Good Health and Well-Being

Ageing of the population is a demographic phenomenon normally associated with developed countries. This particular trend is currently of concern to Singapore. In 1957, 43 per cent of the population was below 15 years of age, and the elderly aged 60 and over never exceeded 4 per cent of the total population. The median age of the population was at that time 18.8 years (Chen and Cheung, 1988). In 1989, persons aged 60 years and older comprised 8.6 per cent of the total population. In absolute numbers, this constituted 229,700 people (Department of Statistics, 1989). By 1987, the median age had matured to 28.4 years (Chen and Cheung, 1988). It has been projected that one in every four persons will be 60 years or older by the year 2030 (Ministry of Home Affairs, 1989). Data compiled from the U.S. Bureau of Census projected that, in Singapore, the increase in the number of elderly between 1985 and 2025 will be approximately 348 per cent, the second highest of 31 countries surveyed (Straits Times, 7 November 1988).

Famine is defined as widespread food shortage leading to a significant rise in regional mortality (Blix, 1971). Historically, major causes of famine have been natural calamities. However, in modern times, when a natural disaster causes insufficient production of food, political and social factors play an important role in determining whether famine becomes widespread and who is affected (Alamgir, 1980; Langsten, 1985; Sen, 1980).

Until recently, it was believed that fertility in Nepal has persisted at a very high level with a total fertility rate (TFR) of around six children per woman. In a recent article, Tuladhar (1989, pp. 15-30), using the birth history data from the 1986 Fertility and Family Planning Survey, obtained a TFR of 5.61 children per woman for the period 1980-1985. This rate was obtained without any adjustment to the raw data. He cautiously concluded that Nepal may be on the verge of the onset of fertility decline. Except for this publication, the author knows of no other studies so far which address the issue of fertility decline in Nepal. Therefore, the aim of this note is to use village-level data to contribute to the on-going debate about the onset of fertility decline in Nepal in general and the study population in particular.

While the dramatic decline in fertility in China in the 1970s has been acknowledged worldwide and is very well documented in the demographic literature both at home and abroad (China Population Information Center, 1984; Coale, 1984, among others), China’s fertility and related population trends in the 1980s have evoked much concern and discussion in recent years (Hardee-Cleveland and Banister, 1988; Zeng, 1989; Kaufman et al., 1989; Greenhalgh, 1989, 1990; Tien, 1990a; Aird, 1990; Poston, 1991, among others).

The fertility decline of Singapore is often cited as a success story of a developing country’s effort to balance population growth with economic development. Since achieving nationhood in 1965, Singapore’s fertility has fallen by almost 70 per cent in about 20 years: the total fertility rate (TFR) dropped from 4.66 in 1965 to a historic low of 1.44 in 1986, after breaking through the replacement level in 1975. The size of successive birth cohorts also fell by about one-third, even though the number of married women of reproductive ages increased by more than 70 per cent. After 15 years of below-replacement fertility, Singapore can be characterized truly as a lowfertility society.

Long overdue, there is a resurgence of interest in population communication and information activities. This is much welcomed because it is time to reconfirm the significant role of communication in the success of national population programmes, and to take stock of the field of population communication. Taking stock does not mean making yet another comprehensive review of past research and programmes; many others have already com- piled excellent assessments (Johnson, Wilder and Bogue, 1973; Echols, 1974; Saunders, 1977; Rogers, Solomon and Adhikarya, 1982; Snyder, Kim and Rogers, 1985; ICOMP, 1986). Instead, what is needed is a focused analysis of the present situation.

Because reliable estimates of the population and related data are needed to guide national development planning, the first population census of the Lao People’s Democratic Republic in 1985 was very important as a way of providing valuable statistics on the size, distribution and characteristics of the population. However, while the census provided good estimates of the population size and related measures such as fertility and mortality, it was less useful as a means of identifying the speed and manner in which the population was changing. Thus, a project was developed by the ESCAP secretariat with funding from UNFPA (United Nations Population Fund) to assist the Government in improving civil registration and vital statistics. The project had two broad objectives. The first was to provide training and support to selected village chiefs as a way of strengthening their role as civil registrars in the hope that this would lead to eventual improvement in the national registration system. The second broad objective was to set up a system of statistical collection, involving regular visits to selected households, to provide good estimates of vital statistics. This system is referred to as a multiround survey. Although it has many methodological weaknesses, this type of survey can provide some valuable population data in a country where financial resources for conducting censuses and surveys are limited.

