Chapter Five: Population Policies and Planning PDF

Chapter Five Population Policies and Planning  Introduction According to World Population Policies Report (2005) For Developing Countries the most frequently identified population issues – HIV/AIDS (in 86 per cent of countries), – Infant mortality (in 72 p...

Chapter Five Population Policies and Planning  Introduction According to World Population Policies Report (2005) For Developing Countries the most frequently identified population issues – HIV/AIDS (in 86 per cent of countries), – Infant mortality (in 72 per cent) and – Maternal mortality (69 per cent).  Cont… For Developed Countries: – the three issues most identified were HIV/AIDS, population ageing and low fertility. The basis of most government statements and policies is distinctly Malthusian in tone, though seldom explicitly so. Three possible bases for the elaboration and implementation of population policies are possible: – state-driven, market-driven, or culture- driven.  Cont… State-driven policies are – those directly designed and delivered by the agencies of the state – Like from the Ministry of Health in maternal and child health programs, or family planning programs – most likely to be designed and effectively delivered where the state is strong, as in socialist countries, and heavily involved in delivering development generally – E.g. China  Cont… When the state is unable:(Market driven) – State's Inability for Direct Control – through the range of development policies over which the state does exercise some control but indirectly – increasing access to education, especially for women or the taxation system – the state may have a preference for free market solutions to economic problems, including demographic imbalances. – Indirect measures, such as improving education or offering tax incentives, can sometimes result in greater population change compared to direct population policies  Cont… Sometimes in levels and patterns of individual behavior and culture: – cultural values affect reproductive behavior and objectives in particular – governments may be reluctant/unwilling to change cultural values largely for political reasons – Developing Countries generally have fiercely nationalistic governments, and draw support from public encouragement of these national values – sub-Saharan Africa- strongly pronatalist societies – 1960s-1980s  Cont… Engineering and managing cultural change inevitably requires long time horizons & often political courage and leadership. do not change quickly Direct policies ---- the aim is explicitly to affect the population characteristic, and are usually government designed and implemented. Indirect policies --- the deliberate/careful, but indirect, consequence of policy with another explicit target.  Changing Emphases in Population Policies Effectiveness ---need to address both the proximate and the background determinants of fertility. Proximate determinants: Factors that have a direct impact on fertility, such as contraceptive use, marriage patterns, and breastfeeding practices. Background determinants: Broader societal factors that influence fertility indirectly, such as education, healthcare, economic development, and cultural norms.  Cont… Promoting mortality decline – through health programs, and – especially childhood vaccination, and improving the environment were clearly directed at reducing mortality Policies in education – designed primarily to enhance the quality of the human resource, – indirectly a major justification has long been known to be the effects on fertility – improved education particularly for women like delay marriage, reduction fertility preference…..  Cont… By the 1980s – major family planning campaigns/movement in Asia and subsequently in Africa, – policies were associated with the proximate determinants, and – especially the culturally affected variables associated with marriage and sexual behavior and reproductive health within marriage. The most prominent element in current programs is the promotion of contraception.  Cont… Most effective direct means to reduce fertility is to raise the contraceptive prevalence rate. Most important of the proximate determinants of fertility in all world regions, and even in most countries of Africa. – For stopping and spacing – Sterilization for women(blocking fertilization) and vasectomies for men(cutting the tubes that carry sperm from the testicles to the urethra) – the contraceptive pill, IUDs, implants an injectable methods for women and condoms for men – Traditional Methods--- postpartum abstinence and breastfeeding  Cont… – Policies for marriage-- raising the age at marriage. The primary factors driving fertility decline are rooted in social and cultural shifts, such as changes in societal values, norms, education, rather than solely in government policies. Historically, fertility decline in the North occurred without government interventions or availability or use of contraception. factors, such as urbanization, increased education (especially for women), changing gender roles, economic development, and shifts in societal values about family size.  Cont… Policies in most countries: – many countries, policies are shifting focus towards empowering women so they can make informed decisions about the number and timing of children they wish to have.  Policies for mortality Two approaches to reducing mortality : 1.Indirect Approach: improve people's quality of life through better economic conditions, improved nutrition, healthier living environments, and access to healthcare. 2.Direct Approach: providing more effective curative and preventive health services that target the proximate determinants of mortality, diseases like malaria, tuberculosis, or diarrheal diseases. These services are often financed and delivered by international agencies(NGOs).  Cont… One of the most intractable policy challenge for mortality reduction to many governments and communities – comes from the exceptional conditions associated with HIV/AIDS.