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National report on population. Prepared for the International Conference on Population and Development, September 1994.
[Tunis], Tunisia, Ministry of Planning and Regional Development, 1994 Aug. 57 p.Tunisia's country report for the 1994 International Conference on Population and Development opens with a brief discussion of the country's history and development achievements (the population growth rate has been reduced from 3.2% in the beginning of the 1960s to less than 2%, and Tunisia has achieved significant improvement over the past 2 decades in human development indices). Tunisia's population policy has gone through 3 stages: the establishment of an important legal framework during the 1950s and 60s, the creation of a National Family and Population Board and establishment of basic health care facilities during the 1970s, and an emphasis on environmentally-responsible development with an attempt to strengthen the integration of population policies into development strategies beginning in the 1980s. The report continues with an overview of the demographic context (historical trends and future prospects). The chapter on population policies and programs covers the evolution and status of the policies; sectoral strategies; development and research; a profile of the family health, family planning (FP), IEC (information, education, and communication), and data collection and analysis programs. This chapter also provides details on policies and programs which link women and families to population and development and on those which concern mortality, population distribution, and migration. The third major section of the report presents operational features of the implementation of population and FP programs, in particular, political support, program formulation and execution, supervision and evaluation, financing, and the importance and relevance of the world plan of action for population. Tunisia's national action plan for the future is discussed next in terms of new problems and priorities and a mobilization of resources. This section also includes a table which sets out the components, goals, strategies, and programs of action of the population policy. In conclusion, it is stated that Tunisia's population policy fits well with the world program of action because it promotes human resources and sustainable development and respects international recommendations about human rights in general and the rights of women in particular.
Health and health services in Judaea, Samaria and Gaza 1983-1984: a report by the Ministry of Health of Israel to the Thirty-Seventh world Health Assembly, Geneva, May 1984.
Jerusalem, Israel, Ministry of Health, 1984 Mar. 195 p.Health conditions and health services in Judea, Samaria, and Gaza during the 1967-83 period are discussed. Health-related activities and changes in the social and economic environment are assessed and their impact on health is evaluated. Specific activities performed during the current year are outlined. The following are specific facets of the health care system that are the focus of many current projects in these districts; the development of a comprehensive network of primary care programs and centers for preventive and curative services has been given high priority and is continuing; renovation and expansion of hospital facilities, along with improved staffing, equipment, and supplies for basic and specialty health services increase local capabilities for increasingly sophisticated health care, and consequently there is a decreasing need to send patients requiring specialized care to supraregional referral hospitals, except for highly specialized services; inadequacies in the preexisting reporting system have necessitated a continuting process of development for the gathering and publication of general and specific statistical and demographic data; stress has been placed on provision of safe drinking water, development of sewage and solid waste collection and disposal systems, as well as food control and other environmental sanitation activities; major progress has been made in the establishment of a funding system that elicits the participation and financial support of the health care consumer through volunary health insurance, covering large proportions of the population in the few years since its inception; the continuing building room in residential housing along with the continuous development of essential community sanitation infrastructure services are important factors in improved living and health conditions for the people; and the health system's growth must continue to be accompanied by planning, evaluation, and research atall levels. Specific topics covered include: demography and vital statistics; socioeconomic conditions; morbidity and mortality; hospital services; maternal and child health; nutrition; health education; expanded program immunization; environmental health; mental health; problems of special groups; health insurance; community and voluntary agency participation; international agencies; manpower and training; and planning and evaluation. Over the past 17 years, Judea, Samaria, and Gaza have been areas of rapid population growth and atthe same time of rapid socioeconomic development. In addition there have been basic changes in the social and health environment. As measured by socioeconomic indicators, much progress has been achieved for and by the people. As measured by health status evaluation indicators, the people benefit from an incresing quantity and quality of primary care and specialty services. The expansion of the public health infrastructure, combined with growing access to and utilization of personal preventive services, has been a key contributor to this process.
In: Population perspectives. Statements by world leaders. Second edition, [compiled by] United Nations Fund for Population Activities [UNFPA]. New York, New York, UNFPA, 1985. 105.Mauritania's Military Committee of National Salvation, inspired both by religious teachings and its participation in the 1974 World Population Conference, has adopted a social and economic development plan aimed at improving the quality of life of the population. With the financial and technical assistance of the United Nations, Mauritania has carried out its 1st national population census and fertility survey; in addition, a Center for Demographic and Social Research was established in 1983. Health efforts are currently aimed at reducing infant and child mortality. Mauritania's approach to population control primarily stresses improvements in maternal and child health. In education, efforts have been directed toward increasing school attendance rates and improving the quality of teaching. Unemployment and underemployment are also being given serious attention. To stem migration from rural to urban areas, which accelerated during the drought, sectoral projects seek to keep people in their areas. The creation of mass education structures is the most tangible expression of the Government's commitment to involving Mauritanians in shaping their own political, cultural, economic, and social destiny. For true harmonization of national population policies, however, a more just, humane international economic order is needed.
