"Regional Mobilisation in Population and Development : A South Pacific Agenda"

The primary purpose of the UNFPA Country Support Team for the South Pacific based in Suva, Fiji, is to provide countries with high-quality technical support services to meet their needs, leading towards national self-reliance in the population field.

Among the functions of the Country Support Team towards this end, the injunction "to provide active and close backstopping to the local pool of national experts" implies more frequent interaction between CST Advisers and national counterparts than is afforded by the occasional in-country technical advisory visit.

This Discussion Papers series has been initiated by the CST, Suva, in an attempt to establish a dialogue among national population programme personnel on the multidimensional aspects of population programmes. The major objective of the series is to help in the conceptualization and development of a more holistic programme approach.

The present paper was originally prepared as a background document for the Senior Officials Meeting on "Population and Sustainable Development in the Pacific", organized by The Forum Secretariat and sponsored by the United Nations Population Fund, at Port Vila, Vanuatu on 6-8 September 1993. The paper was a collective effort by the members of the Country Support Team for the South Pacific. In rather broad strokes, the paper highlights the major population issues in the region and identifies a number of strategies to address these issues for the successful implementation of population programmes.

Stephen Chee
Team Leader

TABLE OF CONTENTS

EXECUTIVE SUMMARY

II. POPULATION PROBLEMS AND ISSUES IN THE SOUTH PACIFIC FOR THE l990s

1. Basic Data Collection and Analysis
   1. The Prevailing Situation
   2. Steps to Improve Basic Data Collection and Analysis
2. Population-Development Integration
   1. Institutional Mechanisms for Implementing Population Development Planning and Policies
   2. Practical Realities and Research Requirements for Integration
3. Population Information, Education and Communication (IEC)
   1. Population Education
   2. Population Communication
4. Maternal Child Health/Family Planning

V. MEANS OF IMPLEMENTATION: ACTORS AND RESOURCES

1. National Action
2. International Co-operation

VI. CONCLUSIONS

EXECUTIVE SUMMARY

1. Despite commendable progress made by some countries over the years, an unresolved agenda of population-related problems and issues still confront the island nations of the Pacific, such as high fertility and mortality; severe pressure on resources, particularly in the social sectors; unemployment and underemployment with consequent escalation in crime and delinquency; slow transformation of women's traditional roles; rising rural-urban migration; out-migration side-by-side with return migration; distorted age-distribution with its implications for dependency; environmental degradation of atolls; and the rising incidence of teenage pregnancy, AIDS/STD, and drug and alcohol abuse. These and other issues call for more consistent mobilization of national, regional, and international commitment and resources to enhance effectiveness in population programmes in order to maintain the quality of care and life.

2. This paper identifies a number of strategies to address these issues and for the successful implementation of population programmes in the Region:
   • Innovations in the methods and scope of collecting relevant and timely data;
     
   • Small-scale research projects to be formulated to plug prevailing data and information gaps;
     
   • The construction of institutional mechanisms to ensure that population factors are fully integrated into development policies;
     
   • The provision of awareness and orientation programmes at the local, national and regional levels to raise citizen concern for population-related problems;
     
   • Integration of population education into formal and non-formal programmes through curriculum and instructional material developments and training of educational personnel and leaders/trainers;
     
   • Improvements in the quality and quantity of family planning services to address persistently high fertility and mortality levels;
     
   • Human resources development via a diverse range of training activities of Pacific Island planners and policy-makers in all of the population-related sectors; Greater concern for the largely unexplored, but potentially damaging consequences of rapid population growth on the viability of the environment;
     
   • Formulation of clear and comprehensive population policies to mobilize national and international commitment and action;
     
   • Integration of population policies into national development plans, policies and strategies and their translation into cohesive multi-sectoral programmes and projects; and
     
   • Strengthened co-ordination of donor assistance by governments and greater efforts in joint programming between donor agencies.

