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In: Comparative perspectives on fertility transition in South Asia. Based on the seminar organized by the Committee on Fertility and Family Planning of the International Union for the Scientific Study of Population (IUSSP) and the Population Council, Islamabad, Rawalpindi / Islamabad, 17-19 December 1996. Papers. Volume II. Liege, Belgium, International Union for the Scientific Study of Population [IUSSP], . 18 p.The International Conference on Population and Development held in Cairo in September 1994 was one of the most important events in the field of population. A shift in policy was adopted from a societal welfare rationale for population control to an individual needs rationale for the provision of family planning services and reproductive health services in order to satisfy the unmet need. The history of the Indian population policy starts in 1951 when such a policy was announced. In 40 years the crude birth rate fell from 44/1000 population in 1951 to under 30/1000 in 1991. The total fertility rate (TFR) of 5.95 in 1972 decreased to 3.4 by 1991. Nevertheless, the fertility decline has been modest compared to the achievement of Bangladesh in a much shorter period of time. In 1993 the health and family welfare programs were placed under the control of the local governments in tandem with economic liberalization measures. Foreign population assistance has increased recently. USAID chose the state of Uttar Pradesh for a large-scale population project in 1994 which is scheduled to run for 10 years. The Family Welfare Program has supplied contraceptives through the government's program: 79% of users of modern methods obtained them publicly in 1992-93. Information, education, and communication activities are also undertaken and demand for contraceptives is encouraged by other promotional activities. While population control has been endorsed by leading scientists, scholars, and policy makers, the exact means of achieving fertility decline has been neglected. Despite this India is clearly in the middle of a fertility transition. There is a disjunction between the public and private receptiveness to contraception, as Indian society sees contraceptive use as a favor done for the government. Because of the legacy of emergency excesses there is still distrust of the family planning program among people. The challenge is to regain legitimacy and stem bureaucratic expansion when delivering services.
JOICFP NEWS. 1994 Jun; (240):6.In this interview (April 21) with Yoshio Koike, United Nations Population Fund (UNFPA) country director, the population situation in Sierra Leone is described. 4.5 million persons inhabit an area of 74,000 sq. km. Independence was achieved in 1961, but the country was under the patronage of the United Kingdom until April 1992 when a military coup occurred. The new leaders are young (22-29 years) and enthusiastic; a democratic general election will be held in 1996 and the municipal assembly election will occur in 1995. Sierra Leone was the ninth African country receiving aid from UNFPA to establish a population policy (1989). A National Population Commission, which has remained dormant, was also established. The population growth rate is 2.4% annually (average for west African countries); the total fertility rate is 6.8. The maternal mortality rate is estimated to be 1400-1700/100,000 live births. The infant mortality rate (IMR) is about 180; for those under 5 years of age, it is 275. Although the country has 470 clinics available on paper, only 25% are operational according to UNFPA. This is the third year of the MCH/FP project, but only 76 clinics provide family planning information and services. Through coordination of nongovernmental and governmental efforts, 20,000 newcomers and acceptors are being recruited for family planning annually. If expansion continues at this rate and repeaters are maintained for 5 years, the contraceptive prevalence rate (CPR) should reach 20%. Currently, it is 2% in rural areas and 9% in cities. The national average is about 4-6%. The CPR should approach the goal of 60% in 10 years. There is no serious objection to family planning on the basis of religion; however, people are not informed about the importance of birth spacing and about where they can obtain services. Information, education, and communication (IEC) activities are being improved.
IPPF / WHR FORUM. 1993 May; 9(1):20-1.The Dominican Association for Family Welfare (PROFAMILIA), an affiliate of IPPF, was the first organization to provide family planning services in the Dominican Republic. In 1966, the time of PROFAMILIA's creation, the total fertility rate (TFR) was 7.5. Shortly after PROFAMILIA's inception, the TFR began its steady decline. The 1991 Demographic and Health Survey (ENDESA-91) shows that the TFR has fallen to 3.3. PROFAMILIA persuaded the Dominican Republic's government to provide full-scale family planning services. In 1968 the government set up the National Council on Population and the Family (CONAPOFA) within the Ministry of Public Health and Social Services to provide family planning services. It now provides family planning services through more than 500 health centers. The Dominican Family Planning Association, set up in 1986, provides family planning services in the Federal District and the easternmost provinces. These family planning organizations have reduced the unmet demand for family planning in the Dominican Republic to 17%, essentially the same levels as in developed countries. Even though mean family size is 3.3, ideal family size is 2, indicating a trend toward smaller families. The adolescent pregnancy rate is 13% in urban areas and 27% in rural areas. 13.3% of adolescents in a union use modern contraceptives, while only 3% of those not in a union do. 25.4% of women of childbearing age, 38.5% of women in a union, and 65.4% of 40-44 year old women depend on sterilization. Only women less than 29 years old significantly use oral contraceptives. The family planning programs need to expand family planning messages to adolescents, particularly those not in a union. PROFAMILIA still implements new approaches to expand services, such as health promotion via community-based services. CONAPOFA has since implemented such a program. ENDESA-91 demonstrates what can be accomplished when an effective government family planning program and a private organization work together.
INTEGRATION. 1992 Aug; (33):2-3.Asia's population accounts for about 60% of world population, and it will grow from 3.1 billion in 1990 to 3.7 billion in 2000. Europe's population of 490 million is not expected to change significantly by 2000. The average total fertility rate (TFR) in Asia in 1991 is estimated to be 3.3. Yemen has the highest TFR (7.4). In 2010 the Asian population will number 4.19 billion, and in 2925 it will further increase to 4.97 billion. Family planning (FP) in Indonesia, Thailand, Japan, China, and in the newly industrialized economies of Hong Kong, Singapore, Taiwan, and Korea have been successful. The fertility rate has dropped to 3.0 in Indonesia and 2.2 in Thailand. The rate of growth has also diminished in India from 2.22% during 1971-82 to 2.11% during 1981-91. The Philippines has adopted the maternal child health (MCH) approach to promote FP. The Integrated Family Planning Project in China has generated a community-based FP/MCH movement by increasing the confidence of the populace especially in rural areas. The UN agencies, bilateral agencies, and international non-governmental organizations based in developed countries have provided family planning assistance in Asia. The National Family Planning Coordinating Board (BKKBN) of Indonesia is sharing its family planning experience with Bangladesh, Nigeria, and Tanzania. BKKBN also signed a memorandum of understanding on cooperation in FP with its Vietnamese counterpart in April 1992. Such technical cooperation will be more effective if UN agencies and donors from developed countries provide financial support.
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.