42.
DOCUMENT NUMBER: PIP/106661
AUTHOR: Brockerhoff M
TITLE: Fertility and family planning in African cities: the impact of female migration.
ABSTRACT:

This study assessed the impact of female migration from rural areas on fertility in African cities in the 1980s and early 1990s. It illustrated how proximate determinants of conception (marital status, cohabitation patterns, use of contraception, breast-feeding, and postpartum abstinence practices) change during the migration process and thereby contribute to city growth. Data from 13 Demographic and Health Surveys (DHS) conducted in Burundi, Ghana, Kenya, Madagascar, Mali, Namibia, Niger, Nigeria, Senegal, Tanzania, Togo, Uganda, and Zambia between 1986 and 1992 were pooled into maternal and child files in order to produce more robust estimates of relationships between female migration and conception and its proximate determinants. The total fertility rates (TFRs) in cities of the 13 countries for the 5-year period preceding the surveys and estimated TFRs in the absence of in-migration from rural areas during the 5 years were determined. Actual TFRs ranged from 3.6 in Madagascar's cities to 5.7 in cities of Niger, considerably lower than national levels. The summary rate for 13 countries was 4.59. Exclusion of the number of births and woman-years in cities contributed by recent migrants produced a rate of 5.55. Logit analyses revealed that rural women who were never married were more than twice as likely to move to cities in the following year than were rural women of the same age who were currently married (p < 0.001). moreover, recent in-migrants who were married were 31% less likely to be living with their husbands in the first few months than were more established city women (p < 0.01). a sharp increase in use of contraception occurred in the second or third year of residence to levels of long term city residents. there was a pronounced increase in abstinence duration following births in the 6 months preceding and following migration from previous lower levels among migrant women which may reflect high levels of spousal separation around the time of migration.

88.
DOCUMENT NUMBER: PIP/108233
AUTHOR: Decosas J ; Kane F ; Anarfi JK ; Sodji KD ; Wagner HU
TITLE: Migration and AIDS.
ABSTRACT:

A successful short-term solution to transmission of AIDS in Western Africa by migrants involves provision of accessible and acceptable basic health and social services to migrants at their destination. The aim is to establish a sense of security and community, which is a health requirement. When migrants are excluded from community life or victimized as carriers of HIV infections, they will be driven by basic survival needs and dysfunctional social organization, which results in the rapid spread of HIV. Closing borders and mass deportation may not be an option. The long-term solution is population policy, environmental protection, and economic development. The focus on mapping the spread of AIDS must shift to a consideration of the migrant social conditions that make them vulnerable to AIDS. The issue of migration and AIDS will be addressed at the First European Conference on Tropical Medicine in October 1995 in Hamburg, Germany. In Uganda, HIV seroprevalence rates ranged from 5.5% among the stable population to 12.4% among internal migrants moving between villages to 16.3% among migrants from other areas. A World Bank project is operating in Western Africa, which traces seasonal male migration from the Cameroon to Liberia, Senegal to Nigeria, and from the Sahel to the coast during dry seasons. National border rules may influence the routes but not the extent of migration. A major destination place is Cote d' Ivoire, which has 25% of total population comprised of migrants from other countries and one of the highest HIV prevalence rates in Western Africa. On plantations prostitutes are brought in. Each prostitute serves about 25 workers. The pattern of sexual mixing contributes to the high HIV rates. Female migration is smaller and usually concentrated in prostitution at place of destination. Illiteracy and poverty drive women migrants into the trade. Their frequent health problems are malaria, pelvic pain, menstrual irregularity, vaginal discharge, and genital sores. Drugs are bought on the streets or from friends and may be of questionable efficacy. Health services may be sought upon return to the home country.

91.
DOCUMENT NUMBER: PIP/133333
AUTHOR: de Schryver A ; Meheus A
TITLE: Sexually transmitted diseases and migration.
ABSTRACT:

Sexually transmitted diseases (STDs) are communicable diseases transferred mainly through sexual contact. With more than 20 pathogens known to be spread by sexual contact, STDs are the most common notifiable infectious diseases in most countries. Despite some fluctuation in their incidence, STDs continue to occur at unacceptably high levels. For most notifiable STDs, the highest rates of incidence are found in 20-24 years olds, followed by people aged 25-29 and 15-19. Among sexually active teenagers, the highest incidence of STD infection is among the youngest teens. For most STDs, the overall morbidity rate is higher for men than for women. STD control programs need to be designed and implemented with the understanding that migration has always been linked with STD. Sexual preference, marital status, socioeconomic status, place of residence, prostitution, migration, principal STDs, populations at risk, and prevention and control measures are discussed. Strategies to prevent STD transmission must remain flexible in order to adapt to prevailing conditions, with adequate clinical services being central in controlling STDs.

