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[Unpublished] 1987. 13,  p.Africa's colonial legacy is such that countries contain not only a multiplicity of nations and languages, but their governments operate on separate cultural and linguistic planes, remnants of colonial heritage, so that neighboring peoples often have closed borders. Another problem is poor demographic data, although some censuses, World Fertility Surveys, Demographic Sample Surveys and Contraceptive Prevalence Surveys have been done. About 470 million lived in the region in 1984, growing at 3% yearly, ranging from 1.9% in Burkina to 4.6% in Cote d'Ivoire. Unique in Africa, women are not only having 6 to 8.1 children, but they desire even larger families: Senegalese women have 6.7 children and want 8.8. This gloomy outlook is reflected in the recent history of family planning policy. Only Ghana, Kenya and Mauritius began family planning in the 1960s, and in Kenya the policy failed, since it was begun under colonial rule. 8 countries made up the African Regional Council for IPPF in 1971. At the Bucharest Population Conference in 1974, most African representatives, intellectuals and journalists held the rigid view that population was irrelevant for development. Delegates to the Kilimanjaro conference and the Second International Conference on Population, however, did espouse the importance of family planning for health and human rights. And the Inter-Parliamentary Union of Africa accepted the role of family planning in child survival and women's status. At the meeting in Mexico in 1984, 12 African nations joined the consensus of many developing countries that rapid population growth has adverse short-term implications on development. Another 11 countries allow family planning for health and human rights, and a few more accept it without stating a reason. Only 3 of 47 Sub-Saharan nations state pro-natalist policies, and none are actively against family planning.
Social Science and Medicine. 1985; 21(1):41-53.This paper explores the emergence of an international fad aiding and monitoring community participation efforts and projects its future outcome based on lessons from previous experiences in other than the health sector. The analysis suggests that the promotion of community participation was based in all cases on 2 false assumptions. 1) The value system of the peasantry and of the poor urban dwellers had been misunderstood by academicians and experts, particularly by US social scientists, who believed that the traditional values of the poor were the main obstacle for social development and for health improvement. However, the precolumbian forms of organization that traditional societies had been able to maintain throughout the centuries were not only compatible with development but had many of the characteristics of modernity: the tequio guelagetza minga and even the cargo system stress collective work, cooperation, communal land ownership and egalitarianism. 2) Another misjudgement was the claim that the peasantry was disorganized and incapable of effective collective action. In Latin America historical facts do not support this contention. A few examples from more recent history show the responsiveness and organizational capabilities of rural populations. The Peasant Leagues in Northeastern Brazil under the leadership of Juliao is perhaps 1 of the best known example. The question is thus raised as to why international and foreign assistance continues to pressure and finance programs for community organization and/or participation. It is suggested that the experience in Latin America (except perhaps Cuba and Nicaragua) indicates that community participation has produced additional exploitation of the poor by extracting free labor, that it has contributed to the cultural deprivation of the poor, and has contributed to political violence by the ousting and suppression of leaders and the destruction of grassroots organizations. Information presented on community participation in health programs in Latin America illustrates that they have followed closely the ideology and steps of community participation in other sectors. A country by country examination indicates that health participation programs in Latin America in spite of promotional efforts by international agencies, have not succeeded. The real international motivation for participation programs was the need to legitimeize political systems compatible with US political values. Through symbolic participation, international agencies had in mind the legitimation of low quality care for the poor, also known as primary health care and the generation of much needed support from the masses for the liberal democracies and authoritatrian regimes of the region. Primary health care delivery can be successful without community participation, in contradiction to what international agencies and governments maintain.
