Culture,climate change and mobility decisions in Pacific Small Island Developing States

The Pacific Small Island Developing States are often considered on the frontline of climate change due to high levels of exposure to climate-related hazards and limited adaptive capacity to respond. In this context, Pacific Islanders may be displaced, or choose to migrate to escape risk and find more secure livelihoods. On the other hand, Pacific political and community leaders stress that mobility can be a threat to sovereignty and culture and should only be considered as a last resort. This paper adopts a cultural ecology framing to gain a greater understanding of these contested local discourses on climate change and human mobility in Kiribati, Tuvalu and Nauru through the use of the Q method. The results reveal a range of shared subjective understandings of climate change and human mobility which show that reasons for, and perceived outcomes of moving are inextricably linked. These subjective understandings highlight that culture, and in particular how Islanders relate to land and religion can influence decision-making, promoting or hindering mobility. The findings therefore support the need for further engagement with communities to recognise and validate their positions on climate change and human mobility to facilitate the planning and implementation of effective policy.

     

The Rising Burden of Healthcare Expenditure in India: A Poverty Nexus

The increasing burden of communicable and non-communicable diseases are imposing unavoidable costs on Indians. As a consequence it exacerbate poverty and drag many poor further down by heavy medical expenses. This study aims to estimate the extent of healthcare expenditure on the individuals who were hospitalized due to various diseases. Further, this study examines the burden of healthcare expenditure on impoverishment level in India. The unit level record of the 71st round of the National Sample Survey Office (NSSO) is used in the analysis. The result reveals, cost of hospitalization due to non-communicable diseases is three times higher than communicable diseases in India. Therefore, an overall level of impoverishment has been increased by 1.61 percent/year which shows the high financial risk for the people surviving at the threshold of poverty.     

Malaria in Pacific populations: seen but not heard?

Most Pacific Island countries are located in the tropics, where there is an abundance of mosquitoes with the potential to carry debilitating or life-threatening vector-borne diseases. This article examines three Melanesian countries in which malaria is endemic—Papua New Guinea, Solomon Islands and Vanuatu—but the threat posed by the spread of malaria gives the issues a broader significance to the Pacific region. After discussing the spatial distribution and prevalence of malaria in the Pacific, the article examines a number of health interventions through which people have sought to control malaria. Although the disease was nearly eradicated in the Pacific in the 1970s, it is no longer in retreat. The article concludes by examining why there are still grounds for cautious optimism, and the challenges that Pacific Island countries face in reducing the impact of malaria on their populations. There is a need for prompt and concerted action on malaria at the national, regional and international levels if the public health concerns arising from the disease are to be adequately addressed.     

Infant mortality in the Marshall Islands

Levy and Booth present previously unpublished infant mortality rates for the Marshall Islands. They use an indirect method to estimate infant mortality from the 1973 and 1980 censuses, then apply indirect and direct methods of estimation to data from the Marshall Islands Women's Health Survey of 1985. Comparing the results with estimates of infant mortality obtained from vital registration data enables them to estimate the extent of underregistration of infant deaths. The authors conclude that 1973 census appears to be the most valid information source. Direct estimates from the Women's Health Survey data suggest that infant mortality has increased since 1970-1974, whereas the indirect estimates indicate a decreasing trend in infant mortality rates, converging with the direct estimates in more recent years. In view of increased efforts to improve maternal and child health in the mid-1970s, the decreasing trend is plausible. It is impossible to estimate accurately infant mortality in the Marshall Islands during 1980-1984 from the available data. Estimates based on registration data for 1975-1979 are at least 40% too low. The authors speculate that the estimate of 33 deaths per 1000 live births obtained from registration data for 1984 is 40-50% too low. In round figures, a value of 60 deaths per 1000 may be taken as the final estimate for 1980-1984.     

