti<mtn h."" much
10 ttloCh tbt lraditioaal...w ..e mid..ue. BUI 1bcy
"lid or .. puticuIII' midwife ia • riltaao of the:
Nil. Ddla: -
","y 1110 hi"" muclI ,n Ia.... For iI 'IIOIlld he.
miIlili '0 ISIlIlDe w, Ibo majority ~ or ~ZtUoa. ocupu dII..- ~ , is off-iJ !tot ;"
--.en to 10 Irwlm....! binh .UtDdoall ooIy til"" - : 1 _ ;. bid. SItt IOIJf , _.......u J-
ber;:ouoo: 1bcy ""' tbom. .. _ y eGUlItria, 1Iw Ga.I~ ~ I if_did _ ,.,.,J .. ,Ito ",/h ~
poor prdcr mditiaml birtll UWldmIl _""" 1M ".. ~ ,.", a/ tIto ';'./r. ..
wba! ""'"' wudaD hahlI a f t is anilabk. Silltt 1M arlr 19701, .riIl1dots IO'IIVI!s !fa-
To bqiD .-ith, _ y ";;11;'" ol poor ........ dilioaal birtll iltoudmllllo.., bull Jklwty dwI:a-
"""" • ~ deal _ u.s mod rmfid,1Oa: m.. I.a 19J2 0IlIy dan • lbird 01. de , ' , . ,
iu-ud rtd ....,. DBd1. IIIlR camorubk ClIlUlllrieJ offne;I my olIicW roarpiIiocl 10 l1'a-
oriIh _lIw ~ mid . . . l!wI 'Iri<h mod=> ditioul ~ iu lbe f_ of rtPtmioa ...
beIlth ~ Tho: uaditiol>al mid.rft is ~ lnWaa. Tocby, _ thoa m.-qUlmft of.u
1l'llW)'l • 'rilIa&e 'IIIllll&Il Iltndf - 'libel l!lorou&hly de.dopiDa; toUIIlric:I Ill", lfaiuina IlfIlImIIlIIOS
IUlIknwIdI the: D ......... ol ...... ,..e, bdidI, aDd f... lraditioMl birth atlm<Wl1I. hkiallll iI baIin.r;
bdloviour ... her tomnlWl;IY. SJ>lo is lllUally wtU- ito ~Itd Heolth 1'nI&romme CIa 1Muainin4
lulO'llll 10 lht family slM: 1ltt_ 1Ild. te'pnitd .,jib of tnditiorW mid.,j- . Bonaladob 'IIilI ILl""
oonfidtua: and IrUIt tllher dllli .,jlb 'M inferio,_ mnined Olle midwifdor n..,. viltaae by 19B5_.
ity and Illl"'tty which 10 mlJlY poor and illi.tIS't tou! of 68.000. 10 Aith. nillllll, lho ailll is aJoo
womt n rtel whon thO)' fin. ~ly stt 10 the front of 'one " aiaed dai ptI" villlllle' Illd 7,SOO arc IIl1"1"
tho Un• • 1 the . nl eollal dinit:. . 1I. ndilll COutStl. In India. OV•• hll1f a millinn
T o OWly women. oIwir" IOOItthin& as inti_
<iIIis IuIv. ta:a "'Iirttrtd Illld ,l""n huit: uaininl.
!illite and JlftSODI.l • child birt h .n,h
IOIIlI!body Il«wtol: of = 1 braiuhrouahs ia kno'IIIod.i:.,
wlto is • <;OtIl ~ MraIlIOl" ond 'IIboor Ultorel'l iu cYftl I r"" 'II«b' tnillint ill I0'Il_
1I:WIbn<b of
lbt lDllthoI ....... to M ..... &ncd 10 the dmial, is child protection can bk • uaditioul midwife
... tIIII<'ClIIIomtd IIOtion. Samr tnditi<:mol Itl d.-iall, ftdlltt illt'itlma' ol . hiId dat!Io
mid";_ ......... n t"'-'...... _ 0IlIy 'IIith all md dUld il.loosI iu poor ..... 1II""~ieI. /\ad
IIpoctI ol prqIlIIltJ ODd dWdbirth, but abo 'IIith .......... tboK to wIooa:I .... ...;.rity of .... __
dWd ..., op 10 md bt)'cDl!be: l\r$llllPllb of lik almdy \lUll. ror bdp ... ue tU 01. bcarina lAd
ODd oriIh !be: lIlOft !Mkd ......s. 01. ............ arilla for dli\d=:I iI l.boIttforr __ cI. .... _
hondf - 'IIith her
Iioti, aDd 'IIith D
' Iil",.,bor famiIr m.
) rttaah, pnJ=, ad
...~ of .oil . -......
~ .."il.1Ik 10 !be:
f IIJIkinI ""'"
mojnriry of
lIOCial oblC'( I of dliIdbinll iatK. la ......,. pamlll ... , lot poor wor\d..

. . 0_of_
- . ~ """,,wi_ aloo dc:u .... !lo<tK and
.... !be: bal-1i!w:II aft.. lh. binJl. Some take . .
l ho ClIOkit.: lAd household . bora In lift !be:
mother limo tn f $ md be .n,h her bfob,r. Some
•
,.
,
. _ 10
E1b11lo, -V.......

e...-" _
-._
.....,. C'V<1! . . . as ,od-puenl. or 1M ""'"' ill EIYJ'l,
~
ea.-.....
I)oIu. . . . . .. .
~ c 1 ,,,I. IS, ..._ e-iI of
I THE STATE OF THE WORLD'S CHILDREN 1985

Women's Time
Of 'M ll'IaJIy probkmo which beset l h~ &R"
opponunity [or a revolution in child haith, twO
11K so profOUDd I.Ild pervasive as '0 demand
ICko<>wI1/d8~nt """" in a report which tradi -
tionally emphasizes oppon unitics rauhc, LbIJl
constn.ints.
Firs" ,b....., is ,h. fOC1 Wt so =Y fflOlh<'n in
poor COJ1UIlun;,i.. Ire al~y so ovcrwheJIMd by
W\1l"k, IJId so IUU\lpported by maI«lominatcd
lIlXi",iQ, tha, Ih~ lui..., uure lime IIld <:"<'f1I.Y left
'0 put in tO action Ih. child protection stratCli..
which migh t oow "" pJICCd 1\ ,heir dil:posaJ.
Second, ,hcn: is Ih. problem that oJ,,,.
1" ' 'lIfCSS
,oward. basic ~tvic<:s _ and tspeciolly (.'[.,Idl .....t.,
lind ere sanillliOll-is still acting as I brUt On
illl'lOJl all ath ... child .umva! ,'ntcgic~
WlNJH:n'. won
AJI1IOSl. without n u ptia n, low«>fl .tr1l1~
for promol;1\A the hahb and growth of children
demand "'0'" of .heir motben. II i. ,berd'arc
without apology ,h., "'c rt1Ufn ror . o\Omtnt '0
Ih. qucnion of IlllOIhcr'l tim e.
l.onicr hreast .fccdini consumes tim<'..,d en-
ergy; oroJ l't'hydral;Oll therapy demand. time and
pluicnu '0 mi. up. r....h ""Julion each momi"i
IJId administer il slowly .. ~ limes . day to .
sick child; prrv~ntil\J malnutrition will mean
taking a child 10 ~ weighed each monlh and
ap"" dinJ ll\Ol<!u- in tM prqIll1O.uon of the four
to five Fttd.5 a day ...hicb arc nCCCSW')' for 'lifer
'""lUling; and maki l\J ",re • child is immunized
mcana repealed lrips to btalth elinica Or ~
tion poIi lS.
Yel many of th e W(lmen ohhe poortIl eotIllIlU-
nilies in I h~ developing world are alrmy working
12 to 16 hnut'5 a day. Ofll'll aptnding many more
bOlltll in ,he fi~ldo lhan tntn, wnmen '"" m;pnn-
sible for at 1_ SO" nf family food producti"" in
the deVi:loping ...nrld. Onee the Iwv<:st ill in, il is
also the woman', inb 10 dn all th~ pnundil\J,
\Win nowing , grinding, bn~in g, alrainiOJ" drying
and .",ril\J of the family'. !I.pl~ f"""". On top of
that, wnmen "'" normally respnll$ible fn, «IlIm-
iog firewood and dnlwing wau"" pthmng fooder
and lookinj afl er animal$, t~nding IUtcbl'll gar-
d ~n. IUId marketing any .urpl.... eookina and
washing up afler "",al., deaning and wasbing
clothes, .., wing and weaving, maintaining oociaJ

Fig.22 S easo na l pattern of dillrmoaal infectio n. in rura l Gam bia

-cc
E
.,
' 300
~
.~ 200

~
~ 100

_____..o 1974
Monlhiy rai11a1 in rrtm. -
_,,_~~_c.._~
1!~75

. 1976
Mclrltt-iy prevalence 01 'N6aI"Iling diarrhoea. "77
I . ... ~..",

"
 Filil.2 3 Pr.v. I.~ of' en••mi, ernong women of the d. ""lopinlil world
1I 63%
I
~
J
_____..__
_
AFRICA
Fl Bgl a 'l worrBl n_ ~
ASIA
CJNol-pregrwrt 'NOIT-.>
obliplions W Illmdin& 10 the sick Illd the
ddmy _1Dd all ollhil iI QO lOP of lhc l.IoIb of
burin. and carini for children.
If the _her liva jn one of the IIwns or shaJlty
IOWns which oow 110_ ll lOOllll • quarter of the
ckvelopm, WfItid, ' heo lI 'e IDly mo fa« Ihe
special difficulties of dq>Ollldi... eotirely 00 rho
nwkn-platt for her familJl s food., oll<ml boun
sway from I>omo • III. Ilrugla to C2l'fI ....
eeeee, md of .... 0Wff0ft....lcd lad daDprous
..,virmnwol iD _hidltobrial"pbcrchildrm.. la
tbe fio., larp$l cilia vi Illdi.. lor _mpl., 6O'ool
:all fImilil:I Iivc ill. IlIlC lOXI:ll _ md . - haft
DCiIhcr oar. _cr __ IIyp:Dic ADimioo..
lD a rural area, tbc tDDtbcr ia Iikdy 10 . . .
ditl'mru ptob/Laa. ~,diartilocaI md 0Ihtt
iafeaioDI _ dllriD&: tbc boIlaiCIl XB» of tbc
I&rinthtltal 'fC# (fe. 22). ~ tbc raifts haft
bqwa, ......... md plaau. C&DDCIt ...... 0..0. tbc
~ bII ripmOl1, tbc ba:vcM mllSt beptbcrod ill.
....t thcte lima, DIOlhcn "*"- k«p murnia& 10
their homa 10 adm;n illcr ,......, oral rohydntiooa
solutioa or to p~ on. cl lb. $I1>IIl and
. o_
LATIN AMERICA
. . . . . . ,. _
freqllCllt mealI _ 1Iich a WUllIiq child ocedL 111
00. Alrican lIItioo, for aampIo, IWft}'I have
lIIowlI <hat WO<DOII'$ work in qrkull\lfC means
thai many $I1>IIl cllildrc:o an Ied, 00 avcn&c, only
1.6 I;ITICII a dly .
..... ;mporl ant .. a mother'. timo ia her ""Ol1Iy.
....nd apia lbe Ulle'lual $11Od.in1 of 1I'II<IICII, and
IIOIIlCtimcs Ihcir ouH od-OU1 exploitation, IQC:IllS
!hit the mather ia frcqllClltl)' ~I and tired, dcYoid
of ,be (:Ipao:;,y for QItI effort _hicll iml'fO"'C'"
IIlCIIlt in her child" wdI-briJ111ll1Y dctlrmd.. or
me ~ IllliUioa ...-.:II .iD tbc tbW ...nI, for
_ mplc, DO 1eK than 2]0 IIIIiIIioe .... atiIllIltd 10
be IIIffcriq from miJ oappiq I"..... il (fi&-
n) .
To !he Ioq "'-a vi pbyaieaIlOil i111iddlo md
bomoI, lIIllII he added tbc pllJlicll bardomi aDd
III1tritimW of .."attd prcpaIICJ _ <II
~-fccdiDa- tbc ... <II thirty, .......... ....
onm 'Palt llO'" <II her -'lilt Iif. ill tbc I<rasfuI
... of rcpnldlXlioo aDd bnal-fotdilll. The
reAlIl ia <hal 100 lIIIIIy ................... wt by
.....t. IlId by dliId-bc&riAI. Even- year, half a
•
[ THE STATE OF THE WORLD'S CHILDREN 1985

