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A review of population, reproductive health, and adolescent health and development in poverty reduction strategies.
Washington, D.C., World Bank, Health, Nutrition and Population Central Unit, Population and Reproductive Health Cluster, 2004 Aug.  p.This review examines how poverty reduction strategies are addressing population (Pop), reproductive health (RH), and adolescent health and development (AHD) issues. We analyzed twenty-one Poverty Reduction Strategy Papers (PRSPs) and associated documents, and conducted interviews with Health, Nutrition, and Population (HNP) staff at the World Bank involved in the poverty reduction strategy process. Based on this review, we recommend actions that the Bank, other donors, government counterparts, and civil society groups can take to better support countries to address Pop/RH/AHD issues in their poverty reduction efforts. Population, reproductive health, and adolescent health and development issues are closely interrelated in cause, consequence and policy implications. To maintain a stronger focus on these three issues, we chose not to analyze related concerns such as gender, nutrition, and education -- all essential components of the multisectoral approach advocated by the Cairo Programme of Action (ICPD, 1994). Other reviews have examined these related issues in greater depth. This paper complements a growing body of work reviewing the application of the PRS framework to poverty alleviation in low-income countries. Compared to previous health and related sector reviews, it provides a more in-depth look at Pop/RH/AHD issues, examines documents related to the PRSP such as the JSA and CAS, and incorporates interviews of key actors with Pop/RH/AHD expertise involved in the PRS process. This review is meant to complement findings from other reviews of the PRS process that focus on broader issues of relevance to all sectors. Our analysis relied on several of these relevant internal and external reviews, including in-depth reviews of gender, the health sector, nutrition, and population and development issues. (Excerpt)
Oxford, United Kingdom, Oxfam International, 2009 Feb. 55 p. (Oxfam Briefing Paper No. 125)'The realization of the right to health for millions of people in poor countries depends upon a massive increase in health services to achieve universal and equitable access. A growing number of international donors are promoting an expansion of private-sector health-care delivery to fulfil this goal. The private sector can play a role in health care. But this paper shows there is an urgent need to reassess the arguments used in favor of scaling-up private-sector provision in poor countries. The evidence shows that prioritizing this approach is extremely unlikely to deliver health for poor people. Governments and rich country donors must strengthen state capacities to regulate and focus on the rapid expansion of free publicly provided health care, a proven way to save millions of lives worldwide. (Excerpt)
Lancet. 2007 Nov 10; 370(9599):1653-1663.Vital statistics generated through civil registration systems are the major source of continuous monitoring of births and deaths over time. The usefulness of vital statistics depends on their quality. In the second paper in this Series we propose a comprehensive and practical framework for assessment of the quality of vital statistics. With use of routine reports to the UN and cause-of-death data reported to WHO, we review the present situation and past trends of vital statistics in the world and note little improvement in worldwide availability of general vital statistics or cause-of-death statistics. Only a few developing countries have been able to improve their civil registration and vital statistics systems in the past 50 years. International efforts to improve comparability of vital statistics seem to be effective, and there is reasonable progress in collection and publication of data. However, worldwide efforts to improve data have been limited to sporadic and short-term measures. We conclude that countries and developmental partners have not recognised that civil registration systems are a priority. (author's)
Deaths and disease burden by cause: global burden of disease estimates for 2001 by World Bank country groups. Revised.
