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Government of Sierra Leone. National report on population and development. International Conference on Population and Development 1994.
Freetown, Sierra Leone, National Population Commission, 1994. , 15,  p.The government of Sierra Leone is very concerned about the poor health status of the country as expressed by the indicators of a high maternal mortality rate (700/100,000), a total fertility rate of 6.2 (in 1985), a crude birth rate of 47/1000 (in 1985), an infant mortality rate of 143/1000 (in 1990), and a life expectancy at birth of only 45.7 years. A civil war has exacerbated the already massive rural-urban migration in the country. Despite severe financial constraints, the government has contributed to the UN Population Fund and continues to appeal to the donor community for technical and financial help to support the economy in general and population programs in particular. Sierra Leone has participated in preparations for and fully supports the 1994 International Conference on Population and Development. This document describes Sierra Leone's past, present, and future population and development linkages. The demographic context is presented in terms of size and growth rate; age and sex composition; fertility; mortality; and population distribution, migration, and urbanization. The population policy planning and program framework is set out through discussions of the national perception of population issues, the national population policy, population in development planning, and a profile of the national population program [including maternal-child health and family planning (FP) services; information, education, and communication; data collection, analysis, and research; primary health care, population and the environment; youth and adolescents and development; women and development; and population distribution and migration]. The operational aspects of the program are described with emphasis on political and national support, FP service delivery and coverage, monitoring and evaluation, and funding. The action plan for the future includes priority concerns; an outline of the policy framework; the design of population program activities; program coordination, monitoring, and evaluation; and resource mobilization. The government's commitment is reiterated in a summary and in 13 recommendations of action to strengthen the population program, address environmental issues, improve the status of women, improve rural living conditions, and improve data collection.
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.