UNITED NATIONS POPULATION INFORMATION NETWORK (POPIN)
UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)

Population Network News No. 2, January, 1993 Part IV



			Population Network News

			  No. 2, January, 1993

			       Part IV



	Demographic and Health Survey Results:   Morocco

	------------------------------------------------



The Preliminary Report of the 1992 Moroccan Demographic and Health 

Survey reveals a decrease in the TFR from 5.9 in 1979 to 4.2 in 1992, 

for a decline of 29%.  This level of fertility is slightly lower than 

the average for the World Bank MN1 region, estimated to be 4.49.  It 

is higher, however, than the average of all lower middle income 

countries such as Morocco, which is 3.57.  



A principal factor in the decline in fertility is increasing use of 

contraception.  Use of all methods increased from 19.4% in 1979 to 

41.5% in 1992.  During the same time period, use of modern methods 

rose from 16.6% to 35.5%, with the pill being by far the most common 

method.  A strong correlation between education and use of 

contraception emerges from the survey:  only 35.7% of women without 

education use contraception, while 57% of those with a primary 

education and 64.9% of those with secondary or higher education do so.

The majority (62.6%) of contraceptive supplies come from the

public sector.



         Demographic and Health Survey Results: Zambia

	-------------------------------------------------

The recent Demographic and Health Survey in Zambia reports a TFR of 

6.5, which is well above the average of 5.56 for countries of the 

Bank's southern Africa region (AF6).  As might be expected from this 

level of fertility, contraceptive use is limited in Zambia: the 

contraceptive prevalence rate for modern methods is 9%, while that for 

all methods reaches 15%. 



	 Demographic and Health Survey Results:   Yemen

	----------------------------------------------------

The 1991-92 Yemen Demographic and Maternal and Child Health Survey 

preliminary report suggests fertility is little changed in this 

country.  The TFR calculated from survey estimates is 7.6 children per 

woman, one of the highest in the world.  Contraceptive use is 

correspondingly low, with only 6.1% of ever-married and 

currently-married women using a modern method.  



	Demographic and Health Survey Results:  Niger

	------------------------------------------------

The preliminary report of the 1991-92 Niger Demographic and Health 

Survey indicates that it remains one of the highest fertility 

countries in the world.  The TFR estimated from the survey is 7.4, 

roughly the same as that found in previous surveys and censuses.  In 

comparison, according to Bank estimates, Rwanda has the highest TFR -- 

8.3 children per woman.  Not surprisingly, contraceptive use is very 

low in Niger, with use of any method at 4% and modern methods, 2%.



	  Demographic and Health Survey Results: Tanzania

	  -----------------------------------------------

Fertility is declining very slowly in Tanzania, according to the 

preliminary report of the 1989-1991 Demographic and Health Survey.  

Previous surveys estimated the TFR to be 6.9 in 1978 and 6.5 in 1988.  

The current rate is 6.3.  In this regard, Tanzania is in line with the 

other countries of East Africa, where the average for the region is 

6.3.  Contraceptive use remains low in Tanzania, with the 

contraceptive prevalence rate for any method at 10% and that of modern 

methods, 6%.



	    Demographic and Health Survey Results: Peru

	   ----------------------------------------------

The major trends appearing in the 1991-1992 Peru Demographic and 

Health Survey final report are an increase in urbanization, increasing 

educational attainment among women of reproductive age, a rise in 

contraceptive use, and a decline in fertility.  While the 1986 survey 

reported a TFR of 4.1, the 1991-92 survey results indicate a TFR of 

3.5.  Use of modern contraceptive methods rose during the same period 

from 23% to 33%; use of any method, including periodic abstinence and

the rhythm method, rose from 46% to 59%.



	Where to Go When You Needed the Information Yesterday....

	------------------------------------------------------------

The population "world" is full of many informal and semi-

formal publications that contain valuable information, but at a

high search cost.  PPAS receives many such documents, a few

of which are outlined below:



*   The Population Reference Bureau's Ready References:  A Resource 

Guide for Strategic Planning lists documents and organizations that 

can provide up-to-date information and analyses on the demographic, 

family planning, economic, and political situation of many countries.  