I. INTRODUCTION

At the other extreme are countries such as Tuvalu which has few natural resources, a small population size (but very high density), little agriculture and exports, but experiences relatively low fertility and population growth, and relatively good social indicators in terms of life expectancy, mortality and literacy and educational enrolments. International male migration to work in overseas merchant shipping is a disruptive factor in the social life of Tuvaluans, but the principal source of foreign exchange earnings for the country and the individual families. Yet, the development potential of Tuvalu remains severely limited and its very existence and survival remains threatened by the "greenhouse" phenomenon of global warming and the rise of the oceans.

The conclusion is, therefore, that the experience facing each and every country in the Region is often very different and even a simplified classification of the nations into Melanesia, Micronesia and Polynesia categories, hardly does justice to the diverse social, economic development and demographic situations each one faces. The implication is that any attempt to design and plan interventionist strategies to influence demographic and development outcomes must be finely tuned and accommodate the country-specific social, cultural, economic and demographic situations which prevail.

II. POPULATION PROBLEMS AND ISSUES IN THE SOUTH PACIFIC FOR THE l990s

Population growth makes it much more difficult for targets to be met for increasing education, health and other services, let alone to maintain the present inadequate level of coverage. Both financial and human resources are strained by the growing demands for services by an expanding population.

In the past, international migration from the Region has provided a safety value for ambitious educated job-seekers who, having found work in Australia or New Zealand, have provided a major source of remittance income for those members of the family left at home. Their success has not been without its drawbacks since it contributed to skill shortages in the Region and led to distorted age - sex structures in the demographic composition of the home countries. Such options for overseas migration, however, are drying up as recession in the recipient countries leads to tighter control on immigration. Indeed, a number of countries may well face the inverse problem, of having to absorb a relatively large number of returnees in a very short time period. This will call for innovative policies to avoid frustration, discontent and possible social unrest.

III. IMPROVING PROGRAMME MANAGEMENT: POLICIES AND STRATEGIES

A. Basic Data Collection and Analysis

To implement policies and programmes to influence demographic outcomes (population influencing policies - family planning programmes, IEC/FLE, raising women's status including education etc.) or to accommodate increasing numbers of people (population accommodating policies - increased health, education, employment, food provision etc) an essential prerequisite is a sound database. Such data should be timely and current, reliable, divisible by geographic area and socio-economic group and amenable to in-depth analysis. To be utilised effectively in policy formulation and planning exercises it is inadequate simply to collect demographic data, e.g. point estimates of fertility, mortality and migration. To explain inter-geographic area or inter-socio-economic differentials in behavioural patterns is the raison d'etre of the study of population-development inter-relationships. Thus, such demographic data must be accompanied by information on the socio-economic variables relating to the same unit of observation. Such data must include:

Household size and age/sex structure, Fertility and mortality histories; Internal and international migration; Knowledge and practice of family planning, desired family size, additional children wanted; Health status and morbidity data; access to health services, information on diet, nutrition, sanitation amenities and water supply; Indicators of schooling/vocational training and skills, rates of labour force participation, certification, labour market insertion (occupation, sector of employment, work status, extent and degree of employment e.g. hours worked, multiple job holding, earnings from all sources).

Adding to this, greater efforts need to be made to establish mechanisms for the regular registration of vital events, births, deaths and marriages. PNG's current attempt to revive the Village Registration System, inherited from the colonial days, but which was allowed to fall into disarray, is a commendable example.

Therefore, this section has pointed the way for a major thrust of the programme. The data to be used in population-development programmes need to be made more timely and relevant, and increase in scope. This will cost money and require well trained personnel¹.