Rural poverty::
trial by seasons
f'" many millions of
malrXJlff.oon a-.:llllnesl; are
me wor\(I ',
C()I ocen~ ale<l
CI>IOtan.
.,10 1M
lIneSS 3I"Ol worIc-1oad ., also 1P\e season "'*'
n>:>rfl women "'. '" 1M Iasl SIIIge5 of PI'fIl1Mi'\CY
..... ""<WIll of II1II yea' las mosl ~, lesIMle.. and conc>!lIlJOI"5
happen ., !he rronm. ~le1y loIi<>¥mg lh8
The tltllll 01 lfle I'llll'OI oS usua~ rho limo of
tleaYleS1 '""'" in the - . I/lIII trrn!, _ !he
_ ' 1 AD ......., _ ""'" at>:>IJt 8 luIo a
1IIO<.<ld IS Illepaled Ie< planhng. Bu1 It IS _ the month ounoo Pregoal"lC\l Bulll'le Gamtloan SloOy
limit of 9f'lal/ISl klcd 'lCi>IOty, _ , 1M Iasl yeaI "S louM tnal. <luI'iI>Q the ' 3W!'1 season women'" the
Iasllt'tee mofll/ls 01 Pf8ll"8I1C'1 ......... /osI'lII weooN
r>aMlSl s ~ Ie ''''' our and 11>1, M.l IS no!

"",-This se;!5CIfIiIi 000tJCiding of mcwo wc.k WIlh leSS

_ .... .gt>s P>eavoesl on mcll\elS MCI V- jIOI.O'lQ
ehiI<'lrM The PI""" of _~ .. "'" I.CIS 'educ<!I$
It>o ""'" D mother can 5P9/'Id on 1M n_ other
,,,,,,,,,. a 51<.oly ill Mal Ga<nI:iolI. lor "" ample, has
~ It'.a1 $'-I~th-old eeees receMI
• C'lII less Drea$l-mll< in lNI 'IWl)I season I/IlOn . ,
me llry season _ bI.lcause the mothat' has less 1.ne
to sockle /let .,t.nI In t.... al-imporlan, -""9
I*w. a rounII cIliIdmay be _ po><haps oriy
!We leeds a ~ ~ 01 IlMI ~ lUr or !lYe
I" ssa""
101 _ I I aM nQrmal g,OW'.(h
lIIf<ltJIII' lI'Ie CCIfTbt"oatl()n t>11\.:>f<!ef -..;01< and lim
t.- ..".,., t..... t.......810 ....... we>gIll
In PregoallCy means mcw'e low lOotl ' ~ ei(lh1 ~,
more iTIllUln"lal rnalru\fdlOn. 8I"I<l mcw'e .,lant
deaths, In IhIs way, l/Ie _SI eHllCl. of the
'p<>Yll<1y season' a'" passed on 10 the mas!
..........ablo - !he molfIef ,.,.j Ihe 'f'(I<I<lg (:!jkI
There ...e !WO ooYlO<IS wars to blum Ill..
sucklen, wasonal ~ 01 PO"fflY OaY-Qlll
cella... CCIUId be PfO\l'Idecl ., ~ llUnng me
ooal< lome when ... hand. ",e r-"'<l ., lhe helOs.
And \of me POOfllS t ll'DIJPS. ""va too<! <II food
soDsod>es CCI<IId be Sl)eCIlIIly oear8<llC I!'G lime 01

w-m fOOO al lIS scarcest. _ "'fl

M l!'oeor ~-
IllgI1BSI Anl:l whal IOQ<l OS <WaiabIe UlAAIly!lOll' FOI the POOf ancI the landless, the ,atf'J)' season
IirslIO "'" men The '''''''''Ils' "'. "*"I !Y'l women 1$ ..:so me lime wnen they ",,, O'OSl winelabio to
&alill\lless . _ I!lo<.Jgh 1IIe\I may be W()(I<Ing as POld>eal and EI(;Qt'I(lfIlIC e><Plo<taliOll "" Robert
MId , ~ no! M/<leI. I/IaI1 It\&II n' -1(I5 in Thai ctlambefs has ....men ill TIle S8a9ooaI DIrl......
same SIU<l\' Ul 'he ~. !he '000' oMktt 01 SIOflS 10 _ ~'"

WIIS ltiur'o:l to De asm.ocn ee ' 10% less It!

IfIQITlet\

"".-is....,.'
Augusl - me _

To make malletS worse,

When illness
oIlhe 'lIIf\$ _ 1118<, "' N<wem-

1r9QII8Ol - _
lI'I S "
&t1O the llmI!
1Iy;t II1II_
" Seasonal stress dr""'" !hem """ (letlI an<!
oepet'dence The ~ lh8t lhefe ", I be
Mure se.>ooneI cnws oonSIn'.iIl, them to keep on
(IODd '''ms WIth me, Pl'SOflS They are thus
sc'ewed dOWn seasonally ...\0 SUDOlll!Ollle ana
seaoon IS alSO tPle "'" season Malatoll . doa_ ~, ,aI;I~ ., wrocII they <JPef1 '"are
dosease, ......, ,nlecl>ons ""'_ C "'l eas es
ancl
roacn
e~teI:l
"*' heoght ~ tne "'inS. And ltoly .. e all
by IIIe mctnefs srlOIIagIe 01 \!me 3I1d
~ta!lOll, SU'l$S 16 passea 00wn1O the wook·
"'" - .......,. CI10klten ckl people tIn<l me __

--
"WllV for 1M 1I"'l'Je11/ wa let-esr'Y"'!l. wasI\Ing
bOIIlng and lXlOkiog whicll <;QUId help 1<a<lP
A3 ~ " <XIrI$(IOrllC\' 8g8JnSllhl moll"" and her
lIIIbom crIIId lI\lS seMO/'l of Ql$a tl.sl I\uflOet
II"'lI So:>rne1..- me 0GJf!W t>eo:>, ... a 'atctle1 , an
..._ ll<>wnward movemen1 inIo deepef PO""
etIy ... _ . are fIlOI1~ Of sold WI\I'IOOl hope
01 'eccM!IY ThIs IS, lheIl, a lifJ'II! when POOf peoiIIe
are ke9l POOf and a ImII when they beCome
POOl,," ..

•
 millionmoth~.. die from '''uSt:> rd~led 10 male....
nilY. Aod for evny OlO'lh"" whG dies, maoy
Slronl. Gn in I 11111..... p ,h~m.isl.ic2Ily knGwn .II
',,,,nomal deplffion'.
If m<I1.h..... in """" ""'''''nunities an: 1G pul ;ntG
prao;tlo. lh. smll,,;cs n ow lvaiJlbl~ f()f prou:aing
lhe li_ and l h~ growtb of lheir children, lhen
lMy will need more lhan jlllll infGrmatic>o-\bey
will need ~ suppon: f!'OlD lb.ir lIICn , Ihcir
=munitin, their lead...'S, and lheir 8""......
menlS. The y will "eed, for mmpl~, lccbnolOll;es
wllkb n:lic:v. Ibem of lh. b~ a day I~"t
coUcct i.ng wood for an ;lIdficien, opw ItO~, or
the hnun I day poundi1li gr'iirl with I patl. and
grioding il with a ROII~, ..r ,b~ mila and hoors a
day spell' canyi1l3 Wll~r. Th.y 'oW a/so need I
faim division, within tM family, of labour and of
food. n.. W1lmao , ofIe" worlting 10118"" and
hard~r, of'en .llS laR Ind leasl. I" h"" own
childhood , the futun: mother usuaUy has las to
rat IbID her bnxh~rs wiLb the l'CSult that h""
growth i$ impai"'" and h." own child«n may be
hom -and may grow up -und~rw~i&bl.lll prq:.
nwt}', t h~ motber is oft~o :.,ft tOO oma11 ash "'" of
lhe family pot with , he rawt thlt !>(r baby is
malnoori$bed even before;t is born (fig . 24}, ln
times of b"'ISI ,feeding, the mother often docs not
...t Ih~ aln SOl) calories Or SO of food ~""h dly
which sb ~ need .. wi<h t h~ l'CSult thll her OWII
body b«olllCli depleted by the Pl'Olcct;on she
givcs to b. l child.
In slton, progress in WOI!ItlI'1 ris!tu is possibly
the masl imponam of all a,h "iJlccs for improving
Ih. I;vesof women Ih.mselves mrJ fOf l upponing
moth.... in Ihetm of usinllh~ new lechniques to
bring about . revolution in child swvi val.
W al~ r and aa nillti""
Th • ....",nd fundlfDClllai prol>l~m;s t h~ lack of
basic amtn;tics - apccial!y of Wi ler SIIpply and
sanilation _ in on many of Ibe world's poorest
=wtitieo., In the rural ...... of , he de""loping
wOfld lIS a whole, f()f example, threc-qIW'\~" of
1M population don n01 hi"" a<:<:ess .o ~:hhu safe
wat.. or sanitation, 10 general, Ih. lowns and
citia .,." better served, bUI I I I....t I qw.rrer of e e
urban POPWltiOO ,,"YO no okpc"dabl~ supplies of
good water Ind almosl halfhlVi: no meansof uf~
sanilation,
It has loog heen 1<nown thaI th"",-qullt~f$ of

Fig.24 Effect of poverty on we ight1Jai n In preg ne ncy

r to!Jlif' ~ ...,.,. in 1""l1W"'"Y i.. lfMt
14 oI _doplotion, ..... _~~ ODd ..... ....".....,..

A NORMAL PREGNANCY A PREGNANCY IN POVERTY

12

.~,
W

6
.~
6
i
•• 2
0
to 20 30
-
"""""
...,'"
ru.<>
ao W
___ r .. ... Wooka
_ of pregnancy
_ _ __ ., .._L _

.... I _ ,""

"
I THE STATE OF THE WORLD'S CIllLDREN 1985

Oral rehydraUon:
story of a breakthrough
Water sail ancl SUQltI' _ a IIimQIO 'orm... 6lII o Lal<I 1 9 ~0s. A.B. F_ _ D.S. ParsoI>s. "'"
me ~lIe <lO' •• ,~ ..... ~ 01 oral NII}'llt;M"'" 1I>etalll' Odonl u-.-.Iy res.oar<:!lOo:S wno Ole "'" SI<.<lytno;l
(OOT), lne Uutmcnl llI:Il "'" Il«M'OI moIooJf-. (II
<leaN ~<MIl ..... r1'lC>I!aI <klnj<lra ~ ""'" IOfIYlIlIIV "'" _ """""0" me '"* ihe....-.-... _
Cf\OICra. mal<e a ~ llISCOoOIY: - . gIu:o$C 1$
01
$.ltaogll,1orwwe, N.-.. Aodo; _ ·S M.IOIy01 em '01
carnes satIs <I/lll .... wtl!> ~
OV UNICEF, _,.. 11>0 wo<>.
oMo:niIoIN
-
1968 tuId"'ll an 01 ."c,,,.\ICifIal ,...",.<:1\.
"""" 10 "" ~
..........., In 0<SC00enng pt-..tv hOI. _ )'Cal'
me F_ 01_0 8I>ll _ ..
~

-
_ lluol ond sail _ on<l how 10 replace
JoMs IicIpIwlo lJrwetSIIy Ill""" how _ PI<>-
vol<os lIuo<I loss _ oonlirm :III> vak>O 01 gIutow
Imlrtl<l ... ~ was --."" OV cnolera
5Iann;J "' 1818. loInaI _
S"'lllli &closs klur Those OOIllOiOOl' st_ JlrOW*' IlIe $C""lIhe
~_.

