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Oxford, England, Oxford University Press, 1991. xii, 290 p.The 1991 World Development Report presented an overview of the world economy and future prospects for development, approaches to development, plans for social development, opportunities for self employment, technology transfers and trade reform, macroeconomic policies, the politics of national governments, and priorities for action. Text was supplemented with figures and statistical tables. Countries were grouped by gross national product into low-income countries, middle-income countries, and high-income countries. Special groups were identified as oil exporters, severely indebted middle-income countries, and Economic Cooperation and Development Countries (OECD). The main theme of this report was the interaction between governments and markets. Competitive markets were considered the most efficient for organizing production and distribution of goods and services in the context of government regulation and government investment in infrastructure. Technology transfers have given countries the opportunities to use resources more productively. Living conditions in developing countries have improved. The income gaps between developed and developing countries have narrowed. Further potential created by technological progress will be dependent on national and international policies and peace. National economies were tied together by global integration in trade, investment, factor flows, technology, and communication. Developing countries were both put at risk from instabilities and weaknesses in the international setting and put in the position of access to knowledge in medicine, science, and engineering. Sustained development was dependent on global conditions and country-specific policies. Developing country growth in real income per capita during the 1990s might average roughly 3% annually, if world trade expanded at over 5% per year and policy reforms continued. The report identified needed reforms.
POPULATION AND DEVELOPMENT REVIEW. 1991 Dec; 17(4):749-51.The report of the Secretary General of the UN on the social and economic conditions in Africa notes the worsening of conditions during 1986-90. Declines were apparent in education, health, nutrition, employment, and income. Government spending on health declined from 6% in 1985 to 5% in 1990 and on education from 15% to 11%. School enrollment declined from 77% in 1980 to 72% in 1987 and 70% in 1990. Primary school enrollments were also affected; i.e., only 65% of those enrolled in 1986 were still in school in 1990. Illiteracy rates dropped from 59.1% in 1985 to 52.7% in 1990, but the absolute numbers rose from 133.6 million to 138.8 million. Female illiteracy is very high at 66% compared to 46% for males. Government funding cuts have also had an impact on nutrition. There were 70 million more severely undernourished Africans in 1989 than in the mid 1970s (80 million), and 40% of preschool children suffered from acute protein energy deficiency, which is an increase of 25% from 1985. There was evidence of large numbers of underweight (26.6%), wasting (10.2%), and stunted children )53.3%). Diseases such as malaria, trypanosomiasis, and schistosomiasis, which had been under control or eradicated reappeared. The <5 years mortality rate remained stable and high at 182/1000. Improvements have been made in expansion of immunization, 22 countries achieved 75% immunization in 1990. There were fewer deaths from measles and diarrheal diseases. Maternal mortality remains high at 1120/1000. AIDS is a serious social problems. By 1991, 6 million people had been infected with HIV including 3 million women an increases are expected. 900,000 HIV-infected babies were born as of 1990. The number of AIDS orphans is increasing. Real wages declined by 30% during the 1980s, and unemployment grew an average of 10%/year between 1986-90. Formal sector employment stagnated, and informal sector employment showed tremendous increases. Substance farming became a survival strategy. Poverty has affected as much as 50% of the African population. Brain drain emigration has resulted in the loss of an estimated 50-60,000 people. For Africa, the future emphasis will be on efficacy, tough minded realism, self-reliance, and grassroots initiatives.
African debt crisis and the IMF adjustment programmes: the experiences of Ghana, Nigeria and Zambia.
