Home | Main Page Title :UNICEF/WHO Joint Committee on Health Policy Document Type :Executive Board Decisions - Programme Country :GlobalDocument Symbol/Series: 1993/16 Year Published : 1993 PDF Link : OSEB Doctype : Executive Board Decisions Detailed information (click on the twistee to see more) Executive Summary: Document Text: On the recommendation of the Programme Committee, The Executive Board, 1. Welcomes the report of the UNICEF/World Health Organization (WHO) Joint Committee on Health Policy (JCHP) meeting in Geneva on 1-3 February 1993, 2. Endorses the following recommendations contained in paragraphs 26, 34-35, 45, 50, 54, 79, 87, 94 and 97 and annex 4 of document E/ICEF/1993/L.11: I. REVIEW OF WHO HEALTH POLICIES AND UNICEF DECISIONS 1. The Executive Boards of UNICEF and WHO should reinforce complementary action to strengthen primary health care (PHC) programmes, to intensify research, to support training, capacity-building, intersectoral cooperation and integrated approaches, to focus on those most in need, and to mobilize resources to augment national efforts in those areas. Every effort should be made to follow up the goals of the World Summit for Children, giving special attention also to human immunodeficiency virus/acquired immune deficiency syndrome in children. 2. It is important that the governing body of each organization should be made aware of resolutions and decisions adopted by the other, so that priorities can be established and action taken to fulfil broad policy goals. 3. Resource constraints should be acknowledged and priorities set accordingly, and optimum use should be made of available resources. II. WORLD SUMMIT FOR CHILDREN Follow-up action 4. The Committee welcomed and saw the need for intermediate goals in order to achieve the longer-term targets of the Summit. It noted, however, that individual regions and countries would have to set their own priorities and timetables within those parameters. Country priorities would be most accurately reflected in the national programmes of action, already completed or currently in the process of completion in some 140 countries. All countries that had not yet embarked on such programmes should be encouraged to do so, and to complete them as soon as possible. 5. The Committee endorsed intermediate goals [as contained in annex 4 reproduced below]. It noted the importance of investment in capacity-building within countries, together with the motivation and training that would permit the implementation of programmes on an integrated basis - particularly within the framework of PHC - and their monitoring. Annex 4 WORLD SUMMIT FOR CHILDREN Intermediate goals for 1995 1. Eliminate neonatal tetanus through both immunization and clean delivery. 2. Reduce measles deaths by 95 per cent and cases by 90 per cent, through high coverage with immunization and reaching those not yet reached. 3. Achieve poliomyelitis-free status in countries in the American, European and Western Pacific regions of WHO, as well as selected countries in other regions, comprising at least 60 per cent of the world population. 4. Achieve at least 80 per cent oral rehydration therapy use and continued feeding in selected countries and 80 per cent of the following in all countries: proper case management at home and health facility, or by a health provider; access to oral rehydration salts and case management; and improving mothers' knowledge. 5. End distribution of free or low-cost breast-milk substitutes in all maternity centres and hospitals in the developing countries by the end of 1992, and in all countries by June 1994; (NOTE: The conformity date for industrialized countries has been set to coincide with the entry into effect of the European Community directive on infant formula scheduled for 1994) and achieve "baby-friendly hospital" status by all hospitals in 1995 in accordance with the "baby-friendly" hospital initiative. 6. Achieve full implementation of universal salt iodization in most of the countries where iodine deficiency disorders (IDD) are a public health problem; where full salt iodization is not possible in areas where IDD are a severe public health problem, supplementation with oral or injected iodized oil will be recommended as a temporary measure. 7. Achieve a significant increase in dietary intake of vitamin A in children from six months to six years of age, through food and/or fortified products, where diets are deficient in vitamin A. Where clinical vitamin A deficiency is a public health problem, vitamin A supplementation for pre-school children every four to six months will be urged, as a time-bound short-term measure, until dietary intakes reach basal requirements. 8. Stop dracunculiasis (guinea worm disease) transmission in all affected villages. Progress made Maternal health and newborn care 6. Noting that, in general, sophisticated technology was not required for maternal health and newborn care, but that adequate training and basic support in the form of equipment were called for, JCHP recommends: (a) Strengthening the collaboration between UNICEF and WHO, together with the United Nations Development Programme and the United Nations Population Fund, in order to accelerate research and development and to provide more effective support to national programmes; (b) Updating and revising the joint UNICEF/WHO statement on maternal and newborn care in collaboration with other organizations of the United Nations system and professional groups; (c) Fostering reliance on, and increased support to, WHO's established research and development processes for the identification and evaluation of technologies, the definition of procedures and the establishment of norms, drawing upon country experiences of UNICEF, national programmes and other organizations; (d) Jointly initiating the upgrading of midwifery as the critical link between safe motherhood and newborn care and a factor in the elimination of neonatal tetanus. 7. Recognizing the importance of maternal health and newborn care, its links with other concerns, notably safe motherhood, and its impact on the elimination of neonatal tetanus, JCHP endorses the broad outline of the basic package for maternal and newborn care, taking into consideration suggestions and concerns expressed during the general discussion. It recommends that UNICEF and WHO should explore ways of improving delivery at an affordable cost, recognizing the considerable work already being done by UNICEF, WHO, the World Bank and other organizations active in the area. Vaccine needs 8. JCHP endorses the action proposed to overcome constraints, namely: (a) Support to countries that have the capacity to produce vaccines so that they become self-sufficient; (b) Through the Vaccine Independence Initiative, procurement of vaccines on behalf of Governments with either convertible or local currencies; (c) Continued negotiation with vaccine suppliers so that they maintain provision of vaccines at affordable prices; (d) Approaches to the donor community so that it contributes greater resources for the procurement of vaccines for the expanded programme on immunization. This action should be given priority. 