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Pretoria, South Africa, Dept. of National Health and Population Development, Council for Population Development, 1991 Jun. 21 p.This booklet presents 1987 data on global population growth estimates and reiterates some of the main points of the Amsterdam Declaration adopted at the International Forum on Population in the 21st Century. These resolutions recognized mankind's responsibility to the future; acknowledged the link between population, resources, and the environment; expressed concern about rapid growth, especially in the developing world; recognized the central role of women in the development process; and defined the goal of development as improvement in the quality of life. The specter of unrelenting population growth is then considered from the point of view of South Africa, which has an annual growth rate of 2% and a population doubling time of 32 years. The booklet then describes South Africa's Population Development Programme, which was instituted in 1984 to maintain a balance between growth and subsistence resources. Each aspect of the program (education, primary health care, job creation, manpower development, the role of women, rural development, and housing) is then discussed in detail with important concepts defined and the ways in which organizations and individuals can contribute to the realization of the goals delineated.
ECONOMIC AND SOCIAL COUNCIL OFFICIAL RECORDS. 1991; (Suppl 1):39-40.This document contains a 1991 UN resolution on the 1994 International Conference on Population and Development (ICPD). After reviewing previous UN action on this issue, the resolution 1) names the conference; 2) makes recommendations about preparatory activities; 3) identifies six broad objectives for the ICPD; 4) identifies population, sustained economic growth, and sustainable development as the overall theme of the conference and identifies six issues which require attention (population growth and structure; population policies and programs; the interrelationships between population policies, development, the environment, and related matters; changes in the distribution of population; linkages between the status of women and population dynamics; and family planning programs, health, and family well-being); 5) stresses the need to take the circumstances of developing countries into consideration; 6) authorizes the UN to convene expert meetings on each issue; 7) requests that appropriate UN agencies guide the preparatory activities and that UN resources be devoted to this task; 8) asks regional commissions to meet to review population policies and programs; 9) sets up a mechanisms to receive progress reports; 10) sets dates for the second and third sessions of the Preparatory Committee; and 11) makes funding recommendations.
POPULI. 1991 Mar; 18(1):4-23.As unchecked population growth threatens to increase ecological destruction and poverty, the world seems to have finally acknowledged the need for population programs. Previous development plans for the 3rd World omitted the population factor, but it has now become evident that this unprecedented growth stands in the way of progress. The current world population of 5.3 billion is expected to increase to 6 billion by the year 2000, 95% of the growth occurring in developing nations. UN projects that the world's population will stabilize at 10 billion in the next century, but only if by the year 2035 women worldwide bear an average of 2 children each. Africa and west Asia have the highest annual population growth rates (2.9 and 2.8, respectively), followed by Latin America and southern Asia (2.2%), both of which have begun to move towards reducing fertility. This massive swelling of population places increased pressures on the environment, food availability, and water supplies. Africa's impressive gains in agricultural production have all but been nullified by population growth. During the 1974 World Population Conference in Bucharest, countries recognized the dangers, and since then, much progress has been made. And during the 1984 International Conference on Population held in Mexico City, countries agreed that development and family planning must go hand-in-hand. Many countries (Barbados, China, Cuba, etc.) have had highly successful family planning programs. Studies indicate that 30-50% of the drop in fertility in the Third World can be attributed to family planning. And these successful programs reflect the commitment to social programs, including education, health, and women's status. Still, there are some 300 million couples worldwide who wish to limit fertility but have no access to contraception. Despite the dangers of unchecked population, family planning efforts must respect human rights concerning procreation.
IN TOUCH 1991 Mar; 10(98):3-11.In order to institute the Alma Ata Conference goals of health for all (HFA) and primary health care (PHC), the author has provided an overview of the tenets of basic management as it pertains to a health services system in Bangladesh. Central government structure is diagrammed. The internal operation is described as composed of administrative decisions; operational management; operational planning; organizing resources; motivating health personnel; appraising staff performance; coordinating; developing public relations; managing information systems; monitoring; conducting evaluations; identification and collection of data pertinent to evaluations; methods and techniques of data collection; reporting of background information; and objectives and methodology of evaluations, findings, and major achievements. Activity is evaluated based on relevance, progress, effectiveness, adequacy, efficiency, and impact. The author finds that Bangladesh's lack of any formal document on national health policy impedes the managerial process. Other inadequacies involve the lack of dissemination of the HFA country paper and unsuitable perceptions of the PHC approach; the deficiencies in the 5 year plans to address the main concerns of the PHC in the health care system such as community finances or inequitable resource allocation; the lack of preventive and integrated care in upazila health management; the lack of definition of responsibilities of institutions; the lack of motivated grass roots level workers who provide coordination with other sectors; the lack of micro or macro evaluations of quality of care; and management deficiencies. Supervision is incompetent. Linkage between formal and informal health sectors are missing. Skills are lacking in operational planning. Conceptualization of PHC is inadequate.
New policies and approaches of health education in primary health care in attaining the objectives of health for all/2000.
IN TOUCH 1991 Mar; 10(98):34-6.This overview of what the WHO Alma Ata Declaration is and how the objectives translate to policy in the structure of health education involves manpower development, professional level training, community involvement, mass media, and related research. Alma Ata identified health education as the first of 8 essential activities in primary health care (PHC). Policy failures in health education included the inability to live up to expectations, the targeting of programs to specific diseases, and to the inappropriate conceptualization of community participation as a process which can be centrally controlled. Other factors were the gap in understanding the relationship between socioeconomic development and health, weak national structure which provided inadequate demonstration of health education project results, the inability of health education to solve individual problems such as working conditions or environmental pollution, and the lack of multisectoral cooperation. In order to achieve the Alma Ata objectives health education must be an agent of social change. Primary health care (PHC) - health education, development of a patient's educational skills, needs to be incorporated into the formal curricula of medical and nursing programs, as well as informal training, planning, and practice among rural and agricultural developers, public health engineers, and educators. Health workers need training in use of appropriate technology and in bridging the gap between the community and existing health care systems. The mass media needs to emphasize basic health necessities, and the importance of health, and solutions to problems. Broad public participation including voluntary organizations is necessary to the multisectoral approach. Research needs to be disseminated to administrators.
PEOPLE. 1991; 18(1):7-8.This article attributes Sub-Saharan national population policy change to the attendance at the 2nd African Population Conference (APC) in Arusha in 1984, preliminary to attendance at the World Population Conference (WPC) in Mexico City in 1984, and the socioeconomic crises which precipitated the disparity between population growth and resources. Demographics are better understood. Family planning is now seen as reflecting traditional African values of birth spacing. Consequently countries have developed specific national policy statements. Liberia, Nigeria, Senegal in 1988, Zambia in 1989, and the Sudan in 1990, have developed comprehensive population policies in addition to those already established in Kenya and Ghana. Zaire and Zambia policies are in the process of endorsement; others formulating policy are Botswana, Burkina Faso, Cameroon, Chad, Cote d'Ivoire, Niger, Tanzania, Togo, and Zimbabwe. Policies are based on APC and WPC documents as well as the N'Djamena Plan of Action (1989). These guidelines tend to include detailed action and implementation plans, including targets for fertility reduction. Approaches to fertility reduction among specialists are still being debated. The significance of national population policy is as a public endorsement in addition to providing an analytical framework.
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.