Poster session on Population and development

According to the latest reports submitted to the international community, Southern Cone countries (Argentina, Brazil, Chile and Uruguay) have shown a noticeable decrease in the level of mortality in children under the age of 5, which grants them conditions to fulfill the goals to reduce child mortality set at their adhesion to the Millennium Summit (2000). Notwithstanding these predictions, said reports, in general, do not address in detail the problems of differences inside the countries and of preventable deaths, two issues which are essential to study to what extent the advances linked to development have enabled the joint realization of human rights. In order to give an answer to this, we refer to the information produced by the national vital statistics offices, and we apply several measures to this information which allow for estimation of differences between social, geographical and cultural sectors (and the temporal dynamics they describe). Likewise, we try to identify preventable deaths and their composition in order to determine the role of the population; so as to give continuity to the decreasing trend in the level of deaths occurring during the early years of life.

The paper studies associations between population development and democratisation process. Political science has found links between democratisation and socio-economic development, but population development's role has been studied much less extensively. There are virtually no studies focusing on the relationship between demographic variables and the dynamics of political regimes in the contemporary world. This paper suggests that demographic variables capturing the spread of individualisation in society can be used to explain the strengthening of democratic rule. Our hypothesis is guided by an idea about fertility decline as a part of a broader emancipation process, driven by increasing centrality of individual's autonomy which encompasses both political and family domains. We assume that in the absence of direct measures, demographic variables can provide a useful account of the individuality dimension. The study applies macro-level approach. Level of democracy in a country, measured by Polity IV rating system, is modelled against demographic and socio-economic variables. We find associations between TFR and democracy index that suggest using demographic indicators as measure of readiness for democracy together with economic variables.

Health financing in India is a critical issue in the wake of rapid demographic and epidemiological transition, low per capita pubic heath spending and rising health care cost. However, there are few studies that examine the role of changing age structure on health spending in India. The aim of this paper is to examine the effect of population growth and age structural transition on household health spending in India and states. It segregates the increased health expenditure due to changing age structure, increased hospitalization and medical cost (real) using decomposition analysis and projects future cost of medical care. The unit data from 52(25) and 60(25) rounds of National Sample Survey, Census of India 2001 and 2011 and Population Projection of Expert Committee 2001-26 are used in the analyses. Results suggest that the real cost of inpatient care has increased over time for all age groups. During 1995-2004, the changing age structure accounts 22% increase in real cost of hospitalization. The shift in age structure alone would lead to an increase of 47% in hospitalization cost, 43% in outpatient cost by 2021 and an increase of 63% in hospitalization cost and 58% of outpatient cost by 2026 at 2004 prices.

India is in a race to reduce Infant Mortality Rate (IMR) to ‘28’ and Maternal Mortality Ratio (MMR) to ‘109’, by 2015. Using a standardized de-composition technique and by using latest IMR/MMR data for the states and the nation during the period 1990-2010, we estimated percent net-contribution of 15 populous states and different periods in shaping India’s IMR/MMR. By fitting linear and exponential regression-curves, predicted IMRs/MMRs for India and 15 populous states, for 2015. Due to favourable contribution to maternal mortality reduction efforts from Uttar Pradesh (33%), Bihar/Jharkhand (19%) and Madhya Pradesh/Chhattisgarh (11%) - India is predicted to attain MDG-5 target by 2016, assuming the pace of decline observed in MMR during 1997-2009 continue to follow a linear-trend. However, the wait may continue until 2023-24 if MMR decline in India follows an exponential-trend. Attaining MDG-4 may take until 2023-24/2033-34, due to low acceleration in IMR decline in Bihar/Jharkhand, Uttar Pradesh/Uttarakhand and Rajasthan. Maximum decline in MMR during 2004-09 coincided with up-take of National Rural Health Mission (NRHM) interventions. Although, India as a nation is not predicted to attain MDGs-4&5, four of its states are predicted to do so. During 1990-2010, MMR reduction efforts were more effective than IMR reduction efforts.

About 50% of the population of sub-Saharan Africa are children and adolescents. This study uses the age-structure-economic framework to analyse census data for three countries in the region to examine whether the large proportion of children and adolescents are economic dividend or burden. Census data for Kenya, Senegal and South Africa were purposively selected for analysis. Descriptive analytical strategies were used to examine the age structure, educational attainment and employment status. The series of census data analysed show vividly that large proportion of young people in the selected countries is mainly dependants. Thus, the youthful population structure is critical to the prevailing high dependency ratio in the countries. Consistent with age-structure-economic framework adopted for the study, the present proportion of children and adolescents are more of economic burden to individual families and governments. Nevertheless, if sustainable fertility decline is pursued through reductionate population policies, the current large proportion of children and adolescents would graduate into the working age population in about a decade or so and dependency ratio would begin to fall. If appropriate economic, social and legal frameworks are put in place, this situation is most likely to propel rapid economic growth.