uncleIponrw>gIl", om ~I e.pe"meol. eJP-

n 100I< ""'" I00 ~ 1<> _ ~ .......... 01 Plolcl !he 6rnI>orital """""""" .
" UlWeI'IOI.IS ~_ -
0 '962 RobenI'tollirQs, """" "M.vllle.~
o 1812 r-. LIllO an Insh phySoc_
....... """"""" try 10 15 01..... . . - .
O"<OS a <:"<lICIIa pallMlO
IrOO"I SPdoJm _
Bu!."'" rna"'''''' """'a'''''' "'lily "
...... oatis ood gluI:::oso 00
I"" pat""'" "'" .. an!t U...
, PMtp$. <l<SIJesSOll , -.:lOO$
""'""" I"lI SlOPS me""""""'" 100 soon ot 1m aM
a<"Y me .,.., ... ..........,
1... UnccI. lo>ll4>o1g a,m." "'" axp,r""""..
ITIIKllCaI ~ . p t _ hos "'Ilflo.. boJll<w 80 I'O'Q me o 1966- 19G8 _ <lore<:lQr "' !he Cl>olo<.
ITII:<locaI p'oIessIlln caJI\s <II a ,emoay ~ ~
.- I\e$eerCIl LlIbOIJ1CI!)''' EMl P;J...,..n l"""" E\lIOgIa-
Pe>/li. PhiIops _ . , QAT 0Wd'"'l ,0" !hel"""'...
!PlY IOCOtJSI!i 0iN<!lCg a !<>'rrW wnicfl _ IS
oI/ISl 1908-1 915 l.oorwtl flogers. "" En!;""'" PO""*'"
WOO''<nII ... CalcIlltll. IJIIIlhllIlV " ,QueM _
l<sl ~ leSl CIufI/'Ig a _ _ • lIPOlemiC
At.al>CIIaloty team '_trial QAT "",,",," !fie IWlfld
oealI1 'a.... !tom 60 '10 10 20 ~ usong orrt'............... /Ill'\> , moQOflI""Y <!<Ill\'-
l<;II' - . . - lr$8WNlOl by

...o
~I!I ooiuIJon Bocarl)On;ll(ll!;;lO(l(I(l " 1915 ( _
"'V" """ CQI\l<InI 01 Ro\JCfO' "'_- 0.'11>'1
<ltaled pa_1S C3!''''''''''' "" 00'-..

...... --
. .. !hi!
0 1911 1'M8<l I)y em war '" EW PaIoSla/I•
<:"<lICII. rages n IhO 'clu!Ion <:alms 01 ~
1'<49 Dam'll Darrow aoo Euwaru f >r~n a, Ylile
..... NUJlY """'" IN"" . o;liInI dI9$ 8I'>Cl ""'"""""""
. . . . - ....... $MO A te.1m IrM1 the .b'\rI$ ItOPl<oM
o '9~ _ PI\"OS ond RayMCltI<l Wa_ '-."'" ceolfe '" C/lIcur.a leO by _
t*> ~ . UoalS 2 ,700 p a _ ....u> OIIT
...,...,.,..
lIM"" SUl~ NallY _C"Ieri "' Bar'\iO.Ok set me
c<>m>c1 b/lI;l""" !Or ...u""""", ~ ~ ___ Mone CWy 3 6'" "'"
t<;lly It>e ...,.,. ..... ,oon 0$ osacl _ ,
Tho $I<lf'/ 01 ", o! ' 0Ily<lt0llClll ..,.. 00l enP
O<aI ~t.., looI< 1orogeo to _ p o ltocre f.Iao\' Il>IlI'1lISlI - """'c V<aI1 InClc • >PaCe 10
Mm<!_l><!lPOQ Ie _ OIl! a......e ~

o 1830 W S -. III 1M<> WcsI In<locs ano __ to l*1ec1 ~ , llOIIl al 1/101 C!'I<IIeril 1\e5l:arC!l
l"'-'. QrYIlS "" IIIllrIlIOIIoI; POlIO<II:I ... ,.. atId S<IflS
10 _ llul!lle eotIW: llOI' I/\,l.' C/'lOl!lt3 0¢$It<>yt 1110
1~!Qr)' """" I"" "'''''''''lJI;lOaI
~IJ<I lor Doer""'"
.... Dosease fleseatcn. llaogIaoesn. aII<l "'"""'""'"
;<>l _ - """""" YoWI<I
....autr1 - .....- lOf' _
pr"""", ",,,,"0\0'1
"""""Y
\ly ''''' lI'eat<lSl _ 01 ae 5 b I l . - _!>Ow 10 ma ~.
QI1T """"'" ana _ 1 0 II-.- ""'" moolllOll(l ~