9. Stressing the importance of the Children's Vaccine Initiative and regretting that its progress has been somewhat slower than initially hoped, JCHP recommends that UNICEF and WHO should give greater attention to publicizing the programme and seeking increased external support for its efforts. Research on the development of new vaccines should also be stimulated. Control of diarrhoeal diseases, including cholera, and acute respiratory infections 10. Noting with concern the large number of deaths still attributable to diarrhoeal diseases and acute respiratory diseases, JCHP recommends that the Executive Boards of UNICEF and WHO should urge Governments to mobilize financial, technical, political and communication resources to provide the technically available means for reducing that mortality. 11. JCHP commends the active cooperation between UNICEF and WHO and among WHO programmes in combating diarrhoeal diseases and acute respiratory infections and urges that it should continue. 12. JCHP recommends that UNICEF and WHO should make every effort to define with countries the mechanisms for achieving their national targets, and to ensure that resources will be made available and a greater effort undertaken to implement national programmes. UNICEF and WHO should continue to work closely at country level in the planning and evaluation of control activities, and to coordinate their technical and financial inputs. This collaboration should also be coordinated with bilateral agencies and non-governmental organizations (NGOs). III. IMPLEMENTATION OF THE "BABY-FRIENDLY" HOSPITAL INITIATIVE 13. JCHP recommends that UNICEF and WHO should urge full compliance, by June 1993, with government action prohibiting distribution of free or low-cost supplies of infant formula, and that the target date of June 1994 should be set for ending distribution of free or low-cost supplies of infant formula in both developing and industrialized countries. 14. JCHP reiterates the importance of achieving the 1995 operational target of the Innocenti Declaration, namely that all maternity wards and hospitals would be "baby-friendly", in accordance with criteria based on the joint WHO/UNICEF statement on breast-feeding and the special role of maternity services. It further reiterates the importance of government action in achieving all targets of the Innocenti Declaration. 15. JCHP reaffirms the importance of UNICEF and WHO support for: (a) Preparation of action strategies for protecting, promoting and supporting breast-feeding, including global monitoring and evaluation strategies; (b) Analysis and survey of national situations and design of national goals and targets for action; (c) Planning, implementation, monitoring and evaluation of national breast-feeding policies; (d) Specialized training and/or services. IV. PROGRESS REPORTS ON COLLABORATIVE ACTIVITIES Healthy lifestyles for youth 16. Praising the work done, JCHP recommends that UNICEF and WHO continue to work together on the following actions: (a) Elaboration and dissemination of knowledge to support global, regional and national investments in the health and capabilities of young people, as an essential contribution to the economic and social development of countries and communities; (b) Design and adaptation of key interventions which contribute to the health and development of young people, including strategies for their implementation and methodologies for monitoring and evaluation, making use of the existing education system and involving Governments; (c) Identification and coordination of technical and other resources which would strengthen and develop national-level activities with existing partners, including health and social welfare, education, and youth-serving NGOs; (d) Mobilization of new partners, such as the media, the world of entertainment, industry (manufacturing, agricultural and the informal sectors), the criminal justice system and NGOs, in order to increase their contribution to improving the health and development of young people. 17. Noting that the area where UNICEF and WHO could make the greatest contribution over the next 10 years would be in changing attitudes, JCHP recommends that the two organizations should discuss further the best means of bringing about change. The aim should be to increase their effectiveness in the four areas listed above by modifying their ways of thinking and by involving other partners. Health education Hygiene education, with specific reference to community water supply and sanitation 18. Appreciating the progress already made jointly in promoting health education in schools, JCHP recommends that UNICEF and WHO should pursue action in that area, for example by: (a) Cooperating with countries to implement comprehensive school health education, taking into account the needs expressed by education and health officials in countries and at the regional consultations on comprehensive school education; (b) Identifying countries that have potential for implementing and strengthening comprehensive school health education with which they would collaborate, together with other international organizations; (c) Identifying operational issues on which they might collaborate, on a meaningful scale, in order to develop or strengthen comprehensive school health education policies and to determine the means to plan and implement collaborative and complementary actions for building up capability in school health education at country level. 19. JCHP further recommends that UNICEF and WHO should intensify their efforts in health information, education and communication through all possible sources, and seek innovative approaches and partnerships with, among others, the media; political, community and religious leaders; the entertainment industry; youth organizations and other NGOs; and existing health and information systems. It emphasizes the importance of well-integrated age-appropriate health education for young and school-age children, adolescents, parents and the community at large. Malaria control 20. Welcoming the partnership between UNICEF and WHO in malaria control and endorsing the main points of the global strategy as set out in the background paper, JCHP recommends that the two organizations prepare detailed strategies based on their "comparative advantages". V. DATE OF THE THIRTIETH SESSION 21. It was agreed that the thirtieth session of the UNICEF/WHO JCHP should take place in Geneva immediately after the ninety-fifth session of the WHO Executive Board in January 1995. Consultations would be held between the two secretariats on the possibility of holding a special session in January 1994.