Issues concerning the content and methodology of the upcomming population census

The author examines the content and methodology of the 1989 Soviet census. Items to be included in the questionnaires for both the total population and the 25 percent sample survey are described. The author notes that questions on housing will be included for the first time. Other topics considered include reliability of data, confidentiality, and organization.     

Fertility decline in Bangladesh: an emerging family planning success story

Bangladesh has a population of 115 million people, and the economic growth rate of 3.7% during the 1980s was undermined by rapid population growth. The annual population growth rate was 3% in the 1960s and early 1970s, 2.5% between 1981-91 decreasing to 2.3% in 1991. The average of number of children is 4.6/woman compared with 7 in the 1960s. Infant mortality dropped from 150/1000 births in 1976 to 118/1000 in 1991. Life expectancy rose from 47 to 54 years. The 1991 Contraceptive Prevalence Survey showed that 39.9% of married women under 50 use contraceptives in 1991 vs. 18.6% in 1981. The use of modern methods increased from 10.9% in 1981 to 31.2% in 1991, while traditional methods rose from 7.7% to 8.7%. Sterilization was most prevalent in 1981. 29,000 female family planning (FP) workers were aggressively engaged in dispensing FP services in 1990. The Social Marketing Company sells pills, condoms, and oral rehydration salts through 130,000 retail outlets. The 1989 Contraceptive Prevalence Survey showed that 40% of pill and condom users obtained them from this network, and 95.4% of women knew about 4 methods of contraception. In 1990 there were 120 private organizations providing contraceptive services. Some of the components of the government FP program include field worker distribution door-to-door of injectable contraceptives (50% injectable usage rate in the Matlab project); recordkeeping activities; a satellite clinic network with access to contraceptive services; and decentralization through the Upazila (subdistrict) approach. The logistics system of FP has improved the warehousing, transportation, and management information system. Foreign aid (mainly USAID) financing of contraceptives helped avert 14.4 million births between 1974-90. The increase of contraceptive prevalence to 50% by 1997 would avert another 21.9 million births during 1991-96 (replacement fertility requires 70% prevalence.     

The timing of maternity in the Netherlands

In this paper the timing of maternity is estimated by a hazard model. The novel aspect of this paper is that it is shown that wages and total household labor income have a significant effect on the timing of maternity. Both the wage rate of the woman and the wage rate of the husband have a negative effect on the timing of maternity. Total household labor income increases the probability of having a child at an earlier age. Calculated elasticities show that the timing of maternity is relatively elastic with respect to wage rates. However, the elasticities of the decision whether or not to have children altogether are much smaller. Women working in the labor market delay the timing of maternity compared to non-participating women. Attending school has the same effect. Until the age of 28 the maternity hazard increases with age, after that it decreases.We benefited from comments on previous drafts by Siv Gustafsson, Joop Hartog, Peter Kee, Herriette Maassen van den Brink, Eddie Mekkelholt, Joop Odink, Hessel Oosterbeek, Hans van Ophem, Gusta Renes, Andre Voskamp, two anonymous referees, and the Managing Editor of this Journal. This paper is a revised version of a paper presented at the third annual meeting of the European Society for Population Economics, Paris, June 1989. The usual disclaimer applies.     

Data collection: are social workers reliable?

Social workers are required to collect a considerable amount of personal information about clients and their families which may be unrelated to direct clinical work. Administrators often use this for the purpose of payment, service documentation, agency planning, and accountability. The worker's concern about the appropriateness of collecting this data may result in poor compliance or even falsification of information. In a survey of Minnesota social workers, noncompliance with data collection requirements was substantial. The authors also found a significant degree of conflict about privacy and confidentiality issues. These findings suggest a basis of concern for those who must rely on accurate data for administrative planning.     

Breast implants, Hippocrates, and burden of proof

The author argues that the burden of proof for the safety and efficacy of some medical devices properly lies with the manufacturers of the devices and with the providers who use them. The controversy over breast implants is used as a case for this shift in the burden of proof of safety and effectiveness.     

Biotechnology: will it break the health care bank?

Pharmaceuticals traditionally have been viewed as a cost-effective component in medicine's technological armamentarium. The use of pharmaceuticals has been estimated to account for 6-8 percent of the nation's total expenditures on health care. The first wave of pharmaceuticals/biologicals that has been produced by the biotechnology industry has offered therapies that can provide much benefit to patients, but it has also raised concern about the cost of these new recombinant drugs. In addition to pricing, methods of promotion and modifications in the FDA approval process have raised concerns.