The booklet is issued as part of the AID-funded OPTIONS project, but 

will also prove valuable to Bank staff working in population.



*  The Population Resource Center produces four-page executive 

summaries targeted to policy makers on numerous topics in population.  

Some that might be useful to Bank staff include:  Contraceptive 

Methods; Unmet Need and Demand for Contraceptives, 1990-2000; World 

Population Trends; Water Scarcity, Population Growth, and Development; 

Population Dynamics in the Middle East; and Demographic Profiles of 

the following countries or regions: Eastern Europe, India, Nigeria, 

Indonesia, and the Commonwealth of Independent States.



*  In addition, the International Planned Parenthood Federation puts 

out Country Profiles which outline the demographic situation in a 

country, provide indicators on health, education, and the status of 

women, and summarize government policy in these areas.  A special 

feature of these reports is a summary of the activities of the IPPF 

affiliate in the country.  To date, PPAS has received copies of the

profiles for Sri Lanka, India, Bangladesh, Nepal, and Pakistan.  



*  For more detailed coverage of population issues in a given country, 

UNFPA undertakes a Programme Review and Strategy Development (PRSD) 

exercise in collaboration with country governments that analyses 

current status and needs, assesses achievements of past population 

activities, and recommends future action in terms of an overall 

national population strategy.  Reports on the exercise have been

published for Bangladesh, Bolivia, Botswana, Ecuador, India, Nepal, 

Nigeria, Peru, South Pacific, Sri Lanka, Syrian Arab Republic, 

Thailand, Tunisia, and Viet Nam.  Guidelines for the preparation of 

the PRSD are also published. 



*  The Special Programme of Research, Development and Research 

Training in Human Reproduction of the World Health Organization (HRP) 

has given us a computerized set of country profiles providing 

historical and current information on collaboration and research 

activities funded by HRP.  In addition to summary information by 

institution and investigator, the country profiles offer brief 

descriptions of the funded projects and a list of national members of 

scientific committees.



			Publications of Note

			-----------------------

Centre Francais sur la Population et le Developpement (CEPED), Women's 

Status and Population:  The Situation of Francophone Africa, (Paris, 

France:  CEPED, September 1992).  The recognition that women's status 

impacts on fertility, migration, and labor decisions is wide-spread.  

Yet consensus has not been formed around how to integrate that

recognition into policies and programs.  This book deals with 

relationships between women's status and population dynamics 

(fertility, migration, health and employment) and presents a synthesis 

of the debates held during a workshop in Lome, Togo which brought 

together practitioners and social scientists who came for the most 

part from Francophone countries in sub-Saharan Africa.  The Lome

workshop was organized by the Division for the Advancement of Women of 

the United Nations; UNFPA and URD collaborated on the publication of 

this volume.



Jane T. Bertrand and Judith E. Brown, Family Planning Success in Two 

Cities in Zaire, WPS 1042, November 1992.  This paper provides an 

in-depth look at two markedly different but successful family planning 

programs in Zaire.  The authors find that the common elements that 

contributed to their success include:  developing a strong sense of

mission among staff members, ensuring an uninterrupted supply of 

contraceptives through outlets in many locations, and establishing a 

system of regular, supportive supervision.  Another important factor 

appeared to be adequate organizational autonomy, allowing staff 

members to take responsibility for program success.



J. Price Gittenger and Carol Bradford, World Bank Project-Financed 

Research on Population, Health, and Nutrition, WPS 1046, November 

1992.  This review of 109 PHN projects financed in fiscal years 1980 

through 1991 focuses on research included as part of a project.  More 

than 90% of the projects financed research, with extremely variable 

results. The study culls many lessons learned from this experience,

including the following:  supervision is crucial to good results;

research that leads to a project outcome is more likely to be 

undertaken and completed than is research with a more general 

objective; peer-group review produces much better research;  and it is 

generally necessary to retain experienced consultants to help design 

substantial research components.



