1. health and fitness
2. disease
3. aids and hiv

THE PACIFIC RESPONSE
To The Hague
A
bout fifty delegates from 13 Pacific Island
Countries (PICs) are expected to attend the
International Forum and its parallel meetings in the
Hague on 4-12 February 1999, organised by the
UNFPA in collaboration with the Government of
the Netherlands. These meetings relate to the fiveyear review of the 1994 International Conference
on Population and Development (ICPD) and its
Programme of Action (PoA). This five-year review
process is known as “ICPD+5”.
The Forum will contribute to the review by
focusing on five substantive themes and by
analysing country-level operational and programme
experience in the implementation of the PoA. The
five themes are: creating an enabling environment
for the further implementation of the ICPD PoA;
reproductive health, including family planning and
sexual health, and reproductive rights; gender
equality, equity and the empowerment of women;
strengthening partnerships; and resource flows and
financing for the implementation of the ICPD PoA.
An International Forum of Parliamentarians on
ICPD+5 will be hosted by the Dutch Parliament on
4-6 February. In the following days, on 6-7
February, an NGO Forum and a Youth Forum on
ICPD+5 will be convened.
Pacific island delegations will be led by Ministers,
with one Prime Minister leading his country
delegation. As at the 1994 ICPD in Cairo, the small
Pacific islands will assert a loud voice on issues of
population and sustainable development. At Cairo,
Pacific island countries’ concerns were reflected in
the Port Vila Declaration on Population and
Development which was adopted at the 1993
regional meeting in Vanuatu. In 1999, island
delegates will be guided in their debate on the key
issues by “The Pacific Response to ICPD+5: Issues
and Key Actions from the Pacific Island
Countries”, a 15-page statement adopted at the end
of the Pacific Ministerial Regional Meeting held in
Nadi, Fiji on 23-24 November 1998.
Participants at the recent Ministerial meeting, 23-24 November 1998, Nadi, Fiji, on the pacific Response to the ICPD-PoA
In this issue:
-Integrating STDs/HIV-AIDs in RH programmes
-Developing and testing model 2000 census questionnaires
-ARH: issues and challenges in the Pacific
- Fiji: an analysis of an employment survey
Programme Management Workshop
In preparation for The Hague
Forum, UNFPA organised a
Management
Programme
Workshop on 16-21 November
followed by a Ministerial
Meeting on 23-24 November in
Nadi, Fiji. The primary objective
of the meeting was to review the
progress made and constraints
faced in the implementation of
the ICPD PoA by countries in
the Pacific which are covered by
programmes of
UNFPA’s
assistance from the Suva SubRegional Office (responsible for
14 island countries) and Papua
New Guinea. Another objective
of
the
16-21
November
workshop was to update country
programme managers, executing
and implementing agencies on
the innovations in the UNFPA
development
programme
process including programme
monitoring tools. Presentations
on these subjects were made by
the UNFPA Representative and
National Programme Officers.
The Regional Workshop and the
Ministerial Meeting which
followed were organised by the
Office
of
the
UNFPA
Representative for the South
Pacific. Ms. Uyen Luong,
Deputy to the Director and
Project directors at the Programme management Workshop.
16-21 November, Nadi, Fiji
Chief, East and South East Asia
Branch, Asia and the Pacific
Division, UNFPA New York,
attended both the meetings and
made presentations on the
UNFPA programming process
and on ICPD+5 activities. The
UNFPA
appointed
newly
Representative for Papua New
Guinea, Mr. Birat Simha, and
his NPO also participated in the
Management
Programme
Workshop as a resource person
and presenter.
About 70 participants attended
the Programme Management
Workshop with 40 government
and NGO project managers
representing 14 PIGs. Other
included
participants
Participants concentrating on a presentation at the Programme
Management Workshop 16-21 November, Nadi, Fiji
2 Southpac News
regional
representatives of
intergovernmental organisations
and United Nations agencies.
were
CST advisers
The
requested by the UNFPA
Representative for the South
Pacific, Mr. Jose Ferraris, to
prepare briefing papers on the
key issues and to serve as
facilitators in the working group
discussions. National project
served as
also
managers
discussants in the plenary
sessions.
“The process of
developing population policies should
continue
to
be
encouraged as a
means of building
national consensus
on s t r a t e g i e s t o
address populationrelated issues.
Greater political
commitment is
required to ensure
that these issues
receive the attention they deserve”.
From
the
“Pacific
Response to ICPD PoA ",
24 November 1998, Nadi,
Fiji.
Ministerial Meeting
New UNFPA
Representative, PNG
Plenary, session during the Ministerial Meeting, 23-24 November 1998
Fourteen PICs sent Ministers or
ministerial
representatives to
participate in the second stage
“Ministerial Meeting on the
Pacific Response to the ICPD
PoA” held in Nadi, Fiji, on 23-24
November 1998. The guest of
honour was the Hon. Dr. Apenisa
Kurisaqila, Speaker of the House
of Representatives, Fiji Islands.
UNFPA
Mr. Jose Ferraris,
Representative, Fiji Sub-Regional
Office welcomed the delegates
and
spoke on
the close
partnership developed between
UNFPA and PICs in promoting
the implementation of the ICPD
PoA. He outlined the Pacific
preparations for the ICPD+5
process.
Ms. Uyen Luong, Deputy to the
Director and Chief of the East
and South East Asia Branch, Asia
and the Pacific Division, UNFPA
Headquarters, thanked the
Fiji
for
Government of
collaborating with UNFPA in
organising
this
important
meeting and highlighted the
important events planned for the
ICPD+5
review
process,
especially the forthcoming Hague
Forum and the Special Session of
the United Nations General
Assembly on 30 June - 2 July.
The UN Resident Coordinator,
Mr. Romulo V. Garcia, also
addressed the official opening of
the Ministerial Meeting.
The major outcome of the
Ministerial Meeting was the
issuance of a Communique and
the adoption of The Pacific
Response to ICPD PoA as the
basis of the submission to the
Hague Forum by the Pacific
island country delegations.
Mr. Birat
Simha took
up his
assignment
as UNFPA
Representative for
Papua New
Guinea,
basedin
Port Moresby, in mid-September
1998.
Mr. Simha has 20 years of
experience in the United Nations
system. He has served the last
eight years (1990-1998) as
UNFPA Deputy Representative
in India and then in Pakistan.
During 1984-90, he served as
Programme Officer in the Asia
and the Pacific Division, New
York; in this capacity, he was the
desk officer for UNFPA’s
programme in the Pacific for a
number of years and he had the
opportunity to visit seven of the
Pacific countries on programme
missions.
During 1979-83, Mr. Simha
served as Junior Professional
Officer (JPO) with the United
Nations Development Programme
(UNDP) in Lagos, Nigeria.
Mr. Simha has a MA in
International Relations from the
Patterson School of Diplomacy
and International Commerce at
the University of Kentucky in
Lexington, USA. He holds a BA
degree in Political Science from
Brandeis University in Waltham,
USA. ■
(3rd from left) Ms. Uyen Luong, Deputy to the Director and Chief of the East
and South East Asia Branch, Asia and the Pacific Division, UNFPA, during the
signing of the "Violence Against Women" project agreement
Southpac News 3
POLICY ANALYSIS
Fiji: Analysis of an Employment Survey
During 1995-1997, UNFPA NPO, Mr. House has been
funded a project in the National undertaking analysis of the data
Planning Office entitled: set which includes demographic
“Assistance in Population, and socio-economic information
Workforce Planning and Human on over 8,000 individual workers.
Resources Development Preliminary results show a very
A garment factory in Fiji (Review magazine)
Planning”. Since that time,
UNDP has taken over the funding
of the project which is now
entitled: “Strategic Human
Resources Planning in Fiji”.
Both phases of the project have
been
executed
by
the
International Labour Office.
During the initial project the
CST Adviser in Population
Policies and Development
Strategies assisted the
Government to design a
survey of employees in the
formal sector with the aim of
exploring the relationship
between levels of workers’
productivity, earnings, and
indices of their human capital
accumulation.
Also to be
explored were elements of
gender concentration and
segmentation in the labour
market.
The data were collected by a subcontractor from the University of
the South Pacific and in recent
months, at the request of the
4 Southpac News
high rate of return on investment
in schooling, particularly at the
upper end of the education
spectrum. Speculatively, this
result may well be a consequence
of the extensive emigration of
highly skilled citizens in the
period since 1987. The returns to
vocational training are significant
and underline the need to expand
the intake of underemployed and
unemployed school-leavers into
these training institutions. While
the education system in Fiji has
expanded impressively in recent
years, this has increased the
competition for jobs in the formal
sector, without provoking any
contraction of wage levels. The
analysis shows that occupation,
contrary to neoclassical
assumptions, is statistically
significant in explaining pay
levels, a result typical of an
imperfect labour market. The
public and parastatal sectors also
appear to set their pay scales for
certain kinds of labour regardless
of supply-demand conditions.
This preliminary analysis finds
that women in Fiji’s formal
sector labour market are
markedly concentrated in certain
sectors and occupations and
appear to earn significantly less
than men with seemingly
comparable human capital
attributes.
When the analysis is fully
complete it is anticipated that
these important findings and
consequent recommendations will
be used to enhance the ability of
the Government to promote
strategic human resources
planning
in
Fiji.
Adolescent Reproductive Health: Issues and Challenges in the Pacific
Dr. Praema Raghavan-Gilbert, Adviser on Reproductive Health and Gender
Introduction
The Pacific is unique in that it is a region
characterized by young populations ranging from
18% in Cook Islands to 25% in FSM (1994 Census)
with all the inherent problems embedded in this
characterisation - high dependency ratio, rapidly
changing socio-cultural values & norms, ever rising
aspirations of the young for education, skills training
and employment. The loss of traditional family role
models and parental guidance in sexual behaviour
and sexual behaviour modeling has also contributed
to loosening of attitudes to premarital and unsafe
The sexual behaviour of adolescents is
sex.
modelled increasingly now after their peers, and not
their parents and elders.
Regional organisations and national governments
are cognizant of the consequences of these changes.
MOH and NGO service statistics indicate rising
levels of teenage pregnancy, sexually transmitted
diseases (including Hepatitis B, HIV/AIDS),
suicides, botched abortions, and abandoned newborn
babies. About 15% of all deliveries in the Pacific
Island Countries between 1990 and 1994 were to
adolescent mothers, 60% of whom were unmarried
(UNFPA/CST Sectoral Review, 1996).
vouth of the Pacific is invested the future of all the
Pacific Island Countries.
Issues
In the past, adolescents were largely neglected in
both health and family planning programmes. This
is partly explained by the fact that in many societies
adolescents are not considered sexual beings until
marriage. Another factor in this systemic neglect is
the unfounded fear that providing information and
services would encourage premarital sexual activity.
As a result, unmarried adolescents have been denied
access to services by law or written or verbal policy.
And yet, young people’s reproductive health needs
require urgent consideration, as indicated by recent
global trends.
A policy framework directed to the
removal of barriers, such as age and
marital status, to the provision of
information
and
services
for
adolescents needs to be formulated
in almost all countries. From "The pacific
Response to ICPD PoA " 24 November 1998, Nadi. Fiji.
ADOLESCENT MOTHERS BY COUNTRY AND YEAR
Country
Cook Islands
% Deliveries to
Adolescent Mothers
19
Fiji
11
FSM
Kiribati
Marshall Islands
9
6.5
21.0
Nauru
N/A
Niue
8.5
Palau**
6.5
11.3
Papua New Guinea
Samoa
4.5
8
Solomon Islands
1.9
Tokelau
4
Tonga
3
Tuyalu
Vanuatu*
10-12
Source: [Katoanga, S.F. UNFPA/CST]
*Source: [Watson (WHO), 1997:5)
**Source: Ministries of Health Reports
Year
1992 (Reduced
to 14% in 1994)
1990
1994
1994
1993 (Reduced
to 14% in 1996/
1997)
1994
1996
1991
1991
1995
1994
1994
1994
1994/95
The picture is depressing for all who work in
adolescent health care because in the future of the
Young people need comprehensive information and
access to services and to have the right to privacy,
confidentiality and respect. When young people
have access to private and confidential services, it
as been demonstrated that they are better able to
protect themselves against sexually transmitted
diseases (STDs), avoid unwanted pregnancy, care
for their reproductive health and take advantage of
educational and other opportunities that will affect
their lifelong well-being.
