Kerala State in southwestern India has achieved some of the third world's best rates of life expectancy, literacy, and infant mortality, despite one of the lowest per capita incomes. Especially notable is the nearly equal distribution of development benefits to urban, rural, male, female, high-caste, and low-caste sections of the populations. An even population distribution, a cosmopolitan trading history, and the development of militant worker and small farmer organizations led by dedicated activists provide the main explanations for Kerala's achievements. Land reform has redistributed wealth and political power from a rich elite to small holders and landless laborers. Public food distribution at controlled prices, large-scale public health actions, accessible medical facilities, and widespread literacy combine with and reinforce each other to maintain and expand Kerala's achievements. Serious unemployment threatens the Kerala experiment, but Kerala nonetheless offers important lessons to development planners, policymakers, and third world activists.

The 1996-2001 Kerala People's Campaign for Decentralized Planning has provided much new information about the possibilities and potential of decentralizing public health and health care services. Analysis of investment patterns of the various government levels involved in the campaign, supplemented with case study materials, allows for an evaluation of the decentralization project against its own stated goals. These included (1) creating a functional division among government levels appropriate to the health tasks each level can best perform; (2) generating projects that reflect the felt needs of the people, as voiced through local participatory assemblies; (3) maintaining or increasing levels of equality in health, especially with regard to income, caste, and gender; (4) stimulating communities to mobilize voluntary resources to supplement devolved public funds; (5) stimulating communities to create innovative programs that could become models for others; and (6) making the health services function more effectively overall. The analysis supports the conclusion that the campaign achieved each of the goals to a large degree. Shortcomings arose from the inexperience of many local communities in drafting effective projects as well as problems deriving from the fact that some sections of the health bureaucracy could not be decentralized. Lessons of the campaign are already being applied to new programs in Kerala.

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Recent developments in population theory have made possible a re-examination of demographic evidence from West Africa which suggests that population growth and migration are primarily responses to changes in the nature of the production system. Precolonial, colonial, and independence period data provide a series of correlations consistent with the approach and suggest a possible new synthesis of the West African data. The poorest countries of West Africa are those bordering on the Sahara Desert, known as the "Sahel" region. In response to the drought and famine in that region from 1968-1974, numerous proposals have been made for increased attention to reducing population growth. The analysis presented in this paper leads to the conclusion that population policies other than those attempting to lower the birth rate are called for. These would include relocation of populations previously displaced by colonial labor migrations and the re-integration of herding and farming production systems, both of which policies should be considered as population policies. Data are presented from specific projects underway in Senegal, Mauritania, and Mali, to illustrate the argument.