RESUMO
Abstract Adolescent fertility -fertility rates at ages 15-19- fell substantially (around 30 percent) between 2000 and 2010. It was the first time Brazil experienced such a decline in those ages since 1970, when the census included one question about children born in the past 12 months. This phenomenon has an important implication for the P/F Brass ratio technique: it underestimates the cumulated current fertility up to age group 20-24 (F2), considering this cohort's previous fertility experience. Therefore, the P2/F2 value, used as an adjustment factor for the reported fertility level, is significantly overestimated. This paper discusses this issue and proposes an alternative to correct the reference period error in the 2010 Demographic Census in Brazil. The results of applying the proposed alternative in this specific context were very similar to those obtained using different techniques, thus supporting the strength of our alternative.
Resumo O Brasil experimentou, entre 2000 e 2010, pela primeira vez desde 1970, quando se introduziu o quesito sobre filhos nascidos vivos nos 12 meses anteriores à data de referência do censo, queda significativa (em torno de 30%) das taxas específicas de fecundidade declarada das mulheres entre 15 e 19 anos (f*1). Esse fenômeno tem uma importante consequência para a aplicação da técnica P/F de Brass: gera um erro, por falta, na fecundidade corrente acumulada até o grupo etário de 20 a 24 anos (F2), se tomada como experiência pregressa dessa coorte, levando a um valor de P2/F2, usado para ajustar o nível da fecundidade declarada, significativamente sobrestimado. O presente trabalho discute detalhadamente este problema e, por fim, propõe uma alternativa para se corrigir o erro de período de referência da fecundidade corrente do Censo Demográfico de 2010 do Brasil. A alternativa proposta, neste contexto específico, gerou estimativas de taxa de fecundidade total muito próximas às produzidas por outras técnicas.
Resumen Por la primera vez desde 1970 —cuando se introdujo la pregunta sobre nacidos vivos en los 12 meses anteriores a la fecha de referencia del censo— Brasil experimentó, entre 2000 y 2010, una disminución significativa de aproximadamente 30% de las tasas específicas de fecundidad declarada de mujeres entre 15 y 19 años (f*1). Este fenómeno trae una consecuencia importante para la aplicación de la técnica P/F de Brass: genera un error por falta en la fecundidad actual acumulada para el grupo de edad de 20 a 24 años (F2), lo que concomitantemente provoca una significativa sobrestimación en el valor de P2/F2 —utilizado para corregir el nivel de la fecundidad declarada—. Este trabajo discute este problema y propone finalmente una adaptación de la técnica original de Brass para aplicarla a los datos del censo de 2010. La alternativa propuesta generó, en este contexto específico, estimaciones de la tasa global de fecundidad similares a las producidas por otras técnicas.
Assuntos
Humanos , Demografia , Coeficiente de Natalidade , Adolescente , Censos , Fertilidade , Brasil , Interpretação Estatística de Dados , Nascido VivoRESUMO
PIP: This article explains that birth delays skew developing world's fertility figures. When successive groups of women who have delayed childbearing start having children, the rapid fertility decline stalls. Such change in the timing of childbearing skews the total fertility rate (TFR). Analysis of the tempo component of TFR trends in Taiwan suggests that tempo effects reduced its TFR by about 10% in the late 1970s and early 1990s and by about 19% in the late 1980s. In Colombia, on the basis of increasing mean maternal age at childbirth between the 1970s and the late 1980s, tempo distortions of the TFR during the most of the 1980s seem likely. Moreover, many developing countries are now experiencing rapid fertility declines that are in part attributable to tempo changes. These changes have accelerated past fertility transitions, but they also make these countries vulnerable to future stalls in fertility when the delays in childbearing end. Since fertility reductions caused by tempo effects lead to real declines in birth rates and hence in population growth, countries that wish to reduce birth rates can take actions that encourage women to delay marriage and the onset of childbearing.^ieng