[Washington, D.C.], World Bank, Disease Control Priorities Project, 2005 Jan.  p. (Disease Control Priorities Project Working Paper No. 18)The World Health Organization has undertaken a new assessment of the GBD for the year 2000 and subsequent years. The three goals articulated for the GBD 1990 (8) remain central: to decouple epidemiological assessment of the magnitude of health problems from advocacy by interest groups of particular health policies or interventions; to include in international health policy debates information on non-fatal health outcomes along with information on mortality; and to undertake the quantification of health problems in time-based units that can also be used in economic appraisal. The specific objectives for GBD 2000 are similar to the original objectives: to quantify the burden of premature mortality and disability by age, sex, and region for 135 major causes or groups of causes; to develop internally consistent estimates of the incidence, prevalence, duration, and case-fatality for over 500 sequelae resulting from the above causes; to describe and value the health states associated with these sequelaeof diseases and injuries; to analyze the contribution to this burden of major physiological, behavioral, and social risk factors by age, sex and region; to develop alternative projection scenarios of mortality and non-fatal health outcomes over the next 30 years, disaggregated by cause, age, sex and region. (excerpt)
New York, New York, United Nations, Department of Economic and Social Affairs, Population Division, 2005. 57 p. (ST/ESA/SER.A/248)Part one of this report provides a global overview of demographic trends for major areas and selected countries. It reviews major population trends relating to population size and growth, urbanization and city growth, population ageing, fertility and contraception, mortality, including HIV/AIDS, and international migration. In addition, a section on population policies has been included, in which the concerns and responses of Governments to the major population trends are summarized. The outcomes of the United Nations conferences convened during the 1990s set an ambitious development agenda reaffirmed by the United Nations Millennium Declaration in September 2000. The 1994 International Conference on Population and Development, being one of the major United Nations conferences of the decade, addressed all population aspects relevant for development and provided in its Programme of Action a comprehensive set of measures to achieve the development objectives identified. Given the crucial importance of population factors for development, the full implementation of the Programme of Action and the key actions for its further implementation will significantly contribute to the achievement of the universally agreed development goals, including those in the Millennium Declaration. Part two discusses the relevance that particular actions contained in those documents have for the attainment of universally agreed development goals, including the Millennium Development Goals. It also describes the key population trends relevant for development and the human rights basis that underpins key conference objectives and recommendations for action. (excerpt)
Vietnam Population News. 2007 Apr-Jun; (43):3-6.On 5 May 2007, Madame Le Thi Thu, Minister-Chair-woman of VCPFC, and heads of ministries and sectors warmly welcomed Ms. Ann M. Veneman, UNICEF's Executive Director. At the meeting, Madame Thu gave a brief on Viet Nam's achievements in child care, education and protection during the past few years and future work orientation. Children's living standards have been unceasingly improved, children's rights have been step by step met in terms of physical, intellectual, spiritual and morality. She hoped to receive the efficient support of UNICEF. Ms. Ann M. Veneman is impressed by Viet Nam's achievements. She said that UNICEF would have focus to HIV/AIDS, childhood injury, and under-five underweight. She recommended Viet Nam to pay more attention to causes of those issues, especially setting up databases and provide data/indicators that can be compared with other countries in the region. During her visit, Ms. Ann M. Veneman also met with Government officials to discuss about related matters. She said Viet Nam is likely to be one of the countries to reach the Millennium Development Goal (MDG) targets, with some of these targets ahead of 2015. Despite the significant progress achieved, there remain challenges, such as disparity between the rich and poor, impacts of HIV on children and protecting children from injury and harm. (excerpt)