104.
DOCUMENT NUMBER: IND/8019117
AUTHOR: Findley SE ; Williams LM
TITLE: Women who go and women who stay: reflections of family migration processes in a changing world.
ABSTRACT:

"This report summarises the results of an extensive literature review of developing country research pertaining to both aspects of migration, women who go and women who stay." The authors examine the similarities and differences between male and female migrants, with a focus on socioeconomic characteristics. Attention is also paid to the problems experienced by women left behind as a result of their husband's migration. The report concludes with some recommendations that could create more options for women, whether they migrate or stay behind. (EXCERPT)

114.
DOCUMENT NUMBER: IND/9005253 ; PIP/027833
AUTHOR: Goldstein S ; Goldstein A
TITLE: Techniques for analysis of the interrelations between migration and fertility.
GENERAL NOTES: Revised version of paper prepared for the Technical Working Group on Migration and Urbanization meeting held under the auspices of the Population Divison, Economic and Social Commission for Asia and the Pacific (ESCAP), Bangkok, 1-5 Dec., 1981.
ABSTRACT:

Focuses on the use of the life history component of th ESCAP survey instrument (for national migration surveys) relying for illustrations on research that used the life history matrix of the Malaysian Family Life Survey conducted by the Rand Corporation's Family in Economic Development Center. After discussing theoretical issues, problems of research design and data, and describing the ESCAP life history matrix (a concisely formulated instrument for ordering, stimulating, and cross checking an individual's recall of a series of personal life events, including residential mobility), the authors discuss analysis using children ever-born, use of sequential data, and the inclusion of different types of migration categories. Other approaches to studying the migration/fertility relationship (econometric models, multidimensional analysis) are briefly noted. The ESCAP survey promises to provide an unusually rich body of data for analyzing migration and fertility, the life history matrix being especially useful for analyses designed to test the selectivity, disruption, and adaptation hypotheses. Recommendations on how additional relevant information can be incorporated are offered.

146.
DOCUMENT NUMBER: PIP/026428
CORPORATE NAME: International Planned Parenthood Federation [IPPF]. Europe Region
TITLE: Migrants and planned parenthood.
ABSTRACT:

Reflections, speculations, and partial evaluations of work already undertaken in the International Planned Parenthood Federation (IPPF) Europe Region concerning migrants and planned parenthood are presented. This project, initiated by the Federal Republic of Germany Planned Parenthood Association (PPA), PRO FAMILIA, stemmed from the practical experiences and problems of 1 family planning association in the Europe region. The original substantive framework, consisting of data collection and correspondence, plenary meetings, and subworking group meetings on specific areas of interest, was not altered. Throughout the project, as the work was accomplished, the emphasis shifted to different aspects to migrant work. The 1st questionnaire was intended to provide a sociodemographic profile of the participating countries, a show European migratory movements, and ascertain the ethnicity of the target groups in the different countries. The 2nd questionnaire was related specifically to PPA and/or other family planning center's data and activities and attempted to explore PPA attitudes toward migrant clients, when special facilities for migrants were provided, and whether PPAs felt there was a particular need for such services. The report provides a sociodemographic background of migration in Europe. In addition it includes information from donor countries and recipient countries, examining family planning services in the Federal Republic of Germany and the UK. It also covers training; information, education, and communication; adolescence and 2nd generation migrants; and migrant work. It is necessary to be particularly aware of political sensitivities in treating immigrant fertility regulation. Ideally, the aim is to provide an integrated service for migrants and natives both, catering to individual needs. Until this is feasible, the goal must be to work toward an integrated service, recognizing the needs and providing special services where possible if this is judged tobe the best approach to catering to those needs. Migrant needs must be discovered rather than assumed. Better use should be made of the available printed material, which should be utilized to complement oral information where possible. Experience has shown that family planning personnel working with migrants need additional training. The main components of this training should include self-awareness, insight, and knowledge.