Fear that access to
(formation and service: will lead to greater sexual
activity among youth, has not been supported by
numerous studies.
Actions taken during adolescence can affect a
person’s life opportunities, behavioural patterns and
health. The loss of human capital in the next
generation of Pacific Islanders through the abrupt
and premature curtailment of educational and
employment opportunities, aspirations, chronic ill
health and premature death is enormous. From a
national perspective, these exposures to health risks
are costly. There are expenditures directly
Southpac News 5
associated with both childbearing and disease, and
indirect costs incurred when the full potential of the
individual is not realized. Moreover, early
childbearing generally leads to higher lifetime
fertility for the individual women and to a reduction
in the time-span between generations. Governments
and civil society cannot continue to ignore these
losses citing custom, religion and taboo as the
impeding factors.
Biologically, socio-culturally and economically the
adolescents of today are different from the youth of
30 years ago. Their bodies mature earlier, they
marry later, have increased opportunities for
opposite – sex interactions and relationships, the
‘outing’ of homosexuality and a greater tolerance in
society of sexual preferences, the globalization and
influence of role models projected throughout the
media, and increasing diffculty in finding good jobs
in a market with moving targets. Adolescents also
live in a more dangerous world with deadly and
debilitating diseases like HIV/AIDS, Hepatitis B
and Herpes.
Adolescents have a diversity of personal and health
needs. These vary with their special life situations
e.g. marital status, sexual activity status, single
motherhood, experience of abuse and rape, street
children, commercial sex workers and adolescents
with special educational and physical needs and
diseases. All have needs that must be approached in
different ways.
It is therefore important to
understand adolescent sexual and reproductive
health in the context of the individual’s overall life
situation. There are no generic solutions.
The role of the proximal social influences such as
parents’ attitudes to sexuality, marital and child
rearing behaviour, religious and educational and
work experience of parents, and the attitude of peers
to premarital sex, contraception
and safe sex practices must be
considered in programme
design.
essential for successful programmes.
Challenges in Adolescent Reproductive Health
Healthy adolescent development is undermined by
factors in the social environment. These include
poverty and unemployment, gender discrimination,
and the impact of social changes on familial and
cultural support systems. While programming for
adolescent health cannot directly focus on the
inequities present in countries, these conditions
represent real constraints to improving the health
and welfare of youth. The attitudes and behaviours
that health programmes seek to influence often arise
from other socio-economic influences. For this
reason, adolescent reproductive health programming
must be integrated with all aspects of social
development.
There is a lack of formal knowledge through
research about adolescence in the Pacific and
therefore about the needs of the different groups.
Without this information, it is difficult to design
effective programmes o reach all adolescents,
except through their active involvement Little is
known, except for anecdotal information about
relationships with their parents and elders in
societies where traditions and customs are fast
evolving as in the Pacific Island Countries.
Commonly held myths and misconceptions, both
generic and specific to the Pacific culture about
sexuality will need to be addressed. The role, level
and quality of communication in the Pacific between
the adolescents, parents, church and school will
need to be better understood and addressed in
information and counselling services.
Male
involvement and responsibility for safe and healthy
sexual behaviour and attitudes will need to be
studied.
(Cont. on p 10)
The distal social influences
related to the prevailing youth
culture, adult and media models
of sexual behaviour, and the
social institutions of school,
religion and law are important
formative environments that
cannot be
in
excluded
programmes designed to reach
adolescents.
A
holistic
understanding of ARH needs is
A group discussion during the Programme Management Workshop
6 Southpac News
Developing and testing model 2000 census questionnaires
Laurie Lewis, Adviser on Population Statistics
Background
Development and Testing of Model Forms
The post-ICPD shift away from priority support to
national censuses to RH, brought with it the need
for more innovative approaches to strategic
planning and funding for the 2000 census round in
the Pacific. During the 1990 round, the Caribbean
islands had developed a cooperative approach
toward the design and processing of censuses
which we in the CST felt might have some
application to the Pacific. Without much success,
we tried to gather information on the achievements
and failures of this exercise. Nevertheless, for the
Pacific, we thought a start could be made through
the convening of a regional meeting of heads of
statistics to apprise them of the current UNFPA
position and to develop a more rational pan-Pacific
approach to census-taking, one that would help
make better use of the scarce human and financial
resources available to the island countries.
At the meeting, the representative of the Australian
Bureau of Statistics (ABS) offered its services to
develop draft forms.
To support work on
developing draft forms, conducting field tests in the
Pacific, printing and distribution of model forms,
and convening an Expert Group to consider further
directions and activities for the regional approach,
the UNFPA Sub-Regional Office in Suva provided
some funding.
To date development is on target. Using ABS
facilities, a draft was prepared in Canberra early in
June. Four field tests have since been conducted by
the CST Adviser on Population Statistics.
The Samoa Pre-Test
The first pre-test of the draft model census
questionnaire was carried out during 11- 15 August
With financial assistance from
UNFPA and collaboration with
Nations
Statistics
United
Division, the Secretariat for the
Pacific Community (formerly
South Pacific Commission),
and the University of the South
Pacific, a Meeting on Strategies
for the 2000 Round of
and
Housing
Population
Censuses in the Pacific was
held in Nadi, Fiji in December
1997.
The 17 national statisticians or
Some of the participants during the Meeting on Strategies for the 2000
their representatives attending
Round of population and Housing Censuses, Nadi, Fiji. December 1997.
this meeting drew up some very
in Samoa, a Polynesian country. The intention was
far-reaching recommendations on how to maintain
to
test the draft questions, particularly their word
the momentum the meeting had provided and
order and the ease of translation into the local
pursue a more regional approach to census taking.
language. For the fieldwork, two areas were
For the CST the most important of these
selected,
one urban (in Apia), the other rural (in
recommendations was that the UNFPA/CST should
northwest
Upolu).
Twenty fieldworkers were
model
population
and
housing
develop
i
n
s
t
r
u
c
t
e
d
t
o
t
a
k
e
n
ote of any problems
questionnaires for the 2000 census round. In its
encountered,
either
in
the English or Samoan
consideration of a CST paper on population and
version
of
questions.
In
all, about 400 interviews
housing census questions/topics, the meeting
were
completed.
Following
the pretest, an open
approved core topics for inclusion in the 2000
discussion
was
held
to
reflect
on some of the
round, and it was felt these would provide the basis
diffculties
experienced
in
the
pretest.
for the models.
Southpac News 7
These fell broadly into three groups: those exposing
problems in the wording or order of the draft
questions that would lead to amendments to the
model questionnaires; those that were of a local
character that would lead to a departure (for
Samoa) from the model questionnaires; and those
dealing with other aspects of design, including
provision for write-in responses, codeability of
responses and issues relating to the use of the
questionnaires for direct key entry.
Second Pre-test in Vanuatu
Capture of responses, coding and appropriateness
of the forms for data entry were tested in Vanuatu,
a Melanesian country, in late September. It was
also necessary to test some of the modifications
made to the models as a result of the first pre-test in
Samoa. Moreover, ‘the mission provided a useful
opportunity to test the questions in a more complex
social setting, using the three lingua franca with
translations into some of the local languages. In
particular it was important to test the changes made
to the economic activity questions. Following the
Samoa test, a separate question on work in
agriculture and fishing was added, designed to lead
into a more detailed classification of agricultural
occupations and to capture in the labour force
women (and sometimes men) who shared their time
between home duties and unpaid agricultural work.
As a result of these tests, and some informal work
in PNG, a large number of modifications were
made to the forms at the ABS, where the model
tiles are housed on Pagemaker format.
Pre-census testing in the PNG highlands
8 Southpac News
Final Tests in Micronesian Countries
Final tests of the forms were made in Kiribati and
the Marshall Islands in October, ensuring relevance
to all Pacific sub-regions and ease of translation
into most of the many Pacific languages.
The third pretest in Kiribati provided the
opportunity to undertake useful experiments in data
preparation and data entry. In the longer run it is
reasonable to assume that scanning technology will
be available in the National Statistical Offices in
the region, and even more reasonable to believe
that it could be available in some way to support
the regional 2000 census programme. However,
while this prospect will clearly influence the
approach taken, it has not been feasible to consider
the efficacy of such technology during this pretest.
The “booklet” design (containing the housing
questionnaire and provision for up to six personal
interviews) had rated highly in the earlier pretests
for its convenience as an instrument for
interviewing. This Kiribati test provided an
occasion to consider the strengths and weaknesses
of the forms for coding and data entry. Following a
short training period, five staff of the Statistics
Office conducted 30 interviews each in various
parts of the main island of South Tarawa. This
fieldwork served three main purposes : it provided
batches of real data for coding, data preparation and
entry operations; it provided an opportunity for the
statistical staff to become familiar with the
structure of the questionnaire; and it permitted a
final review of the questionnaires as instruments for
conducting interviews and recording data
The interviews proceeded smoothly with few
problems related to the questionnaire itself.
However, a few changes were proposed in the
presentation of pre-coded questions and some of
these were incorporated into the next version. One
such example is the question on date of
construction of the housing unit. This has been
difficult in several of the countries in which tests
have been conducted, and space permitting, precoded response categories such as less than 1year,
1-2 years, 3-4 years, 5-9 years and more than 10
years, will be substituted. Additionally, several
comments in the discussions that followed related
to the inappropriateness of some of the response
categories for Kiribati, e.g. for religion. It is
recognized that the structure of some variables,
including administrative geographic units and
religion, will vary from country to country. The
inclusion of response categories for such questions
is intended to provide only a notional set to
facilitate the construction of the model forms.
From the work done in Kiribati, it appeared that the
booklet style of forms was well-suited to data
reporting, recording, coding, and control. The
approach does present some difficulties for direct
data entry, but these can be mitigated through the
use of special code sheets. Other options include
alternative data entry software and scanning, but
these were not considered during this round of
pretests.
In any case, any model system developed should
contain sufficient flexibility to enable countries to
easily adapt model versions to suit their own needs.
To illustrate this point, an individualised version of
the model forms is currently being developed and it
should be possible in time to expand the option still
further.
The very small staff at the Office of Planning and
Statistics (OPS) in the Republic of the Marshall
Islands (RMI) limited the amount of work possible
on the models.
Fortunately, the three earlier
pretests had gone far in resolving the major form
development issues and my concerns in RMI were
not crucial. In the Kiribati test in the use of code
sheets, it was felt that a further streamlining of
processing could be achieved if the responses were
coded directly to code sheets, eliminating the need
to enter codes onto the actual questionnaires. The
adviser thought it would be useful to test this
proposal in RMI. To run a small test the OPS staff
completed a number of interviews. The completed
forms were coded, some directly to code sheets,
others onto the questionnaires. Direct coding to
code sheets did seem to reduce overall time, though
no conclusion can be made from the small trial; the
writer believes that the risk of introducing error
cautions against the adoption of this practice. In
any case, the results confirmed the Kiribati findings
that the use of code sheets facilitated data entry.
More importantly, the visit to the RMI provided a
useful opportunity to compare core questions on the
models with standardized census forms developed
by the US Bureau (USB) of the Census for use in
the former US associated States and the so-called
insular areas. A number of these entities, the
Commonwealth of Northern Mariana Islands, the
Federated States of Micronesia, American Samoa
and RMI, had been represented at the Nadi census
strategy meeting and had supported the idea of
model questionnaires for the entire Pacific region.