An examination of the population structure of Liberia within the framework of the Kilimanjaro and Mexico City Recommendations on Population and Development: policy implications and mechanism.
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, . 111-36.The age and sex composition and distribution of the population of Liberia as affected by fertility, mortality, morbidity, migration, and development are examined within the framework of the Kilimanjaro Program of Action and recommendations of the International Conference on Population held in Mexico City. The data used are projections (1984-85) published in the 2nd Socio-Economic Development Plan, 1980. The population of Liberia is increasing at the rate of 3.5% and will double in 23.1 years. 60% of the population is under 20 and 2% over 75. Projected life expectancy is 55.5 years for women and 53.4 years for men. The population is characterized by high age dependency; 47.1% of the people are under 15 and 2.9% are over 64, so that half of the population consists of dependent age groups, primarily the school-age children (6-11 years). If these children are to enter the labor force, it is estimated that 19,500 jobs will have to be created to employ them. Moreover, fertility remains at its constant high level (3.5%), so, as mortality declines, the economic problem becomes acute. Furthermore, high fertility is accompanied by high infant and maternal mortality. High infant mortality causes couples in rural areas to have more children. These interdependent circumstances point up the need for family planning, more adequate health care delivery systems, and increasing the number of schools to eradicate illiteracy, which is currently at 80%. Integrated planning and development strategies and appropriate allotment of funds must become part of the government's policy if the Kilimanjaro and Mexico City recommendations are to be implemented.
Oxford, England, Oxford University Press, 1988. , 86 p.The 1988 UNICEF report on the world's children contains chapters describing the multi-sectorial alliance to support child health, the current emphasis on ORT and immunization, the effect of recession on vulnerable children, family rights to knowledge of basic health facts, and support for women in the developing world. Each chapter is illustrated by graphs. There are side panels on programs in specific countries, including Senegal, Syria, Colombia, Bangladesh, Turkey, India, Honduras, Japan and Southern Africa, and highlighted programs including immunization, AIDS, ORT, breast-feeding and tobacco as a test of health. The SAARC is a new regional organization of southern Asian countries committed to immunization and other health goals. Tables of health statistics of the world's nations, divided into 4 groups by "Under 5 Mortality Rate" present basic indicators, nutrition/malnutrition data, health information, education, literacy and media data, demographic indicators, economic indicators and data pertaining to women. The absolute numbers of child deaths had fallen to 16 million in 1980, from 25 million in 1950. Saving children's lives will not exacerbate the population problem because, realizing that their children will survive, families will have fewer children. Furthermore, the methods used to reduce mortality, such as breast feeding and empowerment of families to control their lives, are known to reduce fertility.
[Unpublished] 1985. 78 p.A Population/Family Health Assessment was conducted in the Democratic Republic of Madagascar (GDRN) to review population and family planning activities and to make general recommendations for improvement, including the type of US Agency for International Development (USAID) population assistance that should be provided. Despite the fact that Madagascar's population of approximately 9 million is growing at a rate of 2.8% annually, meaning the population will double in less than 25 years, there is no official population policy. Yet, it is significant that the reduction of maternal and infant mortality and morbidity has been identified as an explicit goal in the health sector, and the country's actions long have reflected an attitude of acceptance and support of family planning. The private family planning association is recognized as a nongovernmental organization, which provides clinical and contraceptive services throughout Madagascar. The public health system offers no family planning services. Although the French law of 1920 forbidding the sale and use of contraceptives has not been rescinded, it is not enforced. The private family planning association now provides contraceptive services in 40 Ministry of Health facilities at the request of public health physicians, and the government has approved the participation of 35 medical and paramedical personnel in training courses as well as the installation of laparoscopic equipment in 8 medical facilities. Several other organizations provide child spacing services. Despite the efforts being made, the availability of contraceptive services remains limited, and contraceptive prevalence was estimated at 1% of women aged 15-49 in 1982. Several obstacles impede accessibility to contraceptive services and expansion of family planning programs, including a culture which favors large families, the strong influence of the Catholic Church, and a limited number of medical centers providing family planning services. Further, communication between the Office of Population and the Ministry of Health has not been the most favorable for the development of effective programs either area, but the recent naming of a physician to the position of Director of Population may facilitate closer collaboration. The recommendations made outline a general strategy for the initiation of population activities in the shortterm.
