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Malaysia: where big is still better. For Malays, large families are part of the plan

Asiaweek, 1993 Nov 3.
PMID: 12287219

PIP: The benefits of various-sized families in Malaysia were discussed by several women and supplemented with official statements on family planning (FP). The Director of the National Population and Family Development, Dr. Raj Karim, advised that maternal health is jeopardized when women have more than five children. About 30% of reproductive age women in Malaysia have five or more children. A Federation of FP Associations spokesperson agreed that women should be advised of the dangers of bearing over five children, of the importance of spacing births two to four years apart, and of the ideal age of childbearing (21-39 years). The government lacks an official policy on family size. The government position is, however, compatible with Islamic teachings on spacing in order to protect the health of the mother and child. Islamic law does not permit sterilization or abortion. The "fatwas" of Islamic teaching may have been misconstrued by those not using any form of contraception. Dr. Karim, who has five children, reported that having a large family can be difficult for a woman with a job, a career, and a husband or when both parents work. Most Malays desire large families. The average Malay family size was 4.1 children in 1990; Malaysian Chinese have fertility of 2.3 children and Malaysian Indians have 2.6 children. People say that the benefits outweigh the hardships of a large family.

Matched MeSH terms: Public Policy
Determinants of fertility in Malaysia -- how much do we know?

Ying SL

J Southeast Asian Stud, 1992 Mar;23(1):112-32.
PMID: 12286188
Matched MeSH terms: Public Policy
Population success

Dev Forum, 1982 Jul-Aug;10(6):1, 3.
PMID: 12279227

"The commitment to population programs is now widespread," says Rafael Salas, Executive Director of the UNFPA, in its report "State of World Population." About 80% of the total population of the developing world live in countries which consider their fertility levels too high and would like them reduced. An important impetus came from the World Conference of 1974. The Plan of Action from the conference projected population growth rates in developing countries of 2.0% by 1985. Today it looks as though this projection will be realized. While in 1969, for example, only 26 developing countries had programs aimed at lowering or maintaining fertility levels, by 1980 there were 59. The International Population Conference, recently announced by the UN for 1984, will, it is hoped, help sustain that momentum. Cuba is the country which has shown the greatest decline in birth rate so far. The birth rate fell 47% between 1965-1970 and 1975-1980. Next came China with a 34% decline in the same period. After these came a group of countries--each with populations of over 10 million--with declines of between 15 and 25%: Chile, Colombia, India, Indonesia, the Republic of Korea, Malaysia and Thailand. Though birth rates have been dropping significantly the decline in mortality rates over recent years has been less than was hoped for. The 1974 conference set 74 years as the target for the world's average expectation of life, to be reached by the year 2000. But the UN now predicts that the developing countries will have only reached 63 or 64 years by then. High infant and child mortality rates, particularly in Africa, are among the major causes. The report identifies the status of women as an important determinant of family size. Evidence from the UNFPA-sponsored World Fertility Survey shows that in general the fertility of women decreases as their income increases. It also indicates that women who have been educated and who work outside the home are likely to have smaller families. Access to contraceptives is, of course, a major influence on fertility decline. According to UNFPA some of the Latin American countries have the highest contraceptive use among developing countries. The countries of Asia come next and contraceptives are least used in sub-Saharan Africa where birth rates of 45/1000 are still common. The money for population programs, says the report, has come largely from developing countries themselves. A survey of 15 countries showed them to have contributed 67% out of their own budgets--the rest having come from external aid. And in programs aided by UNFPA the local input has been even higher. During 1979-1981 the developing countries themselves budgeted $4.6 for each dollar budgeted by UNFPA. The report also highlights some of the emerging problems for the next 2 decades--and which will be high on the agenda of the 1984 conference. These include "uncontrolled urban growth" in developing countries as well as an important change in overall population age structure as more and more old people survive. Aging populations are of particular concern to the developed countries but, as the report points out, even countries like China--which has achieved a steep drop in fertility and mortality--will face the problems of an aging population by the year 2000.