170.
DOCUMENT NUMBER: PIP/107603
AUTHOR: Kulig JC
TITLE: Cambodian refugees' family planning knowledge and use.
ABSTRACT:

This ethnographic study describes Cambodian refugees in the US and women's role and status, childbearing patterns, and family planning knowledge and use. The study was conducted using participant observation and open-ended interviews during 1988 and 1990. The study population consisted of refugees and residents of an urban Cambodian community in northern California. Observations of family life were made in the homes and the community. The interviews were obtained from 30 women and 23 men from a variety of socioeconomic backgrounds. Most participants lived in apartments in extended families in lower socioeconomic areas and among mixed racial and ethnic populations. Religious services were held in one small temple or, for larger celebrations, in a school rented for the occasion. Three Cambodian-owned stores sold ethnic food and music cassettes. Large weddings were held in a local Chinese restaurant. Cambodian refugees tended to use health services provided by Vietnamese physicians familiar with Cambodian culture and by healers. Political affiliations in the home country and with the generals were maintained. The celebration of the Cambodian Thanksgiving and New Year, in addition to visits from generals, were the main important social events. The male role was identified as working outside the home. Earnings were given to the wife who was responsible for maintaining the family budget. The female role was not confined exclusively to child care, cooking, and housekeeping. Men might help with laundry or heavy chores, and some women worked outside the home. Female education was found to be encouraged, but challenges to traditional Cambodian rule governing sexual chastity were discouraged, and family honor was a concern. Findings from interviews revealed a mean fertility of 5.5 children. The mean number of deceased children was 0.83. Younger women indicated greater familiarity with Western family planning methods. Therapeutic abortion was reported as a family planning method. The condom and vasectomy were reported, but use was found to be infrequent. Although modern family planning was known, there was little understanding of the impact on the female body or side effects.

185.
DOCUMENT NUMBER: PIP/066803
AUTHOR: Maine D
TITLE: Safe motherhood programs: options and issues.
ABSTRACT:

In response to the Safe Motherhood Initiative announced to the international community by a conference in Nairobi, Kenya in 1987, this chartbook enumerates the size of the problem of maternal mortality, suggests an analytic model of factors affecting maternal deaths, considers 7 main program options, and proposes a 3-part strategy. WHO estimates that there are about 500,000 pregnancy-related deaths yearly, 99% of them in developing countries. Women there also bear the highest risk in their lifetimes because of numerous pregnancies. The highest rate per population is in India and Bangladesh. 6-29% or more of these deaths result from unsafe abortions. The model proposes that pregnancy can result in complications or maternal death, caused by the distant factors related to socioeconomic status, and by intermediate factors related to health and reproductive behavior, health status, and access to health services. The program options discussed are: how to provide contraceptive services and safe legal abortion, prenatal care, emergency obstetric care, train traditional birth attendants (TBAs), inform and mobilize the community and improve socioeconomic status. Many unanswered questions remain among these options, such as how to screen pregnant women for hospital delivery. It is clear that maternal mortality is a leading cause of death in developing countries, and that all pregnant women are at risk. A few obstetric complications cause most deaths: hemorrhage, infection, hypertension, obstructed labor, and complications of unsafe abortion. A cost-effectiveness study of 7 levels in improved care on 6 causes of maternal death is estimated for 1 million rural women. Because we have available, unsophisticated means to prevent most of these deaths, and existing knowledge is sufficient to set up priorities for Safe Motherhood programs, a 3-part strategy is presented. 1) Ensure access to medical treatment of obstetric emergencies, by improving emergency treatment in existing health facilities, upgrading local obstetric first aid, finding ways to improve access to care, and informing the whole community of danger signs. 2) Reduce exposure to risks of unwanted pregnancies by providing contraceptive and abortion services. 3) Establish maternal health services by equipping community maternities, training TBAs, improving prenatal care, and setting up maternity waiting homes.