In the early 1980s the Government of Nepal set a demographic target of reducing the current fertility rate of about six children per woman of childbearing age to 2.5 by the end of the century. To achieve this target, increasing attention has been given to implementing family planning programmes both in the public and private sectors. The key questions are: What level of family planning practice will be required to reach this national target? Through what compositions of contraceptive method use can the fertility target be achieved? What might this effort cost?

Although numerous studies have been conducted on the interaction between fertility and migration in the context of rapid population growth in developing countries, little has been said about the impact of fertility on migration. Instead attention has been focused disproportionately on the effects of migration on fertility (Myers, 1966; Macisco et al., 1970; Zarate and Zarate, 1975; Magnani, 1980; Goldstein and Goldstein, 1981, 1983; Weller and Bouvier, 1981; Findley, 1982; Berry, 1983; Lee and Farber, 1984).

Promotion of temporary methods should not be neglected for spacing or limiting programmes

Following rapid fertility declines and sustained improvements in life expectancy during the second half of the twentieth century, most countries in East and South-East Asia entered the twenty-first century faced with the problem of population ageing. Population ageing, defined as the increasing proportion of older persons in the total population, is projected to progress in East and South-East Asia at rates higher than the average for the world and the less developed regions (LDRs). Among the various challenges arising as a result of the increasing proportion and absolute numbers of the elderly population, ensuring that older persons are provided adequate care is of paramount concern. A rising proportion of the older population relative to that of the active adult and working age population means that each worker will have to contribute towards supporting an increasing number of older persons. Also, given the declining family size, the number of caregivers available per older person will continuously decline. The implications of the growing imbalance in the demographic equation are further aggravated by increasing globalization, migration, the increasing preference for the nuclear family and, in some countries, the HIV/AIDS epidemic.

Rapid economic and demographic growth propelled the tiny coastal town of Shenzhen (close to Hong Kong) into one of the most dynamic and modern-looking cities in China. Because population movement in China has long been heavily regulated, one may be puzzled by the question of how migration could play any major role in fostering Shenzhen’s boom.

Bangladesh has made significant strides towards achieving the Millennium Development Goals (MDGs); however, the scorecard on maternal health falls short of expectations. According to the MDG target, Bangladesh is expected to reduce the maternal mortality ratio (MMR) from around 574 maternal deaths due to pregnancy and childbirth-related complications per 100,000 live births in 1990 to 143 by 2015. Despite some progress, only 44 per cent of this target was achieved by 2000. An additional 56 per cent reduction has to be achieved to meet the MDG target in less than a decade. MMR was estimated to be around 320 per 100,000 live births during 1998-2000 (NIPORT and Johns Hopkins University, 2003). An estimated 14,000 Bangladeshi women die from pregnancy and childbirth-related complications per year (UNFPA, 2006).

Universal child immunization against vaccine-preventable diseases is recognized as one of the most cost-effective ways of reducing infant/child mortality in developing countries (Westly, 2003; Du Lou and Pison, 1996; Ministry of Health [Nepal], New Era, & ORC Macro, 2002; Department of Health Services/Nepal, 2000/2001). However, a considerable proportion of children living in many developing countries are deprived of receiving a complete course of immunization (Westly, 2003). In an effort to understand the key determinants of low prevalence of childhood immunization, previous studies have primarily focused on household structures (Gage, Sommerfelt and Piani, 1997; Bronte-Tinkew and Dejong, 2005); household economic resources (Bronte-Tinkew and Dejong, 2005); parental (particularly maternal) education (Desai and Alva, 1998; Streatfield, Singarimbun and Diamond, 1990); community contexts such as access to health services, community social structure and rural-urban residence (Pebley, Goldman and Rodriguez, 1996); access to health infrastructures and insurance (Gore and others, 1999), and political, institutional and organizational factors (Gauri and Khaleghian, 2002) as potential determinants. These studies have focused on Africa (e.g., Jamaica, Trinidad and Tobago), Central America (e.g., Guatemala) and North America and do not reflect the relevance of sociocultural backgrounds and geographical disparities existing in Nepal.

As in many other Asian countries, norms regarding family life in East Java have changed and will continue to change with the forces of globalization. Family structures used to be the pillars for the support of children and older persons. However, the declining fertility, rising mobility and rising female labour force are changing as are norms regarding the family. Therefore, the question arises as to who and how will the society finance the care of its elderly?

