Good Health and Well-Being

Son preference is commonly believed to be widespread in South Asia and in many developing countries, particularly where women are economically and socially dependent on men (Bairagi and Langsten, 1986; Arnold and Kuo, 1984; Cleland and others, 1983; Vlasoff, 1990). Analysing Demographic Health Survey data from 57 countries, Arnold (1997) showed that son preference remains strong in South Asian countries and, in that area, Bangladesh has the highest ratio of preference for sons over daughters. Sons are generally preferred over daughters owing to a complex interplay of economic and socio-cultural factors. Sons contribute more than daughters to family income, provide adequate support in old age to their parents, impose less of a financial burden and carry forward the family name (Nag, 1991; Ali, 1989). On the other hand, the birth of a daughter is seen as bringing neither ‘benefit” nor “prestige” to the family. Daughters are often considered as an economic liability because of the dowry system as well as the high cost of weddings. Once married, daughters become physically, as well as psychologically, isolated from their natal home and are seldom seen as making significant contributions to their natal family (Chowdhury, 1994). Thus, when the net utility of having a son outweighs that of having a daughter, parents are likely to prefer sons to daughters and may be reluctant to stop childbearing until their desired number of sons has been achieved.

Reproductive health care is being promoted as a way to address a range of women’s health needs as well as improve the quality of services provided for current family planning users. By reducing ill health and premature deaths, reproductive health care is considered a worthy investment in its own right. It also may encourage more women to adopt family planning and thereby lower fertility rates. Women in developing countries face a number of special health risks associated with sexuality and childbearing. According to the World Bank (1993), about one third of the total disease burden that women face is linked to pregnancy, childbirth, abortion and various reproductive tract disorders. Women are more susceptible to sexually transmitted diseases (STDs) including HIV than men (Aitken and Reichenbach, 1994) and can pass these on to their unborn children.

Few community-based studies in India have investigated the determinants of women’s self-reports of reproductive tract infections and other forms of gynaecological morbidity. One of the most striking findings to emerge from the few that have done so is the strong association between the use of female sterilization, or in some cases the intrauterine device (IUD), and reported or diagnosed gynaecological morbidity.

Policy makers will have to plan for megacities of a size and complexity never before seen in history.

The ESCAP region has undergone a substantial change in the growth and structure of the population over the past several decades. Several countries and areas of the ESCAP region have completed the demographic transition, reducing fertility and mortality to low levels, while in many others both fertility and mortality rates remain high. Levels of urbanization and growth of the urban population also vary across the region. This article examines the size, growth and distribution of the population and provides an overview of the patterns of urbanization and urban growth in the ESCAP region. It discusses new and emerging issues of demographic dynamics in the region, in areas such as the economic and social impact of ageing and international migration. Finally, it highlights the implications of the process of urbanization for promoting gender equality and equity, for sustainable development and for reducing the incidence of poverty.

Apart from effective legislation and its enforcement, suitable welfare schemes can facilitate increasing the age at marriage.

Migration, one of the three components of population change, has become an increasing focus of research and policy development in many third world countries. Internal and international movements exert varying degrees of influence on specific countries or regions, depending on a mix of political, social, economic and environmental factors. The internal movement of Solomon Islanders is more visible and increasingly far more important than external movements, which more often than not are for educational purposes. In the third world, internal migration is strongly associated with rural-to-urban drift. However, this process involves a number of different movement streams, characterized by varying patterns and processes associated with various socioeconomic factors in places of both origin and destination (Pryor, 1975).

Many countries are transforming their efforts to meet their population’s reproductive health needs by refocusing maternal and child health and family planning activities into more comprehensive reproductive health programmes. Clearly, the specific directions and magnitude of the changes involved should depend on the socio-economic context and local epidemiology of reproductive health problems, as well as on the current programmatic situation. In seeking to innovate and expand reproductive health services, programme managers and policy makers are generally advised to follow an approach that is (a) public health based - addressing key reproductive health problems, (b) pragmatic - adding interventions and services in an incremental manner and building on what already exists, and (c) participatory - recognizing what different actors can feasibly do (Fathalla, 1996). The need to identify appropriate service delivery models and subsequently scale-up successful efforts is acute.

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.

Remittances not only contribute to raising economic well-being but can also modify the behaviour of the sending communities.