The INFORMAS healthy food environment policy index (Food-EPI) in Mexico: An assessment of implementation gaps and priority recommendations.

Mexico is one of the countries with the highest prevalence of obesity and recently declared a national epidemic of diabetes. Healthy food environments have the potential to improve the diet of the population and decrease the burden of disease. The aim of the study was to assess the efforts of the Mexican Government towards creating healthier food environments using the Healthy Food Environment Policy Index (Food-EPI). The tool was developed by the International Network for Food and Obesity/Non-communicable Diseases Research, Monitoring and Action Support (INFORMAS). Then, it was adapted to the Latin-American context and assessed the components of policy and infrastructure support. Actors from academia, civil society, government, and food industry assessed the level of implementation of food policies compared with international best practices. Actors were classified as (1) independents from academia and civil society (n = 36), (2) government (n = 28), and (3) industry (n = 6). The indicators with the highest percentage of implementation were those related to monitoring and intelligence. Those related to food retail were rated lowest. When stratified by type of actor, the government officials rated several indicators at a higher percentage of implementation compared with independent actors. None of the indicators were rated at high implementation. Government officials and independent actors agreed upon nine priority actions to improve the food environment in Mexico. These actions have the potential to improve government commitment and advocacy efforts to create healthier food environments.

"Calling a state a state": feminist politics and the policing of violence against women in Brazil.

PIP: This document reports on a 1990 case study of one of Brazil's 80 police stations established for the protection of women in response to feminist pressure to address excessively high levels of violence against women. These police stations, staffed by women to respond exclusively to complaints lodged by women, are an unusual institutional response to such violence. The study examines the station established in Salvador in 1986 to reveal which interests were served by the creation of the specialized stations. The first section of the article addresses the fact that Salvador's policewomen have gained little from the creation of the specialized stations and continue to suffer job-related sexual discrimination. Next, conceptions of gender identity among policewomen are analyzed, and the ideologies of "femininity" and "feminism" in the Brazilian context are discussed. The final section compares views on the abuse of women with views on police brutality and relays incidences when the policewomen beat male prisoners. It is argued that certain forms of violence are actually considered necessary to maintain social order and enact justice. It is concluded that all of the involved parties, the state, the feminists, the female citizenry, and Salvador's female police, benefit in part from the existence of the specialized police stations but that there are serious problems also, especially the fact that the policewomen involved are given little or no special training and no career incentives.^ieng

[The Assembly and the national priorities ]. / La asamblea y las prioridades nacionales.

PIP: Social participation and attention to the actions of government have increased dramatically in Ecuador. It is crucial that political debate be broadened concerning the functioning of the National Assembly, thereby opening greater public opportunities for participation. All social groups should be guaranteed access to the debate; expansion of the public sphere is essential for development of effective mechanisms of social inclusion. Those with no capacity to defend their own interests must have a voice. The National Assembly, in addition to reforming the Constitution, must reinforce the role of public men and statesmen at all levels of government. Statesmen place the common interest over special interests and create coalitions to effect necessary changes. The National Assembly must reorient the emphasis of government activities to give all sectors equal opportunity and access to basic public services. The role of the government must be redefined, which includes being equipped with better tools for management and control and with mechanisms for accountability at a time when many believe that globalization and market forces by themselves should dictate the rhythms of political, economic, and social life. Diversity should be respected. Nongovernmental organizations can be of great assistance in fostering dialogue, cooperation, solidarity, and consensus. Ecuadorians must support the goal of human and sustainable development.^ieng

[Public health as a subject for the Assembly]. / La salud publica proposito de la Asamblea.

PIP: Six Ecuadorian political figures and physicians were interviewed on their opinions concerning the problems of the health sector and possible solutions. Ecuadorians anticipate that installation of the National Assembly will lead to diagnosis and reform of societal ills. Health has not been a high priority of political leaders. Only 10% of the population has access to the social security system. Infant mortality rates are very high in the rural sierra, and nearly 70% of indigenous sierra children suffer from chronic malnutrition. The need for broad reform of the health sector has been recognized. The interview subjects agreed that reforms are needed, especially in regard to the Ecuadorian Institute of Social Security, which all agreed had become weakened by excessive political patronage and presence of unqualified political appointees. They agreed that the nation's health is deteriorating each day, but they did not always agree on how to solve the crisis. Among the themes debated were the need for improved coordination of services, increased investment in health services, redefinition of the role of public and private services, participation of the population in the construction of health policy, the need for professional administration, whether the poor should be charged for services, and whether monopolies should be permitted in the field of health care.^ieng

Hillary Clinton takes up defense of U.S. aid for family planning overseas.