Matched MeSH terms: Public Policy
Malaysia [Population education in countries of the region]

Abu-bakar F

Bull Unesco Reg Off Educ Asia Pac, 1982 Jun.
PMID: 12265670
Matched MeSH terms: Public Policy
Southeast Asian perspectives on nutrition needs for the new millennium

Tee ES

Biomed Environ Sci, 2001 Jun;14(1-2):75-81.
PMID: 11594483

Over the last three decades, there has been significant changes in the lifestyles of commmunities, including food habits, and food purchasing and consumption patterns in the Southeast Asian region. As a result, there is a definite change in the food and nutrition issues in the region. Nutritional deficiencies in many of these countries are slowly being decreased in magnitude. On the other hand, the significant proportions of the population are now faced with the other facet of the malnutrition problem, namely diet-related chronic diseases. However, because of the different stages of socio-economic development, the extent of each of these extremes of the malnutrition problems varies considerably between the different countries in Southeast Asia. Nutrition needs in the new millennium would necessarily differ somewhat among these countries while at the same time, there would be a considerable amount of similarities. This presentation highlights several macro issues that countries in the region may focus on in the near future. Various intervention programmes have been undertaken by authorities to tackle the co-existence of twin faces of malnutrition in many developing countries. It would be desirable to have a blue print of such programmes and activities in the National Plans of Action for Nutrition (NPANs) . The NPAN should be more than a framework or a descriptive document. It should be a tool for action, an operational plan that sets out priorities; identifies projects and activities, with details of implementation such as what, how and when; designates responsibilities and accountability for the activities; identifies resource requirements and their source; and sets out the plan for monitoring and evaluation. One of the main obstacles in the formulation and effective implementation of intervention programmes in developing countries is the lack of comprehensive data on the extent of the problems in many cases and the causes of such problems specificy to the communities concerned. It is thus imperative to identify appropriate research priorities and conduct relevant studies. It is also important to have basic baseline data collected at regular intervals such as nutritional status of communities and dietary intake. To conduct all these activities, it is vital to ensure adequate funding, preferably through establishing a dedicated fund for research. There should be closer collaboration between countries in the region in all nutrition activities to enable sharing of resources, experiences and learn from the mistakes of others. One existing mechanism is through the ASEAN structure. The other existing mechanisms are through WHO and FAO. One other mechanism is through the International Life Sciences Institute (ILSI) Southeast Asian Branch. Closely related to this need for networking is the need for continuing harmonization of approaches to nutrition activities in the region. Current efforts in harmonisation include RDA, nutritional status assessment methodologies and dietary guidelines. Other areas of harmonisation in the near future include nutrition labelling and claims.

Matched MeSH terms: Public Policy
Prevalence of dementia and quality of life of caregivers of people living with dementia in Malaysia

Ganapathy SS, Sooryanarayana R, Ahmad NA, Jamaluddin R, Abd Razak MA, Tan MP, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:16-20.
PMID: 33370858 DOI: 10.1111/ggi.14031

AIM: Dementia is the major cause of disability among older persons and leading physical and psychological sequelae for both the person living with dementia (PLwD) and their caregivers. The aim of this study was to determine the prevalence of dementia in Malaysia and identify the factors influencing quality of life (QoL) of caregivers of PLwD.
METHODS: A nationwide survey was conducted among individuals aged ≥60 years. Cognition was assessed with the Identification and Intervention for Dementia in Elderly Africans (IDEA) tool. QoL of older caregivers was assessed using the Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire.
RESULTS: The prevalence of dementia among older adults aged ≥60 years in Malaysia was found to be 8.5%. The prevalence was found to be higher among females, those with no formal education and those in rural areas in Malaysia. The mean QoL of family caregivers of PLwD was significantly lower than the caregivers of older adults without dementia were (P

Matched MeSH terms: Public Policy
Alcohol Advertising, Promotion, and Sponsorship: A Review of Regulatory Policies in the Association of Southeast Asian Nations