New York, New York, United Nations, 1985. 52 p. (ST/ESA/SER.E/39)This monograph presents an overview of the content and direction of courses designed to prepare planning coordinators of developing nations to approach population and development policy making in a richly informed interdisciplinary manner. The conceptual framework for such a curriculum is presented 1st in a theoretical section on the links between the key concepts of population and development. Next, recommendations on curriculum design emphasize 2 main lines of focus: 1) understanding the cultural context in which developmental planning takes place; 2) exploring the available means of action in terms of strategies corresponding to explicit transitional goals in relation to the identified context. The emphasis, rather than on specific technical expertise, should be on providing information on the range of tools available for use in the field at a later stage. The 3rd section involves course orientation; the aim is to turn out planning coordinators capable of formulating integrated population policies. The curriculum should be geared to occupational groups, including senior management, middle-level staff, educators and researchers, and executing agents. Section 4 covers course admission requirements, criteria for teachers and locations. Section 5 presents recommendations for subject matter, presenting a 2 year curriculum, each year divided into 4 modules: 1) knowledge of the context; 2) the population component; 3) the instruments of change, involving developmental economics and planning; and 4) techniques of analysis, systems analysis, econometrics, forecasting and more. An outline of the curriculum detailing topics, course length, and general and specific goals for each course follows. A bibliography covering general works, works on economics, sociology, anthropology and systems concludes the document.
In: United Nations. Department of International Economic and Social Affairs. Population Division. Fertility and family. New York, New York, United Nations, 1984. 107-23. (International Conference on Population, 1984; Statements)The Expert Group Meeting on Fertility and Family was assinged the identification of those areas in current scientific knowledge and concerns regarding fertility and family that were of greatest salience for policy formulation and implementation. Particular attention was to be paid to shifts that had occurred since the 1974 World Population Conference in Bucharest. This article is mainly an overview of the work of the Group and is organized around 3 main themes: 1) advances in knowledge of fertility levels and trends; 2) advances in understanding the relations between development, fertility and the family; 3)theoretical advances and practical experience with regard to policy formulation and implementation. 1) Knowledge of existing patterns of fertility and their composition has increased markedly over the last decade as a result of more data, better estimation techniques for measuring fertility levels and of new approaches to studying the reporductive process and family formation (e.g., the development of analytical models that allow quantification of the role of the various proximate determinants of fertility). A far-reaching realization is that proximate determinants of fertility may respond to the same set of factors but their responses may exhibit different elasticities. 2) In the understanding the relations between development, fertility and family, 2 main areas of concern can be identified. He level and type of analyses to date, especially the empirical ones, have been carried out at the micro-level, focusing on the individual decision maker. Although such models are advances over earlier ones developed largely from classical demographic transition theory, yet, their use has not been entirely satisfying because of the common failure to adequately specify the concepts involved and/or to substitute for them broad socioeconomic indicators in empirical work. In addition, institutional supports for and interrelations with particular patterns of fertility and family have been neglected, resulting, theoretical and practical impoverishment. The 2nd area of concern is the identification of those dimensions of family structure and function that are most intimately interlocked with modernization and fertility change. The discussion focuses on the interplay between modernization, the relationship between the generations, and between the sexes. Finally, there is an increasing awareness that a number of aspirations regarding fertility and family may be contradictory with respect to general advances in policcy formulation and implementation. 4 important trends can be discerned: 1) assessment of the potential utility and effectiveness of policy and programmatic efforts; 2) trends in the definition of desirable goals; 3) new directions in terms of the institutiona means for achieving these goals; and 4) shifts in the perception of the individual's freedom of choice.
New England Journal of Medicine. 1983 Fall; 61(4):659-86.In this examination of Saudi Arabia's health care accomplishments, it is argued that the World Health Organization's primary health care model is not the most appropriate for Saudi Arabia and countries like it. Saudi Arabia's health care policy is closely linked to its very rapid emergence as a new and distinctive society. Whereas most developing countries export physicians, Saudi Arabia imports them because the demand for physicians services cannot be met by the supply of indigenous physicians. Saudi health care development is very different from that of most of the third world. Although the country does have a great deal of western technology, Saudi Arabia seems to be following a different course of development from both the third world and the West. Unlike the West, the cost of medial technolgoy is not a problem for Saudi Arabia. Rather, it solves the problem of how to allocate its oil wealth to maintain political stability. The Saudis intend to make the best health care available to all its citizens; they are very concerned about the effect of modern technology on tradition. Therefore, the selection of technology is based on its cultural compatability, rather than on its costs. Primary care may be more technological and specialized than in the West. In Saudi Arabia primary health care may eventually be delivered entirely by specialists, rather than by general or family practitioners. The Saudis are expected to develop a health care system that will meet their particular needs. As with Saudi Arabia itself, health care is experiencing unprecedented change. Thus, the emerging Saudi system will be unique and innovative. Some of its accomplishments will be adopted by other developing countries; Western countries may look to Saudi Arabia as a natural laboratory of health care experimentation.
