Quality Education

This review analyses the gender dimensions of rapid population ageing in the Asia-Pacific region, shares examples of useful practices and makes policy recommendations within the context of the 2030 Agenda for Sustainable Development and the Madrid International Plan of Action on Ageing. Population ageing is occurring along with urbanization, migration, more women in paid work, smaller families, technological advances and environmental changes. Reports from international agencies and new national policies and plans often fail to respond to the different needs of older women and men and to recognize and benefit from their different contributions. Age and sex discrimination intersect. Women live longer than men yet have higher risk of poor health and disability in old age. Although most older persons continue to live with their families, older women are more likely than men to live alone, be widowed and poor. They have had fewer opportunities to earn or make pension contributions and may lack inheritance rights. Older men are more likely to be socially isolated and miss their earlier roles. Conditions affecting quality of life are more common in older women and often neglected, including sensory impairments, arthritis and incontinence. Risk factors also differ: Women are less likely to be physically active; older men more likely to drink alcohol and smoke. Older women face greater barriers to health care. Caring for dependent older family members is usually the responsibility of women, and paid care providers are disproportionately female. Family caregivers need support, help with assistive devices and respite care. They are often unable to earn and save for their own old age. Government, civil society and the private sector all have important roles. National Governments need to invest in policies that recognize the different rights and roles of older women and men.

The keys to fertility decline would appear to lie in structural changes in the economy, the satisfaction of existing demand for family planning services and generation of additional demand

Tobacco use has been identified by the World Health Organization (WHO) as the most preventable cause of death and disability in the world. Globally, there are 1.1 billion people who smoke, over 80 per cent of whom live in low- and middle-income countries. Of all the people alive today, 500 million will die of tobacco-related causes. Although a staggering 100 million tobacco-related deaths occurred in the twentieth century, it is estimated that, by the end of the twenty-first century, 10 times that number, or 1 billion people, will have died because of tobacco use, and this burden will be borne most heavily by developing countries.

Labour shortages are brought about more by Thailand’s rapidly growing economy and lagging education than by demographic change

In India, programmes and research concerned with women’s health until very recently have focused mainly on the reproductive functions of married women. The recent paradigm shift in the Government’s primary health programme was intended to increase the attention given to gynaecological problems and other aspects of women’s health. Nonetheless, the attention given to the health problems of adolescent girls is still meagre, even though adolescence is a time when looking after health and nutrition can help to build a buffer against the heavy physical demands of the reproductive years. High rates of gynaecological morbidity have been reported in rural populations, adolescents included (Bang and others, 1989; Koenig and others, 1998). However, the health knowledge and problems of adolescents have so far received only minimal attention (Koblinsky and others, 1993).

Until recently, much of the literature concerning population issues in Bangladesh has stressed the presence of conditions that would inhibit a fertility transition — limited opportunities for women in the job market, son preference (Lindenbaum, 1975), the value of children for ameliorating risk (Cain, 1986) and providing familial labour (Caldwell, 1982), the poorly managed national family planning programme (Hartman, 1987), and high infant mortality. Bangladesh is still largely impoverished and agricultural, infant mortality is still high, education levels among women of reproductive age remain low and traditional cultural institutions strong. Yet in this unlikely setting, the total fertility rate has declined from around seven in the late 1970s to well under four in 1994. The fertility transition in Bangladesh was achieved almost exclusively through the use of birth control methods (modem and traditional), with use increasing dramatically from 8 per cent in 1975 to 45 per cent in 1994. Since that time, fertility has remained constant, while contraceptive use has increased to 53 per cent. (Razzaque and others, 2002).

Over the past decade, East Asia has halved the proportion of people living in extreme poverty on a dollar or less per day, from 28 to 14 per cent. During the same period, South Asia, where nearly half the world’s poor live, has seen a more modest drop: from 44 to 40 per cent. While part of East Asia’s success can be attributed to good economic policies, economic growth is by no means a magic potion. In fact, growth can actually increase income inequality and widen the gap between rich and poor. To reduce extreme poverty, social investment is needed to expand opportunities, capabilities and participation so that people can climb out of poverty.

The primary health care system in Sri Lanka has an international reputation for its contributions to reducing the rates of infant and maternal morbidity and mortality. These results have been achieved in part through a comprehensive system of early identification of expectant mothers, careful follow-up and monitoring, almost universal hospital deliveries, postpartum follow-up for three months after delivery, an effective immunization programme, nutrition supplements and the reporting of infectious diseases. A key to this system is the “public health midwife” (PHM) who identifies pregnant mothers, ensures their regular attendance at maternal and child health (MCH) clinics, makes monthly home visits, advises pregnant mothers on nutrition and health, facilitates hospital admission for delivery and responds to emergencies. They also provide postnatal follow-up of mother and child (Ministry of Health and Indigenous Medicine, 1998).

Population ageing has been a topic of considerable interest during the last decade (Knodel, 1999), more so in the developed regions of the world than in the less developed regions. This is so because the process of population ageing has been much slower until recent times in the less developed regions.