Herrera Amul GG

J Stud Alcohol Drugs, 2020 11;81(6):697-709.
PMID: 33308397

OBJECTIVE: The expansion of transnational alcohol corporations (TACs) in Southeast Asia has been suggested as a possible contributor to increased alcohol advertising, promotion, and sponsorship (AAPS), which in turn may have contributed to increasing rates of alcohol consumption and alcohol-related problems. The aim of this scoping review is to document the growth of TACs in the region and to critically evaluate the development of alcohol policies to regulate AAPS in 10 Southeast Asian nations.
METHOD: National policies related to AAPS were reviewed using data from the Global Information System on Alcohol and Health, following the framework of the WHO Global Strategy to reduce the harmful use of alcohol. The policy review was supplemented with data from corporate annual reports, press releases, four databases of academic literature, market research from Euromonitor International, and news articles.
RESULTS: Four TACs--Carlsberg, Diageo, Heineken, and San Miguel--have been expanding operations in Southeast Asia by setting up new breweries, acquiring local alcohol companies as subsidiaries, and entering into joint ventures. In contrast, policies for regulating AAPS vary across Southeast Asia and range from nonexistent to strong control of AAPS. There is strong control of AAPS in countries with existing legislation ranging from a complete ban (Brunei) to almost comprehensive bans (Indonesia, Myanmar, Laos) and partial bans (Thailand). Nonexistent to weak control of AAPS is observed in the Philippines, Singapore, Cambodia, Malaysia, and Vietnam, which mostly rely on voluntary regulation.
CONCLUSIONS: The study's findings point to the growing power of TACs in the region and call for the need for stronger measures based on scientific evidence of effectiveness that are implemented without interference from commercial interests.

Matched MeSH terms: Public Policy
Fulltext Unheard voices : womens’ inner experiences during the Johore flood

Zabedah, B., Badrul Hisham, A.S.

Malaysian Journal of Community Health, 2009;15(3):98-103.
MyJurnal

Introduction : Human displacement during disaster would cause women and their dependent children to be particularly vulnerable. Yet, women failed to make their voices heard. Thus their needs, priorities and perceptions would not be identified which in turn could hinder an effective emergency response and a full recovery process.
Objective : This paper provides a general overview of problems and issues experienced by women and their dependent children during the Johore flood disaster. With this information, relevant agencies shall focus, among other considerations, on the special needs of women and children in planning and carrying out emergency responses in the future.
Methodology : This paper was written based on data and information obtained from the Johore Flood Disaster Report and observations made by the health teams on the flood victims throughout the flood period.
Findings and Discussions : Pregnant mothers with 36 weeks of gestation or more were evacuated from their homes to the health centres or hospitals when the Johore flood disaster struck. Regular maternal and child health (MCH) services were conducted at the flood relief centres. Despite the efforts by health care providers, we observed women facing some unique issues and problems. These include: 1) Effects of loss of security and protection; 2) Disruption of social relations and privacy; 3) Inadequate supply of basic items and; and 4) Economic disruption. Recommendations for future relief work are: i) Predisaster planning for emergency response must engage and involve women representatives. Women must also be recruited as emergency and relief workers; ii) Assessment of predetermined capacity of identified relief centres with gender consideration for evacuees must be done; iii) All relief centres shall have physical partition between families. Breast feeding room with access to clean water should also be provided; iv) Gender, cultural and religious sensitivity with regards to social protection and relations shall be observed at all times; v) Women should engage and be made occupied with suitable activities to encourage healthy social interaction thus avoiding feelings of boredom and helplessness; vi) Basic personal items for women and adolescent girls, such as sanitary towel and undergarments, and places to wash and hang them in privacy must be provided; vii) Elderly women may have to temporarily stay at unaffected relatives’ or old folk homes throughout the disaster period, and; viii) No smoking policy shall be enforced at all times in flood relief centres.
Conclusion : Women and their dependent children have been recognised as one of the vulnerable groups during disasters. Thus, women shall be empowered as partners in formulating any emergency response plan so that together they would be able to complement all disaster mitigation, relief and recovery efforts in amore effective manner.

Matched MeSH terms: Public Policy
Fulltext Focusing health equity, efficiency and health maximization policy review

Thant, Z., Than, Mt, Shamsul, B.S., Wai, P.W., Htun, H.N.

Malaysian Journal of Public Health Medicine, 2013;13(1):64-71.
MyJurnal

With economic growth and significant technological advances in the health sector, many countries have developed aggregate outcomes in terms of both health services and individual well-being. Life expectancy has seen a remarkable increase of more than fifty per cent between 1950 and 2009. Achievement is uneven, however, and some groups are better able to access health services than others. In our review, we explore the need and how to maximize health equity, efficiency and effectiveness. Methodology is the review and web surfing on public health, social science, humanity and development literature. The increasing gap in health inequality, however, calls for further reform of the health system to achieve both equity and efficiency. Health is essential for survival and human capability. Good health enables people to participate in society. A new approach to efficient and cost-effective health service provision is community participation in health development. Participation can increase the skills and knowledge of local people, thus providing opportunities to improve their lives (empowerment). Analysis suggests four functional changes to achieve equity and efficiency in maximizing health outputs: reforms targeting universal coverage to achieve universal access to health; people-centred service delivery through concentrating on health services based on need; public policy change targeting integrated and multi-system health planning; and collective health system and community response to achieve health for all.

