Good Health and Well-Being

Worldwide, stigma and discrimination have been identified as tremendous barriers to addressing the HIV/AIDS epidemic, beginning with Jonathan Mann in the 1980s (Mann, 1987), and by others (UNAIDS, 2001, 2008; Reidpath, Brijnath and Chan, 2005; APN+, 2004). Stigma was defined by Goffman (1963) nearly half a century ago as a discrediting attribute about an individual or group that serves to devalue that person or group in the eyes of the society. More recent theoretical frameworks suggest that stigmatization and discrimination are manifest in a number of contexts, including within families, communities, schools, employment, travel/ migration opportunities, health-care settings and HIV/AIDS programmes (Parker and Aggleton, 2002), and in religion and the media (Malcolm and others, 1998). A study in four countries in Asia found pervasive discrimination, with 80 per cent of respondents having experienced AIDS-related discrimination, including nearly one in five facing discrimination within their families and in their workplaces (APN+, 2004). In a review of interventions to reduce HIV/AIDS stigma, Brown, MacIntyre and Trujillo (2003) noted that stigma affects prevention behaviours, test-seeking, care-seeking, quality of care provided to positive clients, and perceptions and treatment of people living with HIV and AIDS by communities and families. Parker and others (2002) contend that HIV/AIDS-related stigma is often layered upon other stigma, for example, the one associated with engaging in illegal behaviour, such as sex work and drug use. Furthermore, families with HIV-positive members often face stigma from the community. In order to combat stigma and the associated discrimination, it is important to understand the knowledge, beliefs and attitudes and how they vary across groups within a country. Such knowledge is critical for designing interventions to reduce stigma and discrimination.

One of the dramatic demographic changes that is taking place, in both developing and industrialized countries, is the increasing proportion of elderly (people 60 years of age and above) in the total population.

While health care is accorded priority by Asian and Pacific countries in addressing the rapid ageing of their populations, only some include long-term care as part of a continuum of care available in institutional and non-institutional settings with formal and informal caregivers. Measures for avoidable (preventive and amenable) mortality contribute towards preventive long-term care. The delivery of health care by health professionals, allied health professionals and auxiliary care workers is discussed in this review, with examples of the training of nurses and social workers to show the range and variety of training available in the region. Caregiving is increasingly undertaken by migrant domestic and care workers and by volunteer health workers, often as part of community organizations. Institutional care is often perceived as abandonment and de-institutionalization is thus pursued as an “asset-light” policy option. But it should be supported as ageing-in-place, community-based services and platforms, with the integration of health and social care, innovative approaches for engagement and participation, and technology, all of which require trained human resources with the necessary skills and competencies. Other measures to strengthen care provision and support to older persons include expanding filial piety to social piety, changing mindsets and combating ageism for social solidarity and collective responsibility. It also includes measurement and monitoring mechanisms for accountability and course correction.

The International Union for the Scientific Study of Population (IUSSP) held its Twenty-first International Population Conference at New Delhi from 20 to 27 September 1989. The Conference, which was organized at the invitation of the Indian Association for the Study of Population (IASP), was opened by India’s Prime Minister Rajiv Ghandi.

The 1988 Viet Nam Demographic Survey was the first country-wide demographic survey of Viet Nam. The sample was drawn according to the sample design recommended by the World Fertility Survey (WFS). It was a three-stage random probability sample of 4,800 households in 12 provinces and 151 communes.

Probably the most important demographic development to occur during the last quarter century has been the onset of fertility decline in a number of third world countries. While most Sub-Saharan African countries as well as a number in the Middle East and West Asia have yet to participate in this phenomenon, fertility in countries elsewhere in Asia and in much of Latin America has started down a path towards levels far lower than have ever prevailed in their modern histories. Given that mortality declines preceded the fall in fertility, and that most of these populations have been experiencing unprecedented rapid population growth rates at levels that would lead to extraordinary numbers of people in just decades, most observers concerned with population matters view the onset of fertility decline as a logical and welcome development.

Despite the well-documented benefits of breast-feeding for both infant and mother, breast-feeding has, until recently, been given little support. World Health Organization data (WHO, 1981) support the conclusion that, as countries undergo socio-economic development, there is a tendency for the incidence of breast-feeding to decline (Kent, 1981). Many factors contribute to such changes in breast-feeding behaviour. Whilst urbanization and industrialization have been associated historically with declines in breast-feeding (and indeed still appear to be in certain developing countries), the proportion of mothers now returning to breast-feeding in some industrialized countries, e.g. Sweden and the United States of America, is increasing.

Fertility behaviour is determined mainly by the characteristics of individuals, but also by social, cultural, community and institutional factors. The primary aim of this article is to investigate the influence of social and economic institutions on fertility and contraception.