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  1. 1

    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.

    Israel. Ministry of Health

    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.
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  2. 2

    Basis for the definition of the organization's action policy with respect to population matters.

    Pan American Health Organization [PAHO]

    [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.
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  3. 3

    Neonatal tetanus mortality: the magnitude of the problem and prospects for its control.

    Hadjian A

    In: Medical education in the field of primary maternal child health care [edited by] M.M. Fayad, M.I. Abdalla, Ibrahim I. Ibrahim, Mohamed A. Bayad. [Cairo, Egypt, Cairo University, Faculty of Medicine, Dept. of Obstetrics and Gynecology, 1984]. 421-34.

    This paper begins by stating that the mortality from neonatal tetanus has been peculiarly underestimated until recently, and discusses why this has been the case. The availability of a methodology for retrospective surveys and undertaking of such surveys in recent years has thrown much light on the subject. The results of these surveys from 15 countries are presented in tabular form. It is apparent that at present between 500,000 and 1 million newborn infants a year succumb to tetanus. The prospects for control, using the combined approach of improved maternity care and maternal immunization, are discussed, and an appropriate schedule of immunization suggested. The prospects for control are good wherever there is realization of the magnitude of the problem plus reasonable access to even quite basic primary health care. Some activities of WHO in this field are briefly described. (author's)
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  4. 4

    Demographic trends and their development implications.

    United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]

    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.
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  5. 5

    [Ivory Coast: report of the Mission on Needs Assessment for Population Assistance] Cote d'Ivoire: rapport de Mission sur l'Evaluation des Besoins d'Aide en Matiere de Population.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1984 Sep. viii, 57 p. (Report No. 69)

    Conclusions and recommendations are presented of the UN Fund for Population Activities (UNFPA) Mission which visited the Ivory Coast from February 20-March 15, 1983 to assess population assistance needs. Ivory Coast officials believe that the population, estimated at 8,034,000 in 1980, is insufficient given the country's economic needs. Its very rapid rate of growth is estimated at over 4.5%/year, of which 1.5% is due to foreign immigration. 42% of the population is urban. The country has undergone exceptional economic growth in the past 2 decades, and the per capita income is now estimated at over $US1000 annually. Social development does not seem to have kept pace, however, and the mortality rate of 15.4/1000 is that of a country with only 1/2 the per capital income. The 1981-85 Ivory Coast Plan proposes a change from a growth economy to a society in which individual and collective welfare is the supreme goal. Up to date data on the size, structure, and dynamics of the population will be needed to aid in preparation of the 1986-90 and 1991-95 plans. A 2nd national population census is planned for 1985. Until the present, rapid population growth had been considered a boon, but problems are arising of massive rural exodus, high rates of urban unemployment coupled with manpower shortages in agriculture, and growing demographic pressure on health, educational, and social infrastructures, especially in the cities. The government has maintained its pronatalist stance, and government health programs have been directed only to mortality and maternal and child health. The need to control fertility and to use birth spacing as a tool to combat maternal and infant mortality is being increasingly felt, and a private family welfare association was able to form in 1979. A policy of maternal and child health encouraging spacing to improve family welfare would probably be welcomed in the Ivory Coast. The Mission recommended that a population policy be formulated which would correspond to the national demographic reality and development objectives. Basic demographic data collection should focus on the 1985 general census, which should have high priority. The civil registration system should be reorganized. A planned migration survey should cover the whole year to take into acconnt seasonal variations, but preparations should not begin until the census is completed. A multiple objective survey could be undertaken in 1988 to determine the nature and scope of interrelationships between demographic variables and economic and sociocultural variables, and a survey of infant mortality on a small sample could be done in 1989. The planned manpower and employment survey should be completed. Population research should receive high government priority. In regard to maternal and child health, the government should take an official position on the problem of birth spacing as a means of combatting maternal and infant deaths. IEC activities should be expanded, and efforts should be made to encourage the participation of women in development.
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  6. 6

    Assistance by the United Nations Fund for Population Activities to mortality and health policy.

    United Nations Fund for Population Activities [UNFPA]

    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.
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  7. 7

    Technical co-operation in the field of mortality and health policy.

