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Statement of the International Movement ATD Fourth World, an NGO in consultative status category ii with ECOSOC.
[Unpublished] 1984 Aug. Background note prepared for the International Conference on Population, held in Mexico City, August 6-13, 1984. 4 p. (E/CONF.76/NGO/15)This appeal on behalf of the world's poorest families seeks: the destruction of misery in order to build peace and ensure dignity; fair distribution of resources; guarantees of freedom and the right to self-determination for all, especially the poorest; the widest possible choices for all in family planning; and regular public evaluation of demographic policies and programs, especially for the most deprived.
ENVIRONMENTAL CONSERVATION. 1984 Summer; 11(2):167-9.People living in the area just south of the Sahara Desert in Africa face their 3rd major drought since 1900. This drought brings about famine. Drought and famine are only manifestations of more profound problems: soil erosion and degradation. They diminish land productivity which aggravates the population's poverty. Yet soil erosion and degradation occur due to an expanding population. Continued pressures on the land and soil degradation results in desertification. The UN Environment Programme's Assessment of the Status and Trend of Desertification shows that between 1978-84 desertification spread. Expanding deserts now endanger 35% of the world's land and 20% of the population. In the thorn bush savanna zone, most people are subsistence farmers or herdsmen and rely on the soils, forests, and rangelands. Even though the mean population density in the Sahel is low, it is overpopulated since people concentrate in areas where water is available. These areas tend to be cities where near or total deforestation has already occurred. Between 1959-84, the population in the Sahel doubled so farmers have extended cultivation into marginal areas which are vulnerable to desertification. The livestock populations have also grown tremendously resulting in overgrazing and deforestation. People must cook their food which involves cutting down trees for fuelwood. Mismanagement of the land is the key cause for desertification, but the growing poor populations have no choice but to eke out an existence on increasingly marginal lands. Long fallow periods would allow the land to regain its fertility, but with the ever-increasing population this is almost impossible. Humans caused desertification. We can improve land use and farming methods to stop it.
The state of the environment 1985. Environmental aspects of emerging agricultural technologies. Population and the environment.
Nairobi, Kenya, UNEP, 1984. , vi, 43 p.World production of food crops has basically increased from 1945-1985 due to the emergence of agricultural technologies such as petroleum- based chemical fertilizers and pesticides, efficient and sophisticated farm equipment, hybridization, and, recently, genetic engineering. However, only developed countries and a few developing countries, for example India, have experienced this growth. Social, economic, environmental, and political factors such as inequitable access to resources have prevented this phenomenon from occurring in developing countries where the people often experience famine and malnutrition. Nevertheless the technical path which lead to high food crop yields cannot always be adapted by many poor farmers and landless laborers in developing countries. Further, this path is energy intensive and destroys the environment. To increase production in developing countries, the governments must encourage environmentally sound agricultural development, such as integrated pest management and minimum tillage. Despite any attempts at increasing food production in these countries, however, rapid population growth hampers any increases. As population grows, the availability of fertile, tillable land for food crops decreases. In addition, soil degradation and deforestation occur because more trees and plants are cleared to grow crops and, immediately following harvest, a new set of crops are grown quickly thereby depleting the topsoil and its nutrients. Further, people gather more wood for cooking. These governments, with cooperation and aid from developed countries and international agencies, need to address a multitude of problems such as poverty, population growth, environmental degradation, and women's status, in order to bring food production, the status of the environment, and population growth into balance.
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.
[Unpublished] 1984 Jul. , 520, 20 p.This 2-volume, 520-page report represents the 1st attempt at a situation analysis of Ghana. Its focus is the effect of Ghana's economic crisis on women and children. Volume I characterizes the macroeconomic situation in Ghana, the dimensions of poverty in the country, recent demographic trends, and the factors affecting infant, child, and maternal nutrition and mortality. Volume II discusses environmental sanitation, Ghana's health sector, education, general living conditions of families, and social services available for children. It is concluded that external assistance is needed to address the massive and widespread problems created by poverty in Ghana. Since the immediate problems of children and mothers are social, assistance is particularly needed in the form of outright grants or official development assistance. It is suggested that UNICEF should support both local and national interventions. There must be clear indications that all projects or programs are within government priorities. In the case of area-specific projects, local support should be assured and the main beneficiaries should be women and children. Finally, 4 possible areas of interventions are outlined: health, water and sanitation, education, and programs for slums. In the area of health, it is recommended that UNICEF devote particular attention to nutrition, immunization, oral rehydration, growth monitoring, and infection control within the context of general support to the development of primary health care.
