Suchergebnisse

This doctoral research aims to contribute to a better understanding of the effects of development projects on the improvement of living conditions and livelihoods of rural households in Benin. It begins with the analysis of development trends in Atacora known about the last three decades. It is focused on matching between the dynamics promoted by intervention devices and those endogenous or emerging to lead a part in the consideration of the productive trajectories and performance of family farms and also in the analysis of effects of development projects on food security, living standards and poverty of rural households. The post-development theories and the various conceptions of poverty have served as a guideline for research work. The intervention mechanisms conducted in Atacora (north-western Benin) by the various cooperations (bilateral and multilateral) between 1990 and 2010 constituted the research object of this thesis. The empirical phase took place in the communes of Cobly (West) and Péhunco (East). These communes were selected from their contrasting agro-ecological and socio-economic situations and socio-economic indicators on the one hand and on the other on a typology of the concentration of development projects and the perception of their effects by local people. A stratified sample of 344 households (respectively 214 in Cobly and 130 in Péunco) was formed for the characterization survey. Later, a thorough investigation on living conditions and livelihood of households followed and involved 208 households (129 Cobly; 79 Péhunco). Finally 16 case studies (8 per commune) were conducted on the trajectories of evolution and accumulation of property and wealth of households and farms. Due to the empirical research, special attention was given to primary data collection which lasted more than three (3) years. Qualitative and quantitative tools (including PSM) were combined for the analysis of collected data through individual and group interviews. Results show that the development interventions do not always promote the endogenous dynamics but they generate and maintain, in rural areas, pathways that allow the integration and participation of producers in the world market for agricultural products. And to benefit from various promotional activities, producers adopt supported crops, this have some positive and negative consequences. The integration and participation of rural producers of Atacora to international trade, promote the increase of production and crop yields while further increasing their dependence on the world prices of agricultural products. So while the income of producers is increasing their vulnerability to food insecurity is also increasing because many of the food crops, already insufficient (because of the share of the cotton planted and the cotton production quotas established by the government) to cover food needs, are substracted from consumption to be sold on the market to meet urgent liquidity needs. Thereby, Atacora's rural households, despite the increase of their food production, suffered a rupture of food stocks resulting to annual food crises of at least 4 months (16 weeks) which strikes indiscriminately both recipient households than non-project beneficiaries. However with the increase of sources and income level of recipient households (36% of households of the study sites), those beneficiaries improve their homes and food consumption and invest more in the education of their children. This marks a significant difference between beneficiaries and non-beneficiaries of development projects. Indeed, installed with the same resources, we counted, in 2014, twice more prosperous households and fewer poor among beneficiaries than non-beneficiaries. Furthermore farms and households beneficiaries of assistance have accumulated and hold more productive assets (land, farm equipment, livestock rearing), economic assets and holdines (transportation measures, housing, plots and houses to rent, etc.) than non-beneficiaries with a highly significant difference at 1%. However the level of improvements and living conditions induced by development interventions are still inadequate and insecure, as reduced to the equivalent adult,income as well as capital show no significant difference between beneficiaries and non-beneficiaries. Thus, households (even beneficiaries) remain vulnerable to crises so that any natural disaster (flood, drought, pest invasion, etc.), illness, injury and death of a member of the household, provokes the rapid degradation of living standards and the fall into poverty. This is compounded by the fact that farms owners' don't invest really in the restoration and enhancement of the capital '' land fertility ''; mainly in Cobly where the soil fertility level experienced a drastic decline with a consequent increasing use of chemical fertilizers that degrade the soil structure furthermore. It follows that any action aimed at poverty reduction should allow a sustainable improvement in conditions and livelihoods of rural producers by the preservation and restoration of soil fertility on the one hand and the increased resilience to crises on the other hand. Actions to identify specific needs with measures and solutions adapted to each category of producers and households with mainly particular mechanisms of management and restoration of the fertility of agricultural land shall be considered and implemented. ; La présente recherche doctorale vise à contribuer à une meilleure connaissance des effets des projets de développement sur l'amélioration des conditions de vie et d'existence des ménages ruraux du Bénin. Elle démarre par l'analyse des tendances d'évolution ducontexte socioéconomique et du système agraire de l'Atacora sur ces trois dernières décennies pour se focaliser sur l'adéquation entre les dynamiques promues par les dispositifs d'intervention et celles endogènes ou émergentes. Cette recherche aboutit d'une part à l'examen des trajectoires et performances productives des exploitations agricoles familiales et d'autre part à l'analyse des effets des dispositifs d'intervention sur la situation alimentaire, le niveau de vie et de pauvreté des ménages ruraux. Les théories de développement et plus précisément celle du post-développement renforcée par les considérations théoriques liées aux diverses conceptions de la pauvreté ont servi de fil conducteur aux travaux de recherche. Les dispositifs d'intervention conduits dans l'Atacora (au Nord-Ouest du Bénin) par les différentes coopérations (bilatérales et multilatérales) entre 1990 et 2010 ont constitué l'objet de recherche de cette thèse. La phase empirique s'est déroulée dans les communes de Cobly (à l'Ouest) et de Péhunco (à l'Est) du département. Ces communesont été retenues à partir de leurs situations agro-écologiques et socioéconomiques contrastées et des indicateurs socio-économiques d'une part et d'autre part d'une typologie à dire d'acteurs relative à la concentration des projets de développement et à la perception de leurs effets par les populations locales. Après un recensement des ménages, un échantillon stratifié, de 344 ménages (214 à Cobly et 130 à Péunco) a été constitué pour l'enquête de caractérisation. Ensuite, l'enquête approfondie sur les conditions de vie et d'existence des ménages a suivi et a concerné 208 ménages (129 à Cobly ; 79 à Péhunco). Enfin 16 études de cas (8 par commune) ont été conduites sur les trajectoires d'évolution et d'accumulation de biens et patrimoine des ménages et exploitations agricoles. Vu le caractère empirique de la recherche, une attention particulière a été accordée aux données primaires dont la collecte a duré plus de trois (3) ans. Des outils qualitatifs et quantitatifs (dont le PSM) ont été combinés pour l'analyse des données collectées par des entretiens individuels et de groupes. Les résultats révèlent que les dispositifs d'intervention ne promeuvent pas toujours les dynamiques endogènes mais qu'ils suscitent et entretiennent, dans les milieux ruraux, les filières qui permettent l'intégration et la participation des producteurs au marché mondial des produits agricoles. Ainsi pour bénéficier des diverses actions de promotion de filières (mise en place des intrants etde crédits, formation et renforcement de capacités techniques et organisationnelles, facilitation de l'accès aux équipements etdes aménagements hydro-agricoles, l'accès aux nouveaux marchés d'écoulement, etc.) mises en place par les dispositifs d'intervention, les producteurs adoptent les spéculations soutenues avec des conséquences à la fois positives et négatives. L'intégration et la participation des producteurs ruraux de l'Atacora au commerce international favorisent l'accroissement de la production agricole et des rendements culturaux tout en augmentant davantage la dépendance de ces derniers aux cours mondiaux des produits agricoles. Ainsi pendant que le revenu des producteursconnaît un accroissement, leur vulnérabilité à l'insécurité alimentaire augmente également car une bonne partie des productions vivrières, déjà insuffisantes (à cause du poids des emblavures en coton et de la politique gouvernementale de quota de production cotonnière à chaque commune) pour couvrir les besoins alimentaires, est soustraite à la consommation pour être vendue sur les marchés afin de répondre aux besoins urgents de liquidités. De ce fait, les ménages ruraux de l'Atacora, malgré l'accroissement de leurs productions vivrières, subissent une rupture des stocks vivriers avec pour conséquence une soudure alimentaire annuelle d'au moins 4 mois (soit 16 semaines) qui frappe indifféremment aussi bien les ménages bénéficiaires que ceux non bénéficiaires des projets. Toutefois avec l'augmentation des sources et du niveau de revenu des ménages bénéficiaires (soit 36% des ménages des sites d'étude), ces derniers améliorent leurs habitations, l'autoconsommation alimentaire et investissent davantage dans l'éducation de leurs enfants ; ceci marque une différence significative entre les bénéficiaires et les non bénéficiaires des projets de développement. En effet, installés avec les mêmes ressources, en 2014 on décompte deux fois plus de ménages prospères et moins de pauvres parmi les bénéficiaires que les non bénéficiaires. Par ailleurs les exploitations et ménages agricoles bénéficiaires des interventions ont accumulé et détiennent plus de capitaux productifs (foncier, équipements agricoles, cheptels d'élevage), économiques et patrimoine (moyens de transport, logement, parcelles et maisons mises en location, etc.) que les non bénéficiaires avec une différence hautement significative au seuil de 1%. Seulement les améliorations de niveau et conditions d'existence induites par les dispositifs d'intervention restent encore insuffisantes et précaires de sorte que ramenés à l'équivalent adulte aussi bien le revenu que les capitaux ne présentent pas de différence significative entre bénéficiaires et non bénéficiaires. Ainsi, les ménages (même les bénéficiaires) restent vulnérables aux crises et chocs de sorte qu'à la moindre catastrophe naturelle (inondation, sécheresse, envahissement des ravageurs, etc.), maladie, accident et décès d'un membre ou proche du ménage, le niveau de vie se dégrade rapidement et ils retombent dans la pauvreté. Cette situation est aggravée par le fait que les exploitations agricoles investissent très peu dans la restauration et l'amélioration du capital ''fertilité des terres '' cultivées surtout à Cobly où le niveau de fertilité des sols connaît une baisse drastique avec pour conséquence une utilisation de plus en plus accrue, par les producteurs, des engrais chimiques qui dégradent davantage la structure des sols. Il s'ensuit que toute action visant la réduction de la pauvreté doit permettre une amélioration durable des conditions et moyens d'existence des producteurs ruraux en vue de la préservation et de la restauration de la fertilité des terres d'une part et l'accroissement de la résilience aux crises d'autre part. Des actions d'identification des besoins spécifiques assortis de mesures et de solutions adaptées à chaque catégorie de producteurs et/ou ménages avec au centre des mécanismes particuliers de gestion et de restauration de la fertilité des terres agricoles devront être envisagées et mises en œuvre.