[Unpublished] 1984 May 8. 31 p. (CE 92/12)This report shows how demographic information can be analyzed and used to identify and characterize the groups assigned priority in the Regional Plan of Action and that it is necessary for the improvement of the planning and allocation of health resources so that national health plans can be adapted to encompass the entire population. In discussing the connections between health and population characteristics in the countries of the region, the report covers mortality, fertility and health, and fertility and population increase; spatial distribution and migration; and the structure of the population. Focus then moves on to health, development, and population policies and family planning. The final section of the report considers the response of the health sector to population trends and characteristics and to development-related factors. The operations of the health sector must be revised in keeping with the observed demographic situation and the projections thereof so that the goal of health for all by the year 2000 may be realized. In several countries of the region mortality remains high. In 1/3 of them, infant mortality during the period 1980-85 exceeds 60/1000 live births. If measures are not taken to reduce mortality 55% of the population of Latin America in the year 2000 will still be living in countries with life expectancies at birth of under 70 years. According to the projections, in the year 2000 the birthrate will stand at around 29/1000, with wide differences between the countries of the region, within each of them, and between socioeconomic strata. High fertility will remain a factor hostile to the health of women and children and a determinant of rapid population growth. Some governments view the present or predicted growth rates as excessive; others want to increase them; and some take no explicit position on the matter. The countries would be well advised to assign values to their birthrate, natural increase, and periods for doubling their populations in relation to their development plans and to the prospects for improving the standard of living and health of their populations. An important factor in urban growth is internal migration. These migrants, like some of those who move to other countries, may have health problems requiring special care. Regardless of a country's demographic situation, the health sector has certain responsibilities, including: the need to promote the framing and adoption of population and development policies, in whose implementation the importance of health measures is not open to question; and the need to favor the intersector coordination and articulation required to ensure that population aspects are considered in national development planning.
Paris, France, Organisation for Economic Co-operation and Development [OECD], 1988. 90 p. (Demographic Change and Public Policy)This is the first in a planned series of volumes published by the Organisation for Economic Co-operation and Development (OECD) concerning the economic and social consequences of demographic aging in OECD member countries. "This detailed statistical analysis of demographic trends in the 24 OECD countries examines the implications for public expenditure on education, health care, pensions and other social areas, and discusses the policy choices facing governments." Data are from official sources. (EXCERPT)
[Experience with the expanded WHO program on immunization against tetanus] Opyt rasshirennoi programmy VOZ po immunizatsii protiv stolbniaka.
ZHURNAL MIKROBIOLOGII, EPIDEMIOLOGII I IMMUNOBIOLOGII. 1985 Nov; (11):97-103.According to (WHO) statistics, over 1 million infants in the developing countries die each year from tetanus. The estimated annual occurrence of tetanus in the 3rd World exceeds 2.5 million cases, including approximately 1.3 million newborn infants. In 1974, WHO began an expanded program for the systematic immunization of infants against tetanus and certain other diseases. The program uses 2 approaches for preventing tetanus: 1) immunization of infants under 1 year of age with the AKDS vaccine; and 2) immunization of pregnant women or, if possible, all women, with tetanus anatoxin. The 2nd approach is more effective, especially when 2 doses of tetanus anatoxin are administered within a minimum interval of 4 weeks. The anatoxin has no harmful effects on the fetus and can be used during any stage of pregnancy. The program strives to reduce infant mortality caused by tetanus to less than 1 case in 1000 by 1990, and to 0 by 2000. To attain these goals, systematic immunization should be combined with drastic improvements in delivery techniques and hygiene in developing countries. Specialized surveys indicate that initial steps toward implementation of the program resulted in a significant reduction of infant mortality caused by tetanus. Experience with the expanded WHO program shows that elimination of tetanus in infants is a realistic and attainable goal.
POPULATION BULLETIN OF THE UNITED NATIONS. 1986; (19-20):115-24.The United Nations (UN) and the International Union for the Scientific Study of Population (IUSSP) have cooperated since the 1940s. In 1927 an International Population Conference in Geveva established a permanent Population Union to cooperate with the population activities of the League of Nations. The 2 institutions' successors, IUSSP and the United Nations (UN), developed close and productive linkages, collaborating to create a Multilingual Demographic Dictionary, published in English, French, Russian, and Spanish and in many other languages. Meanwhile the Union, at the request of UNESCO, prepared a pioneering study attempting to define the cultural factors affecting developing country fertility in the context of the demographic transition, In 1966 the Union and the UN collaborated to develop criteria for internationally comparable studies in fertility and family planning (FP). The resulting monograph served as a reference for many fertility studies, including the World Fertility Survey. Another study on the impact of FP programs on fertility, resulted in the organization of expert meetings and the production of a manual and monographs on FP program evaluation. There was futher cooperation in a study on mortality, internal migration and international migration, resulting in manuals on methods of analysing internal migration and indirect measures of emigration, among other things. The 1954 Wold Population Conference (WPC) and the 1965 UN WPC were organized by the UN collaborating with the Union, and the Union administered the funds used to bring developing country delegates to the Conference. Subsequent WPCs at Bucharest and Mexico City were political in nature, bu the Union contributed to both a report outlining demographic research needs. The Union also assisted the UN in organizing a series of regional population conferences, and its Committee on Demographic Instruction prepared a report for UNESCO on teaching demography, and cooperated with the Secretariat in funding the UN Regional Demographic Training Centers at Bombay and Santiago.