    United Nations. Department of Technical Co-operation for Development

    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. 270-88. (International Conference on Population, 1984; ST/ESA/SER.A/91)

    This paper reviews the technical cooperation efforts undertaken by the United Nations Department of Technical Cooperation for Development (DTCD) to help combat the high mortality levels in developing countries and to evolve policies in response to the World Population Plan of Action. Although the transfer of medical technology and the provision of drugs and other medical supplies remain important means of controlling death and disease, there is growing recognition of the need to develop national skills to deal with mortality, to maintain a continuous record of mortality and morbidity levels and their response to ameliorative programs, and to analyze the interrelationships between demographic, health, and socioeconomic variables. DTCD has focused on data collection and analysis, the integration of research findings into population policy formulation, and training and skill development to facilitate self-reliance. However, the lack of regular mechanisms for coordinating the activities of the various United Nations agencies that play a role in in technical cooperation in the areas of mortality and health policy has been a serious limitation. Another problem has been the dearth of tested alternative techniques for conducting simple health surveys whose results could be used in planning. Closer cooperation between United Nations agencies in this field is urged. It is also important that the recent reassignment of a low priority to data collection and analysis on the part of the United Nations Development Program be reversed. Unless data collection, analysis, and evaluation are reassigned a high priority, planners will be forced to depend on subjective judgments to evolve mortality policies. Finally, technical cooperation activities that aim to integrate mortality and morbidity control into population policies must be responsive to human rights.
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  8. 8

    Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.

    United Nations. Department of International Economic and Social Affairs. Population Division

    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.
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  9. 9

    Integration of population factors into development planning and programmes.

    United Nations. Department of Technical Co-operation for Development; United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]. Population Division

    In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 175-86. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)

    In carrying out the recommendations of the World Population Plan of Action, the UN has expanded its technical cooperation activities with the countries concerned in diverse population development fields, including studies of the interaction between social, economic, and demographic variables, the formulation and implementation of policies, the integration of demographic factors in the planning process, the training of national staff, and the improvement of the data base and institutional arrangements. Discussion focuses on country problems and policies, national institutional capacity in population and development planning, strengthening national institutional capacities, and integration of population and development in the Economic and Social Commission for Asia and the Pacific (ESCAP) region. The interaction between structural change in population and social and economic development is generally recognized at the aggregate, sectoral, and regional levels, yet it has not thus far been possible to take this factor fully into account in the development planning process in many countries. In too many cases, population policies have been formulated and implemented in isolation and not in harmony with development policies or as an integral part of overall development strategy. Deficiencies in achieving integrated population policies and integration of demographic factors in the development planning process often have been caused or aggravated by a deficient knowledge of the interactions between demographic and socioeconomic factors and by insufficient expertise, resources, and proper institutional arrangements in the field. The population policies most frequently formulated and implemented during the last decade dealt with fertility, population growth, migration (internal and international), and mortality. Many governments continue to assign relatively low priority to the formulation of population policy and the formulation of related institutional arrangements. The fact that population is still understood as family planning by a number of governments also delays the legislative procedure necessary to establish government institutions for population research and study. The need exists to create a viable national institutional capacity through the establishment of a population planning unit within the administrative structure of national planning bodies. The substantive content of the work programs of these units would vary from country to country. There also is a need for a broader approach to the adoption of population policies and development planning strategies. Some progress has been made in integrating population into development planning in the ESCAP region, but the progress has been slow.
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  10. 10

    Long-term effects of global population growth on the international system.

