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Memorandum Order No. 151, 27 January 1988.
This Order creates in the Philippines a National Government Center (NGC) Housing Committee to implement Proclamation No. 137 of 11 August 1987, which set aside 150 acres of land for the development of a housing project. The project is to serve as a prototype for developing land within the framework of the existing urban land reform laws. The Committee has the power to do the following: "b.1) Define the project's concept and strategies of implementation; b.2) formulate policies and guidelines on: b.2.1) land disposition, allocation and distribution of NGC housing site to bona fide residents subject to the provisions of Proclamation No. 137 dated August 11, 1987; b.2.2) population containment within the defined project area; b.2.3) qualified beneficiaries for the project; b.2.4) housing finance for beneficiaries; and b.2.5) project administration and other implementation requirements; b.3) formulate systems and procedures for project implementation; b.4) prepare the project's work program and budget; b.5) identify and mobilize fund resources for project implementation; b.6) monitor and evaluate all phases of project implementation; b.7) make final decisions on all cases and issues affecting project implementation which cannot be resolved at the operations level; b.8) call on any government department or agency for assistance whenever necessary." Further provisions of the order deal with the composition of the Committee, the Project Administrator, support agencies, and funding, among other things.
Assessing the health impact of urbanization.
Several components of urbanization influence health status, but it is difficult to attribute changes in health status to any particular component. The overall impact may be estimated by relating the degree of urbanization of populations to some proxy measure, like the under-5 mortality rates. In this respect the net effect of urbanization is shown to be beneficial. A variety of survey and computational methods have been used to clarify the relationship. Some illustrate the effects of urbanization upon particular clinical conditions, such as promoting the eradication of leprosy, others of particular components, such as overcrowding and pollution, on infant mortality. To help set goals, excess or avoidable mortality may be computed for a country or region by relating its experience to current mortality levels in a developed country; and changes in the levels of avoidable mortality from sentinel conditions such as infectious diseases may be related to changes in particular aspects of urbanization, e.g. improvements in levels of sanitation. Migration to the urban environment imparts the tendency to acquire the health characteristics of the host population. Rapid urbanization causes problems of psychosocial adjustment for older children. Urbanization may impact upon the incidence and prevalence of disability. Where sex-age disability-survey data exist, they may be combined with age-specific mortality data to construct an index of disability-free life expectancy, a more subtle measure for assessing the progressive impact of urbanization. Up to now, however, there have been no international studies of how levels of disability change according to the progress of urbanization, and there are no international census or survey recommendations for harmonizing the classification of disabled people.(ABSTRACT TRUNCATED AT 250 WORDS)
Infant feeding with commercial milk formula in an urban community of central India.
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Participatory analysis for redefining health delivery in a Bombay slum.
BACKGROUND: This paper explores the application of participatory methods in a Bombay slum of 33 households, Budh Mandir, to establish the local women's perception of their health status. METHOD: Six participatory meetings were conducted alongside informal interviews with key informants. The meetings were structured with health ranking, mapping and seasonal mapping exercises. RESULTS: The participatory exercises expose the differences in perceptions between professional health deliverers and the women of Budh Mandir, as well as providing data at a household scale about the incidence of disease and important differences in the interpretation of health problems. CONCLUSIONS: Differences in the perception between local women and health professionals are noted, which, it is argued, have important implications in redefining health delivery. Some methodological problems are identified and solutions are offered. It is argued that participatory methods can act as a process through which slum dwellers can demand appropriate health care for themselves and their families. In so doing, they can redefine their health needs in order that health intervention can be directed more appropriately.
Seasonal pattern of morbidities in preschool slum children in Lucknow, north India.
OBJECTIVE: To quantify the burden of common morbidities for each month in one year, in preschool children. SETTING: Anganwadi centers under the Integrated Child Development Services Scheme (ICDS) in Lucknow, North India. DESIGN: Prospective cohort study, METHODS: From 153 anganwadi centers in urban Lucknow, 32 were selected by random draw. All eligible children registered with the anganwadi worker were enrolled over a period of six months from July 1995 to January 1996. All the subjects were then contacted a second time six months later. SUBJECTS: There were 1061 children (48.3% girls and 51.7% boys) between the ages of 1.5 to 3.5 years. RESULTS: The annual incidence rate (IR) per 100 child-years for respiratory, diarrhea and skin diseases and pneumonia were 167, 79.9, 30.6 and 9.6, respectively. When compared to other seasons, the IR of pneumonia was lowest in the winter months (October to February) while those of diarrhea and skin diseases were the highest in summer (March-June) and monsoon (July to September) months, respectively. Season specific diseases were measles in summer, and fever as the isolated symptom in monsoon. The IR for combined morbidities was the highest in the monsoon as compared to winter months. CONCLUSIONS: Season specific intensification of existing health care resources for these morbidities can be considered. Similar studies are needed from other parts of the country.