Assuntos
Coeficiente de Natalidade , Fertilidade , Dinâmica Populacional , Pesquisa , América , Ásia , China , Colômbia , Demografia , Países em Desenvolvimento , Ásia Oriental , América Latina , População , América do Sul , TaiwanRESUMO
PIP: The author analyzes trends in the components of population growth over the past several decades in Mexico, and presents some medium and long-term projections. He notes the process of mortality decline that has been occurring for nearly seven decades, and illustrates the fertility decline that has been a principal determinant in the reduction of population growth and in the recent changes in age distribution.^ieng
Assuntos
Distribuição por Idade , Coeficiente de Natalidade , Previsões , Mortalidade , Dinâmica Populacional , Crescimento Demográfico , Fatores Etários , América , Demografia , Países em Desenvolvimento , Fertilidade , América Latina , México , América do Norte , População , Características da População , Pesquisa , Estatística como AssuntoRESUMO
PIP: Demography, which should be the basis for planning of any program or project, has traditionally been ignored by Colombian governments. No population statistics are available for the pre-Conquest period in Colombia. Statistics during the Colonial era were based on population counts for division of lands, taxation, and similar considerations. The first census was undertaken around 1770. Colombia's most recent census was in 1993, and another is being prepared for 2000. The censuses have been useful for development purposes despite their significant limitations of completeness and accuracy. Colombia's population in 1997 was estimated at 40,300,000, making it the third most populous country of Latin America after Brazil and Mexico. Fertility has declined considerably since 1965. Colombia's crude birth rate is believed to have exceeded 50/1000 in the 18th and 19th centuries and was estimated at 45/1000 by the Latin American Demographic Center for the first half of the 20th century. The crude birth rate was 41.3/1000 in 1968, 33.1/1000 in 1973, 30/1000 in 1980, and around 26/1000 in 1990 and 1995. The total fertility rate was estimated at 7.0 in 1960-65, 6.7 in 1969, 4.5 in 1973, 3.2 in 1985, and 2.9 in 1995. Fertility declined most appreciably before 1975, but rates continue to drop in rural as well as urban areas and in all geographic zones. For Colombia as a whole the total fertility rate is 4.8 for women with less than 5 years of schooling and 2.4 for those with 8 or more years. It is 2.7 in urban and 4.4 in rural areas.^ieng
Assuntos
Coeficiente de Natalidade , Fertilidade , América , Colômbia , Demografia , Países em Desenvolvimento , América Latina , População , Dinâmica Populacional , América do SulRESUMO
PIP: The extent to which changes in the major demographic variables have caused the aging of the population of Mexico is analyzed. These factors include the decline in mortality since 1950, the increase in international migration since 1950, and the decline in fertility since 1963. These effects are illustrated using a series of age pyramids with and without the impact of the factor under consideration.^ieng
Assuntos
Coeficiente de Natalidade , Demografia , Emigração e Imigração , Mortalidade , Dinâmica Populacional , América , Países em Desenvolvimento , Fertilidade , América Latina , México , América do Norte , PopulaçãoRESUMO
This paper assesses the effects of changes in women's education and labor force participation on nuptiality patterns and their implications for fertility decline in Venezuela. Results show that together with delays in union formation, changes in women's education and labor force participation produced a different, more "modern" type of consensual union, which coexists with "traditional" consensual unions. "Traditional" consensual unions remain a substitute for formal marriage among women from rural origins with low levels of education and higher levels of work experience. "Modern" consensual unions appear to be an option for well-educated women of urban origins. As in developed countries, these unions assume the form of a trial period before marriage or an alternative to singlehood. "Modern" consensual unions are more unstable than "traditional" consensual unions and they are associated with lower fertility.