Marc Joffe


With so many people obtaining Medicaid coverage in the wake of the Affordable Care Act and during the pandemic, it is worth investigating whether this expanded eligibility is improving health outcomes. Overall, decreases in the proportion of uninsured individuals over the last decade are not being matched by improved life expectancy. Indeed, life expectancy at birth in 2021 was lower than it was when the Affordable Care Act passed. But this fact tells us little about the benefits of Medicaid coverage since the decline has been driven in large part by COVID-19 deaths among elderly patients (often not on Medicaid) as well as increased mortality from accidents and drug overdoses.
To better gauge the benefits of Medicaid, it is necessary to look at more specific health indicators. The federal Center for Medicaid and CHIP Services (CMCS) compiles a large variety of healthcare quality measures that could help us analyze outcomes. Unfortunately, most of these measures are not available for all states and all years, making it difficult to assess performance in a systematic way.
One indicator that is generally available is the rate of low birth weight, which is the percentage of newborns weighing less than 2500 grams, or about five pounds eight ounces. Low birth weight (LBW) babies have "a higher risk of morbidity, stunting in childhood, and long‐​term developmental and physical ill health including adult‐​onset chronic conditions such as cardiovascular disease." Consequently, reducing the incidence of LBW should improve public health, but Medicaid services are not achieving this outcome.
A 2019 study in JAMA found no correlation between Affordable Care Act Medicaid expansion and LBW. The authors used administrative records to obtain rates of LBW (and some other adverse birth outcomes) before and after Medicaid expansion in states that accepted the expansion and those that did not. The change in LBW rates in expansion states was not significantly different than that in non‐​expansion states. The authors did find some improvement for Black infants in expansion states, but not for white or Hispanic infants.
Overall, the US is not among the countries that have had the best success in minimizing low birth weight. A 2015 World Health Organization analysis ranked the US 64th among 146countries, with such less affluent nations as Albania. China, and Cuba performing better. Poor US outcomes have been attributed to the use of fertility drugs (which increases the likelihood that a mother will give birth to twins or triplets) and the high rate of Caesarian sections.
According to data from the CDC WONDER Database, 8.3% of US babies born in 2019 were low birth weight. The LBW rate among Medicaid patients was substantially higher, coming in at 9.8% (WONDER also has 2020 and 2021 data, but I chose 2019 data to avoid any pandemic‐​related affects).
In the District of Columbia, the LBW disparity between Medicaid‐​financed births and those with other types of coverage is especially stark. In 2019. DC's overall LBW rate was 9.9%. For Medicaid births, it was 12.7% and for non‐​Medicaid births it was only 7.4%. And, it does not appear that this disparity is caused by a lack of access to government‐​paid medical services: the Medicaid and CHIP Payment and Access Commission (MACPAC) reports that (in 2018) 99.3% of DC Medicaid births took place in a hospital and that 91.7% were attended by a physician, with almost all of the remainder attended by a Certified Nurse Midwife.
The risk of low birth weight can be minimized through proper nutrition, not smoking, and avoiding narcotics. These risks can be controlled with non‐​medical interventions. For example, at‐​risk mothers can be accommodated at maternity homes, where their diet and substance use can be carefully supervised. The widespread use of maternity homes in Cuba may explain the low rate of LBW in that country (although Cuba's health statistics have been subject to criticism).
WONDER provides statistics on tobacco use in pregnant women. In DC, the LBW rate among Medicaid tobacco users was 23.7%. Unfortunately, data are not available for other types of substance abuse or malnutrition, however Wallethub recently ranked DC's drug use fifth among all states (plus DC).
Some states are devoting Medicaid resources to the "social determinants of health", funding non‐​medical services such as housing and nutrition that are intended to address health inequities. DC has an Office of Health Equity that supports "projects, policies and research that will enable every resident to achieve their optimal level of health — regardless of where they live, learn, work, play or age." But these added efforts are not making a dent in LBW.
Despite spending over $3 billion on Medicaid annually, DC (like other parts of the US), has pregnancy outcomes that are on a par with or even below those of developing countries. It appears that providing costly pregnancy services cannot substitute for the basic health precautions we hope all expectant mothers will take.

While the number and proportion of people aged 60 and over will continue to grow in developing countries such as Iran in the coming decades, increasing demand and spending on health and particularly long-term care will pose the same problems that developed countries are facing today. Faced with an aging population marked by the demographic transition, facing increasing longevity and number of people experiencing dependency, frailty and disability reduced number of family caregivers, communities and nations to commit more often an increase in economic berdun . acceleration of demographic transition over a short period for developing countries like Iran should be alarming to their political leaders because none of these strategic planning for aging socio-economic impacts has been elaborated. As baby boomers reach Iran in 1991-1996 at the age of 60 + years to 2050. The Iranian authorities and the social have 40 years (= Windows oppurtunity demographic window "of opportunity") to cover the needs of the elderly population. The prevalence of disability will increase rapidly with age. In our study, we conclude that in 2009, 136 people aged over 60 in 10,000 people are moderately or highly dependent (1,005,400 people in 2009). This means they can not do their activities of daily living and they need help from others. They need another person to help them in their grooming, feeding, transfer, shopping, house cleaning, and so on. For older people with severe dependency, they need help for 24/24 hours. This means they are incontinent, bed ridden and sometimes require artificial feeding (Feeding by naso-gastric or gastrostomy). In the future, in 2050, the number of elderly dependents can be estimated at 544 people / 10000. (5,449,465 people in Iran in 2050) This means that the number of elderly who need care for their life will be multiplied by 4. At the same time, because of declining fertility of this period (2009-2049), the number of children will decline. Thus, parents will not have enough children for their support and care. Another result of our work is estimated that 45% of the Iranian population in 2050 will be aged between 50-80 years, so the average age of family caregivers will increase. ; Alors que le nombre et la proportion de personnes âgées de 60 ans et plus vont continuer de s'accroître dans les pays en voie de développent comme l'Iran au cours des prochaines décennies, l'augmentation de la demande et des dépenses de santé et particulièrement les soins de longue durée poseront les mêmes problèmes de santé publique auxquels les pays développées sont confrontés aujourd'hui.Face au vieillissement de la population marquée par la transition démographique, face à l'augmentation de la longévité et du nombre de personnes en situation de dépendance, de fragilité et de handicap, face à la réduction des possibilités d'aides familiales, les communautés et les nations s'engagent le plus souvent vers une augmentation des structures d'hébergement et de soins, puis reconsidèrent pour des questions économiques la prise en charge à domicile.L'accélération de la transition démographique sur une courte période pour les pays en développement comme l'Iran doit être alarmante pour leurs responsables politiques car aucune planification stratégique de ces impacts socio-économiques n'a été élaborée. Les baby-boomers de 1991-1996 en Iran arriveront à l âge de + de 60 ans vers 2050. Les iraniens et les autorités sociales ont 40 ans (Windows oppurtunity =fenêtre démographique «d'opportunité ») pour couvrir les besoins de cette population âgée. Bien que le vieillissement des personnes soit important le besoin de soins pour une partie d'entre eux le sera encore plus en raison d'une limitation dans leur autonomie quotidienne. La prévalence de l'incapacité va croître rapidement avec l'âge.Dans notre étude, nous concluons qu'en 2009, 136 personnes âgées de plus de 60 ans sur 10.000 habitants sont modérément ou très dépendantes (1.005.400 personnes en 2009). Cela signifie qu'ils ne peuvent pas faire leurs activités de la vie quotidienne et qu'ils ont besoin d'aide des autres. Ils ont besoin d'une autre personne pour les aider dans leur toilette, l'alimentation, de transfert, faire des courses, ménage de la maison, et ainsi de suite. Pour les personnes âgées avec la dépendance est sévère, ont besoin d'aide 24/24 heures. Cela signifie qu'ils sont incontinents, grabataires et ont parfois besoin d'une alimentation artificielle (Alimentation par sonde naso-gastrique, ou gastrostomie). A l'avenir, en 2050, le nombre de personnes dépendantes âgées peut être estimé à 544 personnes / 10000. (5.449.465 personnes en Iran en 2050) Cela signifie que le nombre de personnes âgées qui ont besoin de soins pour leur vie sera multiplié par 4. En même temps, en raison du déclin de la fécondité de cette période (2009-2049), le nombre d'enfants va baisser. Ainsi, les parents n'auront pas assez d'enfants pour leur soutien et leurs soins. Un autre résultat de notre travail évalue que 45% de la population iranienne en 2050 sera âgée entre 50-80 ans, donc l'âge moyen des aidant familiaux va augmenter.