Moni Nag, Family Planning Success Stories in Bangladesh and India, WPS 

1041, November 1992.  This case study of two experimental family 

planning programs, the Matlab Project in Bangladesh and the Kundam 

Project in India, highlights the factors that made these programs 

successful, despite adverse socioeconomic conditions.  The two 

programs have different approaches:  in the case of Matlab, an

organizational system was developed for delivering consumer-oriented 

family planning and MCH services; in the Kundam Project, success may 

be attributed to an organizational system developed for active 

participation of community members in government's family planning and 

other development programs.  The study recommends pilot studies to 

test the replicability of both approaches.



Regina McNamara, Therese McGinn, Donald Lauro, and John Ross, Family 

Planning Programs in Sub-Saharan Africa:  Case Studies from Ghana, 

Rwanda, and the Sudan, WPS 1004, October 1992.  Three successful 

family planning projects in sub-Saharan Africa are examined and seen 

to provide support for an optimistic view for future family

planning efforts in the region.   



Michael H. Bernhart, Strategic Management of Population Programs, WPS 

996, October 1992.  Bernhart surveys the literature on strategic 

management in private/for-profit organizations and applies lessons 

from that literature to population programs.  While acknowledging the 

inherent confusion and frustrations involved in applying strategic

management techniques, the author concludes that the benefits to be 

reaped from engaging in this process are numerous and justify the use 

of such tools. 



Baldwin, George:  Targets and Indicators in World Bank Population 

Projects, WPS 1048 (November 1992).  This paper reviews the procedures 

used by the Bank to evaluate the performance and impact of its population 

program (74 projects are considered) and provides suggestions on ways to 

improve on the evaluation system.  Among the other recommendations are: 

increased use of international comparisons and trend analysis for 

determining progress rather than reliance on target setting; use of DHS 

data as the rule, rather than the exception, in population and health

projections; and more attention to program-level rather than 

project-level performance.





		World Bank Population Projections

		-----------------------------------



PPAS demographers Ed Bos, My Vu, and Ann Levin have completed the 1992-93 

edition of the World Bank Population Projections, which include estimates 

of fertility, mortality, and age structures, as well as projecting 

population sizes by country and region to the year 2150.  Global 

projections indicate that by the year 2025, world population is projected

to reach 8.34 billion, an increase of 52% over the mid-year 1992 estimate 

of 5.44 million.   In 1992, LDCs accounted for 77% of world population; 

by 2025 that figure will reach 83%.  

 

A book of projections giving demographic data for every country in the 

world will be on sale in the Bookstore in late January.  In addition, 

four volumes have already been published as working papers.  They are 

arranged by region:



*  Europe and Central Asia Region, Middle East and North 

   Africa Region, WPS 1016;

*  Africa Region, Confidential Draft Report;

*  Latin America and the Caribbean Region (and Northern

   America), WPS 1033; and

*  East Asia and Pacific Region, South Asia Region, WPS

   1032.



---------------------------------------------------------------------

PNN is a quarterly round-up of news and information relevant to Bank

staff working in the population field.  It is produced by the

Population, Policy and Advisory Service (PPAS) and edited by Chantal

Worzala.



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			Population Network News

			 No. 2, January, 1993

			     Part III



	 Donor Cooperation at Work: The Contraceptive Requirements

    and Logistics Management Needs in Developing Countries Initiative

   ------------------------------------------------------------------

In FY92, the Africa Region and PHRDR (Population, Human Resources Dept.) 

joined the Rockefeller Foundation, SIDA, and other donors in funding the 

work of a UNFPA initiative to assess and respond to the contraceptive 

requirements and logistics management needs developing countries will be 

facing in the medium term.  Specific areas of inquiry include:



	* contraceptive requirements in the medium term;

	* logistics management constraints and solutions;

	* current and future capability for in-country contraceptive

     	  manufacturing;

	* the role of the NGO and private sector in family planning;

    	  and

	* the estimation of condoms required for STD/AIDS

     	  prevention.