Assuntos
Coeficiente de Natalidade , Identidade de Gênero , Casamento/tendências , Parceiros Sexuais , Mudança Social , Adulto , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Venezuela/epidemiologiaRESUMO
PIP: Information on contraceptive knowledge and practice in Haiti is available from four national surveys taken over 20 years: the 1977 Haiti Fertility Survey, the 1983 Contraceptive Prevalence Survey, the 1989 National Survey of Contraception, and the 1994-95 Survey of Mortality, Morbidity, and Use of Services. The proportion of Haitian women in union declaring knowledge of at least one contraceptive method increased from 83% in 1977 to 99% in 1994-95. The influence of educational level and rural or urban residence on knowledge declined over time and was virtually nil by 1995. The surveys indicated that, among women in union, 18% used a contraceptive method in 1977, 7% in 1983, 10% in 1989, and 17% in 1995. Educated and urban women had higher rates of contraceptive usage. The use of traditional methods has declined since 1977, while the proportion of women using modern methods increased from 5% in 1977 to 13% in 1995. Combining the survey results reporting contraceptive practice with analyses of the proximate determinants indicates that contraceptive usage only partially explains the decline in Haiti's total fertility rate from 6 in 1982-83 to 4.8 in 1995. Assuming that the natural fertility rate has remained constant at 17.7 children/woman over the past 2 decades, it was estimated, using the Bongaarts method, that in 1994-95 7.4 births were avoided due to marriage patterns, 3.6 due to breast-feeding and postpartum infecundity, 1.3 due to contraception, and 0.6 due to abortion. It is very likely that the impact of duration of union will decline in the future, as premarital sexual activity increasingly becomes the norm.^ieng
Assuntos
Coeficiente de Natalidade , Comportamento Contraceptivo , Serviços de Planejamento Familiar , Fertilidade , Conhecimento , Casamento , América , Região do Caribe , Anticoncepção , Demografia , Países em Desenvolvimento , Haiti , América Latina , América do Norte , População , Dinâmica PopulacionalRESUMO
PIP: Since some argue that the recent and marked fertility decline experienced in Brazil is related to institutional changes resulting from public policies promoted by the federal government since 1964, the author attempts to shed light upon the role played by such policies upon fertility regulation. Fertility in Brazil and the main explanatory theories are first discussed. The paper then considers the role played by the growth of the consumer society, social security coverage, mass media, and the medicalization of society upon changing patterns of fertility regulation in Brazil. The discussion of government policies and fertility regulation includes consideration of consumer credit policy, social security benefit policy, telecommunications policy, and health care policy. One salient conclusion of the analysis is that the lack of a policy to provide fertility regulation mechanisms other than through the marketplace hurts relatively poor populations.^ieng
Assuntos
Coeficiente de Natalidade , Atenção à Saúde , Economia , Política de Planejamento Familiar , Governo , Necessidades e Demandas de Serviços de Saúde , Meios de Comunicação de Massa , Controle da População , Preconceito , Política Pública , Previdência Social , América , Brasil , Comunicação , Demografia , Países em Desenvolvimento , Fertilidade , Administração Financeira , Financiamento Governamental , Saúde , América Latina , Política , População , Dinâmica Populacional , Problemas Sociais , América do SulRESUMO
"The evolution of the Brazilian population size, its growth rate and relative age structure between 1940 and 1991 as well as its expected trajectory until 2020 are presented in this paper. After briefly considering the quasi-stability of the Brazilian population in the past, the role of fast fertility decline is emphasised in the current changing age structure."