While the number and proportion of people aged 60 and over will continue to grow in developing countries such as Iran in the coming decades, increasing demand and spending on health and particularly long-term care will pose the same problems that developed countries are facing today. Faced with an aging population marked by the demographic transition, facing increasing longevity and number of people experiencing dependency, frailty and disability reduced number of family caregivers, communities and nations to commit more often an increase in economic berdun . acceleration of demographic transition over a short period for developing countries like Iran should be alarming to their political leaders because none of these strategic planning for aging socio-economic impacts has been elaborated. As baby boomers reach Iran in 1991-1996 at the age of 60 + years to 2050. The Iranian authorities and the social have 40 years (= Windows oppurtunity demographic window "of opportunity") to cover the needs of the elderly population. The prevalence of disability will increase rapidly with age. In our study, we conclude that in 2009, 136 people aged over 60 in 10,000 people are moderately or highly dependent (1,005,400 people in 2009). This means they can not do their activities of daily living and they need help from others. They need another person to help them in their grooming, feeding, transfer, shopping, house cleaning, and so on. For older people with severe dependency, they need help for 24/24 hours. This means they are incontinent, bed ridden and sometimes require artificial feeding (Feeding by naso-gastric or gastrostomy). In the future, in 2050, the number of elderly dependents can be estimated at 544 people / 10000. (5,449,465 people in Iran in 2050) This means that the number of elderly who need care for their life will be multiplied by 4. At the same time, because of declining fertility of this period (2009-2049), the number of children will decline. Thus, parents will not have enough children for their support and care. Another result of our work is estimated that 45% of the Iranian population in 2050 will be aged between 50-80 years, so the average age of family caregivers will increase. ; Alors que le nombre et la proportion de personnes âgées de 60 ans et plus vont continuer de s'accroître dans les pays en voie de développent comme l'Iran au cours des prochaines décennies, l'augmentation de la demande et des dépenses de santé et particulièrement les soins de longue durée poseront les mêmes problèmes de santé publique auxquels les pays développées sont confrontés aujourd'hui.Face au vieillissement de la population marquée par la transition démographique, face à l'augmentation de la longévité et du nombre de personnes en situation de dépendance, de fragilité et de handicap, face à la réduction des possibilités d'aides familiales, les communautés et les nations s'engagent le plus souvent vers une augmentation des structures d'hébergement et de soins, puis reconsidèrent pour des questions économiques la prise en charge à domicile.L'accélération de la transition démographique sur une courte période pour les pays en développement comme l'Iran doit être alarmante pour leurs responsables politiques car aucune planification stratégique de ces impacts socio-économiques n'a été élaborée. Les baby-boomers de 1991-1996 en Iran arriveront à l âge de + de 60 ans vers 2050. Les iraniens et les autorités sociales ont 40 ans (Windows oppurtunity =fenêtre démographique «d'opportunité ») pour couvrir les besoins de cette population âgée. Bien que le vieillissement des personnes soit important le besoin de soins pour une partie d'entre eux le sera encore plus en raison d'une limitation dans leur autonomie quotidienne. La prévalence de l'incapacité va croître rapidement avec l'âge.Dans notre étude, nous concluons qu'en 2009, 136 personnes âgées de plus de 60 ans sur 10.000 habitants sont modérément ou très dépendantes (1.005.400 personnes en 2009). Cela signifie qu'ils ne peuvent pas faire leurs activités de la vie quotidienne et qu'ils ont besoin d'aide des autres. Ils ont besoin d'une autre personne pour les aider dans leur toilette, l'alimentation, de transfert, faire des courses, ménage de la maison, et ainsi de suite. Pour les personnes âgées avec la dépendance est sévère, ont besoin d'aide 24/24 heures. Cela signifie qu'ils sont incontinents, grabataires et ont parfois besoin d'une alimentation artificielle (Alimentation par sonde naso-gastrique, ou gastrostomie). A l'avenir, en 2050, le nombre de personnes dépendantes âgées peut être estimé à 544 personnes / 10000. (5.449.465 personnes en Iran en 2050) Cela signifie que le nombre de personnes âgées qui ont besoin de soins pour leur vie sera multiplié par 4. En même temps, en raison du déclin de la fécondité de cette période (2009-2049), le nombre d'enfants va baisser. Ainsi, les parents n'auront pas assez d'enfants pour leur soutien et leurs soins. Un autre résultat de notre travail évalue que 45% de la population iranienne en 2050 sera âgée entre 50-80 ans, donc l'âge moyen des aidant familiaux va augmenter.

Not Available ; India has undergone a series of ups and downs in agricultural production with the climatic conditions playing havoc in the years of abnormality. We faced many droughts in 18th and 19th centuries without much know how to counterfeit their impacts. With the launch of Green Revolution (GR) in the late middle years of 20th century, India has improved its position in food grain production with technological interventions. The States of Punjab, Haryana and Western Uttar Pradesh could make use of GR technologies like high yielding varieties of rice and wheat, use of synthetic fertilizers and pesticides, irrigation facilities etc. and made enormous progress in food production. Currently, agroecosystems are facing the problems of overexploitation of natural resources, decline in soil fertility, ground water level and agricultural productivity. Hence, ensuring sustainable food security is the need of the hour. As per the statement of Minister of State for Agriculture and Food Processing Industries, Government of India (March, 2013), India's productivity of rice (3590 kg/ha) is lower than China (6686 kg/ha), Bangladesh (4219 kg) and Myanmar (4081 kg). Whereas India's productivity of wheat (1661kg) is lower than China (4838 kg) in 2011. China performed better in the productivity of coarse grains (5470 kg) and pulses (1533 kg) when compared to India which stood at 1591 kg and 699 kg respectively. India's per hectare production of pulses is the lowest when compared to its six neighbours - Bangladesh, Bhutan, China, Myanmar, Nepal and Sri Lanka. Besides all our efforts to enhance agricultural productivity through a huge network of institutions, we are still lagging behind due to numerous problems that are inherent in our system. At present, our aim should be to enhance the agricultural productivity without causing much damage to the natural resources and production environment. This calls for a stringent action to evolve varieties and technologies/innovations which can enhance the production/productivity of agricultural crops under changing climatic scenarios. This is possible through some innovative techniques like inducing C4 ness in rice, developing multiple resistant cultivars through MAGIC iv (multiparent advanced generation intercross), development of super hybrids, application of GIS/Remote sensing technologies, nanotechnology, crop modeling etc. All the new generation technologies require policy support for their development as well as adoption for harnessing their full potential benefits. At the same time, the institutions involved in research, extension activities, development departments, banking, planning and execution should all come together and work in coherence to make this a successful venture. This book contains lead papers from distinguished experts, policy makers and dedicated researchers. Efforts are made to compile the latest information on present agricultural scenario in India in comparison with other developed and developing nations and also the major problems faced by Indian agriculture, types of innovations required in research, policy and institutional set up to meet the ever increasing demands for food and nutritional security. It also emphasizes the steps to be taken up by various stakeholders involved in the agricultural production scenario to make agriculture a profitable proposition, without causing much damage to the natural environment. It also covers the important measures to be adopted for creating interest among youth for agriculture and to improve their livelihood security through various interventions by public and private sectors. We hope that this book would be of immense use to researchers in planning their future line of research, for policy makers to take rational decisions on Indian agriculture which would benefit farmers as well as consumers by protecting the soil and environmental quality, for students and general public to have a wealth of information on agriculture in India. It must be mentioned here that while the scholarly papers included in this volume do help enrich the readers' understanding on the issues related to the climate change and sustainable food security, the views expressed by the authors in their respective papers are their own and the editors do not necessarily subscribe to them. We thank all the contributors to this volume. Our special thanks are due to Dr.V.S. Ramamurthy, Director, National Institute of Advanced Studies (NIAS) Bangalore, Dr. Ajay v Parida, Executive Director, M. S. Swaminathan Research Foundation (MSSRF) Chennai, Dr. Parveen Arora, Adviser (ScF), Department of Science & Technology, Government of India (GOI), New Delhi, Dr. A. Arunachalam, Principal Scientific Officer to Director General, ICAR, GOI, New Delhi for their support and encouragement at every stage of its preparation. We are very grateful to Ms. G. F. Aiyasha, Mrs. Mariyammal, Mr.Thomas K.Varghese and Dr. K. Manorama for their kind involvement and contribution. ; Not Available