In: D'Souza AA, de Souza A, ed. Population growth and human development. New Delhi, India, Indian Social Institute, 1974. 27-31.The actions undertaken by UNFPA on population matters have been guided by 3 basic principles. 1st is the emphasis on the right of the individual to have access to knowledge and facilities on the basis of which he/she could decide freely on the family size and child spacing. 2ndly, population has always been viewed by the UN in the larger context of development. 3rdly, the responsibility for action on population questions is considered to be within the sovereign domain of national governments. The increasing involvement of national governments in population activities and the increasing role of the UN system in providing assistance for such programs led to the designation of World Population Year in 1974. The Year provides an opportunity for increasing the awareness and understanding of population questions among people around the world. Community groups have an important role to play in promoting awareness and understanding of the population question among people everywhere. The community accepts ideas more easily if they can be shown to have already acquired a degree of social acceptability. The population question touches the standards of moral and ethical behavior in a personal way. If it can be shown that the new patterns of family life are related in a significant way to well established norms of ethical behavior, it will be so much easier for individuals to follow new patterns of behavior. The role of education in promoting and deepening awareness of population issues should be included in the development of population information.
New York, UN, 1981. 35 p. (ST/ESA/SER.R/43)This report proposes a 1st step towards systematizing the interaction between population and development by using a technique referred to as "mapping" or a matrix of interactions. This technique appears to have a variety of applications for research and planning. Included in the interaction matrix are variables concerning the objectives of development (15 variables), population (10), economic factors (14), instruments (6: education, health care, international aid and capital flow), and sociocultural and exogenous factors (14). A major advantage of the "systems" orientation of this technique is that it encourages endogenization. For example, migration for a given region directly raises or lowers population density, even as the latter affects the propensities to migrate into or out of the same region. Another important feature of the matrix is that it permits the tracing of sequences of linkages between variables. The uses of a systems approach to mapping population-development include: 1) it gives a substantial checklist of factors affecting interrelationships, 2) it lends itself to use as a planning tool for integrating population programs with other development activities, 3) it can help in selecting preformed sets of statistical indicators for complex questions, 4) summaries and comparative analysis can be enriched when placed into a mapping context, 5) areas of similarity and dissimilarity in different research programs can be identified, 6) the mapping context can assist statistical and simulations modules, and 7) the content of a mapping framework could be expanded to embrace larger sets of categories.
Integrating population programmes, statement made at 10th Asian Parasite Control Organization Family Planning Conference, Tokyo, Japan, 5 September 1983.
New York, N.Y., UNFPA, . 6 p. (Speech Series No. 95)The relationship between the Japanese Organization for International Cooperation in Family Planning (JOICFP) and UNFPA has been a vital force in the integration of family planning programs with nutrition and health services. The success of the integrated programs is evidenced by its rapid expansion from a pilot project in 1975 to projects in many countries in Asia, the Pacific and Latin America. The programs are efficient and effective in delivery of family planning services, as well as in linking and integrating these family planning services with other social and development programs. The programs have been designed to meet the needs of the people at the village level, taking into account their cultural sensitivities. This approach has encouraged acceptance and cooperation by the local communities and has made the program credible to the villagers. In fact, this seems to be the key to effective implementation of any type of development project. The coming 1984 International Conference on Popultion is also discussed. It is hoped that the present meeting will produce policy and operational suggestions which can be discussed at the International Conference.