Declining world fertility: trends,causes, implications

This Bulletin examines the evidence that the world's fertility has declined in recent years, the factors that appear to have accounted for the decline, and the implications for fertility and population growth rates to the end of the century. On the basis of a compilation of estimates available for all nations of the world, the authors derive estimates which indicate that the world's total fertility rate dropped from 4.6 to 4.1 births per woman between 1968 and 1975, thanks largely to an earlier and more rapid and universal decline in the fertility of less developed countries (LDCs) than had been anticipated. Statistical analysis of available data suggests that the socioeconomic progress made by LDCs in this period was not great enough to account for more than a proportion of the fertility decline and that organized family planning programs were a major contributing factor. The authors' projections, which are compared to similar projections from the World Bank, the United Nations, and the U.S. Bureau of the Census, indicate that, by the year 2000, less than 1/5 of the world's population will be in the "red danger" circle of explosive population growth (2.1% or more annually); most LDCs will be in a phase of fertility decline; and many of them -- along with most now developed countries -- will be at or near replacement level of fertility. The authors warn that "our optimistic prediction is premised upon a big IF -- if (organized) family planning (in LDCs) continues. It remains imperative that all of the developed nations of the world continue their contribution to this program undiminished."     

Mental health program evaluation: Where you start?

Seduced by the elegance, sophistication and jargon characteristic of new developments in applied research, practicing evaluators are in danger of becoming distracted from achievement of their evaluative goal: that of providing timely, reliable and useful data to program management to facilitate rational data-based decision-making. To avoid such seduction, the author advocates adaptation of simple, inexpensive and efficient evaluative methods tailored to organizational needs and presentation of findings in language readily understood by constituent groups. Likewise, insistance by evaluators upon maintenance of a strict role boundary — that is, limiting role functioning exclusively to those tasks considered evaluation — may be dysfunctional. Rather than detract from accomplishment of his goals, the author maintains that such participation allows development of skills, insights and staff relationships which enhance the evaluator's effective functioning within the organizational context and contribute to organizational acceptance and use of his evaluative results.     

Coordination and citizen participation

This study investigates the validity of the assumption that coordination and citizen participation are related inversely and, thus, are incompatible as features in the same social service reform strategy. Seventeen social service organizations situated in the same urban area were studied. Data were obtained by structured interview. The concepts of coordination and citizen participation were operationalized by means of scales. The findings support the validity of the assumption noted above. Although interpretations of the findings can be provided, they are post-factum. This implies a need for explanatory research which might be guided by theories of community power structure and of organizational behavior.     

Evaluating a private foundation's health program

Public policy decisions in health are increasingly difficult and expensive. Although there will never be enough information available, private foundations can help to bridge the most important gaps in knowledge. Larger foundations may also wish to respond to those who doubt the value of foundation activities. This article reviews the experiences over the past eight years of The Robert Wood Johnson Foundation in employing evaluation and related social research procedures in the planning and implementation of a major philanthropic effort to improve the health and medical care of Americans. Discussed are the still evolving Foundation evaluation framework, the unanticipated problems in undertaking specific evaluations, and the substantive findings of some of the studies.     

Social forecasting: An integral part of corporate planning?

The increasing need for business to monitor the social dimensions of its environment and, hopefully make some forecasts of future trends has met with some constructive response from academics and consultants although not as yet on a very liberal scale. The published literature does not indicate to what extent companies in general attemp social forecasting and, where they do, the degree of integration which exists within their corporate planning systems. The authors, therefore, decided to survey a sample of British organizations to see if they could shed some light on these issues and thereby add some information to the excellent accounts of individual cases of social forecasting in, they suspect, the more advanced and atypical companies. The survey suggests a general picture of: awareness of the value of social forecasting; fairly widespread ignorance of the techniques which do exist, primitive though these may largely be; successful integration of social forecasting into the corporate planning systems of a substantial number of organizations but not in the majority.     

Perceived morbidity, utilisation of health services and factors affecting it in a rural area

A survey of perceived morbidity was carried out in rural population in eight villages and four wards of Saoner town, covering a total population of 8,876. The nature of illness was assessed by weekly visits to the families. History regarding treatment taken for disease and its source was taken. The overall incidence of perceived morbidity was 176.35 spells of sickness per 1000 population per month. Health care agency was contacted for 36.7 per cent spells of sickness. Utilisation of health services was found to be affected significantly by factors like age (chi 2 = 138.36), literacy (chi 2 = 14.123), type of occupation (chi 2 = 433.74), nature of illness (chi 2 = 83.578) and accessibility of health services. A health behaviour model of the population has also been discussed in this paper.     

Regression of area mortality rates on explanatory variables: what weighting is appropriate?

"One can often gain insight into the aetiology of a disease by relating mortality rates in different areas to explanatory variables. Multiple regression techniques are usually employed, but unweighted least squares may be inappropriate if the areas vary in population size. Also, a fully weighted regression, with weights inversely proportional to binomial sampling variances, is usually too extreme. This paper proposes an intermediate solution via maximum likelihood which takes account of three sources of variation in death rates: sampling error, explanatory variables and unexplained differences between areas. The method is also adapted for logit (death rates), standardized mortality ratios (SMRs) and log (SMRs). Two [United Kingdom] examples are presented."