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. 433-55. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)Although population growth is widely regarded as a barrier to economic development and the equitable distribution of income, this paper presents data suggesting that reducing population growth does not generate longterm benefits for the poor. However, increasing equality does appear to generate some decline in population growth. The model from which these data were derived was based on intercountry analyses of 10-year intervals from 1970-2050. Conceptual problems in such analyses include the nature of the unit of analysis, the reference time period, and the conceptualization and measurement of welfare in relation to demographic change and inequality. Moreover, alternative models of social processes (subsistence, neoclassical, institutional, and structural) have different implications. A key element in all these models is the relative rates of growth of different sections of the population. It is assumed that the group that grows fastest is likely to be disadvantaged. Future research in this area will be most productive if it focuses on the multiple roles of population growth in the transformation of systems of production rather than on direct relationships between population growth and inequality. These changes can then be traced indirectly to population growth.
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. 359-81. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)This discussion focuses on the prospective impact of population growth, within the context of global constraints on resources and the environment, on certain basic conditions of socioeconomic development, i.e., food, education, health, housing, and income distribution. A table presents a basic summary of world demographic conditions as of 1980. About 3/4 of the world population of 4.4 billion is in the less developed countries. The population of these countries grows at an annual rate of about 3 1/2 times that of the more developed countries. Compared to the latter, the LDCs' birthrate is more than double, and its total fertility rate is nearly 2 1/2 times as large. The problem of hunger and undernutrition is serious, and continued population growth only makes the task of dealing with it more difficult over time. According to the US Presidential Commission on World Hunger (1980), 1 out of every 8 persons in the world is malnourished, and the number is rising. Poverty is the root cause of undernutrition. The rate of growth of food production has been slightly above that of population. The influence of population growth on food demand has been far greater than that of income growth. New sources of growth in food supply do not portend to be as readily available as before. In some ways current demographic trends will tend to improve the education, health, and housing (EHH) capital. Parents will be able to afford schooling for their children more easily because of later marriages, wider spacing of children, and fewer children. Lower fertility will make for fewer health risks particularly to mothers and infants. The problem of providing basic services for a rapidly growing population could be made more manageable by concentrating more on the human than on the material linkages between inputs and outputs, between the capital formers and the formed home capital. Population growth helps to perpetuate poverty by restraining the growth of wages. There has been a widening gap in per capita income between the richest and the poorest countries and between the middle income and the poorest. The burden of population growth is lessened through any means that raises factor productivity. 1 means would be the removal of conventions restricting the use of any factor below full capacity.
General overview. A. Population, resources, environment and development: highlights of the issues in the context of the World Population Plan of Action.
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. 63-95. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)The acceptance by the international community of the importance of the interrelations between population, resources, environment, and development has been in large measure an outgrowth of the search for development alternatives that would reduce the disparities between developed and developing countries and ameliorate poverty within countries. Possibly the most important task of the Expert Group on Population, Resources, Environment, and Development is to identify more clearly the role of population within these interrelationships, i.e., to identify through which mechanisms population characteristics condition and are conditioned by resource use, environmental effects, and the developmental structure. To a considerable extent the incidence of poverty forms the root cause of many of the problems derived from the interrelationships between population, resources, environment, and development in developing countries. Affluence appears to be the major cause of many of the environmental and resource problems in the developed countries. The first 2 sections are devoted to issues considered crucial in the alleviation of poverty. Lack of food, adequate nutrition, health care, education, gainful employment, old age security, and adequate per capita incomes perpetuate poverty of large numbers of people in developing countries and therefore also their production and consumption patterns, which undermine, through environmental and resource degradation, the very resources on which they depend for their livelihood. The discussion of environment as a provider of resources first considers supplies of minerals, energy, and water. Attention is then directed to the stock of agricultural land that can be expanded through fertilization and irrigation and which may be reduced as a result of desertification, deforestation, urbanization, salinization, and waterlogging. Another section focuses on the need for integrating population variables into development planning. In the formulation of longterm development objectives, population can no longer be regarded as an exogenous force, but rather becomes an endogenous variable which affects and is affected by development policies, programs, and plans.
[Hunger and disease in less developed countries and en route to development (the Third World). Proposal for solutions] Hambre y enfermedades en los paises menos adelantados y en vias de desarrollo (Tercer Mundo). Propuesta de soluciones.
