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Seattle, Washington, PATH, 2013 Apr.  p.To meet the challenge of sustaining reproductive health commodity security in Eastern Europe and Central Asia, the United Nations Population Fund and PATH developed workshops to increase awareness about total market approaches and develop an action plan for the region. This report describes two regional workshops that were held in April 2013.
Road-mapping a total market approach for family planning and reproductive health commodity security. Workshop materials.
Seattle, Washington, PATH, 2013.  p.To meet the challenge of sustaining reproductive health commodity security in Eastern Europe and Central Asia, the United Nations Population Fund and PATH developed workshops to increase awareness about total market approaches and develop an action plan for the region. These workshop materials are from two regional workshops that were held in April 2013.
Finnish Official Development Aid for sexual and reproductive health and rights in sub-Saharan Africa.
Finnish Yearbook of Population Research. 2010; 45:143-170.Finland is one of the donor countries that is most supportive in family planning (FP), Sexual and Reproductive Health and Rights (SRHR) and gender issues. This study examines Finnish ODA for FP and SRHR: its decision-making structure, other stakeholders and funding levels. Data consists of documents from the Ministry for Foreign Affairs (MFA) and interviews conducted at the MFA and with other experts. While Parliament decides on the overall level of ODA funding, the Minister for Foreign Trade and Development has considerable autonomy. Other stakeholders such as the All-Party Parliamentary Group on Population and Development and the Family Federation of Finland (Väestoliitto) engage in advocacy work and have influenced development policy. Although the Development Policy 2007 mentions the importance of health and SRHR issues and HIV/AIDS is a cross-cutting issue, interviewees stated that the importance of health and SRHR in ODA has declined and that the implementation of cross-cutting issues is challenging. Multilateral funding for UNFPA, UNAIDS and GFATM, and thus the proportion of SRHR funding within the health sector, is however currently rising. Funding for population-related activities has increased and represented 4.8% of Finland's total ODA in 2009. Almost all of this funding is directed towards basic reproductive health and HIV/AIDS issues and the majority is directed through multilateral channels (78% in 2009), mainly UNFPA and UNAIDS. IPPF, Ipas and Marie Stopes International also receive support.
Progress in Reproductive Health Research. 1996; (37):6-7.Since the 1960s, thousands of studies have been published on the safety and effectiveness of contraceptive methods. Over this period, new contraceptive methods have been introduced and methods that were being used in the 1960s have been improved. However, many of the advances that have been made in contraception have not been accompanied by updating of family planning policies and prescribing practices to reflect the progress. This has prevented the full range of methods from being available to many potential users. (excerpt)
Laren, Netherlands, World Population Foundation, 1992. 20 p.The World Population Fund is a non-profit organization created in 1987 to increase awareness of the nature, size, and complexity of rapid population growth and to support population projects in developing countries. The foundation hopes that its efforts will improve global standards of living. Projects emphasize the collection, analysis, and dissemination of population information; the formulation and implementation of population policies; maternal and child health care and family planning (FP); and improving the position of women. Collaborating regularly with the Dutch government, the UN, and other international organizations, the World Population Fund is the only organization in the netherlands which concerns itself specifically with problems of world population growth. This report outlines the consequences of world population growth; fund activities in 1991 in information, education, and training; project fundraising; family planning efforts in Burkina Faso, India, and Tanzania; and collaboration with the Consultancy Group for maternal health and FP. Fund accounts are presented. Teenage pregnancy, population pressures and environmental degradation, urbanization, and economic development are discussed. If present population growth trends continue, world population will triple within the next century to 18 billion with 90% of the growth in developing countries. Widespread poverty, malnutrition, disease, and early mortality will be the consequences of such growth. While experience shows that FP programs can help lower population growth rates, demand for FP is greater than supply in most developing countries. In fact, 300 million couples, the majority of whom live in developing countries, are being denied the universal right to freely decide the number and spacing of their children. The persistence of social and political controversy over funding family planning in developing countries, funding shortages, and inadequate policies and programs continue to result in teenage and child pregnancies, abortions, unwanted births, malnourished mothers and children, and maternal mortality. Balanced population policies and programs integrated within development plans are called for. To that end, the World Population Fund in 1992 will emphasize interactions between population growth and environment while also focusing upon the needs of and services for youth.