    Demeny P

    In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International and Social Affairs. New York, New York, United Nations, 1984. 125-43. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)

    4 overlapping and interrelated concerns appear to influence, if unevenly and in varying combinations, the approaches towards international population phenomena embodied in national policies. The concerns have to do with shifts in relative demographic size within the family of nations, international economic and political stability, humanitarian and welfare considerations, and narrowing options with regard to longterm social development. Each of these concerns is a reflection of measurable or perceived consequences of the extraordinarily rapid growth of the world population during the 20th century and in particular of the marked acceleration of that growth since the end of World War 2. None of these concerns has been adequately articulated, either in the academic literature or in international and national forums in which population policies are considered. International action in the population field has become a subset of international development assistance. Among the motivating concerns, humanitarian and welfare considerations have received the most attention. Considerations of economic and political stability also have been often invoked. In contrast, shifts in relative demographic size and the narrowing options with respect to longterm social development have been seldom discussed. Yet, examination of the record of policy discussions of the last few decades confirms that the influence of these factors has been potent. The dramatic increase of the world population is possibly the single most spectacular event of modern history. During the last 100 years global numbers have tripled, and net population growth between 1900 and 2000 will most likely be of the order of 4.5 billion. Concern with the deleterious consequences of rapid population growth on domestic economic development and, by extension on the health of the world economy is a major factor in explaining international interest in population matters. Concern with poverty is another motivating force for international action involving unilateral resource transfers between nations. The potential role of 2 types of population policies -- relating to international migration and to mortality -- would seem to be narrowly circumscribed. The prospects for useful action in the matter of fertility are more promising.
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  11. 11

    [Hunger and disease in less developed countries and en route to development (the Third World). Proposal for solutions] Hambre y enfermedades en los paises menos adelantados y en vias de desarrollo (Tercer Mundo). Propuesta de soluciones.

    Piedrola Gil G

    Anales de la Real Academia Nacional de Medicina. 1984; 101(1):39-96.

    The extent, causes, and possible solutions to problems of hunger, inequality, and disease in developing countries are discussed in this essay. Various frameworks and indicators have been proposed for identifying the poorest of nations; currently, 21 African, 9 Asian, and 1 American nation are regarded as the poorest of the poor. The 31 least developed countries, the 89 developing countries, and the 37 developed countries respectively have populations of 283 million, 3 billion; infant mortality rates of 160, 94, and 19/1000 live births; life expectancies of 45, 60, and 72 years; literacy rates of 28, 55, and 98%; per capita gross national products of $170, and $520, and $6230; and per capita public health expenditures of $1.70, $6.50, and $244. Developing countries in the year 2000 are expected to have 4.87 billion of the world's 6.2 billion inhabitants. The 3rd world contains 70% of the world's population but receives only 17% of world income. 40 million persons die of hunger or its consequences each year. Economic and social development is the only solution to problems of poverty and underdevelopment, and will require mobilization of all present and future human and material resources to achieve maximum possible wellbeing for each human being. Among principal causes of underdevelopment in the 3rd World are drought, illness, exile, socioeconomic disorder, war, and arms expenditures. Current food production and a long list of possible new technologies would be adequate to feed the world's population, but poor distribution condemns the world's people to hunger. Numerous UN agencies, organizations, and programs are dedicated to solving the problems of hunger, underdevelopment, and disease. In 1982, 600 billion dollars were spent in armanents, of $112 for each of the world's inhabitants; diversion of these resources to development goals would go a long way toward solving the problem of underdevelopment. The main problem is not lack of resources, but the need to establish a new and more just economic and distributive order along with genuine solidarity in the struggle against underdevelopment. Several steps should be taken: agricultural production should be increased with the full participation of the developng nations; the industrialized or petroleum-producing nations should aid the poor states with at least .7% and up to 5% of their gross national products for the struggle against drought, disease, illiteracy, and for the green revolution and new agropastoral technologies; prices paid to poor countries for raw materials should be fair; responsible parenthood, education, women's rights, clean drinking water, environmental sanitation and primary health care should be promoted; the arms race should be halted, and the North-South dialogue should be pursued in a spirit of goodwill and cooperation.
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  12. 12

    Sex differentials in mortality.

    Lopez AD

    Who Chronicle. 1984; 38(5):217-24.

