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London, International Planned Parenthood Federation, Europe Region, 1984 Jun. 122 p.Reflections, speculations, and partial evaluations of work already undertaken in the International Planned Parenthood Federation (IPPF) Europe Region concerning migrants and planned parenthood are presented. This project, initiated by the Federal Republic of Germany Planned Parenthood Association (PPA), PRO FAMILIA, stemmed from the practical experiences and problems of 1 family planning association in the Europe region. The original substantive framework, consisting of data collection and correspondence, plenary meetings, and subworking group meetings on specific areas of interest, was not altered. Throughout the project, as the work was accomplished, the emphasis shifted to different aspects to migrant work. The 1st questionnaire was intended to provide a sociodemographic profile of the participating countries, a show European migratory movements, and ascertain the ethnicity of the target groups in the different countries. The 2nd questionnaire was related specifically to PPA and/or other family planning center's data and activities and attempted to explore PPA attitudes toward migrant clients, when special facilities for migrants were provided, and whether PPAs felt there was a particular need for such services. The report provides a sociodemographic background of migration in Europe. In addition it includes information from donor countries and recipient countries, examining family planning services in the Federal Republic of Germany and the UK. It also covers training; information, education, and communication; adolescence and 2nd generation migrants; and migrant work. It is necessary to be particularly aware of political sensitivities in treating immigrant fertility regulation. Ideally, the aim is to provide an integrated service for migrants and natives both, catering to individual needs. Until this is feasible, the goal must be to work toward an integrated service, recognizing the needs and providing special services where possible if this is judged tobe the best approach to catering to those needs. Migrant needs must be discovered rather than assumed. Better use should be made of the available printed material, which should be utilized to complement oral information where possible. Experience has shown that family planning personnel working with migrants need additional training. The main components of this training should include self-awareness, insight, and knowledge.
REVIEWS OF INFECTIOUS DISEASES. 1983 May-Jun; 5(3):452-9.This summary of the worldwide impact of measles discusses epidemiology, reported incidence, clinical severity, community attitudes toward measles, and the impact of immunization programs on measles. Measles, 1 of the most ubiquitous and persistent of human viruses, occurs regularly everywhere in the world except in very remote and isolated areas. Strains of measles virus from different counties are indistinguishable, and serum antibodies from diverse population have identical specificity. Yet, the epidemic pattern, average age at infection, and mortality vary considerably from 1 area to another and provide a contrasting picture between the developing and the developed countries. In the populous areas of the world, measles causes epidemics every 2-5 years, but in the rapidly expanding urban conglomerations in the developing world, the continuous immigration from the rural population provides a constant influx of susceptible individuals and, in turn, a sustained occurrence of measles and unclear epidemic curves. In the economically advanced nations, measles epidemics are closely tied to the school year, building up to a peak in the late spring and ceasing abruptly after the summer recess begins. Maternal antibody usually confers protection against measles to infants during the 1st few months of life. The total number of cases of measles reported to WHO for 1980 is 2.9 million. Considering that in the developing world alone almost 100 million infants are born yearly, that less than 20% of them are immunized against measles, and that various studies indicate that almost all nonimmunized children get measles, less than 3 million cases of measles in 1980 is a gross underestimate. There was adecrease in the global number of reported cases of measles during the 1979-80 period due primarily to the reduction in the number of cases in the African continent and, to a lesser extent, in Europe. It is premature to conclude that such a reported decline is real and that it reflects the beginning of a longterm trend. The contrast between the developed and the developing worlds is most marked in relation to the severity and outcome of measles. Case fatality rates of more than 20% have been reported from West Africa. It has been estimated that 900,000 deaths occur yearly in the developing world because of measles, but data available to WHO indicate that the global case fatality rate in the developing world approaches 2% (in contrast to 2/10,000 cases in the US), and the actal mortality may be greater than 1.5 million deaths per year. The advent of WHO's Expanded Program on Immunization has brought about an awareness of the measles problem. Whenever and wherever measles vaccine has been used effectively on a large scale, a marked reduction in the number of cases has been recorded.