Anales de la Real Academia Nacional de Medicina. 1984; 101(1):39-96.The extent, causes, and possible solutions to problems of hunger, inequality, and disease in developing countries are discussed in this essay. Various frameworks and indicators have been proposed for identifying the poorest of nations; currently, 21 African, 9 Asian, and 1 American nation are regarded as the poorest of the poor. The 31 least developed countries, the 89 developing countries, and the 37 developed countries respectively have populations of 283 million, 3 billion; infant mortality rates of 160, 94, and 19/1000 live births; life expectancies of 45, 60, and 72 years; literacy rates of 28, 55, and 98%; per capita gross national products of $170, and $520, and $6230; and per capita public health expenditures of $1.70, $6.50, and $244. Developing countries in the year 2000 are expected to have 4.87 billion of the world's 6.2 billion inhabitants. The 3rd world contains 70% of the world's population but receives only 17% of world income. 40 million persons die of hunger or its consequences each year. Economic and social development is the only solution to problems of poverty and underdevelopment, and will require mobilization of all present and future human and material resources to achieve maximum possible wellbeing for each human being. Among principal causes of underdevelopment in the 3rd World are drought, illness, exile, socioeconomic disorder, war, and arms expenditures. Current food production and a long list of possible new technologies would be adequate to feed the world's population, but poor distribution condemns the world's people to hunger. Numerous UN agencies, organizations, and programs are dedicated to solving the problems of hunger, underdevelopment, and disease. In 1982, 600 billion dollars were spent in armanents, of $112 for each of the world's inhabitants; diversion of these resources to development goals would go a long way toward solving the problem of underdevelopment. The main problem is not lack of resources, but the need to establish a new and more just economic and distributive order along with genuine solidarity in the struggle against underdevelopment. Several steps should be taken: agricultural production should be increased with the full participation of the developng nations; the industrialized or petroleum-producing nations should aid the poor states with at least .7% and up to 5% of their gross national products for the struggle against drought, disease, illiteracy, and for the green revolution and new agropastoral technologies; prices paid to poor countries for raw materials should be fair; responsible parenthood, education, women's rights, clean drinking water, environmental sanitation and primary health care should be promoted; the arms race should be halted, and the North-South dialogue should be pursued in a spirit of goodwill and cooperation.
New York, New York, United Nations, 1984. ix, 534 p. (International Conference on Population, 1984; Statements ST/ESA/SER.A/90)Contained in this volume are the report (Part I) and the selected papers (Part II) of the Expert Group on Population, Resources, Environment and Development which review past trends and their likely future course in each of the 4 areas, taking into account not only evolving concepts but also the need to consider population, resources, environment and development as a unified structure. Trends noted in the population factor include world population growth and the differences between rates in the developed and developing countries; the decline in the proportion of the population who are very young and the concomitant increase in the average age of the population. Discussed within the resource factor are the labor force, the problem of increasing capital shortage, expenditures on armaments, trends in the supply and productivity of arable land, erosion and degradation of topsoil and energy sources. Many of the problems identified overlap with the environment factor, which centers on the problem of pollution. The group on the development factor was influenced by a pervasiv sense of "crisis" in current economic trends. Concern was also expressed regarding the qualitative aspects of current development trends, defined as the perverse effects of having adopted inappropriate styles of development. Part II begins with a general overview of recent levels and trends in the 4 areas along with the concepts of carrying capacity and optimum population. Other papers discuss the impact of trends in resources, environment and development on demographic prospects; long-term effects of global population growth on the international system; economic considerations in the choice of alternative paths to a stationary population and the need for integration of demographic factors in development planning. The various papers on the resources and environment factor focus on resources as a barrier to population growth; the effects of population growth on renewable resources; food production and population growth in Africa; the frailty of the balance between the 4 areas and the need for a holistic approach on a scale useful for regional planning. Also addressed are: social development; population and international economic relations; development, lifestyles, population and environment in Latin America; issues of population growth, inequality and poverty; health, population and development trends; education requirements and trends in female literacy; the challenge posed by the aging of populations; and population and development in the ECE region.
The Tunis Declaration emanating from the Arab Parliamentary Conference on Development and Population, [May 8-11, 1984, Tunis, Tunisia].