    As part of its regional strategy for attaining health for all, the World Health Organization (WHO) European Region seeks to reduce sex differentials in mortality. In developing countries, the health consequences of social, economic, and cultural discrimination against females have produced a higher mortality rate among females than males. In contrast, there is a trend toward increasing excess male mortality in the developed countries. The sex differential in mortality arises from 2 broad groups of causes: genetic-biological and enivronmental. In high mortality countries, environmental factors may reduce or cancel out the biological advantages that women enjoy over men. As mortality is reduced through improved nutrition, public health measures, and better health care and education, women's environmental disadvantage is reduced and genetic-biological factors may increase the female life span faster than that of males. In the 3rd phase of this process, life style factors (e.g. alcohol abuse, cigarette smoking) may become increasingly detrimental to male health and survival, leading female mortality to decline at a faster pace than that of males. Although males appear to have adapted less well than women to the stresses of modernization, there has been a trend toward high risk behavior patterns among women too as a result of the changing female role. Prospects for the future trend of sex differentials in developed societies depend largely on developments in 2 areas: the effective treatment of degenerative and chronic diseases, which dominate the cause-of-death structure in these societies; and prevention through health education and encouragement of changes in personal behavior and life style. The challenge for women is to resist pressures to adopt a hazardous life style (e.g. smoking) that might offset the benefits of their improved social status.
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  13. 13

    Action by the United Nations to implement the recommendations of the World Population Conference, 1974: monitoring of population trends and policies.

    United Nations. Economic and Social Council. Population Commission

    New York, New York, United Nations, 1984 Dec. 10. 15 p. (E/CN.9/1984/2/Add.1)

    Pursuant to the recommendation of the World Population Plan of Action adopted in 1974, which was reaffirmed by the International Conference on Population in 1984, the United Nations has been undertaking a biennial review of population trends and policies. At the 22nd session of the Population Commission, held in January 1984, the Commission requested the Secretary-General to prepare an addendum to the concise report on monitoring of population trends and policies for the 23rd session, bearing in mind the relatively short time span since the preparation of the last such report. The purpose of the present document is to provide the Population Commission with such information to facilitate its deliberation on the agenda item. Analyses show that the gradual slow-down of global population growth is still holding with the present rate estimated at 1.65%/year, down from 2% during the 1960s. Declines have occurred in both the developed and the developing countries. Regional diversity of population trends have been so large that an overall global assessment seems almost irrelevant for policy consideration at national levels. The future population growth rate is expected to decline slower than it did in the past 15 years unless population policies change significantly. During the 1980-85 period the working age population (15-64 years) in the developing countries is estimated to have increased, on the average, at an annual rate of 2.8%, the elderly population (60 and over) at 3% and women in the reproductive ages (15-49 years) at 2.9%. The most urgent problem for many developing countries is perhaps the continuing very rapid increase of the working age population. The aging of the population, which bears significant policy implications, is among the most salient features of population change in the world, except for Africa. Fertility rates in most developed countries continue to fluctuate at low levels. No current data on developing country rates are available. An overall improvement in mortality in most countries is noted. A high rate of urban population growth in developing countries is a tremendous problem facing these countries. International migration, social and economic implications, demographic perceptions and governmental policies are summarized. National sovereignty, human rights, cultural values and peace are stressed as important factors in population policies. Women's status is discussed as playing a role in population change.
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  14. 14

    United Nations International Conference on Population, 6-13 August 19849

    Brown GF

    Studies in Family Planning. 1984 Nov-Dec; 15(6/1):296-302.

    The international Conference on Population, held in Mexico City in August 1984, met to review past developments and to make recommendations for future implementation of the World Population Plan of Action. Despite the several ifferences of opinion, the degree of controversy was minor for an intergovernmental meeting of this size. The 147 government delegations at the Conference reached overall agreement on recommendations for future international commitment to expanding population efforts in the future. This review examines the recommendations of the Mexico Conference with regard to health, family planning, women in development, research, and realted issues. The total 88 recommendations wre intended to reaffirm and refine the World Population Plan of Action adopted in Bucharest in 1974, and to strengthen the Plan for the next decade. Substantial improvement in development was noted including fertility and mortality declines, improvements in school enrollement and literacy rates, as well as access to health services. Economic trends, however, were much less encouraging. While the global rate of population growth has declined slightly since 1974, world population has increased by 770 million during the decade, with 90% of that increase in the developing countries. Part of the controversy at the Conference focused on the remarkable change of position by the US delegation, which largely reversed the policies expressed at Bucharest. The US delegation stated that population was a neutral issue in development, that development is the primary requirement in achieving fertility decline. Several recommendations emphasized the need to integrate population and development planning, and called for increased national and international efforts toward the eradication of mass hunger, illiteracy, and unemployment; achievement of adaquate health and nutrition levels; and improvement in women's status. The need for futher development of management, training, information, education and communication was recognized. A clear call to strenghten global efforts in population policies and programs emerged.
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  15. 15

    Country statement: Ethiopia.

