Population bulletin of the United Nations最新文献

Renewed emphasis is being given to the role of family planning health care programs. This review of the lessons learned during the past decade provides guidance to policy makers and program managers on ways to improve maternal, infant, and child health through family planning and related health and development activities. It covers policies and laws, accessibility to services, acceptability and quality of services, provision for the special needs of high-risk groups, the use of communications programs, the importance of improving the status of women and the quality of life, and the resources needed to implement such a program globally. Practical steps for integrating family planning fully into maternal and child health care are described.

A number of macro-economic-demographic models have been created for developing countries during the decades of the 1970s and 1980s. Such models purport to simulate relationships between demographic variables and the process of socioeconomic development in the particular country, with the dual purposes of enhancing our knowledge of the process in particular settings and, by examining alternative scenarios, providing useful information to policy makers on the selection of demographic and economic policies to enhance economic development and improve human welfare. This paper 1st reviews the antecedents and then focuses on assessing the demographic functions (fertility, mortality, and internal migration rates) used in the 2 families of models which have had perhaps the largest number of applications in developing countries--the Bachue models, originating at the International Labour Office (Geneva), and the ESCAP models, originating at the Economic and Social Commission for Asia and the Pacific (Bangkok). Each has been applied, with significant variations, in at least 3 countries. Economic-demographic functions are defined as endogenous (and substantively meaningful, from the points of view of this paper) whenever there is an effect of economic growth or change in economic structure on the particular demographic function. The bulk of this paper assesses the realism and endogeneity of the fertility, mortality, and migration functions used in the Bachue and ESCAP models, noting, where possible, both the apparent and prima facie behavioral relationships and those that are actually important on the dynamic simulation. Shortcomings are described, including the lack of government expenditure functions with effects on demographic variables. The paper concludes more positively, noting areas of congruence and appealing endogenous relationships and functional forms specified in certain country models. It also suggests further development of, on the 1 hand, both simpler and more realistic planning models (focusing on particular behavioral relationships or sectors of importance to the country), which will be easier for country planners to understand and hence use, and, on the other hand, more complex research models aimed at enhancing our understanding of fundamental, dynamic relationships between economic factors, government policies and fertility, mortality and migration rates during the course of socioeconomic change.

The recommendations for further action made by the International Conference on Population (Mexico City, 1984) in the area of population distribution and internal and international migration continue to be an accurate reflection of the current state of scientific and political thinking in Latin America, except for the 1 topic on which they are deficient--female migration. An increasing body of research findings demonstrates the importance of women migrants--especially women as independent migrants. The predominance of women in Latin American rural-to-urban migration flows is well known, but female majorities are found in other important flows (e.g., in some inter-urban and international flows) as well. In general, female migrants tend to be younger than their male counterparts. The kinds of employment most commonly sought by women migrants are related to their traditional roles in the home and in child-rearing. The problems faced by migrant women differ from those confronting men who migrate and vary greatly over a wide range of conditions.

This paper provides an overview of recently developed approaches to the measurement of contraceptive continuation and failure rates, using retrospective survey data rather than the data from clinical trials or program statistics which are more traditionally used. The approaches fall into 2 categories, 1 relying on retrospective contraceptive histories and the other on current status information. The 1st section of the paper discusses the need for new methodologies; conventional applications using clinic and acceptor data are described, some recent results from developed countries presented, and their limitations illustrated. In the 2nd section, each new approach is presented in terms of its data requirements, methods of calculation, and empirical applications. Finally, potential sources of bias and the ability of the approaches to accommodate them are discussed.

