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Population Experts in London Meet 15 Oct 1997

THE EARTH TIMES

OCTOBER 1 – 15, 1997

Population experts issues present research at London meeting for the next millennium

Emphasis on reproductive health and importance of educating youths about dangers of disease

By Ashali Varma

LONDON- A hundred years   from now, world population will reach 10 billion, according to

World Bank   projections, almost double of what it is today. However, demographers expect

the numbers to be anywhere between 8 billion and 12 billion depending on how much countries are prepared to spend on education, health, empowerment of women and economic

development. Most of the projected growth will take place in the developing countries which are already strapped for resources and struggling to provide health care, education, jobs, food and housing for more and more people, every year.

What are the priorities for population stabilization? How will an extra 6 to 8 billion people affect the planet? What is urgently needed to stabilize population growth? This was the focus of a one day, media briefing organized by the Rockefeller Foundation in London, September 12. Attended by 24 journalists from Japan, Europe and the US and experts in the field of population, social development and economic growth, the briefing was an update on  population research conducted in the last three years, after the ground breaking consensus reached at the International Conference on Population and Development (ICPD), held in Cairo, in September 1994.

“Cairo produced a broad new consensus,” Dr. Steven Sinding of the Rockefeller Foundation, said, “It placed the context of population on individual rights and health and in the broad context of human development, focusing on health, education and the empowerment of women.”

“If we are to stand any chance of fulfilling the· hopes of people around the world for a better life through economic development, we must provide the means for couples to determine for

themselves   the number of children they have and the timing of their births,” Sinding said.

According to statistics compiled by the Population Council, there are 25 million unwanted births per year, 30 million induced abortions and 250 thousand maternal deaths. By the year 2000, about 800 million adolescents will reach childbearing age.

Recognizing the imperative need to reach out to youth, Ingar Brueggemann, secretary general of the International Planned Parenthood Federation (IPPF) told The Earth Times, “It is important to provide knowledge about sexual and reproductive health and infectious diseases to young people. We do this through radio stations, books, outreach programs conducted by

volunteers.”

It is vital that governments and donors realize the connections between population stabilization and investing in education of girls, providing information and services on reproductive health to all who need it and the empowerment of women, Brueggemann said. According to IPPF, at any one time 120 million women do not want to get pregnant but have no access to contraception and 15 million girls aged 15-19 give birth yearly.

Addressing the meeting, John Bongaarts of the Population Council in New York, said, “Unwanted fertility and high desired family size contribute to half of the population growth.

Increasing the age at which women get married would increase the age of childbearing.

This could reduce momentum of child bearing from 2.8 billion to 1.8 billion over a five year period.” Bongaart pointed out the adverse effects of high population growth: degradation of natural resources; low wages, poverty and low growth in the economy; lagging investment in human capital and infrastructure; low and unequal investment in children (especially girls); compromised reproductive health and higher child mortality and morbidity. “Each factor is a persuasive argument against high population growth, together they make a compelling argument,” he said.

Unfortunately, even in countries which have established family planning and reproductive

health as a national priority there is a huge gap between policy and service delivery at the grassroots level. Dr. Sonalde Desai, of the University of Maryland, presented the case of Ramanagar, a small village in the state of Uttar Pradesh in India.

Uttar Pradesh is the largest Indian state with a population of 140 million. It is also -one of the poorest states with 43 percent of the people living below the poverty line and has the highest fertility, with women having about 4.8 children on average. Surveys show that 60 percent of the women do not receive and antenatal care, 13 percent would like to stop childbearing but are not using any contraception.

“In Ramanagar, which has a population of 1,500 there is no doctor or nurse,” Desai said, “and

our  research team found out that the nurse who was supposed to visit once a week had not been seen for six months.” Even in the larger villages with health centres, the researchers found a lack of trained personnel and medicines. On the other hand, Bangladesh has experienced rapid fertility decline despite low levels of overall development. This is due to high contraceptive use because of effective health programs at the grassroots level.

In addition, government incentives to encourage schooling for children have been very successful. According to Dr. Sajeda Amin, of the Population Council, between 1990 and 1995, the government introduced far reaching programs to keep children in school. Poor families were given a stipend to enable their daughters to finish secondary school. And in the “Food for Education” program, families were given 15 kilograms of wheat a month if their children attended primary school. “In 1981 school attendance was below 20 percent and today its  close to 100 percent,” Amin said.

Dr. Alex Nazzar, a scientist at the Navrongo Health Research Centre in Ghana, spoke of  the

need  to address a community’s concerns before introducing family planning and reproductive health  services. In 1994 the Ghanaian Ministry of Health launched a pilot project in three remote villages in northern Ghana. Previous efforts to provide basic health and family planning services to the 125,000 people living in 12,000 scattered holdings, called compounds, had failed. The people in this area were extremely poor and there was a high level of endemic infectious diseases, high infant and child mortality rates and high fertility.

“More than family planning the women wanted their children to survive,” Nazzar said, “In addition, the men felt that if their wives took contraceptives they would lose control of them and wives would be unfaithful.”

Also, since the men paid a dowry for their wives their attitude was, “I bought you, now your job is to provide me with children.”

It was only after a consultative process involving village chiefs and elders and dealing with their concerns, that a successful health care delivery system was started. Instead of having one distant clinic, they now have a nurse located in the village. Community volunteers worked to build each nurse her own residential compound. Now, child care, immunization, education on sanitation and personal hygiene is taken care of. The nurse also provides family planning education and services, including the pill, condoms and injectables.

By 1996, the original pilot project was found to be so successful that is has been expanded to neighbouring areas. Basic health conditions have ‘improved and the use of family planning services has increased from zero to over 15 percent.

“Cases such as the Navrongo project prove that developing countries can provide opportunities for people from other developing countries to study for themselves what is happening in other parts,” Steven Sinding, of the Rockefeller Foundation said.

In an interview with The Earth Times he talked about rationale behind the South  Partnership (an initiative started with the help of the Rockefeller Foundation and the United Nations Population Fund) in which Partner countries exchange the expertise and experience, they have developed in the field of reproductive health and war empowerment.

“People who are involved with programs like the Navrongo project can become trainers in other countries,” Sinding said, “The value is in the experience these people have in successful

projects which can be replicated in other developing countries.”

In addition, two countries- one with a success story and one that wants to emulate it-can consult with each other and put together a program that can be funded by the World Bank and donor countries, Sinding said.

Regarding his wish list for the Partners, he said, he would like to see many more countries involved in this exchange and an “intensity of cooperation” that would increase the flow of resources into this field.

“I would also like to concrete evidence that these programs are improving services at the level of consumers. This ultimate test for me,” Sinding said.