Financial systems and development

the number of females is much smaller than what rived mostly from official community reports and
would be a normal demographic pattern. In some hospital records, and some reflect only deaths in
countries, the apparent imbalance may be the hospitals and other medical institutions. Someresult
of migration (for example, Kuwait and times smaller private and rural hospitals are ex-
United Arab Emirates), where males enter the cluded, and sometimes even relatively primitive
country to work on contracts. In others, male out- local facilities are included. The coverage is theremigration
or the disproportionate effect of war cre- fore not always comprehensive, and the figures
ates a reverse imbalance of fewer than expected should be treated with extreme caution.
males and may partly hide, or compensate for, the Clearly, many maternal deaths go unrecorded,
excessive female mortality.
particularly in countries with remote rural popula-
Typically, however, in the absence of such fac- tions; this accounts for some of the very low numtors,
a female-to-male ratio significantly below 100 bers shown in the table, especially for several Afriin
the general population of a country reflects the can countries. Moreover, it is not clear whether an
effects of discrimination against women. Such dis- increase in the number of mothers in hospitals
crimination affects mostly three age groups: very reflects more extensive medical care for women or
young girls, who may get a smaller share of scarce more complications in pregnancy and childbirth
food or receive less prompt costly medical atten- because of poor nutrition, for instance. (See Table
tion; childbearing women; and to a lesser extent 28 for low birth weight data.)
the resourceless elderly. This pattern of discrimina- These time series attempt to bring together readtion
is not uniformly associated with development. ily available information not always presented in
There are low- and middle-income countries (and international publications. WHO warns that there
within countries, regions) where the composition are "inevitably gaps" in the series, and it has inof
the population is quite "normal." In many oth- vited countries to provide more comprehensive figers,
however, the numbers starkly demonstrate the ures. They are reproduced here, from the 1986
need to associate women more closely with devel- WHO publication Maternal Mortality Rates, suppleopment.
mented by the UNICEF publication The State of the
The health and welfare indicators in the next five World's Children 1989, as part of the international
columns draw attention, in particular, to the condi- effort to highlight data in this field. The data refer
tions associated with childbearing. This activity to any year from 1977 to 1984.
still carries the highest risk of death for women of The infant mortality rate is the number of infants
reproductive age in developing countries. The in- who die before reaching one year of age, per thoudicators
reflect, but do not measure, both the avail- sand live births in a given year. The data are from
ability of health services for women and the gene- the U.N. publication Mortality of Children under Age
ral welfare and nutritional status of mothers.
5: Projections, 1950-2025 as well as from the World
Life expectancy at birth is defined in the note to Bank.
Table 1. The education indicators, based on Unesco
Births attended by health staff show the percentage sources, show the extent to which females are enof
births recorded where a recognized health ser- rolled at school at both primary and secondary levvice
worker was in attendance. The data are from els, compared with males. All things being equal,
the World Health Organization (WHO) and sup- and opportunities being the same, the ratios for
plemented by UNICEF data. Maternal mortality females should be close to 100. However, inequaliusually
refers to the number of female deaths that ties may cause the ratios to move in different direcoccur
during childbirth, per 100,000 live births. Be- tions. For example, the number of females per 100
cause "childbirth" is defined more widely in some males will rise at secondary school level if male
countries, to include complications of pregnancy attendance declines more rapidly in the final
or of abortion, and since many pregnant women grades because of males' greater job opportunities,
die because of lack of suitable health care, maternal conscription into the army, or migration in search
mortality is difficult to measure consistently and of work. In addition, since the numbers in these
reliably across countries. The data in these two se- columns refer mainly to general secondary educaries
are drawn from diverse national sources and tion, they do not capture those (mostly males) encollected
by WHO, although many national ad- rolled in technical and vocational schools or in fullministrative
systems are weak and do not record time apprenticeships, as in Eastern Europe.
vital events in a systematic way. The data are de-
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