Acculturation inclinations and subjective health status of internal migrants in James Town,an urban slum settlement in Accra

The impact of acculturation on health status has been a subject of debate for over three decades. In this exploratory study, we use cross-sectional data to examine the relative effects of acculturation inclinations on self-rated health statuses among migrants in a poor, urban neighborhood in Accra. Much emphasis is placed on the role of the urban environment in disease outbreaks within the city, the patterns of communicable and non-communicable diseases, spatial health inequalities, and the distribution of sexual and reproductive illness risks in Accra. However, the ways by which acculturation inclinations and dimensions may exert positive or negative influence on health outcomes in such contexts have not been examined. We developed proxies for four main acculturation elements: assimilation, separation, integration, and marginalization. We used results from a semi-structured survey questionnaire with 296 migrants. After controlling for socio-demographic characteristics and social capital, findings from Ordinal Logistic Regression models indicate that the acculturation predictors of subjective health status are assimilation and marginalization. This study is the first step in understanding the possible trajectories by which acculturation affects health in the internal migration context in Ghana.     

Adolescent fertility programs: responding to the needs of today's youth

The 1983 conference on Adolescent Fertility Management in Asia and the Pacific provided a forum for sharing information and experiences. The project was designed to stimulate interest in and strengthen existing programs on adolescent fertility in participating countries, i.e., Bangladesh, Fiji, India, Indonesia, Nepal, Philippines, Sri lanka, and Thailand. Specifically, the conference sought to identify adolescent fertility problems and share experiences in managing adolescent fertility programs, identify gaps in the development and implementation of adolescent fertility programs and projects, and formulate plans to meet the adolescent fertility needs of the participating countries. Capsule presentations of the experiences of the participating countries are presented. Focus is on the projects they have undertaken and proposed activities. In Bangladesh Jatio Tarum Sangha, the national youth organization, seeks to get youth involved in family planning activities through information/education/motivation programs and community development projects. Fiji proposes to establish a youth center to be operated by the Ministry of Health to reduce the incidence of unplanned pregnancy and sexually transmitted diseases in adolescents and to make them more aware of sex-related health problems and the importance of responsible sex. India's Family Planning Association has initiated population education programs for youth. Several projects have been launched in Jakarta to cope with adolescent fertility problems including the adolescent health project, the Consultation Center for Adolescents, and the university-based family health project. The Family Planning Association of Nepal has completed some major programs under its youth project. The Philippines' proposed youth centers are planned to respond to the fertility related needs and problems of Filipino adolescents. Innovations of the center are: the operation of several youth-serving government and private agencies under 1 roof, and encouragement of youth participation in designing and running the center. Sri Lanka does not have much of an adolescent fertility problem. Virtually all fertility is said to occur within marriage. A study on adolescent fertility is planned. Thailand has launched several government and nongovernment programs to reach adolescents both in and out of school. Government programs include counseling services and the National Family Planning Communication for Premarriage adolescents. Key issues are identified and recommendations are made.     

Estimates of the population of Puerto Rico and the outlying areas: 1980 to 1986

This report presents estimates of the population for July 1, 1980 to 1986 for the Commonwealth of Puerto Rico, the US Virgin Islands, American Samoa, Guam, and The Commonwealth of the Northern Mariana Islands. Census counts for 1980 are also shown for each of the areas. Components of population change for these areas for the 1980-1986 period are also shown. Most of the statistics used to prepare the area estimates were obtained from the local governments of the outlying areas. Except for Puerto Rico, all of the areas estimated are growing at a rate well above that of the US (64% from April 1, 1980 to July 1, 1986). Of the areas, Guam has exhibited the highest % of growth since 1980--19.6%. Although Puerto Rico and the Virgin Islands have increased in population since 1890, both experienced population declines between 1985 and 1986. The Virgin Islands' population declined by 1.2%, from 110,800 to 109,500, while Puerto Rico's decreased by 3%, from 3,282,000 to 3,274,000.     