Civil Registration: Since these provide the most basic rates for monitoring changes in the health and demographic situation, it is essential that coverage be improved. In many of the Micronesian and Polynesian countries where coverage is already reasonably high, it should be feasible to extend it. What is required is the political will to create viable systems and the willing cooperation of agencies who could make them work. In many of these countries, village chiefs or councils, women's groups, district education and health staff, police, NGOs, Churches and other groups could all be involved in encouraging the registration of births, deaths and marriages. With a strong commitment, a series of national and district seminars would be required to provide information on how the systems work. In some cases, modifications to the basic system might be required, but these would be slight. The key is involvement at the grassroots level. For countries in Melanesia with virtually no registration systems, the same involvement at the grassroots is essential, but the achievement of full coverage is more ambitious. Costs, too, would be far higher as the administrative and legal machinery would need to be established or strengthened. The strategy in these cases might be to focus on a few areas at the outset. These experimental areas will help identify the more important factors or influences for improving registration. In time they will serve to demonstrate the success of the system as it is extended to other areas. Migration, Health and Other Administrative Records: Users need to recognise the potential usefulness of these records and the relative ease with which they might be compiled into statistics. National statistical offices need to work with the substantive agency in improving base record systems, including forms and information flows. In many cases it might be possible to network processing systems to transfer raw or processed data directly to the statistics offices for further processing and publication. Population Censuses: Further encouragement is needed to promote national capabilities in the skilled areas of design, mapping, data processing and analysis. The key is training in-country where it is feasible, overseas where it is not. Greater interaction is required between producers and users of data, formally at seminars, less formally in open discussion, of what is needed and how it can be produced. Sample Surveys: These are almost certainly under-utilised. They can potentially help explain more complex behaviour related to family formation and migration than any of the other sources. Recent experience in other countries has shown that even relatively small samples can produce valuable results, so long as the methodology is sound, and training is appropriate and field control is effective. They also require far closer cooperation between statisticians and users in defining the scope of a survey and in guiding the analysis. Technical requirements for designing, selecting and controlling samples are more demanding and require special training. The technical assistance that might be needed to develop survey capabilities might justify a regional rather than country approach to survey taking. Gender Issues: As the concerns of women become more prominent there is a growing demand for gender sensitive statistics that reflect changing situations and roles. Unfortunately, in many countries there is a dearth of relevant data. While the population censuses and surveys can be more fully tabulated to provide information by sex for all major variables, the statistical offices have been accused of a lack of urgency in developing new statistical instruments to address issues of critical concern to women. Thus, data relating to the perceptions of women as victims of crime and aggression, combatting stereotypical attitudes to changing roles at home and in the work place, are for the most part non-existent. Surely, if we are to realise a completed demographic transition in the South Pacific, we must know much more about the roles and activities of our women. Such information contributes the fundamental prerequisite for designing policies to redress their inferior situation and raise their status.

B. Population-Development Integration

i. Institutional Mechanisms for Implementing Population Development Planning and Policies

ii. Practical Realities and Research Requirements for Integration

Demographic and socio-economic research is a much more specialised area and, no doubt, too specialised to be initiated and undertaken on a day-to-day basis by the typical line-Ministry planner. However, before research is undertaken it is necessary to identify research priorities for each country in the population area. Given the nature of the integration challenge, these issues are necessarily interdisciplinary and multisectoral. For example:

These are just a few examples of some of the obvious research issues prevailing in the Region. The UNFPA CST has the mandate and potential to contribute a great deal to helping national-level planners to crystallize these issues and to help them identify the policy-related questions to be researched. Again, small-scale research projects could be technically backstopped by CST members with the assistance of collaborators from the small number of Universities in the Region and from academics in the USA, New Zealand and Australia.

C. Population Information, Education and Communication (IEC)

The goal of population education is, in general, to provide young people and adults with an awareness of the inter-relationships between population and development, especially socio-economic aspects which fall under the rubric of 'quality of life', such as the environment, resources, health, education, employment and other social services, as well as traditional beliefs and practices. Through this, it is hoped that a critical understanding will be developed, enabling the individual to make reasoned and conscious decisions regarding family life, population - related issues within his community, and policy within the nation. The ultimate goal of population education, therefore, is not to indoctrinate people regarding issues which affect them at the most basic level, e.g., family size, but rather to pose realistic alternatives, to have them examine likely consequences, and to enable the individual to develop rational decision-making behaviour. It is only through these cumulative individual decisions that population issues, as well as a whole array of social and economic challenges raised by the process of development, may be surmounted. Thus, population education programmes must address the specific values, needs and priorities of the region and each country.