192.
DOCUMENT NUMBER: PIP/081130
AUTHOR: Mamdani M ; Garner P ; Harpham T ; Campbell O
TITLE: Fertility and contraceptive use in poor urban areas of developing countries.
ABSTRACT:

In developing countries, urban population size is growing rapidly, especially among the poor. Continued rural-urban migration contributes sizably to this growth (40-50% of urban growth), especially since most people who migrate to the cities are young. Natural increase accounts for the remaining urban growth (50-60%). Even though the urban poor tend to have fertility rates either lower than the urban mean or intermediate to those of rural and urban areas, young demographic profiles ensure expanding urban populations. In addition, fertility rates of the urban poor are different between cities and within cities. Factors encouraging fertility are a fall in traditional fertility- inhibiting behaviors, especially breast feeding and postpartum abstinence taboos. The rise of women in the labor force, adoption of modern ideas, increased need for child labor, and the breakdown of the extended family contribute to these changes. Factors which decrease fertility are falling proportions of people marrying at an early age, increased age at first marriage, increased spousal separation, and increased use of contraception. Socioeconomic differentials and issues of equity explain, to a certain extent, the high fertility and low contraceptive use in some poor urban areas. Policymakers need to complement any social and economic development strategies with definite improvements in the structure of family planning. These improvements include expanded economic, geographic, and cultural access to contraceptives; diversified contraceptive outlets; and attention to quality of family planning services. Further, effective communication of family planning information to individuals and the population is needed to increase contraceptive use. Communication and improved family planning strategies must include promotion of condoms to reduce the spread of HIV and to prevent unwanted pregnancies. Existence of family planning services does not reduce population growth without individual and community participation in using and promoting family planning.

205.
DOCUMENT NUMBER: PIP/112221
AUTHOR: Miller J ; Wulf D
TITLE: The camps for the displaced population in Rwanda, October 11-18, 1993.
ABSTRACT:

This article gives a description of conditions among Rwandan refugee women living in camps. The discussion is based on a trip to the camps. A brief history of political strife over the decades between the Hutu and the Tutsi is given. Ten major relief agencies were assisting the displaced in October 1993: CARE International, MSF/Holland, MSF/Belgium, Croix Rouge/Belgium, the World Food Program, the International Committee of the Red Cross, Croix Rouge/Rwanda, Catholic Relief Services, and GTZ. Types of assistance included provision of drinking water, sanitation, health care, reforestation, food and non-food aid, family reunification, and distribution of aid. Living conditions in the camps differed depending upon proximity to the war zone. Relief agencies did not operate at all near war zones. Food distribution occurred at a distance from the camps in order to assure control and to forestall riots. Large numbers of people were reported to be involved in theft of food and forging of food cards. The corruption occurred at all government levels and was considered indicative of the breakdown in social relations due to the civil strife. Camps sites were similar to normal settlements, with exception of hut construction and density of housing. Rwandans tend to live isolated from one another as a natural by-product of the hilly terrain, and the high density camp setting was an adjustment for Rwandans. The war exacerbated the natural mistrust of outsiders. Health conditions ranged from dire to adequate. Family planning was provided through community volunteers. Although displaced populations moved onto cultivable land, local populations were accepting due in part to the entire population being eligible for food rations. Women delivered in the huts, but the baby was brought to health centers for check-ups, where the mother received another food ration card. Supplemental feeding centers served children, who were found to be under 70% of the accepted standard. Income generation programs and social mobility were limited due to mistrust. AIDS was widespread, and 33% of adults in Kigali were suspected of being HIV positive.

218.
DOCUMENT NUMBER: PIP/144568
AUTHOR: Nduna S ; Goodyear L
TITLE: Pain too deep for tears: assessing the prevalence of sexual and gender violence among Burundian refugees in Tanzania.
GENERAL NOTES: VAW.
ABSTRACT:

This document concerns the prevalence of sexual and gender violence among Burundian refugees in Tanzania. Since 1993, the International Rescue Committee (IRC) has been assisting the Burundi refugees in Tanzania. Most of the IRC services were focused on comprehensive primary health care and by 1996 it had diversified its reproductive health care services by addressing the difficult issues of sexual and gender violence. The IRC implemented an assessment project of Countering Sexual and Gender Violence in refugee camps in northern Tanzania and Zaire. The project staff used in-depth interviews and community survey of women aged 12-49 years to gather information. The initial results of the IRC assessment suggest that approximately 26% of the 3803 Burundi refugee women in the established camp of Kenembwa have experienced sexual violence since becoming a refugee. Refugees have been subjected to such violence at every stage of their quest for safety. Among the perpetrators include soldiers, policemen, Burundi and Tanzanian nationals, fellow refugees, relatives, husbands, and one reported case of a rape by a nongovernmental organization security staff member. Included in this report, are detailed elaboration of the processes and results of the assessment project conducted by IRC.

