Sustainability of family planning and health projects

USAID has assisted the Ghanian Ministry of Health since 1991 to boost family planning services under the Ghana Family Planning and Health Project by providing supplies and information and increasing the effectiveness of HIV/AIDS prevention and control. The sustainability of the health system is endangered by favoring capital expenditures in lieu of continuous expenditures; the lack of linkage between project activities and regular activities; the centralization of resource flow; and too ambitious targeting. Capital outlays provided by USAID featured in the construction of four public health laboratories, but their operation also requires continuous financing amounting to about 10% of the whole investment. The latter is the responsibility of the government, although the details of these recurrent costs were not detailed at the outset and providing these funds for continuous operation may impair the operation of other systems. The resource constraints could be alleviated by an effective cost-recovery system or by the general improvement of the economy. The lack of linkage between project and regular activities is serious at regional and district levels. The centralization of resource flow means that most resources are kept for headquarter level activities, thus other activities suffer and the health sector becomes excessively reliant on donor support. Too ambitious planning stems from pressure on donors and hastily implemented projects result in duplication and waste. Closer consultation with the parties involved would improve the situation. The rivalry of technical and policy groups has contributed to past deficiencies. Double funding for the same activity has also occurred further increasing the dependence on donor funding. By concentration on people and systems sustainability would be enhanced, while cost recovery would help the operation of the laboratories. The Health Education Unit (HEU) recognized the importance of IEC and obtained financing for such activities.     

A problem in household composition

"Distinction made between household-persons and household-markers [the person who identifies the family or household as a unit] is formalized in the notion of nested populations. This leads to an extension of the Leslie model into a formulation of growth for both population and households. The extended model involves the matrix presentation of household composition where ratios of household-persons who are age 0, per household-marker, function as surrogate values for fertility rates. The extended model describes change over time in the distribution of population by age, and in the distribution of households by age of household-marker, or household-head. The model involves the inversion of a nonnegative matrix, and is feasible only if it yields, projected over time, nonnegative entries in vectors representing distribution of population by age, and distribution of household-heads by age. Conditions for the feasibility of the extended model are discussed, and a sufficient condition for feasibility over a single interval is identified." (SUMMARY IN FRE)     

Premarital relationships and livelihoods in Ghana

This study is based on interviews with a sample of 400 single women aged 18-25 years from the Fante ethnic group in Cape Coast, Ghana, in 1991, and on focus groups. This case study illustrates the importance of economic and living arrangement support expected from partners in premarital relationships. Support may be for living and maintenance ('chopmoney', provisions, household items, and rent); for financial security (provision of capital); and for clothing and hairdressing. Women did not always require economic support in premarital relationships. Women expect boyfriends to provide 'chopmoney' (money for food and general upkeep) and contribute some money for the rent. Only 36% of sexually active women expected their boyfriends to supply food provisions. Premarital sexual relationships are used to obtain start-up capital. The author refers to evidence that senior government officials engaged in sexual transactions with clients before loans and credit facilities were offered. 87% of sexually experienced women expected their partners to pay for at least part of clothing expenses. The study revealed that there was considerable disparity between women's expectations and actual receipt of economic support. 56% desired, but only 36% received, 'chopmoney' in full. 40% expected their partners to pay for household furnishings in full, while only 10% did so. 55% expected capital, but only 15% received it. The three most frequently received benefits in full were hair dressing, shoes, and dresses. Men provided most non-negotiable items as a means of "boosting their egos." Many young women rely on the support of men in order to improve their status. Ghanaian men control financial resources and economic power. Mothers of adolescent daughters encourage premarital sexual behavior. Prostitution is considered different from sexual exchange relationships. It is argued that gender inequalities and domestic abuse are perpetuated through sexual exchange relationships.     

Breaking the glass ceiling

The glass ceiling is a form of organizational bias and discrimination that prevents qualified professionals from achieving positions of top governance and leadership. This article examines glass ceiling barriers that keep physicians from the upper reaches of management. While these factors apply mainly to women and minority physicians in academia, and are attributable to sexual harassment and discrimination, physicians as a class are frequently denied executive management positions. Such denial results from inadequate preparation for a career in health care administration. Important issues in the professional development of physician executives include mentoring, training and education, administrative experience, and cultural and personality factors. All of those must be considered when making the transition from medicine to management.     