The Timing and Pace of Health Transitions around the World

Estimates from some 700 mostly national studies of survival in the past are assembled to create a broad picture of regional and global life expectancy gains across space and time and to examine implications of that picture. At the initiation of their health transitions, most countries had a life expectancy between 25 and 35 years. Countries that began later made gains at a faster pace. Those faster gains are usually associated with the dissemination of Western medicine. But rapid gains occurred in the period 1920–50, largely before the availability of antibiotics or modern vaccines. Especially rapid gains came in the years immediately after World War II in countries where the leading causes of death were communicable diseases that could be managed with antibiotics but also in countries where the leading causes of death were degenerative organ diseases. Both periods of rapid gain await satisfactory explanation. The bibliography of more than 700 sources is published separately on the web at « http://www.lifetable.de.RileyBib.htm ».     

The effects of climate change on the geography and timing of human mobility

Human mobility over different distances and time scales has long been associated with environmental change, and the idea of climate change is now affecting movement in new ways. In this paper, we discuss three cases from the South Pacific to explain the ways anticipated climate futures are changing mobility in the present. First, we examine village relocation in response to coastal erosion and inundation in Fiji, drawing on our study of the unfolding experience of Narikoso village in Kadavu Province. In contrast to this spatially constrained process of permanent relocation, we examine the spatially extended yet temporally constrained seasonal migrant worker programme that aims to support economic development in the Pacific Islands by providing temporary work visas in Australia and New Zealand. Finally, we examine the likely effects of proposed open labour markets as a means to promote climate change adaptation, through a study of the analogous example of Niuean migration to New Zealand which has resulted in both permanent migration and a slow circulation of people between both countries. Across these examples, we highlight emerging and potentially constructive ways in which climate change is altering the spatio-temporal patterns and rhythms of mobility.     

Below-replacement fertility of ethnic Indians in Fiji: a decomposition analysis of the components of changes in the total fertility rate

The population of Fiji consists of two major ethnic groups, Fijians and Indians; it also comprises other groups, such as Europeans, Chinese and other Pacific Islands. The 2007 Census showed that there were 56.8 % Fijians and 37.5 % Indians, with the remaining 5.7 % consisting of other groups. This paper examines ethnic variation in fertility using current fertility estimated directly from the census data. As the Fiji census continued to gather information on the relationship of mothers with their own children, this information has been used to estimate fertility trends over the past 15 years preceding the census by the application of the own-children method. Fiji has recently undergone a spectacular decline in fertility but with a marked variation between Fijians and Indians. The total fertility rate (TFR) among Indians dropped to 2.8 in 1986 and 2.5 in 1996. It continued to decline further, approaching below the replacement fertility of 1.9 in 2007. By contrast, Fijian fertility reached 3.9 in 1996. As with that of Indians, Fijian fertility also fell sharply, to 3.2 in 2007. This paper uses a decomposition analysis technique to determine the components of changes in the TFRs due to marital structure and marital fertility among Fijians and Indians, covering the intercensal periods, 1966–1976, 1976–1986, 1986–1996 and 1996–2007.     

Differential mortality of Asians and Pacific Islanders in The Pacific Labour Trade

Quantitative evidence is presented on the differential mortality suffered by Indian and Pacific Island labour migrants on Fiji’s plantations between 1883 and 1919, and by Japanese, Chinese and Pacific Island labour migrants in the phosphate mines on Ocean Island and Nauru between 1913 and 1940. Pacific Island labour migrants suffered much higher death rates than Asian labour migrants, due, it is suggested, to their much greater vulnerability to newly introduced infectious diseases. This paper was generated by an ongoing project supported by the Australian Research Grants Scheme. I am indebted to Maie Raud for excellent research assistance, to Doug Munro for stimulating my interest in Ocean Island and Nauru while on a Visiting Research Fellowship at The Flinders University of South Australia, to Bryan Gandevia and Barry Smith for a most helpful correspondence on disease in history, and to Stanley L. Engerman, Brij V. Lal, Barrie Macdonald, Doug Munro, Jonathan J. Pincus, Leonie Randall, Barry Smith, Richard H. Steckel and two anonymous referees for comments on an earlier version of this paper.     