Assuntos
Distribuição por Idade , Coeficiente de Natalidade , Densidade Demográfica , Dinâmica Populacional , Crescimento Demográfico , Fatores Etários , América , Brasil , Demografia , Países em Desenvolvimento , Fertilidade , América Latina , População , Características da População , América do SulRESUMO
PIP: Mexican fertility levels did not change dramatically in the years 1988-97, but maintained a gradual downward trend. In the late 1960s and the entire decade of the 1970s, the fertility decline was spectacular. National fertility surveys beginning in 1976 have provided rich information on fertility trends and their determinants, which along with census data reveal the history of the past 3 decades of fertility change. The 1995 total fertility rate of 2.9 was less than one-half of the 1965 total fertility rate of 7.1. The age pattern of fertility has also changed, with the proportion of births to younger mothers progressively increasing. The average age at childbirth declined from 29.2 in 1965 to 27.4 in 1995. The 1995 age-specific fertility rate for women over 35 was one-fourth that of 1965. Sterilization is the most widely used contraceptive method among women over 30, and, at present, 70% of women over 35 are sterilized. The decline in adolescent fertility is due primarily to the rise in average age at first marriage. The marital fertility rate among women 15-19 years old remains at about 400/1000, a high level explained by the frequency of marriages to legitimize prenuptial conceptions. Comparison of fertility data for 5-year periods shows the impact of contraceptive usage and of the family planning program, especially during 1975-80, when the public family planning program was most active. The age pattern of fertility decline suggests that women used contraception more to limit than to space fertility. Fluctuations in fertility after 1980 appear to be linked to the relaxation of public sector family planning activities. The average number of children born by age 40 declined from 5.68 for women born in 1941-45 to 3.46 for those born in 1955-60.^ieng
Assuntos
Coeficiente de Natalidade , Comportamento Contraceptivo , Planejamento em Saúde , América , Anticoncepção , Demografia , Países em Desenvolvimento , Serviços de Planejamento Familiar , Fertilidade , América Latina , México , América do Norte , População , Dinâmica PopulacionalRESUMO
PIP: Brazil is South America's largest country and home to nearly half of the continent's people. Despite solid economic growth, Brazil has one of the world's widest income disparities. In the early 1990s, nearly 40% of urban and 66% of rural Brazilians lived in poverty. The streets of Brazil's cities are home to a large population of street children. Although it is difficult to estimate, 10 million children and youths may be either homeless or making a meager living off of the streets. Street children may be linked to prostitution and drugs and be the targets or perpetrators of violence. Child labor is an issue in Brazil. Today an estimated 30% of rural children and 9% of urban children ages 10-13 work in the formal economy. In some rural areas, 60% of workers are ages 5-17. Child labor also contributes to Brazil's relatively low educational attainment levels. UNICEF estimates that around 1990 only 1/3 of all Brazilian children continued on to secondary school, compared to 74% and 47%, respectively, for the Latin America and Caribbean regions. Immunization rates among Brazil's children are rising but still lag slightly behind regional averages. The mortality rate for children under age 5 decreased dramatically from 181 deaths for every 1000 live births in 1960 to 61/1000 in 1994. During the same time period, the average number of children born to a woman during her lifetime dropped from 6.2 to 2.8. This fertility decline is related in part to increased access to and acceptance of family planning. Contraceptive prevalence, including traditional and modern methods, is around 66%, with female sterilization and the pill being the most popular methods. Brazil's abortion rates are high, despite laws limiting access to abortion services. One estimate suggests that about 30% of all pregnancies are terminated through abortion each year.^ieng
Assuntos
Coeficiente de Natalidade , Proteção da Criança , Escolaridade , Emprego , Estudos de Avaliação como Assunto , Pobreza , Urbanização , América , Brasil , Demografia , Países em Desenvolvimento , Economia , Fertilidade , Geografia , Saúde , Mão de Obra em Saúde , América Latina , População , Dinâmica Populacional , Classe Social , Fatores Socioeconômicos , América do Sul , População UrbanaRESUMO
South Korea and Cuba are dissimilar in religion, economy, culture and attitudes toward premarital sexual relations. In 1960, Korea instituted a national family planning programme to combat rapid population growth. Cuba explicitly rejected Malthusian policies, but made family planning universally available in 1974 in response to health needs. Both countries have undergone rapid fertility declines and today have less than replacement level fertility. Both countries have also used a similar mixture of methods, including a high prevalence of female sterilisation. Abortion has played a major role in the fertility decline of both countries, rising in the first half of the fertility transition and then falling, although remaining a significant variable in the second half. It is concluded that access to contraception, voluntary sterilisation, and safe abortion has a direct impact on fertility and has been associated with a rapid fall in family size in two very different countries.