The Limpopo Province is one of the nine Provinces in South Africa, located in the far north of the country, bordered by Gauteng (south), Mpumalanga (south-east) and North West (south-west) Provinces along its southern border. It links the country to the southern African Democratic Countries, via Botswana, Zimbabwe and Mozambique, along its northern borders both economically and hydrological. The Province is characterised by insufficient and highly variable rainfall patterns upon which the agricultural sector depends on, prone to extreme climate events (such as drought and flood), high concentration of rural poor and socioeconomic inequalities. Water scarcity and inefficient available water use are some principle constraints evident from low agricultural productivity. Limpopo smallholder farmers (LSF) are faced with numerous challenges, ranging from resource access to agriculturally marginal farmlands located in the former demarcated homelands in agro-ecologies characterized by erratic rainfall, poor soil fertility, low crop productivity, degraded landscapes, and lack of irrigation and limited land for expansion. Climate change is projected to be an additional stressor, threatening small-scale agricultural farmers' productivity and livelihoods. A primary concern addressed by this thesis is to generate scientifically based information that can help to enhance the farmers' ability to respond effectively to current and future climate regimes. The overall aim of this study was to develop and evaluate climate smart agriculture (CSA) strategies for attaining resilience and adaptation pathways in smallholder farming system to climate variability and change. CSA is an approach that transforms and changes the direction of agricultural development under human-induced climate change. This aim was addressed through the following specific objectives:  to carry out field survey- and desktop-analysis to investigate whether the LSF perceived past and future climates are in agreement with scientific evidence, and how farmers' inclination to adopt climate smart adaptation practices is influenced by past climate experiences, as well as their constraints and future climate concerns.  to conduct field experimental trails to evaluate effects of climate smart practices on soil moisture and maize yields, then used to parameterise, calibrate and validate the daily time-step APSIM model, and lastly upscale them to sub-catchment level to test their effects across different soils, climates and locations by coupling the APSIM model with geographical information system. This was done to test if increasing surface residue application leads to higher soil-water retention, and thus maize yield; and if insitu rainwater harvesting (IRWH) in combination with conservation agriculture leads to higher yields than conventional practice.  to assess the likely impacts and opportunities of LSF's crop management practices under changing environmental conditions, and  to determine when incremental adaptation is not an option and transformational adaptation might be suitable or needed to address risk and vulnerability of Limpopo Small-scale agriculture under climate future projections. CSA practices aimed at reducing small-scale farmers' exposure to climate-related risks and increasing their productivity, while improving their resilience and adaptive capacity to climate variability and change were identified. The practices were selected on bases of incorporating an integrated soil, water and crop management strategies approach, to increase and sustain crop productivity by increasing water availability, crop access to soil-water and soil-water holding capacity. A structured survey questionnaire was used to collate data on across 6 villages (n = 201) to better understand the LSFs practices, experiences and perceptions, with emphasis on climate variability and change. The data was initially used to determine if the LSFs understood impact of climate variability and change, thereafter, utilized the collected information to determine what influences the LSFs willingness to adopt climate-smart adaptation practices. This was archived through a multiple-mediation analysis of farmers past climate experiences, adoption of climate-smart adaptation practices, their future concerns regarding extreme climate, and physical and socio-economic adaptation constraints, presented in Chapter 2. The LSF indicated that they have noticed changes in climate (citing hotter conditions and shifts in rainfall onsets) and perceived that temperature are more likely to continue to increase in far distant future while the rainfall will decline. Their observations and perceptions were found to be consistent with historical climate records, and climate model projections, particularly temperature regimes. The multiple-mediation analysis suggests that past climate experiences of LSF directly influenced willingness to adopt climate-smart practices, and indirectly by concerns about future extreme conditions, economic and physical adaptation constraints. Summary 104 In the third chapter, field experiments data were conducted over two seasons (i.e. 2013/14 and 2014/15) at University of Limpopo Syferkuil Research Farm in Limpopo Province, on effects of tillage practices on maize crop production are presented. The practices considered were (i) tillage practices (i.e. IRWH, no-till (NT) and conservation tillage (CT) practices), (ii) surface organic mulch cover, (iii) planting dates and (iv) maize cultivars. IRWH is documented in literature as mitigating dry spells by increasing soil-water storage and improving crop production. Application of mulch cover is linked with reducing unproductive water loss via evaporation. Integration of both tillage practices and surface mulch cover improves infiltration and hence increases soil-water storage required particularly during critical maize crop growing periods, such as vegetative and reproductive growth stages. The two seasons offered an opportunity for the comparison of field experimental treatments, with the start of El Nino during the second growing season and the above normal rainfall in the first season. In the first season yields there were no treatment differences, with average maize grain and biomass yields of 5 and 10 ton per ha, respectively, while in second season the yields were half that of the first and treatment effects were found with high yields from NT tillage practice, followed by IRWH and then CT. Further, maize productivity increased with increments in surface mulch levels. The soil-water and plant available water in the first season were high for NT followed by CT and then IRWH, whereas, for the second season were high for CT followed by IRWH and then NT. In the field experiment, during below normal rainfall, NT performed slightly better than IRWH. This observation suggests that these practices are likely to be more of benefit during dry spells and/or below average rainfall years. The data from the field experiment and secondary data were used to parameterize, calibrate and validate a daily process-based farming systems model, APSIM - Agricultural Production Systems sIMulator. The model calibration indicated a positive strong relationship between predicted and observed maize grain yields and biomass. The validation analysis suggests that the model is capable of simulating soil-water, biomass (r = 0.82 and RMSE of 572 kg.ha-1) and grain yields (r =0.76 and RMSE = 2 577 kg.ha-1). In order to simulate the effects of IRWH on hydrological processes and crop productivity APSIM was configured with a runoff generation area and a basin collection along a soil profile. This concept was adopted from the PARCHED-Thirst model and yielded a strong correlation with observed data. The strong correlation between model simulations and observed were also found in validation analysis of effects of CT and NT tillage practices. The calibrated model was used for climate impact and adaptation strategies analysis. To perform the analysis over the Limpopo Province, in unmeasured or tested locations and environmental conditions - an APSIM-GIS coupling approach commonly used in hydrological modelling, was adopted in this research for scaling up the validated model's farming systems to sub-catchment scale, for simulating the tillage practices effects on agro-hydrological responses across varying climate and soils over different locations and time period. Findings from the simulations based on APSIM-GIS coupling over maize producing areas in the Province on effects of tillage practices with different surface mulch levels on agrohydrological responses, suggested the available soil-water content increased with increments in surface residue, but these positive effects were negated in some sub-catchments with high rainfall and/or through drainage losses. A similar trend as soil-water content was observed for maize grain yield, but with even more sub-catchments experiencing higher yields, and some decrease with increments in residue application levels mostly in high rainfall areas. The combination of both tillage and surface residue yielded higher maize grain yields in IRWH combination and less so in NT. In order to select an ensemble of representative General Circulation Model (GCM) suitable for assessing future climate scenarios, GCM's similar to those presented in Intergovernmental Panel on Climate Change 4th Assessment report were used, and only those available at daily time-step and empirically downscaled (to climate station level) were selected for inclusion in the fourth chapter. Further, the GCMs scenarios values used were from the A2 emission (low mitigation) storylines forcing over the Limpopo Province. Then, a set of these GCMs scenario values representing four random locations assumed to representative of the Province were selected. The selection process was based the GCMs performance in predicting past climate conditions, followed by their representation of a range of future climate projections, with precipitation as dominant determinant factor owing to all GCM projections suggesting a similar direction in temperature regimes. Crop management scenarios, developed from LSF survey data, were surface mulch application only for poor-resourced farmers, whereas, for better-resourced farmers both nitrogen fertiliser and surface mulch application, both farmer groups with early and late sowing dates. The practices identified were different sowing dates, N fertilizer and surface mulch application, and interaction effects of the Summary 105 practices. These were used for climate change impacts assessment of LSF system across maize growing sub-catchments over the Province, using the calibrated coupled APSIM-GIS modelling system. Two climate projections periods, i.e. 1971-1990 and 2046-2065, were used and findings from the assessment indicated that an increased fertiliser use leading to higher soil fertility would increase yields for present and future projections. The incorporation of surface mulch effect lead to significant declines in simulated grain yields (over 90 %) mainly in high rainfall areas. Early sowing dates had significant effect on potential maize yields with 48 % increase, over 58 % of the Province. The interaction effects of the management scenarios are likely to result in up to 17 % higher yields. Therefore, N fertilization should be part of the practices that allow higher productivity even under less favourable climate. Poor-resourced farmers' potential maize yields under projected future climate will be negatively impacted, with some gains arising from those who plant early and do not apply surface mulch. Better-resourced farmers were shown to have an opportunity to capitalise on climate change impacts, compared to their counterparts mainly due to application of N fertilizer. The current poor farmer management practices are not resilient to prevailing climates and are postulated in climate futures leading to significant low crop productivity. Soil fertility, planting dates and soil-water availability, in particular, were identified as factors influencing productivity in the Province. Projected increase in temperature was found to be the main contributors to low or reduce productivity, even with wetter future projections from the GCMs. The incremental, systemic and transformational adaptation modes, identified from literature as likely climate adaptation pathways, represented by adopt of short duration cultivars, mainstreaming supplementary irrigation and shifting from cereal crop to livestock ranching as adaptation measures (respectively). These adaptation modes were used to assessing plausible optimal adaptation phase for LSF by mid-century, using median GCM and coupled APSIM-GIS modelling approach. The findings indicate that transformational adaptation might be required much earlier than suggested from literature to be towards end of the century, as some areas are already experiencing extreme climate risks and vulnerabilities that might not be alleviated by incremental adaptation measures, as a result of increase temperatures exceeding the historical variability thresholds. Further, the results suggest that for the beneficial effects of climate-smart practices to optimize agricultural productivity, they would need to be targeted and adapted to a specific biophysical condition. The traditional cropping systems assessed in this study indicated spatially varied potential gains and losses in yields, however, farmers can capitalise on change climate by adopting better cropping practices and using seasonal forecast linked sowing dates. Incremental adaptation measures, such as farm management, are suggested not to be sufficient for addressing projected climate impacts at mid-century. This is expected to occur in certain areas and/or systems, particularly specialised cropping systems, when the climate-related risks and vulnerabilities far outweighs the adaptive response, and thus requiring transformational adaptation. Such transformational adaptation, in terms of landuse change has already observed in the region with traditional crop farmers opting for ranching and game farming, and large scale adoptions of irrigation.

