ASEAN to have common population projects

The ASEAN countries (Indonesia, Malaysia, the Philippines, Singapore, and Thailand) agreed to cosponsor population programs, especially for the rural and underprivileged. An attempt will be made to integrate population programs with development programs. The feasibility of using research findings for developing and implementing family planning programs will be studied. The development of an intercountry personnel training program for pouplation and development programs will be considered. Multimedia support for population programs will also be studied.     

1980 ASEAN programme roundup: a model in the making

Association of Southeast Asian Nations (ASEAN) experts and heads of national population programs held their 4th meeting in Singapore from November 24-28, 1980. Program heads resolved to take steps to link their national activities in the population field with those of the ASEAN Population Program and carry out studies and a joint programming exercise in 1981. Progress reports on the following Phase 1 projects were given: 1) integration of population and rural development policies and programs in ASEAN countries including Indonesia, Malaysia, Philippines, Singapore, and Thailand; 2) development of an inter-country modular training program for personnel in population and rural development; 3) multi-media support for population programs in the context of rural development in ASEAN countries; 4) utilization of research findings in population and family planning for policy formulation and program management in ASEAN countries; and 5) migration in relation to rural development. Phase 2 projects approved by ASEAN country participants were also discussed: 1) institutional development and exchange of personnel, 2) women in development, 3) developing and strengthening national population information systems and networks in ASEAN countries, 4) population and development dynamics and the man/resource balance, 5) studies on health and family planning in ASEAN countries, 6) population migration movement and development, and 7) development of ASEAN social indicators.     

Assessment of family planning programme effects on births: Preliminary results obtained through direct matching of birth and programme acceptor records

Abstract In order to match birth and family planning acceptance records and thereby to obtain estimates of pre- and post-acceptance fertility, use is made of seven-digit national identity card numbers, issued to all adult West Malaysians. These unique numbers are recorded on live-birth records and national family planning programme acceptor records of West Malaysian women. The application and preliminary results of this method of direct computer matching of these sets of records for assessing the effects of a family planning programme on fertility are described. Pre- and post-acceptance fertility rates are presented in terms of contraceptive methods used, and the key characteristics of race and age of programme acceptors, and are discussed in terms of marital duration and number of children at the time of acceptance.     

ASEAN projects reviewed

The ASEAN Population Expert Group met in Manila and was followed by a meeting of the ASEAN heads of population programs, during the period November 5-10, 1979. Heads of population programs from Indonesia, Malaysia, Singapore, Thailand, and the Philippines attended. The meetings were held to review progress-to-date on phase 1 projects and to consider the development of an expanded population program. 5 projects funded by UNFPA are reviewed in tabular form with the project, the sponsoring country, date of implementation, data analysis, and date of completion. Suggestions were made for improving and extending these projects and it was also suggested that all projects being developed and proposed should include a section on use of research. 7 new projects were proposed as phase 2 projects. The 1st, sponsored by Malaysia, deals with women in development; project 2, lead by Thailand, will investigate population movement and its effect on development; project 3, led by the Philippines, will develop and strengthen national population information systems and networks in ASEAN countries; project 4, led by Indonesia, is directed towards institutional development and exchanges of personnel; project 5, led by the Philippines, will examine population and development dynamics and the man/resources balance; project 6, led by Thailand, will develop ASEAN social indicators; and project 7, led by Indonesia and Malaysia, will make a comprehensive analysis of existing medical/health care and family planning systems. It was recommended that an executive director of the proposed ASEAN population coordination unit should be appointed to expedite the recommendations of the meeting related to preparation and submission of phase 2 project proposals.     

Determinants of Infant Mortality in Older ASEAN Economies

Infant mortality in the Association of Southeast Asian Nations (ASEAN) has been declining, yet disparities remain between the nations. This paper therefore explores the determinants of infant mortality in the older ASEAN-4 economies, Malaysia, Thailand, Indonesia and the Philippines using an Autoregressive Distributed Lag (ARDL) Error Correction Model framework. The key findings of the study are: First, there is evidence of long-run relationships among infant mortality, education, female fertility, income and access to healthcare. Second, the determinants of infant mortality vary between countries. Female fertility emerged as the main determinant of infant mortality in Malaysia, while access to healthcare matter for infant mortality in Indonesia, and to a lesser extent for the Philippines. The income effect is significant for reducing infant mortality in Malaysia, while female education is important for Indonesia and Thailand. Third, the speed of adjustment of infant mortality rate is comparatively low in ASEAN-4.     