PIP: It is argued that access to contraception, voluntary sterilization, and safe abortion had a direct impact on fertility decline in two countries (Cuba and Korea) that differed in religion, economic conditions, culture, and attitudes. Both countries achieved below replacement fertility through high rates of contraceptive prevalence and ready access to legal abortion. Family planning services were provided in both countries through the public sector and in Korea through a subsidized private sector. Fertility decline in both countries occurred at the same time as the initiation of family planning programs. Family planning was introduced in Korea in order to reduce population growth and in Cuba in order to reduce the incidence of induced abortion and not for demographic reasons. Both Korea and Cuba had successful family planning programs over the past ten years that combined awareness, accessibility, and perceived quality. Korea adopted legal abortion as a means of reducing high maternal mortality rates and fertility. Cuba adopted legal abortion, during a period when the government lacked hard currency and consumer items such as birth control pills. Even antibiotics were difficult to obtain, particularly for teenagers. Both countries worked to improve services for teenagers. The experiences with family planning in both countries provide support for the theory that socioeconomic forces are not needed to push fertility lower. It is suggested that access to reversible and permanent contraception and safe abortion increases the speed of the transition and permits lower fertility than would otherwise be achieved without formal family planning programs. Fertility decline occurred in Korea under rising incomes and Cuba experienced declines during a period of economic declines. Both countries need to expand options for reducing exposure to pre-union adolescent pregnancies.
Assuntos
Coeficiente de Natalidade/tendências , Comparação Transcultural , Serviços de Planejamento Familiar/tendências , Crescimento Demográfico , Cuba/epidemiologia , Características da Família , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recém-Nascido , Coreia (Geográfico)/epidemiologia , Masculino , Gravidez , Comportamento Sexual , Valores SociaisRESUMO
PIP: The Colombian National Survey of Demography and Health was conducted in 1995 within the third round of world Demographic and Health Surveys. This survey was realized with the participation of 10,112 households containing 11,140 individuals in 5 regions of the country. It showed that 99.6% of women in Columbia were familiar with family planning methods and 72% of married women or those living in consensual union used contraceptives, especially those who were more educated and lived in urban areas. 58% of uneducated women used contraceptives vs. 77% of those who had higher education. Uneducated women preferred sterilization, while better educated women preferred IUDs and the condom. The Colombian women thought that the ideal number of children was 2 or 3 vs. a real fertility rate of 3. In Colombia there has been a significant decline of fertility since the 1960s. According to the 1995 National Demographic Survey (ENDS-95) fertility had declined by 23% in the previous 5 years and by 14% in the previous 10 years. In the Pacific region of the country the total fertility rate stayed high at 5, while in the large cities like Bogota, Medellin, and Cali the average number of children was 2.5. 17% of girls 15-19 years old were either mothers or pregnant with their first child. 9% of girls 19 years old had at least 2 children. With regard to sex behavior, 1 of every 5 rural women and 6% of those in urban areas did not know how to avoid HIV infection. 82% of women did not change their sex behavior after having learned about AIDS; 5% demanded to know the sex history of their partners; and 3% decided not to have sexual relations. Regarding sexual violence, 72% of the women said that verbal abuse is also violence. 26% of adolescent girls had been sexually abused by a relative, half of them by stepfathers, in a country where second and third unions are increasingly frequent. Among women who were victims of violence, the percentage who complained to the authorities increased from 11% to 27% between 1990 and 1995.^ieng
Assuntos
Atitude , Coeficiente de Natalidade , Comportamento Contraceptivo , Anticoncepção , Demografia , Violência Doméstica , Infecções por HIV , Comportamentos Relacionados com a Saúde , Conhecimento , Gravidez na Adolescência , Delitos Sexuais , América , Comportamento , Colômbia , Crime , Países em Desenvolvimento , Doença , Serviços de Planejamento Familiar , Fertilidade , América Latina , População , Dinâmica Populacional , Psicologia , Comportamento Sexual , Problemas Sociais , América do Sul , VirosesRESUMO
To describe Chile's stage of epidemiological transition, a descriptive study of the changes to the demographic and economic profile of this country during the last 20 years is presented. The decline in the total fertility rate from 3.4 in 1970 to 2.6 in 1992 and the important decrease in general and infant mortality rate has led to an increase of life expectancy of 8 years for men and 9 years for women. This has resulted in changes to the age structure and causes of mortality and morbidity of the population. A reduction of 82% in the proportion of deaths among children < 1 year and a 73% increase of mortality amongst those 65 years and older can be observed. In line with these changes non-communicable diseases have increased from 53.7% of all deaths in 1970 to 74.9% in 1991. In the same period mortality rates from cardiovascular causes have decreased from 189.6 to 161.1 per 100,000 population, whilst their relative proportion of all causes has increased from 22.3% to 29%. High prevalence of risk factors should lead to a significant increase of chronic diseases in future years. Regarding morbidity, a high incidence rate for tuberculosis persists together with an increase of infections of the digestive system and of sexually transmitted diseases. A decrease in the rates of diseases preventable by immunisation has been noted. It is concluded that, as defined by population mortality statistics, Chile is in a post-transition stage but with a persistence of some infectious diseases corresponding to a transitional stage of development.