Model Census questionaire
It would be useful to see the extent to which the
core questions included on the two sets of forms
could be reconciled.
The broad comparison is shown below. The good
news is that most of the questions included on the
Pacific region models are also included on the USB
models. However, the special emphases given to
more precise measurement of fertility and
mortality, and subsistence/market orientation and
women’s unpaid work in agriculture are not
properly reflected in the USB model.
More
generally, the USB model forms appear far too
lengthy and too complex for the Pacific
environment. This comment applies especially to
RMI, given the shallow resource base and the
shortage of time to plan and prepare for the census,
and to recruit and train fieldworkers. In both 1981
and 1988, the censuses were clearly deficient in a
number of respects related to both coverage and
content. There is little doubt that if the forms were
overloaded in detail, under-coverage would occur
and the quality of the key statistics would suffer.
Moreover, the shift from a de jure census in 1981
to de facto in 1988 has affected comparability. The
Pacific model is designed on the assumption that
countries will be adopting a de facto approach to
their 2000 census round, although this assumption
is in no way intended to suggest that this approach
is well-suited to all countries. The USB model, in
contrast, is based on usual residence and it is worth
noting that if adopted, the change would introduce
further problems of comparability with the last
census.
Southpac News 9
Comparison of the number of questions
included on the insular areas models for the US
Bureau and Pacific region
Form type
Cover page
Housing
Personal
TOTAL
Model
Pacific
USB
2
2
8
38
53
33
43
93
Matched
questions
2
7
25
34
The adviser’s recommendation is to use the Pacific
models for the core items, since this would give
RMI most of what a census should provide and, at
the same time, promote regional standardization.
Additional questions could be added, but this
should be done sparingly and only after meetings of
the census technical and user committees, both
properly briefed on the costs and dangers of being
over-ambitious.
An Expert Group meeting of selected Pacific island
countries, regional organisations, and multi- and
bilateral donors is proposed to follow the final
testing programme, allowing some time to consider
comments on the drafts, to allow ABS to make
further amendments, and to print and distribute
quality copies of the model questionnaires.
Already, a number of achievements have been
observed. Close cooperation among the island
nations of the Pacific, despite large variations in
size, economic development and census history is
clearly the most important. The acceptance almost
overnight of statistical standards consistent with the
recommendations of the UNSD and Regional
Commission will also go far to contribute to
strengthening of Pacific statistical services. A good
illustration is the impetus this work gives to the
discussion of the creation of a common database for
use by all UN agencies under the UN Resident
Coordinator System. Other recommendations of the
December 1997 meeting, for example the call for
common software for census data processing and
the development of a common tabulation plan, will
all start from the model questionnaires.
Many questions remain to be answered on the
future of the regional initiative. One of these being
posed by countries participating in the testing
programme, for example, relates to the facility that
the regional programme will provide to map from
the model to national questionnaires, to take
account of local variations and provide options.
The proposed Expert Group could address these
questions
and
establish
more
permanent
institutional arrangements for development and
technical assistance. It will also be necessary to
consider the addition on non-core questions or
topics in a way that would not contravene the
principle of regional standards. This will
necessarily involve considerations of related
technical issues such as the creation of a common
data directory, standards for coding, editing, data
entry, tabulations and analysis. It will also require a
huge input for documentation of procedures and
preparation of manuals.
There is a long way to go in ensuring a regional
strategic approach to the 2000 censuses and
beyond. But a great start has been made.
Adolescent Reproductive Health: Issues and Challenges in the Pacific
The judgmental attitudes of the service providers
and the provision of adolescent friendly services
within existing health structures will need to be
assessed and addressed as should the design and
implementation of youth friendly service delivery
points.
In many countries, governments will need to
demonstrate commitment to the ICPD PoA on
Adolescent Reproductive Health by legislation and
policy changes which clearly state that adolescents
are entitled to Adolescent Reproductive Health
information and services both as a human right and
as a commitment to investing in their human capital.
10 Southpac News
(Cont. from p 6)
Since little is known through research on the
complexity of issues facing adolescent reproductive
health behaviour in PICs., it is crucial that young
people be involved throughout the different phases
of programming from needs assessment to
evaluation. Advocacy efforts to convert and recruit
influential members of the community to push for a
multi-sectoral approach to
link education,
employment and health of the adolescence of the
PICs must be unrelenting. ■
Extracted from the paper presented at the UNFPA Programme
Management Workshop, 16-21 November 1998, Nadi, Fiji.
INTEGRATING STDS/HIV-AIDS IN REPRODUCTIVE HEALTH
PROGRAMMES AND SERVICES
Dr. Salesi Finau Katoanga, Adviser on Reproductive Health (Programme)
Why Integration?
The ICPD PoA’s concept of promoting and
implementing STDs/HIV-AIDS programmes in
integration with other major components of RH
care programmes and services in the context of
primary health care (PHC), is fully endorsed and
supported by all Pacific Island countries (PICs).
The PICs’ overwhelming support of this concept is
based on several favourable factors including the
following: every PIC has a sound and operational
health care system and a functional PHC system;
integration will shift the STDs/HIV-AIDS
programmes from specialised clinic-based to a
more holistic and cost effective approach especially
Participants at the Programme Managemet Workshop during
at the PHC level; several components of RH care
such as family planning, maternal health care (safe
motherhood) child health care, human sexuality are
already integrated and they all have similar target
groups as those under the STD/HIV-AIDS
programmes; employment of trained multi-purpose
health care providers should be more cost effective
than under the vertical programmes; better
utilization of facilities, equipment and supplies;
integration can reach more people especially
women adolescents and youth on STDs/HIV-AIDS
and screening
education and information;
programmes for STD/HIV-AIDS, breast and
cervical cancers, and infant care and safe
motherhood could be provided under ‘one clinic’.
Limited success
Inspite of the presence of favourable factors that
should have enhanced the move to integrate
STDs/HIV-AIDS with other major components of
RH care programmes and services, the progress has
been very slow and not as successful as expected in
several Pacific Island countries.
The PICs’ commitment to the promotion and
implementation of the integrated approach as per
ICPD PoA recommendations is unwavering. Every
PIC is striving to operationally change its
programme from the narrow spectrum of MCH/FP
to the wider domain of RH care programmes and
services. Training of multi-purpose RH care
providers has started in most PICs. The
introduction of the ‘syndromic management
approach’ has enhanced the integration of
STDsHIV-AIDS programmes
with family planning, MCH,
infertility, management of the
consequences of abortion and
infant care at the PHC level.
the
The
programme on
prevention and control of
been
STD/HIV-AIDS has
successfully integrated with
other components of RH care
in terms of information,
education and communication
(IEC) programmes in all PICs.
a group session
Co-ordination among donor
agencies and partners on RH is
more visible. STDs/HIV-AIDS services are
available at MCH/FP clinics/centres/hospitals at the
Secondary/Tertiary levels. In this respect, a client
can receive maternal care, screening and treatment
for STDs/HIV-AIDS as well as cervical and breast
This is,
cancer screening under one clinic.
however, confined mainly to the urban centres.
Constraints and barriers
There are major constraints hindering progress in
integration. The term ‘integration’ is interpreted
differently from country to country, leading to
some difficulties in understanding and slowness in
implementation. For example, most PICs’ health
services are organised into secondary and primary
health care levels (with very limited tertiary levels).
Each level has a distinctive function in terms of
policy setting, planning, budgetting, provision of
services etc. As such, the application of the term
Southpac News 11
integration in terms of administration, management
and service delivery varies. Certain coordinators of
individual programme such as MCH, FP, STDs,
HIV-AIDS may be reluctant to integrate for fear of
losing authority. Training of multi-purpose RH care
workers is not as easy and inexpensive as
previously thought due to the wide range of staff
capability and skills especially at the PHC level.
Unforeseen increased workload of multi-purpose
staff has already led to demands for monetary
compensation. On the other hand, the increased
workload could also affect the quality of services.
The need to train more specialized staff at
secondary/tertiary levels is still substantial.
Refurbishing and upgrading of facilities and
equipment will cost more. The RH needs of
adolescents/youth are still neglected in some PICs,
even under the umbrella of integration.
Stigmatization of MCH/FP services if associated
with STDs/HIV-AIDS still exists in some PICs.
Men are still reluctant to patronise the programmes
like MCWFP and STDs to acquire condoms.
Commitment to prioritization of the major RH/FPSH issues of concern is still weak in some PICs.
This leads to slow progress in the operationalisation
of RH/FP-SH key components and subsequently
the integration of services. Trained staff on STDs
syndromic management are either prevented by law
from carrying out this activity or not provided with
appropriate supplies.
Disappointingly, in some PICs, HIV-AIDS
programmes are not folly integrated with STDs.
Some policy makers still argue that both vertical
and integrated RH care programmes/services do
have specific roles to play, hence, they should both
be adopted. Commitment by PICs to change the
current programme from MCH/FP to RH/FP-SH
has been officially effected in only one country.
The way forward
A clear understanding of the term integration in
relation to management, administration and service
delivery, and its application to the local condition
is
essential.
and environment
absolutely
Furthermore it must be noted that integration is not
a strategy to fall back on when vertical programmes
run out of funds or are unsuccessful. Government’s
support to amend health policies and acts to
accommodate the necessary changes associated
with integrated RH/FP-SH services should be
strengthened. Operational research is essential to
assess the factors for failure or success in
integration efforts. The results should be used to
design new integration strategies to further improve
the quality of integrated services, multi-purpose
staff training, etc. It is important to reduce the high
turnover of RH care providers, especially the
specialists.
The PHC infrastructure must be
strengthened. It will make integration easier if RH
care components are carefully and realistically
prioritized and operationalized incrementally. The
roles of the staff under the integrated programmes/
services must be clearly defined, bearing in mind
that some will be more informed and skilful in
STDs/HIV-AIDS, while others on MCH/FP, etc.
As such, they should be encouraged to support and
complement each other. The STDs programmes
must be fully integrated with HIV-AIDS in all
aspects as a necessary condition for integration
with other components of RH care programmes.
Cooperation must be strengthened among the key
stakeholders. The RH needs of men, women and
adolescents/youth should be given equal attention
under the integrated programmes.
Perhaps the biggest challenge is to integrate the
budgets along with programmes and services.
From first hand observation and experience, when
the budget is amalgamated or
integrated, the programme is
also easily integrated. Thus,
everything from planning to
evaluation, from budgeting to
acquisition of equipment/
supplies, from training to
provision of services, etc.,
should progress as designed
and expected.
Expanded from the paper presented
at
the
UNFPA
Programme
Management Workshop. 16-21
November 1998, Nadi, Fiji,
Programme Managers at the Programme Management Workshop
during a group session
12 Southpac news
Technical Support Activities – In Brief
Papua New Guinea
Dr. Praema Raghavan-Gilbert,
Adviser on Reproductive Health
(RH) and Gender visited Papua
12-16
New Guinea from
October. The mission’s three
components were: first, to
provide technical assistance to
UNFPA
and
DOH
in
strengthening the operationalization of the AusAID Women &
Children project by exploring
areas
of
collaboration
particularly in family planning,
and to mainstream gender
concerns in RH services.
on "Quality of Care and
Gender" at the National
Workshop for senior nursing
supervisors
from
all
ten
provinces.
During the second week, the
a participant
Adviser was
observer and assessor at a fiveday Adolescent Reproductive
Health Training Workshop
conducted by the Regional
Training Project of the Fiji
School of Medicine for nursing
educators from Solomon Islands
and Vanuatu.
Tonga
Second, working with the key
women’s organisations in PNG
to reach a consensus on
sensitizing men to gender issues
and to improve the quality of
male involvement in RH. The
last component was to provide
the women’s organisations with
a more structured approach to
achieving these goals in their
programme activities.