Population programme of China]

Results of population programs started in China during the last decade have attracted worldwide attention. The Chinese population issues are important due to the following characteristics: 1) China is the most populated country in the world, with over 1 billion people (22% of world population), by the end of 1980; 2) its population is 80% rural; 3) despite improved living conditions that have helped lower the mortality rate from over 20/1000 before Liberation to 10/1000 in the 1960s and finally 6-8/1000 during the last decade, the Chinese population has increased from 540 million soon after Liberation to the current 1 billion, with an average yearly growth rate of 2%; 4) China has a young population, with 36.8% under 14 years old and less than 5% over 65, hence education and employment are big issues; and 5) due to longterm backward economy resulting from feudal and colonial influence before Liberation, efforts in developing a strong Chinese economy have met with many obstacles. The above 5 features of the Chinese population have important bearing on solving China's population problems and in building its economy, developing its society, and realizing its 4 modernizations. Although China is self-sufficient despite its large population, it faces many problems and challenges especially in the areas of educating its young population and subsequent employment. To achieve a strong economy and to improve the welfare of its people, China has put efforts into controlling the size and improving the quality of its population during the past decade. Programs in population control will continue to take priority in China.     

The demographic effects of a contraceptive programme

Abstract The calculation of the number of births prevented for each item of contraceptive service provided entails the integration of a variety of factors relating to the potential fertility of users and the duration and effectiveness of use. This article differs from previous essays of this kind in that estimates of future potential fertility are based not on fertility rates but on age-specific means of inter-live birth intervals, modified by periods of use overlapping post-partum sterility, and by the probabilities attached to the development of permanent sterility and to the successful adoption of extra-programme birth control. In the first three years after acceptance of intra-uterine contraception by some 9,000 postpartum women of several ethnic origins in Singapore, it is calculated that about 4,800 births were prevented.     

India: Population programme exceeds targets

The National Population Policy of India caused a great increase in the performance of sterilization. A total of 8.4 million sterilizations for the 1976 fiscal year was projected. Vasectomies were performed twice as often as tubectomies. From April to September 1976, 550% more sterilizations were performed than in 1975. Cash compensations are made for postoperative complications or deaths due to sterilization operations.     

New home for a dynamic programme

In Nepal the promotion of activities aimed at improving the skills and status of women was formerly the task of the national organization, Mahila Sangathan, but is now the responsibility of the newly created Subcommittee for Women's Affairs. The subcommittee operates under the guidance of the Co-ordinating Council for Social Services under the sponsorship of Her Majesty the Queen. The subcommittee cooperates through chapters located in each of the country's 75 districts. Many of these chapters are actively engaged in 1) promoting family planning via door to door campaigns and through training local women for family planning motivational work; 2) stimulating the production and marketing of crafts made by women; 3) providing legal assistance to women; and 4) conducting literacy programs for approximately 10,000 women. A new headquarters for the subcommittee is being built with UNESCO assistance. The committee hopes to establish a library in the new building since a lack of reading material is hindering progress in its literacy program.     

Philippines: total maternal care programme

The Total Maternity Care Programme, launched in June 1975 by the University of the Philippines at the Philippine General Hospital, aims at complete care for both mother and baby. Since the program began, requests for female postpartum sterilization have exceeded capacity. The postpartum ligation rate increased from 14% to 30% in a 6-month period. Reasons for this increase are word of mouth publicity, growing consciousness of the disadvantages of large families, and diseases contraindicating pregnancy. Reasons why women declined sterilization are mentioned. Based on the success of the program so far, it is recommended that Total Maternity Care Programmes be extended to the other maternity hospitals in metropolitan Manila.     

Mindfulness-based programme on the psychological health of pregnant women

Problem

Preparation of psychological well-being is an important component of antenatal education for childbirth, but few courses focus on this component.