Contraception. 1984 Dec; 30(6):505-22.The World Health Organization (WHO) conducted a randomized comparative trail of th effects of hormonal contrception on milk volume and infant growth. The 341 study participants, drawn from 3 obstetric centers in Hungary and Thailand, were 20-35 years of age with 2-4 live births and previous successful experience with breastfeeding. Subjects who chose oral contraception (OC) were randomly allocated to a combined preparation containing 150 mcg levonorgestrel and 30 mcg ethinyl estradiol (N=86) or to a progestin-only minipill containing 75 mcg dl-norgestrel (N=8). 59 Thai women receiving 150 mg depot medroxyprogesterone (DPMA) intramuscularly every 3 months were also studied. An additional 111 women who were using nonhormonal methods of contraception or no contraception served as controls. Milk volume was determined by breast pump expression. No significant differences in average milk volume were noted between treatment groups at the 6 week baseline visit. However, between the 6th and 24th weeks, average milk volume in the combined OC group declined by 41.9%, which was significantly greater than the declines of 12.0% noted in the progestin-only group, 6.1% among DMPA users, and 16.7% among controls. The lower expressed milk volume among combined OC users did not impair infant growth. No significant differences were observed between treatment groups in terms of average infant body weight or rate or weight gain. Users of combined OCs may have compensated for their decreased milk volume by providing more extensive supplementary feeding or more prolonged suckling episodes. These results suggest that the estrogen content of combined OCs adversely affects the capacity of the breast to produce milk; thus, family planning programs should make nonestrogen-containing methods available to breastfeeding mothers. Although no effects on infant growth were noted in this study, the possibility of such efects cannot be excluded in populations where infant growth largely depends on the adequacy of unsupplemente d lactation.
Paper presented at the Nineteenth Session of the UNICEF/WHO Joint Committee on Health Policy, Geneva, February 1-2, 1972. 40 pFamily planning is an integral part of the health care of the family and has a striking impact of the health of the mother and children. Many aspects of family planning care require the personnel, skills, techniques, and facilities of health services and is thus of concern to UNICEF and WHO. Once individual governments have determined basic matters of family planning policy and methods, UNICEF and WHO can respond to requests for assistance on a wide range of activities, with the primary goal being the promotion of health care of the family. Emphasis will be placed on achieving this by strengthening the basic health services that already have a solid foundation in the community. The past experience of UNICEF and WHO should provide valuable guidance for assistance to the health aspects of family planning, particularly as they relate to the planning and evaluation of programs; organization and administration; public education; the education and training of all medical personnel; and the coordination of family health activities both inside and outside the health sector. The review recommends that UNICEF and WHO first regard the capacity of the host country to absorb aid and maintain projects, and that specific family planning activities, such as the provision of supplies, equipment, and transport, be introduced only when the infrastructure is actually being expanded. Capital investment should be viewed in relation to the government's ability to meet budgetary and staff requirements the new facilities demand.
HEALTH TRANSITION REVIEW. 1996 Apr; 6(1):101-3.The 1994 International Conference on Population and Development (ICPD) program of action mainly focuses upon empowering women so that they can make their own reproductive decisions using contraception and health care provided by health systems. However, male reproductive health also should be considered, thereby requiring attention to urology and infertility, as well as gynecology in the reproductive health services. The program of action, however, fails to consider men except for when they are asked to support women. Men are asked to support and not interfere with women, consistent with the North American feminist demand that women have total control. The authors consider the truth about the prevailing generalities about men's and women's roles and relationships. Their positions are based upon ethnographic field research among working-class people in Istanbul during 1994 and 1995. The narratives assembled through their research warn against presuming knowledge of whether the man or the woman controls fertility. One cannot say that the use of male methods of contraception means that men have absolute power over fertility control.