235.
DOCUMENT NUMBER: PIP/113911
AUTHOR: Martin P ; Widgren J
TITLE: International migration: a global challenge.
ABSTRACT:

Trends in international migration are presented in this multiregional analysis. Seven of the world's wealthiest countries have about 33% of the world's migrant population, but under 16% of the total world population. Population growth in these countries is substantially affected by the migrant population. The migration challenge is external and internal. The external challenge is to balance the need for foreign labor and the commitment to human rights for those migrants seeking economic opportunity and political freedom. The internal challenge is to assure the social adjustment of immigrants and their children and to integrate them into society as citizens and future leaders. Why people cross national borders and how migration flows are likely to evolve over the next decades are explained. This report also presents some ways that countries can manage migration or reduce the pressures which force people to migrate. It is recommended that receiving nations control immigration by accelerating global economic growth and reducing wars and human rights violations. This report examines the impact of immigration on international trade, aid, and direct intervention policies. Although migration is one of the most important international economic issues, it is not coordinated by an international group. The European experience indicates that it is not easy to secure international cooperation on issues that affect national sovereignty. It is suggested that countries desiring control of their borders should remember that most people never cross national borders to live or work in another country, that 50% of the world's migrants move among developing countries, and that countries can shift from being emigration to immigration countries. The author suggests that sustained reductions in migration pressure are a better alternative than the "quick fixes" that may invite the very much feared mass and unpredictable movements.

242.
DOCUMENT NUMBER: PIP/134672
CORPORATE NAME: Reproductive Health for Refugees Consortium
TITLE: Refugee reproductive health guide to needs assessment and evaluation. Draft for field testing.
ABSTRACT:

This manual was prepared to guide relief workers in their efforts to assess the reproductive health needs of refugee women and provide services in five areas: sexual and gender violence, family planning, HIV/AIDS and sexually transmitted diseases, safe motherhood, and emergency obstetrics. After identifying reproductive health problems prevalent in refugee and displaced person settings, the manual presents a matrix of general needs assessment and service delivery issues. These include breadth of services offered, access, usage, resources, service coordination, and quality of care. For each of the five programmatic areas, guidelines are presented on essential needs assessment questions, suggested strategies for collecting information, and recommended interventions and indicators. Involvement of refugee women in the use and evaluation of this manual is critical to its effectiveness. Field staff will test this guide in the year ahead, after which time it will be modified in response to feedback from the field. A feedback and evaluation form concludes the document.

272.
DOCUMENT NUMBER: PIP/091499
AUTHOR: Tam L
TITLE: Rural-to-urban migration in Bolivia and Peru: associations with child mortality, breast-feeding cessation, maternal care and contraception.
ABSTRACT:

4 hypotheses were tested: 1) the 0-23 month mortality rate was significantly associated with mothers' migration status, and 2) the use of prenatal care (PNC) for the index child was analyzed with controls for socioeconomic and maternal-related variables. Hypotheses 3 related to the use of modern birth delivery services and 4 reflected the association with traditional and modern contraceptive usage with the aforementioned controls. Hypotheses 5 related to stopping of breast feeding during the first 24 months of life. Data were obtained from the Demographic and Health Surveys of Peru in 1986 and Bolivia in 1989. Mothers were grouped into urban or rural native, or recent or old (over 7 years) migrant. Logistic models and Cox's proportional hazard models were used in the analysis. The results indicated that the worst conditions for children were among rural natives in both countries: low maternal education, high percentage born in "inadequate family formation patterns," and the highest percentage with the poorest household conditions; urban natives had the reverse patterns. The mortality risk for children aged 0-23 months in Peru was .065 for urban natives, .075 for old migrants, .093 for recent migrants, and .147 for rural differences were statistically significant. The risk in Bolivia, respectively, was .080, .084, .139, and .120. In the bivariate analysis, PNC and contraceptive usage were found to be significantly associated with migration status in both countries; urban natives were the most frequent users. Family formation patterns, the place of birth, and marital status variables medicated the effect on the use of PNC, modern birth delivery care (MBDC), and use of contraception through the migration variables, while wealth, use of contraception, and maternal education affected the use of PNC, MBDC, and use of contraception without mediation from the migration variables. MBDC was also found to be closely related to mothers' migration status; the most frequent users were urban natives in Bolivia, while in Peru the old migrants and rural natives had the greatest likelihood of using MBDC. An end of breast feeding among migrants was less likely than urban natives, and more likely among rural natives. Children of migrant mothers had a mortality risk in between rural and urban natives in Bolivia and Peru. Explanations are given for the migration effects.