POPULATION BULLETIN OF THE UNITED NATIONS. 1986; (19-20):125-8.The Committee for International Co-operation in National Research in Demography (CICRED) was formed in 1972 as a result of an initiative taken by the Director of the Population Division of the United Nations Secretariat, and currently holds consultative status with the Economic and Social Council Among its accomplishments are the organization of seminars on demographic research in relation to population growth targets and on infant mortality in relation to the level of fertility, and demographic research in relation to internal migration. CICRED was also instrumental in gaining the co-operation of national research institutions in a project resulting in the publication of 56 national monographs. In cooperation with the population Division, CICRED prepared and published 2 editions of a population multilingual thesaurus. This collaboration also led to the creation of the Population Information Network (POPIN). In 1977 CICRED launched the Inter-center Co-operative research Program. The various elements of the program are in different stages of completion. In particular, they involve cooperation with the Population Division in the areas of intergration of demographic variables into planning, aging and differential mortality. (author's modified)
[Unpublished] 1986. Presented at the All-Africa Parliamentary Conference on Population and Development, Harare, Zimbabwe, May 12-16, 1986. 7 p.The Second African Conference on Population and Development, held early in 1984, marked a decisive stage in African thinking about population. During the 12 years between the 1972 and 1984 conferences, African nations learned in detail about their demographic situation and confronted the ever-increasing costs of development and their lack of physical and administrative infrastructure. In the midst of these and other concerns came the drought, which for over a decade in some parts of the continent has reduced rainfall, dried up rivers, lakes, and wells, and forced millions into flight. It is in this context that population became an African issue. African countries on the whole are not densely populated nor do they yet have very large concentrations in cities. Yet, population emerges as more than a matter of numbers, and there are features which give governments cause for concern. First, the population of most African countries, and of the continent as a whole, is growing rapidly and could double itself in under 25 years. Second, mortality among mothers and children is very high. Third, life expectancy generally is lower in African than in other developing countries. Fourth, urbanization is sufficiently rapid to put more than half of Africa in cities by 2020 and 1/3 of the urban population in giant cities of over 4 million people. The 1984 conference recognized these and other uncomfortable facts and their implications for the future, and agreed that attention to population was an essential part of African development strategy. Strategy is considered in terms of the 4 issues mentioned. First, high rates of growth are not in themselves a problem, but they mean a very high proportion of dependent children in the population. About 45% of Africa's population is under age 14 and will remain at this level until the early years of the 21st century. Meeting the needs of so many children and young adults taxes the ability of every African nation, regardless of how rapidly its economy may expand. Understanding this, a growing number of African leaders call for slower growth in order to achieve a balance in the future between population and the resources available for development. Reducing mortality requires innovation. Among the new approaches to health care are the use of traditional medicine and practitioners in conjunction with modern science and the mobilization of community groups for preventive care and self-help. Health care and better nutrition also are keys to improvement in life expectancy and call for ingenuity and innovation on the part of African governments and communities. Part of the solution to the impending urban crisis must be attention to the viability of the rural sector. The role of the UN Fund for Population Activities in addressing the identified issues is reviewed.
[National Conference on Fertility and Family, Oaxaca de Juarez, Oaxaca, April 13, 1984] Reunion Nacional sobre Fecundidad y Familia, Oaxaca de Juarez, Oax., a 13 de abril de 1984.
Mexico City, Mexico, CONAPO, 1984. 228 p.Proceedings of a national conferences on the family and fertility held in April 1984 as part of Mexico's preparation for the August 1984 World Population Conference are presented. 2 opening addresses outline the background and objectives of the conference, while the 1st paper details recommendations of a 1983 meeting on fertility and the family held in New Delhi. The main body of the report presents 2 conference papers and commentary. The 1st paper, on fertility, contraception, and family planning, discusses fertility policies; levels and trends of fertility in Mexico from 1900 to 1970 and since 1970; socioeconomic and geographic fertility differentials; the relationship of mortality and fertility; contraception and the role of intermediate variables; the history and achievements of family planning activities of the private and public sectors in Mexico; and the relationship between contraception, fertility, and family planning. The 2nd paper, on the family as a sociodemographic unit and subject of population policies, discusses the World Population Plan of Action and current sociodemographic policies in Mexico; the family as a sociodemographic unit, including the implications of formal demography for the study of family phenomena, the dynamic sociodemographic composition of the family unit, and the family as a mediating unit for internal and external social actions; and steps in development of a possible population policy in which families would be considered an active part, including ideologic views of the family as a passive object of policy and possible mobilization strategies for families in population policies. The conference as a whole concluded by reaffirming the guiding principles of Mexico's population policy, including the right of couples to decide the number and spacing of their children, the fundamental objective of the population policy of elevating the socioeconomic and cultural level of the population, the view of population policy as an essential element of development policy, and the right of women to full participation. Greater efforts were believed to be necessary in such priority areas as integration of family planning programs with development planning and population policy, creation of methodologies for the analysis of families in their social contexts, development and application of contraceptive methodologies, promotion of male participation in family planning, coordination of federal and state family planning programs, and creation of sociodemographic information systems to ensure availability of more complete date on families in specific population sectors. The principles of the World Population Plan of Action were also reaffirmed.