Samoa
The
Adviser
on
RH
(Programme). Dr. Salesi
Katoanga, was in Samoa from
24 August to 4 September to
assist in the UNIFEM sponsored
workshop on “Gender
Awareness. Analysis and
Strategic Planning ",
The purpose of the mission of
the Adviser in RH (Programme)
to Tonga was to serve as a
resource person in the “Ninth
South Pacific Nurses Forum
Conference" held at Nuku'alofa,
Tonga, from 17-21 August 1998.
The forum organized and hosted
by
the
Tonga
Nurses
Association was Officially
opened by Her Majesty Queen
Halaevalu Mata’aho of Tonga.
Vanuatu
In a joint mission, the Adviser
on RH and Gender and Adviser
in RH (Programme) were in
Vanuatu from 25 to 31 July to
provide technical assistance to
the MOH in finalizing the
project document as per the new
UNFPA guidelines for WHO
endorsement and processing for
approval by the UNFPA Field
Office.
The Adviser on RH/Gender also
conducted two short training
sessions on key issues relating to
quality of care from a health
management perspective.
*******
Mr. William House, the Adviser
on Population Policies and
Development Strategies, was in
Vanuatu from the 6-13 October
1998, to provide assistance in
revising a draft population
policy document for submission
to the Population Board.
The Adviser also presented his
analysis of the Vanuatu KAP
for
Survey
“Prospects
Demographic Change in
Vanuatu the Results of a KAP
Survey , at the Club Vanuatu
before a large audience of over
40 persons, with participation
from
representatives
of
Government, NGOs, donor
agencies and the Churches.
Solomon Islands
The Adviser on RH and
Gender undertook a mission
to the Solomon Islands from
25 October – 8 November.
The first week of the
mission had two objectives:
familiarization with RH and
Gender programmes, and
serving as a resource person
Women in the Highlands in Papua New Guinea
Southpac News 13
Population Advocacy
World Population Day
During her opening remarks at the World Population
Day celebration, at the Soqosoqo Vakamarama
(Women’s Association) headquarters in Nabua,
Suva, Fiji, on July 10 1998, the First Lady, Her
Excellency Adi Lady Lala Mara, acknowledged
UNFPA’s support towards the Women’s
Association’s family health promotion programme.
As a result, the health promotion programme has
expanded coverage to all provinces and included a
broader perspective of reproductive health.
Adi Lady Mara during the celebration of the World population
Dr Lepani Wakatakirewa on behalf of the Ministry
for Health, highlighted the improvements in the
health system in Fiji due to technical assistance and
support of UNFPA.
SOWP Report Launch
Suva, Fiji
The Honorable Dr. Apenisa Kurisaqila, Speaker of
the House of Parliament of Fiji, officially launched
the 1998 State of the World Population Report at the
Centra (Suva) Hotel on the 2 September 1998 with
Mr. Jose Ferraris, UNFPA Representative for the
South Pacific.
The launch was preceded by the presentation of
prizes by Mr. Kolinio Rainima Meo, Deputy
Permanent
Secretary,
Ministry of Education, to the
winning entries in the essay
competition on adolescent
reproductive health. The
essay competition was
organized by the UNFPA
Field Office during the World
Population Day. In his
address, Dr. Kurusiqila called
on Pacific Island leaders and
decision makers to promote
policies that will meet the
challenge of creating an
enabling environment in
which all generations can
make informed choices and
free decisions for themselves.
Day, July 1998
while ensuring participation
of both the young and the
elderly.
Apia, Samoa
In his remarks, during the launching of the UNFPA
State of the World Population Report in
Samoa, the Minister of Health, the
Hon.
Misa Telefoni, emphasized the
Mr. Stephen Chee, Director of the UNFPA CST,
represented the Executive-Director of the United Nations importance of cultural concepts of
Population Fund (UNFPA) in the first-ever launch of the Faitama (caring for youth) and
State of World Population Report in Sydney on 2 Faimatua (caring for the aged). He said
September. The event was organized by the United that young people who care for their
Nations information Centre (UNIC), Sydney, and jointly parents are also cared for by their
hosted by the Australian Institute of International Affairs, children when they become old. The
minister also stated that the country had
New South Wales Branch.
recently adopted a national policy for
the
aged. Present at the launching
The Director also visited Canberra to introduce the
ceremony
were Mr Luke Mataiciwa,
SOWP Report to strategic groups, and to brief them on
National
Programme
Officer and Dr:
the work of the Country Support Team in the South
Salesi
Katoanga,
CST
Adviser on
Pacific.
Reproductive Health (Programmes).
14 Southpac News
IN BRIEF
CST Internal Seminar
On 7-9 December 1998, the UNFPA Country
Support Team for the South Pacific held an internal
technical workshop. The focus of the workshop
was on management of reproductive health
programmes in small Pacific island countries in the
post ICPD-period.
Discussions during the two and a half days centred
on 3 main issues in managing RH programmes in
these island countries, namely constraints and
challenges; operationalization of reproductive
health programmes and development of an enabling
environment for RH programmes.
On 26-30 October 1998, the Adviser on Population
Policies and Development Strategies participated in
the Thematic Workshop: “Population, Poverty and
the Environment” at the FAO Headquarters in
Rome. Its objective was to assist TSS and CST staff
to identify the programming implications of the
complex array of linkages between population
trends, the incidence of poverty and environmental
degradation, and to deal with such implications in
programme and project design as well as technical
assistance.
******
The Adviser on Reproductive Health (Programme)
and the Adviser on Population
Advocacy and IEC, attended a
thematic workshop entitled
Applications
of IEC and
Advocacy to Reproductive
Health which was held in
Geneva on 26-30 October for
TSS specialists and Country
Support Team Advisers.
*****
(Rigth) Mr. Azfar talking about "Population, Poverty
during his public lecture
Visiting resource people included Ms. Marilyn Rice
WHO/TSS Health Education and Promotion
Specialist and Mr. Azfar Khan, TSS Specialist in
Urbanization
and
Migration,
Population
Distribution based at ILO Geneva. On 8 December,
Mr. Azfar gave a public lecture on “Population,
poverty and employment”attended by 30 peop1e.
*****
Thematic Workshops
The Adviser on Reproductive Health & Gender was
in the United Kingdom from 6-18 September 1998
to attend the Reproductive Health Programme
Evaluation Course conducted by the Institute of
Population Studies at the University of Exeter. The
primaly objectives of the course were to strengthen
the knowledge and skills of the participants in
evaluating RH programmes and to increase
understanding of the role of evaluation in RH
programme development.
******
On 14-18 December, 1998, the
Adviser on RH (Programme)
participated in a ‘Design
Workshop for a Distance
and Employment"
Learning
Module
On
Reproductive Health Including Family Planning
And Sexual Health ‘. The workshop was organized
by Mr. Amfinn Jorgensen-Dahl, Principal
Programme Development Officer at the UN Staff
College, International Training Centre of the ILO at
Turin, Italy.
*****
IMPS Workshop
The UN Statistics Division organized a training
workshop on the IMPS software in Suva for 23
Pacific Island country census and statistics
department personnel from 14 countries from 29
June-17 July.
Mr. Yacob Zewoldi and Mr. Carlos Ellis of the
UNSD sewed as resource persons for the
workshop. Other resource persons included Mr.
Michael Levin (US Bureau of the Census), Mr.
Nuri Ozsever (Adviser on Population Data
Processing and Data-base Management, UNFPA
CST, Bangkok) and Mr. Laurie Lewis (Adviser on
Population Statistics, UNFPA CST, Suva).
Southpac News 15
Ni Sa Moce, Laurie!
Mr. Laurie Lewis, the Population Statistics Adviser,
retires from UN service on 31 December 1998.
Retirement or separation from service...these are
unwelcome words not only to the CST but also to
Pacific Island programme countries at this time.
Unwelcome to the CST because Laurie retires from
service at a critical juncture when his expertise will be
in great demand for the 2000 Round of Censuses in
the Pacific island countries. He has devoted over 35
years in providing technical assistance in census
activities to more than forty developing countries
throughout the Asia and Pacific region, first for 10
years as a Statistician with the Australian Bureau of
Statistics, then during 1981-1993 as UNFPA/ESCAP
Regional Adviser in Population Censuses and
Surveys, before being re-located to the Suva Office of
the UNFPA Country Support Team as Adviser on
Population Statistics since April 1993. In between, he
had variously taught at the University of Papua New
Guinea as Associate Professor in Demography, served
as a consultant to the World Fertility Survey, and
worked for the World Bank in Bangladesh.
During the 18 years he served in the Asia and the
Pacific region, in the United Nations system, Laurie’s
special contribution has been in the planning, analysis
and utilization of population censuses and surveys.
His
experience
and expertise in
census activities
are
widely
acknowledged by
national statistical
His
offices.
knowledge of data
collection
and
census systems in
the Pacific island
is
nations
unequalled.
Mr Lewis with his Medal of
Merit of Vanuatu
In September 1998, Laurie was awarded the National
Medal of Merit of Vanuatu by the President for his
contributions to the nation over the past thirty years,
in supporting capacity building in population
statistics.
Laurie’s professional life is not likely to stop with his
retirement from UN service. The Director and Staff of
the UNFPA Country Support Team wish him even
further glorious achievements and satisfaction in his
future endeavours.
Farewell, Laurie!
New PAIEC Adviser
Ms. Susan Aradeon joined the CST in October
1998 as Advisor on Population Advocacy and
Information, Education and Communication
(PAIEC).
Although Ms. Aradeon is an American, she has
lived and worked most of her adult life in Nigeria.
She first worked in Nigeria as a Peace Corps
Volunteer in a teacher training college for girls.
Later she returned with her Nigerian husband to
teach at the University of Lagos. In the late 1980’s,
she changed to a career in international consulting
and programme management in the reproductive
health area, working on a number of USAIDfunded projects and with the Management Sciences
for Health and Planned Parenthood Federation of
Nigeria.
She returned to New York in late 1995 and
undertook advocacy and IEC proposal and project
evaluation consultancies
for UNFPA and the
International
Planned
Parenthood Federation.
In 1997 she worked in
Papua New Guinea with
the
Curriculum
Development
Division
(CDD) of the Department
of Education on the start-up of the Population
Education Project, for six months, under the
auspices of UNFPA and then for an additional two
months with the support of the PNG Government’s
World Bank funding for education.
Ms. Aradeon has a BA from Smith College in
Massachusetts, an MA from Columbia University
in New York, and a PhD from Ahmadu Bello
University in Nigeria. n
REPRODUCTIVE RIGHTS AND REPRODUCTIVE HEALTH
The Right to Choose
The State of the World Population 1997 Report of the
United Nations Population Fund (UNFPA), titled “The
Right to Choose: Reproductive Rights and Reproductive
Health”, highlights a topic that touches the lives of
everyone on the planet. This Report was launched
worldwide, silmutaneously in a number of cities by senior
UNFPA officials, on 28 May.
awareness that reproductive rights are an integral part of
human rights, and that laws and policies must he
strengthened and better enforced so all people can ernjoy
sexual and reproductive health and free choice’.
In the Pacific. we are justifiably proud of achievements
efforts
in social of
development. By some standard measures, wellbeing is relatively high compared to many developing
countries in other regions. Absolute
poverty
and
deprivation
are
comparatively unknown. Social
indicators of human development have
attained respectable levels in many
countries of the Pacific sub-region due
to the commendable
Governments, non-governamental
organizations (NGOs), and the donor
community. But is there reason for
complacency’?
There are threats to the prevailing
levels of real welfare. High natural rates
of population growth are exerting
In this issue
The New Generation : their Right to Choose
"Reproductive and sexual health is a right for both men
and women', the report begins. At issue are the rights of
all people to enjoy the best possible sexual and
reporductive health, and to b free to make their own
decisions about sexuality, marriage and childbearing.
Thus, 'a key aim of this year's report is to increase global
(Photo: Fiji Times)
intense pressure
on the social
services and
economic
institutions of
the sub-region.
