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Background Paper on Reproductive Health [PDF]
Author(s):  Carla AbouZahr
Date of Publication: September 01 1999
"Adapting to Change," Core Course on Population, Reproductive Health, and Health Sector Reform. World Bank Institute. The articulation of the concept of reproductive rights, accompanied by growing strength of the women’s movement and the advent of the HIV/AIDS pandemic, became the impetus behind the paradigm shift in reproductive health care that Cairo represents. Despite a generalised adoption of the Cairo wording, there still exist different ways of conceptualising reproductive health, which makes it hard to define its precise boundaries. It is also difficult to precisely assess the extent to which reproductive ill-health outcomes contributes to the overall burden of disease among different groups of people due to some disadvantages of the existing epidemiological databases and summary measures of population health such as DALYs. However, it is clear that the suffering associated with poor reproductive health is large, especially in developing countries, and more particularly among the poor, which implies its risk factors. Impact of poor reproductive health can be further investigated beyond maternal morbidity and mortality.

Background Paper on Reproductive Health--Slide Presentation [PDF]
Author(s):  Carla AbouZahr
Date of Publication: September 07 1999
Power Point Presentation for Adapting to Change Core Course.

Boundaries of Reproductive Health (Cairo Version) [PPT]
Author(s):  Allan G. Hill
Carla AbouZahr
Date of Publication: October 09 2000
This is a handout for the World Bank’s Adapting to Change Core Course on Population and Reproductive Health. The main topics include: Measuring population health; Measuring reproductive health (definition, data and difficulties); Priority-setting (What information do we need?); Valuing health status (why, who and how?)

But How Much Does it Cost? [PDF]
Author(s):  Abdo Yazbeck
Date of Publication: September 13 1999
It is not hard to argue the importance of financial constraints in motivating policy makers and service providers to make difficult decisions. Then, the prioritization needs bring about a question, “but how much does it cost?” Worded differently and at different stages of the development of services or benefits packages, the question can be asked in the following ways: 1. What are the available resources for these sets of interventions? 2. How much are we currently spending on these interventions? 3. What is the unit cost for the interventions being considered? 4. What is the additional cost needed in order to provide these interventions? Question 3 and 4 are the main focus for this session.

Case Study: Benefit Incidence of Safe Motherhood Services in Vietnam [PDF]
Author(s):  James C. Knowles
Date of Publication: December 07 1999
The present case study focuses on safe motherhood services. It uses household and facility survey data collected by the General Statistics Office (GSO) of Vietnam in 1995-1996, together with estimates of health service delivery unit costs prepared earlier by the World Bank (1995), to prepare a benefit incidence analysis of safe motherhood services in Vietnam.

Delivering a Package of RH Services--The Use of a Matrix of Services [PDF]
Author(s):  Marc Mitchell
Date of Publication: September 13 1999

Delivering Reproductive Health Services in Health Reform Settings: Challenges and Opportunities [PDF]
Author(s):  Tom Merrick
Date of Publication: September 13 1999
This note addresses two important issues that affect these efforts: the implementation of health reforms and of the reproductive health approach to services called for by the 1994 International Conference on Population and Development (ICPD) in Cairo. It will outline key features of health reform and reproductive health, identify points of intersection and possible conflict between them, and discuss how program managers in both areas might work more effectively to achieve their common goals.

Demographic Transitions and Economic Miracles [PDF]
Author(s):  David Canning
Jaypee Sevilla
David E. Bloom
Date of Publication: August 07 1999
Developing countries are undergoing a demographic transition from high rates of mortality and fertility to low. This transition has important implications for the age structure of populations. While different countries are in different stages of this transition, those that have completed it earlier demonstrate a strong record of economic growth. This is no coincidence. We spell out the linkages that exist between the demographic transition and economic outcomes, and argue that the transition creates conditions that make more rapid economic growth possible. In short, demography matters for growth. Whether the potential for rapid growth is realized depends crucially on the conduct of policy, which must be designed to accomplish three things. First, it must aim to accelerate and complete the transition. This requires renewed attention to population policies that aim to reduce fertility. Second, it must aim to transform the growth potential created by the transition into actual growth. This entails policies that facilitate high employment, savings, and human capital accumulation. Lastly, policies should anticipate consequences of the transition that lie further off into the future. This includes being able to provide adequate health care and pension income for larger and longer-lived old generations of retirees.

Dependency Burdens in the Developing World [PDF]
Author(s):  John Bongaarts
Date of Publication: December 30 1998
The paper was prepared for Symposium on Population Change and Economic Development, November 1998. The demographic transitions, which in most developing countries are far from complete, are accompanied by fairly predictable declines, first in mortality and, after a delay, also in fertility. These well established trends have less well known consequences for the distribution of the population by age and for the dependency burden which is defined as the ratio of dependent young and old to the population of working age. The age dependency ratio varies widely over the course of the transition but this pattern is quite predictable.