Washington, D.C., World Bank, 1986 Aug. x, 102 p.This report provides a comprehensive assessment of the magnitude and underlying causes of Africa's rapid population growth and suggests a framework to help African leaders design policies to address this problem. The report has 3 themes. The 1st theme is that rapid population growth in Africa is slowing economic development and reducing the possibility of raising living standards. Africa's population growth rate, the highest in the world, has accelerated from an average of 2.8%/year in 1970-82 to 3.1%/year in 1985. Population growth is expected to continue to rise for at least another 5-10 years. In addition to undermining economic growth and per capita income growth, the population explosion implies higher child and maternal morbidity and mortality, further degradation of the natural environment, constraints on expanding education and health care services, and falling wages. A comprehensive population policy in African countries must include efforts both to slow this growth and to cope with its consequences. A 2nd theme is one of cautious hope arising from recent indications of a change in ideas and behavior regarding fertility. More and more African governments are expressing alarm about population growth and are supporting family planning measures. Improvements in women's status, especially in female education, are occurring and can be expected to have a fertility reducing effect. Increased availability and accessibility of family planning services could raise Africa's contraceptive prevalence rate from its current level of 3-4% to 25% in the next decade. The 3rd theme is that strategic reorientation of the direction and nature of government involvement in the area of population policy is required. Although governments should not seek to be the only provider of family planning services, they must take the lead in generating a climate of legitimacy for family planning. An increase in external assistance will be necessary if family planning is to become a realistic option for Africans.
World Health. 1985 Nov; 13-15.In November 1980, Dr. Halfdan Mahler, Director-General of the World Health Organization (WHO), and James Grant, head of the UN Children's Fund (UNICEF), drafted a joint program to improve the nutritional status of children and women through developmental measures based on primary health care. The government of Italy agreed to fund in full the estimated cost of US$85.3 million. When a tripartite agreement was signed in Rome in April 1982, the WHO/UNICEF Joint Nutrition Support Program (JNSP) came into being. It was agreed that resources would be concentrated in a number of countries to develop both demonstrable and replicable ways to improve nutrition. Thus far, projects are underway or are just starting in 17 countries in Africa, Asia, Latin America, and the Caribbean. In most of these countries, infant and toddler mortality rates are considerably higher than the 3rd world averages. Program objectives include reducing infant and young child diseases and deaths and at the same time improving child health, growth, and development as well as maternal nutrition. These objectives require attention to be directed to the other causes of malnutrition as well as diet and food. JNSP includes nutrition and many other activities, such as control of diarrhea. The aim of all activities is better nutritional status leading to better health and growth and lower mortality. Feeding habits and family patterns differ from 1 country to another as do the JNSP country projects. Most JNSP projects adopt a multisectoral approach, incorporating varied activities that directly improve nutritional status. Activities involve agriculture and education as well as health but are only included if they can be expected to lead directly to improved nutrition. A multisectoral program calls for multisectoral management and involves coordination at all levels -- district, provincial, and national. This has been one of the most difficult things to get moving in many JNSP projects, yet it is one of the most important. Community participation is vital to all projects. Its success can only be judged as the projects unfold, but early experiences from several countries are encouraging.
