Bolivia - National Land Administration   Project (Supplemental Credit)

Vinokur, Anatoly; Godinho, Joana; Dye, Christopher; Nagelkerke, Nico

Bolivia - National Land Administration Project (Supplemental Credit)

Vinokur, Anatoly | Godinho, Joana | Dye, Christopher | Nagelkerke, Nico

Madagascar's population is estimated to have reached 10.3 million in 1985 with a current rate of growth of 3.0 percent. Assuming unabated growth, population would increase to over 28 million by 2015 creating extraordinary constraints on the country's development. Demographic and economic projections demonstrate that these constraints can over the longer term be eased by reducing the high level of fertility. This, however, does not happen automatically. It requires sustained efforts on the part of the Government to develop a population policy and to set action programs with particular attention to strengthening and expanding the family planning structure in conjunction with maternal and child health programs. In light of the health system's limited absorptive capacity and severe financial constraints, the Government faces difficult choices in reconciling the substantial oversupply of medical and paramedical graduates with the needs for physical resources such as drugs and medical supplies and improvement in in-service training and in managerial skills of existing personnel. Consequently, the development of a health strategy and long-term health plan on the basis of an improved health statistics system is of critical priority.

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