1. Awareness and Commitment

Identify population - related problems. Identify specific groups for awareness creating campaigns - e.g. church leaders, politicians and policy makers, teachers, traditional leaders, local government leaders, women and youth leaders, media personnel, etc Organise national and local seminars to create awareness of population-related issues and to clarify the concept of population IEC for formal and non-formal sectors and to decide on national and/or local goals in relation to IEC. Set up an interdepartmental planning and coordination committee, including government departments and NGOs, for planning, coordinating and implementing IEC activities Strengthen population IEC administration in the country by ensuring technical and financial support in departmental plans, e.g. for creating a separate population education section in the curriculum development units, integrating population education in present educational and communication programmes, employment or deployment of personnel for population IEC.

2. Curriculum Development and Teaching Materials

In the non-formal sector there is still a dearth of instructional materials focused on specific target groups, including the illiterate and neo-literate. Specific instructional materials need to be developed for a wide spectrum of target groups - general public, youth and women's groups, churches, chiefs, workers, policy-makers and planners, community development workers, health-care workers, etc. Special attention should be given to the integration of population education into literacy programmes in the context of 'Education for All'.

3. Training

4. Research and Evaluation

Even where population education programmes have been in existence for several years, impact studies have not been undertaken. In short, research and evaluation, for a variety of reasons already mentioned, are very weak components of population education in all countries in the Pacific. Hence, there is a need to initiate a variety of evaluation and research activities, including KAP surveys of various target groups, evaluative research studies on the effects of population education on the target groups, longitudinal studies of the impact of population education programmes, etc. in addition to the pretesting and formative evaluation of instructional materials.

In recent years most of the Pacific Island nations have been alerted to new areas of concern which might have a tremendous impact on the quality of life of the people, many of which are directly or indirectly related to population. Such issues as the destruction of mangroves, pollution of the lagoons, over fishing, and erosion, can be attributed directly to population factors. Other environmental concerns such as the "greenhouse" effect, drift net fishing etc. largely attributable to outside forces, are also being discussed. Other emerging areas of concern in the Pacific include teenage pregnancy, AIDS/STD, drug and alcohol abuse, suicide, and health problems due to change in diets and lifestyles. Some of the Pacific Island countries, for example, have among the highest STD and diabetes rates in the world.

It is not clear who decides and how the new areas of concern are integrated or introduced into the formal and non-formal educational programmes in countries in the Pacific. But these areas of concern should be addressed through education and other services and resources need to be mobilized to address them.

Population information and communication activities in most countries in the Pacific region have been fragmented, and largely undertaken by governments and NGOs. There is nothing in any of the countries that can be termed a population communication programme or strategy', in spite of the wide array of channels and systems used for population communication in the region. There are several are several reasons for this. First and foremost is the fact that, at most, only a few of the countries have an explicit population policy. Without such a national population policy, there is no clear direction fr a population programme, which would include a population communication strategy. Even with a population policy, individual sectors are left, more or less, to do their own thing' without coordination, or monitoring of their efforts.

In population communication, other than the periodic messages produced by the health education sections of the Ministry of Health over the radio in many countries, the population communication capacities of current efforts are generally weak, and programmes produced lack consistency, and are, at best, sporadic. This is due, not because the media are not supportive, but mainly because people connected with population programmes make so little use of them. The media, for their part, have shown themselves to be receptive. Hence, training and support for population communication development, including message development, materials, technique, etc., are urgently needed.

The challenges for communications programmes for the future include:

Much of the CST's contribution in this subject area has been already ably stated by Dr Katoanga in his paper. The rationale for the MCH component has been widely accepted and reflected in the considerable programme successes in pre- and post-natal care, nutritional improvements and the increased rate of immunization against the 'deadly diseases'. The consistent decline in mortality and morbidity is a consequence of these interventions, although infant and maternal mortality remain disturbingly high in some of the Melanesian countries.