•
 III lbc il laal ill tlX' dndopiq wMd ;"...a-
tttel, ill ~ Wly ... 1IIIOI:Mr, with iaadcq....le
Wllet supply aDd saniI...... AlId W1W re:Iuin:Iy
l'llCefluy, it has ~ _'1ll!'d !hal proridifIc &oed
Wllet aDd wUlllioa radIitie$ llIaUld !hcn:fon
WISb aWlY I oimihr p'op...li.... of lbe poor
world'. helhh problnDI.
h. p ~lX, ~..... ....Ilet by ill<'lf has b«ll
mown In have: diuppointln.ly uure dIm oolhe
hulth or Io....-mco"'" roma:,unluel. 10 tile lilhl of
Ihe indllllrialiud ....ti.....• o-a n perience , Ihia
should ..... haft hftn su~. TIle al)' of
1 md.... Iud put piped ~Il.er ;'110 aImoot eV<!f)'
bo:law by the middIo: of tlX' l. C'e:IIllUJ. B ill it _
_ W1W early lhiI C'e:IIIIlf)' thai lbc ;,. ido no e of
dW'rboal inl"eetim:l bqIJI i"' Slerp dedille. ll _
1M teluc:md _ ol Wllet 10 ~ byp,1X
-t>idI liuIIy bfouaId ahoal tlX'dodiae_Oftf
half a '''' 'U"", mer tlX' WIIU ...ppiy iadf_
;M'Ilkd
lo pa:tie", the rauID .Wllet ... fIll/y PI....."
haft ~ Iftdcd with ......, alum by ll"'ftB"
1Kll" Illd inlemuiooll a,vndeo wbo .... _
inftltia& IUl:cmtial _ 01 lIlIf;IM)' itt Sl1dl
fI"'lIrem>es lhroa&b<>ul 11M: d"dopiaa world.
BUI II this time or new oppommitin f... advances
ill hallh, it is ""'" Im""" , t.ha.n ever 10 keep
failh with the ImporUllCl: cl ,er I.IId Wlilalioot
Fig.25 Impaet of Im pro ved wate r supply on he . lth end nutrit ion
jlF='-;;='~~
.~~
':" l:~~
~ O'ap ~~ o
t:F
~
_181 Jri'tlIl ~ ' 0
CIah a'lCCIr1l8 l U
....
,..
-...
....
8' ' I""y
-_._---
_ , ....<_ ...
....ica (fia;. lS).
F... it remaiallraa!hal _ iIIDeII ir reWed
10 u.nsrle e=etIo dilpC4l', poor h)'lieae, IJ>d
,e
waler IUpp/ieI whicb .... iIIIdeq.... in eilher
qlLllll;I, Of quali. y. And it rmtainIa faet <hat few
thanles elD brin& . llIIll)' potmlw benefits loa
COlI\llltmllY .. I.lIIple qll&nlil iel of don waler and
.-Ie and hnieok melhod. of .....i\.luOo:_
With deall .... ler and Anilallon, a rornmunily
an dnnic:1Uy mluce the ;lll:id~ of lbe pan-
sitic ~ whicb Ap Ihe e!lUly of hundreds of
mllli"". of adul" and affect lbe nutritional hultll
ollule alllllbm 01 cbildmL III a COIllllJ'l' like
Blnc1wklh, for aampk, Oftf .~'" of Ii_year·
oIdt .... Qff)'itIJ a medillllHO-bnY)'''''' J.nad itt
tbeir bodies. Apan. froIll call1illa inlernal dalllq:c,
wd> baY)' puBDc bds abo ......_ caIaria
MId .... tlw::to:f<x• .-:!lot _ 0I-'aw:riJ:ic-.
W'nll dna _ atId _itllion, a .........""it)'
can alao ~ mlua: the ;~ of
diarrlooaI iafu:Doa.. E..... if ORT is aftilable 10
prlII«I tIw cltiJd llailla tile -.sl comcqueDCa
01 diaoTtI«al inf«tiouo, low- or Ii." tud:I infec-
u.- a year .... a IIlIjor bunka for bl1Ih IDIIlben
and dliJdrm and a ..nou. ,"-.It 10 &fII"I.b..
ll.odllCiol the ff'equc:no:y, ...... oIl. the .....mty, of
diarrhoeal disc is therd"ore an imporwu pan
~ 'lItil\OlS IEd.diorl
~ ofet:ko IS I'lrl.aIgn
" I I $l) pliO I ,,,,p o.e,,ellS
. ... _a..-... . __
•
I THE STATE OF THE WORLD'S CHILDREN 1985
Bhutan:
ending the 100 tragedy
Across ll\lI 'gortte MIl' 01 me Himalal"lS -
""""",n 1tldia. NepaL 6I>IIlaIlllo'ld SOI.f\hemCtVn3
_ an ttSIlIm llld 1Cl mIIiDn po<lllIe ;tre al'flocted
Wllh lOCI.'" llBIiCIenc)I <lisortlots lIOC'l The C<lI'I-
~ range ~cm l/>e asl>IIutemenl 01
<,pile - an ~ at 1M thy'o,", gIanO lh.Ol
resu/Is ,n " s..-,g at "'" han! 01 ~ .... neck - to
_ . rnefl\llI and pflysocal re\ardallon In Bnutan,
60 '1> or me 1 3 mlIIion pclllUIabOn """'" from
QOIIfe - and more ""'" 5% are born ,~'" reta<ded
mental " "'''","Jell t>ecause oTIacl< o! tOOne or>
lI\e<r mot!letS' ,,"ItS.
In "Hlas . . - gcotre IS er>clemIc, 1ho lad< at
_ allecl$meloerus01 ..... womb Thltoarnage
oone - _iary """"0 me 12 wool.. . tIeI C<lI'I-
cep(JCfl -IS W1~ 1«~ LIro>IIIy. ee resuIl
is a Cf'I<Id ...IIO .. born _ _ I",m" $0 ",
cnance oIl!e1ng entw dea l or mule C' both _ and
e 40 1\ ct>anoe 01 motor s'....' /maMIe., SUCh ... It
nalWig II"~or ....., _ a soasIIc paral\'SlS.
PI>ysicaI as wei as _ grOwth IS r.
la rded - 75% 01 ehoidIOtl with severe 10d>tle de1OQ-
ency nlMlI grow 10 nOlin'll ~
~ Irllge\l)' is UIlerty .. . o:a:ssary r", oIll11
I<noM1 _ 1"-..0, _oe!oenc'/ .. """oJ
!hi 0lISIe$l to PI""""!. Tho most"",,",y used. sate .
cheap, and ~ """ll48 " - 's of suwIe-
"*llJng s\aple oet. WI1tJ ioone IS 10 iOClale sail. '
In 1983, I!le KII'lgOOm 01 BroIlatl, 0IIII of me
wo.l<h mo<sI aerlOOSIy effec1lld ""l ions , began
pj:arnno It oalJOO-wlOa P'OQratnme tel CQ<I/IollO
by llI'0\IId1ng .., ~ !fl ""PPII' ol ,"""U,tt
sal,
IM<ttIllll 1M 5l1li usec:I by Ill......" '" 1 3 ,......,
pecIllie ..... aImDs1 ...... llI'jll. il'J1 a .t«:> 10 lItlY
further «toe debc>olncy d<SQt(IerS Ana d IS . . . -
pOs:>oOIo by the !acI """ all Bnulan's san IS
.m(IOI1ed hom Ir>lll/l !lnlugn only 1"0 _em
I)()t(l<O CI""""'Il posts F""" November 1984
O/'IWlUCIS. I'ISIe<I(l 0' \lOWllI Sl'<IlQh1 to 1~ malllel&
and be;ng <!IsI>e<IIe<l !IvoJO/l<lUl 1tle oO\l<.llll_ , all
lNlllllPO<1ed sall Os t.nII taI<etl TRl 10 Pl....IIS.l()I.
•
It>e """,room llOI<le< ~ _
"'ll on " a centmI
~ pIaI'l adds 30 O'ammes ot loana 10
every ton o! sail The.mpot1 '" ",la of nor>-oDClat«l
sall IS lllereafteo- a I>J'1ISNItlle o/fenCfI. a fact
cloettY lldvoet!lSIld a1 everv border lXl$I .
Defaalolg _ oeIw::>encV IS almost as smpla
as I!Iat - bul n()l QU<'e
Most III Blluran', pepoIa\Jon .... on 1M " Ilageo
01 !!Ie flimalayan loothoIIs, ",",linQ lhe llOUlhern
maI "'t """"" 0IlCIl • _ 10llIIV _ lIleye<nlOl
1>'<XluCe 1Qo' ~_ Many P'>OI'le !t>ererore
llIIV 8 wtlOIe _ ', SI.«llY of salt 81 OIllItllJ'le As ~
ill ~ pacl<ed " " " _ "' 75.j<1iO IUI<I bagS
_ "-to be lo8ded ilIId unloacled USIIIg Slee!
hoOk. , the $aft IS <lXPO$Gd 101M"" 0.... IIIe
"""""" 01 • ytJ8I, 8 grall' deal III rMi$IUr8 IS
_ ltom l!>e lI1/1lO!lpIleo'e and "'" ..... may
","'., onI\I 10'll. 01 1M io(lne wIIo::!' lIaS been
added 10 pr.......t ""'"'" llefI<;wtcy. III\! sal! muSI
""""""'" be maoe to hold on to 81 leas' 50 '10 01
Ihe added lOdir'e for ., leasI 8 yMr
To $OI'ooG 1nII protllam, me "",.ta<1 salt laaw'II
ltlG pr~ oIanl '" _01lOIII1II IS beotIg
packe<l '" $nlilller QU8ntlbe!l """'II a ' ·1IgI11 POlY--
Il1ene ba\1S - bagS wIlICtl a!SO carry 1>'",1"" mas-
sages atloul irronunozallOn ilIId 0flII 'G/lV(Ir8bOn
"""'"w.-.e
By "'" onl 01 the cenlury Bnuta<, WII nal'll ~
ou1 ClelOClG<lCY <lI$OIdet$ Mel ,f aa goos
~ to plan tne<1 kom 1IIi(l.1985 no more
Ilnul8nese cN<\'..... "1/1 be b<m 0< \I«lW o,op
menlIIlIy ..,..; ghysIcaIy J<lla<dad by !he lac!< 01
kxlino in n- <MIS And row !hal the """'"
"""'"'''''''''' has _ fI"I3<\e, !he """""II C051S 01
the wt'o:lIe
parson _OI)eIat"",
_ wd be less than 10 cern. IlI!f
... ClC>.O:llI. . _ _ ""lonll all _ " " " ' _
_, _ saII _ _ IOO-"""'. •_ _ of
_ 001 <ar> ""'" etJolc:>to"I_al """"
,._ • • • . - - . , . . COO'!
of child prn' mwo J1r;'I"Ilia-and il canOOl be
achieved Wilhoul a hil b su",dard of balh ptMna!
and domestic hygiene. Acl, ievmg 'ha,
sland ard
requira 'ha' appnnimale ly 2(1 10 25 Uues of
WIler per penon per day ee
availloble C"*: <n lhe
hOml: al all hou~ and on all daY" or the y.....
Wi<.h c1ea" waler and Anilation, I commun ily
eon also impl'tWC its level of nUlrilion - by irri&a-
tlcn of ercps aad k.ilchen p rdms, by mlucing the
infoctionl. and paruilic l"'i<U whi.ch ·",..le' lhe
food thaI is elllen, and by l'I~enl;ng lhe conlanli_
nation of food itself.
Wilh I don WII'" supp ly, a comm unity can
also ml""" lhe daily burden of felcb;"g and
cartying Wi ler _ I burden ..'hich frequently lakes
four houl'$ a dly in run<l II=- of lhe developing
world. Waler supply can d teref_ Illve Ihe mosl
valuable of III ~lralqic sescueces for bringing
aboul I revolution in child heallh -Ihe lime and
""eI"Ily o( IPOthers.
f or all lh.... adYIJIlqes, <.he «lSI of wale.
s"l'ply ill nOl e~ve in a _ 'ie,y commined 10
meeting lbe buk needs ofiits people. UN ICE Ps
~oal office ;" New Dd l!>i h.u cal<lllloled Ihal
Ihe a.'enjl< COSI lor the inslallation and use of
hand _p"mp! S1Jpplying fl'esh waler 01"", 10
people'. homes in hard _rod ' :ln'U of Ind i. is I...
Ihln 60 t:elIts per petlO\\ pc:r year.
If ..fe ...ler and oanilalion can offer SO much
ror so Uttle, why hiv e 1Cl:"al 1"'lllHCale waler
proiecn proved 10 be so dIioapp<'lint;llg in lh.i.
ef(m on <ommunily heal<.h' On.e l8ai n, Ihe
discrepaney M W«n pgtent iallnd perfortllllnce is
a measure of the dilferrn<:l: hclwem ava.ilabiUly
and usc:. Even when piped " ..ter io.Vlillble it will
nol ml""" illn... unlea I ':<JltIlt1Wli.y uses il for
frequem w;qhing nf hands lilld bodies I nd for lhe
d ean ing of utensils and cun lting s"rfac<S. And
even wilh impro,ed oanillLuon, illness will 1101
decline onless latrines are kCpl clean and ~ by
everybody _induding the ,:hildrcn. It is widely
believed, in developed IS well IS developing
<:oUlIlries,Ihat it is nO!. 10 i1npcnam (or .hiJ dten
to usc: la,rin.. o.r to was.h lhei. hands aflerwarcls.
BUI lhe lm is lha l chiJdn:n are Ihe main $<Iurceo
IS _ U as lh. main suff....n nf diarrhoeal
infe<:lion..
In o<.her word.. lhe promnlion nf knnwledje
and Ihe infnrmed involvemenl Of families and
comm"nilies are jllSl IS imp'.....n' fo.r m.o.king
.....ter ." pply effect ive IS ,hey are for making
Q R T and inunwUzali"" effect ive. It is 110< walet
or :sarU1I.ion which wuhes away illne<s, i' is
peo:lple'. informed usc: of those: (acililies whic:h Can
improve rnmm" nilYhelll h and magnify lhe cffm
of all other all emplJ .0 pro, m th e lives and the
growlh of children.
These lessons are now beginning 10 permc:ate
...ler sup ply and san;l.li"" proiecu <.hroughotl'
lhe developing world - proiero '0 whieh UNI-
CIi F nOw devoIes mon than nne-q uaner of iu
financial , csourees each year. An example ill Ihe
drin king WIler and sanitation prniecl in lmo Sl~le,
N ileri. , which hIS $<I far drilled 49(1 borehnJ..,
lrained I.lOO vill"8 e-based workers ( VBW.),
built or begun ,he building of 1,500 latrill'" and
brou ghl impro\"Cd waler su ppUes ' 0 a qua rte' of a
milliOll people,
The lIDO proj«t i. too new '0evalua.. i..
impact 00 heallh. BOI alilhose: who ate invol\"Cd
in suppnning lhe proie<:l -<.he Federal Govern-
menl of Nigeria, the Stale governmenl of lmo, <.he
Wnrld Heallh Ooganization, <.he RO$II lnstilute cr
T ropical HYJliene, I"'" Nigerian Iloivmilies, and
UNIC EF _ are f"Uy I ware lhal ;1 ia .he informed
involvemenl of ,he comm" nily which wiU make
<.he diff....".., bet"'een SU<:ceII an d failure. Ac-
oordin,g In prngress repgrIJ f""" UN ICEP.
l.ajjos office,-
'7lw ""'" <>in'11k p,micipauwy .kmnI" 0/ rM
rm>jw « <. , 0' 'M vill"lllO lewl wJo.,. VR W. ""'*.
lluri", "''''",imel "'fit, vi/lam "'ou dKioimls
0""'" /IoTt1ro1e siri", /lJId paylIIel1t 0/ VB W.. mol4en
_ 1_ d","A~ t~ ;" 'M' }""".g <ltilJrm,
OM IIWlU)I OM lob , Ort «nmilntud 10 .0",lruer
tilt fn''''P piOtto"".. 11M 101Ti1\tt.., n. proj«, is
t"1J1I'1U 01 - . . bft:,,~ in Ilttir rolt IU "",ur
a>/I«rtm, food AolldlnJ, OM <AiM ....rm, IL'l1/IItJl
i"i'"," />tlumioolr tAo' /wills tilt ...,. to />t,ur
IttoIlA. "
u
I THE STATE OF THE WORLD'S CHILDREN 1985
Changing Perceptions
A child survival and dc~lopmen[ revolution, if
i, isto 1IICc«d in the roming decade, "'ill be
achieved by ordiDaI)' people doio, Wbl l it is
passibl. fo< them 10de b,,,, and no w. f'o' preseo'
kno wledge could mabie lh. parmlS of the poor
world [0 improve their own and ,h.i, ohildren'.
hoal'h it, " ')'1 which . '" affordlble, practicable,
and which w;hicve result> in 111m own lif<:limc:s.
T1>iI II primary heahh can: beginning witb
peopl., primary he1ltb care sheddio. ~]. lMdical
mystique, primary !Kahh ca... learning [0 wall:
bdort;' can run , primary !leah!> can: ' ..hicb is l1li
much the roncem of the schooh""'hcr, Ih.
""IUnltff. lhe religious leader, th. Wale:lr .n,;ott<,
lbe ...... modi.. and ,I\( ordinary citl:oen '" ;\ is of
the official health services tMmstlva .
Present health ."rvices _tv.... primary huhl>
scrvk.. _are DOt ,"SUy ~ibl. 10, and CannOl
be d.~ndcd OJ! by, tbe majon ly of lhe dc~lopin l
world', peopl.. Healt h Nucation can ,p.o.i80S. if
Ihey an 10 serve thai majority, sbould thado",
CQ~n tnl1. on promoting thO$t ""' i..... which
p<:oplc caq undenlu for ,hcmsclvell and thost:
K OOns w bieh have the g....tCl' imp~<;l m Ihe least
<:os,. Rcan' brn lu hmughs DOW offer " group or
. uch actions which =
,ogC1her SO powcrful 'hal
'h I')' MUld en~bl e panDI5 \0 InIllulioniu t hUd
.urvival and child heahh in l h e ~lop ing world.
The more gn"",omen' p:ovid.. ,h. .. rvi<:cc
"'hich sup pon Ihis parell,al action _ by 'M Imo-
ing of community health IV<>fk..... or 'he deploy_
1IlC1l' or ..rrmol .. rvi~ Dr th. srtllin g up of
ilDlDurm:aIiOll pas1$, or ,he illsallint. of d ean
WI ,er suPflly -,he more dramalie'he 'ClullS will
be. Bu, 'he pl'X1:t1l dearly bc&iDS wi'h ,he
cmpowcriDg of peop l.. And as 'he hral'b ministry
of nne de,eloping co un ' ry ha$ rc«nlly said:-
"nil" ",m llOl alld will 00' t!>!I' IK" qu it 4 unrotn'Jul
pro<m; quiu tAu"",,,,!)' "" n lIt'I(J«I<d... 77rt ......
ptoph *.".., lilt """" liry will tI(J«4 a, IIi dnr <mJ,
oj IItt !Ita/lir JnfIias. A t,Itt..,.....
rilllr, I."'" willbf
dlt '" wi", """" oj litU /rt;Jllr poohloru by
lluMuivn, 0,", I~ will ht "'ott ro",,'*.oj.......,..,
oj lilt wllir r4Tt "'It.. .
'lui' ""I,1r /tMb alld tNl"",in, ,1It oppt<>pri4ltruu
/n . ,,,," _'lis, """ ,A
NUlOI;"" will (>O!'t ,lit !lllI)I ,. UfIr",uoi,>,p,mici",,-
I"'" in ,lit full... ....... .. .
tr
If it can sucettd, the proce:a of empoweriog
p....llt. _ wba tever illl genesis - is unlikely to be
conlioed ' 0 matters of he~llb alon e. lbc belief
,hat life can be improved and cireumstlUlCCS
changed by ooc's own oni<ms is both an end and a
means of devetopmen, itself, aO csscntiall'"'ludc
to political panicipatiWl. 10 ,he struggle for land
..fOllll and economic justicl:, and to IIcW auiludcs
'owards family siu and • funber fal l in l he rate of
popul~lion g rowt h.
A$ both • cause and a consequence of ,his
process, • peop lc'5 pc=plion of wha t is normal
and wbal is ..",..puble OIly also DndC1llo a
pro fou nd change. A$ Tarzic Viu"",hi bas wriltCtl,_
~WNn tw ,,,/*,,!.nil a <AilJ <wJ'tIiNt "nd ~Wp­
"..", l'tWIu,;"n "'" ate 1"11ri,,, abm.llJringi.., ~bm.1
a III<Uf ri~ i.., JM <"""'" ~/tm< 1 iJPnIi" , r-pk',
"..",,,1lIMn in wAicA ""mn",1""cp'a"", ~J a low
leoti ~J '-IIA11M Il AitA "'It ~J Jc"lk alllClfl ,lIti,
<MM,." if I«ltd up ... I<riaJly {JT J~ufu lly Jtctctd
irrtd,abi/irie/.. W, <tJt I"/h;,,, " bm.' 'rtl1UJrmn;Ojl
duply inwid alti,llllt. and f>rll£rica aM IItlpi"il
"."pk 10 or< U7>tT IAt Aill. WMI lICC4s l<> lit doM lAm
is '" prtstft' new b owkdtc ItJ ptop/t "." l<\:IJIla
."'~ IAenutl"" sa clrllngt ,Ad, f>tr<tPI"'" oj
'sumMlily' or ~w,aml;ry~"
In the yean 10 come, il will nO\ be xcep:ed ""
normal ' ha, /\lOR l b&fl 10,(100 children die ClICb
dJy fn:lln . pn:w:us whieb P=fIII can preval' by
usinB urnple ina,..,m"a ll fnund ;n almost ev"""
"""""
la 'he yean '0 come, i' will n<K be m p:<d ..
aormal ,h., IIllIny miUioDll of chi ld "'n should d ie.
and many more be left disabled. for 'he lICk of .
$S con,,", of imm uniza lio n..
In th e ~~rs to come, it will not be mpled IS
oonna! tha' half a tnilUon d!ildten I.... their
eyesighl e"",b yelt for the lICk of I vilamin A
tab lCl , or of a few Rfft nS in their evelling meal, ar
thOI , ens of 'holl$locb should be mentally re-
tarded for Ihe lac:k of I few milliRrammt:S of iod in<
in their die t.
In th e yea.. to come, it will n01 be a""cpt ed IS
normal for 10 milUon habies a year 10 be born
IlI3lnourUhed because Iheu, lIIOlbm did nOi ha~
eno ugh 10 ea', or thaI million' of child",n, small
for Ihdr age, should sil .Ii" loa1y in the ohade
,n 'lead of playioll, Iarninli, and IrowinglOIhe,r
full polenlial.
Over t.hc nnl few yean , 'I will nOi be easy ' 0
lIIOUnl Ihe massive cffOIl ' 0 change t.hit 'n ormal-
ily'. II will require , IS lbit "'POll has lried 10
. how, both poUtical comnUlTTleOl al 'he rngbaT
le"els and the Il\Obilizatillo of aU I"*ihle raoU,-
=- nationally and iO lel1ution.all ~ - 10 =pD" 'er
and suppon pa<enli wilb th e knowled,e and Ih.
n\ea'" to hrilli aboul soch a cbange. BUI by Ihe
same ,oken , lht'" it IIOW 101 opponuniTy for any
govcmmen' , and all1lll.5t an~ ol'lllnizatioo or
,nd ,vidual, 10 playa pan in bringinll about Ihis
oignificanl improvcmen, ,n lb. lives of the world' s
childrm.
If, ,n Ihe face of Ihis opport un' IY, we ",,"<inue
10 allow ", many million' of YOU1l3 clilldrm ' 0 die
Ind so many millions lIIOl", ' 0 bocome disabled
and IlI3lnouris.hed, then there will ind ~ be.' CI ~
10 ..k for whom 10 man)' bells Inll. For wbal
relIlis'ie hope will Ihere 1>0: lef' for I I1IOfC just,
more humane, more pe:oooful world, and what
pritt 'be 'sanct i,y' of hun"" life, if ,b at world
i8n0fC'$ wch an opportuni lY as Ibis ' 0 u _e 'be
Uvcs and heallb of so l1IllDy of il' most \'IIID~hle
membenl?
If, on lhe oc her band , 'his ch.allenl e were 10 be
"""Cln ed, Ihen 'I would be a >isn of bore as mucb
for .he adult world IS for iii child"'o. For
although in one ....... what it at isis"" it •
",lati_ely modesl set nf practical obiectives whicb
can be achieved OVer ' n:asonabJy . bon period of
'ime, in anocber >cl1SC w. are ,allc.ing .bou,
nocbinl I... lban a genuine step fo.....a rd for
civilizalion i,..,lf.
10 OUr oationll societica, and in lbe inlerna-
tional COO\IlIunity, we have lbe Iwowledae , we
have the ,echniquca, w. have the ol'l anizational
ClpKi ly. We are Iherefo'" confront ed with a " ark
question: do we hlv, lhe will?
And of .!t<lu who would ",&uc Ihal i. it nOi a
matter of will but of TCSOUTCes, lt musl now be
asked - how low d_ ,h. «1<11 ha_e 10 fall befon'
lhe will is found? We are now talkinll abou' a
particular opport unity 10..ve the uves of approlti-
.....Iely 7 milUon young childrm I year, and 10
prD1C<:1 the normal developmenl of many milli<lns
~, at a «1<11 which <:c:rtainly don nO!. ."cccd •
f"""ion of \ " of . M world' s gross inlemal i<lnaJ
prod uC1.. If lbe will 10 ace. pI Ibat ch.all. ng. is
miosinll, Ihen perhaJlS il will n• ....., be Ihe",. For
in aU realism, it is unli k.ly lhat the'" will e.....,
"llain be such an opport unity til do 10 much for 90
many, IUId for so linle,
u
- - -- 11- - -
LIFELINES
Extracts and summaries from recent
research and writing on strategies for
protecting the lives and normal
development of the world's children