Violence against women continues to be a global epidemic that kills, tortures and maims physically, psychologically, sexually and economically. It is one of the most pervasive forms of human rights violations, denying women and girls’ equality, security, dignity, self-worth and right to enjoy fundamental freedoms. Violence against women is present in every country, cutting across boundaries of culture, class, education, income, ethnicity and age. The evidence of the magnitude of the problem of domestic violence in developing countries is growing fast. In recent years, there has been a greater understanding of the problem of domestic violence, which is one of the forms of violence against women, its causes and consequences, and an international consensus has developed on the need to handle this sensitive issue in an appropriate fashion.

A major issue in all societies, especially those that are ageing, is the extent to which the elderly can live independently. Cognitive functioning is a crucial factor in the degree of independence of the elderly, while cognitive impairment can predict the loss of functions and even death. There is a close and direct relationship between social support and cognitive functioning, and social support-preventable cognitive impairment (Bassuk and Berkman, 1999). A recent cross-sectional study demonstrated that intergenerational support improved the cognitive functioning of the elderly in rural China (Wang, Li and Zhang, 2005). However, within the context of high levels of migration of working-age adults from rural to urban areas of China, multivariate analysis of longitudinal data on changes in the cognitive functioning of the elderly is required. This article presents an analysis of selected data from a 3-wave longitudinal survey conducted from 2001 to 2006 among 997 parents aged 60 and older living in rural Anhui Province, China, showing that intergenerational transfers, especially financial transfers, have a significant influence on the changes in the cognitive functioning of the elderly. As such, the findings bring a new dimension to the current scientific discussion on the impacts of changing traditional patterns of intergenerational support for elderly persons in China.

Malnutrition is a persistent problem for both children and mother throughout the world. In developing countries malnutrition is an important root of infant and young child mortality, morbidity and reduced life span. It is considered that if malnutrition cannot be reduced and prevented, it will be impossible to achieve many of the Millennium Development Goals (MDGs) including the goals on extreme poverty and hungry, primary education, child mortality, and incidence of infectious diseases. The World Summit for Children in 1990 recognized malnutrition as a contributing factor in half of all deaths occurring among young children. The nutrition goals for the decade 1990-2000 include reduction of both moderate and severe protein-energy malnutrition among children under five years of age by one half of the 1990 levels (UNICEF, 1990). However, the reduction of child malnutrition by half in a decade was one of the most ambitious goals set by the various summits convened during the 1990s. As a result, all of the nutrition goals were not successfully achieved during the period 1990-2000. As a step towards building a strong foundation for attaining the internally agreed development goals, including the MDGs, a consistent set of intermediate targets and benchmarks during the course of the decade (2000-2010) were set to help the unmet goals (UNICEF, 2003; United Nations, 2001). One of the most important goals regarding nutrition during the period 2000-2010 was the one on reducing child malnutrition among children aged under five by at least one third of the 2000 levels, with special attention paid to children under two years of age—especially reduction of stunted and underweighted children by at least one third during the period 2000-2010 (UNICEF, 2002).

More than 500,000 maternal deaths occur worldwide every year, of which a quarter to a third of all deaths is the result of pregnancy-related complications (WHO, 2000). The regional variation in reproductive health outcome is also very wide as about 99 per cent of maternal deaths occur in developing countries. A woman living in Africa faces 200 times greater risk of dying from complications related to pregnancy than a woman living in an industrialized country (WHO, 2000).

Remittances are growing in importance in our globalizing world and, consequently, they are receiving greater attention from researchers. At the microeconomic level, researchers tend to use household surveys to examine why people send remittances, how the characteristics of remittance recipients compare to those of non-recipients, how remittances impact poverty and the income distribution, if remittances are spent for consumption or investment purposes, and in order to access the role of remittances as an insurance mechanism. However, an issue that has received less attention is the role of gender in remittance decisions, from the perspective of both senders and receivers. In Viet Nam, the doi moi economic reforms that began in 1986 have led to large-scale economic transformation in the country, and gender has emerged as an important distinction for understanding how economic growth benefits society and the various subgroups of the population (Long and others, 2000). Viet Nam represents a case of transition from the traditional patriarchal social structure of Confucianism, to a structure of formal equality under socialism, and currently, with further changes taking place, to a market economy. Using the Viet Nam Living Standards Surveys (VLSSs) for 1992-1993 and 1997-1998, which include information about remittance flows at the individual level, attempts are made to shed some light on the role of gender in remittance decisions in Viet Nam during the period of rapid economic transformation.