Economic Analysis of Population and Reproductive Health Policies [PDF]
Author(s):  James C. Knowles
Date of Publication: December 07 1999
This paper uses the example of a safe motherhood program to present a standard simple economic framework for the evaluation of policies related to family planning and reproductive health (FP/RH).

From UNPFA Web Site: Report of the Ad Hoc Committee of the Whole [PDF]
Date of Publication: December 06 1999
Report of the Ad Hoc Committee of the Whole, Key actions for the further implementation of the Programme of Action of the International Conference on Population and Development (1 July 1999). This paper has been taken from the UNFPA web site at

Future Population Growth and Policy Options [PDF]
Author(s):  John Bongaarts
Date of Publication: September 29 1999
This paper reviews population projections for the world and its major regions until the year 2050. A brief summary of the latest United Nations projections and their underlying assumptions is presented first. This is followed by a discussion of the implications of the changes in the age composition that accompanies the demographic transition. The concluding section outlines three main policy options for slowing population growth: a) Reduce unwanted fertility and the unmet need for contraception by strengthening family planning programs; b) Reduce the demand for large families through investments in "human development", in particular education, gender equality and child health; c) Address the momentum of population growth by encouraging delays in childbearing.

Gender, Reproductive Health and Reproductive Rights [PDF]
Author(s):  Marilyn Lauglo
Date of Publication: September 07 1999
A gender perspective is an integral part of the reproductive health approach to population activities. This becomes more and more true in the context of health sector reform aimed at improving equity, equality, efficiency and sustainability. Fundamental to the Cairo Programme of Action (POA) is the underlying principle which places women’s needs at the centre of population and development concerns. This includes the right of women to make autonomous reproductive choices and the right to high quality services which are designed around women’s experiences and needs. This requires an understanding of women’s roles, responsibilities, and positions in their homes, communities, and other public arenas.

Go to UNFPA Web Site to view The State of World Population 1999 [HTM]
Date of Publication: December 06 1999
Documents available on UNFPA Web site.

Government, Population, and Poverty: A Win-Win Tale, Chapter 9 [PDF]
Author(s):  Nancy Birdsall
Date of Publication: December 07 1994
Robert Cassen and contributors “Population and Development: Old Debates, New Conclusions”, Transaction Publishers, New Brunswick (USA) and Oxford (UK), 1994. Chapter 9. Traditional concern that rapid population growth slows development in poor countries has been reinforced in recent years by growing awareness of the fragility of the natural environment and its apparent vulnerability to the stresses associated with increasing population size. But reinforced concern has not led to a consensus about whether governments should intervene actively to reduce population growth rates. This chapter first summarizes the three principal concerns raised by rapid population growth in developing countries: slower economic development, greater environmental damage, and greater poverty and income inequality. It then links these concerns to specify rationales for government intervention to reduce rates of fertility, demonstrating he basis for these rationales in simple welfare theory. Finally, the chapter discusses the kinds of public policy interventions that these rationales justify.

How to Buy a $12 Package at $3.50, a Bangladesh Case Study [PDF]
Author(s):  Abdo Yazbeck
Date of Publication: September 13 1999
The time-log presented below describes the events leading to and during project preparation for the Bangladesh Health and Population Program Project (HPPP) also known by the Government of Bangladesh as Health and Population Sector Program (HPSP) and previously known as the Fifth Bangladesh Health and Population Program (HAPP-5).

Improving Interactions With Clients: A Key to High-Quality Services [PDF]
Date of Publication: July 01 1999
Outlook, 17:2, July 1999, PATH, Washington, D.C.

Monitoring Reproductive Health: Selecting a short list of national and global indicators -- Part 1 [PDF]
Author(s):  World Health Organization
Date of Publication: January 01 1997
WHO, Geneva.

Monitoring Reproductive Health: Selecting a short list of national and global indicators -- Part 2 [PDF]
Author(s):  World Health Organization
Date of Publication: January 01 1997
WHO, Geneva.

Monitoring Reproductive Health: Selecting a short list of national and global indicators -- Part 3 [PDF]
Author(s):  World Health Organization
Date of Publication: January 01 1997
WHO, Geneva.

Population and Reproductive Health: The Big Pictures [PDF]
Author(s):  Margaret Catley-Carlson
Date of Publication: September 20 1999
This 13 page paper in PDF focuses on new directions in population.