Matched MeSH terms: Public Policy
Thai midwives brought into family planning

IDRC Rep, 1974 Mar;3(1):17-20.
PMID: 12333530

PIP: In Thailand "granny" midwives are being tested and trained to take part in modern family planning and public health programs. In Malaysia a survey of conditions relating to an increase in induced early termination or abortion of pregnancies is in progress. The International Development Research Centre (IDRC) supports these projects as well as others in Asia. Local paramedical workers, like the "barefoot doctors" in China, are being trained. In Thailand a growth plan is attempting to reduce the annual rate of population increase from about 3.3% to 2.5%. Many granny midwives have been contacted. Several methods of incentive and training are being tried and will be evaluated. Eventually granny midwives in all of Thailand's 60,000 villages will be enlisted in the national planning program. Of Thailand's 6 million married women of reproductive age less than half use modern birth control methods. Abortion is illegal in Thailand which is a predominantly Buddhist country. The project in Malaysia is being carried out by the University of Malaysia and the Federation of Family Planning Associations. Abortion is also illegal in Islamic Malaysia, although there are illegal abortion clinics. Trends so far reported to IDRC indicate that 1) lower class women are more cooperative interviewees than others, 2) most couples use some method of birth control, 3) many wish to interrupt their pregnancies, 4) poorer families have more children than wealthier ones, 5) the Chinese and Indian people show a greater tendency to limit families than do the Malays, and 6) most couples want 3 or 4 children.

Matched MeSH terms: Public Policy
Population mobility in Peninsular Malaysia

Jones GW, Sidh MS

Dev Forum, 1979 Dec;9(2):1-21.
PMID: 12336532
Matched MeSH terms: Public Policy
Malaysia implements the integrated approach

Asian Popul Programme News, 1977;6(1):24-8.
PMID: 12260250
Matched MeSH terms: Public Policy
A review of the Australian healthcare system: A policy perspective

Dixit SK, Sambasivan M

SAGE Open Med, 2018;6:2050312118769211.
PMID: 29686869 DOI: 10.1177/2050312118769211

This article seeks to review the Australian healthcare system and compare it to similar systems in other countries to highlight the main issues and problems. A literature search for articles relating to the Australian and other developed countries' healthcare systems was conducted by using Google and the library of Victoria University, Melbourne. Data from the websites of the Commonwealth of Australia, the Australian Institute of Health and Welfare, the Australian Productivity Commission, the Organisation for Economic Co-operation and Development and the World Bank have also been used. Although care within the Australian healthcare system is among the best in the world, there is a need to change the paradigm currently being used to measure the outcomes and allocate resources. The Australian healthcare system is potentially dealing with two main problems: (a) resource allocation, and (b) performance and patient outcomes improvements. An interdisciplinary research approach in the areas of performance measurement, quality and patient outcomes improvement could be adopted to discover new insights, by using the policy implementation error/efficiency and bureaucratic capacity. Hospital managers, executives and healthcare management practitioners could use an interdisciplinary approach to design new performance measurement models, in which financial performance, quality, healthcare and patient outcomes are blended in, for resource allocation and performance improvement. This article recommends that public policy implementation error and the bureaucratic capacity models be applied to healthcare to optimise the outcomes for the healthcare system in Australia. In addition, it highlights the need for evaluation of the current reimbursement method, freedom of choice to patients and a regular scrutiny of the appropriateness of care.