A UNFPA staff of three now oversees and disseminates the results of 

in-depth studies of the situation in specific countries, at the rate of 

four per year.  To date, missions have been sent to Pakistan, Zimbabwe, 

and India, with work currently underway in Nepal.  The countries to be 

visited in calendar year 1993 are Nigeria, Turkey, Philippines, and

either Brazil or Mexico.



              		Brainstorming at the UN:

      	        Cost Recovery and Family Planning Program

                	   Sustainability

	     ---------------------------------------------	



Given population growth, economic problems, and rising costs, the amount 

of public resources available for family planning and public health 

services in many countries is falling behind demand.  Jyoti Shankar Singh, 

Director of the Technical and Evaluation Division of the UNFPA, chaired a

brainstorming session of demographers, economists, and family planning 

specialists on the issues of cost recovery, resource mobilization, and 

program sustainability.  The session raised preliminary issues and 

strategies (including cross-subsidization, social marketing, 

cost-effectiveness, and private/public mix); identified relevant country 

experiences (Kenya, Burma, and the Bamako initiative, among others);

and outlined next steps in the preparations for a Consultation

on Cost Recovery to take place in June 1993.



                          Contraceptive News

    			------------------------

*  The U.S. Food and Drug Administration (USFDA) approved the three-month 

injectable contraceptive Depo Provera for use in the United States in 

October 1992, twenty-five years after the Upjohn Company first filed it 

for approval.  This ruling means that USAID can now supply Depo to family 

planning programs in developing countries.  They plan to begin doing

so in early 1993.



*  Swedish health authorities approved RU 486 for use in Sweden in 

September 1992.



*  Scientists in India are hot on the trail of a contraceptive vaccine 

for women.  At the same time, the WHO Special Programme of Research, 

Development and Research Training in Human Reproduction (HRP) has 

conducted safety trials of its prototype antifertility vaccine in rats 

and rabbits, finding no adverse affects either on pregnant animals or 

fetuses.  Work continues on developing a vaccine that will remain 

effective for 12 months or more following a single injection.



*  The vaginal ring, a progesterone-only contraceptive that can be 

controlled by the user, has been extensively tested and proven safe and 

effective.  Roussel Laboratories Ltd. (UK) has applied for a product 

license and will begin producing and distributing it soon. 

 

           Breastfeeding and AIDS: The Debate Continues

 	   ----------------------------------------------

On average, one of every three babies born to women with HIV becomes 

infected.  While it is known that the HIV virus can be transmitted 

through breast milk, the extent to which this mechanism causes AIDS in 

infants remains unclear, partly because it is very difficult to detect 

the HIV virus in infants under the age of one.  Recent research suggests,

however, that the risk is actually higher for infants born to women who 

become infected after giving birth than for those born to mothers who 

already have the virus.  In order to shed additional light on the 

transmission of HIV through breast milk, a proposed Bank project in 

Honduras (Health and Nutrition) includes a small research component

addressing this question.  



>From a policy perspective, the WHO and UNICEF have concluded that the 

general promotion of breastfeeding should continue.  The relative risk of 

increasing infant mortality from infectious disease and malnutrition from 

declining rates of breastfeeding is far greater than the potential for

increasing infant mortality due to the transmission of AIDS through 

breast milk.

  

For more info, consult Gabrielle Palmer's article, "Breastfeeding: the 

debate," in World AIDS, November 1992.



    IPPF Reports on Male Participation in Family Planning in Africa

    ---------------------------------------------------------------

Most family planning programs target their services to women, often 

combining contraceptive services with maternal and child health care.  

While this approach has many benefits, it ignores men -- the other 

partners in contraceptive decision making.  In Africa, the objections of 

husbands, and men more generally, have long been viewed as a major 

barrier to contraceptive acceptance.  However, recent surveys and other 

research have shown a positive attitude among many men, but lack of

communication between partners on issues related to fertility

and sexuality.  