Prioritization: When The Rubber Hits The Road [PDF]
Author(s):  Abdo Yazbeck
Date of Publication: September 13 1999
As this session will show, there are no simple or purely technical answers. Moreover, the different disciplines and interests involved in this sector bring into prioritization sometimes contradictory objectives, tools and decision criteria. The next section will briefly describe the different tools used in measuring wants and resources and some the difficulties with defining and measuring wants. Section III explores the disciplines and advocates that are typically involved in a prioritization exercise for population and reproductive health services. A list of prioritization criteria is described in section IV followed by the different approaches to prioritization. The last section summarizes a new theoretical model for combining the different prioritization criteria.

Public Spending on Health Care: How Are Different Criteria Related? [PDF]
Author(s):  Philip Musgrove
Date of Publication: March 01 1999
Health Policy, 47.

Report on Symposium on Population Change and Economic Development [PDF]
Author(s):  Nancy Birdsall
Steven Sinding
Date of Publication: December 07 1999
This is the Chairman’s Report on a technical symposium held as one of the preliminary meetings to the ICPD+5 Forum in The Hague, Netherlands, and the Preparatory Committee Meeting (Prepcom) for the 1999 Special Session of the UN General Assembly. The Symposium reviewed new evidence on the effects of demographic change on economic growth, on poverty and inequality, and on sustainable use of natural resources, since the 1994 ICPD in Cairo, then further considered the extent to which new evidence might bear on future development policies and programs.

The Tools for Adapting to Change [PDF]
Author(s):  Marc Mitchell
Arlette Campbell White
Date of Publication: September 13 1999

The Transformation of Reproductive Health Services [PDF]
Author(s):  Sharon Fonn
Date of Publication: September 07 1999
The Transformation of Reproductive Health Services Project (TRHSP) is a project undertaken by Women’s Health Project, a South African non-governmental organisation involved in women’s health policy research, development, implementation and evaluation. The context is a country, which, since 1994, has been engaged in general societal transformation aimed at decreasing inequity in the country. Using the TRHSP experience as a case study, this paper is intended to indicate that incorporating gender into health programming and health system development is possible. Further that gender analysis can be used as a tool for improving service quality. In addition tools are described which can be used by institutions or individuals who wish to do so.

UNFPA "Transformation and Momentum" from 1998 State of the World Population [PDF]
Date of Publication: February 06 1998
Chapter 1 from the 1998 UNFPA "State of the World Population". Greater numbers of people are living to older ages, and higher proportions of most countries’ populations have lived at least sixty years, than at any time in the past. At the same time, unprecedented numbers of teenagers, the result of past high fertility, are growing towards adulthood. The impact of these “new generations” will reverberate throughout the 21st Century. This paper examines the new generations’ situations in mid-1998, as well as the prospects of those who will be elderly in the future, and further discusses their implications for sustainable development.

Value for Money in Reproductive Health [PDF]
Author(s):  William McGreevey
Date of Publication: September 07 1999
This Power Point Presentation in PDF summarizes a World Bank EDI Training on Value for Money in Reproductive Health: Issues and Options for Governments and Donors.

What Can Be Done to Foster Multisectoral Population Policies? Summary Report of a Seminar [PDF]
Date of Publication: May 01 1997
Although the 1994 Cairo population conference affirmed the need for broadly defined multisectoral population policies, little tangible progress has been made toward realizing the goal of these policies. This report provides a brief summary of an informal seminar cosponsored by the Population Council and the Overseas Development Council on “What Can Be Done to Foster Multisectoral Population Policies” on 28 May 1997. The purpose of the meeting was to generate frank discussion among those working in the population field about the national, international, institutional, political, and policy factors that have, so far, largely impeded articulation and implementation of multisectoral population policies.

Why a Course on Adapting to Change? [PDF]
Author(s):  Tom Merrick
Date of Publication: December 06 1999
14 pages, Power Point Presentation.

Why Analyze the Costs of Essential Package Components? [PDF]
Date of Publication: September 07 1999
This is a short Power Point Presentation in PDF that looks at Analyzing the cost of Essential Package Components.

World Health Report 2000: Chapter 1 [PDF]
Date of Publication: October 10 2000
From the WHO website at Health systems consist of all the people and actions whose primary purpose is to improve health. They may be integrated and centrally directed, but often they are not. After centuries as small-scale, largely private or charitable, mostly ineffectual entities, they have grown explosively in this century as knowledge has been gained and applied. They have contributed enormously to better health, but their contribution could be greater still, especially for the poor. Failure to achieve that potential is due more to systematic failings than to technical limitations. It is therefore urgent to assess current performance and to judge how health systems can reach their potential.