Assuntos
Demografia , Adolescente , Adulto , Idoso , Causas de Morte , Criança , Pré-Escolar , Chile/epidemiologia , Doença Crônica/epidemiologia , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos , Urbanização/tendênciasRESUMO
PIP: Explanations of the fertility transition in Costa Rica, as elsewhere in developing societies, have stressed the impacts of socioeconomic changes on the demand for children and of increased supply of family planning services. This paper goes beyond this demand-supply paradigm and examines the additional causal contribution of the "contagion" of birth control practices by social interaction. Aiming at conceptual precision, a simple dynamic model is used to simulate a fertility transition process with interaction diffusion effects. An inspection of the data about the Costa Rican transition shows several characteristics suggesting interaction diffusion effects, notably its pervasiveness toward all socioeconomic strata and the lack of evidence of a downward shift in fertility preferences. Maps of the timing of fertility transition indicate an ordered spatial pattern suggestive of contagion between neighboring areas. An areal regression analysis reveals inter- and within-area contagion effects on birth control adoption. Focus group discussions show real-life situations of interaction diffusion for birth control adoption. These discussions also give qualitative hints of the circumstances surrounding diffusion of birth control, as well as give hints of major value changes that paralleled fertility transition in Costa Rica. (author's)^ieng
Assuntos
Coeficiente de Natalidade , Comunicação , Serviços de Planejamento Familiar , Modelos Teóricos , Dinâmica Populacional , Apoio Social , América , América Central , Costa Rica , Demografia , Países em Desenvolvimento , Características da Família , Fertilidade , Relações Interpessoais , América Latina , América do Norte , População , PesquisaRESUMO
PIP: This article summarizes some results from the 1994 Bolivian Demographic and Health Survey. Mortality declined to 75 deaths per 1000 births for infant mortality for the 5 years preceding the survey. Under-5 mortality declined to 116 per 1000 births. The declines were still not as low as in some other neighboring countries such as Peru and Paraguay. Smaller declines are attributed to low levels of immunization. Only 37% of children 12-23 months old were fully immunized, and some regions had only 25% coverage. 28% of children under 3 years old were malnourished or stunted. Although malnourishment was high, the amount in 1994 was a decline from 38% in 1989. Maternal mortality declined from 416 deaths per 100,000 live births during 1984-89 to 390 during 1989-94. Low levels of maternity care are considered a major cause for the high maternal mortality compared to other South American countries. Only about 50% of mothers received prenatal care or medical assistance at delivery in the 3 years preceding the survey. Fertility declined to 4.8 children per woman in 1994 from 6.5 births per woman in the early 1970s. The mean ideal family size was small, at 2.5 children per woman. Almost 50% of currently married women were using family planning. 18% used a modern method. 22% used periodic abstinence. Almost 25% of married women did not know a modern method of contraception. Although improvements in maternal and child health were evident, there is still room for considerable improvement in the health and well being of this population.^ieng
Assuntos
Coeficiente de Natalidade , Demografia , Mortalidade Infantil , Mortalidade Materna , Mortalidade , América , Bolívia , Países em Desenvolvimento , Fertilidade , América Latina , População , Dinâmica Populacional , América do SulRESUMO
The changes in health conditions that have occurred in most of the countries of Latin America in the second half of the twentieth century are analyzed. "This paper analyzes the main mechanisms involved in the epidemiologic transition, which are: changes in risk factors, fertility decline and improvements in health care technology." The authors use a mortality profile ratio, obtained by dividing the mortality rate due to infectious and parasitic diseases over the mortality rate due to cardiovascular diseases and neoplasms, to analyze trends in 15 countries. "Three distinct groups can be recognized. Each of them represents a different transitional experience. Such experiences are discussed in detail, including a new 'protracted polarized model' of the epidemiologic transition, which characterizes several Latin American countries. Finally, evidence is provided to illustrate the relationship among economic development, fertility change, and mortality profiles." (SUMMARY IN ENG)