Disability among older women and men in Fiji: concerns for the future

This study examines the composition of elderly population at risk of disability and speculates the impact of disability on the quality of their lives and their longevity. Using census and survey data collected in Fiji, life table estimates of unimpaired life expectancy across time are presented for older people and the potential costs of disability, in terms of productive years of life lost. From a planning perspective, the study discusses medical and support services that may be needed to support older individuals in Fiji. The study also describes policy implications of the findings, focusing on the older women, and considers the implications for older women of other developing countries.     

Disability Among Older Women and Men in Fiji: Concerns for the Future

SUMMARY

This study examines the composition of elderly population at risk of disability and speculates the impact of disability on the quality of their lives and their longevity. Using census and survey data collected in Fiji, life table estimates of unimpaired life expectancy across time are presented for older people and the potential costs of disability, in terms of productive years of life lost. From a planning perspective, the study discusses medical and support services that may be needed to support older individuals in Fiji. The study also describes policy implications of the findings, focusing on the older women, and considers the implications for older women of other developing countries.     

Population estimates for Puerto Rico and the outlying areas: 1980 to 1987

This report estimates the population for July 1, 1980, to 1987 for the Caribbean areas of the Commonwealth of Puerto Rico, the US Virgin islands, the Pacific areas of American Samoa, Guam, and the commonwealth of the Northern Mariana Islands. The components of population change for these areas for the 1980-1987 period are also presented. Some highlights of the data follow. 1) All areas except for St. Croix and Puerto Rico are growing at a rate well above that of the US (7.4% from April 1, 1980 to July 1, 1987). 2) The Virgin Islands (population 106,100 in 1987) have shown the highest growth rate (9.8%) since 1980. Growth in St. Thomas and St. John (population 53,600) account for 72% of the total Virgin Islands growth. 3) St. Thomas and St. John together have a net immigration rate of just under 1%; St. Croix (population 52,400) had a net outmigration rate of almost 10%. 4) Puerto Rico (population 3,292,000) experienced a -7.1% net outmigration, and population increase of 95,000. 5) At 23%, Guam (population 130,400) has the largest % population growth; 21% of this growth is due to net immigration. 6) All 3 areas in the Pacific grew in the 7-year period; their overall growth rate was 23%, compared with 3% in the Caribbean areas.     

The effect of female education on fertility: A simple explanation

This paper investigates the structure of the relationship between female education and fertility. It is based on data published in First Country Reports of the World Fertility Surveys for eleven countries—Costa Rica, Colombia, Dominican Republic, Panama, Fiji, Korea, Malaysia, Pakistan, Sri Lanka, Thailand, and Indonesia. The cumulative marital fertility of educated women is shown to be similar in different settings. A lack of uniformity in the education and fertility relationship including the curvilinear nature of this relationship observed across countries is shown to be attributable to marked differences between countries in the average fertility of women with no education rather than to the presumed differences in the average fertility of the educated women. The structure of the relationship is shown to be similar across several developing countries. This analysis suggests that advancement in female education can be expected to influence fertility behavior even without simultaneous changes in other factors such as increasing opportunity for participation in the paid labor force in the modem sector.     

Aikane: accounts of Hawaiian same-sex relationships in the journals of Captain Cook's Third Voyage (1776-80)

The journals recorded by Captain James Cook and his associates on Cook's Third Voyage of discovery (1776-1780) include extensive eyewitness accounts and analyses of the Hawaiian people and their culture-the first to be made by Europeans and Americans. Among these are several reports of young men called aikane, who were attached to the court or train of the ali'i (chiefs), and whose functions were sexual, social, and political. Among these aikane were several who acted as intermediaries between the sailors and the Hawaiians, and whose influence and conduct profoundly affected the course of events at Kealakekua Bay, where Cook was killed in February, 1779. The information contained in these materials suggests that such Hawaiian same-sex relationships are more important than currently accounted for in accepted theories of Hawaiian ethnohistory.     