ENTRE NOUS. 1995 May; (28-29):15-6.The World Health Organization Regional Office for Europe SFP unit was asked by UNICEF in November 1994 to produce a background document for policymakers, decision makers, and bilateral donors to identify main needs in family planning in the countries of Central and Eastern Europe (CCEE) and Newly Independent States (NIS). A draft document containing 22 country reports on family planning and reproductive health in the CCEE and NIS was distributed in December 1994. The draft also included data, an outline of the current situation, recommendation for action, and international activities. The project is now being extended to include all CCEE and NIS countries, with the full report to be published in June 1995. Both the draft document and the report can be requested from the SFP unit. Excerpts from the document are presented.
POPULATION HEADLINERS. 1994 May; (230):8.The Pope, in attempts to influence the United Nations Population Fund (UNFPA) and the International Conference on Population and Development (ICPD), held a meeting at the Vatican with Dr. Sadik, Executive Director of UNFPA and Secretary General of the ICPD. At that time, the Pope strongly criticized population programs that try to impose limits on family size. Of particular concern were programs that try to persuade couples to have 1-2 children. Dr. Sadik commented that the disagreement was really over contraception, and the access to control of one's own fertility. There were also points of agreement. The Vatican had also called a meeting of all ambassadors accredited to the Holy See, which is about 120. The purpose was to explain the Church's position on population and development prior to the ICPD meetings in Cairo during September 5-13, 1994. It is a rare occasion when all ambassadors are summoned to the Vatican for a meeting. Diplomatic sources said that the meeting was a direct attempt to influence the ICPD. It was officially reported that the Pope will address the General Assembly in October. This will be the first time that Pope John Paul II has addressed the assembly since 1979. Archbishop Martino commented that the Pope would be commemorating the Year of the Family and the 50th Anniversary of the UN. The address will be directed to issues about the family.
JINKO MONDAI KENKYU / JOURNAL OF POPULATION PROBLEMS. 1992 Jul; 48(2):22-7.The second meeting to spearhead the "Independent Commission on Population and Quality of Life" (temporary name), initiated sand sponsored by the Rockefeller Foundation, was held in Italy on March 4 and 5, 1992. The meeting was attended by 21 people representing the US, Britain, Germany, Holland, Sweden, Japan, Indonesia, Mexico, and Egypt, as well as the UN Population Fund, Ford Foundation, MacArthur Foundation, and Hewlett Foundation. The topics the commission discussed were its scope and purpose; its role; the selection of its staff director and chairman; its official title; its location; schedule of meetings, reports, publications, hearings, and activities; and its budget and fund raising. Made up of distinguished politicians, scholars, celebrities, intellectuals, and women from developing countries, the Commission will have its own new perspective in conducting international population projects. Population problems handled by the Commission should include international migration, aging populations, poor public health, and the low status of women as well as population control by planned parenthood in developing countries. Environmental issues will also be included. The Commission currently lists 8 candidates for chairmen and 6 candidates for staff director. The Commission will be called either the "Independent Commission on Population" or the "Independent Commission on Population and Quality." The majority favored Europe as the headquarters site. It was suggested that 4 to 5 million dollars per three years will be needed. The following countries and organizations will be able to offer financial assistance in one way or another: Sweden, Holland, Britain, Germany, US, the UN Population Fund, the Ford Foundation, the MacArthur Foundation, the International Planned Parenthood Federation, and the Rockefeller Foundation. Japan, the World Bank and the Hewlett Foundation have already been asked to contribute. It was suggested that other Nordic countries and Canada also be approached about funding.
