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New York, New York, Oxford University Press, 1993. xii, 329 p.The World Bank's 16th annual World Development Report focuses on the interrelationship between human health, health policy, and economic development. WHO provided much of the data on health and helped the World Bank on the assessment of the global burden of disease found in appendix B. Following an overview, the report has 7 chapters covering health in developing countries: successes and challenges; households and health; the roles of the government and the market in health; public health; clinical services; health inputs; and an agenda for action. Appendix a lists and discusses population and health data. The report concludes with the World Development Indicators for 127 low, lower middle, upper middle, and high income countries in tabular form. All developed and developing countries have experienced considerable improvements in health. But developing countries, particularly their poor, still experience many diseases, many of which can be prevented or cured. They are starting to encounter the problems of increasing health system costs already experienced by developed countries. The World Bank proposes a 3-part approach to government policies for improving health in developing countries. Governments must promote an economic growth that empowers households to improve their own health. Growth policies must secure increased income for the poor and expand investment in education, particularly for girls. Government spending on health must address cost effective programs that help the poor, such as control and treatment of infectious diseases and of malnutrition. Governments must encourage greater diversity and competition in the financing and delivery of health services. Donors can finance transitional costs of change in low income countries.
Guildford, England, Butterworths, 1989. 54 p.This report examines the trends of demographic ageing in Europe up to 2025. By that date one European in four could be aged 65 or over. With trends continuing towards the contraction of working life, severe imbalances may occur in individual life cycles, in the structure of the workforce, and in socioeconomic provision for an ageing population. The report further considers the potential impacts of these emerging imbalances on living conditions, consumption patterns, and socio-medical/health care provision for the old. Finally, a range of responses are outlined to the challenges of possible intergenerational conflict surrounding the nexus of issues related to demographic ageing.
Bangkok, Thailand, United Nations, Economic and Social Commission for Asia and the Pacific [ESCAP], 1987. 10 p. (Population Research Leads No. 25)The Asian and Pacific region's decline in fertility and mortality over the past 2 decades has resulted in large shifts in the age composition of national populations, which affects planning in nearly every social and economic sector. For the region as a whole, the crude birthrate is estimated to have remained at 40/1000 population until about 1970, declining to 27/1000 in the 1980-85 period. This rapid decline in fertility has complicated population policy formulation and the integration of population factors into development planning. The demonstration that government programs could alter demographic trends meant that population no longer could be treated simply as an exogenous variable in development planning. The combination of previously high fertility and declining mortality, which particularly affected the survival rates of infants and children, resulted in a small increase in the proportion of the population of the region below age 15, from 37% in 1950 to 41% in 1970. By 1985, the latter proportion dropped to 35% because of declining fertility. Due to the previously high fertility and more recent declines, the proportion of the population in working-age groups increased from 56% in 1975 to 61% in 1985 and is projected to reach 65% by 2000. Providing employment for this rapidly increasing population of labor-force age is a major challenge for countries of the region over the next several decades. For those few countries in the Asian and Pacific regions who had low birth and death rates by 1960, the current issue is demographic aging. As the rate of population growth per se decreases in importance as a planning goal, other aspects of population, such as spatial distribution, take on more significance. The rising marriage age and organized family planning programs were the primary causes of fertility decline in the region, although the decline was limited in South Asia where large pockets of high fertility (a total fertility rate in the range of 5-7) remain. The contribution of rising marriage age to further fertility decline is approaching the limit, except in the countries of South Asia where the marriage age continues to be below 20 years. In most of the countries of the region, the potential also exists for a 2nd generation "baby boom" resulting from a changing age structure. This would in turn slow down the pace of fertility decline unless compensated by a rapid fall in fertility of younger married women caused by successful implementation of family planning programs and other associated socioeconomic changes. Aside from the straightforward implications of demographic change, changes in age structure also imply changes in consumption patterns. Thus, planning for production, consumption, investment, and distribution always should incorporate changes in age structure.