287.
DOCUMENT NUMBER: PIP/104281
CORPORATE NAME: International Conference on Population and Development [ICPD] (1994: Cairo)
TITLE: Report of the International Conference on Population and Development (Cairo, 5-13 September 1994). Preliminary version.
ABSTRACT:

This preliminary report of the 1994 International Conference on Population and Development (ICPD) opens by presenting the resolutions adopted, including the text of the Programme of Action. The report then provides details on the organization of the ICPD (the date and place, preconference consultations, attendance, the opening and election of the President, messages from Heads of State, adoption of the rules of procedure, adoption of the agenda, election of officers, the organization of work, accreditation of intergovernmental and nongovernmental organizations, and the appointment of members of the Credentials Committee). Information is then provided on the general debate, the report of the Main Committee, the adoption of the Programme of Action, the report of the Credentials Committee, adoption of the report of the ICPD, and the closure of the conference. Annexed to this report are a list of documents, opening statements, closing statements, and a list of parallel and associated activities which took place during the ICPD.

292.
DOCUMENT NUMBER: PIP/122588
CORPORATE NAME: World Health Organization [WHO] ; United Nations High Commission for Refugees [UNHCR] ; Joint United Nations Programme on HIV / AIDS [UNAIDS]
TITLE: Guidelines for HIV interventions in emergency settings.
ABSTRACT:

In emergencies, the priority concern is the people who are at risk of imminent death from injury, starvation, exposure, or disease. With an estimated 30-40 million people expected to be infected with HIV by the year 2000, HIV/AIDS control must be regarded as a critical component of emergency responses. The purpose of this manual is to provide guidelines to enable governments, nongovernmental organizations, and United Nations agencies to adopt the measures necessary to prevent the rapid epidemic spread of HIV in emergency situations such as natural disasters and civil strife and to care for those already affected. HIV spreads fastest in conditions of poverty, powerlessness, and social instability--situations at their most extreme during emergencies. For planning purposes, emergencies can be divided into five stages: the destabilizing event, loss of essential services, restoration of essential services, relative stability, and return to normality. Although the nature of the emergency dictates HIV/AIDS interventions, basic elements of a response to any emergency include prevention of HIV transmission through safe blood transfusion, availability of materials and equipment needed for universal precautions, condom provision, and the dissemination of basic HIV/AIDS information. This manual both outlines salient goals during each stage of an emergency and provides standards for relief workers for delivery of the minimum package of HIV interventions in emergency settings.

299.
DOCUMENT NUMBER: PIP/117215
CORPORATE NAME: United Nations. High Commissioner for Refugees
TITLE: Reproductive health in refugee situations. An inter-agency field manual.
ABSTRACT:

This interagency field manual on reproductive health (RH) in refugee situations was produced during a workshop that addressed this specific issue. The manual is organized into chapters on background issues related to RH programs, a Minimum Initial Service Package, safe motherhood, sexual and gender-based violence, prevention and care of sexually transmitted diseases including HIV/AIDS, family planning, other RH concerns, RH needs of adolescents, and surveillance and monitoring. The appendices pertain to the essentials of IEC programs, the legal rights of refugees relating to RH, a glossary of terms, and an evaluation form. This 1995 field manual will be field-tested, and users are asked to contribute their suggestions in preparation for a revised manual within the next 2 years. All RH activities should follow the principle that "reproductive health should be available in all situations and be based on refugee, particularly women's, needs and expressed demands, with full respect for the various religious and ethical values and cultural backgrounds of the refugees, in conformity with universally recognized international human rights." RH care should be important in ameliorating pregnancy and delivery complications, malnutrition and epidemics, and a failure of law and order. Delivery of RH is made more difficult by the breakdown of preexisting family support networks, the loss of income, the isolation of women as family heads, and an emphasis on life-threatening situations. Successful RH programs require adequate staff and funding and effective community participation, integration of services, IEC, advocacy for RH, and coordination of activities among relief agencies. Monitoring is important for identifying high-risk groups, confirming the most serious conditions, and identifying trends.