    [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.
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  16. 16

    Reflections on population.

    Salas RM

    New York, Pergamon, 1984. 240 p.

    This book, a sequel to "International Population Assistance: The First Decade," characterizes the work of the UN Fund for Population Activities (UNFPA) with the developing countries up to 1984, relating these experiences to the issues before the 1984 International Conference on Population. The 1st chapter provides an overview of the significant developments in population up to the 1984 International Conference on Population. The next 7 chapters discuss the following main issues before the Conference and generally reflect the arrangement of the document to be brought before the Conference concerning recommendations for further implementation of the World Population Plan of Action: fertility, status of women and the family; morbidity and mortality; population distribution, internal and international migration; population growth and structure; promotion of knowledge and implementation of policies and programs; international cooperation and the role of UNFPA; and the year 2000 and beyond. Within each of these chapters, excerpts have been arranged in an analytic order, with the aim of facilitating the flow of arguments presented. Appendices contain the 5 "State of World Population Reports" issued from 1980-84 and 7 Rafael M. Salas statements which, primarily due to their focus on the population issues of particular importance to the major regions of the globe, are reproduced in their entirety. This volume reflects the process of population policymaking of the UNFPA with the developing countries in support of their population programs in the past 15 years. These policies were sanctioned and validated, both nationally by the countries themselves and globally by UN deliberative bodies and conferences. The experience of UNFPA in policy formulation indicates that an effective population policy must have its proper time perspective and must be scientifically determined in its component elements, normative and applicable at different levels, multisectoral in its emphasis, and measurable in its impact and consequenes.
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  17. 17

    Concise report on the world population situation in 1983: conditions, trends, prospects, policies.

    United Nations. Department of International Economic and Social Affairs. Population Division

    New York, United Nations, 1984. 108 p. (Population Studies, No. 85; ST/ESA/SER.A/85)

    The 3 parts of this report on world, regional, and international developments in the field of population, present a summary of levels, trends, and prospects in mortality, fertility, nuptiality, international migration, population growth, age structure, and urbanization; consider some important issues in the interrelationships between economic, social, and demographic variables, with special emphasis on the problems of food supply and employment; and deal with the policies and perceptions of governments on population matters. The 1st part of the report is based primarily on data compiled by the UN Population Division. The 2nd part is based on information provided by the Food and Agriculture Organization of the UN (FAO) and the International Labor Organization (ILO), as well as that compiled by the Population Division. The final part is based on information in the policy data bank maintained by the Population Division, including responses to the UN Fourth Population Inquiry among Governments. In 1975-80 the expectation of life at birth for the world was estimated at 57.2 years for both sexes combined. The corresponding figure for the developed and developing regions was 71.9 and 54.7 years, respectively. In 1975-80 the birthrate of the world was estimated at 28.9/1000 population and the gross reproduction rate was 1.91. These figures reflect considerable decline from the levels attained 25 years earlier: a crude birthrate of 38/1000 population and a gross reproduction rate of 2.44. World population grew from 2504 million in 1950 to 4453 million in 1983. Of the additional 1949 million people, 1645 million, or 84%, accrued to the less developed countries. The impact of population growth on economic development and social progress is not well understood. The governments of some developing countries still officially welcome a rapid rate of population growth. Many other governments see cause for concern in the need for the large increases in social expenditure, particularly for health and education, that accompany a young and growing population. Planners are concerned that the rapidly growing supply of labor, compounded by a trend toward rapid urbanization, may exceed that which the job market is likely to absorb. In the developed regions the prospect of a declining, or an aging, population is also cause for apprehension. There is a dearth of knowledge as to the impact of policies for altering the consequences of these trends. Many policies have been tried, in both developed and developing countries, to influence population growth and distribution, but the consequences of such policies have been difficult to assess. Frequently this problem arises because their primary objectives are not demographic in character.
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  18. 18

    Must these children keep dying?