In: Development perspectives for the 1990s, edited by Renee Prendergast and H.W. Singer. Basingstoke, England, Macmillan, 1991. 37-57.Sub-Saharan African countries suffer from rapidly growing external debt and the concomitant burden of its service; debt service in 1987 accounted for 40.6% of exports. Liberal and neo-Marxist rationales exist to explain the development and existence of the African debt crisis. The former view, however, drives the market-oriented development approach of the IMF and World Bank and has resulted in the development and imposition of structural adjustment programs (SAP). Main components of SAP are exchange rate reforms or currency devaluation; trade liberalization; export promotion; rationalization of public expenditure, capital, investment, and employment in the public sector; privatization and commercialization of public enterprises; producer price adjustment; wage restraints; withdrawal/reduction of subsidies; tax structure reform; and financial/administrative reforms. SAP, however, ignores that the narrow production base of post-colonial African states encourages unpredictable export earnings which in turn make it hard for countries to concurrently service debt and pay for imports to cushion the effects of SAP. Internally, programs also ignore the inflationary effect of devaluation while underestimating the social cost of domestic tightening on living standards. While national leaders are willing to take steps towards much-needed structural reform, they object to SAP policies which exacerbate Africa's dependence upon external financial flow. The African Alternative Framework to Structural Adjustment Programmes for Socio-Economic Recovery and Transformation therefore proffers that the IMF modify its policy to allow African states to strengthen and diversify production capacities. Recommendations are largely reflationary and would require substantial internal and external funding. In sum, donor and recipient states must recognize that both internal and external factors caused the present situation and that interested parties must continue to explore viable options for action; African nations need structural reform but with out paralyzing their productive bases; and that the social costs of SAP must be evenly distributed in order to be politically acceptable. The structural adjustment experience of Ghana, Nigeria, and Zambia are presented as examples of these realities and conclusions.
PAKISTAN DEVELOPMENT REVIEW. 1991 Winter; 30(4 Pt 1):493-6.Comments on the UN paper on the Development Decade of the 1980s and the next decade of the 1990s by Gamani Corea are presented. Corea's statements about the future are considered fair, but negative and lacking in quantitative input. As an econometrician and a quantitative economist, the author feels that the shortterm and mediumterm economic prospects are that 1988 was a good year, 1989 all right, and 1990 was recessionary for some countries. Recovery is anticipated by 1992. The Gulf crisis of 1990-91 caused fluctuations in energy prices and uncertainty or fear in people, which is hoped to be transitory and without major impact on economic matters. Positive expansion in the world economy after 1992 is anticipated, in spite of the recessions in the UK and some Nordic countries. Western Europe slowed, but the advent of the Single Market is favorable to an upswing. The Asia/Pacific arena is strong, and achievements in South Korea are considerable. Mexico, Venezuela, Colombia, and Chile are promising. Other economic problems in Latin America are only temporary. South Asia has done well. The Middle East and North Africa may have more lasting consequences of the Gulf war. Sub-Saharan Africa is in trouble with the race between population growth and food supplies, and negative or near zero growth rates/capita. Developing countries are experiencing severe recessionary adjustment periods in world economic malaise. With the collapse of socialism, there is no viable "Second World," and there are industrialized and developing countries. Eastern Europe and the USSR have a skilled population with the potential for producing world class goods and services. Primary commodity markets are expected to rise again which will strengthen export earnings in the developing world. Macroeconomic visions of hope are based on contingencies: financial fragility, issues related to the Gulf crisis, poor financial conditions in the US and to a certain extent in Japan and other financial centers. Trade negotiations in the Uruguay Round are in difficulty, which restricts free trade, and dilutes strong and vigorous activity which helps development. The economic restructuring of Europe is moving more slowly, but the Arms race is still extant in Third World countries such as Iraq. Price stabilization efforts may be futile attempts when underlying behavior patterns of production and consumption take over. Europe is the primary growth area. The Peace Dividend has been reduced because of Iraq's postures. South/South trade may be an option for developing countries. There is potential for expansion in e.g., and electronics, medical care, telecommunications, bioengineering, metallurgy, software construction. Technology and economics and international cooperation and coordination are hopeful prospects for the future.