304.
DOCUMENT NUMBER: PIP/141495
CORPORATE NAME: Symposium on Internal Migration and Urbanization in Developing Countries (1996: New York)
TITLE: Internal migration and urbanization: recommendations. Symposium on Internal Migration and Urbanization in Developing Countries: implications for Habitat II.
ABSTRACT:

In 1996, the UN Population Fund sponsored a scientific symposium on internal migration and urbanization in developing countries. The symposium, attended by internationally recognized experts in this field, addressed the linkages among population dynamics, urbanization, and human settlements, and provided policy guidance. In this article, the recommendations provided by these experts are presented. Some of the issues referred to were the following: the needs of vulnerable groups of migrants; development of sustainable land use; poverty reduction and employment creation; acquisition of environmentally sustainable and healthy human settlements; strengthening of sustainable transport and communications systems. In addition, the recommendations cited were: improving urban economies; creating balanced development in rural settlements; decentralization of the governments' administrative systems; prioritizing metropolitan planning and management; increasing information and communication; and formulating general policy issues on population distribution. Moreover, specific recommendations were made concerning population and urbanization; environment and quality life in urban areas; production, consumption, and environmental protection; gender and sustainable human settlements; poverty in urban/rural settlements; conservation and rehabilitation of historical and cultural heritage; employment and economic growth; and aging, human health, and community care in an urban environment.

335.
DOCUMENT NUMBER: PIP/111939
AUTHOR: Wulf D ; Miller J
TITLE: Somali refugees in Kenya.
ABSTRACT:

Drought and civil war devastated much of the Horn of Africa in 1991 and 1992, leaving millions of people homeless in Ethiopia, Somalia, and the Sudan. Many others were forced to flee their countries. By the end of 1992, almost 500,000 refugees had reached asylum in 12 camps and four border sites, mainly in Kenya's northeast province. Approximately 110,000 Somali and Ethiopian refugees repatriated in 1993, leaving 370,000 refugees still in Kenya by the end of 1993. A cross-border operation to repatriate the Somali refugees; rebuild or rehabilitate schools, clinics, hospitals, and water systems; and provide seeds, tools, and water pumps to farmers has been in place since the end of 1992. Approximately 30 international and African relief agencies are involved in the operation, which had an estimated cost of $58 million in 1993. The authors, in October 1993, visited the Liboi, Ifo, Dagahaley, and Hagadera refugee camps. They describe which agencies are helping the refugees, general living conditions of the refugees, general and reproductive health care and services, and aspects of the lives of female adult refugees.

344.
DOCUMENT NUMBER: PIP/107866
AUTHOR: Zulkifli SN ; Khin Maw U ; Yusof K ; Lin WY
TITLE: Maternal and child health in urban Sabah, Malaysia: a comparison of citizens and migrants.
ABSTRACT:

Findings from this study conducted in urban Sabah, Malaysia, support the view that migrants, as opposed to natives, are at a disadvantage with regard to education and income and are more exposed to negative environments in Malaysia compared to their home countries. Migrants are found to have less contraceptive use and higher proportions of women who never had prenatal care. Crude birth intervals are found to be similar in both the native population and the migrant population. Migrant women who breast feed are a larger proportion. The comparison of women who used prenatal care suggests that some migrant women use prenatal care late in pregnancy and only register at child health clinics as a means of obtaining citizenship. Pregnancy wastage is similar in both groups of migrant and native women. Infant mortality is higher among births to migrant women, but the differences are not statistically significant. It is suggested that poor living conditions contribute to the higher infant mortality. Logistic models reveal that maternal educational level is a statistically significant predictor of pregnancy wastage and infant mortality. Risk of pregnancy wastage is also significantly affected by household income. Piped water supply and sanitary facilities are insignificant predictors. The lack of a relationship is interpreted as potentially a function of disparity in the time frame of variables. The authors recommend an improvement in access to health care and in living conditions. The study area is primarily rural and the population is scattered, which makes for more difficult delivery and distribution of services. Voluntary use of health care services by migrants needs to be encouraged. Government policy should shift to improving local government capacity to provide health care, improving the responsiveness of relevant public agencies, lowering health care costs, increasing service demand among the poor, promoting private sector cooperation, and encouraging migrant movement to small and intermediate sized cities.