New York, New York, United Nations, 2007.  p. (ESA/P/WP.202)The 2006 Revision is the twentieth round of official United Nations population estimates and projections prepared by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. These are used throughout the United Nations system as the basis for activities requiring population information. The 2006 Revision builds on the 2004 Revision and incorporates both the results of the 2000 round of national population censuses and of recent specialized surveys carried around the world. These sources provide both demographic and other information to assess the progress made in achieving the internationally agreed development goals, including the Millennium Development Goals (MDGs). The comprehensive review of past worldwide demographic trends and future prospects presented in the 2006 Revision provides the population basis for the assessment of those goals. According to the 2006 Revision, the world population will likely increase by 2.5 billion over the next 43years, passing from the current 6.7 billion to 9.2 billion in 2050. This increase is equivalent to the size the world population had in 1950 and it will be absorbed mostly by the less developed regions, whose population is projected to rise from 5.4 billion in 2007 to 7.9 billion in 2050. In contrast, the population of the more developed regions is expected to remain largely unchanged at 1.2 billion and would have declined were it not for the projected net migration from developing to developed countries, which is expected to average 2.3 million persons annually. (excerpt)
Population and Societies. 2005 Jan; (408):1-4.The United Nations has just published projections of the world population until 2300. The population is expected to increase for fifty years then stabilize… or explode or implode, depending on whether fertility remains durably above or below replacement level. But how much value should we place on projections so far into the future? François Héran explains that this exercise in demography-fiction is useful if it teaches us how to avoid the disaster scenarios of population explosion or implosion. (excerpt)
Lancet. 2007 Feb 3; 369(9559):354-355.Return of the Population Growth Factor: its impact on the Millennium Development Goals, a report of hearings held in the UK Parliament in 2006, focuses on the devastating impact of population growth on the Millennium Development Goals (MDGs). The report was released on Jan 31. The Inquiry Chairman, Richard Ottaway, Member of Parliament (MP), concludes: "The evidence is overwhelming: the MDGs are difficult or impossible to achieve with the current levels of population growth in the least developed countries and regions." Experts from around the world who testified to the hearings described the beneficial effects of slowing rapid population growth, as did Cleland and colleagues recently in The Lancet. Slower population growth permits greater investment in education and health, helping to lift nations out of poverty (MDG 1). By contrast, high birth rates in sub-Saharan Africa have helped increase the number living in extreme poverty from 231 million in 1990 to 318 million in 2001. In Ethiopia, 8 million people already live on permanent food aid, and the projected population growth from 75 million today to 145 million in 2050 presents an insurmountable challenge. Rapid population growth has a detrimental effect on the hope of achieving universal primary education by 2015 (MDG 2). (excerpt)
PLoS Medicine. 2006 Apr; 3(4):e211.One of the most unsettling images for newcomers to many parts of Africa is the sight of undernourished women bearing unfeasibly large vessels of water long distances over rough terrain to supply the needs of their families. A sense of outrage that anyone should have to live like this in the 21st century forms the basis of the humanitarian imperative that drives development programs, especially those that focus on basic needs such as access to safe water. When such a program reduces from three hours to 15 minutes the time that women spend fetching water each day, surely it can be described as a success, without the need for any "scientific" assessment of what has been achieved? In this issue of PLoS Medicine, we publish a study that did assess such a program. Mhairi Gibson and Ruth Mace (DOI: 10.1371/journal. pmed.0030087)--from the University of Bristol, United Kingdom--compared villages in Ethiopia that benefited from a tapped water supply with other villages that did not. Outcome measures included the nutritional status of women and children, mortality rates, and birth rates. There were a number of surprising findings, most notably the large increase in birthrate in the villages where the water supply intervention took place. (excerpt)
Toxicology. 2004 May 20; 198(1-3):39-44.The United States Public Health Service set an interim standard of 50 mg/l in 1942, but as early as 1962 the US Public Health Service had identified 10 mg/l as a goal which later became the World Health Organization Guideline for drinking water in 1992. Epidemiological studies have shown that about one in 10 people drinking water containing 500 mg/l of arsenic over many years may die from internal cancers attributable to arsenic, with lung cancer being the surprising main contributor. A prudent public health response is to reduce the permissible drinking water arsenic concentrations. However, the appropriate regulatory response in those developing countries with large populations with much higher concentrations of arsenic in drinking water, often exceeding 100 mg/l, is more complex. Malnutrition may increase risks from arsenic. There is mounting evidence that smoking and arsenic act synergistically in causing lung cancer, and smoking raises issues of public health priorities in developing countries that face massive mortality from this product. Also, setting stringent drinking water standards will impede short term solutions such as shallow dugwells. Developing countries with large populations exposed to arsenic in water might reasonably be advised to keep their arsenic drinking water standards at 50 mg/l. (author's)