PAKISTAN DEVELOPMENT REVIEW. 1991 Winter; 30(4 Pt 1):497-501.Papanek's responses to the Gamani Corea paper on UN strategy for the 1990s in international development are presented. Corea's paper is considered as an evolution of thinking about development economies. Over 40 years, some issues have faded and others have taken prominence, and some issues have been ignored even though of considerable importance to development. 4 areas are identified for discussion: 1) the changing role of planning, and the market, poverty, and the environment; 2) north/south issues; 3) major changes in the world economic system; and 4) the world economic environment and the role of domestic policies. The greatest change has occurred in the emphasis on environmental consequences of development in contrast to past concerns with achieving a high rate of growth with some attention to land tenure issues. There is also an emphasis on the private sector and foreign private investment. Planning has taken a recessive role. Income distribution and poverty alleviation is also of concern. Although government intervention is no longer fashionable, it is not clear what provisions there are in the market for assuring that the poor have a reasonable share of the growth. The north/south issues are discussed in terms of the limited bargaining power of developing countries. Contributing factors are the multiplicity of objectives desired simultaneously. The UN resolutions on development strategy do not always reflect developing country's objectives. Suggestions are made to bargain 1) on objectives crucial to many developing countries, 2) on objectives that generate the least resistance among the industrialized countries, and 3) on those objectives where there is reasonable consensus on what needs to be done. Major changes in the world economic system that are not included in UN strategy but will affect policy are: 1) US leadership has declined as the principal supplier of capital; 2) US absorption of world exports is shrinking; 3) the peace dividend will insure stability if not an increase in transfers; 4) increased competition for markets and private investment will come from Eastern Europe and the Soviet Union; and 5) a response needs to be made to technology changes in the US, Japan, an Europe in order to stay competitive. There is recognition that countries shape their own destiny and can be successful with the appropriate policy mix.
New York, New York, UNFPA, 1991. 44 p.When discussing issues of population and the environment, 2 factors stand out: 1) poverty is continuing to grow, rather than shrink. Worldwide over 1 billion people live in absolute poverty and the total international debt of low-income countries is over $1,000 billion and growing; 2) social sector programs designed to maintain health, family planning services, housing, and education are constantly underfunded and do not receive the priority that they merit in national and international development programs. This report from the UNFPA contains discussions of sustainable development, the problem of growing urban populations, the balance between population and resources, land degradation, tropical forest destruction, loss of biodiversity, water shortages, population impacts on quality of life, and policy considerations.
INTER-AMERICAN PARLIAMENTARY GROUP ON POPULATION AND DEVELOPMENT. BULLETIN. 1991 Dec; 8(11):1-3.The author indicts World Bank, International Monetary Fund, and overall developed country policy as responsible for Latin America's large impoverished and disenfranchised child and adolescent population. As an example of the magnitude of the problem, he notes that 1/3 of Brazil's 150 million population is comprised of youth and children. 8 million live on the streets, of which only 1 million receive official aid. Forced to fend for themselves, these youths fall into drug addiction, prostitution, and crime, suffering poor health, malnutrition, and widespread illiteracy. Many are sold, imprisoned, kidnapped, and exploited. Street children in Rio de Janeiro even suffer the added threat of being killed by the Squadrons of Death who consider the murder of juveniles a solution to delinquency. The state of affairs has deteriorated to such an extent in Peru that abandoned children are considered the most significant social problem. Argentina, Bolivia, Haiti, Honduras, Guatemala, and Nicaragua all suffer similar problems of impoverished youths, and claim some of the highest infant mortality rates (IMR) in the world. Cuba is the only country in Latin America with an IMR comparable to and often lower than many developed countries. Chile and Costa Rica follow closely behind in their achievements. Where Latin America already holds the largest gap between wealthy and poor, meeting adjustment demands of Northern economies and countries has only made conditions and inequities worse. Recession and poverty have worsened at the expense of youths. Attempting to pay down debt over the 1980s, improvements in Latin America's trade balance have gone unnoticed as the South has grown to be a net exporter of capital. Latin American nations need more than token charitable donations in times of emergency and particular duress. Development programs sensitive to the more vulnerable segments of society, and backed by the political will of developed nations, are called for. Unless constructive, supportive policy is enacted by Northern nations to help those impoverished in the South, social rebellion and continued, enhanced resistance should be expected from Latin American youths in the years ahead.