G rowth Mo nitoring
Oral Rehydration T herapy
Breast-feeding

Imm unization

Fe male Education
Fam ily Spacing
Food Supplements
 Lifeli nes: an introduction
The cel'*1II IhIrnc DIlle '"$lale oIlt~ Wo.to:fs
O*lfeol" report . 11* _lew. ' ..,
~..a
one>: ~ 'loeI'IOl:It I;OlAd now enable perenlS
..., 10 t:nlg abcu1 a It'\IOUon 11\ ChlcI
~.., 0ll>GII»'6" ~. oIl'le report_
0tJ.. .. men c)eWI. Pre!JI!nI kIlo ' """_
1IlCSe II::lw-<:oIl nl8h:Us [actJ sectIOn tlnrQs
...."..... . ~ an kC , .. 'tlCI\)S and QJOIe!I
tonna ~ flo ljlOllo lll' and tlDI'IdusKlns!rom reo!lIll
research ancl "'fIIlng on 0rIII 01 eo '~Ielnc

"""""'"
Pnmary I'leal1h care " !he lllCa whod1 makllS
poss I'eYOIllIJon III <:ndl2 $lFYIYiI/ ~ dlild
deIo '. t The $llfead at llduCa~ on. com-
ITUIICiIllOfIt, lIIlCl soeiiII Olll3J1lo'llbOfl is Ihl! new
C>'cumstanee whlc/l ma~t;!5" achocvabIe Gtowlh
mtlIIllOlong. Qllit .onydrllhon lI1e<;lpy , breast·rood-
irlg. 0100 Ifll mlJnl ~IlIlOr' are Inc lec1lnq:JC$ wi\Idl
mako thIS 'CVOIuUon atforO<lb40 lM!I1 woth very
I,mnild 'll$OlIlCCS

It IS ""POlla n! 10 rocogn<so \h<I1, I!.IIIN n a rry

campaogn 10 J1'lPIoYe child survrval and growth.
pnon t llS wtI dill.. lIIOCOI'dolU 10 nallOniII and local
C1rr:umstancos The b.w J)i u ..llII ·~tellne· l«:h-
IIIQI.eS discusset:l 11 Pan , ot lhIri .epon are
a-. because Ihey lQ boo-cosl. lhev are
IlvaiIaDllI now Ihcr 8Choe¥o,lIPId .esuIt5. Ihey ...,
Ilhlsl InYe!$aIy fdevart, ;n;l IheV ~
:nnary IlCleIII't care by 0f1Idwlg DeOPlie .. lalung
_ ....... ~ ~ b . . . own heaIll'I, And III
m rc:.liIbOll ",m 1Md'l1llhllr, IIlfY oller a oon-
ildcfatl'- degrro (II llIl:1t1Qlui , IIgIIIf-.I h S)nOII.
QISbc , Ql 01 ~"riea_-tIIdI
os lie c:«*lII pltble1l 01 ChId tIe<IIIl n ehold
de'o<*Jpl . . . . . hi world ICday 1_ P\lgCS "2 10
'n
.. llCUlui , .-u '_cl'l Ns _ _ h: hell
0ltIIll chao'; lee,. 8CluC3tIon. ~ spac-
ong, lIIlCl load to,iQClIIo.c ,-..; are ;;Iloo among
!I'le ..... ~ IeYcf1l; b I3ISO'lQ lI' e le"'lI ol
d'*l -..-J IVld Cl'IIICI halIIl. AIInJgh rntft
CCISIlr anti men dllIloAl ID .chIcoo'O, _
tJ_ igIl5 ... lhc .... 0/ women are 01 such
po:entaal ~ Ihltl they ITlISI eeo now tle
COIJIlld -nono lI'Ic blellklhfough$ .. kl"OlO1oc'gc
wild! COJid charooe Il1o 'abo be!WCCfl lhe ~Ih
ana woarth 01 nal101l11
Growth Monitoring
MQln~ln'r;"" in tAiIJJrMd «111 ptnfI Q 7'I1I .ly IIllm " VMl _ "" ~ _ _ looIoI...-
/!IDIral aM pJrysital derr</pPtrrnll. 7h ....r of
""'/11"'';''''' "pqtJtrty a",r its Ilmr--rmn ..Iur;""
_""'
__ *".."... . . . ., .-
"""""""Y. ..... . ."" til _ -. ~
01 ........ 01 ...... 10 00lI'"
r- In I:auque lG_1 choIoml,
rkpn.b t<:O>IQmir """,'Jralld-WI jlU.ire. In 1M <lunrog _ _ ~ 0I1J1o """"'........"., "*"'I' til
Mwrwr. /OIlJoC(JJ' IIILIItodr a" l1t'<likrl*
1!1t111I'i
10 n,niJiamdy rtdl.u 1M ill'idn!u "NI """';1)' of _ _ "" ".".. __ ""* -.",...
""'"""'" """"•
l>\< " " " _, 1>.>1.",.
Ole net. _ Ole ""'" """"""". - .01
........ . ....
01 _ .
.