    Fraser B; Fraser S

    Australian Society. 1984 Jun 1; 3(6):27-8.

    An estimated 15 million infants, largely from Africa, Asia, and Latin America, died in 1983. Many countries in the Third World have infant mortality rates of 150-200/1000 live births. UNICEF has outlines 7 steps that could significantly reduce the infant mortality rate: 1) use of growth monitoring charts, 2) oral rehydration therapy, 3) breastfeeding for at least 1 year, 4) a massive immunization campaign, 5) food supplementation for pregnant women and children at risk, 6) a family spacing education campaign, and 7) extension of female education. 2 other measures not emphasized by UNICEF but important for the health and survival of children are a government system of welfare for the care of the aged to partially solve the need for children and the equal valuation of male and female children. Concerned Australians are urged to spread the word about the UNICEF report, provide funds, and influence the Australian government to offer help through UNICEF to developing countries. Technically qualified people can go to Third World countries and work for better conditions. It should be noted, however, that Australia has its own Third World sector. The Aboriginal population is severely disadvantaged in terms of all the major indicators of quality of life. The infant mortality rate among Aboriginals is 25/1000 live births, which is 2.5 times the Australian national average. Life expectancy at birth is 53 years, or 20 years less than the national average. 80% of Aboriginals have no educational qualifications, and 80% are unemployed. Aboriginal households have less than 60% the average income available to non-Aboriginal households and the housing of the majority of the Aboriginal population is substandard.
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  19. 19

    Country statement--Liberia.

    [Unpublished] [1984]. Presented at the Second African Population Conference, Arusha, Tanzania, January 9-13, 1984. 3 p.

    Liberia's population characteristics and dynamics are briefly decribed, the current status of population data collection is noted, and the government's population policies and programs are summarized. National censuses were conducted in 1962 and 1974 with assistance from the UN Fund for Population Activities (UNFPA), and a 3rd census is planned for February 1984. National population growth surveys were conducted in 1969 and 1972, and demographic growth surveys were undertaken in 1978 and 1979. An administrative structure for registering births and deaths was recently created, however, most births occurring outside of hospitals and clinics will not be covered. In 1973, a demographic unit was established at the University of Liberia to develop the manpower needed to upgrade population data collection procedures. According to data collected in the 1974 censuses and subsequent surveys, the birthrate is 48.6, the death rate is 17.3, and the gross reproductive rate is 3.2. the total fertility rate is 6.7, and the infant mortality rate is 110.4. Life expectancy at birth is 49.1 for males and 52.5 for females. there are 97.3 males/100 females. The proprotion of the male population under 15 years of age is 47.9%, and the respective proportion for females is 46.9%. The total population is 1.8 million. Although Liberia does not have a population policy, the government recently established a National Population Committee to formulate a national policy and to coordinate population acitivities. 3.5% of Liberia's women of childbearing age currently use family planning services provided either by the International Planned Parenthood Federation or by the government with the assistance of UNFPA and the US Agency for International Development.
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  20. 20

    The United Nations Conference on Population.

    Salas RM

    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.
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  21. 21

    Statistics on children in UNICEF countries.


    New York, UNICEF, 1984 May. 280 p.

    The data in this set of 135 country profiles for 1981 are made up from 9 major sources and cover the countries and territories with which the UN International Children's Emergency Fund (UNICEF) cooperates. In terms of infant morttality, countries are divided into 5 infant mortality groups: a very high infant mortality (a) group of countries, with a 1981 infant mortality rate (IMR) estimate of 150 (rounded) or more deaths per 1000 live births; a very high infant mortality (b) group of countries with a 1981 IMR estimate between 110 (rounded) and 140 (rounded); a high infant mortality group of a middle infant mortality group of countries, with a 1981 IMR estimate of between 26 and 50 (rounded); and a low infnat mortality group of countries, with a 1981 IMR estimate of 25 or less. For each country data are also presented on nutrition, demographic, education, and economic indicators.
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  22. 22

    Some problems in the making of population projections.

