A survey of the family planning work done in Dongguan County

The total fertility rate of women of childbearing age of Dongguan County in China has been decreasing gradually from 5.9 during the period following the liberation in 1949 to 2.05 in 1982. In order to encourage young couples to implement the policy of family planning consciously, the people's government of Dongguan county decided in July 1980 that all cadres and employees in county towns who received 1-child certificates would be exempted from house rent of 45 square meters from the time they get their certificates and would be allocated a living space of a 2-children family until their children reached age 16. It also stipulated that every couple could enjoy 1 month's holiday every year for 3 years and during the holiday, their salary, bonus and rate of attendance would not be affected. Because women bear less children today, they are relieved from heavy household chores and become the main working force in collective production. As a result, the development of town-run enterprises was stimulated and the total industrial output value of these enterprises increased. The average monthly salary of each female worker is about 100 yuan. In 1984, the average income per capita of the country rose to 649.2 yuan. The implementation of family planning work has eased the tension in the education field. Previously, because of the large number of school-age children in rural areas, teachers had to teach 2 classes. In the past 4 years, great emphasis was laid on intellectual investment. During this period, 2351 schools were built and several fundraising projects were implemented. Since 1981, more than 200 new running water projects were built, and new public services have been developed, including old age homes.     

Education and the professionals. Some aspects of innovation in medical education adopted by Ahfad University for Women

This article describes the establishment in 1990 of a School of Medicine at Ahfad University for Women in Sudan. The school was premised on the view that women doctors would have a better opportunity to affect and improve women's health than men doctors. The curriculum is innovative and relies on a community orientation and a problem-solving approach. Medicine and health are taught in a holistic way. The new approach is rooted in the Alma Ata Declaration in 1978 of Health for All by the year 2000. The new method of delivery of medical care in the School of Medicine is based on the promotion of health through health education, prevention of disease, proper nutrition, provision of a safe water supply, attention to maternal/child health and family planning, and attention to the treatment of endemic diseases. In order to teach primary health care, medical schools must change their practices. Delivery of health care will have to be changed. New curriculum approaches emphasize learning objectives in each of the teaching modules and small group teaching. Integrated learning means the separate disciplines of medicine are taught as a whole multidisciplinary unit. Case management learning has the potential for increasing motivation and the ability to discover the knowledge needed to solve the problem. McMaster University relies on a problem-oriented approach to medical education that prepares the student for coping with changes in medical knowledge in the future. The challenge for educators is to create an efficient and comprehensive curriculum that will prepare a doctor for lifelong learning. Health settings have also changed to deemphasize sophisticated hospital settings in favor of community-based health centers. Ahfad University is the only one of its kind in Sudan. Medical education includes 6 years of schooling divided into 3 phases.     

Accounting for the transition from inpatient to outpatient surgery

This article reports on some of the factors that have advanced and impeded hospital progress in moving from inpatient to outpatient surgery. Early on, patients, physicians, and hospital administrators all agreed that outpatient surgery had an intuitive appeal. Patients liked it because they didn't have to go in the hospital. Physicians liked it because they could get in and out of the outpatient surgery center more easily than the main hospital operating room. Administrators recognized the inherent appeal of outpatient procedures but were unable or unwilling to switch services from inpatient to outpatient for a variety of reasons. First, empty hospital beds and diminished scope of inpatient operations are a threat to the power of administrators. Moving surgery from inpatient to outpatient settings reduces inhouse operations. Second, reimbursement incentives were definitely in favor of continued inpatient care long after technology was in place for outpatient care. The third and most critical reason was that cost data on outpatient operations were just not available for making decisions on when to move into the outpatient setting. This review of the literature was intended to document the lack of relevant cost-based accounting. Instead, many other factors that more directly slowed progress were encountered. More than anything, this illustrates the erratic course of progress in health care reform.     

Modeling household fertility decisions with generalized Poisson regression

This paper models household fertility decisions by using a generalized Poisson regression model. Since the fertility data used in the paper exhibit under-dispersion, the generalized Poisson regression model has statistical advantages over both standard Poisson and negative binomial regression models, and is suitable for analysis of count data that exhibit either over-dispersion or under-dispersion. The model is estimated by the method of maximum likelihood. Approximate tests for the dispersion and goodness-of-fit measures for comparing alternative models are discussed. Based on observations from the Panel Study of Income Dynamics of 1989 interviewing year, the empirical results support the fertility hypothesis of Becker and Lewis (1973). Received January 7, 1997 /Accepted April 3, 1997     

Demographic changes as a problem for social security systems

The relationship between demographic changes and the social security system is explored. The focus is on the current situation in the Federal Republic of Germany, but consideration is also given to comparable developments in other developed countries. Emphasis is placed on how changes in the age distribution of modern populations affect the relative proportion of the productive and the dependent populations.     

International and internal migration decision making: a value-expectancy based analytical framework of intentions to move from a rural Philippine province

"The study compares determinants of internal and international migration intentions, drawing upon interview data from a sample of adults in Ilocos Norte, a largely rural province in the Philippines. A regression model is applied to test the relative determinants of intentions to migrate to Manila and to Hawaii. The study is based on a value-expectancy model of migration decision making. The results document the importance of subjective expectations related to the attainment of different values and goals in Manila and Hawaii."