Asia-Pacific Population Journal - Volume 15, Issue 1, 2000

In 1998, Thailand’s Health Systems Research Institute, a unit within the Ministry of Public Health, launched a comprehensive review of health services available to elderly people in Thailand. As part of this review, staff at Khon Kaen University gathered data on the provision of services by public facilities. Four methods of gathering data were used: (a) interviews with policy makers and implementors; (b) a survey of elderly people in the community; (c) exit interviews with patients at hospitals; and (d) observations in hospitals. This article summarizes results obtained through the latter three methods, A more detailed account of all four methods and the results can be found in the final report (Kamnuansilpa and others, 1999).

Biologically a female is more capable of surviving than a male (Madigan, 1957). This fact is also reflected in the Model Life Tables (Coale and Demeney, 1983), which are based on a compilation of historical European data and from a few, quite limited data sets available in the early 1960s for other regions of the world. Currently, in most of the developed countries the expectation of life at birth for a female is longer than for a male by five or six years. However, the picture was different until recently in several South Asian countries including Bangladesh (DSS, 1992), where expectation of life for males was higher than for females. The scenario started to change recently in this country (DSS, 1995). However, the expectation of life is an age-standardized summary measure of mortality and does not give a clear picture of the change in mortality in different age groups. Mortality may be affected differently at different ages by various events such as birth, which affects a female only, and different life-styles such as occupation. In this article, an attempt has been made to examine the time trends of mortality and make a relative comparison of the mortality change between males and females in different age groups in a rural area in Bangladesh.

Bangladesh has achieved a considerable increase in contraceptive use over the past decade, resulting in an appreciable decline in fertility. The programme efforts have been largely facilitated by major changes over the past two decades, both positive and negative. Positive changes include female education, female empowerment, female mobility and access to the media. Negative changes include increasing landlessness, and rising unemployment and underemployment. Also, other changes have taken place such as change in the family size norm and a decline in infant and child mortality (Caldwell and others, 1999). In addition, fertility decline is also due to other proximate determinants besides contraceptive use.

During the past four decades, Sri Lanka has experienced significant changes in the level and pattern of fertility. The total fertility rate has declined from about 5 children per woman in the early 1960s to near the replacement level of 2.1 by the end of the 1990s despite the fact that the number of women in the reproductive age group more than doubled during this period.