"",I"a,ri,w" ~ aM ilS impar, a" child MoIlJr aM _""""" and """'" nloceouo _ -"*' _ ...
..., ........,0'0"""
dt'Dtlo/l"'f11 ~
M"I"al1;' ;q" h4s ",,,,,y ca ..... ~ oj ",!rich ~1IetI1
- ,-
h., .... ' _ ... w
- _ .. ...,.,.,.~. lh(Iy~
.-_ ""*"'"
i,,/mUm i.s pooN hly ,Iu ~I i",pqr'a"~ TIv ... ......,.._illIO
~ ..., orN!MtY. """ ect.OIII "'*""""'" ...... """\11 ...
i"visiblt l/quillt IfQum of ,,,,,,,,,,I fT!IU'lJr Jrapt><1tJ me "..., "".."... OIS 0I1tCU111 a'lIl CIVO<JC _ _ ....,
_"""""II d>oil o_<ln .,_
" - "'-----
10", btj.". II <!rild It«omn "",1_rilW fUp/a r ra """"'"'vlom_1
Iood 0/1<JrIlIlJ0S or .'
." '''IMy ..";girl,,, aM IN "..,,/ a <hild """"ir <It<m
ru ...m.. ";,,IV Ihis Jail";,,, trotr,ir aM '" prrwi<k
a" .ar{lo ...,... "" Ii> MfJIMn a""
wi,}, """Un. Ar
,-. ..... .
_ .. . -
., .... "'Lwll '" _
~

"""'''' """"1\1_ ..... """". """""'"

'" " IV ,....

="" " . " " '-.-

1M, lUigi, ",al""ln,;"" ran bt .. kfri~ly ,mil, and _ , IIUI .. ""'" ",... • me ....'" til .. lOo'II; """'" til
<lrN P/)' pm>nlu4. Willi bo>,ic ad"",., 6""Wtir III,," i. ,d', ........ ....,. ~ _ ""'"" .......IN<IY-..
--.v """
Il''''"'''', ..., 10 _ l>W'~
<10M> "'"
'''""k r<m IMuftm Iotlp mo'....... '1um..1.... If'
J1rtTIt", 1tt0$l ,Mid lItal"u uirUm. Mart 1M " 2()() -.nc:e '" 111<>"""""'" ........*'" WI ~ """"
01lI'lCllQn '" - ,~ ..
dill."'" troW' }, <lw ru "", I'WW """'''' i",a "'" i.
""" 80 <II"" Iria.
, _'*"'..
Dl~ .. only "'" cno;l

"'*'\1""'" mIL<I <II "'" _

_.!loc1ong.:oo_
"""" '" . ~ ....,.
me ~_

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

...".,., .... . - ........ It>O'\' .... along ..,..,....., t<orn

Malnutrition and Infection

lA< k 01 food .. oolr
' .....bly .... - .
Uoh<tia.;
_ oI
<a
<rltMoo·. _ , "'. ....
01 oil .. "pelted
=_.. _
til ...... '¥"""" -..0
-_.
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-....-
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1lO«I_1O"","_ _ - - . . 1 """lIieM """""""
mIIOISUI*' ..,. ,<IlalIng "'>\tI' .... _

.. """"~ cO<e!<Jl -...; 01 ....,.-,g _

to _
. ......" "'" lI<r

_ ,- ,..,
. . .. ~
_,_or-.\I'oOl"",.. lO<l . ........... _~ ,.....,.", tIIOl, . . _>go. ~_ """"""'Ii 8 _ 0 1

---
_ - - ' '""" _ Intod.... _ oIoy a ~ _ _ ........... - - ICl, ... _ """_-..."",

- _IIiI""
_ .. causng ...... ""'...... N" _ ~ .. ~ tor ~~ ~ '" IS '\, 01 1M _ Such <:I'Il.t'. ..... _
'"'
... ...... _ ....

- ".. __
~ r-.~ ~lx:uIS _ _ ....
""",",nl"""'_ ol ~ ~ ..."

_---
o t _ ...~~ """""""...., aOflOOl

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'[)",nng <lo&rltlooa . .. r_ _ w ,,- .. _ _
• ......, _
aIQo"'" _
1NW'Itd""""-
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. ...-_--
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_ _ ., ......"" "" 10 ..... \'0** .., WI'" ...., - .
,.,~ " ......," ......., "" """ .....,. I _ ................. """'""
""'"*""'
A_
110">$ {j/W'I!(l
~~UOCl,
te!S _ , """
_ _ """" orom "'PlI ""'Il
- _
011 \6 ,.... Qual(rn:".,

.• -_ .......... _--- --_ -_

""'-'" "'.. __ fIOJ!I<I'<JIl .....'

. .. - -,..,
---- ~"""_ "1eO
...,gIll " ' "

01 _ 1 0 ..... .. ""'" In ~., ..... ""tnoor>I """'. '" ~Q

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~ tll'
trIO "" '" 01 ...
l'l_.1ooI
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l<>- 5fi~ 01 - '·""_l
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..

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~

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.... .....,..,..,. _ • noh_~ """*" r"..,. '*' """'_ Malnutrition and Weaning _ ,

_
... _ _ r""l' ClIO """'..... trIO ..... , "'*'PIO' '" No< _wi.. _ . """ _ .. Ilo$lo _
r""'_... '.....
_. -
ClIO'""''''''rqoc.",tIllOO<ll>y''''''''''''lllltw1' 10001.. io oddiboo .. 1In oBllk. 100> • _ < '"
... ~ _ _ ..."",," _rom. n,.ycan....,. <IoiW _ .... io 1 pon. '" _ ...,
"""""" 10""'" lO<I<Ing _ ... _ _ ....,. M<:Il>\< _
'" .. oj
"""'"""
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. . - . <:aUOO -
onIeo:tot.. ~ .. _
01 ............. ""'0'lIl "'" _
""""" .
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-·--.. .,. . .,1_..- _"" " . . .
WEANING - WHEN
.... ~ _...., ................ ....... .-
,.. _ " ... _ ....._ rHo u.- _ _ .,. _ "" .. IO<iD aa _ J To """'" -...;,

n
II UFELINES' GROWTH MONITORING

2
..
.,-. _---_
.....-. _-
" ' _ .. . . . . .
. . ... ...
• _ _ "' 1l<9" "' _ _ "'-"'"r_

__ -_ ..... _ ._ ... _ -
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CONTAMINATED
A __• __ WEA1';'ING
. .._ _ FOODS
_ ... _

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. <NIl """ . . "" ...-, ...". <loOI

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Tablo I: ht«tltlp olfood _pia .........

.... ccptablo _to of_ .... ~ ~

_
,, _ _

-
WEANII'G _ HOW

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oneorytllo ona_
ffIII I!IrIgO< ~ .""'
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be ..."" """
-.ow, 10 IOCIl'!' QUObI,lV>ltor·nca,iII ""'fJIO wllO;1l .

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r_...._
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PARASITES
~

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1h<I,,",_,(;OI,_~ _ 1""... ""'........ _
<to IN!'" cn«I ...._10_
" - "'""..-.- _ . ....,.., .. . - y _ . _ .....
e-- ......._ ,,-, _ ,_ .. , .. """'" _ tli1SIII' _ QUOC:I</'l ~ -.. ~ ., ....
lII'
...... ' """..I""",...". _

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cOlkl .. _ _•
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_
..... """" •
.. 0\flI'''''''ll<''0Il _ _ ll"'" _
~

, .. ...--...
LOW BIRTH-WEIGH T .... _ - "'" ",,",,'a!1'D"""' , _ _ ......"
"""""* __ <:lin _ "' '"'''' 100<11 _

-
___ _ _ " 'NO' _ ,..,
~ -. .. " ... - """'''''' -
~, ~
<I!onc";"'" " ' _ fw# !.,,,",,,,,, no 1 _ro<:<l
'¥s.--
""""' ''
IMPORTANCE OF GROWTH
RoguIar ~"'lI1II' """ll'W'lI..... ..., """"1tIll '" ... _ ""
B OITLE-FEEDING • "'"'" ~ CI1llfI, '"" mao.e !a/lomg ;I""'" _ ICIn;
IN __ !<om IO' _. ~ Ia _Ioo<loog .,"""'" 01 !lOk><:<I _ _ """.. Orat ~ _
~_ ~ lake _ ID ""'"'" ~ _
""" .... "'"
""""
Nt ,,", , '.'0 *'l<Ill', _
_ ...1 ........ _ OIl ~j ......,-.... """" ~ . _ _ ""'", _ _0
<:ausII III _ " " ' " 1_ ~ . no. 3 -_ _",I
""'
__ _ _- ' . ....-
'_ "'" _"I' '" """"
ID _ .....,...,..
"""""II
.~ -","","---by~

-_. '--,-
HUNGER AND POVERT Y ".,.. .. 01 _ _. .........
~_ _ W _ """",",,", 1<0 ........ _ .•

"'--
'"""_ "" """"_ """"II" lOeal. .,.1Otlg .... _ c , _
""'" _ ....... """"'ll __ 1I>D ..0Il"'" """"" 10{IDol
""'" _ . . . , "'" """"""" 'O'It> """'" Ia 1Juy. e..t ...

.
....."
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, , _ """ . -......: Il'O""" 10 _ fI>e P'JO' _
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A CI'IlO:l .. not 10''-'11 _ _• _
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.... _ _ .. _ " " " ......... Dolore
h""" """" "'"__ ov- <>I ~ .,
.... _ "'......... _ IIlirnoWv IN • .....,.....
n", ",0I;0r" .. , _100";
"" 01 wI1IIl
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_ \IfO¥I'llll' """'" """"" . ... ,
'*'" "'" <:t>oot .. ID -.or, "" """,""'"

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boIcn IDD
~ ..Ill .... 0'.. <!IangO ID POOl lID bOI1

-_ -
_ _ ... _ _ "'"'" hit . ...." " • "' _
~ <:M _ I;t!r1MIly t>o act>o,...,;l , _ . , ... ......,.,._"""_ 1.. _ ' ....... ""'Y
_.IV _ _ '" .... . _ t:oeIo<e III< "'*' _

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'19oJ'¥ """"""lI' ...:ogIt:nIj 01 .. I'D"''II G/loICltef1 oncl ",.
"""""'l ~ 01 ..... _
_ , _ """ t>a _ on '0'""," CI'lol<T, d'oIllreo1 *' ,,",, 01
W,1Il "'" "Pfl'DP".11t ... _

--- ....
INVISIBLE MALNlJf;RITIQN -.:e lr<rn ' - ' " """""- _ _ """ Ihen ",.., ...
__,,,' 01 __ """"'" _ " 10 """"II, lIlDI' ' ' '
&.,•. ""lie,"'
_
I .. ....... .,..,......-, do;Iil"' ....
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"1(:dIcn. ...,., meIDre
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 II LIFELINES: GROWTH MONITORING

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IT LIFELINFS' ORAL REHYDRATION THERAPY

Oral Rehydration Therapy

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_ lor <>fill _ TIw:t _ ..... _ . . - . PREVENTION OF DIARRHOEA
_l>6'" ol .... _ _ ..""""' _ _ --:J-.& _,""'...._ Ill _ """*t.dcl1b'on
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,
Causes
_ , po
of Diarrhoea
Ii.. rb< IOdiorrbo<.. 1O<, __
_ -.ilar..w;" .. ..... nink ..,
THE PATHOGENS Oral Rehydration
.. ~ _ . _ ' " w>'" ".,..'<!'t O/lll WIlrI1l1CI ou.... h'<HII <Io ~'- bo _ <boapI, p«" .'«1 11}'
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TRANSMISSION ,.. ...., ""..- In _ ....., "'"
.. co_ _ or .._ot 11> 1i'J" ,. ot ... .
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or.
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_ Oroo""""" ",,~ • _ ORAL REHY DRATI ON SALTS
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The - . . lYI ~ l /UNlCl-' ,"""""""'_ _ lor
~~ "
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TH E LINK WIT H MEASLES s-.. nr<""","' _"
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ally '" _ _ mor'*I' ........ ., ol To ". "'-""'l ...... """ _ <II _
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_ ... """""""'Y ....., 10 ae..lOp 0 _ ..... '"