In: Third Asian and Pacific Population Conference (Colombo, September 1982). Selected papers. Bangkok, Thailand, Economic and Social Commission for Asia and the Pacific, 1984. 9-40. (Asian Population Studies Series No. 58)This report summarizes the recent demographic situation and considers prospective trends and their development implications among the 39 members and associate members of the Economic and Social Commission for Asia and the Pacific (ESCAP). It presents data on the following: size, growth, and distribution of the population; age and sex structure; fertility and marriage; mortality; international migration; growth and poverty; food and nutrition; households and housing; primary health care; education; the working-age population; family planning; the elderly; and population distribution. Despite improvements in the frequency and quality of demographic data collected in recent years, big gaps continue to exist in knowledge of the demographic situation in the ESCAP region. Available evidence suggests that the population growth rate of the ESCAP region declined between 1970 and 1980, as compared with the preceding decade, but that its rate of decline was slow. Within this overall picture, there is wide variation, with the most developed countries having annual growth rates around 1% and some of the least developed countries having a figure near 3%. The main factors associated with the high growth rates are the past high levels of fertility resulting in young age structures and continuing high fertility in some countries, notably in middle south Asia. The population of countries in the ESCAP region is expected to grow from 2.5 billion in 1980, to 2.9 billion in 1990, and to 3.4 billion persons by the year 2000. This massive growth in numbers, which will be most pronounced in Middle South Asia, will occur despite projected continuing moderation in annual population growth rates. Fertility is expected to continue its downward trend, assuming a more widespread and equitable distribution of health, education, and family planning services. Mortality is expected to decline further from its current levels, where life expectancy is often at or around 50 years. In several countries, more than 10 in every 100 babies born die before their 1st birthday. The extension of primary health care services is seen as the key to reducing this figure. Rapid population growth and poverty tend to reinforce each other. Low income, lack of education, and high infant and child mortality contribute to high fertility, which in turn is associated with high rates of natural increase. High rates of natural increase feed back to depress socioeconomic development. High population growth rates and their correlates of young age structures and heavy concentrations of persons in the nonproductive ages tend to depress production and burden government expenditure with high costs for social overhead needs. Rapid population growth emerges as an important factor in the persistence of chronic undernutrition and malnutrition. It increases the magnitude of the task of improving the educational system and exacerbates the problem of substandard housing that is widely prevalent throughout Asia.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 289-303. (International Conference on Population, 1984; ST/ESA/SER.A/91)The United Nations Fund for Population Activities (UNFPA) assistance program encompasses basic data collection, population dynamics, formulation of population policies, implementation of general policies, family planning activities, communication and education programs, and special programs and multisector activities. This paper focuses on UNFPA assistance in the area of mortality. The Fund does not provide support for activities related to the reduction of mortality per se; rather, it contributes indirectly to the improvement of infant, child, and maternal health through assistance to family planning programs integrated with maternal-child health care. The types of activities UNFPA supports in this area include prenatal, delivery, and postnatal care of mothers and infants; infant and child care; health and nutrition education; promotion of breastfeeding; monitoring of infant malnutrition; and diagnostic studies and treatment of infertility and subfecundity. The Fund has cumulatively expended about US$87.3 million for activities in the area of mortality and health policy. The Fund is currently providing collaborative assistance to the World Health Organization and the UN for a comprehensive project aimed at measuring mortality trends and examining the roles of socioeconomic development and selected interventions in the mortality decline in certain developing countries. At present there is a need for research on the persistence of high mortality in the least developed countries, the early levelling off of life expectancies in many countries, and the determinants of socioeconomic differentials in mortality. Understanding of the mortality situation in many developing countries has been hindered by a lack of descriptive data on mortality by socioeconomic, regional, and occupational status. The real challenge lies in the implementation of policies designed to reduce mortality; political, managerial, and cultural factors unique to each country, as well as pervasive poverty, make this a difficult process.
Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 37-79. (International Conference on Population, 1984.; ST/ESA/SER.A/91)This paper reviews the major issues that have emerged in the analysis of mortality and health policy since the 1974 World Population Conference. The 1st part summarizes current mortality conditions in the major world regions and evaluates progress toward achieving the goals of the World Population Plan of Action. It is noted that the current mortality situation is characterized by continued wide disparities between the more developed and less developed regions, especially during the 1st year of life. The 2nd part focuses on the synergistic relationship between health and development, including social, economic, and health inequalities. It is asserted that mortality rates in developing countries are a function of the balance governments select between development strategies favoring capital accumulation and concentrated investments on the 1 hand and strategies oriented toward meeting basic needs and reducing inequalities in income and wealth. Data from developed countries suggest that economic development does not necessarily lead to steady gains in life expectancy. Some variations in mortality may reflect changes in family relationships, especially women's status, that are induced by social and economic development, however. The 3rd part of this paper analyzes the effect of health policies on mortality, including curative and preventive programs and primary health care. The lack of community participation is cited as a key factor in the weak performance of primary health care in many developing countries. In addition, there is strong evidence that the concepts and technologies of modern medicine must be adapted to existing systems of disease prevention and care to gain acceptability. The 4th section, on the implementation of health policies, discusses health care management, planning, and financing. It is noted that successful implementation of health policies is often hindered by scarcity, inadequate allocation, and inefficient utilization of health resources. Finally, more effective means to cope with rising costs of health care are needed.
Lancet. 1985 Jul 13; 326(8446):83-5.Despite increasing attention to maternal and child health programs, most do little to reduce maternal mortality. In developing countries, maternal death rates of 100-300/100,000 births are common; rates are even higher in rural areas. Only 1 of the components of most maternal-child health programs (oral rehydration, growth monitoring, breastfeeding, family planning, and immunization) can reduce maternal mortality--family planning. Women who have many births or give birth at either extreme of the reproductive cycle are more likely to die of complications than other women. If all women who want to limit their families had access to efficient contraception, matenal mortality would be substantially reduced. Also needed is a major investment in a system of comprehensive maternity care. 75% of obstetric deaths are due to hemorrhage, infection, toxemia, and obstructed labor. Many of these complications occur among women with recognizable risk factors. It is recommended that the World Bank make maternity care 1 of its priorities. The Bank could initiate a program based on the construction of maternity centers in rural areas, the recruitment and training of staff for these centers, and the provision of supplies and drugs. Because women receiving maternity care can be offered family planning services as well, this proposal provides the World Bank with an opportunity to work toward its goal of reduced population growth rates.