TIDSSKRIFT FOR DEN NORSKE LAEGEFORENING. 1991 May 30; 111(14):1729-33.The 4 cornerstones of reproductive health according to the WHO are family maternal care neonatal and infant care, and the control of sexually transmitted diseases. In recent years, the AIDS epidemic has caused concern in the world. The world's population doubled to 4 billion from 1927 to 1974, and it will reach 6 billion by the year 2000. The rate of growth is 1.4% in China and 2% in India vs. .3% in Europe. Contraceptive prevalence is 15-20% in Africa, 30% in South Asia, and 75% in East Asia. Shortage of contraceptives leads to abortion in eastern Europe. In 1985 in the USSR, there were 115.7 abortions/1000 women (mostly married) aged 15-44; and 6.4 million abortions for 5.5 million births in 1989. RU-486 or mifepristone combined with prostaglandin has produced abortion in 90% of first trimester pregnancies. After approval in France in 1987, it was used in 40,000 abortions in the following year. 90% of the estimated annual 500,000 maternal deaths occur in developing countries. In Norway, the rate is fewer than 10/100,000 births vs. 100/100,000 in Jamaica. In the mid-1980s, 26% of rural women in Thailand, 49% in Brazil, 54% in Senegal, and 87% in Morocco went without maternal care. In Norway, infant mortality is 6-8/1000 live births vs. 75-150/1000 in developing countries. A WHO investigation on causes of infertility in 25 countries found a 31% rate of tubal pathology in 5800 couples. In Africa, over 85% f infertility in women was infection related. Venereal diseases and infertility are associated with premarital sexual activity in young people. Various donor agencies and the WHO Special Program of Research, Development, and Research Training in Human Reproduction are providing help and resources including AIDS research.
The Soviet question: as the new commonwealth rises from the ruins, will Western family planning assistance come to the rescue?
FAMILY PLANNING WORLD. 1992 Jan-Feb; 2(1):22-3, 25.Family planning in the old Soviet Union was administered through roughly 100 Family and Marriage Centers scattered across the hugh country. Unfortunately they only provided abortions and help for infertile couples, and not much else. The old Soviet government gave contraceptives a low priority and as a result they were only available as imports on the black market. The result is a lot of ignorance and misinformation about oral contraceptives, IUDs, and sexuality in general. The average Soviet women has 4-6 abortions in a life time. The USSR's infant mortality rate in 1991 was 23/1000. In 1988 its maternal mortality rate was 43/1000. The contraceptive prevalence rate in 1988 was 13.7%. There are some small, encouraging signs of change. The abortion rate fell 15.4% between 1975-1988 according to JOICFP. In 1989 the Soviet Family and Health Association (SFHA) was established in order to improve these horrible statistics. The biggest obstacle to the success of the SFHA is the political instability currently being experienced as the Commonwealth is being formed. The IPPF helped raise $14,000 dollars to purchase 15.5 million Malaysian condoms. UN aid is only in the form of technical assistance since the Commonwealth is considered a developed nation. This is the same problem currently facing the Eastern Block nations. The Commonwealth is really like 2 different countries in terms of its family planning needs. The states of the South and East have a population growth rate of 2.5% annually. While the states of the North and West have a population growth rate of 0.6%. Until political stability is achieved in the new Commonwealth, donor nations are going to be unwilling to offer a great deal of assistance. Ultimately the Commonwealth is going to have fund its own family planning system aided by the technical advice from the West.
POPULATION TODAY. 1992 Feb; 20(2):8-9.A debate within the UK public health community has centered around the feasibility of campaigns to improve child survival rates in Africa in the absence of equally aggressive efforts to increase family planning acceptance. The central spokesperson in this debate, Maurice King of the University of Leeds, has argued that population growth in sub-Saharan countries is undermining the carrying capacity of available resources and threatening ecological collapse. These countries are not exhibiting the characteristic demographic transition pattern, in which declining death rates eventually create conditions conducive to lower birth rates. Instead, they have fallen into a "demographic trap " in which population increases are outstripping growth in food production. To remedy this situation, King advocates the introduction of the concept of sustainability of the ecological foundations of health into the World Health Organizations's official definition of health. Richard Jolly of UNICEF has countered King's articles with the insistence that UNICEF has long supported child survival within the broader context of family planning provision and advocacy of birth spacing.