Implementing Quality RH Programmes
PRSD in the Pacific
Viewpoint : Poverty and population
Poverty in Fiji
Human poverty index
Peer education
Role models package
CSA
In brief
3
5
7
7
9
11
12
13
16
Many countries are finding it extremely difficult to
maintain, let alone expand, the quality and quantity of
social services, including reproductive health services. This
will surely endanger prospects for further improving the
education and health status of women and children, a
prerequisite for inducing greater demographic behavioural
change and promoting sustainable development.
A central theme of the 1997 UNFPA report is that
reproductive choice, gender equality and sustainable
development are closely connected -- a linkage the
international community has recognized repeatedly at the
1990s series of conferences on social development issues.
Pacific Island Countries (PICs) had actively participated in
the International Conference on Population and
Development (ICPD) in Cairo in 1994 and the Fourth
World Conference on Women in Beijing in 1995.
Therefore, the principles and programmes of action
adopted at these conferences carry special relevance to the
prospects and potentials for improvement of reproductive
rights and reproductive health in these countries.
Despite expressed commitment to these concepts,
however, broad-based reproductive health strategies are yet
to be developed. Reproductive health services are still
narrowly focused on maternal and child health and family
planning. Full perspectives of ICPD principles on
reproductive rights and reproductive health are also yet to
be fully realized. One reason is that the present
programmes and donor support were designed before the
various international conferences, As other stories in this
newsletter show, there clearly is a movement towards more
comprehensive reproductive health programmes in the subregion.
There will be much to do. Although family planning
services are generally available in all Pacific Island
countries, accessibility to a broader range of contraceptive
methods, as well as level of practice, vary widely.
Knowledge of reproductive health and human sexuality,
especially among the young population, is low,
undoubtedly due to inadequate information, education and
communication activities. Family planning integrated
with Maternal and Child Health (MCH) has focused on
married women, leaving sexually active young people and
men outside the purview of reproductive health
programmes. Women’s perspectives, despite this MCH/FP
integration, are inadequately taken into account in the
design of programmes. It is quite paradoxical that, in the
PICs, despite fairly good health services, maternal
mortality and morbidity rates are also high.
The growing incidence of sexually transmitted diseases
(STDs) and HIV/AIDS, especially among the young
population, must he a matter of grave concern. The
incidence of teenage pregnancy is clearly an indication of
rising adolescent sexual activity. In most of the PICs,
access to reproductive health services by young people is
severely constrained, even where it is not prohibited.
The Report states that “the most practical and effective
population and development policy is to create an
environment in which people can freely make reproductive
choices and decisions. This implies a priority for
investment in basic social
services such as education
and health care. Especially,
it means investing in women
and redressing the gender
The right to survival/right to life
imbalance, so that women
can make choices on an
The right to liberty and security of the person
equal basis with men”.
Reproductive Rights
The right to the highest attainable standard of health
The right to family planning
The fight to many and found a family
The fight to a private and family life
The right to the benefits of scientific progress
The rights to receive and impart hformation and to freedom of thought
The right to education
The right to non-discrimination on the basis of sex
The right to non-discrimination on the basis of age
2 Southpac News
Thus, to make the right to
choose meaningful, action is
especially needed in two
areas: first, to establish the
broad human rights which
enable
sexual
and
reproductive rights, and
create the conditions for
their exercise; and, second,
to put in place information
and services that meet the
full range of requirements
for sexual and reproductive
health.
Implementing Quality Reproductive Health
Programmes in Pacific Island Countries
acific island countries are among many nations
which are acting on the recommendations of the
ICPD to shift from restrictive MCH/Family
Planning to a more comprehensive set of
Reproductive Health services, including family
planning and sexual health.
Re-designing reproductive health
programmes
Although the reproductive health concept is relatively
new, the major components were already established as
separate departmental programmes of health ministries.
Thus, it was necessary to work towards the integration of the
various components in a coordinated reproductive health
programme. An effort was made by the PICs, in cooperation
with the UNFPA, to review progress made, and to assess the
major problems and issues to be given priority attention in
future years. Already, national programme managers are
implementing various measures to strengthen quality aspects
in reproductive health activities.
Increasing choice, improving quality
The reproductive health programme in Fiji
incorporates STD/HIV/AIDS along with
maternal and child health, and family planning.
To provide a wider choice of contraceptive
methods, Norplant was introduced in 1995 on
a pilot basis; it is expected to expand its
availability nation-wide. Vasectomy promotion
as a procedure in health centres has increased
male participation in family planning. Six
doctors were trained in vasectomy in South
Korea in 1995 in preparation for this campaign.
While in 1995/96 activities were concentrated
on establishing a comprehensive reproductive
health programme and increasing method
choice availability, in the next two years the
emphasis is on increasing access t o
contraceptive methods and counseling services.
This will be done with reintroduction of the
CBD concept in service delivery and formal
training for nurses in insertion of IUD. Even
though programme managers do not view
teenage pregnancies to be a serious problem in
Fiji, the incidence of STDs, especially syphilis,
is a matter of concern. Active promotion of
condoms, including increasing availability through vending
machines, is expected to be launched.
A holistic approach
The Republic of the Marshall Islands was one of the
first Pacific countries to adopt a national population policy
in line with the ICPD Programme of Action. The policy takes
a holistic view of population problems, although
reproductive health is a major plank of the document. A
significant step to revamp the reproductive health
programme was the undertaking of a Fertility and Family
Planning Survey in 1994 and the strengthening of the health
information system in 1995. No major problems were
encountered in integrating MCH/Safe Motherhood and
family planning with STD/HIV/AIDS structurally under the
Primary Health Care Bureau of the Ministry-of Health and
Environment. Priority areas in the programme are said to be
maternal morbidity, adolescent health, STD/HIV/AIDS and
IEC. Programme activities will address the family as a unit
of decision-making and focus on community participation.
Particular emphasis is being given to adolescent reproductive
health and sexuality problems. The high rate of teenage
Percentage of Births to Teenage Mothers (15-19 years)
Source: WHO Western Pacific Regional Data
Bank 1995 and Official estimates
Southpac News 3
Polynesian variations on
the theme
Contraceptive Prevalence Rate (%)
Neither Cook Islands nor Tonga see
integrating
STDs/HIV/AIDS,
adolescent reproductive health, and
MCH/family planning as a problem.
The constraint is limited resources. For
the Cook Islands Ministry of Health,
the economic difficulties encountered
by the government over the past year
meant that the priority was to maintain
basic services rather than mount new
programmes.
The strategy adopted in promoting
the integrated reproductive health care
concept in the Cook Islands is to
decentralize reproductive health, family
planning and sexual health activities so
that services and information can be
Source: WHO Western Pacific Regional Data
obtained from clinics around the island.
Bank 1995 and Official estimates
Information, Education and
Communication activities form the core of the strategy to
pregnancy is a major concern. Hence, programme managers
maintain gains made and to keep up awareness through
are exploring the possibility of providing contraceptive
educational programmes, including television and radio
services to adolescents. The ministry is collaborating with
spots, newspaper articles, and health education talks and
The Youth to Youth in Health, an NGO to raise public
workshops for school children, uniform organizations and
awareness and mobilize support concerning adolescent
community groups on topics targeted at the specific
health issues.
audiences.
In Palau, population programme efforts are directed at
methods;
maintaining availability of contraceptive
outreach
and
community
programmes;
supporting
strengthening human resources development at different
levels to ensure quality RH/FP/SH services; developing
educational materials; promoting better nutrition for women
and children and breastfeeding; and supporting the
development of the National Population Policy.
In reproductive health, “the overall goal is to get men and
women to see these issues from the point of view of joint
responsibilities”, said the Minister of Health. “The systems
are in place, but providers need to upgrade their knowledge
and skills in order to provide a more holistic care to
individuals with RH/FP/SH needs.” To address adolescent
reproductive health problems, especially teen pregnancies
and STDs, it is planned to provide health education and
counseling at clinics and in schools; to main free condom
distribution at accessible (but discreet) sites; work with
teenage peer groups to promote responsibility; and initiate a
lecture series in all high school freshmen orientation
programmes.
4 Southpac News
In Tonga, while maintaining service delivery and
ensuring availability and accessibility of contraceptive
choice, advocacy and educational programmes are targeted
at women, youth and religious leaders. Efforts are being
made to seek funding for activities targeting greater male
involvement in family planning and reproductive health
programmes. Clearly, also, the plans of programme
management to undertake limited research activities. for
example operations research and KAP studies, are attempts
to find out ways to design a quality of care programme that
will reach and serve clients better.
For Tokelau, with a total population of less than two
thousand people, the scale of the challenge may not seem
forbidding but the transportation difficulties it faces may be
a constraint in offering a wider choice of services and timely
quality of care. The programme prefers an incremental
approach of adding on new services or promoting particular
themes in reproductive health. Health management is giving
emphasis to improving general diagnostic capability in STD
treatment.
Programme Review & Strategy
Development in the Pacific
very five years, in cooperation with Governments,
UNFPA undertakes a programme review and
strategy development (PRSD) exercise, aimed at
establishing a strategic framework for a new Country
Programme based on emerging national needs and an
assessment of lessons from past experience. This is a
comprehensive and time-consuming exercise. The
outcome is a set of recommendations for a general
strategic framework for UNFPA’s next five-year
Country Programme of assistance. In the case of both
the 14-country sub-regional “South Pacific Programme”
and the Papua New Guinea country programme, the
1992-1996 cycle was extended by one year, so it is
expected that the programme for the next funding cycle
will cover the 1998-2001 period.
The South Pacific sub-regional PRSD
The South Pacific Programme of UNFPA overseen
by the regional office in Fiji covers 14 island states.
Programme review and strategy development for this
multi-country situation of geo-cultural diversity and
differential levels of development, despite some obvious
commonalities, is both complex and challenging.
The process in the South Pacific PRSD exercise took
IS months, commencing in early 1996, and involved the
following major activities:
Sectoral analyses were undertaken, through field
research and desk reviews by CST advisers and
national consultants, in the first half of 1996,
resulting in about 40 indepth situational reports on
the population and development, reproductive health
(including family planning and sexual health),
gender, and advocacy and information, education,
and communication areas.
Given the emphasis on reproductive health for
programme funding, national priority workshops
were organized in nine selected Pacific island
countries during the second half of 1996.
Special regional focus group meetings on youth and
on gender were sponsored by the UNFPA
Representative in Fiji, on 15-16 October, and in
Samoa, on 10- 11 December to identify and debate the
key issues and problems in these two priority
concerns.
In addition to these extensive consultations and
documentation, assessments were commissioned on
UNFPA-funded regional projects and of the 19921996 programme activities as a whole. A Background
Paper was also prepared by the UNFPA field office.
Against this background of preparation, a formal
PRSD mission was organized. The mission members
consisted of Dr. Atiqur Rahman Khan, Adviser in the
CST Bangkok as Team Leader and expert on
Reproductive Health; Ms. Trinidad Osteria, Professor
and Director of the Social Development Research
Centre at the De La Salle University, Philippines, as
consultant on Gender, Population and Development;
Ms. Delia Barcelona, Programme Officer in the
Technical and Evaluation Division, UNFPA New
York, as expert on Population Advocacy and IEC;
and Mr. William House, Adviser in the CST Suva, as
expert on Population and Development Strategies and
Participants at the Regional Strategy Developement Workshop in Nadi, Fiji
Southpac News 5
rapporteur of the mission.
The mission which was
mounted on 2-28 March,
1997, was coordinated by
Ms.
Etta
Tadesse,
UNFPA Representative to
Fiji. Ms. Eriko Hibi,
Programme Officer in the
Asia and Pacific Division,
UNFPA HQ, joined the
second part of the PRSD
mission.