A brief introduction to China's family planning programme

China's family planning program is described in reference to its goals, approaches, and achievements. Between 1949-83, China's population increased from 541 million to 1,024,950,000. The population has a young age structure, and the median age is 22.9 years. 80% of the population is rural, and 90% of the population lives in the southeastern region of the country. In view of this demographic situation, the government recognizes the need to control population growth. China's goals for the year 2000 are to increase industrial and agricultural input by 400% and to keep population size below 1.2 billion in order to ensure that per capita income increases. In accordance with these goals, the government, in 1979, began advocating a 1-child policy. To ensure the survival of single children, the government also launched a program to upgrade maternal and child health (MCH). In some rural areas and among certain minority groups, the 1-child restriction is not applied. Family size goals will vary with time. These variations will reflect the need to maintain a balance between economic growth and population growth. A variety of incentives are used to promote the 1-child family. For example, single children receive medical and educational benefits, and in some rural areas, the parents of single children can obtain additional land contracts. Economic disincentives are also used. The government seeks to obtain compliance with the policy primarily through educating the public about the consequences of uncontrolled population growth. All channels of the mass media are used to deliver the messages, and the publicity campaign is especially intensive in rural areas. A comprehensive plan to provided family planning and population education for middle school students is currently being implemented. Each local area develops its own fertility control plan. This plan is then incorporated into the nation's overall plan and the overall plan is implemented from above. Family planning workers bring free contraceptives directly to the people, and family planning motivators are found in almost all villages, neighborhood committees, factories, and military units. As a result of these efforts, China made great strides in controlling population growth and improving MCH during the last decade. The birth rate declined from 27.93 to 18.62, and the total fertility rate declined from 4.01 to 2.48. 124 million couples were practicing contraception by the end of 1983. 41% used IUDs, 37.4% relied on tubal ligation, 12.9% relied on vasectomy, 5.1% on oral contraceptives, and 1% on other methods. The quality of maternal and child care also improved. 92.7% of all deliveries are now performed by trained midwifes. Infant and maternal mortality rates declined considerablely in recent years. Currently the respective rates are 35.68/1000 live births and 0.5/1000 live births. In 1983 alone, the gross national agricultural and industrial output increased by 46.1%. Since 1979 per capita income increased annually by 18.3% among rural residents and by 10.7% among urban workers. China controls and operates its own population program, but in recent years, it increased its cooperation with UN Fund for Population Activities, other UN agencies, and nongovernment agencies. China recently completed its 3rd national census, and demographic research institutes have been established in 10 universities.     

Massive drive to reenergize the family planning programme

A massive drive has been launched throughout India in an effort to reenergize the family planning program. The Prime Minister has made a special appeal to the nation from radio and television networks and through the press to adopt the small family norm as a way of life. The Chief Ministers and the Health Ministers in the States have made similar appeals to the people and the doctors. The current drive was preceded by 18 months of concentrated efforts to vitalize the family planning program. The change in nomenclature from "family planning" to "family welfare" created some misunderstanding regarding the government's own commitment to the program, but it is now widely understood that while family welfare aims at the total welfare of the family, family planning is an essential part of it. The government has tried to involve all sectors of society in program efforts. The mass media is now focusing attention on "family welfare" almost continuously. In villages, a large-scale program of organizing education camps of opinion leaders is now underway. The rural health scheme, initiated in October 1977, promises to bring about increased participation of the people in village programs. 54,000 community health workers have already started serving the rural population in their areas. In 2-3 years there will be 1 trained community health worker in every Indian village.     

An operational research programme for monitoring and evaluation

5.1. As indicated above, UNICEF in Sudan at present is really left with no option but to develop their own monitoring programmes to realistically assess the rewards, and possible problems of child survival strategies. Yet, as stated before, monitoring is the only manner in which the field efficiency and effectiveness of programmes can be assessed. Simple demographic surveys are one of the principal information sources on health statistics in developing countries. These surveys are conveniently organised to collect information on special groups at greatest health risks, such as mothers and children, and to gather valuable explanatory data on the economic and social factors affecting the health of the household members. Household surveys have an important role to play in monitoring and evaluating primary health care, since they sample directly the intended beneficiaries and thus can be used to judge the extent to which programmes are meeting their expected goals. Reporting forms currently in use in PHCP programmes need drastic simplification and revision to make them more relevant to policy and programme priorities. Attempts might also be made at micro-level participatory planning and monitoring with the participation of additional technical personnel. By closely monitoring the progress of projects and their effect on the situation of children and women in the project areas, it is hoped that the most effective and efficient models for integration of interventions for child survival and development will be developed. This paper has drawn attention to some future directions in making the best use of household surveys and health care utilization that can be collected through these surveys to periodically monitor programme implementation with the specific purpose of reducing costs, improving efficiency and accelerating implementation. Simultaneously with the surveys, there is a great need to develop comprehensive case studies to determine whether the programmes are achieving what they claim. Past experience has to be studied very carefully and thoroughly at all stages of the programming process to avoid duplication of activities and wrong decisions. One last comment: it is necessary to give more attention to observational feedback based on the situation of the areas and not to get too scientific. Sporadic trends and changes happening in the right direction are the first signs of behavioral changes, and these need to be vigorously pushed, promoted and disseminated. Otherwise there is no room for social marketing and scaling up.     