New York, UNFPA, 1985 Mar. viii, 68 p. (Report No. 70)The UN Fund for Population Activities (UNFPA) is in the process of an extensive programming exercise intended to respond to the needs for population assistance in a priority group of developing countries. This report presents the findings of the Mission that visited Burma from May 9-25, 1984. The report includes dat a highlights; a summary and recommendations for population assistance; the national setting; population policies and population and development planning; data collection, analysis, and demographic training and research;maternal and child health, including child spacing; population education in the in-school and out-of school sectors; women, population, and development; and external assistance -- multilateral assistance, bilateral assistance, and assistance from nongovernmental organizations. In Burma overpopulation is not a concern. Population activities are directed, rather, toward the improvement of health standards. The main thrust of government efforts is to reduce infant mortality and morbidity, promote child spacing, improve medical services in rural areas, and generally raise standards of public health. In drafting its recommendations, whether referring to current programs and activities or to new areas of concern, the Mission was guided by the government's policies and objectives in the field of population. Recommendations include: senior planning officials should visit population and development planning offices in other countries to observe program organization and implementation; continued support should be given to ensure the successful completion of the tabulation and analysis of the 1983 Population Census; the People's Health Plan II (1982-86) should be strengthened through the training of health personnel at all levels, in in-school, in-service, and out-of-country programs; and the need exists to establish a program of orientation to train administrators, trainers/educators, and key field staff of the Department of Health and the Department of Cooperatives in various aspects of population communication work.
[Unpublished] 1984. Presented at the Second African Population Conference, Arusha, Tanzania, January 9-13, 1984. 21 p.This discussion of Ethiopia focuses on: sources of demographic data; population size and age-sex distribution; urbanization; fertility; marital status of the population; mortality and health; rate of natural increase; economic activity and labor force activity rates; food production; education; population policies and programs; and population in development planning. As of 1983, Ethiopia's population was estimated at 33.7 million. Agriculture is the mainstay of the economy. Ethiopia has not yet conducted a population census, however, the 1st population and housing census is planned for 1984. The population is young with children under 15 years of age constituting 45.4% of the total population; 3.5% of the population are aged 65 years and older. The degree of urbanization is very low while the urban growth rate is very high. Most of the country is rural with only 15% of the population living in localities of 2000 or more inhabitants. In 1980-81 the crude birthrate was 46.9/1000. The total fertility rate was 6.9. Of those aged 15 years and older, 69.2% of males and 71.3% of females are married. According to the 1980-81 Demographic Survey the estimates of the levels of mortality were a crude death rate of 18.4/1000 and an infant mortality rate of 144/1000. At this time 45% of the population have access to health services. It is anticipated that 80% of the population will be covered by health care services in 10 years time. Ethiopia is increasing at a very rapid rate of natural increase; the 1980 estimation was 2.9% per annum. Despite the rich endowments in agricultural potential, Ethiopia is not self-sufficient in food production and reamins a net importer of grain. Enrollment at various levels of education is expanding rapidly. There is no official population policy. Financial assistance received from the UN Fund for Population Activities and the UN International Children's Emergency Fund for population programs is shown.
London, International Planned Parenthood Federation, Europe Region, 1984 Jun. 122 p.Reflections, speculations, and partial evaluations of work already undertaken in the International Planned Parenthood Federation (IPPF) Europe Region concerning migrants and planned parenthood are presented. This project, initiated by the Federal Republic of Germany Planned Parenthood Association (PPA), PRO FAMILIA, stemmed from the practical experiences and problems of 1 family planning association in the Europe region. The original substantive framework, consisting of data collection and correspondence, plenary meetings, and subworking group meetings on specific areas of interest, was not altered. Throughout the project, as the work was accomplished, the emphasis shifted to different aspects to migrant work. The 1st questionnaire was intended to provide a sociodemographic profile of the participating countries, a show European migratory movements, and ascertain the ethnicity of the target groups in the different countries. The 2nd questionnaire was related specifically to PPA and/or other family planning center's data and activities and attempted to explore PPA attitudes toward migrant clients, when special facilities for migrants were provided, and whether PPAs felt there was a particular need for such services. The report provides a sociodemographic background of migration in Europe. In addition it includes information from donor countries and recipient countries, examining family planning services in the Federal Republic of Germany and the UK. It also covers training; information, education, and communication; adolescence and 2nd generation migrants; and migrant work. It is necessary to be particularly aware of political sensitivities in treating immigrant fertility regulation. Ideally, the aim is to provide an integrated service for migrants and natives both, catering to individual needs. Until this is feasible, the goal must be to work toward an integrated service, recognizing the needs and providing special services where possible if this is judged tobe the best approach to catering to those needs. Migrant needs must be discovered rather than assumed. Better use should be made of the available printed material, which should be utilized to complement oral information where possible. Experience has shown that family planning personnel working with migrants need additional training. The main components of this training should include self-awareness, insight, and knowledge.