The PRSD team members
visited Fiji, Marshall
Islands, Solomon Islands
and Vanuatu to undertake
field observations and to
Abassador Alik Alik of the Federated States of Micronesia openiong the UNFPA
consult with senior
Regional Strategy Development Workshop. On his right: Mr. Savenaca Siwatibau,
officials in government,
Head of the ESCAP Pacific Operations Centre; left: Ms. Etta Tadesse, UNFPA
UN agencies, bilateral
Representative for the South Pacific.
donors and the NGOs,
before settling down to the task of digesting and
Headquarters; Ms. Ann Larson, Senior Lecturer,
synthesizing the vast amount of information.
Tropical Health Programme, University of Queensland,
A culminating event in the PRSD exercise was the
Brisbane; and Ms. Vineeta Rai, Adviser on Gender,
holding of a Regional Strategy Development
Population and Development in the Country Support
Workshop in Nadi, Fiji, on 20-22 March under the Team, Kathmandu. The resulting evaluation report of
sponsorship of UNFPA. Attended by over SO senior programme activities in 1992-1996 provided a firm basis
for the PRSD exercise in 1997.
government officials, representatives of NGOs,
regional organizations, bilateral donors and UN
agencies, with the PRSD team members as
The second part of the Planning process was a review
facilitators, the Workshop was the first ever sub- of various population sectors and the country situation.
regional consultative meeting convened to discuss the Undertaken during 20 April to 7 May, by a joint team of
preliminary findings and conclusions of a PRSD three CST Suva advisers and a national consultant on
mission and to participate in strategy development for gender issues, Ms. Kathy Lepani, working in close
the next programme framework. An Aide Memoire collaboration with UNFPA field staff and national
counterparts, the review exercise produced a number of
summarizing the key issues and proposed strategies
was endorsed by Workshop participants.
analytical background papers focused on the major areas
Based on the consensus achieved at the Regional
of reproductive health, family planning and sexual
Strategy Development Workshop and the Report of health; population and development strategies; gender;
the PRSD Mission, the UNFPA Representative has and advocacy and IEC. These sectoral reviews were
submitted a Country Programme document for
meant to provide an assessment of the current national
approval and funding. The programme cycle for situation, particularly in terms of needs, capacity,
1998-2001 then begins with the development of sub- available resources, the activities of other donors and
programmes and the formulation of national and
likely future developments. An executive summary of
regional projects in consultation with governments the major findings was circulated to various
and other organizations.
development partners and national counterparts by the
UNFPA Representative for their comments.
PRSD in Papua New Guinea
In Papua New Guinea, which has a separate UNFPA
country programme, the process of forward planning
started with a comprehensive programme evaluation in
November 1996 by a team of consultants comprising
Dr. Berit Austveg,
Evaluation Officer, UNFPA
6 Southpac News
This led logically to the strategy development phase.
A follow-up mission was undertaken by Mr. William J.
House, Adviser on Population Policies and Development
Strategies; Dr. Salesi Katoanga, Adviser on
Reproductive Health/Family Planning and Sexual
Health; and Mr. Laurie Lewis, Adviser on Population
(Cont'd on page 15)
Population and the threat of poverty in the
Pacific Islands
he recently published Human
Development Report 1997 states that
among the world’s more than one
billion poor people, many are illiterate.
need safe water, reasonable nutrition and health
services, and their lives are brief. The theme of
the report is human development to eradicate
poverty within the first decades of the 21 st
century. The publication of the Fiji Poverty
Report has encouraged the authors of this
column to address the issue of population and
poverty in the context of the Pacific Islands.
Absolute poverty is often seen as a condition
of failure to meet the barest essentials of physical
existence, which means being unable either to
produce sufficient food or to have remunerative
work or income in order to purchase enough for
oneself and one’s family. For the overwhelming
majority of people in the countries of the Pacific,
poverty, using this definition, has not yet
emerged as a major problem. However, if the
definition is expanded to take account of a
shortfall in a wider range of ‘basic needs’,
including adequate food and a balanced diet,
water and sanitation. clothing and housing, and
access to public transport. good health and
education, the situation in the Pacific may not
look so healthy.
Absolute or relative poverty
One of the issues that complicates the
measure of poverty is that there is no general
agreement about whether poverty should be
considered as absolute or relative in nature. The
idea that poverty is absolute and depends on
access to a fixed range of goods and services to
satisfy basic needs is, however, recognised as
being very unrealistic. There is always a relative
component in any definition of poverty, that
relates the circumstances of the least well off to
the general. The notion of poverty to be adopted
must be set in the context of a particular social
and economic structure. Therefore, it is
necessary to conceptualise poverty and identify
specific groups of poor in the countries of the
Pacific.
At the micro-level it is important for policy
purposes to analyse those sub-groups of house-
Poverty in Fiji
The 1996 Poverty Study in Fiji was a joint
initiative of the Government and the United Nations
Development Programme. The Report, published in
April 1997, analyses current information about the
extent and nature of poverty in Fiji. The purpose of
the study is to understand the causes and
consequences of this poverty in order to assist the
Government and various non-government bodies to
develop appropriate policies and programmes that will
improve the conditions of the poor and the vulnerable,
as stated by the Minister of Finance and Economic
Development.
In seven chapters, the Report describes the pattern
of income distribution in Fiji; analyses the incidence
and trends of poverty; profiles the poorest
households: discusses the processes of
impoverishment; and analyses policies, strategies and
programmes of poverty alleviation.
The study found that income is unevenly
distributed between different parts of the country and
between rural and urban places, as expected. Fiji is
no longer a country of self-employed, self-sufficient
farmers, though the subsistence sector is an important
source of livelihood. The study showed that various
ways of calculating the poverty line gave a fairly
consistent estimate of about 25% of households in Fiji
living in poverty. However. many households seem to
have incomes close to the poverty line.
There has been a slight trend of increasing
inequality in income since the late 1970s. Based on
analysis of the 1990-1991 National Household
Income and Expenditure Survey data, the Report
shows that the bottom 20% of households received
5% of all income in Fiji while the top 20% received
50%. However, the slight closure of the gap between
rural and urban incomes since the late 1970s shows
the positive impact of government policies and
programmes of regional and rural development.
Significantly, there is a widening income gap &
both urban and rural areas.
The poor of Fiji are not necessarily the subsistence
villagers, the unemployed, or the lazy. Most poor
households have someone in paid employment, but
the jobs they have do not pay enough to keep them
out of poverty. Many households do not have access
to land and sea resources, and eve” for those that do,
subsistence does not provide a good livelihood.
(Cont‘d on page 10)
Southpac News 7
Poverty by area and ethnicity, 1990-91
economy, together with strong
community
affiliations,
has
ensured that absolute poverty and
deprivation, as found in other parts
of the world, are almost unknown.
The commitment to the extended
family is demonstrated and
maintained by
substantial
remittance flows from those
members who have left for
employment in nearby urban areas
or overseas.
Not all is well
Source: Fiji Bureau of Statistics, 1990-91 HIES
holders within surveyed communities which suffer the
greatest relative deprivations, in order to identify their
demographic and economic features, and to design antipoverty and pro-development measures. They, and other
groups like them, could then become the focus of
development efforts and relief assistance from the
governments, or from aid-agency projects. Given the
subsistence and agricultural nature of most countries in the
Pacific, it seems likely that those households falling in the
bottom 20 per cent of the distribution of income and asset
holdings - including land, food production, and access to
various social services - are vulnerable to falling into relative
poverty. This is particularly true of the rapidly growing
number of urban households, without access to enough land
for growing subsistence crops, without access to a wage job
in the formal labour market, and who have been cut off from
their local communities.
By most standards, the Pacific island countries might be
regarded as being well developed in that they are generally
peaceful, politically independent and have social structures
which are highly effective in meeting the basic needs of their
populations. Pacific islanders have long been highly mobile,
between the outer islands and the capital towns or cities, and
between their own countries and the more developed
countries of the Pacific-rim. Fundamental to this system of
movement is a society where the extended family and the
local community are the primary units of social reference.
“Subsistence affluence” in the agrarian based village
8 Southpac News
Long time harmonious social
conditions, however, are under
threat as the traditional social
fabric
is
challenged
by
modernising influences of formal
education, improved
communications systems and
visiting or returning family
members based overseas. The
political dominance of traditional chiefs and elders is under
challenge by democratising activists; women’s movements
have grown to press for an improvement in the status of
women and a reduction in overt discrimination; and the
growing numbers of educated youth are challenging
traditional authority in the home and community. The
confrontation between the traditional and the modern is
found particularly in the new and growing urban centres,
where problems arise in the spreading shanty towns and
concomitant increasing crime rates; the opening of women’s
crisis centres to deal more transparently with domestic
violence inflicted on wives; the rising incidence of teen
pregnancies, as in Fiji, Solomon Islands and Marshall
Islands, as young unmarried girls become sexually active at
earlier ages; an increasing number of reported STDs and the
threat of an AIDS epidemic; a growing incidence of suicide,
particularly among the urban youth of Samoa; growing food
insecurity in some rural areas as traditional social safety nets
are removed; and increasing obesity and associated noncommunicable diseases as more sedentary lifestyles are
adopted and imported processed foods replace traditional
diets.
Population dynamics and poverty
Evidently, not all is well in the seemingly tranquil Pacific
Island countries. At the risk of oversimplification, many of
these emerging social problems are attributable to the
complexities between the sub-region’s population dynamics
and its generally underdeveloped state, giving rise to a
general feeling of vulnerability to the threat of increasing
poverty and inequalities. As populations grow and pressure
on limited land intensities, the challenges to the traditional
systems to provide food and other kinds of support to all in
need become more difficult. Not surprisingly, there are signs
of breakdown in traditional systems of production,
distribution and welfare. In matrilineal societies, such as
the Marshall Islands, women’s traditional claims to their
land are being usurped. Throughout the region there are
frequent land disputes between rival indigenous claimants,
between those who have emigrated and those who have
remained behind, as in Polynesia, and between land owners
and those who have leased their land for modem sector uses,
as in Fiji.
In many of the Pacific countries the share of the under 15
age group exceeds 35 percent and as this bulge in the
population moves into its childbearing years, even if ongoing behavioural change continues and the average woman
bears fewer children than her mother, there will be many
more Pacific islanders by the year 2010 than at present.
Even the option of overseas migration as a means of shelving
surplus population may be curtailed. The Australian and
New Zealand doors may close fast on Samoan and Tongan
immigrants and the end of the Compacts of Free Association
with the United States may curtail the present migration
option of people from Palau, FSM and the Marshall Islands.
As these young populations age, as mortality declines
and as fertility rates fall, the Pacific island states may expect
a rise in the average age of their populations, with an
increasing number of elderly people to care for.
In the traditional setting, the extended families and
coherence of rural communities were able to provide the
physical and social needs of their elderly. But in the
crowded urban centres, where for many young people the
task of supporting their own immediate nuclear families is
becoming increasingly difficult, a growing number of elderly
people will be abandoned. Governments so far have largely
neglected this vulnerable group, hoping that the ‘Pacific way’
will find its own solutions; but as the demands for geriatric
care and welfare support grow, national policies will need to
allocate priority to these areas.
Vulnerable economies
The prospects of initiating economic growth and
sustainable development to help support social and welfare
programmes do not appear promising as the Pacific countries
suffer from a lack of natural resources, underdeveloped
human resources with poor labour market skills, isolation
and inadequate infrastructure.
Human Poverty Index
The UNDP Human DeveIopment Report 1997 introduces the
Human Poverty Index (HPI) as a new means of evaluating
development from a “deprivational perspective”, that is,
poverty of lives and opportunities. The Report notes that “if
human development is about enlarging choices, poverty
means that opportunities and choices most basic to human
development are denied-to lead a long, healthy, creative life
and to enjoy a decent standard of living, freedom, dignity,
self-respect and the respect of others”. The HPI has been
developed as an additional measure of poverty in developing
countries, beyond the income indicator and the Human
Development Index.
The HPI presented in the 1997 Human Development Report
concentrates on the deprivation in three essential elements of
human life: longevity or life span, as represented by the
percentage of people expected to die before age 40;
knowledge, as measured by the percentage of adults who are
illiterate; and a decent standard of living, as represented by
a composite of three variables, namely the percentage of
people with access to health services and safe water, and the
percentage of malnourished children under five.