ASIA-PACIFIC POPIN BULLETIN. 1991 Jun; 3(2):7-11.George Walmsley, UNFPA country director for the Philippines, discusses demographic and economic conditions in the Philippines, and present plans to revitalize the national population program after 20 years of only modest achievements. The Philippines is a rapidly growing country with much poverty, unemployment and underemployment, uneven population distribution, and a large, highly dependent segment of children and youths under age 15. Initial thrusts of the population program were in favor of fertility reduction, ultimately changing to adopt a perspective more attuned to promoting overall family welfare. Concurrent with this change also came a shift from a clinic-based to community-based approach. Fertility declines have nonetheless grown weaker over the past 8-10 years. A large gap exists between family planning knowledge and practice, with contraceptive prevalence rates declining from 45% in 1986 to 36% in 1988. Behind this lackluster performance are a lack of consistent political support, discontinuities in program implementation, a lack of coordination among participating agencies, and obstacles to program implementation at the field level. The present government considers the revitalization of this program a priority concern. Mr. Walmsley discusses UNFPA's definition of a priority country, and what that means for the Philippines in terms of resources nd future activities. He further responds to questions about the expected effect of the Catholic church upon program implementation and success, non-governmental organization involvement, the role of information and information systems in the program, the relationship between population, environment and sustainable development, and the status of women and its effect on population.
PEOPLE. 1991; 18(4):10-2.The head of the United Nations High Commission for Refugees, Sadako Ogata, anticipates continued growth in the numbers of migrants and refugees in the 21st century, in part as a result of the collapse of the political and economic systems in developing countries and Eastern Europe. Development assistance that provides jobs, alleviates poverty, and seeks to maintain family structures in developing countries is necessary for both urban and rural areas, and nongovernmental organizations are being urged to prioritize education, training, and primary health care activities. Of particular concern are the special needs of refugees and migrants who are women and children. Children are most susceptible to the diseases, especially diarrhea and subsequent dehydration, that are prevalent in refugee camps. Needing further attention is the psychological trauma to refugee children created by dislocation and exposure to war. Maternal-child health care, including family planning, is another area in need of greater emphasis. Although women head most families in refugee camps, camp management tends to be male-dominated and the special needs of women and children are not receiving sufficient attention. Activities that go beyond basic sustainment of life will have beneficial effects in the longterm as well, as refugees are repatriated and reintegrated into the community.
Washington, D.C., National Council for International Health [NCIH], 1991 Mar 31. , 27 p.AIDs provides a unique and unprecedented opportunity to affect behavioral change, open up discussion on sexuality, and strengthen health and educational programs. This National Council for International Health policy report encourages collaborative multisectoral programs to deal with the issues of AIDs orphaned children. The contents include introductory chapters as well as chapters on the economic, public health, and social implications of AIDs in the Third World; supporting the child, family,and community; recommendations for the role of NGO's and the role of donor agencies; and conclusions. It is hoped that NGOs and donors will be mobilized to deal with a problem that will strain the already inadequate health, social and financial resources of developing countries, and thereby affecting the increasing demand for long term child care. WHO estimates of HIV infected children <5 years are 10% of 25-30 million by the year 2000. The current problem also includes children orphaned from the estimated 3 million women who will die in 1990. The economic implications are that economic productivity is reduced, low income families will be unable to provide for the additional orphaned children, and debt and low prices for exports have already reduced national budgets and reflect less social spending. The public health implication is the 1-10 US dollars/per person health spending cannot accommodate AIDs screening which alone cost 1 US dollar. AZT costs 20,000 US dollars a year/per child, or the combined annual income of 133 Mozambique farmers. A child's AIDs hospitalization in Zaire costs 4 months wages for the average workers. A funeral costs 11 months wages. In Rwanda, the doctor/patient ratio is 1:36,000. Child survival may be reversed because of reduced credibility in breastfeeding and immunization, confidence in common health remedies, and of confusion between AIDs symptoms with other treatable ailments. AIDs confronts Africans with a challenge to their cultural beliefs and marital, family, and sexual patterns. The alternatives for care are the extended family, alternative residential facilities, and adoption and foster placement. It is recommended that NGO's increase information exchange/program coordination; balance short term emergency assistance with long term sustainable solutions; give priority to maintaining a child's sense of identity and ties with family, clan, and community; involve communities in all phases of project planning, implementation, and evaluation; provide resources to empower women to make choices; and ensure the discrimination due to HIV infection does not occur. Donor agencies should encourage NGOs to pursue multisectoral solutions; increase funding and improve dispursement means for NGOs; facilitate information exchange, funding, conducting research, offering strategic guidance, and taking responsibility for program coordination; ensure the sustainability of AIDs orphan's projects; and realize the goal of improved status of women and children legally, socially, and economically.