    Tabah L

    In: United Nations. Department of International Economic and Social Affairs. Population projections: methodology of the United Nations. Papers of the United Nations Ad Hoc Expert Group on Demographic Projections, United Nations Headquarters, 16-19 November 1981. New York, United Nations, 1984. 15-6. (Population Studies No. 83; ST/ESA/SER.A/83)

    As the UN demographic estimates and projections cover all the developed and developing countries, special problems are encountered in data collection and evaluations. The responsibility for the UN projections rests primarily with the Population Division, but the results are the product of collaboration by all responsible offices within the UN system. This is 1 of the strengths of the UN population projections, yet there are numerous problems concerning those projections. Aside from the perpetual difficulties with collection and estimation of basic demographic indicators from incomplete data, all of which must be continuously undertaken, there are 8 major problems which have become more important in recent years and concern the current UN demographic projections. The 1st problem is the question of meeting the needs of the users who are the researchers, the planners, and the policymakers. The 2nd problem is that significant improvement can be made in the methodologies with, on the 1 hand, the prodigious advances in calculation devices and research techniques and on the other, a better knowledge of the economic and social context of demographic variables. The 3rd major problem in the component method of projections of fertility, which continues to be the most influential component to the future population of most nations. Another component of projection, mortality, has become a pressing issue in the field of projection as well. Knowledge of mortality in the third world is highly fragmentary. The 5th problematic issue is urbanization and city growth. There are severe problems with data comparability and projection methods. Sixth, for several developing and developed countries international migration plays a significant role in their population growth. More problematic than estimating the current net numbers of migrants is formulating assumptions about future patterns of international migration. Seventh, thus far demographic projections have largely been based on the demographic theory of transition, which appears to continue to be useful for developing countries. Yet, the demographic transition models are affected by a wider variety of trajectories than anticipated. Finally, no one has been able to explain clearly the major simultaneous movements of fertility of the developed countries. The question of obvious policy significance is what will happen in the future.
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  23. 23

    Family planning and health: an evaluation.

    Pomeroy R

    Planned Parenthood Review. 1984 Spring-Summer; 4(1):9-10.

    The Planned Parenthood Federation of America supports international family planning efforts through its affiliation with the International Planned Parenthood Federation (IPPF) and the activities of its own International Division, Family Planning International Assistance (FPIA). FPIA is founded on the beliefs that family planning is a basic human right; family planning programs benefit individuals, families, communities, and nations; and family planning along with other needed socieconomic programs can have a major impact on development. Careful timing, spacing, and limiting of births is directly and causally related to improved infant and maternal survival through readily observed and easily explained mechanisms. Mothers in developing countries are anywhere from 10 to 20 or 30 times as likely to die in childbirth as mothers in developed countries. Risks are greatest for mothers under 18 years old, over 30, for those having births within 2 years of a previous birth, and 4th or later deliveries. The differences occur for women at all levels of affluence and access to medical care in all societies, but are particularly sharp in developing countries. Among the poorest countries, 200 or more of every 1000 liveborn infants may die in their 1st year compared to fewer than 10/1000 live births in some wealthy egalitarian countries. The infant mortality rate is so closely related to the overall level of well-being in a country or region that it is regarded as 1 of the most revealing measures of how well a society is meeting the needs of its people. Many of the risk factors for maternal mortality also contribute to infant mortality. Infant mortality in developing countries drops appreciably when women practice family planning and reduce the number of high risk pregnancies. Throughout the developing world, the higher risk infants born to very young or older mothers, mothers with recent previous pregnancies, and mothers with 3 or 4 previous births are 3-10 times more likely to die in their 1st year. Too short birth intervals may threaten the life of the older child through early weaning and resulting increased susceptibility to malnutrition and infection. Careful planning of births through contraception can result in a population better able to contribute economically and less likely to strain the medical resources.
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