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Report of the Expert Group Meeting on Fertility and Mortality Levels, Patterns and Trends in Africa and their Policy Implications.
In: United Nations Economic Commission for Africa [UNECA]. Population dynamics: fertility and mortality in Africa. Addis Ababa, Ethiopia, UNECA, 1981 May. 1-31. (ST/ECA/SER.A/1; UNFPA PROJ. No. RAF/78/P17)The Expert Group Meeting on Fertility and Mortality Levels, Patterns and Trends in Africa, held in Monrovia late in 1976, examined the various aspects of the interrelationships of fertility and mortality to development process and planning in Africa. Focus in this report of the Expert Group Meeting is on the following: background to fertility and mortality in Africa; usefulness and relevance of existing methodology for collecting and processing and for analyzing fertility and mortality data; fertility and mortality levels and patterns in Africa -- regional studies and country studies; fertility trends and differentials in Africa; mortality trends and differentials; biological and socio-cultural aspects of infertility and sterility; the significance of breast feeding for fertility and mortality; nutrition, disease and mortality in young children; evolution of causes of death and the use of related statistics in mortality studies in Africa; and fertility and mortality in national development. It was suggested that a strategy for development with equity must direct itself, among other things, to the issue of how to monitor progress in the elimination of underdevelopment, poverty, malnutrition, poor health, bad housing, poor education and employment through the use of indicators which measured changes in those variables at the national and local levels. In order to achieve development with equity, it was obvious that demographers and policymakers should ensure that there was regular monitoring of socioeconomic differentials in mortality and morbidity rates since such differentials essentially measured inequality in a society. The following were included among the recommendations made: recognizing that fertility and mortality data for a majority of African countries are now 20 years out of date, efforts should be directed toward collecting and analyzing fertility and mortality data by the use of both direct and indirect methods; and international and national organizations should support country efforts to improve the supply of data and analytical work on census and other existing data.
[Unpublished] 1983. Presented at the International Conference on Population, 1984, Expert Group on Fertility and Family, New Delhi, January 5-11, 1983. 22 p. (IESA/P/ICP. 1984/EG.I/8)The World Health Organization (WHO) has been studying several national surveys with regard to certain health related aspects of fertility. The primary purpose of these studies was to stimulate the use of data by the national health authorities for an improved care system for maternal and child health, including family planning. Some preliminary results are reported in this discussion, in particular those relating to contraception, the reproductive health of adolescents, infertility and subfecundity, and breastfeeding. The national surveys concerned are those of Bangladesh, Indonesia, the Republic of Korea, the Philippines, and Sri Lanka. The methods of analysis were simple and traditional, except for 2 points: some of the data had to be obtained by additional tabulation of the raw data tapes and/or the recode tapes since the standard tabulations of the First Country Reports did not include the needed information; and Correspondence Analysis was used in an effort to stimulate and facilitate the use of the findings for improvements of national health programs. Methods of contraception vary widely, from 1 country to another and by age, parity, and socioeconomic grouping. The younger women tend to choose more effective modern methods, such as oral contraception (OC); the older women, i.e., those over age 35, tend to seek sterilization, if available. It is evident that the historical development of family planning methods has greatly influenced the current "mix" of methods and so has the current supply situation and the capacity of the health care system (particularly in regard to IUD insertions and sterilizations. Use of contraception among adolescents to postpone the 1st birth was practically unknown. The risk of complications at pregnancy and childbirth, including maternal and infant death, is known to be particularly high for young mothers, and the results clearly showed that the infant mortality rate is highest for the youngest mothers. All the women who suffer from infertility do not recognize their condition, but the limited data still point to the need to consider the health needs of women who suffer from unwanted fecundity impairments. This may require medical intervention to cure infections or the offer of relevant sexual counseling. Some infecundity may require the improvement of nutritional and personal hygienic levels before meaningful achievements are made. The prevalence of breastfeeding has declined in some population groups, and the consequences can be expected to be deleterious and to involve serious increases in specific morbidity and mortality.