A cost benefit analysis of the barbados family planning programme

Abstract Of the Caribbean islands, Barbados has the lowest fertility level. The crude birth rate in 1970 was only 20·5 per 1,000, which is one of the lowest found in any country of similar economic development anywhere in the world. In 1960 the crude birth rate was much higher, at about 33·6 and for almost 40 years before that had fluctuated around a value of 33. Thus, a decline of about 40% has been achieved within the comparatively short period of a decade. The reasons for this rapid decline are of particular interest to all those concerned with population growth and economic development in the less developed areas. In Barbados, the importance of population control and the role of family planning was recognised early by the government and other civic agencies, and the Barbados Family Planning Association (BFPA), an autonomous national family planning agency, was established. Since its modest beginning in 1955 the BFPA has grown to be a major social institution, comprising 14 clinics situated in various localities throughout the island. In 1970, a full-time staff of 28 were providing services to an estimated 10,000 clients, about 20% of all women of reproductive age. Funds for the BFPA have come from local government with considerable assistance from international agencies.     

Study findings on evaluation of integrated family planning programme performance

In 1976 the United Nations's Economic and Social Commission for Asia and the Pacific launched a comparative study on integrated family planning programs in a number of countries in the region. In November 1979 the study directors from the participating countries meet in Bangkok to discuss the current status of the studies in their countries. The Korean and Malaysian studies were completed, the Bangladesh study was in the data collecting phase, and the Pakistani research design phase was completed. The meeting participants focused their attention on the findings and policy implications of the 2 completed studies and also discussed a number of theorectical and methodological issues which grew out of their research experience. The Malaysian study indicated that group structure, financial resources, and the frequency and quality of worker-client contact were the most significant variables determining program effectiveness. In the Korean Study, leadership, financial resources, and the frequency and quality of contact between agencies were the key variables in determining program effectiveness. In the Malaysian study there was a positive correlation between maternal and child health service performance measures and family planning service performance measures. This finding supported the contention that these 2 types of service provision are not in conflict with each other but instead serve to reinforce each other. Policy implications of the Korean study were 1) family planning should be an integral part of all community activities; 2) family planning workers should be adequately supported by financial and supply allocations; and 3) adequate record keeping and information exchange procedures should be incorporated in the programs.     

A study on the demographic impact of an IUD programme

Abstract This paper discusses and presents data obtained through various studies and surveys on the effect of the IUD contraceptive programme in Taiwan. It has been demonstrated that the fertility of IUD acceptors before first acceptance was 58 % higher than that of married women in general and that, after acceptance, it declined by about 76%. The corresponding fertility decline among married women in general was only about %. Acceptors had had more recent births, as indicated by their shorter 'open interval' of 20.7 months, compared with 374 months among the women in the KAP survey sample. If the fertility of IUD acceptors had declined at the same rate as that of married women in general in the absence of IUD, the insertion of about 4 IUDs would probably prevent one live birth in the following year. Observation over a longer period, however, is needed to determine the demographic effect of IUD. Data on fertility control practice after termination, type of termination of pregnancies after first acceptance, life-table rates by various socio-demographic characteristics of acceptors, and the 'life expectancy' of the first segment of IUD are also presented.     

China's birth control action programme, 1956-1964

Abstract Drawing upon available information this article throws light on China's birth control action programme, focusing on (1) its organizational set up, (2) the modes of communication, persuasion and pressure employed, (3) products and services provided, and (4) strategies resorted to. The Chinese approach to the birth control campaign has been characterized by two distinct and related strategies: (1) 'tien hsien mien hou' strategy, and (2) 'mass campaign' strategy. According to the first strategy - literally 'point first space later' - the organized efforts are to be concentrated initially on the upper socio-economic strata and major urban areas, then gradually extended to cover lower strata and lesser cities, and eventually expanded to encompass the entire rural areas. This strategy also means that at the regional level a pilot project should be undertaken first, and the experience subsequently employed to tackle a larger area. The 'mass campaign' strategy means conducting crash, intensive, extensive and intermittent publicity campaigns, involving all means of communication at the regime's disposal.