[Unpublished] 1990. , 3,  p.In February 1990, a writer for the international publication Population Reports attended the WHO Interagency Consultation to Discuss Strategies for Coordinating and Improving Global Condom Supply in Geneva, Switzerland to garner the most recent facts about the international supply of condoms and their distribution to be incorporated in an upcoming issue. The WHO/Global Programme on AIDS (WHO/GPA) expanded its role recently to become a major procurer of condoms. Its traditional role remained as coordinating agency of condom strategies against AIDS. The writer recommended that the issue on condoms include a short box featuring WHO/GPA condom activities. Participants agreed that national AIDS programs should focus more on condom services. This could include formation of a condom subcommittee, involvement of a condom programming specialist in drafting medium term national plans, and incorporation of condom distributor experiences in planning. Further they emphasized the need to recognize and consider family planning program experience in supplying and distributing condoms. Participants also conceded the need to no longer differentiate between condom use for AIDS prevention and for family planning. Several agencies including WHO/GPA and USAID addressed the need for quality control including increased emphasis on logistics and distribution channels. They did acknowledge, however, that implementation of quality assurance measures in many countries would be hard and time-consuming. 1 item that received considerable discussion was a generic condom which USAID intended to purchase under its next contract. USAID also planned on switching its focus from quantity to condom distribution and quality control. UNFPA adopted the new WHO Specifications and Guidelines for Condom Procurement. IPPF considered doing so also.
PEOPLE. 1991; 18(4):33.Never before has the World Bank (WB) spent more money than the United States Agency for International Development (USAID) on population and family planning programs (FP). The WB's budget calls for US$340 million dollars for FP compared to USAID which has budgeted US$322 million, some of which may not be allocated. The 1991 WB figure is double the 1990 of US$169 million which was an increase of 40% over the 1989 figure. Total international FP in 1989 was US$757 million including WB and USAID. In the last 25 years the US has Contributed over US$4 billion to FP. Japan contributes about 8% (they announced they will increase their spending on FP by 1.8% for 1991). Norway, Sweden, the Netherlands, Canada, Germany, and the United Kingdom each provide about 4-6% of the total. However, FP accounts for only 1.3% of all total official development assistance. In 1991 the WB has 13 new programs and loans which will be given to Nigeria and Rwanda for the 1st time. The United Nations Population Fund (UNFPA) estimates that a total of US$4.5 billion is needed by 2000 just for FP, with developing countries contributing the same amount. The US house of Representatives recently voted to increase spending with US$300 million for FP in addition to USAID's budget bringing the total up to US$400 million for 1992. Estimates suggest the US should increase spending to $600 million in 1992 and US$1.2 billion by 2000.
PLANNED PARENTHOOD IN EUROPE. 1991 May; 20(1):27-8.The Tbilisi Declaration of 13 October 1990 approved by participants at an international conference supported by UNFPA, WHO/Europe, PPF/Europe, and the Zhordania Institute is printed in its entirety. The original conference document was altered inspite of IPPF Europe Regions' protestations and final approval that the conference document remain intact. In dispute was the last sentence in the "contraception reduces abortion" section, which originally left out the modifiers and stated that with appropriate backup, simple safe inexpensive ... procedures exist for use in PHC settings. ILPPF urged government agencies to change participant's views; a position expressed and agreed with in Tbilisi. The document itself is concerned with the right to reproductive health, a major public health problem, contraception reduces abortion, and the impact of legislation. The UNFPA formal position on abortion is stated as "not a means of family planning;" government support does not imply endorsement of national policy. UNFPA is concerned with increases in the availability of family planning. Participants agreed that couples and individuals have the right to decide freely, responsibly and without coercion the number and spacing of children, the right to reproductive health, self-determination, and that every child should be a wanted child. Recognition was given to unwanted pregnancy and unsafe abortion as major public health and social problems. Also, it was recognized that abortion rates are highest in countries with weak education in FP and sexuality and constraints on women. Criminal sanctions have no impact on the abortion or birth rates, but are associated with unsafe abortion. Abortion can be reduced through family planning. There is need for 1) high quality reproductive health services that respect women's autonomy and dignity; 2) early sex education; 3) lifestyle changes to place responsibility also on men for contraception, family formation, and rearing; 4) increased government funding for service and training. Central and East Europe are in greatest need. The goal of the document was to insure life which contributes to one which is rich and joyful.