The report stresses that family planning programs must work to promote 

these changes in attitude, and reach men through various mechanisms:  IEC 

campaigns, men-to-men service provision and counseling, counseling for 

couples where feasible, and programs targeted toward youth.  These 

services should be acceptable and appropriate to both men and women,

not divided along gender lines.  The report summarizes the experiences of 

IPPF affiliates in eight African countries, and discusses the findings of 

workshops on the various steps of program design and implementation:  

baseline research on attitudes, needs assessment methods, assessment of 

IEC strategies, integration and service delivery, and evaluation of

programs targeting men.  



	   Women's Education and Fertility:  An Overview

	   --------------------------------------------- 

The Expert Meeting on Population and Women of the International 

Conference on Population and Development, 1994 was held in Gaborone in 

June of 1992.  The conference generated a number of interesting papers, 

one of the most impressive of which was "Women's Education, Fertility and

the Proximate Determinants of Fertility," by Shireen Jejeebhoy.  This 

paper and further work being done by Dr. Jejeebhoy updates the 

meta-analysis of the relationship published by Cochrane in 1979.  The 

paper goes beyond that work by incorporating the enormous amount of new 

data and new analysis that have become available.  Perhaps more important

is the innovation of linking education and other dimensions of women's 

status.  Education's effects are multiple. Some of these apply to men and 

women, while some are unique to women. Among the latter effects, perhaps 

the most important is the impact of education on women's ability to 

assume more power within traditional patriarchal families.



Education affects the number of children a woman can have by changing her 

health and her breastfeeding behavior, the number she wants to have and 

her ability to control fertility.  Thus, education can increase or reduce 

fertility, depending on the circumstances.  Jejeebhoy's review of the 

evidence shows, as Cochrane's earlier efforts did, that in very

underdeveloped environments a few years of primary schooling is 

associated with small increases in fertility.  It is only with completed 

primary schooling that significant reductions in fertility are observed 

in these environments.  Dr. Jejeebhoy's review of the evidence emphasizes 

that understanding the channels through which education affects

fertility is essential for policy formulation.



  The Effects of Fertility Decline on Children's Education in Thailand

  --------------------------------------------------------------------                                     



In a recent paper, John Knodel (University of Michigan and Population 

Council) examined the impact on children's education of the substantial 

fertility decline experienced by Thailand in the last twenty or thirty 

years.  The evidence indicates that smaller family size and lower 

fertility levels have had beneficial effects at both the macro and micro

level.  On the national level, lower fertility has meant declining 

primary school age cohorts, allowing the extension of pre-primary and 

secondary education in existing primary school facilities.  While primary 

education is nearly universal, secondary school enrollments have been

increasing.  On the familial level, statistical analyses show that larger 

families send a smaller proportion of their children to school for 

shorter lengths of time, while a larger percentage of children from small 

families are sent to school for longer periods.  Thus, by allowing for 

greater investments per child on the part of both parents and the 

government, fertility decline has helped to improve the quality of 

education in Thailand.



For more information, see John Knodel:  "Fertility Decline and Children's 

Education in Thailand:  Some Macro and Micro Effects",  The Population 

Council Working Paper No. 40, 1992. 



---------------------------------------------------------------------

PNN is a quarterly round-up of news and information relevant to Bank

staff working in the population field.  It is produced by the

Population, Policy and Advisory Service (PPAS) and edited by Chantal

Worzala.



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			Population Network News

			 No. 2, January, 1993

				Part II



                  Workshop on Population Research

		  -------------------------------



Understanding of the relationships between population and income 

growth is important for designing development strategies and as one of 

the many justifications for Bank involvement in the population sector.  

