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  1. 1

    Liberia: population and development.

    Brown E

    In: The 1984 International Conference on Population: the Liberian experience, [compiled by] Liberia. Ministry of Planning and Economic Affairs. Monrovia, Liberia, Ministry of Planning and Economic Affairs, [1986]. 232-47.

    This paper summarizes those aspects of the 1984 World Development Report which deal with population prospects and policies in Liberia. Sub-Saharan Africa is the only area of the world where there has not yet been any decline in the rate of growth of the population, and Liberia with a population of 2 million and growing at the rate of 3.5%/year has 1 of the highest growth rates in that area. The birth rate is 50/1000 of the population, and the death rate is 14/1000. The fertility rate is nearly 7 children/woman and is not expected to decline to replacement level before year 2030. Infant mortality is 91/1000, and half of all deaths occur among children under 5. Projecting these demographic trends into the future leads to the conclusion that the population will double in 20 years and exceed 6 million by 2030. Although fertility will begin to decline in the 1990s, the population will continue to increase for a few years with the growth rate declining to 2%/year by 2020 and 1.2%/year by 2045. Such rapid population growth will cause great stress on the country's ability to provide food, schools, and health care. For the children themselves, large, poor families, with births spaced too close together, means malnutrition, poor health , and lower intellectual capacity. And the cycle of poverty continues over the generations as the families save less and expend more on the immediate needs of their children. In macroeconomic terms, a growth rate of l2%/year means a massive explosion of need for food, water, energy, housing, health services and education, with a gross domestic product (GDP) growth of only 2%/year; and this projection is probably optimistic. The rural sector will not be able to support the 23% additional rural labor force, which will migrate to the towns, adding to the already high urban growth rate of 5.7%/year from natural increase. In this society, where literacy is only 20% and secondary education completed by only 11% of the girls, it is estimated that only %5 of eligible couples practice birth control despite the fact that it costs less than $1.00 per capita. Government must step in to ensure that resources exist for population planning at county and local levels. Government is responsible for making demographic data accessible and for coordinating population program inputs. Government should also make sure that family planning programs can be implemented through integration with existing health services. A project including restructuring of health care management, financing and delivery, as well as development of a national population policy, has been proposed for World Bank and other international agencies' support.
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  2. 2

    Birth spacing and childhood mortality.

    Sathar ZA

    Ippf Medical Bulletin. 1983 Aug; 17(4):2-3.

    Recent evidence from developing countries indicates that there is a relationship between the length of the interval between consecutive births and the survival of the younger sibling. This relationship has long been observed in the developed world. A study conducted by the World Health Organization in 9 largely metropolitan locations in developing countries found a reverse J-shaped pattern, with mortality rates initially falling with increased intervals but showing an upturn for the longest intervals of 5-6 and 6 or more years. The birth interval-mortality link tended to be stronger for postneonatal rather than neonatal and child mortality. A World Fertility Survey (WFS) cross-national analysis found a longer birth interval substantially improved the survival chance of the youngest child in all 29 countries studied. This advantage persisted to 5 years of age. The ratio of the infant mortality rate of children born within an interval of less than 2 years to that of those born after an interval of 4 years ranged from 1.26 in Venezuela to 3.91 in Syria. A 2nd WFS study found that the birth interval-mortality link persisted when maternal education was controlled. More detailed analysis of data gathered for this study from Pakistan revealed that the association between birth interval and mortality of the younger sibling was unaffected by the early death of the older sibling. Although it has been hypothesized that competition between children for food and attention is the major causal mechanism in the birth interval-mortality link, this finding suggests that maternal depletion (giving rise to low birth weights and inadequate breast milk) plays a role. However, the additional finding that survivorship of order 5 and more births was unaffected by average spacing patterns once the length of the immediately preceding birth interval was controlled suggests that maternal depletion may not be cumulative. The data from Pakistan further show interval length to have the same effect on mortality of the older sibling, even when length of breastfeeding was controlled, suggesting that involuntary weaning because of the next pregnancy is the critical explanatory factor. This research points to the need for a renewed emphasis on contraception for spacing purposes.
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