WORLD WATCH. 1990 Sep-Oct; 3(5):29-34.In the early 1950s, the Soviet Union and several of its Eastern European satellites completed their transition from high to low fertility before the US and Western Europe. They did this even though there were not enough modern contraceptives available to meet the needs of its citizens. As late as 1990, the Soviet Union had no factories manufacturing modern contraceptives. A gynecologist in Poland described domestically produced oral contraceptives (OCs) as being good for horses, but not for humans. The Romanian government under Ceaucescu banned all contraceptives and safe abortion services. Therefore, women relied on abortion as their principal means of birth control, even in Catholic Poland. The legal abortion rates in the Soviet Union and Romania stood at 100/1000 (1985) and 91/1000 (1987) as compared to 18/1000 in Denmark and 13/1000 in France. All too often these abortion were prohibited and occurred under unsafe conditions giving rise to complications and death. Further, the lack of contraceptives in the region precipitated and increase in AIDS and other sexually transmitted diseases. On the other hand, abortion rates were minimalized in Czechoslovakia, East Germany, and Hungary due to the availability of modern contraceptives and reproductive health services. Hungary and East Germany even manufactured OCs. OC use in these 2 nations rated as among the world's highest. East Germany also treated infertility and sexually transmitted diseases. The region experienced a political opening in latecomer 1989. In 1989, IPPF gave approximately 15 million condoms and 3000 monthly OC packets to the Soviet Union to ease the transition. More international assistance for contraceptive supplies and equipment and training to modernize abortion practices is necessary.
New York, New York, UNFPA, 1988 Dec. vii, 72 p. (Report Number 97)The United Nations Fund for Population Activities (UNFPA) has a continuing program that responds to needs for population assistance in developing countries. This work covers the needs assessment mission to Turkey. Covered are and overview and a summary of recommendations and includes population policies and development planning: data collection, analysis, and dissemination: health and family planning (FP); information, education, and communication (IEC); and special populating groups, women and youth. Population policies and development planning, including the institutional and legal framework; research and training; and needs and recommendations are also covered. Data collection, analysis and dissemination and includes, censuses, surveys, vital statistics, population register, and other sources are also discussed, as in a review of health and family planning, health policy and status, health services, maternal and child health (MCH) and family planning, family planning practices, and manpower development and supervision. The report concludes with a description of bilateral assistance, and non-governmental assistance.
Reproduction and family planning in Ethiopian society: a survey of existing knowledge and possible application in MCH/FP services.
[Unpublished] 1986. 23 p.The mission makes an exploratory study of existing knowledge of reproduction and reproductive control in the social context of Ethiopian society. The bibliography to be generated by the mission will contain much material about reproductive questions and attitudes toward child spacing. This material continuously shows that children have a high value, and that they are considered as the most important natural resource that the country has. The bibliography will also cover family planning in Ethiopia. The report then identifies the different government bodies dealing with population or family planning, including sections of the Office of the National Committee for Central Planning, the Ministry of Education, the educational mass media, the University of Addis Ababa, the Ministry of Agriculture, the Ministry of Labour and Social Affairs, and several non-governmental organizations. These units, their current activities, and their future roles in population activities are discussed. In addition to all activities which are mentioned, there is a need to intensify the collaboration between different sectors which deal with health as a subject and with health education. One of the main goals of the mission was to recommend actions to be taken by the Swedish International Development Authority (SIDA) in support of the Ethiopian government and non-government institutions in order to improve the conditions for their work in maternal and child health and family planning services.
PEOPLE. 1987; 14(2):33.3 agencies in Turkey are placing family planning centers in factory settings: the Family Planning Association of Turkey (FPAT), the Confederation of Trade Unions (TURK-IS), and the Family Health and Planning Foundation, a consortium of industrialists. The FPAT started with 27 factories 7 years ago, educating and serving 35,000 workers. The 1st work with management, then train health professionals in family planning, immunization, infant and child care, maternal health, education, motivation techniques, record-keeping and follow-up. Worker education is then begun in groups of 50. New sites are covered on a 1st-come-1st-served basis. This program is expected to be successful because newcomers to city jobs are beginning to see the need for smaller families, and accept family planning. TURK-IS has conducted seminars for trade union leaders and workers' representatives and provided contraceptives in 4 family planning clinics and in 20 hospitals run by Social Security, a workers' health organization. They have distributed condoms in factories and trained nurses to insert IUDs in factory units. The businessmen have opened family planning services in 15 factories, with support from the Pathfinder Fund, and hope to make the project self-supporting.