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1I LIFELINES' ORAL REHYDRATIONTHERAPY

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<lon'll rohydrallQn ~..., II> I;(lI'Jf;<O orauoo oIItIQ _ _ cny ... ""''''''"
lne~ .. ons .. _ _ .... ""'.-..... 01 was Il'eal« on ChoO"" _ .. ... 'll
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~1_.I'<><I""""""''''''._Id'_1y Home Remedies
'" 35' _ 9 4J.pa '_ana Wlon OilS
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II lJFELINES' ORAL :REHYDRATION THERAPY

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ORT AND UNCLEAN WATER

-_._---..--_
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New Developments
~0FIS_ " _ ",,,,_,,,,""ancl81_
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THE COLOSTRUM PROBLEM

llr ~ _ •• -..m. 0 """"*,,,at«!
\'fIIowdn _ _ ""V ?~ ml <lur<1II IiIsl
Factors in the Decision """ , _
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U.CK OF KNOWLEDGE
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Supporting Mothers
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., ~ . ., . 'o..,y_
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"--
Il_ _ • , _ g """, ~""""'lOtI <tll:aIllI <lCCl# ' " T HE STABILITY OF VACCINES
_ . . - - . . ... - . . _ _Ite::to n." I .. _ 1lsoI'
Tho ~ 01""""""" . . - . ""'**""".,.,..",...,
1lCI:l ......., ..
l.Iom........", 1rI.YI _""'" ol _ ... .. lect<v,.
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....,...,....., IasI one _ '" 3 r C
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"'..,., I....' '"'" ... ~".,_"""'"
,~

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OJ 0<\I0l''''''d _ll«VI/I,. f'<(Jgrill'l 101 ora.l<l 0- 'S<1al 19 aO ~1<liIl ""orillOtlCS ......."""'"" • .-
"""""' 10 - . " .. _ .. '""""""'" '"""'" 01 _ 01 37'e lOt """ _ Ttao
""",,,,,,,"",,'I lI"<'Dil¢lfY ~aOIy II'IC<ea><l .... oIIocWl.~
....~_......,.,...". Tho_... """~-.r"'

COSTS
CoIII paftd ";111 110< ...., .. I
. -- .....'>10 _ .... IlIc ""'" 01 ;
01 <~101_
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.......
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tQOtI I"" ~

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""""""" ow. so.dl_ """""
......_ . - . <It _ "'. IOr
_ " " " """" <:OSl
Jo, _ .. "'.,....'\1
NEW VACCINATIO N TECHNI QUES
~_
• ' \'hl'llCl ancl •
..........,....,., Of "",MQomloIy. ...'" _
... ~

_ " ' . """""" Only "'" hoo ~_ .

U!<1cI CPI
",og<." " rooIO _
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_ _ "_ ...". , . - .... y '"
c_ , .. "'" """" III
IT LIFELINES' IMMUNIZATION

...",_...
n.. ~
,-_ _ -,.-""---
_
n
...
11'....""'•• """""" So

_....-
_
Q' •.,. • ..,...,... """"'" _
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am 101 . . - ..., _ _
00 thO'

THE COLD CHAIN _ WOi'I<fn;

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(XlOI . -. If1<lrft I\0'IO 01<111 ~ _
"""" ""ll'O\Ood, .... It.-
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--
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"', ..,.. "" , , - ~.-:I 11''''''''' mot .. ...,., ,,.,. Woo'Ill-'~. _ ' l l hi

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10 In '"""" """"" ...... _ _ 01 "" f Pl In '9&' , _ _ ,.... lock 01

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percblm '" _ """"" ... COSIly ..... no4

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_ , "'_ to _ ....... """"" or _ ...... ..,..
.,_lhe_
. . . . . . . . - II> _ _ ""'" • """"" '" ~mo 1""Il """"II" Coverage: The Demand
~"""""al_.""""_OI_."

- - --
111<1 SIOI>Pn "' .,... '""" _"""""""" 1...../ _ ....",., ~ WIiO ......... 01 &1 .................. ,...... "in 3 '
...... """"".... ....." """" _ ,.. """""'Y .. .,.,..... ""'"""'''''' """"""" '918 .... , 98J !olr<I _ til <Ir<l<><lUI
""""""'" """ (lIQOOOCl ~ "" """"0'_ ,,,_ ll'J ,.... - . .... rOOl_ rwdDPT '"",,' _ _ ~ O' ~

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"""Il ""'" <cd '" iliaci<- .,

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---
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.-,., . ' 0;' ,,...

... -
NEW VACCINES t••" . . _ "...
- '''-~
....-.,...' '
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......""""..".,. 01 ",_,~

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1llso _ ....,."....,'"""10Jt<lu<:e MOTIVATION

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NIlCI> _ 1M ... slogo bo """""'aIOd • ,.........,. car. ,~

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""""'-ow. = --
efIacy IU ~ !Xn>';)IIy IJCj<n1 I1Il "'"""''''''' gil <lC¥dopon;

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_--
HUMAN RESOU RCES
.
............... to • ""'"" ".,.." .. """" 10- . . . _ '
lar,/l
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IS one 01 ""
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---

....
.......
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-_
~-
..""'_ .. _ 0<IIa-<t>a00 " .. """""'" ' - - " ...,
" ........ """"""'...", _ _... "'ago , r... _
_ ~ ,.., ' ~ ~ . 01 _"01 TAKING UP THE SLACK
"""" _ '" ""Il'"mm,.., "'" ,... ...... ''''''''ll "" .~ _ ... _ . . - ...............
"""" __ ""'"""*' "01.,.,t>oon- ._ -..01
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Ill .........
....
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r... , III """" " two.....

•
 Immunization
,. .
and
v
PHC011<<<<1 ......
• itII 0Ikt unoall!' .. iolotcilt,. pri....., 11oo_ can l PHe)
~

-_ 0IftUV"""" __ """ bO _ _,...,.

Ole - . . : I """'II _ """" """""" ._ 1>1'
<fMIol! " 1Nw IiISl _ '" "'>. ""!7I ~ _ _ ...
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loo<lorlg, _
10
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.,.......... .. """'
...... .. .... _ .0‫>סס‬oo '" "'...._ _ ~,_... _ " ..

"
II LIFELINES' FEMALE EDUOO'ION

Female Education
~

itwlJ.,
.. - , . _ .....t'--m. _ _ w_ ......
utJ-z -* dWJ ~.
11.... -0,......
li0vq ., .-.rtP ..
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..dial..
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,~
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...ana iMl w, __"w u
&<au InNIdI
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., Irmw ~ _ImtiII..our;. . " ., /I
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,

~ ~' IMt Po mIwi1fc IN ~ ...bm

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_ _ _ , 8 17 _ ' 91< ldltlWll_
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ft••,,,;"I.- i" j",pq.,u«.
.~

77rt "..."".iJ..... I,••,•• ""',...... 1 rdll<'.'''.

<LOI.
An Independent Force
im/'fllf!td ,' 11d ,,,roiwl .w.... 1IOl':It. bon ill.....;·
"",td ,.,. w",it..l mflI,<lt. 8 . , i/ iJlllrNdyck.n II"" " "' ~ _ _ ,,* "' _ 01 _
Iitt ,;"" .1 ,;,iJ ;, .... of rAo. 10m !wI,' _ '*'......... . - . D l _ . l M n g _01
_
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-""'Yr _
' . . ._

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

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<1/1It •

_
_ ' . ... -..
Education and Survival
M..,._. ........ _ .....
F..n>ot_·_br_ .. _ ........,

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

...' -
".w"" "e._IoOP_""..-c._.....
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Possible Explanations
n,. .... ...... .. ... _0.01 IT. ............
IW....-
--...-----,- "'--
..,j _ _ """ _ lia:I.

. _... -
-.ardo. _eaw-a _" ._~ .. pIa- Girls in School
-n. _ _ ......,.. ....., _ F"c: .,, _-..n._ _
.. .
~
~

~"" _ -.c ... "'"

' .... _ _ allN_•• m .. _ lltoow"l"" _ _ •• _ , .. "" ..
_....... oaaetI'
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'acodII' CI. .... .. ~ co.. ...
=- ---_... ..._--
.... = ....,....- .. _ - . - ..
:e=:o:-'':''''":'::::.01' 1"""IfOo'o _ , ~ ...,

_- .....---_---
_ S<Mncao. __

----_
. _ " I •• _ .. • _

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StII .. _ _
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__ ' 1_ "_ ..""._"'..... _
"'1' ''_.. "

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

e.-IlIJ _ _ . _ IOp;I_al ...

... ----, ' ,,__.._.,_a. - _" _ _ , .. 11 _ .. _ _ """..,

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. . - , _os otJIoIj' 0> _ -.y _ . 01t0r0c
lo<"qor .."""' .........~"'"

--
"'-_ "..,.. . NT""'*'"
al _
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....... ..,......,,""-_
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/
.. QIOWIIl .,....,.

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"
II LIFELINES' FAMIIX SPACING

Family Spacing
Family plannin, is o/tnt """deli ..~ ""'PlY il , , _..... ol ... _
_ill
(II .... ...,.,... '" " " " ' . . - •

. _. . .... _--
_ wtlI1 • _ '" ~ ol _ """ , 8 ".,,,,,,,. .
"'''' PU of fKJPIllolimt c01IlmL Ytl tmI ii /lint ttIm

--'",,_"""""--- -----"
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..wid " ill /It a Ji<'tJ'n!~1 aM w""', CtU<. j or j a",ily
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Benefits of Spacing
EFFECfS ON OLDE R SIBLING
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U LIFELINES: FAMILY SPACING

MOTHERS' LIVES
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T"" f{l«iji( ftmru 0/ /004 "'ppU_'~'''''' IIator .. "" ....., "' San .. Mono CaAuo I' GuI_ ~)
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II LIFELINES, FOOD SUPPLEMENTS

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FREQUENT PREGN ANC IES

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- ---III- - -
STATISTICS
Economic and social statistics on the
nations of the world, with particular
referen ce to child ren's well-being

Basic indic ators

Nutriti on

Hea lth
Educ ation

Demographic indicators
Economic indicatol'll

Less populous countries

III THE PATTERN OF CHILD DEATHS

The developing world's Trends in infant mortality in the developing

share of population, c cunmee, 1950-1980
births, and child death s

C Developing wOOd 's share

_ 0Ml0ped coontries' share
IMA (infant deaU", per \.000 live births)
- - - --1°
i 20 40 60 80 100 120 140 l ao 180 200 220
riO ,=
LESS DEVELOPED COUNTRIES

WORLD POfIULATION
•
4,607 MILLION
....... IIM)flE DEVELOPED COUNTRIES

"""
MWU

~"""
"""
NOFlli ERN

ANNUAl BIRTHS """

""""""
127 MILLION
"""

ANNUAL INFANT DEATHS

(0-11 MONTHS) 10.3 MIllION

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

ANNUAL CHILD DEATHS
(1-4 YEARS) 4.3 MIWQN LAllN AMERICA
M'. ...... _..-d...__..._".. -""""",-....-..-
.. ,_"'_,
""
Index to Countries
In lroe loIIaw1ng lAtlIeS 11... (XIUI1tn!lS 1It8 lIsIecI III ~ ",r;ler 01 tntilrll mon~ Counties .. \t1 111lt same
,mes Are Osle<l "'OhaDel""", I he 'uJe<enOII numbefs """""'lI1\IlIIal QI(W are S/'IOwn ., !he ~i;lIIabetlCllllISI 01
COUIlinCli below

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TABLE 6' ECONOMIC INDICATORS