New York, New York, United Nations, 1991. x, 58 p. (ST/ESA/SER.R/113)With approximately 12% of its 1980 population over age 60, Argentina's elderly constitute a higher-than-average proportion of the total population when compared to other developing countries. Governments are increasingly assuming greater responsibility for the care and support of the elderly. Accordingly, this paper describes the social and economic aspects of population ageing in Argentina, with the aim of providing planners with a better understanding of the social and economic implications of these demographic changes. Better understanding should result in the development of appropriate plans and policies targeted to the elderly. While the ageing process in Argentina is comparatively advanced when compared to other developing countries, ageing presently proceeds at a slower pace when compared to past trends. Slow ageing is also projected into the future. The elderly, themselves, have been ageing, and tend to live to a greater extent in urban areas. Elderly women when compared to men are more likely to live alone and in urban settings. Despite a stagnating economy, social gains and improvements in living conditions for the elderly have been largely sustained. The working-age population grew more slowly, however, over recent decades than the total population. The number of retirement system beneficiaries also grew over the period, with retirement benefits reported as the leading sources of income among the elderly. The health care system remains strained by the country's present economic situation, with care failing to reach all of the elderly. Wide societal agreement exists that the family should be a major care provider. With more than 1/2 of all persons aged 65 and over living in extended or mixed households, the family plans an important care and support function.
An agenda for action in sub-Saharan Africa. A collaborative initiative of the World Bank, UNFPA and IPPF.
INTEGRATION. 1991 Mar; (27):10-7.An Agenda for Action to Improve the Implementation of Population Programs in Sub-Saharan African in the 1990s is a joint project of the World Bank, the UN Population Fund, the IPPF, the WHO and the African Development Bank. The goals of the agenda are to build public consensus and commitment to population activities, to bring together beneficiaries, implementors and policy makers with these groups to improve population program implementation, to share country program experiences, to make African institutions responsible for ("Africanize") the Agenda, or ultimately to include demographic factors in development. 20 African countries are the focus of the Agenda, grouped by region and language. Major issues include socio-cultural and economic roadblocks, poor transportation infrastructure, lack of community participation, no alternatives to early marriage for women, poor political commitment by decision-making or health ministries. Family planning programs can be improved by better contraceptive technology, program design, and human and financial resources for implementing programs. The methods by which the Agenda proposes to reach its goals are to do literature searches of action strategies, in-depth country analyses, inter-country sharing of experiences, analysis of implementation capability based on case studies, and analysis of contraceptive technology assisted by WHO's Special Programme of Research, Development and Research Training in Human Reproduction and the Population Council. The Agenda will be managed by a Population Advisor Committee, which is an African "think tank," and regional Country Group Task Forces, coordinated by the World Bank's Africa Technical Department.
PEOPLE. 1991; 18(1):16-7.This report on the turnaround in Madagascar population policy notes the importance of the educational experience provided at the 1984 Mexican World Population Conference. The author describes his experiences in developing and implementing a population policy. When people were informed that past food was exported and now imported (265,000 tons in 1985), increasing land usage was not seen as a solution to population growth. The National Environmental Action Plan now in effect helps to underscore the importance of population distribution so that land is not needlessly cultivated. The public response was disinterest initially, but education has been successful in convincing people. The dominant Catholic religion has recognized the population problem and there is only disagreement on the means ( Catholics prefer natural means). Cultural attitudes are changing at all levels due to the economic crises and greater number of people being unable to feed their children. In 1989, the Population Unit of the Ministry of Economy and Planning provided detailed studies of the consequences of population growth, thus forming the basis of the present policy. The plan targets a reduction of population growth from 3.1% to 2% for the year 2000, increasing life expectancy from 55 to 60, and reducing infant mortality from 120 per 1000 live births to 70 and the number of children per family from 6 to 4. Although the policy has been accepted and people ready to use family planning, services to urban centers as well as rural areas is yet unavailable.