PIP: In November 1996 during her address to the Sixth Conference of Wives of Heads of State and Government of the Americas in La Paz, Colombia, and in her weekly newspaper column, US first lady Hillary Rodham Clinton pledged her own and the Clinton administration's complete support for reversing the severe reduction in funds for the international family planning program imposed by the 104th Congress. This revelation reflected the administration's preparation for a strong and vocal defense of the international family planning program, which will be facing its greatest political test in February 1997. Bolivia has the highest maternal mortality rate in South America, and half the deaths are due to illegal, unsafe abortions. Mrs. Clinton presented a $2.25 million USAID award to a $5 million Pan American Health Organization program that aims to reduce maternal mortality. In her December 3, 1996, column, she used family planning campaigns in Bolivia as an illustration of sensible, cost-effective, and long-term strategies for improving women's health, strengthening families, and reducing the abortion rate. Such programs educate people about the benefits of birth spacing, breast feeding, good nutrition, prenatal and postpartum visits, and safe deliveries. Mrs. Clinton has also visited other poor countries to learn about the special needs and conditions of women's lives. UN Ambassador Madeleine Albright has recently been nominated to be the first female Secretary of State. Many people see her commitment to improving the status of women through development efforts and her recognition of the close relationship between development and diplomacy as encouraging. The concern and commitment of these two powerful women could prove valuable in the upcoming test for international family planning aid. Congress must vote on a resolution to approve Clinton's report that the reduced funding is having a negative impact no later than February 28. If both the House and the Senate pass the resolution, already appropriated funds will be released in March rather than in July.^ieng

Mexico's immunization programme gets results.

PIP: With a decline of almost 60% over the past decade in the mortality of children under age 5 years old to the current rate of 33 child deaths/1000 live births, Mexico has joined the 20 countries listed by UNICEF as making the most progress in reducing child mortality since 1980. Much of this progress can be attributed to Mexico's immunization program, which has brought the proportion of fully immunized children under age 5 years to 94% over the past 5 years. Mexico's president has been instrumental in the program's success, having a personal interest in childhood vaccination and supervising the twice-yearly immunization coverage surveys. Even though presidential elections are being held this year, the immunization program should remain strong regardless of who wins because all of Mexico's political parties have pledged to remain committed to immunization. Awareness in the population about the need for vaccination is maintained with the help of the mass media, especially radio and television. The country's enthusiasm for vaccination seems to be paying off in terms of declining child mortality and the eradication of wild poliovirus. The immunization program reaches all but 2-3% of Mexico's children, despite some logistical difficulties and resistance to vaccines among certain religious groups such as the Mennonites and Jehovah's witnesses.^ieng

USA President Clinton acts to ensure reproductive health.

PIP: In 1984, in Mexico City, the Reagan administration announced its policy prohibiting USAID from supporting any nongovernmental organization which used its own or US funds for any abortion-related activities. Even though this policy was intended to reduce the incidence of abortion, it had the opposite effect because the cut in funding left some areas of the developing world with no family planning services or information at all. Further, this policy resulted in a loss of $17 million (US) or 25% of the budget of the International Planned Parenthood Federation (IPPF). On January 22, 1993, US President Clinton reversed this policy. IPPF considered President Clinton's action to be a significant event for women's health, human rights, and global development. This reversal will provide family planning services to about 300 million couples who want to practice family planning but could not do so because they did not have access to it. SHortly after President Clinton's announcement, IPPF began writing a proposal to USAID for funds to restore programs that the Mexico City policy eliminated. IPPF hoped the reversal would spark international recognition of the need for safe access to abortion. Other actions President Clinton has taken to promote reproductive health are reversing the Reagan and Bush administrations' rule prohibiting abortion counseling at federally-funded clinics, requesting that the US Food and Drug Administration study the possible marketing of RU-486, removing the ban on abortion in military hospitals, approving regulations allowing fetal tissue research, and appointing an abortion rights advocate as Surgeon General. The Catholic Church opposed all of Clinton's abortion policies. However, many congregations, priests, and Vatican officials are dissatisfied with the Pope's anticontraception position.^ieng