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.     

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.     

Marriage selection and age patterns of mortality: a mathematical investigation

"In this paper, we use simulation models to demonstrate the complexity of the relationship between the marriage selection process and the resulting RMRs [relative mortality ratios]. In particular, we show that marriage selection alone can produce a relative mortality ratio which remains large and relatively constant at ages far beyond the marriage span....Our general objective...is to determine the range of age patterns of relative mortality which could, in theory, result from marriage selection on the basis of health characteristics. We also evaluate the effects of variations in the marriage selection mechanisms on the resulting mortality patterns....We develop and apply several simple mathematical models of the marriage selection process. In order to distinguish the potential consequences of marriage selection from marriage protection, we consider hypothetical populations in which causal effects are absent....We begin by considering an extremely simple marriage selection process and subsequently explore a more realistic selection model based on recent death and marriage rates for Japan."     

Chinese Communist Party Central Committee calls on Party and Youth League members to take the lead in having only one child (per couple), [open letter,September 25, 1980

This open letter from the Central Committee of the Chinese Communist Party concerns the question of controlling China's population growth. To limit the total population of China to 1.2 billion by the end of this century, the State Council has advocated 1 couple giving birth to only 1 child. China's total population will reach 1.3 billion after 20 years and will exceed 1.5 billion after 40 years. Besides the family needing to increase the cost of upbringing, increasing population also requires the state, in order to solve their education, employment, and otheer problem, to raise education expenditures, investments of equipment, and outlays for social and public utilities. The phenomenon of population "aging" will not occur within this century because at present 1/2 of the total national population is below the age of 21, while elderly people above age 65 consist of less than 5%. After 40 years of the practice of 1 child per couple, some families may experience the problem where the elderly lack people to care for them. In the future when production is developed and the people's lives are improved, social welfare and social security will certainly increase and improve continuously. To control population growth, the Party and government have already adopted a series of concrete policies; considerations and allowances are to be given to single children and their families with respect to admission to childcare centers and primar schools. Young comrades must begin with themselves, while old comrades must educate and supervise their own sons and daughters.     

Setting health priorities: a review of concepts and approaches

The setting of health priorities is primarily concerned with the equitable distribution of resources and is now more than ever an important part of strategic planning within the National Health Service (NHS). The basic information which can be used to assist in such decision-making and the process by which different agencies become involved are important aspects of priority-setting; this article is based on a major review of the research literature on these aspects and provides a discussion and an analysis of experience within health and other fields. From this material a number of possible approaches to priority-setting are identified and discussed. The article concludes that, before it can be decided how priorities should be set in the future, outstanding questions about how far rational approaches are feasible, about who is to be involved and what role they should play, and about how far such decisions are to be taken nationally or locally will need further consideration.     

新的产业革命

微电子工业方面的非凡进展触发了一场"第二次产业革命".在这场革命中,新技术将使原来由人力操作的工种自动化.这种自动化看来会提高生产率,但将威胁大量的就业机会.当国家科学院的一个委员会声称,"现代的电子工业已经宣告了一场第二次的产业革命……它对社会的影响甚至比原来的产业革命更大",这时候就该引起我们迫切重视了.因为科学院的各个委员会向来是不夸大事实的.并不是唯独科学院指出了电子工业技术的最新进展是势不可挡的社会变革的先驱.在过     

当代意大利经济学流派评介

当今,经济学家是十分走红的人物,有人甚至称他们为"当代皇室的智囊".近几年来,经济学家充斥宣传机构、各级政府和议会.在各个领域内,经济学家们都在进行着激烈的斗争.甚至两伊战争也不是将军们的意见,而是经济学家们对关闭霍尔木兹海峡所造成的后果的预测占了压倒的地位.他们似乎扮演了这场战争的主要角色.但是,如果我们注意观察一下世界经济的发展情况就会发现:经济学家们当前在经济问题面前却是一筹莫展.在如何使经济重新繁荣起来这个问题面前,市场经济的调节者们从来没有象今天这样显得无能."新经济主义者"们则表现得更加"本分",他们主张"让市场自己     

当代世界的异化

今天大量的技术力量集中在资本主义国家,增殖资本的动力促使资本主义国家给技术发展规定了明确的方向,即把它纳入剥削劳动和剥削"无产者"国家的总实践里.因此分析技术世界的异化,应首先考虑资本必然带来的不平等和不合理.由于与资本的存在相联系的现象在阶级关系和民族关系中很重要,因而要消灭某些异化形式,就必须准备进行深刻的改革,实现社会对财富的控制.但是,某些畸变的根源应该到资本以外更深的地方去寻找.当马克思研究价值的生产和积累过程中的资本运动时,资本主义生产体系还处于尚未发展成熟的初级阶段,因此不论是对价值的生产和占有的分析,还是对由此产生的异化现象的分析,都