Population and Development Review. 2006; 32 Suppl:1-51.By the end of the twentieth century, although expansion of population numbers in the developing world still had far to run, the pace had greatly slowed: widespread declines in birth rates had taken place and looked set to continue. To what degree population policies played a significant role in this epochal transformation of demographic regimes remains a matter of conjecture and controversy. It seems likely that future observers will be impressed by the essential similarities in the path to demographic modernity that successive countries have taken in the last few centuries, rather than discerning a demographic exceptionalism in the most recent period--with achievement of the latter credited to deliberate policy design. But that eventual judgment, whatever it may be, needs to be based on an understanding of how demographic change over the last half-century has been perceived and the responses it has elicited--an exercise in political demography. Such an exercise, inevitably tentative given the recency of the events, is essayed in this chapter. (excerpt)
Emerging Infectious Diseases. 2006 Jul; 12(7):1058-1065.The new International Health Regulations adopted by the World Health Assembly in May 2005 (IHR 2005) represents a major development in the use of international law for public health purposes. One of the most important aspects of IHR 2005 is the establishment of a global surveillance system for public health emergencies of international concern. This article assesses the surveillance system in IHR 2005 by applying well-established frameworks for evaluating public health surveillance. The assessment shows that IHR 2005 constitutes a major advance in global surveillance from what has prevailed in the past. Effectively implementing the IHR 2005 surveillance objectives requires surmounting technical, resource, governance, legal, and political obstacles. Although IHR 2005 contains some provisions that directly address these obstacles, active support by the World Health Organization and its member states is required to strengthen national and global surveillance capabilities. (author's)
Women and Environments. 2005 Fall / Winter; 23-24.These days, fat is a serious global issue. Indeed, the World Health Organization (WHO) recently declared that fat - or, to use the medical term, 'obesity' -- has reached epidemic proportions on a global scale. According to the WHO, more than one billion adults world-wide are overweight, and at least 300 million of them are clinically obese. The WHO concern over the international obesity problem adds to and sets the tenor for the more local (national, provincial, city-wide) discussions about obesity that are constantly appearing in newspapers, popular magazines, television and radio programming, left-leaning and anti-globalizations publications, and local government policies. But is obesity really as big a problem as it appears to be? In this article, I explore the wildly popular global obesity epidemic by analyzing the international health policy of the World Health Organization. I argue that the WHO's obesity policy, more than trying to deal with the global obesity epidemic, in fact helps to produce obesity as a global problem. Instead of asking, "what is wrong with our world that it makes people fat?", we should be asking, "why all this concern with obesity? Who is concerned, anyway, and why now?" As some feminists have argued, the regulation of women's bodies through the diet industry has had devastating consequences for many women. Asking questions of the obesity epidemic instead of taking it for granted as the truth opens up the possibility of exploring how the contemporary concern with obesity is tied to political and economic processes, as well as gendered, racialized and national inequalities. (excerpt)
New York, New York, United Nations, 2005.  p.Global poverty rates are falling, led by Asia. But millions more people have sunk deep into poverty in sub-Saharan Africa, where the poor are getting poorer. Progress has been made against hunger, but slow growth of agricultural output and expanding populations have led to setbacks in some regions. Since 1990, millions more people are chronically hungry in sub-Saharan Africa and in Southern Asia, where half the children under age 5 are malnourished. Five developing regions are approaching universal enrolment. But in sub-Saharan Africa, fewer than two thirds of children are enrolled in primary school. Other regions, including Southern Asia and Oceania, also have a long way to go. In these regions and elsewhere, increased enrolment must be accompanied by efforts to ensure that all children remain in school and receive a high-quality education. The gender gap is closing — albeit slowly — in primary school enrolment in the developing world. This is a first step towards easing long-standing inequalities between women and men. In almost all developing regions, women represent a smaller share of wage earners than men and are often relegated to insecure and poorly paid jobs. Though progress is being made, women still lack equal representation at the highest levels of government, holding only 16 per cent of parliamentary seats worldwide. (excerpt)
Accelerating fertility transition in sub-Saharan Africa - UN conventional: a point of view - Brief article - Statistical data included.