IV. NATIONAL AND REGIONAL CAPACITY BUILDING

Because of the small size of most of the countries in the South Pacific, it is totally impractical and inefficient for each one of them to develop its own independent institutional structure and machinery for population and development policy formulation and implementation. Clearly, despite the great differentiation in demographic situations, there is much to be gained from increased collaboration and co-operation in the field of population and development planning. The smaller countries which cannot possibly utilise the full-time services of specialists in the different fields must be able to call upon, and pay for, such specialised services as they may require from time to time. The establishment of the University of the South Pacific is one striking example, and the Fiji School of Nursing is another, of how such economies of scale can be realised. But how can similar institutions be created or strengthened to promote such collaboration?

The UNFPA Policy Review and Strategy Development (PRSD) Mission to the South Pacific in 1991 identified such needs: "Lack of adequately trained personnel has slowed progress in policy formulation integrated planning; data collection, analysis and research; and information dissemination; as well as implementation, monitoring and evaluation. Therefore, the Mission recommends that the development of national and/or regional skills should be a high priority, with use of national/regional institutions to the extent possible. In this context, the Mission further recommends that support should be rendered to national and regional training/research institutions for organising and conducting training and research" (p.77).

In the field of data collection and analysis, technical support services to the Pacific countries need to be upgraded and better co-ordinated. The idea of organising a Regional Census Analysis Programme and replacing short-term technical advisory services with longer term advisers, first mooted by the PRSD mission, needs to be reviewed further².

Production, testing and dissemination of IEC material; Motivational, counselling skills; Family planning technologies, including insertion/removal of lUDs, sub-dermal implants, bilateral tubal ligation under laparoscopy and vasectomies; Midwifery, including ultrasound foetal heart beat and growth monitoring, application of partograph, supportive supervision; Management of MCH/FP programmes, including identification of groups/individuals at higher risk and target setting, identification of objectives, strategies and activities, implementation, supervision, monitoring and evaluation; Community motivation and participation, with special reference to youth and men's groups, women's organisations, religious communities, and schools; Development of innovative methodologies to improve/increase community awareness, e.g., drama production, songs, poster contests in schools and elsewhere; development of new teaching/training methodologies and production of training material; Development and application of a MIS, including collection and analysis of all MCH/FP indicators and feedback mechanism; Use, maintenance and repair of audio- visual equipment.

An essential starting point for planning is the preparation of estimates of future population, disaggregated by functional age categories, sex and sub-national levels based on most recent information, and the translation of these estimates into future resource requirements. As population projections are not systematically, fully and consistently used in the national, sectoral and regional development plans of South Pacific countries, we recommend that training activities pay adequate attention to the techniques of projections needed for national, regional and sectoral planning. In this connection, the training should include the application of recently developed software for demographic analysis, population and other functional projections, and for integrated planning.

Workshop for the Development of Prototype Materials for Integrating Emerging Concerns of Population Education into Formal and Non-Formal Education Programmes, including Literacy; Workshop for the Development of Population Education Curriculum in Primary Education and Teacher Training Institutions; Group Training Course in Population Education for Non-Formal Education Project Personnel; Regional Consultative Seminar; Inter-country Study Visits in Population Education for Key Personnel in Formal and Non-Formal Education Sectors; Workshop on Evaluative Research/Research Studies in Population Education.

At the national level, a legal framework should be developed embodying a commitment to sustainable management of resources; National and sub-national policies should be formulated in response to emerging needs; Population and environmental considerations should be incorporated into national development plans with respect to promoting sustainable development; To enhance policy analysis, planning, management of resources, there is a need to establish a comprehensive system to identify and evaluate the complex inter-relationship between population and environment; All significant changes in natural resources need to be monitored and this information should be fed back into the national development plan; The capacity of Environment and Conservation Units must be strengthened through upgrading the institutional technical framework by increasing the number of local experts and training personnel in data collection and analysis, policy formulation and planning and research activities, with special emphasis on sustainable resource use in development; There is an urgent need to establish and improve base-line data covering physical measures, as well as social attitudes and awareness indicators; To strengthen the implementation of policies, Governments should introduce incentives and regulatory measures as well as enforcement procedures and legislative penalties3.

