Good Health and Well-Being

Longitudinal research, which includes panel research, is the term used to differentiate the methodology and utility of prospective studies from that of cross-sectional research. It describes not a single method, but a family of methods that measure change by linking individual data across time (Zazzo, 1967, cited in Menard, 2002).

During the early phase of the demographic transition in Sri Lanka (in the 1920s), the birth rate persisted at about 40 per 1,000 population, with the death rate fluctuating at around 20 per 1,000. A slight decline in the death rate was observed from the late 1920s onward. After the 1940s, the crude death rate dropped at an unprecedented level: about 1.5 deaths per 1,000 population per year on average, before reaching the level of 12 deaths per 1,000 population by the middle of the twentieth century (Caldwell, 1986).

Low fertility has become an important area of demographic research as fertility in many countries has fallen to levels well below replacement. Advanced countries have experienced low fertility trends for decades (United Nations, 2000), and some are experiencing lowest-low fertility (i.e. TFR below 1.3) (Kohler, Billari and Ortega, 2002; Caldwell, 2006). Less developed countries, by contrast, have recently experienced low fertility levels, and there no longer seem to be any barriers to most countries reaching replacement level and subsequently falling below that level. According to the United Nations, by 2000, around 44 per cent of the world population lived in countries where fertility had fallen below the replacement level. This proportion is expected to increase to 67 per cent by the year 2015 (United Nations, 2000). According to the United Nations median variant projections, approximately 80 per cent of the world’s population is projected to live in countries with below-replacement fertility before mid-century (United Nations, 2002a). Several East and North-East, as well as North and Central Asian countries have attained below replacement in recent decades (Gubhaju and Moriki-Durand, 2003; Atoh, 2001; Hirschman, Chamratrithirong and Guest, 1994; Knodel, Chamratrithirong and Debavalya, 1987). However, countries have attained low fertility in different ways (Perelli-Harris, 2005) and thus, every country and region may have a unique experience in reaching low fertility. For instance, Hirschman, Chamratrithirong and Guest (1994) have argued that the distinctive attributes of East Asian countries such as Hong Kong, China; Singapore; the Republic of Korea; and Taiwan Province of China in terms of rapid economic growth and Confucian cultural heritage would not make them a model for fertility decline in other countries in Asia.

The Programme of Action of the International Conference on Population and Development (ICPD) held in Cairo in 1994 called for the establishment of strong linkages between sexual and reproductive health (SRH) and HIV/AIDS by enhancing the capacity of health-care providers, including all family planning providers, in the prevention and detection of, and counseling on, sexually transmitted diseases, including HIV/AIDS, especially among women and youth.

Sample surveys carried out during the last four decades have proven the existence of “unmet need”, a term coined to describe a significant gap between a woman’s sexual and contraceptive behaviour and her stated fertility preference. According to the Demographic and Health Surveys (DHS) definition, a woman has an unmet need for contraception if she is fecund, sexually active and not using any contraceptive method, and yet does not want a child for at least two years. If a woman is pregnant or amenorrhoeic after giving birth, she is also considered to have had an unmet need if she had not wanted the pregnancy or birth either when it occurred or ever (Ross and Winfrey, 2002).

The paradigm shift in population and development that occurred at the International Conference on Population and Development (ICPD) in Cairo, in 1994, from reduction in population growth for socio-economic progress to ensuring sexual and reproductive health and rights as a fundamental human right and as a means for improving the quality of life, has also become apparent in the Pacific. The Millennium Development Goals (MDGs) provide the current global framework for development efforts and were formally endorsed in 2000 by 189 countries, including Pacific island countries. The importance of sexual and reproductive health was not fully articulated during the formulation of the MDGs as an explicit goal. However, during the World Summit convened in 2005, world leaders endorsed the fundamental human right of “universal access to sexual and reproductive health services” - an additional target to the MDG 5, as a result of intense lobbying by sexual and reproductive health advocates, including the Prime Minister of Tuvalu. The full integration of the MDGs into national sustainable development strategies and plans outlining an allocation of a certain percentage of the national budgets to poverty reduction is requiring a lengthy internalization and implementation process for many Pacific island countries. Part of the challenge for many of those countries has been the relevance of the poverty definition and the prevailing perception by some country leaders that “poverty of opportunity” is the more fundamental issue.

Since the late 1970s, China has been making strong efforts to accelerate the pace of modernization. Because the Chinese Government considers poor economic development and rapid population growth to be the main obstacles to modernization, it has emphasised both of those aspects.