UN Chronicle. 2002 Jun-Aug; 39(2): p..Population generally contributes to economic development. But in the context of poverty and limited resources, high fertility can provoke health, economic and demographic problems, such as infant and child mortality, cases of infanticide, infant and child abandonment, inadequate education and unemployment. In most sub-Saharan countries, despite considerable efforts in the field of reproductive health, fertility remains at high levels (5 children per woman). The process of fertility transition will probably be achieved over a longer period of time than initially anticipated, by 2010-2025. Nor will fertility decline occur at the same pace throughout. Thirteen countries, among them Burkina Faso, Chad and Guinea, have not begun the fertility transition; 22 are progressing through the incipient stage of transition; and in some countries, such as South Africa, Zimbabwe, Botswana, Kenya and Cape Verde, transition is advanced. (excerpt)
UN Chronicle. 2000 Summer; 37(2): p..The World Health Organization (WHO) on 9 June launched an action plan to save 13.4 million people in the drought-ravaged Horn of Africa from plummeting into a major health crisis. WHO said that even if the severe drought lifted, the people in the region, already worn down by natural and man-made disasters, would not be able to save themselves unless health was targeted. According to the agency, an investment of just $25 million would substantially reduce death and illness from preventable diseases and save thousands of lives in the seven affected countries: Djibouti, Eritrea, Ethiopia, Kenya, Somalia, the Sudan and Uganda. WHO's action plan aims to reduce the countries' vulnerability, improving the population's basic level of health by helping health professionals throughout the region improve the quality of what little water there is, combat severe malnutrition, and crack open essential access to basic health services such as immunization. The new plan includes community-based epidemic surveillance projects, which enlist local networks in reporting on disease out breaks, resulting in rapid diagnosis and response. (excerpt)
Washington, D.C., World Bank, 1977 Nov. 18 p.The attached paper provides the most up-to-date and authoritative statement that is available on World Bank lending policies in the population sector. The paper parallels closely an official Bank statement that was recently distributed to staff as an internal document. Since the paper is concerned only with the Bank's lending operations, it does not deal with other aspects of the Bank's population activities, such as the coverage of population in Bank economic reports or Bank research in the field. The paper defines the "population sector" as the Bank sees it and then describes the Bank's lending objectives, the range of fertility-reducing interventions possible in the light of current understanding of fertility determinants, the types of delivery systems available for the provision of family planning services, typical project content in the sector, and the use of "population components'' in non-population projects. The paper also explains how a number of general Bank policies -- e.g., on procurement, project justification, user charges, local-cost financing, co-financing, and project monitoring and evaluation -- are applied in this sector. (author's)
Washington, D.C., World Bank, Operations Evaluation Department, 1992.  p. (World Bank Operations Evaluation Study)The World Bank has always regarded industrialization in developing countries as a major element of the structural transformation process that signifies economic development. Up to the end of fiscal 1990, lending to all industrial activities constituted 16.9 percent of the Bank's total cumulative lending, and came to US$41.4 billion. Of this sum 63 percent was channeled through the financial intermediaries, and 37 percent went to industrial projects. Similarly, the mandate of the International Finance Corporation engaged it heavily in industrial development, not only by the provision of loans to private industrial enterprises, but also by participating in the equity of such enterprises. The Bank's broader support of infrastructure and human resource development also fed into industrial development. While the Bank's support of industrialization has been consistent and significant, the nature of the support has changed over time. Through the 1950s and much of the 1960s, the Bank took for granted industrialization strategies based on import substitution, generally pursued in the framework of comprehensive planning and extensive government participation in industrial activity. The Bank saw its main objectives as institution building (in DFCs), improved project evaluation, resource mobilization, and greater freedom for private enterprise. Over the 1970s the intellectual climate on industrialization strategies changed. The newly-industrialized countries (NICs) of East Asia rose to prominence. Outward-oriented trace policies came to be regarded as central to industrial success. During this period, the Bank's emphasis also shifted. The Bank engaged increasingly in policy dialogue with borrowers on broad issues of strategy. In the 1980s, with the culmination of this shift in a series of structural and sectoral adjustment operations, the Bank's philosophy of industrial strategy took a clear, defined, and theoretically rationalized form. It is this philosophy that is the subject of this study. (excerpt)
[Washington, D.C.], World Bank, 1977 Nov.  p.The Bank entered the population field because its experience drove it to the conclusion that attempts to raise the standard of living in a great many developing countries were being seriously hindered, if not thwarted, by the growth of population. The Bank has no fixed idea how large the population of any particular country ought to be, but it is convinced that, in most developing countries, the faster population grows, the slower will be the improvement of living standards. In many countries "population drag" is not just a minor element in the picture; it is one of the main explanations of why living standards are improving so slowly. In the mid-1960's, about two-thirds of total annual investment in a sample of 2.2 developing countries was required to maintain per capita income constant, leaving only about one-third to increase it. The corresponding figures for a representative sample of 19 developed countries were one-quarter and three quarters. The cost of rapid population growth is therefore large, and it falls most heavily on the poorest. High rates of fertility increase the number of children the labor force must support. Some of these costs are borne by the individual household, while others, such as education, are borne primarily by society. Without a decline in fertility, increased expenditures are necessary merely to provide the same inadequate instruction to larger numbers of students. Rapid population growth is an important cause of inequality of incomes. The expansion of the labor force exerts downward pressures on wages and creates unemployment; in agriculture, the effect is often the fragmentation of landholdings and growing landlessness. (excerpt)
Triumph or threat? The birth of a baby boy in Yugoslavia is cause for celebration and concern - five billionth person.
