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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.
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.
[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.
Paris, France, Organisation for Economic Co-operation and Development [OECD], 1988. 90 p. (Demographic Change and Public Policy)This is the first in a planned series of volumes published by the Organisation for Economic Co-operation and Development (OECD) concerning the economic and social consequences of demographic aging in OECD member countries. "This detailed statistical analysis of demographic trends in the 24 OECD countries examines the implications for public expenditure on education, health care, pensions and other social areas, and discusses the policy choices facing governments." Data are from official sources. (EXCERPT)
[Unpublished] 1986. Presented at the All-Africa Parliamentary Conference on Population and Development, Harare, Zimbabwe, May 12-16, 1986. 7 p.The Second African Conference on Population and Development, held early in 1984, marked a decisive stage in African thinking about population. During the 12 years between the 1972 and 1984 conferences, African nations learned in detail about their demographic situation and confronted the ever-increasing costs of development and their lack of physical and administrative infrastructure. In the midst of these and other concerns came the drought, which for over a decade in some parts of the continent has reduced rainfall, dried up rivers, lakes, and wells, and forced millions into flight. It is in this context that population became an African issue. African countries on the whole are not densely populated nor do they yet have very large concentrations in cities. Yet, population emerges as more than a matter of numbers, and there are features which give governments cause for concern. First, the population of most African countries, and of the continent as a whole, is growing rapidly and could double itself in under 25 years. Second, mortality among mothers and children is very high. Third, life expectancy generally is lower in African than in other developing countries. Fourth, urbanization is sufficiently rapid to put more than half of Africa in cities by 2020 and 1/3 of the urban population in giant cities of over 4 million people. The 1984 conference recognized these and other uncomfortable facts and their implications for the future, and agreed that attention to population was an essential part of African development strategy. Strategy is considered in terms of the 4 issues mentioned. First, high rates of growth are not in themselves a problem, but they mean a very high proportion of dependent children in the population. About 45% of Africa's population is under age 14 and will remain at this level until the early years of the 21st century. Meeting the needs of so many children and young adults taxes the ability of every African nation, regardless of how rapidly its economy may expand. Understanding this, a growing number of African leaders call for slower growth in order to achieve a balance in the future between population and the resources available for development. Reducing mortality requires innovation. Among the new approaches to health care are the use of traditional medicine and practitioners in conjunction with modern science and the mobilization of community groups for preventive care and self-help. Health care and better nutrition also are keys to improvement in life expectancy and call for ingenuity and innovation on the part of African governments and communities. Part of the solution to the impending urban crisis must be attention to the viability of the rural sector. The role of the UN Fund for Population Activities in addressing the identified issues is reviewed.
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.
Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.
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.
New York, UNFPA, 1985 Mar. viii, 68 p. (Report No. 70)The UN Fund for Population Activities (UNFPA) is in the process of an extensive programming exercise intended to respond to the needs for population assistance in a priority group of developing countries. This report presents the findings of the Mission that visited Burma from May 9-25, 1984. The report includes dat a highlights; a summary and recommendations for population assistance; the national setting; population policies and population and development planning; data collection, analysis, and demographic training and research;maternal and child health, including child spacing; population education in the in-school and out-of school sectors; women, population, and development; and external assistance -- multilateral assistance, bilateral assistance, and assistance from nongovernmental organizations. In Burma overpopulation is not a concern. Population activities are directed, rather, toward the improvement of health standards. The main thrust of government efforts is to reduce infant mortality and morbidity, promote child spacing, improve medical services in rural areas, and generally raise standards of public health. In drafting its recommendations, whether referring to current programs and activities or to new areas of concern, the Mission was guided by the government's policies and objectives in the field of population. Recommendations include: senior planning officials should visit population and development planning offices in other countries to observe program organization and implementation; continued support should be given to ensure the successful completion of the tabulation and analysis of the 1983 Population Census; the People's Health Plan II (1982-86) should be strengthened through the training of health personnel at all levels, in in-school, in-service, and out-of-country programs; and the need exists to establish a program of orientation to train administrators, trainers/educators, and key field staff of the Department of Health and the Department of Cooperatives in various aspects of population communication work.
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.
[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.