Asia-Pacific Population Journal - Volume 27, Issue 2, 2012

The Indian State of Kerala – known for its remarkable achievements in improving the health of its inhabitants – is now facing several challenges due to population ageing, which is coupled with a tremendous increase in chronic non-communicable diseases among older persons. This has resulted in great demand for inpatient care among older persons. Against this backdrop, an attempt is made in this article to understand the demand for inpatient care by older persons and to examine its implications in terms of direct and indirect monetary costs. The article uses India’s National Sample Survey data for Kerala. Results show that demand for inpatient care among older persons is heavily dependent on economic status, although the differences in utilization between the elderly and non-elderly in each income group are not significant. On average, the cost of inpatient care is higher for older persons when compared with other age cohorts, leading to a consequent greater loss of household income, especially for older persons belonging to poor households. It is concluded that the public health sector will not be able to address the health-care needs of poor older persons and that there is a need to evaluate and promote the capacity of the private health sector in meeting this need.

In recent years, there has been a change in the thinking of policymakers about urbanization in India. In the Eleventh Five-year Plan (2007-2012) it is argued that urbanization should be seen as a positive factor in overall development, as the urban sector contributes about 65 per cent of GDP. There is also a growing realization that an ambitious goal of 9-10 per cent growth in GDP depends fundamentally upon a vibrant urban sector. As India is implementing the Twelfth Five-year Plan (2012-2017), the urban transition is considered to be one of the major challenges, requiring a massive expansion in urban infrastructure and services. Against this backdrop, the results of the 2011 census assume enormous significance in enhancing understanding of the magnitude, growth and interstate variations in the levels and rate of urbanization. Urbanization has increased faster than had been expected according to the 2011 census. This has reversed the declining rate of urbanization witnessed during the 1980s and 1990s. Also, for the first time since independence, the absolute increase in the urban population was higher than that in the rural population. In this article an attempt has been made to study the trends, patterns and components of urban population growth in the light of the results of the 2011 census.

Three periods in the evolution of population policy in Viet Nam are documented in this article: its initiation during the 1960s and 1970s; its maturity in the 1980s and 1990s; and its legalization in the 2000s and early 2010s. A framework was used for stakeholder analysis in the sociopolitical context of Viet Nam to analyse interactions between leading state agencies in the development of population policy and their influence on the organizational structure of the population programme. The current tensions in the implementation of the population programme are highlighted, and a new population policy is called for that would be more conducive to addressing broader population and reproductive health issues, in order to respond more effectively to new challenges arising from the socioeconomic and demographic transition of the country.