UN Chronicle. 1987 Nov; 24(4): p..Secretary-General Javier Perez de Cuellar took tiny Matej Gaspar in his arms a few minutes after he was born and proclaimed him the five billionth person on the planet. It was a fine Saturday morning in Zagreb, Yugoslavia, capital of the Croatian Republic. Matej was born at 8:25 a.m. on 11 July 1987. The healthy, blond, 7 pound, 9 ounce boy is the second child of Sanja and Dragutin Gaspar. Matej's mother is a nurse, his father an electrician. "You should be thankful that your son has been born in prosperity", the Secretary-General said to the smiling 23-year old mother while flashbulbs popped and more than 150 journalists from all over the world jostled to cover the scene. He noted that 9 out of 10 children in the world were born in developing countries. (excerpt)
UN Chronicle. 1986 Aug; 23: p..Five priority areas for national and international action are highlighted in a 53-page report of the Secretary-General on the critical economic situation in Africa (A/S-13/2) placed before the General Assembly's thirteenth special session. The priority areas include: national and collective self-sufficiency in food production and agricultural development in general; efforts to meet drought and desertification; rehabilitation and development of transport and other structures; development of human resources and social services, with attention to the role of women and the need to protect vulnerable groups; and external financial resources and the problem of external debt. The report states that droughts and famines suffered by many African countries from 1983 through 1985 attracted the world's attention to the plight of Africa. Emergency aid and good rains brought some relief, and although the food situation remains "precarious' and in some areas "quite serious', the immediate threat of mass starvation has subsided. (excerpt)
UN Chronicle. 1994 Dec; 31(4): p..The 16-Chapter Cairo Programme of Action reaffirms the connection among population growth, poverty, patterns of production and consumption and the environment. it states: "Progress in any component can catalyse improvement in others." The Programme emphasizes the need for harmonizing population trends and patterns of development in order to increase the standard of living of current populations, while at the same time not jeopardizing the needs of future generations. It also emphasizes the imperatives of empowering women and guaranteeing choice in regard to family planning, and stresses that advancing gender equality and ensuring women's ability to control their own fertility are "cornerstones" of population and development programmes. The principle of "sovereignty", which guarantees that each country would decide for itself which programme recommendations are relevant to its conditions and needs, is also enshrined in the Programme. (excerpt)
UN Chronicle. 1997 Fall; 34(3): p..In the middle of 1996, world population stood at 5.77 trillion persons. Between 1990 and 1995, it grew at the rate of 1.48 per cent per annum, with an average of 81 million persons added each year. This is below the 1.72 per cent per annum at which population had keen growing between 1975 and 1990, and much below the 87 million added each year between 1985 and 1990, which now stands as the peak period in the history of world population growth. These figures are from the recently released 1996 Revision of the official United Nations population estimates and projections, prepared by the Population Division of the Department for Economic and Social Information and Policy Analysis. The report indicates that currently 4.59 billion persons--80 per cent of the world's population--live in the less developed regions and 1.18 billion live in the more developed regions. The average annual growth rate is about 1.8 per cent in the less developed and 0.4 per cent in other regions. (excerpt)
Commission gives high priority to monitoring global trends - UN Population Commission meeting, Mar 28-31, 1994 - includes information on preparation of action program to be recommended at the Sep 5-13, 1994 International Conference on Population and Development, Cairo, Egypt.
UN Chronicle. 1994 Jun; 31(2): p..The effect of population growth on the environment, the role and status of women, and the demographic implications of development Policies were among major topics discussed by the Population Commission at its twenty-seventh session (28-31 March, New York). "The most important lesson we have learned is that population growth and other demographic trends can only be affected by investing in people and by promoting equality between women and men", Dr. Nafis Sadik, Executive Director of the UN Population Fund (UNFPA) and Secretary-General of the 1994 International Conference on Population and Development, told the 26-member body. In the single text approved during the session, for adoption by the Economic and Social Council, the Commission asked that high priority be given to monitoring world population trends and policies, and to strengthening multilateral technical cooperation to address population concerns. (excerpt)