To help Bank staff learn about recent developments in research on 

these linkages,  PPAS (Population, Policy and Advisory Service) held a 

training course on January 12th.  Entitled "Research on Population and 

the Growth of per Capita Income in Developing Countries:  New Findings 

and Their Significance," the seminar brought together eminent

economists and demographers.  The presenters included:  Allen Kelley 

(Duke), Didier Blanchet (INED, France), Robin Barlow (Michigan), and 

Lant Pritchett (World Bank).  T.N. Srinivasan (Yale) served as a 

commentator.  After a review of the research findings, Bank 

researchers and operations staff participated in a discussion of the 

research and policy implications for the Bank.  While consensus was 

not fully formed on the best approach to solving the question of how

and why population growth affects economic growth and development, the 

session did help to formulate further avenues for research and policy 

discussion on the topic.



International Conference on Population and Development (ICPD), 1994

--------------------------------------------------------------------



The fall of 1992 witnessed three meetings leading up to the ICPD, 1994 to 

be held in Cairo, Egypt. In October 1992, the Expert Group Meeting on 

Family Planning, Health and Family Well-Being took place in Bangalore, 

India.  Discussion at the meeting centered on the need to focus on 

individual needs rather than demographic targets, the means to link 

family planning to other development activities such as improving women's 

status and maternal and child health, and methods for developing better 

cost estimates for family planning programs.  The group, including Tom 

Merrick from the Bank, drew up recommendations for submission to the 1994 

Conference.  



November 1992 brought the Expert Group Meeting on Population Growth and 

Demographic Structure to Paris, France.  Focusing on the relationship 

between population growth and socioeconomic development, the meeting 

looked at linkages between population change, sustainable economic 

growth, and the distribution of income and social services. 

Claudia von Monbart, External Affairs Counselor of the Bank's European 

Office, represented the Bank.  



In December 1992, the Third African Population Conference took place in 

Dakar, Senegal, with Mrs. Ishrat Husain and Mr. Ben Gyepi-Garbrah  

attending from the Bank.  The conference consisted of two  sessions: an 

Expert Conference and a Ministerial Conference.  Parallel activities

were also conducted on the African family and the role of women.  

Discussions at the meetings centered on evaluating progress made in 

achieving the Kilimanjaro Programme of Action for population and 

sustainable development adopted in 1984 and providing recommendations for 

its continued implementation.  Other topics included: the African family

in the context of socioeconomic development; strategies for sustainable 

development; emerging population problems and new orientations and 

strategies; and population policies and programs in Africa.





---------------------------------------------------------------------

PNN is a quarterly round-up of news and information relevant to Bank

staff working in the population field.  It is produced by the

Population, Policy and Advisory Service (PPAS) and edited by Chantal

Worzala.



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			Population Network News

			 No. 2, January, 1993

			      Part I



            	  Bank Projects Under Preparation

 		  --------------------------------



* Papua New Guinea - Population and Family Planning Project 

(Appraisal).  



The Government of Papua New Guinea established a population policy in 

March 1991, guided in part by the Bank sector report Management, 

Manpower, Money: A Select Review of Health and Population in Papua New 

Guinea.  The proposed project will assist in the implementation of 

that policy through assistance to the family planning program.  The 

project has two main elements:  support for family planning service 

delivery and long-term capacity building for the population program. 

Specific project components include many of the traditional elements 

of a population project: upgrading of health facilities, staff 

training, technical assistance, supply and distribution of 

contraceptives and related drugs, development of a health and family 

planning promotion unit, and funding for a national demographic survey 

and provincial data system.  More innovative aspects include funding 

for training, technical assistance, and financial support for NGOs 

working in the field and operational/behavioral research and research 

training.  The proposed IBRD loan of $6.9 million, scheduled to go 

before the Board in March 1993, represents about 20% of the total 

project costs.  



* Zimbabwe - STD/HIV Prevention and Care Project (Identification).  



The Initial Executive Project Summary for the Zimbabwe STD/HIV 

Prevention and Care Project outlines three broad strategies for 

slowing the spread of these diseases: provision of condoms, 

diagnostics for STDs and HIV, and drugs to treat STDs and 

opportunistic infections associated with AIDS.  Bank lending in these 

areas is necessitated by the high rate of AIDS and STD prevalence

in Zimbabwe (as of July 1992, of the total population of about 10 

million, over 14,000 people had been diagnosed with AIDS and an 

estimated 800,000 were infected with HIV).  Another motivating factor 

is the recent decision by USAID to phase out its provision of condoms 

to Zimbabwe by 1994.



