November Issue of DevelopNet News

Dania Granados (mailto:granados@VITA.ORG)
Wed, 6 Nov 1996 10:20:54 EST

Message-ID:  <9611061520.AA29606@lan.vita.org>
Date:         Wed, 6 Nov 1996 10:20:54 EST
From: Dania Granados <mailto:granados@VITA.ORG>
Subject:      November Issue of DevelopNet News
To: Multiple recipients of list DEVEL-L <mailto:DEVEL-L@AMERICAN.EDU>

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       November 1996                             Volume 6, No. 11

IN THIS ISSUE

POPULATION WATCH Levelling Off

LITERATURE REVIEWS

Recognizing Traditional Medicine

Construction in The Middle East

ORGANIZATIONS Management of Health Systems

VITA PROJECTS New South Africa Project

ANNOUNCEMENTS

Public Sector Management for the Next Century

Wind Erosion

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DevelopNet News is published monthly by Volunteers in Technical Assistance (VITA) in Arlington, Virginia, USA. For additional information, please see the end of this newsletter.

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P o p u l a t i o n W a t c h

LEVELLING OFF

Last Friday (25 October) the Earth supported 5,853,266,546 people, according to one overly precise estimate. Some readers of this Newslet- ter remember the year 1946, when there were only half as many people. Today, the global population continues to grow, but a little slower than 50 years ago. Research workers believe prompt action can slow growth even more and may improve the likelihood that the human species will survive its fast growth phase in better shape than has been supposed. The reasons for population growth are well understood and the technolo- gies for slowing it are widely accepted.

Our present period of rapid increase started early in the 19th century and was largely due to conquests of disease and hunger through achieve- ments in science. Informed estimates tell us that the growth will level off 100 to 150 years from now. At that time, the global birth rate will just offset deaths.

What is the problem today?

Why do birth rates remain high today, especially in Africa and South Asia? Recent studies show that low levels of education, social con- straints upon women, and weak family-planning programs are the main reasons. And even if these conditions could be quickly corrected, populations would grow rapidly for a while because these regions have large numbers of young people entering the reproductive age group.

In a recent review (http://www.worldbank.org/html/hcovp/popu/popdev .html) the World Bank staff said that careful investment of development money can reduce the momentum of population growth. Investment timing is critical: "Slowing population growth sooner rather than later could reduce the future global population size by 2,000 to 3,000 million when global population finally stabilizes at the end of the next century. Delaying such investments will only add to the ultimate costs of poverty reduction."

In his book, Living Within Limits (Oxford, 1993), Garrett Hardin notes that a few authors deny the population crisis. But the view prevails that global population increase is a serious problem -- everybody's problem. Although developing countries have the highest growth rates, the wealthier countries consume more resources and produce more wastes. For example, Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States represent only 10% of the world's population, but consume more than 40% of its nonrenewable energy resources. Therefore, even small population increases in these countries can have a signifi- cant global impact. The same countries also originate most of the tech- nologies usable anywhere to conserve natural resources and reduce the impact of waste disposal. And they bear a significant share of world development costs. So the wealthier countries have a legitimate interest in spreading the understandings and technologies for population planning and environmental protection.

Methods and costs

Planning realistically, what can be done to retard population growth? First, appreciate that decreases in birth rates now, even if small, will have larger beneficial effects years ahead. Policy makers in both rich and poor countries are now coming to understand what is needed: changes in reproductive health, education, and the economy; improvement in the social position of women, especially empowering them to choose the num- ber of children they will bear (please see "Women at the Margin," Devel- opNet News, October 1996); and effective family-planning programs with ready access to family planning services.

The World Bank says that $8 per person annually will provide a basic preventive health care program, including maternal and child care, in the poorest countries. Raising girls' primary school enrollment to the level now available to boys will increase the annual education budget of the developing world by only two percent. The present annual cost of family planning services, $5,000 million, is less than 5% of military expenditures of developing countries. This amounts to $1 to $1.25 per capita, or about $10 to $20 per contraceptive user. Thus, financing is not the main issue.

Family planning programs generate savings. Consider Zimbabwe: each year, that nation now spends about $19 per contraceptive user, $40 per client for maternal and child health, and $120 per primary-school pupil. If fertility should drop, annual savings in health care costs could reach $121 to $130 million by the year 2015. By 2015, the annual savings in public expenditures for education could reach $270 to $340 million. From studies in many countries, the World Bank concludes: "Increased family- planning expenditures are cost-effective, long-term investments in human capital investment and family welfare."

Social and economic change

Because of higher living standards, many developing countries are redu- cing their population growth rates and improving child health. In Kenya, the number of children a woman can be expected to bear in her lifetime dropped from 8.1 in 1977 to 5.4 in 1993. In Bangladesh the rate has dropped from 7 to 4.9.

Better maternal and child health lowers the inclination of many couples to produce large families. In child health, one spectacular advance is the use of oral-rehydration solution, a really cheap treatment for diarrhea-induced dehydration. The treatment now reaches 70% of the world's children and saves one million lives a year. Another advance is the increase in breastfeeding, a practice described by health authori- ties as the single, most cost-effective child survival intervention.