The relationship between population density and cancer mortality in Taiwan.
Many investigators have examined urbanization gradients in cancer rates. The purpose of this report was to identify urban-rural trends in cancer mortality rates (1982-1991) for municipalities in Taiwan. For this purpose, Taiwan's municipalities were classified as rural, suburban, urban, or metropolitan, using population density as an ordinal indicator of the degree of urbanization. Average annual age-adjusted, site-specific cancer mortality rates were calculated for both sexes within each population density group. Significant increasing trends with more urbanization were observed in mortality rates for cancers of the lung, pancreas, and kidney among both males and females, as well as male prostate cancer, and female breast and ovary cancer. In addition, this study revealed a significant rural excess for nonmelanoma skin cancer among both males and females, as well as male non-Hodgkin's lymphoma, and cancers of the female bone, and female connective tissue. Analytic studies for sites with consistent urban-rural trends may be fruitful in identifying the aspect of population density, or other unmeasured factors, that contribute to these trends.
The big, bad city: mega-city myth?
This paper raises the question of whether or not the virtues of big city size were exaggerated in the literature which appeared in the 1970s with respect to developing country megacities. It examines negative externalities (especially pollution), the capital costs associated with megacity growth, the productivity advantages of large cities, the role of spatial restructuring towards a policentric pattern as a relief to core city congestion, and the problems of metropolitan management (including the appropriate institutional framework). The adoption of constructive policy actions could handle the following problems: that the declining rates of megacity growth may reflect declining productivity advantages; that capital costs of urbanization increase strongly with city size; that there are diseconomies of scale in urban management; that negative externalities may be more severe in developing country megacities in physical but not in imputed monetary damage terms; and that policentric evolution may be hampered by the wrong type of government intervention.
Perception about AIDS among residents of a Calcutta slum.
A study was carried out in a slum area of South Calcutta to assess the impact of the current mass education programme against AIDS. Two hundred and six residents, mainly of lower middle class, aged 18-60 years of both sexes were selected at random. They were interviewed to know their perception and sources of information about AIDS. Two-third of them had their own TV and radio, which they watched/heard for about three and half hours each day. Another 28% watched TV outside for about one and half hours a day. About 46% were daily readers and 20% occasional readers of newspapers. Fifty nine percent knew about persons vulnerable to get AIDS, but most of them associated it to promiscuity only. Avoiding it was the main means known to them for preventing AIDS. The role of condom in it was known to only 2.5% residents. The source of their knowledge was mainly TV, either alone or with other mass media (67%). Such knowledge was related to higher education. To make perception about AIDS more effective, it is suggested that local health and voluntary agencies should involve the community in the AIDS education programme along with the back-up of mass media. An apex agency solely responsible for AIDS education should be set up for each big city to co-ordinate the activities of local agencies.
[Opening up of the Far North and demographic health processes].
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Urbanization and childhood leukaemia in Taiwan.
BACKGROUND: In the 1980s socioeconomic development was dramatically rapid in the urbanized municipalities of Taiwan due to a prospering economy. This study addressed the question: Could differences in the incidence of childhood leukaemia (age <15) be demonstrated between urban and rural communities in Taiwan between 1981 and 1990? METHODS: The log-linear regression model was used to assess the effects of age, level of urbanization, and calendar year on the variation of childhood leukaemia incidence rates between 1981 and 1990. RESULTS: Between 1981 and 1990, the overall incidence rate of childhood leukaemia increased by 20% (rate ratio (RR) = 1.2, 95% CI: 1.0-1.5). As compared to rural areas, metropolitan regions showed a significantly higher incidence rate during the study period (RR = 1.3, 95% CI: 1.1-1.6). This urban-rural difference was particularly notable among children <5 years old (RR = 1.5, 95% CI: 1.2-1.9). Dose-response analysis further indicated that risk of childhood leukaemia was monotonically associated with levels of urbanization. The significant gradient in the risk of childhood leukaemia with urbanization was contributed solely by children in the 0-4 years age group. CONCLUSIONS: We noticed a relationship between urbanization and risk of leukaemia in children. Because of a dramatic influx of people into metropolitan areas during the 1980s, our findings may have provided support for the putative association between 'population mixing' or 'population density' and risk of childhood leukaemia. Whether such association can be attributable to virus infection or other aetiologically related leukemogens warrants further investigations.