* China - Comprehensive Maternal and Child Health (MCH) Project 

(Identification). 

 

While the rural health care system in China has made remarkable gains 

over the past decades, great regional disparities exist in indicators 

of maternal and child health.  In addition, reforms made in the 1980s 

led to a fee-for-service system that placed health care, and 

especially preventive services, out of the reach of many families.  

The proposed project would address the needs of disadvantaged rural 

areas by building on a successful 300-Counties MCH project financed by 

UNICEF, UNFPA, and WHO.  Funding would cover additional training, 

increased access, affordability, and utilization of MCH services, as 

well as through improved planning, management, and referral services. 

Among other project goals are increased contraceptive method choice, 

improved service quality and access, and provision of individual 

family planning counselling and education.





              Bank Projects Approved to Date in FY93

  	      ----------------------------------------



* Ecuador - Second Social Development Project: Health and Nutrition.  



Economic shocks in the form of reduced oil prices and natural 

disasters complicated adjustment efforts in Ecuador and led to 

decreased public expenditures in the social sectors during the 1980s.  

The present project attempts to address some of the problems of 

widespread poverty by (i) increasing the access to and quality of 

basic social programs in the areas of health care (including family

planning), nutrition, and water and sanitation, and (ii) strengthening 

the policy and institutional capacities of the MOH (Ministry of Health) 

and lower levels of administration.  Among the priority health care 

interventions to be supported are prenatal, childbirth, and postpartum 

care, as well as family planning.  Of the $70 million loan approved in 

October 1992, approximately $15 million will support population activities.





                      Bank Sector Work

		      -----------------



* Malawi Population Sector Study (grey cover).  



In 1985, the Bank conducted a population sector review for Malawi 

whose principle recommendations were (i) the formation of formal

capacity to formulate population policy and integrate population into 

the planning process, and (ii) the strengthening of the child spacing 

components of the MCH program.  The 1992 sector study finds that 

progress in implementing those recommendations has been quite good, 

but further steps are urgently needed to respond to the pressures a 

population growth rate of 3.5% per annum places on natural resources

(especially arable land), the labor market, and provision of social 

services.  Recommendations focus on ways to improve the integration of 

population into development planning and means to address both supply 

and demand constraints to an expanded child spacing program. 



* Yemen - Health Sector Study.  



Yemen is a fast-growing country (the annual rate of natural increase 

is 3.1%) which has recently experienced large amounts of return 

migration from the Gulf crisis and political unrest in East Africa 

(the total number of return migrants approaches 1 million).  Health

indicators for the country are poor, with maternal mortality one of 

the highest in the world (10 per 100,000 live births) and fertility 

very high (the total fertility rate is eight children per woman).  In 

recognition of the health and social consequences of high fertility, 

the government has recently adopted a population policy, including the 

formation of a National Population Council.  After assessing the 

status of Yemen's health sector, this study recommends a greater focus

on preventive care (including family planning), a better health

environment, and better sector management, including decentralization 

of the provision of health services.  



* Jordan - Poverty Assessment.  



The poverty assessment currently underway for Jordan will be one of 

the first to include a chapter on population and its links to poverty.  

The rationale for such a chapter includes the historically important

role of migration in Jordan, the recent influx of returnees from the 

Gulf Crisis, and a rate of natural increase of over 3% per year (the 

RNI does not include population growth due to migration).  The chapter 

will discuss Jordan's demographic structure and trends in population 

change, as well as the linkages between those trends and various 

dimensions of poverty.  The main mission takes place in January 1993.



---------------------------------------------------------------------

PNN is a quarterly round-up of news and information relevant to Bank

staff working in the population field.  It is produced by the

Population, Policy and Advisory Service (PPAS) and edited by Chantal

Worzala.




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