In general, a higher standard of maternal and child health is part of economic development. It reduces the birth rate because (1) both sexes usually are in the work force, (2) parents can look forward to pension income at retirement, (3) the cost of raising a child is high, (4) children don't make up a significant part of the work force, and (5) education and job training delay the start of child bearing.

Reducing birth rates presents complex issues, as revealed by several unfolding case histories. The remarkable achievements in Egypt were summarized in "A Quiet Breakthrough" (DevelopNet News, April 1995). However, what works in Egypt may not work elsewhere. The World Bank insists that country-specific strategies are needed is dealing with population planning. Planners should "take into account individual country needs, cultural values, and financial and institutional con- straints. In many cases, the appropriate role of government will be to ensure that adequate information is available and to remove obstacles to the effective functioning of the private sector." Moreover, the design of programs must involve participation of the people who will be affec- ted. And where needed infrastructure is absent, specific investments in it will be required.

L i t e r a t u r e R e v i e w s

RECOGNIZING TRADITIONAL MEDICINE

Xiaorui Zhang, 1996. "Traditional Medicine and WHO." World Health, year 49, no. 2 (March - April). Special Issue on Culture and Health.

The World Health Organization established its Traditional Medicine Pro- gramme nearly 20 years ago, urging governments "to give adequate import- ance to the utilization of their traditional systems of medicine." In 1991, the program decided to focus on national policies, herbal medi- cine, and acupuncture.

Most countries dedicate a sizable effort to traditional or "alternative" medicine. Practitioners may include traditional birth attendants, herb- alists, and bonesetters. In Ghana, for 20,000 people there is one physi- cian but 1,000 traditional practitioners. In the United States in 1992, about a third of the population made at least some use of such alterna- tive treatments as herbal medicine, acupuncture, chiropractic, and home- opathy. And 74% of the British think that alternative medicine should be available as part of the national health service.

Medicinal plants and herbs are widely used and some are important to health. Sales of these products are increasing. The author, Xiaorui Zhang (World Health Organization, Geneva, Switzerland), says, "despite the existence of herbal medicines over many centuries, only a relatively small number of plant species -- about 5,000 -- have been studied for their possible medical applications. Even less information is available on safety and efficacy." Acupuncture is simple to apply, has minimal side effects, and costs little. Advances have been made in understanding the mechanisms of acupuncture.

The principal concerns of international health organizations regarding alternative medicine are to use well the human and natural resources to achieve the widespread benefits of good health. WHO maintains 24 research centers, 8 for acupuncture and 16 for herbal medicine. The issues are safety and efficacy -- or risks and benefits.

CONSTRUCTION IN THE MIDDLE EAST

Andrew Gaved, 1996. "Middle East Sustains Pace." International Construc- tion, volume 35, no. 8 (August), page 14.

The Middle East is experiencing continued growth in construction activ- ity, for which the private sector is mainly responsible. International contractors are profiting from work on pipelines, petrochemical works, and power plants. Among the largest projects, exceeding $1,000 million each, are an aromatics plant in the United Arab Emirates, an infrastruc- ture and utility project in Saudi Arabia, and an aluminum smelter in Oman. Many projects in Egypt, Syria, and Saudi Arabia are providing work for specialists in petrochemical, power, and cement-plant construction. Hotels and large residential complexes are under construction in Dubai and Saudi Arabia.

Many ambitious civil projects are planned as the result of a recent international meeting in Jordan, and actual construction is taking place on toll roads in Tunisia and a $480 million Maghreb Highway. Projects soon to be undertaken in Lebanon include port expansion, a 1,000-meter sea wall, and a British Embassy; all in Beirut.

In planning stages, partly the result of the Jordan meeting, are two six-year projects: a highway joining Europe to North Africa and an $850 million coastal road from Egypt to Morocco, in which a single lane is being upgraded to four lanes. Also planned are the Gulf of Aqaba Ring Road linking Jordan, Israel, and Egypt, and a bridge over the Suez Canal. But these projects, according to Andrew Gaved (International Construction, Chicago), are "heavily dependent on individual governments agreeing and committing the funding."

O r g a n i z a t i o n s

MANAGEMENT OF HEALTH SYSTEMS

Management Sciences for Health is a private, nonprofit corporation that bridges the gap between what is known about public health problems and what is done to solve them. It makes available technical assistance, training, systems development, and applied research services to aid decision makers throughout the world in using techniques of modern man- agement to improve the delivery of primary health care and family plan- ning services. The technical assistance is focused in Population and Family Planning, Health Financing, Strengthening Health Services, Man- agement Information Systems, Management Training, Drug Management, and Management Tools. The corporation's largest and best-known program is its Population and Family Planning Program which works with public- and private-sector family planning organizations in more than 25 developing countries to improve their capability to manage and deliver high-quality family planning services.