The number of Filipinos ages 60 and over is expected to increase from 6.8 million in 2010 to almost 10 million in 2020. However, previous studies indicate that the projected expansion in the size of the Filipino older population could also mean a corresponding increase in the number of persons with disability. In light of this projected scenario are there enough provisions, especially health insurance, to meet their future demands for health care?

Using the 2008 National Demographic Health Survey, this study aims to: a) present the characteristics of Filipino older persons covered by any health insurance system to identify which segment of this population should be targeted in the expansion of health insurance coverage; and b) examine the role of health insurance coverage in the health care utilization of older persons in the Philippines.

Preliminary results reveal that less than half (45.8%) of Filipino older persons are covered by health insurance, most common of which is the PhilHealth (35.7%). Coverage is higher among men, those who are younger, and those who are better educated and wealthier. Among those who were hospitalized in the past year significant proportion relies on health insurance, especially PhilHealth (41%), to cover their medical expenses.

The study is designed to investigate and analyze the management and utilization of Health Management Information System (HMIS) in Busia District. The major aim of the study was to find out the management and utilization of health management information system in Busia district, Uganda. The study was both qualitative and quantitative in nature in two Health Sub-Districts in Busia. Documents review, key informant interviews and a Semi – structured questionnaire were used.
From the findings it is concluded that the management and utilization of the HMIS is still inadequate. Majority of the reporting health units were government owned implying that private practitioners were not represented and yet they have a significant role in health care delivery. Based on the above issues the study recommends that: there is need to establish record offices at all health centers; HMIS focal persons should be motivated ie transport, allowances etc; there should be an HMIS focal person at the HSD level to collect data from all the health units in the HSD; the government should take the initiative to recognize and include private practitioners in the HMIS; and Health workers including those in private practice should be trained in data management.

The focus of the present article is to assess inter-state differential among states of India in the context of changing status of women and social opportunities. To determine women’s changing status, different indicators like female literacy rate, median age at first marriage and first birth, using modern contraceptive, received at least one Antenatal checkup, Institutional delivery, exposed to any source of media, work status, involved in decision making. However overall literacy rate, percent of urban population, household with piped drinking water, any toilet facility, electricity facility, house type as pucca, full vaccination coverage, crude birth and death rate and total fertility rate are considered as social indicator. To examine the association between two dimensions from NFHS-1 to NFHS-3, we created two indices named as Women Status index and Social Development Index using Taxonomic approach. The nexus between social development and women status has been figured out with help of correlation and upshots proves the intense association between two dimensions. Results reveal that during NFHS-1 women’s status is observed highest in Kerala and lowest in Assam, Bihar and Uttar Pradesh. However with enhancing social opportunities, status is improving but its degree is still very low in northern states of India.

Globally, delivering in health facilities is encouraged as a single most important strategy in preventing maternal and neonatal deaths. However, access to facility-based delivery care remains very low in many developing countries including Tanzania, despite the user-fee exemption policy. The study assesses the relationship between socioeconomic status and place of delivery in three districts in Tanzania.

Data originate from a larger cross-sectional survey of random households conducted in three districts in Tanzania in 2011. Logistic regression model was fitted to examine how socioeconomic status and other factors influence place of delivery.

Overall, 75.5% of all participants delivered in facilities. The wealthier and more educated a woman was, the more likely that she would deliver in a health facility (OR=4.34, 95% CI 1.86-10.13). Also Sukuma and Ngindo ethnic groups were less likely compared to ndengereko to deliver in health facilities (OR=0.60, 95% CI 0.36-0.98) and (OR=0.40, 95% CI 0.18-0.89) respectively. Other significant predictors were gravidity, religion, district and type of residence.

Access to facility-based delivery care in Tanzania is significantly skewed in favor of socioeconomically wealthier and more educated women, despite the user-fee exemption policy for delivery care being operational.

Well established theory by Wilkinson said that income is closely related to health care. This study tried to reveal whether maternal health care varies by wealth quintiles in selected states. DLHS data from 2002- 2008 were utilized for the purpose. Orissa showed the pro-poor distribution among social-group as well as by wealth quintiles. Percentage of women had ANC visit in first trimester and full ANC of their pregnancy was higher in Orissa and Chhattisgarh compared to other states. Natal care showed different pattern. MP improved its level in safe births substantially from a 20 percent to 44 percent during survey interval. It was higher in state of Madhya Pradesh (MP), Rajasthan and Orissa and even a sharp increase was seen for institutional births at public institutions these states. Proportion of women had ANC visit in first trimester increases from poorest to richest quintiles. Concentration index shows the inequality has reduced in all states except Chhattisgarh. Low prevalence has been observed among poorer group in all EAG states while richer section is dissimilar in different indicators of maternal care. Inequality is higher for full ANC than other two indicators; safe and institutional births. Greater within caste economic inequality was observed in states with low levels opposite to state with better performance.