Estimates of the HPI, prepared for 78 developing countries;
having adequate data, reveal that in almost half of the
countries covered the HPI value exceeds 34%, implying that
about a third of their population suffer from human poverty.
(Papua New Guinea, the only Pacific country included in the
sample, has a HPI value of 32%).
Comparison of the HPI with income-based measures of
poverty show that some countries have done better in
reducing income poverty than human poverty, while other
countries have done better in reducing human poverty than!
income poverty. Clearly, progress in reducing poverty in
income and progress in reducing poverty in human choices;
and opportunities do not always move together.
Thus, in monitoring progress, the focus should not be on
income poverty alone, but on indicators of human poverty as
well, says the Report.
■
They also suffer to various degrees from an exposure to
outside forces beyond their control. This makes them
extremely vulnerable to factors affecting their economies and
income levels, their ability to export and import, to create
employment opportunities for burgeoning numbers of new
job seekers and to satisfy the increasing demands being
placed on their social sectors, particularly in education and
Southpac News 9
family planning, and education services under these
health. Their land and sea resources are also vulnerable to the
conditions.
This will endanger prospects for further
over-exploitation of their scarce natural endowments by
improving the education and health status of women and
over-zealous, often foreign loggers, mining operators and
fishermen. Population pressure, particularly in urban areas, children, a pre-requisite for inducing declines in the overall
natural rates of population growth.
has endangered the fresh water supplies and sanitation
facilities and made segments of the population vulnerable to
While population and development programmes have
outbreaks of diseases. And since many of the countries of
made commendable progress in the recent past, the road
the sub-region remain heavily dependent on foreign aid
ahead presents new and profound challenges. One great
flows to cover public sector budget and trade deficits,
including large differences between levels of domestic challenge lies in convincing rural couples that it is in their
best and their nation’s interest to bear
savings and investment, they
fewer children. New and innovative
remain vulnerable to the
“While
population
and
methods are needed to disseminate the
increasing likelihood of a
development programmes have
population message via the influential
reduction in this aid support.
traditional leadership and churches
made commendable progress in
who, perhaps, have not been fully
In addition, the small but
the recent past, the road ahead
utilised in the past.
privileged formal sector
presents new and profound
workforce, largely dominated
challenges”
Demographic processes are also
by the public sector, whose pay
giving rise to a growing underclass in
and conditions of work far
exceed those available to the majority of the labour force, are the towns, fuelled by continuing migration from the rural
threatened by economic restructuring and retrenchment of areas and the increasing number of elderly people. The
the Government workforce. The trade advantages enjoyed by problems presented by rising urbanisation, including
inadequate housing, unemployment, increasing inequality
some island economies which have gained preferential
access to developed country markets for some of their and the spread of poverty and disadvantaged groups can he
products (e.g. garments and sugar from Fiji; automotive wire minimised, but will need to he addressed with greater
urgency by governments. International agencies, it is hoped,
harnesses from Samoa) are threatened by the move to make
the international trading environment more competitive, thus will continue to support policies and programmes which
endangering many jobs in the private sector. And, under the alleviate poverty and deprivation in the Pacific Islands.
pressure of population growth and the lack of buoyancy in
the formal job market, the subsistence sector in many of the
island countries is extremely vulnerable because of its role as William J. House & Laurie Lewis
the employer of last resort and the absorber of surplus labour UNFPA Country Support Team, Suva
in the economy. Diminishing returns of subsistence output
per unit of land and human effort have set in, resulting in
rising costs of agricultural output. Marketing infrastructure
for surplus farm products remains grossly inadequate in all
(Cont'd from page 7)
Poverty in Fiji
of the countries. As urban consumers switch away from
traditional foods to a lower cost diet of imported canned and
Poverty pervades all communities, Fijian, Indo-Fijian, and
processed foods, the incidence of non-communicable
Others.
The gap between the rich and poor is increasing according
At the same time,
diseases has risen dramatically.
to the Report. Rut much could be done to improve the situation
population pressure has reduced the availability of good
with relatively little money. especially in housing.
agricultural land and hastened the adoption of unsustainable
farming practices, endangering further the livelihood of
During the 1990s, the Fiji Government has given renewed
future generations of islanders.
emphasis to poverty eradication and has put in place new
programmes to assist poor and disadvantaged families. The study
Threat to quality of life
concluded that a three-pronged strategy for poverty eradication in
Fiji would involve improving the productive capacity of the people:
Meanwhile, with less than dynamic national economies improving access to and the performance of social services; and
from which to derive tax revenues, and dwindling sources of increasing the capacity of community groups to work with and
aid funding, many Governments are finding it extremely assist the poor.
difficult to maintain, let alone expand, the quality and
quantity of social services. It will be increasingly difficult to Source: Fiji Poverty Report (Government of Fiji and UNDP, April 1997)
improve the quality of social services, especially in health,
10 Southpac News
First
peer
education
in
reproductive
ixteen university students from the Port Moresby
campus of the University of Papua New Guinea
(UPNG) have just completed the first part of a
Reproductive Health Peer Education training course. The
course started on the campus on 24 March and later moved
to Motopore Island, concluding on Saturday 5 April.
The training is part of a reproductive health project for
youth, funded by UNFPA and implemented through the
UPNG, NGOs and Churches. It was developed in
recognition of the extent of problems in this area, including
teen pregnancies and rising levels of STDs and HIV
infection, as well as difficult male-female relations,
including violence and rape.
health
training
in
PNG
recognize the risks and act responsibly in regard to sexual
matters.
The topics covered in the course included emotional and
physical health, most at risk groups, myths, definitions of
sensuality and sexuality, touching, male-female
relationships, factors influencing sexual drive,
basic
physiology, family planning, STDs and HIV/AIDS:
consequences of behaviour, values, human rights and
responsibilities, and communication and counselling skills.
Students involved in the course were male and female,
mostly aged about 20 years, who came from a variety of
provinces and are studying psychology, arts and public
administration.
Also
participating were three
lecturers from the Goroka
and Moresby campuses.
They participated in group
discussions, role plays and
lectures and were provided
with hand-outs and videos
from PNG, the Pacific and
other countries. The
students thoroughly enjoyed
the course and actively
participated throughout.
At the end they
commented on how the
frank and open discussions
of matters which tended to
be “kept in the closet” in the
past helped to change their
attitudes and made them
feel more relaxed and less
anxious about this very
University students in a reproductive health education programme in Papua New Guinea
important subject. Many
said that they now recognize the seriousness of the risks and
The purpose of the workshop was to help students be
the need to act responsibly and how one’s behaviour can
impact on others and on one’s future. One male student said
knowledgeable and comfortable with the subject so that they
that he had thought that womanizing was part of a style a
would be in a good position to educate and support their
peers about reproductive health matters. Using young people man needs to be competitive against other men and that
as a source of information and advice has been found to be
knowing the consequences now he is convinced that he
a useful mechanism for conveying reproductive health should stick with one partner and not “roam”. The
information as they often prefer to discuss such sensitive
discussions on HIV and STDs particularly impacted on the
matters with people of their own age - but this process is
students and many said that they now felt a responsibility to
often inhibited by their mutual ignorance. By training a core go out and inform others about these very serious risks to
group of young people it is hoped to increase the pool of
wellbeing. The three lecturers also commented on how they
accurate information amongst their peers and help them to
wished they had such opportunities when they were younger
Southpac News 11
and how important it was to follow up after the course. Both
the students and the lecturers are now planning how to do so.
At the closing ceremony on Saturday, the students
concluded the training with some very creative drama and
poster presentations which demonstrated how much they had
learnt during the course. Before presenting their certificates,
the Vice-Chancellor of UPNG, Dr. Rodney Hills,
congratulated the students on their work and the way in
which they accepted the responsibility to educate and support
their peers. He pointed out that this was the first time that
such training had been undertaken in PNG and that they were
privileged to be part of this and to benefit from the
experiences of UN agencies in other countries. He also
noted that it was not just PNG that had taboos about
discussing adolescent sexuality as all countries had trouble
discussing this very important topic and that it was very
important that this reticence be overcome - for everybody’s
sake. It was noted that parents and other adults also need to
be much better educated about human sexuality and needed
help in being able to discuss the topic. He was pleased that
this aspect would also be addressed by the UNFPAsponsored project.
Role models package
The National Women’s Day celebration in Papua New
Guinea saw the official launching of the Role Models
Package (RMP). The package was officially launched in Port
Moresby on 7 April 1997 at the Islander Hotel. Among the
guests that evening were Lady Stella Chan, Mr. Peter Barter,
Provincial and Local Government Affairs Minister and Mr.
Moi Avei, National Planning Minister. The package was
produced as a follow up to the Role Model project last year.
Mr. Avei, who with Lady Chan unveiled the package,
spoke on the State’s contribution to women’s advancement
and development. He encouraged women to take the
initiative in programmes for the advancement and
development of women as the State was more often a policymaker. Lady Chan congratulated UNFPA for putting the
package together as she hoped the package would inspire
women in PNG in their various career paths to do better.
“There are few women in senior positions and young women
need examples which would inspire them to continue with
their schooling and make them consider entering areas of
work which were traditionally male-dominated”, said
Margaret O’Callaghan, UNFPA Representative. Papua New
Guinea like other parts of the world, has broken barriers of
male-dominated areas. Women have demonstrated that they
are capable of succeding in non-traditional areas.
Papua New Guinea women who have broken barriers to
make their mark in the development of the country have been
featured in a video documentary, a booklet and posters as
mentors for the younger generation. The women who were
featured in the package included Josepha Kanawi
(Commissioner, Lands Title Commission), Anna Solomon
(Editor-in-Chief & Publisher, Word Publishing), Veronica
Podgily (Industrial Relations Officer, National Airline
Workers Union), Petrina Dikin (Policewoman - Community
Relations), Winifred Abaijah (Businesswoman), Jane
Mogina (Biology teacher) and Aivu Tauvasa (Chief
Executive, Investment Promotion Authority).
Mr. Moi Avei, Minister for National Planning, Papua Guinea, with 7 of the Role Models
12 Sourhpac News
Some of these
women
visited
provincial high
schools last year
talking to students
about the trials and
tribulations they
went through to get
to where they are.
The programme
continues this year
with visits to
national
high
schools
and
possibly extending
it
to
include
community and
primary school
students because
attitudes develop at
a very young age
Country Support Activities
Sub-Regional
Research on women’s
perspectives on RH services
and adolescent sexuality
t the request of the UNFPA
Representative of the South
Pacific, and in cooperation
with the Population Studies
Programme Director at the University
of the South Pacific, the Adviser on
Population Statistics developed a
research project design on “Women’s
Health including Adolescent
Sexuality and Women’s Perspectives
on Reproductive Health Services” for
selected Pacific island countries.
A
The main purpose of the surveys is
to help in establishing an empirical
database that will include basic
population parameters and more
specialized programme-oriented data
in these and other areas. The survey
on Women’s Perspectives will collect
information on their health needs,
views, beliefs, and expectations from
current
health
services
and
programmes, as well as their selfawareness. particularly as it relates to
their actual and potential decisionmaking power over their reproductive
behaviour. Similarly, information on
adolescent sexuality and fertility is
essential if the sub-regional
Programme is to address the needs of
adolescents. to identify the more
important issues to guide awareness
creating activities at the national and
community levels, and to highlight
gaps in our knowledge as a basis for
further
research
and
IEC
interventions.