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TABLE 7' BASIC INDICATORS ON LESS POPULOUS COUNTRIFB

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General Note em the Data
T~ cla\iIllItMOed ." II>05e labfeS WC aa;omp" Hied
b\I dehr.!lOIIS, """CSS. and ,,.plaMtlons DI SOQn!l and
'r<lIw:IuaIlooIrlOleS ..net" III.. llelIn<\lOO o! !he lil/Ut.1Il
dllle<eont ~om lhc genemI <lclinillon l>Oo"III """" 1abies
d!lI'Mld from so"""'Y'"""c,. ,,- ""'" major """,cesare
1<S1ell if> thol ""DIiIn<Il<lry matCriaI _ wilIlfleY1lab1y """""
" __ range 01 reliability I:J!IK'.... lJOVtWnn>llf>t ""Ta
have tlueo1 USfJd wher1M,tr POwbIo. " thI!I many C3SoQS
_ " lh8re aro no reliable ,>!1daI ",," 'CII, "'""""'tell
mad!! by It1e reIeYanI lJnotedI\l;l lioos agency haveb<!<ln
<Ise<l WI""" soc!1 Ifltemati<lIWIy standardized esti-
maleS do no! " XO$I, II>e tallieS draw .., dilLa from
,*,ltnl UNIGH f~ alhee: A.il 5UCh llNiCEF field
o ~"'" 5CIIJrQlII Pt" rr,a.I<Ol(l Wl1.I> • or '(
Ito: 1.... ,11$ lor int"", mortalIty rales, ~ mcll8C tancy.
crude boAA rate . CtlIde dBal/l tale. IOIe. are ~ of lho1
reQIJIa. _ on esbmates an e proiecIlore"t"<IOttak8tl
by l!le unJted Nations POpUllJlion l:M$o:)n . TI\e$e ar>j
othe< IfItemalalal """",,-tes are 'evJSCd perooaiclllly
wtIIC!1 explains wily lIOmll 01 Itll'I data <l<1Ie< hom IIIO$I!
Ioun<l ., oar1ier UNICEF PlibllcaW'lS. In ltMt ""'" of
GNP per capo," and 00.6. , ltle 1l:Ila are tnI! relUII 01 a
ctIt'IllrOlOUlI Ill"""'" 01 " ' ",""lg and ~ Iong by 1M
WO<ld Banlc and CEQ) 'OSl'"':!'''''''''
wnere pgsslble orOy <XitJ'II)'eIlerlsNe '" sarwIe
nalo:lnlll <lam have been used a/thoUgn, as if> U.. Iablc
on 'W3Sllng' . Ih8rO are cer1aII • • Xo;ep\JOIl3, Wllere me
hQures ,e!", 10 Oft, a PllIt of Ihe C<lOf'l\IY lfUS.
"'CIIc;lred In a 1001001"
Tn riltll<Jrlll C<l</fll"es by l/IO '""'" inolCluor use<! on
eese IabIes - !he esl,mare oj me ioIar11 mortaJloi rat<!
lor 1962 _ sA rates nave beerl , ,,,,",,*, Ie> Ihe near....
, 0 '" Ihe case of oouolriool ..Ill a ,ale 01 50 '" Il1Ol'''
o.Yf " """"0'" with rlli es below ~O. wt>ore _ ..
usuaIy a IltIIIV compt_ _ '''I/lStrallOn SYS!tm, has
me bgure Deen fOIJOOed 1<I meneatC3t unit

Signs and explanations

~ od'\eIWise staled, Ito. QIfJ'lmaty measures fCII me I<>Jr lMR Qf\lUP$ 01COOnlr"'" are1he """""'" ......... lor
eacIl 'F"'-" Ttl!: mad,,,,, IS 1M mlddlll . ..... of, dloIa WI ;llTangod III 0f0el of 1J>Iq'OII>de.

Di!tanol~

UNICEF lllllCl oHlCI:! ecoc e

(l Less lha~ IlIIIl LhIlunn .... 00'M1
II 8M lootnole at II'llI en<l l~ the _
Y UMCEF fl(lld oHooe 1lOUi'C.: _ lootrlOle 81ero 01
~-
Most oj lIMo 11.11'1 ~ ... ., t1 , .. preperM by Ih. UN Pos!ul.Uon OM n 1fl' 'Ion. l ly
eompel.bho bule ...In\l ."'1 In -... caMe, _ ..II.....' y dltle< tr n.tionel
11\IUI",

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Footnotes to Tables
......
Tab le 1:

-,-..-•• -- ..-
(It<l' r>or _ ..
'
".
lDID
aeec ,-
--
r.... ""'_
...-.,...,~ -
'9~'
Incfll;lllors I9ID
1918
ID19
t.., P!loPo • 0.."

--..
,~ r"", ......... 1981
'919
GOol',*_
~- leBO

"'''''''''' ......... ,
"'-Y .......... 1Sf!

--
'a1~
••
~
-~-
~~~

-~- ".
':n
19/1
'O_ ....

..- ".
"~ 1910
'.~'g'~ -~-
---- "--
ro................ 1918
lorD
-~-

_..-- --
19/9
1919
r............ '_l" ~""'-
,,,...................
-~-
'979
'9/9
~
'919

-~-
'9SO
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,-
'919

--
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CoW"",, .. "

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CH'~_
".
".
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'9 19
rsec

Table 2:
Nul<ltL:l/1
~

---
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.9 10
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--
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,all
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Table 3:
.. ----
--
---
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----
OPT _ _
1979
__

-- ---
~ '1 13
Heal1h
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f3":
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Variations in infant m ortality rate (IMR) within countries
l.Jke lh8 31il)r<l\ll! GNP per caorta. lI>e ' \/llI;'tge IMFl
lot" • courrtry can _ a rTlISIell<long PIClUl'll of IIle
SIlua1lOl1 1M skJ""lantlPOO<IIt .... 8I areas, Ito. ~
lMR "usu,lIly C<lOSido!fab/y _ I N I natJonlll a""'lIoQII
Cc:vlveroety me lMR is usualI'I' much _ ... nang """'"
""tn Ilogher ~ oT9duciltlOO Of ncome. S""ll$l.a on
INI <lO tl"",,>c8!I In lMR "'1tUn lXlIIfllIies 3"' thereTore
coset.... liI.lPPko_ 10 1I>It RlllioMf _ aoel ,
The anaoche:l laDle _ Ill l'M:I _ cI ",ea.ur.. at
lMR vanatJons ";!IwI COIInlrles
Mea1Iu<ll A. coII.>mns 2 to 4 , SIIC7MI "'" 1lS1m111eQ
_"""!age of bittrIs PO' 1.000 POPUlalion COCUIfII1V In
areas wherlll118 lMR 1& more IIlan 25'11 8DO'1U. Of 25 %
DIllow . h I naT.o<l!W
CQ/'I'IP/IJe<:l to _
_age Tills "'""'""'" oarI I)e
of """""" clisllit'uloon (or
rela!"'" ~. v.ow.n; tt>e percentage ol" <;QUIlIIy's
POPUIaIion """""""i 0'lC0<Ile$ ....... T.."" 1""""""-
ilb<M:! Of beklw Ihe IIiIllOrIaI aver:lgll
MeMure B. COklmns 5 to 8, ll/IOWS !he 8S1W11aleCl
perce<1lage ol lhe coomry'. population 'll In..eas
wt'''<l11he IMR ill 150 per 1,000 end 100 To 149,
50 to 99, end _ lhe<l 50 TIIi!l r'le"" "" can
be
C(In'I(Iared to ~ of absoIuIe PQVe<tlI. S/lowIng
the percenl8llle o! a coomry's POPUIaTICf\ "'1Il'iIl tIeIow
varlCIUS POY8'1Y lines of II'l(:I'Ill\SII\il _ "'"
1", margin 01 en", """"'-l .. I/IIl Il$Iul1lItes
!te,...,."",,, a<'d In IIle es1"""I"'ll Ploceoo._ varlea
,.
WICleIy tfom COIWlIry 10 COU'ltrY. PlI<li<>J\aIfy on the """"
01 IIle secor>d measure. mai<lro;l ~ "'l)Of1...., nol1tl draw
<:<><ICkJslons kom sm<il <l1flereroeo 1M me tJgu,... !lul
ser-.,ibIy ~, the dill. can tie an impDrlan1 COITIPIe-
men110 data S/IOwItlg ""oonarlMR .', en>geS
n" irU",esttng 10 IlOIe III me case ell lIlI! fllS! meastJflI
ttIallhe degreoo of regional ineQu3JiIy <:lolls no! (lepend
on me overal motlaIlly kwel Thus Ja/TIaIca onc:I
V_.uela. WI'" low """"'0" mortaMy _ . s/>ow a
much llIealet <lllgtOO of neQUllIi ty !han os rouna f<;w
a<a"'llle in Indo! II a. Morocco 0( Nooh SLdoo whe«!
0'Yet8II mo<tallty levels are I't'lIJctl higlIer Ott'er "".,nl
il\ldles show lhe 'ole 01 \I3IICIUS _ and II(:(W rorroc
fac ~ .. ""'"'laIriInIl """" diHerenlials -'bove .. 1tIe'/
M ve c.Ieatfy estaI:lIisI>lld TIIaI lho _ IlOUl:alecl me
moIher, me 9'e<ltet the 1l/C10atlibly IIlIl1 tile ctuId wi
$l>'VMl. IWl Ih<s &Pl)lIeS lO bolo I'1ogIl _ low ,nfan t
rnonab1'I COOIllIoes. In lact. 1M ' ' ' 'lIOn
mo<llIIoIy by lhe mothet', ecluCahOn IS nlepIwldent ot
~ child
lhe overaI lollill or morlali!y
Ne><1 _ 's SUr.. of tile v.\ri1's C/liII:ken '8\Xl<1 \Oil
IooIc in !TICIIa dl!1ail at I/Id SUl>laCl 01 IMIl ............
",ltIIn <;QUIlnOllS, In !he mllllnblllll, " Is tvpad !hilt
OOUtlbies wiI t>!I er>cCII!'aoa<' '" PIl""'" !TICIIfI delatler.l
eslJmlltes 01 IIl\efIIaI l'.IR W'Olhons _ as well lIS 10
monIlot Ille PlOgr8Sli ..... red UC1lOn. ftSll'ICIBIIy .. tria
~ !ugh« lMR ala\llS <;II" areas
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THE STATE OF THEWORLD'S CHILDREN 1985
In th~ last two years, the State of the
World', C hildml report, with t he help of
tm: mus-mroia, has drawn wm ld·wilk
a!len tioo to the fact Ihal four I'dalively
lilnI!/c and IOW<OII methods could now
eDa ble pll'Cntl themselves 10 halve the nile
of c:hild dea ths and child disability in the
de\'eJopinl wwld - so SlIviq an cstimated
20,000 lives a duy.
In Part I of tM yar', AIIClIXnJ, ;1 iI
pouiblt to report OIl the progrm of lbete
stralegi~ as lhey begin 10 llO mlll..roOD in
differe n t part s of the world. FOf as the
5Kretary-GcnenJ of the United Nations
hat $aid,.
... . . 1M _ Id-wilk ~ b$ bwn
","",ragi".. 71m ",.. ""IIIi.rralabll rips /la /
a tim/aIM , Mid . Ilroitlal rffIOl"rio!t /u;u brpn
OXFORD UNtvE RSITY PRESS
Pric:e B .SO nCt in UK $6.95 USA
10 tprtoJ IJC10SS 1M world altd aflm ,... Itqpe
tlull 'Ilt " "'" II/ ,,,jall' fllId child IIIfIf'laliry,
.,illlO tkpl&rably ItJgh, IIlaJ' ", JTJIIUd
drllJliclllly ill lilt fl1ftJffl1bk /ullin. ..
Pan II of the report brinp 11IIct!ler
summaries-in ~bk ' O(l(e5 Ind quotes'
form - of the latest raean:h . nd wriUfIlIS on
the low-COSl methods wbich makt a ch1ld
.umnl revcluticn possible.
Part 1II is a full Itatisticai lleClion ..i th ,ll.
nation lillurm on nutritlcn, healt h,
edUOIlion, popubtion, an d o:conomic
Pros"*- In keeping wllh tM IDe$Sqe or
the Kport i1Klr, the StaU5lkalllhles lisl W
nllions of the world not in order o f thcir
GN PI bUI in orela' or
their ch ild surviYll
.'a
ISBN O-I9-g2&496-9