Seit Beginn des Ackerbaus hat sich eine an die Kulturarten angepasste Ackerbegleitflora und -fauna entwickelt. Intensivierungsprozesse der landwirtschaftlichen Produktion führten in den letzten Jahrzehnten zu einer stetig voranschreitenden Umstrukturierung vieler Agrarlandschaften und einer Abnahme der Habitatdiversität. Diese Entwicklung war verbunden mit einem dramatischen Verlust der Artenvielfalt und einem drastischen Rückgang der Populationsgrößen von Segetalarten. Eine Reihe von Studien zeigt aber, dass eine artenreiche Segetalflora eine entscheidende Rolle bei der Erhaltung der Funktionsfähigkeit von Agrar-Ökosystemen spielt, z.B. durch Förderung höherer trophischer Ebenen oder durch die Bereitstellung von Ökosystemdienstleistungen. Die vorliegende Arbeit untersucht die Auswirkungen der ackerbaulichen Intensivierung auf die Segetalvegetation in Mitteldeutschland sowohl auf Landschafts- als auch auf Populationsebene. Die Ergebnisse dieser Untersuchungen wurden zur Evaluierung bestehender Projekte zur Förderung der Segetalflora genutzt und liefern eine Grundlage für zukünftige Schutzstrategien. Die Ergebnisse der Untersuchungen zeigen eine dramatische Verarmung der Segetalvegetation auf allen wichtigen Hierarchiestufen. Auf europäischer Ebene konnte für alle europäischen Länder nachgewiesen werden, dass ein höherer Weizenertrag auch mit einer erhöhten Zahl gefährdeter Segetalarten einhergeht. So hatte jede zusätzlich produzierte Tonne Weizen/ha eine Gefährdung von etwa zehn weiteren Segetalarten Ländern zur Folge. Dabei scheinen die an bestimmte Kulturarten angepassten Spezialisten am stärksten vom Aussterben bedroht zu sein. Die Untersuchungen belegen, dass der verstärkte Einsatz von Herbiziden in den EU-Mitgliedstaaten in Mittel-und Nord-Westeuropa zu einer Selektion ausgewählter Segetalarten geführt hat, die an die heutigen nivellierten Standortbedingungen angepasst ist. Auf Gesellschaftsniveau, zeigen unsere Untersuchungen deutlich, dass die Intensivierung der Nutzung von Agrar-Ökosystemen zu massiven Verschiebungen in der Zusammensetzung von Segetalgesellschaften geführt hat. In den 1950er/60er Jahren konnte die Mehrzahl der Vegetationsaufnahmen noch auf Assoziationsebene zugeordnet werden, während sich aktuelle Vegetationserhebungen oft nur noch auf der Ebene höherer Syntaxa wie Verband, Ordnung, Klasse oder als floristisch stark verarmte Fragment-Gesellschaften einstufen ließen. In diesem Zusammenhang kann in den letzten fünf Jahrzehnten auch eine Verringerung des regionalen Artenpools um 23 %, ein dramatischer Artenverlust auf Plot-Ebene (mittlerer Verlust von 17 Arten pro Aufnahme) sowie stark zurückgehende Populationsgrößen kennzeichnender Arten belegt werden. Die Ergebnisse verdeutlichen auch, dass die Intensität der Veränderungen in der Vegetationszusammensetzung zwischen den unterschiedlichen Böden variierte, wobei sandige Standorte weniger stark betroffen waren. Des Weiteren hat sich der mittlere Deckungsgrad der Segetalarten drastisch auf ein Zehntel des früheren Wertes reduziert, wohingegen der Deckungsgrad der Kulturpflanzen anstieg und die Kulturpflanzenvielfalt abnahm. Archäophyten, Neophyten und die meisten Grasartigen zeigten zum Teil starke Frequenzverluste ähnlich denen von einheimischen krautigen Pflanzen, aber nur geringe Veränderungen in ihrem Anteil an der Gesamtdeckung der Segetalarten. Der beobachtete Anstieg der "Ellenberg-Zeigerwerte" für Stickstoff und Bodenreaktion deutet darauf hin, dass die höhere Düngergaben in Kombination mit der heute üblichen Anwendung von Herbiziden und den sehr dicht stehenden Kulturpflanzenbeständen als Hauptursachen für Veränderungen in der Segetalvegetation angesehen werden können. Der beobachtete Trend einer Vereinheitlichung der Gesellschaftstrukturen von Segetalarten, bei der Spezialisten und diagnostisch wichtige Arten zurückgehen und die Anzahl und Abundanz der Generalisten zunimmt, spiegelt die Vereinheitlichung von Anbausystemen und der Optimierung des Nährstoffangebotes in den letzten Jahrzehnten wider. Der beobachtete Rückgang der Populationsgröße, insbesondere bei selten gewordenen Arten mit geringer Populationsgröße (Adonis aestivalis L. und Consolida regalis S.F. Gray), wirkten sich auf die genetische Vielfalt dieser Populationen aus. Da die genetische Struktur zwischen den Arten und Populationen variiert, ist in diesem Zusammenhang auch die Komplexität der Landschaftsstruktur entscheidend. Anders als erwartet war die genetische Diversität innerhalb einzelner Populationen in weniger stark strukturierten Landschaften wesentlich höher als innerhalb von Populationen in strukturreichen Landschaften. Populationen aus strukturreichen Landschaften unterschieden sich genetisch zudem stärker voneinander als Populationen strukturärmerer Landschaften. Darüber hinaus wurde bei der fremdbefruchtenden C. regalis eine höhere Diversität innerhalb der Populationen festgestellt, während die selbstbefruchtende A. aestivalis eine geringere Diversität innerhalb der Populationen aufwies. Allerdings zeigten weder A. aestivalis noch C. regalis eine signifikante "Isolation-by-Distance" unabhängig von der Landschaftsstruktur. Zusammenfassend zeigt die vorliegende Arbeit, dass auf allen Hierarchiestufen von der kontinentalen Ebene, über die Phytocoenosen bis hin zu Populationen einzelner Arten starke Veränderungen in den Segetalgesellschaften stattgefunden haben. Um das nationale Ziel der Erhöhung der Populationsgrößen der Mehrzahl der Arten in landwirtschaftlich genutzten Ökosystemen bis 2015 zu erreichen, sind neue, effektive und innovative Maßnahmen dringend erforderlich. Um den fortwährenden Biodiversitätsverlust in der Agrarlandschaft entgegenzuwirken ist vor allem eine entsprechende Ausgestaltung der Gemeinsamen Europäischen Agrarpolitik (GAP) für die Förderperiode 2014-2020 von zentraler Bedeutung. ; Since the first creation of arable land a crop-adapted flora and fauna has developed as a byproduct of low-intensity agriculture. Intensification and economic optimization of agricultural production during the last few decades have led to simplified agricultural landscapes and a decrease in spatial heterogeneity, resulting in a dramatic loss of species diversity and population decline of arable plants. In this context, numerous recent studies have pointed out that a diverse arable flora plays a key role in the functioning of agricultural systems, acting to maintain beneficial ecological functions (e.g. support of higher trophic levels or provision of ecosystem services). The aim of this thesis is to provide insights into the influence of agricultural intensification processes on shifts in arable vegetation from the continental to the population level for evaluating existing arable plant conservation schemes and proposing future strategies. Within the framework of this thesis, all observational studies were carried out in Central Germany. This study demonstrates a dramatic impoverishment of the arable vegetation on all major organisational levels. At the continental European scale, we found a positive relationship between national wheat yields and the numbers of rare, threatened or recently extinct arable plant species in each European country. It was found that for every extra tonne/hectare of wheat produced approximately ten more plant species become nationally threatened. Specialist species adapted to certain crops were among the most threatened. The results from this study showed that the increased use of agro-chemicals, especially in the EU Member States in Central and North-Western Europe, has selected against a larger group of arable species adapted to habitats with intermediate fertility. Moving to finer scale on the community level, this study clearly demonstrates that the European-wide intensification of arable habitat use has led to massive shifts in the arable plant community composition. In the 1950s/60s, most of the relevés could be easily assigned on association level, while the recent relevés could often only be classified at the level of higher syntaxa such as alliance, order, class or 'fragmental' floristicallyimpoverished communities. In this context, our analysis revealed a reduction of 23% in the number of species in the regional species pool during the 50-yr period, dramatic losses in plot-level diversity (median loss of 17 species per relevé) and decreasing population sizes of rare and diagnostic species. The results also indicate that vegetation changes depended on geological substrate, with sandy sites being less severely affected. Furthermore, the average cover of arable plants has dramatically decreased to a tenth of its original extent, while crop cover generally increased and crop diversity decreased. Archaeophytes, neophytes and most Poaceae (including some highly competitive weeds) showed large frequency losses similar to that of indigenous herbarceous plants, but only modest changes in their share of total arable plant cover. The observed increasing Ellenberg indicator values (EIV) for nitrogen and pH indicate that N-fertilisation may, in combination with increasing usage of herbicides and denser crop stands, act as a major driver of change in the arable vegetation. Consequently, the reported clear trend towards homogenization in community structure, where specialists and diagnostic species have disappeared and generalists increased is reflecting the growing uniformity in crop management schemes and soil fertility levels in recent time. The reported decreasing population sizes, especially in rare species with small populations (in this case Adonis aestivalis L. and Consolida regalis S.F. GRAY), are shown to affect their genetic diversity. In this context, also landscape complexity plays an important role because genetic structure varies among species and populations. However, contrary to expectation, within-population diversity levels of the species were significantly higher in populations located in monotonous landscapes than in populations of structurally diverse landscapes. Populations from diverse landscapes differed more significantly from each other than those from monotonous landscapes. Furthermore, we observed high within-population diversity for the outcrossing C. regalis, but low within-population diversity for the self-pollinating A. aestivalis. However, neither A. aestivalis nor C. regalis showed a significant isolation-by-distance regardless of landscape structure. In conclusion, the present study shows that arable plant communities are under dramatic threat, affecting all major organisational levels from the European scale to the population level. The rapid shifts in the highly dynamic agro-ecosystems within the last few decades have strongly influenced community structure, plant diversity, population sizes and genetic variation. To achieve the defined target of increasing the population size of the majority of species in agricultural ecosystems by 2015, new, effective and innovative schemes and programs are urgently required. Especially the design of the Common agricultural policy (CAP) after 2013 will be of major importance for the task to halt the loss of arable plant biodiversity in the agricultural landscape.