Population statistics] as of July 1, 1997

In thousands, Thailand's total population as of July 1, 1997, was 60,440, of which 30,202 were male and 30,238 were female. 19,087 live in urban areas and 41,353 live in rural areas. 12,141 live in the northern region, 19,678 to the northeast, 7566 in the South, 13,112 centrally, and 7943 in the Bangkok metropolis. 16,288 were under age 15, 39,073 aged 15-59, and 5079 aged 60 and over. There were 15,558 women of reproductive ages 15-44. Crude birth and death rates per 1000 population were 15.6 and 5.0, respectively, with an overall natural growth rate of 1.1%. Infant mortality was 25.0 per 1000 live births. Male and female life expectancies at birth were 66.6 and 71.7 years, respectively. Further life expectancies at age 60 for males and females were 18.8 and 22.0 years, respectively. The rate of total fertility per woman was 1.98 with a contraceptive prevalence rate of 72.2% and an anticipated population of 70,642 in the year 2012.     

Temporary and illegal labour migration: the Israeli experience

In recent years, Israel has become a major recipient of documented and undocumented temporary labour migrants from many countries outside the Middle East region. The purposes of this article are to describe Israel's experience of temporary labour migration and its concomitant, illegal labour migration; and also to explore what her policies on temporary labour migration indicate about the nature of the policy-making process in this policy domain in Israel.
To these ends the article traces the evolution of temporary labour migration – legal and illegal – and recent policy initiatives of the Israeli government. It then considers some of the major conceptions of the policy-making process found in public policy literature. The article concludes by pointing to the uniqueness of Israel's experience of temporary labour migration and to the fact that her policies have been overwhelmingly reactive – inadequately considered, ill-conceived, ambivalent in relation to their ultimate purpose and, in the course of implementation, vulnerable to "privatization" (being taken over by vested interest groups).
Analysis of the most recent policy initiatives designed to reduce the number of legal labour migrants and address the problem of illegal labour migrants, reflect a policy-making process that is not followed by commensurate action.     

Migration experiences of Turkish women: notes from a researcher's diary

The article reviews the migration experiences of Turkish women who were either involved in external migration or were exposed to migration by being left behind upon the emigration of their husbands. It includes notes on statements made by some returning women and women whose husbands returned home.
The statements were encountered during a comprehensive field survey conducted in Turkey. Since the literature on women and external migration is, in general, blinded by a view of migrant women as "traditional" regardless of their ethnic, regional, religious and other background variables, it is expected that their exposure to the "modern" western culture will automatically pave the way to their emancipation.
The diary entries of statements made by migrant women portrayed in this article question such an axiomatic proposition by pointing to the significance of background variables and certain features of household structures.     

Family migration and the economic status of women in Malaysia

"The impact of family migration on women's economic position in a developing country setting is an area that has received relatively little research attention. Incorporating a lifetime perspective, this study makes use of the retrospective migration histories of husbands and wives from the second round of the Malaysian Family Life Survey to estimate how joint migration with the husband affects women's socioeconomic achievement. The findings show that family migration depresses the chances of working, but it does not significantly reduce socioeconomic attainment of those who do work. However, when a woman migrates with her husband she does forgo the substantial advantage she could have derived had she moved alone."     

"How much do you spend gambling?" ambiguities in survey questionnaire items

The validity of a survey's findings is dependent upon the clarity and lack of ambiguity contained in each individual item yet minimal attention has been directed to this issue in most prevalence studies. Researchers have shown a tendency to accept the uncritical assumption that respondents interpret seemingly simple and straightforward items such as 'how much do you spend gambling?' in a consistent manner. No attempt is made to confirm the uniformity of responses by clarifying the mathematical formulae used by respondents to derive their answers. The purpose of this paper was to examine the consistency shown by a sample of 181 medical undergraduate subjects in estimating the level of gambling expenditure in a series of five case vignettes describing various scenarios of wins and losses during a session of gambling. Results revealed a wide variation in calculated figures depending upon whether or not subjects interpreted the item to mean net expenditure or turnover. Only two thirds or less of subjects calculated the figure to be the difference between the initial amount risked and the residual at the conclusion of the session. It is suggested that more attention be paid in prevalence and clinical studies to providing subjects with clear instructions on how to calculate expenditure estimates.