Matched MeSH terms: Public Policy
Fulltext Raising cigarette excise tax to reduce consumption in low-and middle-income countries of the Asia-Pacific region:a simulation of the anticipated health and taxation revenues impacts

Ho LM, Schafferer C, Lee JM, Yeh CY, Hsieh CJ

BMC Public Health, 2018 Oct 19;18(1):1187.
PMID: 30340557 DOI: 10.1186/s12889-018-6096-z

BACKGROUND: According to the World Health Organization (WHO), 80% of the world's smokers live in low- and middle-income countries. Moreover, more than half of the world's smoking-addicted population resides in the Asia-Pacific region. The reduction of tobacco consumption has thus become one of the major social policies in the region. This study investigates the effects of price increases on cigarette consumption, tobacco tax revenues and reduction in smoking-caused mortality in 22 low-income as well as middle-income countries in the Asia-Pacific region.
METHODS: Using panel data from the 1999-2015 Euromonitor International, the World Bank and the World Health Organization, we applied fixed effects regression models of panel data to estimate the elasticity of cigarette prices and to simulate the effect of price fluctuations.
RESULTS: Cigarette price elasticity was the highest for countries with a per capita Gross National Income (GNI) above US$6000 (China and Malaysia), and considerably higher for other economies in the region. The administered simulation shows that with an average annual cigarette price increase of 9.51%, the average annual cigarette consumption would decrease by 3.56%, and the average annual tobacco tax revenue would increase by 16.20%. The number of averted smoking-attributable deaths (SADs) would be the highest in China, followed by Indonesia and India. In total, over 17.96 million lives could be saved by tax increases.
CONCLUSION: Excise tax increases have a significant effect on the reduction of smoking prevalence and the number of averted smoking-attributable deaths. Middle- and upper-middle income countries would be most affected by high-taxation policies.

Matched MeSH terms: Public Policy
Fulltext Emerging challenges for sustainable development and forest conservation in Sarawak, Borneo

Alamgir M, Campbell MJ, Sloan S, Engert J, Word J, Laurance WF

PLoS One, 2020;15(3):e0229614.
PMID: 32126070 DOI: 10.1371/journal.pone.0229614

The forests of Borneo-the third largest island on the planet-sustain some of the highest biodiversity and carbon storage in the world. The forests also provide vital ecosystem services and livelihood support for millions of people in the region, including many indigenous communities. The Pan-Borneo Highway and several hydroelectric dams are planned or already under construction in Sarawak, a Malaysian state comprising part of the Borneo. This development seeks to enhance economic growth and regional connectivity, support community access to services, and promote industrial development. However, the implications of the development of highway and dams for forest integrity, biodiversity and ecosystem services remained largely unreported. We assessed these development projects using fine-scale biophysical and environmental data and found several environmental and socioeconomic risks associated with the projects. The highway and hydroelectric dam projects will impact 32 protected areas including numerous key habitats of threatened species such as the proboscis monkey (Nasalis larvatus), Sarawak surili (Presbytis chrysomelas), Bornean orangutans (Pongo pygmaeus) and tufted ground squirrel (Rheithrosciurus macrotis). Under its slated development trajectory, the local and trans-national forest connectivity between Malaysian Borneo and Indonesian Borneo would also be substantially diminished. Nearly ~161 km of the Pan-Borneo Highway in Sarawak will traverse forested landscapes and ~55 km will traverse carbon-rich peatlands. The 13 hydroelectric dam projects will collectively impact ~1.7 million ha of forest in Sarawak. The consequences of planned highway and hydroelectric dams construction will increase the carbon footprint of development in the region. Moreover, many new road segments and hydroelectric dams would be built on steep slopes in high-rainfall zones and forested areas, increasing both construction and ongoing maintenance costs. The projects would also alter livelihood activities of downstream communities, risking their long-term sustainability. Overall, our findings identify major economic, social and environmental risks for several planned road segments in Sarawak-such as those between Telok Melano and Kuching; Sibu and Bintulu; and in the Lambir, Limbang and Lawas regions-and dam projects-such as Tutoh, Limbang, Lawas, Baram, Linau, Ulu Air and Baleh dams. Such projects need to be reviewed to ensure they reflect Borneo's unique environmental and forest ecosystem values, the aspirations of local communities and long-term sustainability of the projects rather than being assessed solely on their short-term economic returns.

Matched MeSH terms: Public Policy
Fulltext Cancer control programs in East Asia: evidence from the international literature

Moore MA

J Prev Med Public Health, 2014 Jul;47(4):183-200.
PMID: 25139165 DOI: 10.3961/jpmph.2014.47.4.183

Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East. Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.

