Quality Education

Family planning communication is not a new subject in Asia. Organized family planning programmes began in Asia as early as the 1960s. Bangladesh, China and Taiwan province of the People’s Republic of China, Hong Kong, India, Indonesia, the Republic of Korea, Singapore, Sri Lanka and Thailand have led the way not only in offering family planning services but also in developing information campaigns and educational programmes to inform and persuade people to practise family planning. While other parts of the world were debating whether the words “family planning” and specific types of contraceptives could even be mentioned in public, Governments in Asia were subsidizing mass media promotion of smaller families and of specific contraceptive methods. The evidence is clear that Asia has led the world in family planning communication.

Breast-feeding has always been synonymous with human reproduction and the nourishment of infants. Yet it is only in the last 20-25 years that its effects on fertility and child survival have been systematically investigated. In light of the accumulated scientific evidence, the promotion of breast-feeding through family planning and maternal and child health programmes is increasingly considered to be a public health policy priority, especially in developing societies. In some countries, explicit policies to promote breast- feeding have been enacted. Research is being undertaken to assess the infant feeding situation, monitor changes, if any, in infant feeding patterns, and evaluate the impact of specific policies and programmes.

As a consequence of their rapid fertility declines and pronounced mortality improvements in recent years, many of the developing countries in Asia have become increasingly aware of a number of serious aging problems (Ogawa, 1988a). More importantly, primarily because the demographic transition in these Asian countries has been substantially shorter than in the developed countries (Leete, 1987) the process of population aging in the former has been and will be considerably faster than that observed in the latter. China provides a salient example of fast population aging among the developing countries in Asia.

Fiji is made up of about 332 islands in the south-west Pacific. About a hundred of the islands are usually inhabited; most of the remaining islands are used for temporary residence and for occasional plantation. Fiji has a long history of census taking: although the first census was taken in 1879, it was only a very rough head count. A more comprehensive census was taken in 1881; this census, in fact, inaugurated the series of decennial censuses which continued until 1921, after which there was, however, a break in this series. The next census was not conducted until 15 years later, in 1936. From then on the censuses have been conducted every 10 years; the last census took place in 1986.

The degree of personal autonomy of women in India varies from state to state. Several studies have noted the regional variations in the status of women in India (Karve, 1965; Srinivas, 1978; Mitra, 1979; Dyson and Moore, 1983). Women’s personal autonomy is manifested in practices such as veiling (purdah or ghungat), pressures to get girls married at a very young age (partly to protect their virginity and partly to ensure compliance with parents’ wishes in respect of the choice of spouse), denying or limiting educational or employment opportunities to girls, attaching differential values to sons and daughters, restricting the ability of women to control their fertility by pressuring them to produce children (particularly male heirs), restricting their access to information, and economic and health resources etc.

In the context of East and South-east Asia, the Philippines is an underachieving country; living standards have not improved much in recent years. (Table 1 provides some relevant data about the Philippines.) In this setting, breast-feeding is especially important for child health and child nutrition as well as child spacing. The Philippines is one of several developing countries having comparable national data on breast-feeding trends for the past several decades.

The populations of most developing countries have been growing rapidly in recent decades. During the 1970s and 1980s, the number of persons of working age has often grown even faster than total populations. The struggle to provide enough employment for a burgeoning labour force often fails, resulting in high unemployment plus a large part of the working population “visibly underemployed” (working fewer hours or days than they would like) or “invisibly underemployed” (doing work of extremely low productivity for low income or underutilizing skills).

Thailand is in a relatively advantageous position compared with most other countries in the region with respect to data to document trends and patterns of breast-feeding and related infant feeding practices. Relevant questions, even if not always strictly comparable, have been included in a series of nationally representative surveys conducted during the last two decades. The information provided by these surveys makes clear that a trend towards a decline in the duration of breast-feeding was underway during the decade of the 1970s, but that during the 1980s the decline halted. In addition, the proportion initiating breastfeeding was high throughout the two-decade period and appears to have recently increased to the point where, at the national level, it is now close to universal.

Myanmar is experiencing relatively high fertility and declining mortality rates. In 1973, the population size was nearly 29 million. It increased to 35 million in 1983 with an annual intercensal growth rate of 2.02 per cent (Union of Burma, 1986a; Part 1, p. 14). Since 1948, when it became independent, Myanmar has struggled for economic development and an improved quality of life. But there have been many obstacles and socioeconomic development remains the main challenge to be met. Successive attempts have been made by means of various short- and long-term plans.

The clinical efficacy of various contraceptive methods is well known. However, relatively little is known about their use-effectiveness (which refers to both technical failure of a method and the failure to use a method properly in actual life conditions, especially in developing countries). Use-effectiveness data for programme as well as non-programme methods are necessary for assessing the impact of contraceptive use on fertility (Bongaarts and Potter, 1983).