The development of human populations is determined by the demographic dynamics of fertility, mortality and migration. Health and disease patterns are a major component of all three demographic events. Epidemiology, the study of the distribution of disease and mortality as well as their causes and consequences, is therefore a substantial component of public policies and public interest. Researchers have identified global patterns of development in disease and mortality. One of the most fundamental global patterns is the theory of the Epidemiologic Transition by Omran (1971). The theory describes three stages of disease patterns in the transition from a population mainly challenged by pestilence and famines to a population facing primarily degenerative and "manmade" diseases. During the first stage, population growth is limited by Malthusian positive checks, which refer to population stagnation or reduction caused by famines, pandemics and violent deaths. The transition theory goes on to describe how changes in socioeconomic, cultural and political circumstances shifted the demographic pattern (decline and stabilization of mortality and fertility rates, rising life expectancy) to arrive in an era determined by degenerative and "manmade" disease, such as cancer or diseases of the cardiovascular system. The effects of the epidemiological transition are not only noticeable in the size and composition of the population but also in the economic output produced by the population. Decreased mortality and morbidity due to lower prevalence of infectious disease increases economic productivity and labor efficiency (Omran 1971). Through the prolonged survival of adults, the attainment and transmission of knowledge and skills is intensified and supports the development of national economic growth. While leaving behind some obstacles for population growth and economic development, a society whose health status is largely determined by degenerative diseases faces new challenges. With continuously increasing life expectancy in most developed countries, a large share of the population lives not only until the end of their economically active period, but as also well beyond that. Entering the last stage of Omran's Epidemiologic Transition during the middle of the 20th  century, the developed world experienced a strong increase in cardiovascular disease (CVD) mortality until the 1980s. From that time, mortality due to cardiovascular diseases began to fall again, while the morbidity rate for CVD was still increasing. These diverging trends in mortality and morbidity are caused by improvements in the treatment of acute cardiovascular events, leading to a higher share of patients surviving an initial event. Alongside high and increasing survival rates among CVD patients, the prevalence of CVD and CVD-related medical problems is also very high. Currently, CVD is the leading cause of death in developed countries, accounting for about 40 percent of all deaths. This thesis examines the case of Sweden, where over 40 percent of all-cause mortality is caused by CVD (Socialstyrelsen 2009). Treatment for diseases of the cardiovascular system is rather intense and therefore costly, because it not only includes medical intervention for acute events but also treatment for risk factors such as diabetes and hypertension, as well as medical management of chronic heart disease. Sweden has a universal healthcare system that is almost entirely tax-financed, implying that the costs associated with CVD account for a substantial share of the overall public healthcare costs in Sweden. In 2010, the direct and indirect costs of CVD amounted to roughly SEK 61.5 billion (~$9.3 billion). Direct costs contain expenditures for physicians, hospitalization, medication and home healthcare. Indirect costs account for costs of lost future productivity caused by premature mortality. The expenditures for healthcare of CVD patients represent around eight percent of the total healthcare expenditures in Sweden in 2010 (Steen Carlsson and Persson 2012). Given the high public costs for treatment of CVD and the economic loss due to premature morbidity and mortality among CVD patients, research on the causes and consequences of CVD has high priority within the field of public health. The prevention of the onset of the disease as well as the prolongation of general good health has become the focus of recent research on CVD. Those efforts are reinforced by the findings of previous research demonstrating that a substantial share of CVD is not inevitable and the onset and course of CVD can be altered by actions of the healthcare system and, more importantly, by the individual itself, through the maintenance of a healthy lifestyle. One important impact factor for CVD was found in socioeconomic status (SES) (Adler et al 1994). SES could be linked to many CVD risk factors and appears to be the origin of major direct and indirect impact pathways to the onset and progress of the disease. A large share of studies in the field of social epidemiology, sociology and public health focus on the relationship between SES and various health outcomes, including CVD. Some large-scale studies have  had the specific aim of evaluating the link between SES and CVD such as the Framingham Heart Study (Dawber and Kannel 1958) the Whitehall Study II and the co called "Black report" (Department of Health and Social Security 1980). During recent decades many studies have confirmed the existence of a social gradient, finding better health among individuals in the higher social classes (Cabrera et al 2001; Mackenbach et al 1997; Pocock et al 1987). The link between SES and health is not a straightforward one, however. One reason for the complexity of the relationship between SES and CVD lies in the variety of SES measurements. SES can be operationalized in a number of manners, such as occupation, economic performance, education, labor market attachment or other characteristics, and most of these measurements are highly correlated with each other. Formal education can be expected to lead to occupational success, while both characteristics are the basis for income attainment and labor market participation. While all these forms of operationalization will influence the risk for CVD in a similar way, regarding the direction of the effect, the magnitude of the effect can vary substantially. Furthermore, the effects of SES will vary depending on the demographic characteristics of individual. The individual ethnic background and marital status will shape SES impact on CVD as will the sex and age of a person. This thesis investigates SES differences in the onset of CVD among samples of the population in contemporary Sweden. The overall aim is to achieve a broad picture of SES impact factors and their direct as well as indirect effects on CVD, taking other risk factors and individual characteristics into account. Throughout the papers, included in this thesis, SES is operationalized in different forms. Therefore, each paper investigates a different aspect of the relationship between SES and CVD, emphasizing the complexity of the relationship. The findings from this study will be useful for identifying opportunities for future CVD prevention programs aiming at reducing SES differences and the resulting health impact among the population. For many of the CVD risk factors there is the risk of reverse causality. On the one hand, lower SES could be the reason for unhealthy lifestyles and therefore increase the risk for CVD. On the other hand, the incidence of CVD could cause changes in labor market attachment and income level. This thesis is taking part of the causality problem into account by limiting the analysis to the onset of CVD (only the first CVD event for every person). Furthermore, the empirical part of the thesis focuses on coronary heart disease as the main subgroup of CVD, thereby excluding more rare forms of CVD, mainly incidences of stroke, for which the empirical results of SES impact have been less consistent.Building on established theories and models, this thesis identifies new aspects and impact  pathways of SES in relation to the onset of CVD, taking into account a set of additional risk factors and their potential effects on CVD.

Migration has become an important phenomenon in many countries of Europe and Central Asia. The development implications of migration in the region were first examined in the flagship report "Migration and Remittances: Eastern Europe and the former Soviet Union." This report builds on the World Bank's earlier work and focuses on an aspect of migration which is important, from various aspects, to practically all countries of the Europe and Central Asia region. The role that the diaspora can play is a major part in overall migration policy of the countries of Europe and Central Asia. This report represents a first step towards understanding the role that Europe and Central Asian diaspora can play in their home countries and how the Bank can facilitate these relationships. The report is part of the World Bank's migration program in countries of Europe and Central Asia, which was initiated with the aim to help countries respond to policy, institutional and program challenges of migration and remittances in the quest for sustained economic growth and poverty reduction.

Marc Joffe


According to the United Nations, the world population surpassed the eight billion mark on November 15, 2022, and reached 8.045 billion on July 1 of this year. But these figures vary significantly from US Census Bureau estimates which placed the global population at just 7.979 billion at the beginning of July.
Population and especially population growth estimates are an important basis for policy. The UN projects that the population will continue to grow into the 2080s when it will reach 10.4 billion. Reacting to these figures, Liu Zhenmin, UN Under‐​Secretary‐​General for Economic and Social Affairs observed: "Rapid population growth makes eradicating poverty, combatting hunger and malnutrition, and increasing the coverage of health and education systems more difficult."
Writing in The Guardian, the newspaper's former environment editor John Vidal concluded "The hard fact is that in an age of climate breakdown, human numbers matter. And the ecological impact of another 2–3 billion humans will be immense." He went on to note that the Intergovernmental Panel on Climate Change had identified global population growth as one of the two biggest drivers of growing CO2 emissions, the other being increasing GDP per capita.
Concerns about climate change, hunger, and inadequate service provision may be mitigated if the world's population is growing more slowly and is on course to stagnate earlier than the UN expects.
A country‐​by‐​country comparison of the UN and US Census figures reveals some large discrepancies in both directions. The accompanying table shows all cases in which the respective estimates differed for a given country by five million people or more.