Household epidemiology of Cryptosporidium parvum infection in an urban community in northeast Brazil.
OBJECTIVE: To examine the transmission of Cryptosporidium infection in households with an identified person with cryptosporidiosis. DESIGN: Prospective cohort study. SETTING: An urban slum in Fortaleza, Brazil. PARTICIPANTS: Thirty-one households with a child less than 3 years of age (index case) who was positive for Cryptosporidium parvum using acid-fast and auramine-stained stool smears. MEASUREMENTS: Three stool samples (at 0, 2, and 6 weeks after identification of the index case) and two serum samples (0 and 6 weeks) were collected from each family member in households with an index case of Cryptosporidium infection. RESULTS: Forty-five percent of index cases of Cryptosporidium infection were associated with persistent (> 14 days) diarrhea. Secondary cases of Cryptosporidium infection were identified either by stool examination or seroconversion in 18 (58%) of 31 households involving 30 persons, yielding an overall transmission rate of 19%. Of the 202 persons in this study with at least one serum sample available for analysis, 191 (94.6%) had evidence of antibodies (either IgM or IgG) to Cryptosporidium. CONCLUSIONS: Cryptosporidium parvum is highly transmissible and infective in the family setting, with transmission rates similar to other highly infectious enteric pathogens such as Shigella species. These data are cause for added concern because of the rapidly increasing rate of seropositivity for human immunodeficiency virus.
Infant feeding practices of peri-urban areas of Gorakhpur.
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Some models for patterns of urbanization, migration and development.
"This paper aims to study the pattern of urbanization and the evolution of [the] relationship between rural-urban migration and the degree of economic development taking Gross National Product...into consideration. Intercensal age-specific rural net out-migration rates are also estimated from [tabulations] of the proportion of rural population of India by age through a recently developed procedure based on generalized stable population by Stupp (1989). A comparative study is also made between [the] survival column of India with a developed nation like Japan."
Impact of nutrition education on health of the mother and newborn belonging to the poor urban slum community.
To find the nutritional knowledge among mothers of one child of the poor community and to relate status of education to the nutritional health of them and the newborn and to get a thorough knowledge on the impact of nutritional education, a comprehensive study was undertaken in an urban slum area. Nutritional grading was done through scoring system. There were 47 mothers (24.1%) out of 195 having normal nutritional grade and 37 mothers (19%) having severe nutritional grade. There were 80 mothers having 'no knowledge' on maternal nutrition. 'Adequate knowledge' was found in 31 cases. Mothers (n = 80) of 'no knowledge' delivered babies of average weight 2.3 kg whereas 'adequate knowledge' mothers gave birth to babies of average weight 2.9 kg.
Social context of human immunodeficiency virus transmission in Africa: historical and cultural bases of east and central African sexual relations.
The literature relating to the social context of sexual relations in East and Central Africa has several implications for the heterosexual transmission of human immunodeficiency virus (HIV). Colonially created cities in the region still discriminate economically and socially against women. Rapid urbanization is occurring, but migrants maintain strong ties with rural areas. Traditional attitudes towards marriage and sexuality affect urban behavior in the extent of marital stability, the frequency of polygyny, and the emotional bond between spouses. Ethnic groups in Kampala and Nairobi exemplify the cultural foundations of two forms of sexual relations found in the region, one characterized by prostitution and the other by small circles of interchanging lovers. The first results in a more rapid spread of HIV through the urban population and outwards into rural areas. Each pattern exerts unique constraints on behavioral change and requires different prevention campaigns.
Comments from Pacific representatives.
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Divorce in contemporary Japan.
Data from the 1985-86 Japanese census are analysed to explore the determinants of the divorce rates in Japan's forty-seven prefectures, using two theoretical models: (a) the social integration model, which is shown to have a greater utility in predicting Japanese divorce levels than (b), the human capital model. Female emigration patterns play a significant role in affecting the divorce rate. Population increase and net household income are also important predictors of the Japanese divorce rate and urbanization has a great influence in modern Japan. Demographic and aggregate variables such as migration, urbanization, and socioeconomic factors are useful when organized under a social integration model.