Information: Management Sciences for Health, 165 Allandale Road, Boston, Massachusetts 02130-3400; tel. +1 (617) 524-7799, fax: +1 (617) 524- 2825, e-mail <mailto:development@msh.org>, URL http://www.msh.org

V I T A P r o j e c t s

NEW SOUTH AFRICA PROJECT

VITA's new project in Gauteng, South Africa, will provide financial services to South Africa's microenterprises, especially those operated by blacks and other nonwhites, women, and the poor.

Why was South Africa selected for the project? It is a good choice because of VITA's experience with projects designed to create income generation and employment opportunities. Both benefits are crucial as the country struggles to cope with its post-apartheid, nation-building challenges.

With an estimated population of 43.5 million, a population growth rate of 2.25% and climbing, and some two million illegal immigrants, the country's formal sector cannot absorb job seekers. Coupled with these unemployment problems the country also suffers from racial inequities in income distribution. For example, although 75% of the population is black, black-owned firms account for only 3% of the gross domestic product.

VITA's president, Henry Norman, says, "This program will try to increase employment and more equally distribute income by developing specific services for historically disadvantaged, growth-oriented enterprises. It will also facilitate existing organizations' efforts to make microenter- prises growth-oriented." Direct services to microenterprises will include loans ($1,000 to $5,000) and assistance with commercial viabil- ity reviews and marketing and business plan development. VITA will help individual borrowers define the best use of their loan funds, which may include paying for technical assistance and training. Existing, nongov- ernmental organizations will receive loans ($5,000 to $50,000) to be used by them in turn lending and in certain cases other income- generating activities. In addition VITA will share crucial information from around the world, based on the best practices for microenterprise development.

Three South African commercial banks already provide loan capital to small and microenterprises. But collateral requirements have been a serious constraint. Furthermore, these banks traditionally have avoided risk and preferred to serve the larger financial needs of people and entrepreneurs who already have money, rather than the relatively poor. The lack of technical assistance and training has further isolated historically disadvantaged businesses, particularly those confined to townships and homelands without adequate support systems to develop business management skills or linkages with large firms and financing institutions.

Business opportunities already exist in Gauteng and in Durban, where another office will open. A third office will most likely be opened in Transkei in the third year of project implementation. The Microenter- prise Support Project expects to serve 200 entrepreneurs and six NGOs in its first year and, by the end of its three-year implementation period, 1,200 individuals and 66 NGOs. It expects to achieve self-sufficiency by 2001. The project will be developed under a contract with the U.S. Agency for International Development, signed last September.

Information: Barbra Bucci, <mailto:msp@vita.org>.

A n n o u n c e m e n t s

PUBLIC SECTOR MANAGEMENT FOR THE NEXT CENTURY

This international conference will be held at the University of Man- chester (UK) 29 June to 2 July 1997. It aims to extend the understanding of change in the public sector of developing countries and transitional economies. Participants will include research workers in public sector management, senior public agency staff members and political leaders from developing countries and transitional economies, development agency personnel, international consultants, and managers in nongovernmental organizations. They will review the experiences and achievements of the last decade of change initiatives, explore the conceptual frameworks that have guided reform, and seek effective approaches for the future.

The conference will cover these topics: Beyond the New Public Manage- ment: Theory and Practice; Public Service Delivery: Room for Improve- ment? Human Resources and the New Public Management Public Services, Citizens and NGOs; Privatization and Public Enterprise Reform; Inform- ation Systems and the Public Sector; Gender and Governance; "Good Gov- ernance" and Public Sector Management; and Local Level Management: Local Government, Field Administration and NGOs.

Information: Conference Secretary, Institute for Development Policy & Management, Crawford House, Precinct Centre, Oxford Road, Manchester, M13 9GH, UK; tel. +44 (161) 275 2800, fax +44 (161) 273 8829, e-mail mailto:<debra.whitehead@man.ac.uk>, URL http://www.man.ac.uk/idpm/newstuff.htm

WIND EROSION

Wind erosion is a serious problem in many parts of the world. To address its effects and their control the Wind Erosion Research Unit of the U.S. Department of Agriculture and Kansas State University will hold an International Symposium on Wind Erosion from 3 to 5 June 1997. It will bring together leading scientists, conservationists, and policy makers to identify present and future wind erosion threats to sustainability; summarize current understanding of wind erosion processes, prediction, and control; identify societal needs; and develop strategies for sus- taining agriculture, protecting the environment, and conserving natural resources against the ravages of wind erosion.

The symposium will feature plenary, concurrent, and poster sessions. Abstracts will be available at the symposium and all manuscripts will be considered for a special publication to be mailed to registered Sympos- ium participants. Authors of oral or poster presentations must submit an abstract (English preferred) of no more than one page by 31 December 1996.

Information: Wind Erosion Symposium, Throckmorton Hall, Kansas State University, Manhattan, Kansas 66506; tel. +1 (913) 532-6495, fax +1 (913) 532-6528, e-mail <mailto:sym@weru.ksu.edu>, URL http://www.weru.ksu.edu/.

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