The UN's estimate for China is especially doubtful. China's official population estimate was 1,412 million at the end of 2022 reflecting an 850,000 person drop from the previous year. And the decline is likely to have accelerated in 2023 with demographers forecasting a lower number of births than in 2022 and perhaps a million excess deaths from COVID-19 following the termination of pandemic restrictions.
Chinese authorities have not been forthcoming about COVID deaths adding to suspicions that they are overstating the nation's population. One independent expert, Yi Fuxian of the University of Wisconsin‐​Madison estimates China's population at no more than 1.28 billion which is at least 130 million below the official figure. Fuxian offers evidence that the Chinese authorities have been systemically overstating births for decades.
He also casts doubt on the UN's estimate of India's population. That nation's last Census, in 2011, found 1,211 million people, or about five million less than the UN data show for that year. If fertility has plummeted more than the UN expected the gap between more recent estimates and reality will likely be magnified. We will only know for sure when India conducts its next Census in 2024.
While US Census estimates appear to be better than UN estimates for China and India, both are flawed in the case of the third most populous country, the United States. Both sources place US population at slightly under 340 million as of July 1, 2023 (for the US Census, I'm referring to its International Database data file; a lower number is shown on the Census Bureau's World Population Clock web page).
However, the US Census Bureau's July 1, 2022 domestic population estimate was 333 million, reflecting a 1.2 million increase over the prior year and a 1.9 million increase over the 2020 decennial Census. Even with the bounce‐​back in population growth post‐​pandemic, it is hard to imagine US population totaling more than 335 million as of July 1, 2023, suggesting a five‐​million‐​person overestimate in both global datasets.
So, there is good reason to believe that the global population did not exceed 8 billion last year and may still be below that milestone in late July 2023. Given the lower 2023 level and apparently slower growth in recent years, the UN's projection of a 10.4 billion peak in 2086 should also be called into question.
Other researchers have more modest growth expectations. The Institute for Health Metrics and Evaluation projects a peak population of 9.7 billion in 2064, while Earth4All expects a peak of less than 9 billion around 2050 with an even lower maximum if development in poorer nations accelerates.
Whether we should welcome slower population growth is open to debate. While the mainstream view focuses on the threats of overpopulation, Cato's Marian Tupy welcomes new people as a source of innovation. As Tupy wrote when the world population purportedly hit the 8 billion mark last November: "Every new human being comes to the world not only with an empty stomach, but also a pair of hands, and, more importantly, a brain capable of intelligent thought and new knowledge creation."
But regardless of whether one welcomes or fears population growth, the policy debate is impoverished by stale and inaccurate data. We often hear that we're entitled to our own opinions, but not our own facts (a quote often attributed to the late Senator Daniel Patrick Moynihan but which appears to have earlier origins). Yet in this case, the very foundational question of how many people now reside on earth, there is no reliable source of ground truth.

Purpose
The purpose of this study/paper Manipulating Golden Wombs' (2017) is to show the author's non-site intervention of authoritarian – undemocratic maneuvering of both women's and earth's "golden" wombs. The burning fossil fuels in myriads of flame colors, signal the power and distress of Earth's wounded womb, memories of war, environmental destruction and human fatality, and descend to decline as extinguished Oil Drops (2017), creating a void. Global warming poses a problem for fossil fuel systems and those who profit from them.


Design/methodology/approach
The title of this paper has been inspired by Cara New Dagget's book, The Birth of Energy (2019), posited in the nascent realm of energy "mortalities." Now, confronting a world warmed by sweltering fossil fuels, the book provides us with a direction to thinking energy beyond the "Calvinist view" of everlasting work. Spellbound by Manipulating Golden Wombs' (2017), the audience canter around the outer surface of the centrally positioned, circulating luminous "acrylic" oil drops highlighted by hundreds of mono-frequency lamps impregnated with desert biodiversity. A closer look takes spectators through a fiery desert, across the fossil fuel fields into the depths of its scorching oil wells, its womb, as they sense the "real-time" catastrophe that had occurred beyond the gallery wall.


Findings
These artists' objective with their interventions is to "root it to the contour of the […] land, so that it's permanently there and subject to the weathering," so the audience is "sort of curious to see what will happen to this" (Schmidt, 1996, 225) through the course of time. The works resists the resistance of nature and social culture, as well as of body and intellect by emphasizing the intransience, however complex, of human beings with the ecosphere in which they survive (Novak 2002, 23). The surfacing of the under-surface of the land and ocean life triggers the idea of the private space, which involves role-play, gender norms and the control over women's lives in the capitalist and Gulf societies. Authoritarianism, fossil fuel capital, high-energy use and militarism make the climate politics critical to planetary security. This combustible convergence gave birth to Manipulating Golden Wombs' (2017).


Research limitations/implications
Ganz reminds us that devouring less energy appears to be almost unharmonious with the current politics of being "Modern." Sacrificing energy resonances with abstinence at best, and widespread death and injustice at worst. But, consuming an overload of energy is incompatible with a multispecies existence on Earth. Scientists caution "a cascade of feedbacks could push the Earth System irreversibly onto a 'Hothouse Earth' pathway," the consequence of which could be an uninhabitable, unsafe globe for beings (Steffen et al., 2018). Even though it sounds vivid, it is hard to overstate the crisis in the midst of what environmentalists and biologists term as a sixth extinction event (Kolbert, 2014), in line with a "biological annihilation" that paints "a dismal picture of the future of life, including human life" (Ceballos et al., 2017).


Practical implications
It is not only the land's womb that we have hurt; we have miffed the hearts of the water network, and "Othered" and the wombs of many women and most surfaces of the Earth have been penetrated, unconsented! To sustain a biodiverse sphere, to pause the deaths of the planet's flora and fauna and to thrive on Earth, we need to work on renewable sources of energy based on "new collectively shared values, principles, and frameworks" (Steffen et al., 2018). We need to stop Manipulating Golden Wombs' (2017). Are we ready to accept the challenge? (Lau and Traulsen, 2016)


Social implications
Petro-masculinity has multiple global dimensions and manifests in multiple and locally specific ways (Dagget, 2018). This encourages the geographically diverse artists discussed in this paper to embrace alternative visions, to make bold and explicit statements on gender and global diversity, equity and rights. Through history, women, in specific, embodied the entirety of the Ecocene and its life cycle and explored it in the context of their own relationships, health, sexuality, fertility, reproduction, childbirth, illness and inescapably death. The artists' interventions' visual physiognomies and intentions point toward a comprehensive agenda of action that leads to remedial courses toward reinstating the biome to a healthy condition.


Originality/value
Manipulating Golden Wombs' (2017) enacts the historic all-consuming fires, penetrating the "shared environment," burning the fossilized fuels exuding from Earth's penetrated womb. The higher cone-shaped oil drops irradiate the intense dazzling images of oil wells in flames and the desert flora and fauna nestled within the scorching inner arena. This aligns with the private space provided to women. The wombs are smothered in the fuming fires of the Gulf war. The darker, narrower lower oil drops, iconic of the remnants of fossil fuel, are the residual sludge within which the land and water species are enmeshed and ensnared to death. The potency of the enactment of the drops "enables the viewer to see [him/]herself seeing, to become aware of how she perceives the world around [him/]her and in doing so participates in shaping it" (Eliasson, 2009, p. 25) as a form of engagement, which involves an "attention to time, movement and changeability" (pp. 18–21).

The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. Data for this research was provided by MEASURE Evaluation, funded by the United States Agency for International Development (USAID). Views expressed do not necessarily reflect those of USAID, the US Government, or MEASURE Evaluation. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with licence no. SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law-2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. ; Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. ; Research reported in this publication was supported by the Bill & Melinda Gates Foundation, the University of Melbourne, Public Health England, the Norwegian Institute of Public Health, St. Jude Children's Research Hospital, the National Institute on Aging of the National Institutes of Health (award P30AG047845), and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). ; Peer reviewed