[Unpublished] 1984. 12 p.Parliamentarians from 16 Arab countries met in Tunis, Tunisia, on May 8-11, 1984, to discuss the current demographic and development situation in the Arab nations. The participants agreed that currently income is poorly distributed both within and between Arab countries (per capita income varies from US$500-US$30,000), life expectancy varies markedly between countries, international migration is extensive, the annual population growth rate is 2.9%, and population policies in most Arab countries are poorly formulated. The participants recognized the reciprocal relationship between development and population. They noted that the development process includes meeting the moral, material, health, and fertility needs of all segments of society; development requires broad participation; cooperation with other 3rd World countries is essential; industrialized nations should limit their use of resources; and Arab nations should act on the recommendations of international conferences on population and development and adhere to the agreements between Arab countries on migration issues. The participants recommended that participants continue to actively promote social equality in the Arab world and that Arab nations 1) formulate policies to keep resources and population within balance and to reduce mortality differentials in their own countries; 2) establish fertility goals that take into account population growth, the health and welfare of mothers and children, human rights, and social equality; 3) promote policies which preserve the traditions of the Arab world; 4) improve women's rights by increasing economic and educational opportunities for women, expanding the decision-making role of women, and ensuring that women are presented in a favorable light in the mass media; 5) address the needs of the most vulnerable members of society; 7) improve services for the urban poor and reduce urban growth through rural development and the establishment of small cities; 8) establish policies to reduce the brain drain, to ensure the welfare and rights of migrants, to encourage Arab investment in the development of Arab countries, and to encourage trained Arabs to return to their country of origin; and 9) to mobilize world opinion against Zionist expansionist and forced migration policies. Furthermore, the participants call for action on the part of the delegates, Arab nations, and interational organizations to facilitate the operationalizing of these recommendations by focusing attention on population and development issues, by collecting, analyzing, and disseminating information on population and development, and by providing financial support.
Washington, D.C., Environmental Fund, 1984 Oct. 18 p. (Monograph Series)This paper sets forth an ecolate view of the population problem based on an understanding of the world as a complex of intricately interconnected systems. It is suggested that world poverty is more a problem of "longages" of demand than shortages of supply. The desired standard of living of a population and the carrying capacity are inversely related. When a large population living at a low standard transgresses the carrying capacity of its environment, both the population and the standard of living go down. The practice of attrition offers a means of bringing population growth to a halt. The normal mortality rate will reduce population size as long as the fertility rate is sufficiently reduces. International relations should be based on the assertion that national sovereignty mandates national responsibility. A nation freed of the responsibility of taking care of its own problems through foreign aid has little motivation to put an end to its population growth. Similarly, countries such as the US are urged to resist the invasion of immigrants or both natives and immigrants will be reduced to poverty. Although poverty can be shared, wealth cannot, suggesting that redistribution policies are doomed to failure. It is concluded that if the threat to the balance between population and resources is not seriously addressed, all nations will experience "the tragedy of the commons."
Development: Seeds of Change. 1984; 2:60-2.There are 4 major bottlenecks on the Official Development Assistance (ODA) road to a more successful grassroots level developmental approach. These bottlenecks include conceptual and technical complications, administrative or financial complications; and political drawbacks. ODA seems to experience considerable difficulty in understanding or in "digesting" concepts like "participation," "bottom-up planning," and "process approach." These concepts are rarely discussed in detail on high bureaucratic or political levels and are hardly ever translated into policy instructions. Effective grassroots level developmental action basically requires the donor to accept the prevalence of the target group in many respects. This is also an essential element of the process approach. For ODA agencies in particular, the requirements of a process-like approach raise considerable technical complications. Their natural partners in the developing countries are governments and government departments that may hold different views on how to achieve development. Effective poverty alleviation almost automatically leads to political consequences, even in countries where the governments favor the poor. Poverty alleviation means additional support to the poor to allow them access to scarce development resources that would otherwise be taken up by the less deprived. It also requires the organization, the mobilization, and the conscientization of the poor and their supporting agencies to increase their countervailing power. On the homeside of ODA agencies poverty-alleviating activities are often not wholeheartedly welcomed politically for various reasons. Keeping in mind all the complications, the question arises as to whether ODA could still be maneuvered into a position of effective poverty alleviation. Some possible openings are identified. ODA agencies should to their utmost take notice of effective poverty alleviation that already takes place in various parts of the world and not stick too much to their bureaucratic duties and should continue experimenting as seriously as possible. Participatory activities should be prepared as much as possible in close cooperation between donors and recipient counterpart organizations right from the start. An important role of ODA is to launch intensive inservice training programs to increase the professionalism of its field workers. Finally, non-ideal types of participatory approaches should be pursued as long as the ideal remains out of reach.