Assuntos
Coeficiente de Natalidade , Causas de Morte , Serviços de Saúde , Saúde , Mortalidade , Atenção à Saúde , Demografia , Países em Desenvolvimento , Fertilidade , América Latina , População , Dinâmica Populacional , PesquisaRESUMO
PIP: On June 21, 1994, in Sao Paulo, a meeting took place of reproductive health professionals: service providers, university professors, representatives of nongovernmental organizations, secretaries of health of states and municipalities. They issued a manifesto on reproductive health in Brazil. In view of the preparations for the 3rd International Conference on Population and Development to take place in Cairo in September, 1994, it is hoped that these points will be incorporated into the official platform and in government action plans. Reproductive health is a basic human right. The growth of population decreased in Brazil in the 1980s, yet assistance in the area of reproductive health is still insufficient and unsatisfactory. The population decrease did not result in the improvement of health care and family planning. Maternal morbidity and mortality rates are still high in Brazil, especially in the north-northeastern regions, where it is 10 times higher than the national rate. There are 5 maternal deaths per 100,000 live births in Canada, 8 in the US, and 140 in Brazil. 90% of these deaths could be avoided by routine reproductive health measures. Important causes of infant mortality in Brazil are malnutrition and infectious diseases, which could be prevented by lifting the low socioeconomic level and through vaccination and birth spacing. Although fertility has been on the decline, the fertility of 10-19 year old adolescents has increased significantly, leading to high mortality rates for their infants. An estimated 1.4 million abortions occur per year in Brazil with frequent complications because of its illegal, clandestine nature. It is also estimated that 6-8 million women have been sterilized, which is the primary means of family planning because of the lack of other contraceptive options. The combination of cesarean-tubal ligation operations has been institutionalized in health services, which creates major distortions in the delivery of health care. Sexually transmitted diseases are on the rise, and HIV infections are contracted mainly from sexual intercourse and IV drug abuse. Furthermore, it is absolutely necessary for men to participate in family planning education in order to raise the status of women.^ieng
Assuntos
Aborto Induzido , Coeficiente de Natalidade , Estudos de Avaliação como Assunto , Mortalidade Infantil , Mortalidade Materna , Gravidez na Adolescência , Medicina Reprodutiva , América , Brasil , Demografia , Países em Desenvolvimento , Serviços de Planejamento Familiar , Fertilidade , Saúde , América Latina , Mortalidade , População , Dinâmica Populacional , Comportamento Sexual , América do SulRESUMO
PIP: Although Latin American fertility over the past three decades has been fairly well documented, less is known of pretransition fertility, operationally defined as occurring before 1960. Data shortcomings have limited fertility estimates for these years, especially for population subgroups. This document attempts to reconstruct levels and trends in the total fertility rate for the pretransitional period using census retroprojection. The study was done in rural and urban zones to evaluate the existence of heterogeneity in each country, and in accordance with the availability of census data. Four countries were selected to represent the diversity of observed fertility in the region. Honduras's transition was late, slow, and initiated at a high level of fertility. Even in 1990 the total fertility rate exceeded 5. Costa Rica and Colombia had intense transitions and 1992 total fertility rates of around 3. Colombia had a rapid transition and total fertility rates averaging under 3 in 1990. The general hypothesis of this work is that pretransition fertility varied between and within countries. It was not precisely "natural" fertility inasmuch as the elites practiced some fertility control. Fertility change began when groups practicing fertility control became a majority, starting with the development of the middle class. The estimates indicate that pretransitional fertility in the 4 countries