This paper review progress over the past 5 years with respect to the 6 recommendations adopted at the International Conference on Population 1984, which specifically address the situation of women. They include: 1) integrating women into development, 2) women's economic participation, 3) education, training, and employment, 4) raising the age at marriage, 5) the active involvement of men in all areas of family responsibility, and 6) the ratification of the Convention on the Elimination of All Forms of Discrimination against Women. Several important areas potentially relevant to population issues which were omitted from the Conference recommendations are identified and discussed--namely, the situation of women (in particular, older women, women who are the sole supporters of families, and women and migration) and the situation of women in times of severe economic adversity. Finally, progress made with respect to data on women is highlighted, and caution is advised with respect to continued calls for new data. In contrast to the Nairobi Forward-Looking Strategies for the Advancement of Women, the recommendations are noted for implying an almost unresolvable conflict between women's biological and economic roles. However, it is pointed out that the goals of the Convention on the Elimination of All Forms of Discrimination against Women for full equality of men and women would require that the same choices be available to both sexes with respect to labor force participation. While it is too soon to have a clear perspective on the pace and direction of change during the past 5 years, the author finds it impossible to be optimistic about current trends because, in too many areas, progress regarding women has either stagnated or moved into reverse gear. The disappointing record is partially attributed to the tendency for policy makers to see the promotion of economic growth through sound economic policy and advancing the status of women as competing rather than complementary goals.

The impact of differentials in key socioeconomic variables on fertility levels in 32 developing countries is assessed through multiple regression analysis of aggregate-level data on 27 developing countries for 3 recent guinguennia, grouped into 4 categories according to region (Latin America vs Asia/Oceania/Africa) and stage of fertility transition (recent vs relatively prolonged fertility decline). The results demonstrate the substantial impact of differences in child survival and educational attainment on the intercountry variance of fertility rate ranges from 46-84%), while economic indicators (per capita gross national product and % labor force in agriculture) have slight net impact.

This paper assesses the feasibility of sustainable development for various low-income countries in the context of prospective population growth. In that context, development that is sustainable is development that does not endanger the natural systems that support life on earth. Since a short time has elapsed since the Mexico City Conference, not all the developmental goals highlighted at that meeting could be reviewed. Emphasis in this paper is placed on an assessment of recent trends in food production and availability, employment and poverty issues, with an emphasis on India, China, and a few other Asian countries on which the author has had access to information. In the view of the author, the key to sustained development in the face of likely continued population growth up to the end of the 21st century lies in technological change and effective use of the human and physical resources in developing countries. Adequate planning and judicious adaptation of the institutional framework can help to avoid the suffering and misery of millions of people currently alive and also those who will be born during further decades.

Taking stock of accomplishments in the field of population reveals that significant progress has been made since the late 1960s but that much remains to be done. Important challenges in population for 1990 and beyond include the implementation of more effective family planning programs, greater accessibility to better family planning services at the local level, a wider range of choices in contraceptive methods, and better training and supervision of family planning delivery personnel. Another major challenge is to give attention to the various aspects of the role of women--beyond mere acknowledgement and to the actual implementation of programs. Further, policies need to be formulated and implemented across several sectors to deal with the complex interaction between population, resources, and the environment. To devise such policies, knowledge of the interrelationships needs to be clarified and refined. Finally, still greater emphasis will have to be placed on improving the integration of population and development. Accomplishing that will require wider awareness, enhanced coordination and adequate resources--an increase of at least $100 million per year from now to the end of the century over the annual current level of some $550 million for all external assistance for population.

This paper summarizes the natural history, surveillance, and global patterns of infections with the human immunodeficiency virus (HIV), the etiologic agent of AIDS The focus is primarily on HIV-1 because surveillance of HIV-2, which has recently been recognized as a separate type of the virus, is only just beginning. The natural progress of the disease is described, from acute infection through asymptomatic phase to the clinical illness phase. Available evidence on the speed of progression from infection to AIDS and possible co-factors in that progression are reviewed. The 3 patterns of AIDS which are described characterize the experience of different regions according to the types of transmission ( i.e., homosexual versus heterosexual, contaminated blood, drug use) and demographic characteristics of the affected persons. An epidemiologically based short-term forecasting model for AIDS cases is presented and used to project the demographic impact of AIDS in a hypothetical central African country. In that hypothetical setting, the impact of AIDS is shown to be disproportionately felt in urban areas, where the projected increase in population will decrease by 30% due to AIDS deaths by 1997; the growth rate of the rural population will be only slightly affected. In conclusion, the global prevalence of the disease, and prospects and implications for the future are discussed. Without effective drugs for treatment and no vaccine for prevention of HIV infections, the short-term outlook is not good. HIV/AIDS is expected to be an increasing public-health problem in the next 2 decades.