Estimates of fertility in Bangladesh

The attempt is made to estimate fertility levels in Bangladesh on the basis of data collected during the 1974 Census. In the 1st section attention is directed to providing an overall picture of the demographic situation in the country. Comparisons between the 1961 and 1974 data demonstrates that the 1974 Census data provide consistent results. Factors such as the degree of urbanization, literacy and economic participation rates--considered as indicators of development--all seem to show little progress during the intercensal period. The use of child/women ratios (CWRs) provides plausible evidence of the likelihood of a fertility decline. A decline in CWR values is small for "all areas" but a marked decline can be noted for "urban areas." The recorded mean number of children is less in 1974 than in 1961 for women under age 35 whereas for the older groups the 1974 Census shows higher mean numbers. The Bangladesh Fertility Survey (BFS) data result for the total fertility rate of 6.58 is very close to that estimated for the 1974 Census--6.59. The reverse survival method also indicates that birthrates have been lower during the 1969-1974 period.     

The impact of P.L. 93-641, the National Health Planning and Resources Development Act, upon health and mental health programming

Federal legislation regarding health care in the U.S. has increased rapidly in the past few years. A major law with potential far-reaching effects was enacted as a result of increasing legislation and rising health care costs. This law,The National Health Planning and Resources Development Act,has created a network of over 200 local, mostly nongovernment units, called health systems agencies. These agencies are responsible for areawide health planning, plan implementation, review and approval of federal health care expenditures for local programs, and facilities review. They will affect health and mental health programs at the local level. The article is directed to local health and mental health care providers who will, of necessity, deal directly with the local HSA's.     

Migration, remittances and rural development: findings of a case study in the Indian Punjab

Rural household survey data in the Ludhiana district of the Indian Punjab was used to study the nature and role of remittances in rural development. Of the 1646 outmigrants from the area since 1961, the 949 women who migrated for marriage and children under 12 years old were excluded from the study. Nearly all husbands who outmigrated had sent remittances. Parents and grandparents were 2nd and 3rd most likely to remit, but their numbers were small. Education did not correlate with remittance. Distance and time since emigration did not affect remittance. The frequency and the size of remittances are discussed. Remittances to outmigrants were insignificant. The remittances from outmigrants seem to raise the incomes and the levels of living of rural households. The remittances serve the purpose of redistributing income from urban to rural areas. Remittances also widened the gap between rich and poor in the rural areas because the better-off groups were more likely to receive remittances than the poorer groups. Most of the money sent from outmigrants was spent on consumable goods, food and clothing. Only a small proportion was spent on productive investment. This was usually done by farming families who invested in land or farm necessities. It is concluded that remittances from outmigrants can have a positive effect on the rural economies. Investment opportunities for nonagricultural families must be provided.     

Institutional factors,government policies and appropriate technologies

Traditionally the use of inappropriate technologies in the developing countries has been explained by the existence of factor price distortions, e.g. the price of labor being artificially raised by labor legislation, and the price of capital being reduced by subsidies and unrealistic exchange rates. In reality the technological choice is often determined by economic conditions and the local sociocultural/political conditions. The institutional framework of the country may discourage the appropriate technology. The obstacles can be overcome when the following conditions are met: 1) a national consensus about the need for development efforts and importance of policy goals; 2) promising market prospects and/or an effective marketing system; and, 3) sufficient industrial competition in both home and international markets. Institutional problems come from the generation and diffusion of technologies from the supply side which are introduced to people who do not see the need for them. More emphasis on the marketing side ususally results in application of correct technology, especially where governments fund research and development projects and formulate their plans on the basis of a concrete investment or production plan and a clear idea about the target market. Land reforms and agricultural price policies are needed as well as the establishment of an efficient national administrative network.     

Authority Systems

This is the second of the Paul F. Lazarsfeld Lectures, whichwill be presented annually under the auspices of the Centerfor the Social Sciences of Columbia University, heir to theBureau of Applied Social Research. James S. Coleman's paper,delivered on March 7, 1980, follows upon the first Lecture,given by Hans Zeisel in Philadelphia under the auspices of theCenter for Research on the Acts of Man. From this time forward,the Public Opinion Quarterly plans to ensure continuity of publicationof the annual Lectures in the journal which Paul Lazarsfelddid so much to sustain.     

Network analysis in evaluation: some words of caution

Network analysis, a methodology derived from general systems' theory, can be utilized as a community mental health administrative-evaluation procedure. Evaluation parameters derived from analysis of patient data as they “flow” through a network of agency services, provide measures of systemic functioning. These parameters include “longest paths” and various ratio relationships as evaluation measures of service delivery. The limitations of network analysis are examined by means of conceptual analyses, and phenomena that emerged from research experience. The necessity for both quantitative and qualitative data to ensure a meaningful evaluation of mental health services is explained. Conclusions about the value of the network analysis approach are considered.     

The hospitals and population growth: The voluntary general hospitals, mortality and local populations in the English provinces in the eighteenth and nineteenth centuries part 2

Summary In the second part of this article the number and nature of hospital cases treated in the light of physical, medical and surgical limitations are examined. Each hospital's records of treatment are summarised and discussed. Whether or not the hospitals were able to tackle successfully some of the major diseases and causes of death and thereby exert a positive influence in reducing mortality rates is then considered. Two main conclusions are drawn. First, that the hospitals had a positive role to play within their patient catchment areas, but that this was insufficient to affect national mortality trends decisively. Secondly, the hospitals' influence was of greater importance before the mid-nineteenth century. Despite advances in medical knowledge and techniques, population pressure, overcrowding and the growing incidence of serious cases in hospitals coupled with outbreaks of 'hospital diseases' meant that the results of hospital treatment may have become less impressive. But even then, mortality levels in the hospitals were low and the hospitals did not merit their reputation of being 'gateways to death' or as institutions 'which positively did harm'.