was not higher than the level at the moment when the transition began. Pretransitional fertility was relatively stable through about 1950, with variations in the total fertility rate not exceeding 1 child per woman. The total fertility rates of the 4 countries already differed before the 1950s, calling into question the view of the population of Latin America as uniform and homogeneous during the period. Heterogeneity was not limited to the lower fertility of Argentina and Uruguay on the one hand contrasting with high rates elsewhere in Latin America. Substantial differentials were observed in all 4 countries in rural and urban rates. Only in Honduras were the rural-urban fertility differentials caused almost entirely by differing patterns of nuptiality; in the other 3 countries differentials persisted even after controlling for earlier and more stable rural unions. Mortality declines and increases in fertility apparently occurred in all 4 countries in the 1950s and early 1960s. The secular reduction in fertility began after the increases in all countries studied except Honduras. In Colombia and Costa Rica, the fertility increases during the 1950s were primarily due to changes in nuptiality, but in Chile less than one-fourth of the fertility increase was due to nuptiality change. Part of the fertility increase was also due to improved health conditions.^ieng
Assuntos
Coeficiente de Natalidade , Fertilidade , Casamento , População Rural , População Urbana , América , América Central , Chile , Colômbia , Costa Rica , Demografia , Países em Desenvolvimento , Honduras , América Latina , América do Norte , População , Características da População , Dinâmica Populacional , América do SulRESUMO
PIP: Statistical data describing the dramatic fertility decline and increase in contraceptive usage in Colombia since 1965 are presented in this article. Colombia's estimated crude birth rate, which fluctuated around 45/1000 for the first half of the 20th century, fell from 45 in 1965 to 41.3 around 1968, 36 in 1970, 31 in 1975, 28 in 1985, and 26 in 1990. The total fertility rate declined from an estimated 7.0 in 1960-65 to 6.7 in 1969, 4.5 in the 1973 census, 3.2 in the 1985 census, and 2.9 according to the 1990 Demographic and Health Survey. The most significant fertility declines occurred before 1975, but fertility continues to decline in rural and urban zones and in all regions of Colombia. Some isolated groups of women maintain high fertility. Rural women, women in the Atlantic region, women in consensual unions, less educated women, and those not employed outside the home had higher fertility rates. Marriage age, and important proximate fertility determinant, changed significantly only between 1975-86. Age at first union was around 19 years between 1969-76 vs. 21 years for 1986-90. The median age at first marriage was estimated at 22.1 years in 1976 and 22.8 in 1985. By 1985 the median age at first marriage was 23.4 years in urban areas and 2.2 years lower in rural areas. The causes of the fertility decline have not been precisely identified, although such factors as urbanization, improved health services, increasing educational levels, and female employment are believed to be involved. Colombia's crude death rate has declined from 22/1000 in 1930-51 to 13.5 in 1964, 9 in 1973, and 6 in 1985. The decline has been attributed to improved health conditions, introduction of vaccines and antibiotics, and general development of the medical sciences. The national infant mortality rate was 27/1000 live births in 1990, but elevated levels persist in the marginal areas of large cities, in remote rural areas, and among the least educated. Colombia's fertility decline has partially compensated for the mortality decline, and the rate of natural increase has slowed significantly. Around 1964-65, the Colombian Association of Medical Faculties and the institution that developed into PROFAMILIA began offering family planning services, and in 1969 the national government began offering family planning services through its maternal-child health program. The volume of the Ministry of Health Services has fluctuated considerably over the years in response to political pressures, and the other programs have endured political attacks from diverse quarters. But much of the population has firmly accepted contraception. In 1990, 69% of urban women, 61% of rural women, and 66% of all women currently in union used a method; 14% used pills, 12% IUDs and 2% rhythm, and 5% withdrawal.^ieng