Women are not accorded equal status with men in practically all countries of the world. Compared with men, women have very limited opportunities in most spheres of economic and social activities (Sadik, 1986; Curtin, 1982). However, there is a close association between various aspects of women’s status or position in society and demographic patterns of fertility, mortality and migration. This association is shown to be more pronounced with regard to fertility and the social processes associated with it (United Nations, 1975).

A detailed description of Indonesia’s efforts in the development of information for family planning requires a review of the history of the family planning programme and its information, education and communication (IEC) component, especially since the introduction of new activities such as “social marketing”

One of the potential benefits of family planning programmes in developing countries is that limiting family size can increase women’s ability to participate in productive activities, which in turn can contribute to the economic wellbeing of the family. This argument is based on the assumption that reproductive and productive activities compete for a woman’s limited time and hence women with a small number of children to rear are able to engage more in economic activities than those with larger numbers of children. Thus, the prevalence of small families should be desirable to both the families and the Government. Despite this, however, little is known about the impact of reduced family size on women’s participation in the labour force.

Recently, considerable importance is being given to the study of breastfeeding practices in different settings in developing and developed countries. Breast-feeding is important, particularly in developing countries, because of its relationship with child health and birth spacing. It is well documented that mother’s milk is the best food for the newborn child and it has a significant impact on reducing mortality in infants. Apart from these benefits, breast-feeding also plays an equally important role in controlling fertility in developing countries.

The ecological zones in Nepal known as hills and mountains, which comprise three fourths of the country’s territory and contain 56 per cent of its population, are suffering from increasing environmental hazards, notably deforestation, soil erosion, landslides, flash-floods and desertification (NPC, 1985, p. 200).

It is generally believed that the higher level of fertility prevailing in some populations has been sustained by certain religious tenets favouring large family norms. There are numerous studies which have demonstrated that Roman Catholicism has played an important role in upholding fertility at a relatively higher level on account of its consistent condemnation of artificial methods of birth control (Day, 1968; Murphy and Erhart, 1975). There are still other studies which have linked the relatively higher fertility prevailing in most Muslim populations to certain Islamic teachings concerning population control (Kirk, 1968; Nagi and Stockwell, 1982). There is, however, no general concensus among Muslim religious authorities about the different forms of birth control: the majority endorsing family planning, some sanctioning induced abortion, and most opposing sterilization.

Women have more limited opportunities than men in most economic and social activities. It has been asserted that aspects of women’s status or position in society are closely related to the demographic events of fertility, mortality and migration. For instance, evidence from a variety of studies demonstrates a positive relationship between women’s education and occupation on one hand, and child survival on the other. This phenomenon, therefore, leads to the conclusion that women’s limited opportunities in terms of education and occupation can result in lower child survival.

Breast-feeding is known to prevent women from becoming pregnant under certain circumstances. In recent years, reproductive physiologists have been studying the hypothalamic-pituitary-ovarian axis to learn more precisely how lactation postpones the return of “fertility,” or fecundity. Family planning researchers are interested in knowing not only how breast-feeding inhibits ovulation, but how the return of fertility can be predicted during breast-feeding so that its natural contraceptive benefit can be relied upon with confidence.

Urbanization is characterized by the movement of people from rural areas to urban areas (Kupper and Kupper, 1985, p. 874). The term urbanization refers to such a redistribution of population as a demographic phenomenon, and the changing morphological structure of urban agglomerations and their development as social phenomena. The migration of populations links the rural areas with urban areas and is affected by “push” forces from rural areas and “pull” forces from urban areas. Different degrees of these forces determine the different pace, patterns and processes of migration and urbanization and the transition of populations.

The notion that the “starting”, “spacing” and “stopping” patterns of reproductive behaviour take place within a particular institutional and cultural environment and respond to changes in that environment is a basic sociological orientation to socio-demographic analysis (cf. Davis and Blake, 1956; Freedman, 1961-1962 and 1975; Hawthorn, 1970; McNicoll, 1980; Lesthaeghe, 1980).

Although questions on family size desires have been included routinely in fertility surveys for several decades, questions that attempt to assess the strength of those desires have been much less common. For example, neither the World Fertility Surveys nor the Contraceptive Prevalence Surveys included such questions. The on-going round of Demographic and Health Surveys include questions on strength of fertility motivation, but analyses of the effect of strength of motivation on contraceptive use have not yet been reported.

Population Ageing and its Economic and Social Implications was one of the agenda items considered at the Fourth Asian and Pacific Population Conference, which was held in Bali, Indonesia, from 19 to 27 August 1992.