In: Ghosh PK, ed. Third world development: a basic needs approach. Westport, Connecticut, Greenwood Press, 1984. 115-45. (International Development Resource Books No. 13)The basic needs approach is critically examined, and the appropriateness of donor agency support for the basic needs approach is questioned. The basic needs approach is plagued by operational problems. It is difficult 1) to define minimum basic need levels, especially if absolute standards are advocated; 2) to measure basic needs; and 3) to implement basic needs programs in such a way as to ensure that only the poorest segments of the population derive benefits and that the benefits remain in the hands of the poor. Basic needs advocates fail to deal with the question of economic growth. They assume that economic growth will continue and ignore the fact that there is a trade-off between satisfying basic needs and investing in growth. They also ignore the issue of trade-offs between fulfilling present and future basic needs. The basic needs approach implies a specific development pattern, and the longterm consequences of this implied development pattern are not sufficiently examined by advocates of the approach. The basic needs approach requires a development pattern that stresses rural development and labor intensive production instead of industrialization, capital intensive production, and growth of the modern sector. Ultimately, the development pattern advocated by this approach will result in an international division of labor between the developing and developed countries which will not improve international marketing conditions for the developing countries since developed countries will not be willing to substantially increase their importation of labor intensive products from the developing countries. Donor agencies need to adopt a cautious attitude toward funding and promoting the basic needs approach. Many developing countries strongly resent the basic needs approach. They feel that donors and the developed countries do not have the right to force them to focus their energies on eradicating poverty. They also fear that the approach is an attempt to reduce financial assistance. Donor agencies lack sufficient expertise to evaluate poverty-oriented programs and to assess the long range impact of many of these programs. In one country, a donor-supported basic needs program to increase agricultural productivity had the unexpected result of reducing the price of agricultural products. Another project aimed at improving living standards in a particular rural community unexpectedly increased property values and, ultimately, led to the migration of the former residents to an urban slum. Furthermore, donor agencies do not have the right to impose development strategies on aid recipients. Development strategies must be formulated by the recipients, and donors should support only those strategies which accord with the development goals of the recipient countries.
[A possible objective from now to the year 2000: reduce infant mortality in the third world by half] Un objectif possible d'ici 1' an 2000: reduire de moitie la mortalite infantile dans les pays du tiers-monde
Hygiene Mentale. 1984 Jun; 3(2):41-9.Every day 40,000 children die throughout the world, most of them in developing countries. There is a close relationship between infant mortality, life expectancy at birth, the adult literacy rate and national income per capita. Why such huge differences between the infant mortality rate of 7/1000 (live births) in Sweden and 208 in Upper Volta? The 4 scourges which afflict developing countries: hunger (malnutrition), disease, ignorance and poverty are responsible for this state of affairs. The author suggests that coordinated action by governments and International Agencies should be taken to halve the infant mortality rate by the year 2000. He notes that in the past 3 mistakes were made which should not be repeated. The 1st was to improve the living conditions of the population. The green revolution in India provides a striking example of an important progress which benefited only the wealthier farmers. A 2nd mistake was to believe that only a medical approach reduces the infant mortality rate. A 3rd error was to overlook the importance of health education and not to seek the active participation of the people concerned. The author recalls that the International Union for Health Education carried out a sanitary and social program from 1975 to 1978 in Africa, south of the Sahara. To this effect, the IUHE had to find out what the people really wanted, whether they could be motivated to increase the welfare of the villagers by measures adapted to existing possibilities, and to study how the people could recruit health workers among the villagers and train them to create village health committees. 4 weapons used together should reduce the infant mortality rate by 1/2 in the developing world before the end of the century. They are: the promotion of breast feeding, the extended coverage of vaccinations, the early detection of malnutrition and the treatment at hoem of diarrheic diseases thanks to oral rehydration. (author's modified) (summaries in ENG, SPA)
New York, UNICEF, 1984 May. 280 p.The data in this set of 135 country profiles for 1981 are made up from 9 major sources and cover the countries and territories with which the UN International Children's Emergency Fund (UNICEF) cooperates. In terms of infant morttality, countries are divided into 5 infant mortality groups: a very high infant mortality (a) group of countries, with a 1981 infant mortality rate (IMR) estimate of 150 (rounded) or more deaths per 1000 live births; a very high infant mortality (b) group of countries with a 1981 IMR estimate between 110 (rounded) and 140 (rounded); a high infant mortality group of a middle infant mortality group of countries, with a 1981 IMR estimate of between 26 and 50 (rounded); and a low infnat mortality group of countries, with a 1981 IMR estimate of 25 or less. For each country data are also presented on nutrition, demographic, education, and economic indicators.