V. MEANS OF IMPLEMENTATION: ACTORS AND RESOURCES

The formulation of a comprehensive population policy is a first, but only preliminary, step in the direction of implementing a comprehensive population programme. Clear and comprehensive statements of population policies are important instruments for mobilization of national commitment and resources for population activities. In addition, clear policies assist international and regional funding agencies in planning their assistance programmes.

Governments and donors are still inclined to support piecemeal population-related projects while paying lipservice to the programming approach. The litmus test of all policy interventions through individual projects should be whether there is consistency within and between projects and whether they promote the national goals and targets as set out in the population policy. Better management of donor assistance, including training in aid co-ordination, will contribute to national goal achievement.

Governments should not attempt to do everything to meet the expanding agenda of population needs. The voluntary sector has specialized roles and can often be innovative in service delivery and communication and advocacy activities. Strengthening the partnership with NGOs might require supportive governmental policies, including changes to restrictive laws and regulations, and modest direct financial and technical assistance. More country programmes in the region need to establish government-NGO collaborative mechanisms and refine the processes for encouraging greater NGO and private sector activities in the population field.

B. International Co-operation

First, the amounts provided today are far from sufficient. Second, the increase in resources has varied over the years, partly from the shifting value of the US dollar and partly from the changing priorities of the major sources of aid. Third, the same small number of countries provides the bulk of the assistance today as in 1969. Fourth, despite overall increases in the contribution of leading sources of assistance, population assistance as a share of the total official development assistance is still modest - approximately 1.3 percent. Fifth, population concerns are usually overlooked in development assistance programmes outside the population sector. Sixth, the three major assistance channels (bilateral, multilateral and NGO) are used more or less evenly. Source: Nafis Sadik (ed.), Population Policies and Programmes Lessons Learned from Two Decades of Experience (New York, 1991).

Within the region, several United Nations agencies (including UNDP, UNFPA, WHO, ILO, UNICEF, UNESCO, the World Bank and ESCAP), government bodies (AusAID, NZODA, USAID), inter-governmental bodies (SPC, Forum Secretariat, ADB) and non-governmental organisations (IPPF, SPAFH, PCI, JOICFP, etc) are involved in population-related projects in several countries. Such interventions are obviously supportive of national and regional needs in population activities. Indeed, a World Bank study for six Pacific countries with a combined population of 1.5 million indicated an overall aid infusion in the 1980s of US$147 per capita or a total of US$220 million - on a per capita basis substantially higher than that for similar countries in the Caribbean, Africa and the Indian Ocean.

As the region competes for sustained population assistance funding, including a larger chunk of overall external development aid, key issues in aid coordination should be addressed to optimize the benefits of international co-operation. Inappropriate donor policies and procedures in the social sector sometimes affect the ability of small countries in the Pacific to use aid well, though in some cases the lack of absorptive capacity - arising from inadequate skills in aid management, limited organisational and management capacity, institutional limitations and insufficient infrastructure, etc - might be the real reason behind the poor results from external assistance. Donors need to invest resources in capacity building. In addition, simplification of procedures, stronger co-ordination and co-operation among donor agencies and greater efforts in joint programming will ensure that population assistance programmes will be country-driven rather than donor-driven. Importantly, too, this will result in a programme-orientation rather than a project focus in population assistance.

In view of countries' frequent preference for multilateral assistance and because of its major role as a source of funding for population programmes, the UNFPA should be encouraged to continue its role as adviser to governments for in-country co-ordination of population assistance and to help promote mechanisms for international co-ordination of population assistance.

VI. CONCLUSIONS

In all the countries of the Region the institutional structure and technical capacity for integrating population factors into the development planning process remain grossly underdeveloped. International technical assistance in this area will be required for a long time to come. While some institutions have been constructed to promote the status of women, which we see as the linchpin for any attempt to bringing about demographic behavioural change, real shifts away from the traditional roles played by women have been rudimentary.

Population policies and programmes must not be viewed simply as being concerned with population growth and family planning. As this paper has stressed, they involve issues relating to maternal and child health (as well as family planning), data collection and analysis, population education and communication, employment promotion and human resources development, and development planning across all the sectors on which population-related factors have an impact.

Footnotes