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Washington, D.C., World Bank, 1997. xi, 118 p. (World Bank Discussion Paper No. 356)In order to begin the process of assessing the effectiveness of the World Bank's work in the health, nutrition, and population sector (which has involved loans of nearly US$10 million in 89 countries since 1970), this report reviews this work and presents an assessment strategy. The introductory chapter is followed by a literature review on determinants of trends in fertility and mortality conducted to aid identification of evaluation benchmarks. Chapter 3 covers the tools and methods used to evaluate population and health policies, beginning with the methodology used to assess the effectiveness of family planning programs and moving on to broader considerations of health policy and program evaluation, cost benefit analyses, and service delivery evaluation. The fourth chapter sketches the World Bank's involvement in the health, nutrition, and population sector and summarizes the results of previous reviews of the World Bank's experience in this area. Chapter 5 presents an evaluation framework for assessing the World Bank's effectiveness in influencing the demand responsiveness of service delivery structures and institutional capacity in borrower settings as well as development effectiveness in terms of: 1) clinical/epidemiological effectiveness, 2) accessibility and equity, 3) quality and consumer satisfaction, and 4) economic efficiency. The proposed evaluation will provide a cross-country analysis of the World Bank's entire lending portfolio in this sector as well as country sector impact studies.
In: Quantitative approaches to analyzing socioeconomic determinants of Third World fertility trends: reviews of the literature. Project final report: overview, by Indiana University Fertility Determinants Group, George J. Stolnitz, director. [Unpublished] 1984. 79-91.Simple no-work/work distinctions are an unreliable basis for estimating causal linkages connecting female employment/work-status patterns to fertility. World Fertility Survey (WFS) data show about 3/4, 1/2, and 1/4 child differentials for over 20, 10-19, and under 10 years marital duration grouss respectively, for women employed since marriage. Effects on marriage seem strongest in Latin America and weakest in Asia. Controlling for age, marital duration, urban-rural residence, education, and husband's work status. But from the results of a number of WFS and other studies, it seems relationships of work status and fertility are difficult to confirm beyond directional indications, even in Latin America. A UN study using proximate determinants such as contraception and work status including a housework category indicated differentials in contraceptive practice were not significant net of control for education. Philippine data indicates low-income employment might increase fertility by decreasing breastfeeding, while WFS data from 5 Asian countries indicated pre-marital work encourages increased marriage age, without being specific about effects. Also, female employment must affect a large population to have a real impact on aggregate fertility, since female labor force activity is likely to change slowly if at all. Data presently available do not cover micro-level factors that may be important, such as effects of work on breastfeeding, nor do they lend themselves to examination by multi-equation analysis. More work is needed to isolate effects of work-status attributes like male employment, and to analyze intra-cohort mid-course fertility objective changes, as well as new theoretical process models such as competing time use and maternal role incompatibility.
In: United Nations. Department of International Economic and Social Affairs. Population Division. Fertility and familiy. New York, New York, United Nations, 1984. 321-51. (International Conference on Population, 1984; Statements)This paper presents a conceptual model indicating some of the established and hypothesized links between a number of labor laws and policies, in particular International Labor Organization (ILO) conventions, divisions of labor and resources by sex and age, familial roles and fertility. Brielfy outlined are the content and goals of some of the ILO conventions and programms that have a bearing on the conditions widely thought to be related to fertility decline. These include improved status of relatively deprive groups, such as women and children, and individual access to training, employment and incomes. These changes are viewed in terms of their potential impact on family relations, including changing parental roles and costs of bearing and raising children in view of the impact of diminishing child labor, and the increasing availability of social security benefits. Another aspect is sexual equality, in particular the impact of equality in the occupational sphere on equality in the domestic sphere and the consequent effects on reproduction. In addition, the impacts of social and spatial mobility are indicated and the potential effects on role conflicts, individualism and lower fertility. A thrust of the paper is to emphasize the critical intervening nature of changing familial roles, which have been neglected, both in labor reports and related activities as well as in the documentation and policy-making related to fertility. Micro-evidence from a variety of cultural contexts shows how changes and differences in allocations of tasks and resources and status benefits between kin, parents and offspring, wives and husbands are associated with changes and differences in fertility-related aspirations and patterns of regulation. Finally, the discussion serves to underline the pervasive and profound nature of the potential impacts of divisions of labor and employment policies on fertility levels, demonstrating that changes in familial roles and relations are central to this process of linkage. Thus, the need is made apparent for more knowledge and understanding of the dynamics of change in this area at the micro-level and in a variety of cultural areas, if government policies and programms are to achieve their specific goals with respect both to employment and demographic policies.