Matched MeSH terms: Public Policy
Application of theory-based evaluation for the critical analysis of national biofuel policy: A case study in Malaysia

Abdul-Manan AF, Baharuddin A, Chang LW

Eval Program Plann, 2015 Oct;52:39-49.
PMID: 25898073 DOI: 10.1016/j.evalprogplan.2015.03.007

Theory-based evaluation (TBE) is an effectiveness assessment technique that critically analyses the theory underlying an intervention. Whilst its use has been widely reported in the area of social programmes, it is less applied in the field of energy and climate change policy evaluations. This paper reports a recent study that has evaluated the effectiveness of the national biofuel policy (NBP) for the transport sector in Malaysia by adapting a TBE approach. Three evaluation criteria were derived from the official goals of the NBP, those are (i) improve sustainability and environmental friendliness, (ii) reduce fossil fuel dependency, and (iii) enhance stakeholders' welfare. The policy theory underlying the NBP has been reconstructed through critical examination of the policy and regulatory documents followed by a rigorous appraisal of the causal link within the policy theory through the application of scientific knowledge. This study has identified several weaknesses in the policy framework that may engender the policy to be ineffective. Experiences with the use of a TBE approach for policy evaluations are also shared in this report.

Matched MeSH terms: Public Policy*
Population change and educational development

Jayasuriya JE

Bull Unesco Reg Off Educ Asia Pac, 1982 Jun.
PMID: 12265642
Matched MeSH terms: Public Policy*
Fertility trends and prospects in East and South-East Asian countries and implications for policies and programmes

Leete R

Popul Res Leads, 1991.
PMID: 12285439

PIP:
Fertility trends and prospects for east and southeast Asian countries including cities in China, Taiwan, the Republic of Korea, Thailand, Indonesia, Malaysia, the Philippines, Myanmar, and Viet Nam are described. Additional discussion focuses on family planning methods, marriage patterns, fertility prospects, theories of fertility change, and policy implications for the labor supply, labor migrants, increased female participation in the labor force (LFP), human resource development, and social policy measures. Figures provide graphic descriptions of total fertility rates (TFRS) for 12 countries/areas for selected years between 1960-90, TFR for selected Chinese cities between 1955-90, the % of currently married women 15-44 years using contraception by main method for selected years and for 10 countries, actual and projected TFR and annual growth rates between 1990-2020 for Korea and Indonesia. It is noted that the 1st southeast Asian country to experience a revolution in reproductive behavior was Japan with below replacement level fertility by 1960. This was accomplished by massive postponement in age at marriage and rapid reduction in marital fertility. Fertility was controlled primarily through abortion. Thereafter every southeast Asian country experienced fertility declines. Hong Kong, Penang, Shanghai, Singapore, and Taipei and declining fertility before the major thrust of family planning (FP). Chinese fertility declines were reflected in the 1970s to the early 1980s and paralleled the longer, later, fewer campaign and policy which set ambitious targets which were strictly enforced at all levels of administration. Korea and Taiwan's declines were a result of individual decision making to restrict fertility which was encouraged by private and government programs to provide FP information and subsidized services. The context was social and economic change. Indonesia's almost replacement level fertility was achieved dramatically through the 1970s and 1980s by institutional change in ideas about families and schooling and material welfare, changes in the structure of governance, and changes in state ideology. Thailand's decline began in the 1960s and is attributed to social change, change in cultural setting, demand, and FP efforts. Modest declines characterize Malaysia and the Philippines, which have been surpassed by Myanmar and Viet Nam. The policy implications are that there are shortages in labor supply which can be remedied with labor migration, pronatalist policy, more capital intensive industries, and preparation for a changing economy.

Matched MeSH terms: Public Policy*
[Family planning programs and birth control in the third world]

Wohlschlagl H

Demogr Inf, 1991;?:17-34, 153.
PMID: 12343122

PIP: The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than socioeconomic factors. Contraceptive use increased in Mexico from 13% in 1973 to 41% in 1978 among women of fertile age. According to 1984 and 1988 UN data modern methods of contraception were used by 70% of women in China, 60-65% in Southeast Asia, Costa Rica, and Puerto Rico. In contrast, less than 5% used them in most countries of Africa, 15-20% in West Asia, 25-30% in South Asia, and 40% in Latin America. The pill was the most popular method. From the early 1980s in South and East Asia 1/5 of women got sterilized after attaining the desired family size. Less than 10% of women used IUDs in developing countries. FP programs have benefited from higher education levels and economic incentives and sanctions and exemplified in Singapore, China, South Korea, Thailand, and Taiwan.

Matched MeSH terms: Public Policy*

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