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Washington, D.C., World Bank, Operations Evaluation Department, 1992. xii, 159 p. (World Bank Operations Evaluation Study)The World Bank's first assessment of operations concentrates on development over the past 25 years and the Bank's role in Indonesia, India, Bangladesh, Brazil, Kenya, and Senegal. The major issues for the World Bank are discussed, including the neglect of population issues in the nonpopulation sector, policy promotion, project issues, donor coordination and involvement of nongovernmental agencies (NGOs), country organization of population and family planning (FP) activities, the need for a longterm program approach, the extent and allocation of bank resources, and implications for evaluating and staffing Bank population activities. The implications are that too much attention has been paid to inputs rather than outputs for accountability purposes. Attention must also be paid to nonpopulation activities. Appropriateness of the content is more important than the extent of the resources transfer. Errors of commission are pointed out, but there is need to identify errors of omission. The implications for staffing in the field in both nonproject and project work. A small core of dedicated people has been effective thus far, but in the long run greater technical resources are needed, particularly in countries with little assistance or indigenous capacity. The statistical appendix includes tables on demographic indicators for selected countries and years; donor expenditures, 1982-89; summary data for 1990 for case study countries; appraisal project costs and bank financing by category of expenditure for population projects in case study countries; bank lending by sector, for decades between 1970 and 1990; appraisal estimates of civil works, furniture, and equipment in bank population projects; and commitments for international population assistance by the World Bank and other donors, 1952-89. Annexes 1 and 2 pertain to Bangladesh's population program (executive summary, demographic situation, environmental and social and economic context, the national FP program, population projects and the Bank's institutional style), and conclusions and a similar discussion for Indonesia.
Washington, D.C., World Bank, 1992. xxvii, 133 p. (World Bank Country Study)In the early 1990s, the World Bank sent a team of specialists in demography, medicine, hospital administration, health policy, personnel, medical technology, and finance to China to examine the present health status of the population and to protect its future status. Before making any projections, however, they had to learn what demographic and epidemiologic factors would basically determine future health status. The main factors driving China's health transition included aging of the population; increased risk of developing chronic disease caused by changes in life style, dietary, environmental, and occupational risk factors; and changing morbidity and mortality patterns (i.e., shift from infectious to disabling and chronic diseases). The team mapped out specific strategies, which can indeed be achieved, to avert a health care crisis. The strategies revolved around a sustained effort of primary prevention of chronic diseases, especially circulatory diseases, which caused considerable premature mortality. The team illustrated how different formulas of total health expenditures would affect epidemiologic outcomes. The team learned that health care costs would probably increase due to unavoidable demographic trends (especially demographic aging), epidemiologic forces, and utilization and unit cost changes. Suggested primary prevention strategies alone would not be enough to control health expenditures to a level where feasible equity can be maintained. China must also greatly improve efficiency of hospital services, personnel, and technologies. The evaluation team concluded that the government needs to reassess policies for financing primary and preventive health services, the basis and conditions of insurance, and the role of prices and incentives in directing use and provision of services.
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)
New York, New York, United Nations, 1984. ix, 534 p. (International Conference on Population, 1984; Statements ST/ESA/SER.A/90)Contained in this volume are the report (Part I) and the selected papers (Part II) of the Expert Group on Population, Resources, Environment and Development which review past trends and their likely future course in each of the 4 areas, taking into account not only evolving concepts but also the need to consider population, resources, environment and development as a unified structure. Trends noted in the population factor include world population growth and the differences between rates in the developed and developing countries; the decline in the proportion of the population who are very young and the concomitant increase in the average age of the population. Discussed within the resource factor are the labor force, the problem of increasing capital shortage, expenditures on armaments, trends in the supply and productivity of arable land, erosion and degradation of topsoil and energy sources. Many of the problems identified overlap with the environment factor, which centers on the problem of pollution. The group on the development factor was influenced by a pervasiv sense of "crisis" in current economic trends. Concern was also expressed regarding the qualitative aspects of current development trends, defined as the perverse effects of having adopted inappropriate styles of development. Part II begins with a general overview of recent levels and trends in the 4 areas along with the concepts of carrying capacity and optimum population. Other papers discuss the impact of trends in resources, environment and development on demographic prospects; long-term effects of global population growth on the international system; economic considerations in the choice of alternative paths to a stationary population and the need for integration of demographic factors in development planning. The various papers on the resources and environment factor focus on resources as a barrier to population growth; the effects of population growth on renewable resources; food production and population growth in Africa; the frailty of the balance between the 4 areas and the need for a holistic approach on a scale useful for regional planning. Also addressed are: social development; population and international economic relations; development, lifestyles, population and environment in Latin America; issues of population growth, inequality and poverty; health, population and development trends; education requirements and trends in female literacy; the challenge posed by the aging of populations; and population and development in the ECE region.