Draper Fund Report. 1984 Jun; (13):1-3.The UN International Conference on Population to be held in Mexico City in August 1984, responding to an unprecedented upsurge of interest in population over the last decade, offers developed and developing countries the opportunity to assess current and likely future population trends, to comment on programs and progress during the past 10 years, and to determine desirable future directions. More developing countries are reporting diminished declining fertility and family size in countries of widely varying ethnic, social, and economic makeup. Although it is likely that the future will bring a steadily declining rate of world population growth, culminating in stability, present trends indicate that it will take more than a century for world population to stabilize. Meanwhile growth continues. The developing world's annual average birthrate from1975-80 was twice as high as the developed world's. Also there are large areas, much of Latin America and most of Africa, where growth rates continue very high. Other areas, such as parts of Asia, do not follow the general declining trend despite trend despite, in some instances, a long history of population programs. Interest in population programs and demand for resources to support them are growing, but the population dimension is sometimes unrecognized in development planning. The experience of the last decade illustrates that population assistance can make a uniquely valuable contribution to national development when it is given in accord with national policies, is appropriate to local conditions and needs, and is delivered where it can make the most impact. Substantial evidence exists that women in the developing world undertand the risks of repeated pregrancy and would like to take steps to reduce them. It is evident that providers of family planning services are not yet sufficiently responsive to women's own perceptions of their needs and that the social and economic conditions which make family planning a reasonable option do not yet exist. Influxes of immigrants, short and long term, legal and illegal, create particular problems for receiving countries. It is important for sending countries to know what effect the absence of their nationals is having on the domestic economy and essential for receiving countries to consider the protection of the human rights of international migrants, including settlers, workers, undocumented migrants, and refugees. It is a particular responsibility of the industrialized nations to make careful use of limited resources and to ensure that their comsumption contributes to the overall balance of the environment. In most developing countries infectious and parasitic disease remains the primary cause of death, particularly among the young. Much of this toll is preventable. The International Conference on Population provides an opportunity to establish in broad terms the conditions and directions of future cooperation.
New York, New York, UNFPA, 1982. 38 p. (Report No. 51)Tonga's annual population growth rate is 2.01% (1975-1980). There is a high birth rate, but emigration has eased population pressures somewhat. Tonga's development plans include population objectives and the nation has a family planning program; but there is no comprehensive national population policy. The Mission recommends that new posts be created within the planning structure for dealing with population concerns. The posts should be filled by trained nationals. A constraint to planning has been the lack of statistics. More survey data are needed. The Mission recommends that the censuses continue decennially. Registration of emigrants should be adopted, and that steps should be taken to help expand and strengthen the capacity of local institutions for social and economic research. Post-secondary courses should be developed to this end. The Mission also recommends assistance for filling vacant supervisory posts, strengthening the training capability of the Tonga Health Center, and recruiting more pulbic health nurses. Another recommendation is that health data collection and health education be strengthened. Curricula and materials on population concerns should be designed and teachers trained in their use. The Mission recommends expanding the use of radio for communication of population and health information. Women's activities and organizations need coordination. Extensive village-based training is recommended for women, youth, and rural residents.
New York, New York, UNFPA, 1983. 59 p. (Report No. 53)An estimated 53.7 million people lived in Vietnam in 1980. The government wants to lower the rate of population growth as soon as possible. Its short-term goal, to lower the annual rate to 1.7% by 1986, is to be met through the national family planning program. The government wishes to get more married women in the reproductive age group to use contraception--from 20% at present to 50-65% by the year 2000. 2nd major population goal is resettle 10 million people from the northern to the southern part of the country by the end of the century. Efforts should be made to improve the vital registration system. Population research is concentrated in the State Planning Committee, the research arms of various ministries, and in Government research agencies. This research needs to be strengthened. Overseas training and study tours should be provided for strengthening staff capabilities. Assistance should be provided for the government's primary health care approach with emphasis on community participation. Urgently needed are essential drugs and contraceptives--especially condoms. A factory for testing and packing condoms should be built, once the quality of locally produced latex improves. The Mission recommends that a systematic manpower development analysis be undertaken to aid the government in determining training needs of health personnel; their curricula should include more population and family planning content, and motivational and communication techniques. An audiovisual (AV) center was established in Hanoi; however the information, education, and communication (IEC) program needs strenthening. Aid should also be given for low-cost media production in the AV subcenter being started in Ho Chi Minh City. Perservice training of primary and secondary teachers will include population education. Women's activities should be promoted.