Accelerated immunization programmes and CSDR: their meaning and broader implications for development.

PIP: This editorial introduces a special issue of "Assignment Children" devoted to the theme of universal child immunization by 1990. Not only will this campaign significantly reduce morbidity and mortality from 6 childhood diseases, but it will also, through the experience of massive public participation, create conditions favorable for achieving development goals in areas other than health care. Immunization is a means for enabling those who have grasped the concept of protection of one's children to carry this effort into other areas for other goals. If families are to be empowered in this way, the knowledge and know-how held by the experts at the top must be melded with traditional knowledge and the wish of parents to protect their children from disease and death. The usual concept of development conveys ethnocentric and central power biases as well as a fragemented and sectoral approach. In contrast, accelerated immunization programs represent an example of action within a new development paradigm. This approach addresses not just symptoms, but fundamental causes of underdevelopment in the areas of health and survival. Although the underlying causes of poverty are only marginally affected by such campaigns, the validation of important goals of the majority of the population can release social energy and increase individuals' control over other aspects of their life.^ieng

The condition of women and children's well-being.

PIP: The contents of a volume devoted to the condition of women and children's welfare demonstrate that women's legal status, economic resources, and access to skills all influence their ability to fulfill their various maternal roles. Women participate in economic development, but in the lowest paid categories of the labor force. Existing national government structures for women are usually restricted to welfare concerns and have had limited overall effectiveness in raising the status of women. Many of women's health problems are related to their low status in society and could be substantially reduced. Women in developing countries are increasingly faced with economic and social constraints which discourage breast feeding. A number of case studies emphasize different aspects of women's needs, but all recognize women's overwork and lack of time; the necessity of income-generating activities that will allow women to meet their children's needs, and the fact that none of the income-generating projects examined is integrated into an overall governmental development strategy. Structural changes are required to alleviate the problems of women.^ieng

Some examples of the many models of rooming-in.

PIP: Description of alternatives to the western practice of early postpartum separation of mother and infant, a custom encountered less frequently in less developed countries. The increasing incidence of early mother-child separation is reflected in a concurrent decrease in the number of breastfed babies. Close parent-child contact and feeding on demand also tend to be neglected. The infants thus deprived have increased susceptibility to illness. Changes in hospital practices allowing for rooming-in seem to be correlated with a higher prevalence and duration of breastfeeding after discharge. In rooming-in the newborn infant is kept within easy reach of its mother 24 hours a day. To provide this proximity while minimizing irritation to others sharing the room, as well as decreasing opportunities for neonatal infection, while necessitating as little renovation as possible, several innovative designs have been forwarded. An early model utilizes crib-drawers built into a separating wall between mother's room and nursery; this allows the mother to pull the baby's crib into her room or to push it back into the nursery as desired. Another model utilizes a small sound proof nursery within a larger mother's room (capacity 4-5). In other cases, cribs have been equipped with rollers and mothers allowed free access to the nursery. The thrust, though, is now toward total rooming in; some facilities are being built to accommodate 2 or 3 mothers at most, with their newborns in the same room. It is not yet acceptable in industrialized countries for mother and newborn to share the same bed; however, this is the norm in many underdeveloped countries.^ieng

Social planning with the urban poor: new government strategies in the making.

PIP: The problem of a rapidly increasing and disorganized urban population has not received its deserved attention. Recently, the magnitude of the problem of unplanned urban growth has become more apparent, and governments are directing their attention to remedial efforts. The biggest challenge, is to devise strategies appropriate to the diverse regions involved and to secure the cooperation of the urban populations in carrying out these strategies. Shortage of funds again makes it imperative to involve communities productively. Micro projects which were considered adequate in the past are proving to be unequal to this new task. The theme of this journal issue is the development of policies, strategies and programs to effectively meet the needs of women and children living in slums and shanty towns, and on finding ways in which the basic services strategy can be applied in urban underprivileged areas. 4 case studies, 2 in Latin America and 2 in Asia, of innovative approaches assisted by UNICEF are included in this issue. The different settings of Rio de Janeiro, Lima, Kuala Lumpur and Colombo reveal large differences in the scope and nature of the problem and the means used to correct it. Also included are the results of field research in 6 developing countries which provide recommendations for alternative approaches to child care in keeping with mothers' work schedules in both rural and urban areas.^ieng