Magistritöö Linna- ja tööstusmaastike korralduse õppekaval ; Toetused on muutunud põllumajandustootjatele lisasissetulekuallikaks. Hekseldamise nõude ümber oleva problemaatika vähendamiseks on oluline selgeks teha, miks seda on hakatud piirama. Magistritöö eesmärk on koostada analüüs hekseldamise nõude muutumise otstarbekusest ning selgitada välja, kas heksli maha jätmise keelamine on põhjendatud või toimitakse põllumajandustootjate suhtes ebaõiglaselt. Töö aitab kaasa arusaamisele, miks hekseldamist on hakatud piirama. Töö eesmärgi täitmiseks on seatud järgmised uurimisülesanded: • anda ülevaade hekseldamise nõude muutumisest ning milline on see aastatel 2017- 2019; • välja selgitada hekseldamise positiivsed ja negatiivsed mõjud põllumajandustootjatele ja keskkonnale; • välja selgitada Viljandi- ja Valgamaa põllumeeste suhtumist hekseldamise piiramisse; • välja selgitada, kuidas suhtuvad PRIA, Keskkonnaamet ja Maaeluministeerium hekseldamise piiramisse. Esimese uurimisülesande täitmiseks on kasutatud peamiselt PRIA publikatsioone ja artikleid, mis olid seotud otsetoetuste nõuetega. Teise uurimisülesande täitmiseks on kasutatud vaatlust, teadusartikleid rohumaade hooldamise teemal ning sarnaseid uuringuid. Materjalide läbitöötamisel on kasutatud kvalitatiivset tekstianalüüsi ja kvantitatiivset uurimismeetodit. Magistritöö kolmanda uurimisülesande täitmiseks koostati küsimustik Viljandi- ja Valgamaa põllumajandustootjatele. Neljanda uurimisülesande täitmiseks viidi läbi kaks poolstruktureeritud intervjuud PRIA ja Keskkonnaameti ametnikega ning saadeti küsimustik Maaeluministeeriumi ametnikule. 2019. aastal tuleb hekseldatud rohi kokku koguda, põhjuseks on toetuste suunamine aktiivsetele põllumajandustootjatele. Hekseldamise negatiivsed mõjud on järgmised: hekseldamisest on saanud eraldi tegevusharu, hekseldamine piirab aktiivset tootmist, tõusevad maade hinnad, põllulindude arvukus langeb, liigirikkus väheneb, toitainete sisaldus suureneb jne. Positiivseteks mõjudeks on sissetulek, sobivus taastamisvõtteks, kasutamine halva ligipääsetavuse ja madala haljasmassi kvaliteediga põldudel ning vaadete avatud hoidmine. PRIA ja Keskkonnaameti ametnike arvates on hekseldamise nõude karmistumine põhjendatud, sest sellest on kujunenud eraldi tegevusharu. Hekseldamise positiivseks mõjuks on rohumaade taastamine. Maaeluministeeriumi ametniku arvates on hekseldamine marginaalsel tasemel, kuna see moodustab vaid 6 % väljamakstavast toetussummast. Magistritöö autori arvates on hekseldamise nõude karmistumine põhjendatud, sest sellel on eelkõige negatiivne mõju keskkonnale. Käesolev magistritöö aitab põllumajandustootjatel paremini mõista, miks hekseldamise kasutamine rohumaade hooldamisel ei ole hea mõte. ; Area payment schemes have altered to additional source of income for agricultural producers. To lessen the problematic discussions over chopping requirements it's essential to explain why it is being restricted. The aim of current master's thesis is to compose an analysis about the expedience of changing the requirements on grasslands chopping in Estonia and to ascertain the justification of prohibition of leaving chopped grass on fields and the possibility that legislators are acting unfairly towards agricultural producers. It should contribute to the understanding of why chopping the grasslands is restricted. To achieve the goal author raised four research tasks: • to give an overview, how the requirements on chopping the grasslands in Estonia have changed in past and what are the distinctions in 2017-2019; • to ascertain negative and positive impacts of chopping the grasslands to environment and agricultural producers; • to find out the attitude in relation to restrictions of chopping among farmers in Viljandi and Valga county; • to survey the stands towards restrictions of chopping the grasslands among public servants in Estonian Agricultural Registers and Information Board (ARIB), Environmental Board and Ministry of Rural Affairs. To achieve first research task mainly articles and publications related to requirements of area-related aid from Estonian Agricultural Registers and Information Board were elaborated. To achieve second research task observation and elaborating scientific articles and similar surveys about maintaining the grasslands were used. To work through the material qualitative and quantitative text analysis were used. To achieve third research task a questionnaire was prepared for agricultural producers in Viljandi and Valga county. To achieve fourth research task two semi-structured interviews were conducted with the public servants of Estonian Agricultural Registers and Information Board and Environmental Board and one questionnaire was distributed to the servant of Ministry of Rural Affairs. From 2019. and further on its prohibited to leave chopped grass on fields. The requirement is established to refer subsidies to active agricultural producers. Negative impact of chopping the grasslands is related to fact that chopping has become a source of subsistence for non-producers, which limits the possibilities of expanding for active agricultural producers, increases the land prices, decreases the direct support unit rates, the multiplicity of wild birds, declines the biodiversity and increases the soil fertility. As a counterbalance to this positive impact of chopping the grasslands is a considerable income for owners of permanent grasslands, it's suitable for grassland restoration and puddles cleaning likewise is the best option for maintaining grasslands with poor access and low grass quality. Public servants from Estonian Agricultural Registers and Information Board and Environmental Board believe that restricting the requirements is reasonable as chopping has become an individual branch of economy. In their opinion positive effect related to chopping is the restoring of unused grasslands. The servant from Ministry of Rural Affairs considers chopping grasslands marginal as it forms only 6 % from the amount paid out for area-related support. Author of current master's thesis considers the restriction of chopping requirements grounded as it first and foremost has negative impact to environment. Current master's thesis helps agricultural producers realize why chopping is not the best way to maintain grasslands.

Demographic situation in Ukraine has a tendency to decline in fertility and having few children. The main reasons are socio-economic situation, lack of adequate housing conditions and parents' concerns of the impossibility of securing the children's future . In addition, the statistics clearly indicate the need for a speedy resolution of the reproductive health problems.Currently, Ukraine has a government social program of family support, which aims to preserve traditional family values, strengthening motivation for marriage registration, birth and conscious parenting, enhance social protection for families who are in difficult circumstances, prevention and combating violence family. One of its areas is preventive, cultural and educational work in educational institutions, which takes care of the Ministry of Health. In particular, in the Institute of Pediatrics, Obstetrics and Gynecology NAMS of Ukraine was created National Center for Family Planning and Reproductive Health, which provides medical care to young families for family planning and the emergence of a healthy young generation, performs most preventive and educational activities among people.At the same time we must not forget the traditional Ukrainian family values, which are based on family and religious and spiritual traditions. It should be retained the historical heritage of the family, its cultural and national traditions, creating a culture of family relations, mutual respect and responsibility for child rearing, and recognition of the importance of women and men equality in family relationships. These and other issues were discussed at a hearing in Parliament dedicated to the goals and objectives of family policy in Ukraine. According to the participants' opinion (delegates from ministries and departments, public organizations and clergy) preparation to family life must begin with families, kindergartens, schools, keep it in high school, forming family values and giving more attention to promoting this issue in the media area. ; Демографическая ситуация в Украине имеет тенденцию к малодетности и спаду рождаемости. Основными причинами считаются социально-экономическая ситуация, отсутствие надлежащих жилищных условий, а также опасения родителей насчет невозможности обеспечить будущее детей. Кроме того, статистические данные убедительно свидетельствуют о необходимости просветительской деятельности среди молодежи и скорейшего решения проблем в сфере репродуктивного здоровья.В настоящее время в Украине действует Государственная целевая социальная программа поддержки семьи на период до 2016 г., целью которой является сохранение традиционных семейных ценностей, усиление мотивации к регистрации браков, сознательного рождения и воспитания детей, повышения социальной защиты семей, оказавшихся в сложных жизненных обстоятельствах, предупреждение и противодействие насилию в семье. Одним из ее направлений является профилактическая и культурно-просветительская работа среди молодежи в образовательных учреждениях, которую курирует Министерство здравоохранения Украины. В частности, на базе Государственного учреждения «Институт педиатрии, акушерства и гинекологии НАМН Украины» был создан Государственный центр планирования семьи и репродуктивного здоровья, который оказывает медицинскую помощь молодым семьям относительно планирования семьи и появления здорового молодого поколения, проводит большую профилактическую и просветительскую деятельность среди населения.Вместе с тем нельзя забывать о традиционных украинских семейных ценностях, основанных на семейных и религиозно-духовных традициях. Сохранение исторического достояния семьи, ее культурных и национальных традиций, формирование культуры семейных отношений, взаимного уважения и ответственности за воспитание ребенка, признание значимости и равенства женщины и мужчины в семейных отношениях – основные составляющие государственной семейной политики.Об этом, среди прочего, говорилось на слушаниях в Верховной Раде Украины, посвященных целям и задачам семейной политики государства. По мнению участников мероприятия, среди которых были представители министерств и ведомств, общественных организаций, а также духовенства, процесс подготовки человека к семейной жизни необходимо начинать с семьи, детского сада, школы, продолжать его в высшем учебном заведении, формируя семейные ценности и уделяя больше внимания пропаганде этого вопроса в информационном пространстве. ; Демографічна ситуація в Україні має тенденцію до малодітності та спаду народжуваності. Основними причинами вважаються соціально-економічна ситуація, відсутність належних житлових умов, а також побоювання батьків щодо неможливості забезпечення майбутнього дітей. Крім того, статистичні дані переконливо свідчать про необхідність просвітницької діяльності серед молоді та якнайшвидше розв'язання проблем у сфері репродуктивного здоров'я.Наразі в Україні діє Державна цільова соціальна програма підтримки сім'ї на період до 2016 р., метою якої є збереження традиційних сімейних цінностей, посилення мотивації до реєстрації шлюбів, свідомого народження і виховання дітей, підвищення соціального захисту сімей, які опинилися у складних життєвих обставинах, попередження і протидія насильству в сім'ї. Одним із її напрямків є профілактична і культурно-просвітницька робота серед молоді в освітніх закладах, якою опікується Міністерство охорони здоров'я України. Зокрема, на базі Державної установи «Інститут педіатрії, акушерства і гінекології НАМН України» було створено Державний центр планування сім'ї та репродуктивного здоров'я, який надає медичну допомогу молодим родинам щодо планування сім'ї та появи здорового молодого покоління, проводить велику профілактичну і просвітницьку діяльність серед населення.Водночас не можна забувати про традиційні українські сімейні цінності, які ґрунтуються на родинних та релігійно-духовних традиціях. Збереження кращих історичних надбань сім'ї, її культурних та національних традицій, формування культури сімейних відносин, взаємної поваги та відповідальності за виховання дитини, визнання значущості і рівності жінки й чоловіка в сімейних стосунках – основні складові державної сімейної політики. Про це, серед іншого, йшлося на слуханнях у Верховній Раді України, присвячених цілям та завданням сімейної політики держави. На думку учасників заходу, серед яких були представники міністерств і відомств, громадських організацій, а також духовенства, процес підготовки людини до сімейного життя необхідно розпочинати з родини, дитячого садочку, школи, продовжувати його у вищому навчальному закладі, формуючи сімейні цінності і приділяючи більше уваги пропаганді цього питання в інформаційному просторі.