Adolescent fertility programs: taking the first few steps

Adolescent fertility programs in Asia and the Pacific have a long way to go to check the problems associated with adolescent fertility, but a start has been made. Delegates from 8 countries met in 1982 to share their problems and experiences in their own countries. The conference participants drew up plans to deal with a high rate of adolescent fertility, sexually active adolescents, out-of-wedlock births, unwanted pregnancies, sexually transmitted diseases, prostitution, rape, abortion, and drug addiction. The delegates felt that for adolescent fertility programs to be effective the program workers must first be equipped with the needed skills through proper training. Inadequate knowledge of the subject matter, inability to communicate with adolescents, personal bias, and lack of counseling skills were among the worker-related problems that conference participants identified. A few months after the conference, participant countries conducted a training program on the effective delivery of adolescent fertility-related information and counseling services. The training program, held in Manila from January 23 to February 2, 1984, was conducted by the Population Center Foundation and sponsored by the Family Planning International Assistance. Training program objectives included: in crease the participants' knowledge of sexuality-related matters; help them to communicate better with adolescents on matters related to sexuality and fertility; make them aware of other ways of responding to fertility-related information needs of adolescents; and improve their skills in counseling adolescents. Lectures, structured learning activities, discussions, role playing, and other methods were used to maximize learning. The training program was divided into 6 modules: group dynamics; human sexuality; information dissemination; counseling techniques; management; and action planning. The plans of Fiji, India, Indonesia, Nepal, Sri Lanka, Thailand, and the Philippines are reviewed. Organizers of the training program are confident that the action plans of the individual countries will take shape soon and clear the path toward more effective adolescent fertility programs.     

Asian-Pacific round of WFS activities

The primary aim of the World Fertility Survey (WFS) program is to assist countries to acquire the scientific information that will permit them to describe and interpret the fertility of their populations. A 2nd purpose is to increase national capacities for fertility and other demographic survey research, particularly in developing countries; while a 3rd objective is to collect and analyze data on fertility which are internationally standardized and therefore permit comparisons between 1 country and another. The WFS studies are generally single-round surveys of households selected to provide a national probability sample, with information collected from eligible women with the help of a carefully designed individual questionnaire. The recommended WFS questionnaire consists of 7 sections: 1) respondent's background; 2) maternity history; 3) contraceptive knowledge and use; 4) marriage history; 5) fertility regulation; 6) work history; and 7) current husband's background. For countries wishing to investigate certain topics in greater depth, various modules have been developed by WFS which can be incorporated into the questionnaire. So far, 35 developing countries and 17 developed countries have been participating in the WFS program, including 14 ESCAP countries. 11 of these countries (Bangladesh, Fiji, Hong Kong, Indonesia, Japan, Malaysia, Nepal, Pakistan, Republic of Korea, Sri Lanka, and Thailand) have already completed their 1st report and many have begun activities with regard to the 2nd-stage analysis of the WFS data. 3 of these, Nepal; Sri Lanka; and Indonesia; have also held seminars to discuss the survey findings and further analyze the WFS data.     

Influence of grandmothers on breastfeeding practices in a rural community in Papua New Guinea: A critical discourse analysis of first-time mothers’ perspectives

BackgroundAlmost all babies are breastfed in Papua New Guinea (PNG); yet appropriate breastfeeding practices are not always followed.AimTo explore the perspectives of first-time mothers in rural PNG on how the language and discourse of grandmothers about infant feeding influence their breastfeeding practices.MethodsA critical discourse analysis (CDA) approach was used to theoretically frame the analysis of twenty first-time mothers’ narratives.FindingsAnalysis revealed three themes: (i) prescribed knowledge repository, (ii) social control and dominance, and (iii) disapproval and role conflict, which provides an understanding of grandmothers’ differing views and positions on infant feeding practices and their influence on breastfeeding.ConclusionThis study shows that grandmothers remain influential in infant feeding practices in rural PNG. There appears to be a societal expectation that empowers grandmothers in the maternal decision-making processes regarding breastfeeding practice. Grandmothers’ influence includes the early introduction of complementary foods to infants less than six months old. Interventions aimed at promoting, protecting, and supporting breastfeeding need to include grandmothers.