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[Population policies and programs worldwide and in Rwanda].
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[Young physicians and their private practice].
A postal survey was carried out in Spring 1999 on a random sample of 3623 physicians having settled up their private practice during the first half of the 90's. The number of replies amounted to more than 1800. The proportion who "bought the right to be introduced to the clientele" have raised during the recent years. Those who bought the "right" succeeded to obtain more rapidly a "sufficient" number of patients. In general, the financial situation of French young practitioners was good during the 90's. The proportion of failures was not higher than 3%. France has been characterized by large gaps between its geographical areas as concerns medical staffing, a feature potentially harmful to equity in access to health services. In view of designing sound policies in the matter, medical practitioners were asked if they accepted to change their installation site in case an allowance of 50,000 Francs (about 76,000 Euros) was granted. Less than 4% replied "yes" and 18% "perhaps" to the question. These figures concerned changes of site within the same region. The prospects of migrating to an other region gathered even less enthusiasm. It is evident that policies aimed at reshaping geographic medical staffing should be multi-faceted and not grounded on simple financial allowances.
Immigration policies and trends: a comparison of Canada and the United States.
This paper discusses recent migration to North America with reference to the 1962 and 1967 Canadian immigration regulations and the 1965 United States Immigration and Nationality Act. Despite the similar emphasis on manpower and kinship criteria as the basis for the admission of immigrants, differences between Canada and the United States exist with respect to the importance of immigration for the respective economies, the organization of immigration, the formal regulations, and the size and composition of migrant streams. After an examination of the volume, origin, and occupational composition of immigration to Canada and the United States, flows between the two countries are studied. The paper concludes with a scrutiny of changes in immigration regulations which are pending in both countries.
The demographics of macro-economic-demographic models.
A number of macro-economic-demographic models have been created for developing countries during the decades of the 1970s and 1980s. Such models purport to simulate relationships between demographic variables and the process of socioeconomic development in the particular country, with the dual purposes of enhancing our knowledge of the process in particular settings and, by examining alternative scenarios, providing useful information to policy makers on the selection of demographic and economic policies to enhance economic development and improve human welfare. This paper 1st reviews the antecedents and then focuses on assessing the demographic functions (fertility, mortality, and internal migration rates) used in the 2 families of models which have had perhaps the largest number of applications in developing countries--the Bachue models, originating at the International Labour Office (Geneva), and the ESCAP models, originating at the Economic and Social Commission for Asia and the Pacific (Bangkok). Each has been applied, with significant variations, in at least 3 countries. Economic-demographic functions are defined as endogenous (and substantively meaningful, from the points of view of this paper) whenever there is an effect of economic growth or change in economic structure on the particular demographic function. The bulk of this paper assesses the realism and endogeneity of the fertility, mortality, and migration functions used in the Bachue and ESCAP models, noting, where possible, both the apparent and prima facie behavioral relationships and those that are actually important on the dynamic simulation. Shortcomings are described, including the lack of government expenditure functions with effects on demographic variables. The paper concludes more positively, noting areas of congruence and appealing endogenous relationships and functional forms specified in certain country models. It also suggests further development of, on the 1 hand, both simpler and more realistic planning models (focusing on particular behavioral relationships or sectors of importance to the country), which will be easier for country planners to understand and hence use, and, on the other hand, more complex research models aimed at enhancing our understanding of fundamental, dynamic relationships between economic factors, government policies and fertility, mortality and migration rates during the course of socioeconomic change.
Micro-consequences of low fertility in Singapore.
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Rural-urban migration, urban unemployment and underemployment, and job-search activity in LDCs.
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[Population policies in Latin America: 10 years' experience].
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The delivery of family planning services in Egypt with particular reference to population policy and health care planning.
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Modelling population changes in small English urban areas.
The authors examine processes underlying the growth of small urban areas in England. "There is evidence of 'people-led' growth in environmentally attractive locations (for example, through retirement migration). However, growth of small- and medium-sized towns also reflects employment decentralisation and deconcentration to freestanding or satellite towns, and the extension of commuter hinterlands.... Government policies encouraging growth are also demonstrated to be significant." The processes resulting in population decline in some small towns are identified. "The impact on modelling growth in urban areas of a diversity of causal processes and locational contexts for growth is considered."
Vital to future generations. The Bali Conference has recommended that 4% of all official development assistance be earmarked for population programs.
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Population, internal migration, and economic growth: an empirical analysis.
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A dynamic model of regional population growth and decline.
"This paper presents a two-sector dynamic model of regional population change. The model contains a migration equation, an earnings equation, and an amenity equation for each region. In the context of this model, migration is seen as a disequilibrium process through which the regional populations move towards equilibrium positions. Migration occurs when one region is perceived to be superior to the other on the basis of its earnings and amenity levels. Equilibrium is achieved when population movements between the regions eliminate any differences in their relative attractiveness. A comparative-static analysis of the model is presented to analyze the effects of policy changes and exogenous shocks on the distribution of population among the regions." The geographical focus is on the United States.
Urbanization and mental health in developing countries: a research role for social scientists, public health professionals and social psychiatrists.
Urbanization in developing countries involves changes in social support and life events which have been shown to affect mental health; mainly depression and anxiety, particularly among low income women. Although depressive and anxiety disorders have a high prevalence and account for a large proportion of visits to primary health services there is little international health research in this field. The determinants, extent and outcome of the association between urbanization and mental health requires multi-disciplinary research by social scientists, social psychiatrists and public health professionals. An appreciation of different conceptual models and associated methods is required before effective research can begin. Other issues such as the avoidance of environmental determinism; the separation of macro-social and micro-social variables; the weakness of urban/rural comparisons of mental health; the role of rural to urban migration; the debates about cross-cultural psychiatry; and the policy-relevance of research, all need consideration in the development of research into this rapidly emerging, but relatively neglected problem.
The poisoning women of Tiszazug.
This article examines the social causes of the infamous Tiszazug murders (i.e., the poisoning of more than forty people, mainly men, by their female relatives) in interwar Hungary. First, it looks at those elements in peasant culture, such as the traditional neglect of the sick elderly and the disabled, which proved conducive to a violent solution of family problems. Then, the essay analyzes the changes in family structures and inheritance patterns and discusses the impact of political events such as the end of overseas migration, the dissolution of the Austro-Hungarian Empire, the autarchic policies of the "successor states" and the failure of land reform on peasants' lives. Finally, the article looks at the discovery of the murders and the peasants' interpretations of the poisonings.
An overview of papers presented at Building Global Alliances III: The Impact of Global Nurse Migration on Health Services Delivery.
Global nurse migration has become a major phenomenon, impacting health service delivery in both developed and developing countries. The phenomenon has created a global labor market for health professionals and fueled international recruitment. International migration and recruitment are viewed as solutions to staffing shortages for some countries and as exacerbating problems for others. As a result, migration and recruitment have become prominent features of the international health policy debate.
The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain.
BACKGROUND: The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa. METHODS: We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA. RESULTS: More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64%) in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools. CONCLUSIONS: Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.