Pacific rim conference on
persons with disabilities
Dr. Salesi F. Katoanga, the
Adviser
on
Reproductive
Health/Family Planning Programmes,
was in Hawaii, from 17-22 February
1997, at the invitation of the
University of Hawaii at Manoa, to
deliver the keynote speech at the 13th
Annual Pacific Rim Conference on
Person with Disabilities and to
in
the
conference
participate
The theme of the
deliberations.
conference, “Strengths Through
Families, Communities and Culture”,
regarding the care of disabled persons
Total Fertility Rate [women 15-49 years]
Source: WHO Western Pacific Regional Data
Bank 1995 and Official estimates
highlighted the unique qualities of the
Pacific island countries in terms of
community participation in the
promotion and support of this type of
programme. Needless to say, the
reproductive health of persons with
disabilities was a major focus of the
Adviser’s address.
Strengthening population
information systems in the
Central Asian Republics,
Bishkek, Kyrgyzstan
Mr. Laurie Lewis, the Adviser on
Population Statistics, participated as a
resource person at the above
Symposium from the 17-22 March in
Bishkek, Kyrgyzstan. Six technical
papers were presented at the
symposium by resource persons. The
papers raised many of the more
important technical issues in census
planning and design, fieldwork, and
processing and dissemination of data.
The Symposium also provided an
opportunity to display the UNFPA
TSS/CST system working in concert
with other agencies. UNFPA was
represented from New York by the
Director of the Asia and Pacific
Division, Mr. Nizammudin, and a
senior official of TED, and locally by
the UNFPA Representative. The UN
Statistical Division was represented
by its Director, Mr. Hermann
Habermann and three other staff. The
UNFPA/CSTs were represented by
Mr. Laurie Lewis and the Population
Adviser from the Kathmandu Team.
The Regional Commissions for
Europe (ECE) and Asia-Pacific
(ESCAP) were both represented,
reflecting the regional duality of the
Republics. In addition representatives
of
the
national
statistical
organizations of the United States,
South Africa and India were present,
added to the feeling, stressed by the
Director of the UNSD, that national
statisticians were part of a global
community.
Southpac News 13
7th
triennial
conference of Pacific
women
The Adviser on RH/FP
Programmes was in New
Caledonia from 15-18 June
1997 attending the Pacific
Women in Action-Shaping the
Future Towards the year 2000
Conference.
The
main
objective of this regional
conference was to provide the
opportunity for the National
Government Focal Points and
N o n- G o v e r n m e n t a I
Organizations to review
planning and programming
strategies for increased
participation and recognition of
women’s contribution to the
total development of Pacific island
nations and territories. The meeting
was sponsored by the South Pacific
Commission.
The adviser’s presentation focused
on what has been achieved in the area
of reproductive health including
family planning and sexual health
since Cairo and Beijing.
Marshall Islands
Preparing
for
the
1998
population and housing census
With barely a year to go, the RMI
is preparing for the major census field
enumeration, scheduled for November
next year. The last census, held in
1988. recorded the highest fertility
and population growth rates in the
Pacific. Although these rates have
declined, they remain high and pose
serious problems for sustainable
national development. Data from the
census will help in addressing many
of the demographic and economic
problems currently being confronted.
Apart from high population growth,
and exceptionally high levels of
urbanization, flows of external
funding are in decline and
unemployment is rising as job
14 Southpac News
Participants at the Pacific Women Workshop in Noumeu, New Caledonia
opportunities in the private sector fail
to respond in a generally depressed
economy. The census results will
help in planning and implementing
the package of reforms initiated by the
Asian Development Bank, especially
the reduction in size of the public
sector.
The need for a census is widely
recognised and is given full support
by the Government and NGOs. At a
Cabinet meeting held in April 1997,
His Excellency the President of the
RM1 approved the conduct of a
Population and Housing Census in
1998 and authorised the Office of
Planning and Statistics (OPS) to carry
out the census exercise.
Mr. Laurie Lewis and Mr. Bill
House of the UNFPA CST assisted
the OPS in developing a strategy for
the census and preparing budget
estimates.
income on a nearby US Military base.
Despite the formulation of a National
Population
Policy
in
1995,
implementation of the population
programme in RMI faces severe
constraints, including a major
downsizing of the public sector and
budgetary reductions. The workshops
were aimed at rejuvenating the
population programme and promoting
the design of a National Action Plan
in which each agency will fully
articulate a well designed and
coordinated set of activities, including
more emphasis on awareness-raising
on Ebeye and the outer islands.
Emanating from the Ebeye
Workshop was the identification of
the Primary Health Care Unit as the
principal focal point for future
population activities and a call for
UNFPA to assist in data analysis of an
on-going household survey and the
provision of support for a volunteer
nurse/midwife.
Awareness workshops
In addition, during their joint
mission on 23 June-4 July, Messrs
House and Lewis helped to conduct
two awareness-raising workshops in
Majuro, the capital, and Ebeye, a
densely populated island heavily
dependent for employment and
The advisers also briefed the
recently appointed National
Population Coordinator on the major
role he might play in raising the
profile of population concerns
throughout the Republic of the
Marshall Islands.
Niue
Awareness workshop on
population and development
Sponsored by the Niue National
Committee on Population and
Development and Statistics, a series
of workshops were held from 17 to 23
April, utilising the results of the 1994
Mini-census to identify the more
important population issues and to
consider the policy implications and
strategic options. Separate workshops
were conducted for the Heads of
Departments and for mid-level
managers. More informal sessions
were provided for members of the
National Committee of Population
and Development and for Members of
Parliaments.
Apart from a brief period between
1991 and 1994, the population of Niue
has experienced continuous decline
since 1966. Even since 1994. this
decline has continued, reducing the
population of Niue in the last 30 years
from in excess of 5000 to about 2000
people.
The most important contributing
factor to this decline was the large
stream of emigration to New Zealand.
The age-sex structure of Niue, reflects
the youthful nature of this emigration.
The elderly are over-represented as
the 20-35 year old cohorts have
become depleted. Falling fertility and
the reduction in the number of young
women entering reproducing age. has
also resulted in a rapid fall in the birth
rate.
Attempts to attract overseas-based
Niueans to return to the small island
nation
have
proved
largely
unsuccessful. A common theme in all
the workshops was the importance of
ensuring that development planning
concerned itself with improving the
attractiveness of Niue, especially to
young Niueans.
Job creation.
housing, leisure and education were
important to the youth, and national
policy should he directed to these
areas. Young people themselves. in
special questions added to the 1994
census, claimed that they preferred to
live in Niue.
The Niue government was assisted
by Mr. Laurie Lewis, the UNFPA
CST Adviser on Population Statistics,
in the analysis of the 1994 census and
in conducting the workshops.
Tonga
Gender analysis
The Adviser on Reproductive
Health/Family Planning assisted in
conducting a training workshop
organized by UNIFEM on Gender
Analysis in Tonga from 16-18 April
1997. There were 21 participants,
from government departments and
NGOs, 3 observers and 8 resource
persons.
The primary objective of this
workshop was to provide follow-up
gender analysis training with specific
reference to local case studies and to
identify and discuss existing and new
integrate gender
mechanisms to
dimensions at both national and
sectoral levels. The adviser also
reviewed and held discussions on
existing data in the socio-economic
sectors with particular emphasis on
the gender disparities and helped
develop follow-up sectoral activities.
National population census
Following a mission to Niue, the
Adviser on Population Statistics was
able to spend an afternoon in Tonga,
with the staff of the Statistics Office
to discuss progress in the National
Preliminary
Population Census.
results are now being prepared and the
low growth since 1986 is a reflecction
on the continuing out-migration.
especially to New Zealand. but
increasingly to Australia and the
United States.
A short Post Enumeration Survey
was conducted to confirm the census
count, and the Acting Government
Statistician is confident of the
accuracy. The meeting provided a
useful opportunity to discuss some of
the problems being experienced
during data entry and editing, and the
overall impression is that processing
is proceeding smoothly.
Unlike the 1986 census for which
a delay of almost 5 years was
experienced in releasing the official
report, the plans for 1997 arc to
complete all processing and basic
analysis within a year.
PRSD in PNG
(Cont 'd from page 6)
Statistics in Papua New Guinea from the
25 May - 13 June 1997. The CST
advisers were again joined by Ms. K.
Lepani to cover gender issues while Ms.
Susan Aradeon, the short-term consultant
on the UNFPA Population Education
Project, had responsibility for the
Population Advocacy and IEC sector. Ms.
Cathy Amos, Mr. Matthias Lasia, and Mr.
Homolpi Warom of the National Planning
Office were also assigned to work closely
with the team during the follow-up
strategy development exercise.
The team of CST advisers and
consultants, in close consultation with the
UNFPA Representative, developed a
detailed Review and Strategy Options
Paper encompassing a review of the
current country population programme in
Papua New Guinea, the priority issues to
be addressed and the proposed strategies
for the next programme cycle in 19982001, emphasising those areas that might
be supported by UNFPA. A Strategy
Development Workshop was held on 10
June, attended by government and NGO
representatives and other concerned UN
and bilateral development agencies. The
Workshop endorsed a set of issues and
proposed strategies which were submitted
to the Government in the form of an Aide
Memoire by the UNFPA Representative.
After formal endorsement of the Aide
Memoire, the UNFPA Representative will
present a proposed programme framework
for the next funding cycle to UNFPA
Headquarters for review and approval. It
is expected that the programme for the
next four years will build on the
momentum generated by the present
programme activities.
Southpac News 15
In Brief
CST participation in Thematic
Workshops
STOP PRESS
Logical Framework Training
World Population in Fiji
During 29 January-31 January 1997, Mr. William
House, Adviser on Population and Development
Planning and Policy, and Mr. Stephen Chee, Director,
participated in the first of a series of Logical Framework
(LogFrame) Training Workshops, sponsored by the
UNFPA at the New York headquarters. The workshop,
held over a 3-day period, included a total of 14
participants: 5 UNFPA Country Representatives, 2 CST
Directors, 2 CST Advisers and 5 UNFPA headquarters
staff.
The LogFrame approach is useful in making explicit
the reasoning behind a programme and the
interrelationships between explicit project activities and
interventions, their outputs or results and the
contribution of the impacts of the sub-programme or
project for broader country programme or development
goals.
Indicators Workshop
Throughout the Pacific islands, World Population
Day on July 11 was observed with special activities
organized by governments, non-governmcntal
organizations, schools and communities.
In Fiji, competitions, displays, newspaper
supplements, radio broadcasts and television
programmes helped to publicise the significance of
World Population Day and highlighted the special
reproductive health of young people the New
Generation. Health centres around the country held
displays featuring reproductive health including farmily
planning and sexual health awareness throughout the
week.
Under the gracious patronage of tier Excellency, Adi
Lady Lala Mara, the First Lady, a reception was held or
Friday night, 11 July, at Government House,
Government ministers, senior officials, community
leaders, diplomats and UN staff were invited.
Mr. Laurie Lewis, Adviser on Population Statistics,
was at the UNFPA HQ in New York from the 10-14
February to attend a thematic workshop on reproductive
health indicators. The aims of the workshop were to
enable participants to gain a general understanding of
the uses of indicators, the methodologies to collect
information, and the feasibility of collecting various
types of information; and to determine priorities in
collecting data at different levels in the development,
monitoring and evaluation of UNFPA interventions in
the three main programme areas.
The First Lady launched a publication in the Fijian
language "Na i vola dusidusi me vukea na kena karoni
Kei na taqomaki ni bula ni mata vuvale ”, or “Trainer’s
manual on family life”, produced by the Soqosoqo
Vakamarama (or Women’s Organization), of which she
is the President. The UNFPA Representative, Ms. Etta
Tadesse, read a message from Dr. Nafis Sadik.
UNFPA’s Executive Director, on the occasion of World
Population Day 1997.
The outputs of the workshop were a proposed set of
indicators for use for each of the UNFPA thematic areas.
The workshop provided a useful forum for the exchange
of ideas betweeen advisers from different regions and
reinforced the need for suport for collection of basic data
and establishment of information systems.
Dr. Sadik’s message ended with these words: “Every
country and every culture is different; what we have in
common is that we all want the best for our young
people. They will shape the world of the 21 st century:
■
they deserve the best possible start”.