The Pan American Health Organization
Promoting Health in the Americas

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Health Surveillance & Disease Prevention & Control — Communicable Diseases: 
Acute Respiratory Infections - Anthrax - Antimicrobial Resistance - Campylobacter - Chagas -
Cholera - Dengue - Diarrheal/Enteric Diseases - Disease Outbreak News -
Emerging/Reemerging Diseases - Filariasis - Hantavirus - InfluenzaAvian |  Pandemic |  Seasonal - International Health Regulations - Leishmaniasis - Leprosy - Malaria -
Neglected Diseases - Parasitic Diseases - Rabies - Research - Salmonella - Shigella - Smallpox -
Tuberculosis - West Nile Virus  - Yellow Fever  -
Health Analysis & Statistics - Chronic Diseases - Veterinary Public Health

Full Text (306 pp, PDF)

Cover & Contents

Part I
1. Maternal and Child Health Situation and Trends in Latin America and the Caribbean (J. Yunes & A. Díaz)
2. Local Health Systems: A Strategy for Increasing Coverage and Equity in Health Care (J.M. Paganini)

Part II
3. Integrated Approaches and Components in Maternal and Child Health Care (C. Valenzuela & Y. Benguigui)

Part III
4. Integrated Child Development (E.N. Suárez Ojeda)
5. Control of Diarrheal Diseases (CDD) (C. Valenzuela)
6. Control of Acute Respiratory Infections (ARI) (Y. Benguigui)
7. Expanded Program on Immunization (EPI) (C.A. de Quadros, J.-M. Olivé, C. Nogueira, P. Carrasco & C. Silveira)
8. Integrated Management of Childhood Illness (Y. Benguigui)
9. Health of Adolescents and Young People (M. Maddaleno)
10. Reproductive and Perinatal Health (J.A. Solís)
11. Breastfeeding (M.R. de Carvalho, C. Bancroft, J. Canahuati & C. Muxí)
12. Maternal and Child Nutrition (M. Gueri & M. Peña)

Maternal and Child Health Activities at the Local Level

Maternal and Child Health Activities at the
Local Level: Towards the Goals of the
World Summit for Children

(Y. Benguigui, S. Land, J.M. Paganini & J. Yunes, 1998)

The development of maternal and child health at the local level is a key strategy for fulfilling the commitments assumed at the World Summit for Children, held in New York in 1990. This Summit, which brought together representatives of 146 countries and heads of states of 71 countries, adopted the World Declaration on the Survival, Protection, and Development of Children.

It also approved a plan of action for the governments, international agencies, and other entities that are working to reduce maternal and child morbidity and mortality, malnutrition, and illiteracy; improve drinking water supply and sanitation services; and enhance the social status of women.

In response to the establishment of the goals of the Summit, all the countries of the Region have developed operational plans that include the technical bases, strategies, and means for achieving the goals for the year 2000. The Interagency Coordinating Committee formed to monitor progress toward the goals of the Summit also set mid-decade goals to be achieved by 1995, with their respective indicators and strategies.

Even more recently, the International Conference on Population and Development, held in Cairo, Egypt, in September 1994, established various objectives relating to maternal and child health, including health promotion and infant survival, reduction of preventable morbidity and mortality, and reduction of disparities between and within countries. The participating countries also agreed to implement actions to strengthen the nutritional status of mothers and children and promote breastfeeding as a key strategy for infant survival.

At the Summit of the Americas, held in Miami, Florida, in December 1994, the leaders of the Region established, in the Declaration of Principles—known as the Partnership for Development and Prosperity: Democracy, Free Trade, and Sustainable Development in the Americas—the objective of eradicating poverty and discrimination in our hemisphere, which implies ensuring equitable access to basic health services and giving special priority to women and children. At the same time, each participating government made a commitment to support local health authorities in implementing strategies and activities relating to prenatal, delivery, and postnatal care; reproductive health; immunizations; treatment of diarrheal diseases and acute respiratory infections; and other maternal and child health needs.

With a view to providing practical instruments to facilitate attainment of the goals adopted by the World Summit for Children and endorsed by the other meetings mentioned above, this technical publication has been prepared to assist health personnel at the operational level in the implementation, development, and monitoring of activities at the local level in health establishments and in the community, aimed at achieving the expected results in terms of both the mid-decade goals for 1995 and the goals established for the year 2000.

The approaches presented in this publication are rooted in the strategies of local health systems and the decentralization processes under way in the countries, which seek to give greater responsibility to the provincial, state, regional, and local levels for the organization and execution of programs. This transformation of health systems is one of the principal strategies by means of which the health sector seeks to achieve better coordination and ensure more efficient use of available resources.

Based on the foregoing considerations, this publication presents a set of guidelines for the implementation and development of health activities, prioritized in accordance with the goals of the World Summit for Children and based on the strategic and programmatic orientations of the Pan American Health Organization. Each chapter represents an effort to adapt regional and national plans to local and community-based parameters and to place at the disposal of health personnel at the operational level, in a single volume, technical instruments that will help them to apply in their daily work the principles and strategies for the various components described in each chapter, bearing in mind the need to adapt them to local epidemiological profiles and priorities and to seek programmatic and operational integration of health care for the target population group.

It is hoped that the content of this publication will facilitate the implementation of activities to improve health conditions for mothers and children, which will be reflected not only in the life of each individual but in future generations, who will reap the benefits of current efforts to achieve health for all.

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