Copenhagen, Denmark, WHO Regional Office for Europe, 1987. 58 p. (ICP/MCH 518; RM/79/P05 (UNFPA); EUR/HRA target 15)A teachers' training workshop on natural methods of family planning in a nonreligious context was convened by the Regional Office for Europe of the World Health Organization (WHO) in August 1986 anttended by participants from 14 countries. This was the first WHO European Region workshop on natural family planning, which is increasingly accepted as a positive, effective means of controlling fertility. The workshop was organized to create a greater awareness of the natural methods of family planning as an appropriate health technology that can be used to identify the fertile phase of the menstrual cycle to aid couples in avoiding or achieving pregnancy and as the basis of education about fertility. A major recommendation of this workshop was that the term "natural family planning" should be replaced with the term "fertility awareness methods" in order to correct the implication that other contraceptive methods are unnatural and bad. To suit the variety of individual needs and preferences, family planning professionals should offer fertility awareness methods as one option in an extensive repetoire of possibilities. The cervical mucus or cervical palpation methods are more appropriate for postpartum or premenopausal women than the basal body temperature method, since the latter is not very effective when ovulation is irregular. Fertility awareness should also be promoted as a back-up when other contraceptive methods are not available and as a means to help infertile couples achieve pregnancy. The teaching of fertility awareness methods in a nonreligious context should address other forms of sexual activity and the possibility of using barrier methods on fertile days. The teaching of fertility awareness should be integrated into all health and education curricula aimed at youth and adults, professionals and nonprofessionals. Since these methods require cooperation on the couple's part, a special curriculum should be designed for men.
NUFUSBILIM DERGISI/TURKISH JOURNAL OF POPULATION STUDIES. 1987; 9:63-73.From the perspective of the UN Fund for Population Activities, Turkey has a population problem of some magnitude. In 1987 the population reached 50 million, up from 25 million in 1957. Consistent with world trends, the population growth rate in Turkey declined from 2.5% between 1965-73 to 2.2% between 1973-84; it is expected to further decrease to 2.0% between 1980 and 2000. This is due primarily to a marked decline of the crude birthrate from 41/1000 in 1965 to 30/1000 in 1984. These effects have been outweighed by a more dramatic decline in the death rate from 14/1000 in 1965 to 9/1000 in 1984. Assuming Turkey to reach a Net Reproduction Rate of 1 by 2010, the World Bank estimates Turkey's population to reach some 109 million by the middle of the 21st century. The population could reach something like 150 million in the mid-21st century. Some significant progress has been made in Turkey in recent years in the area of family planning. Yet, some policy makers do not seem fully convinced of the urgency of creating an ever-increasing "awareness" among the population and of the need for more forceful family planning strategies. Government allocations for Maternal and Child Health and Family Planning (MCH/FP) services continue to be insufficient to realize a major breakthrough in curbing the population boom in the foreseeable future. Most foreign donors do not consider Turkey a priority country. It is believed to have sufficient expertise in most fields and to be able to raise most of the financial resources it needs for development. The UNFPA is the leading donor in the field of family planning, spending some US $800,000 at thi time. Foreign inputs into Turkey's family planning program are modest, most likely not exceeding US $1 million/year. Government expenditures are about 10 times higher. This independence in decision making is a positive factor. Turkey does not need to consider policy prescriptions that foreign donors sometimes hold out to recipients of aid. It may be difficult for foreign donors to support a politically or economically motivated policy of curtailing Turkey's population growth, but they should wholeheartedly assist Turkey in its effort to expand and improve its MCH/FP services. Donors and international organizations also may try to persuade governments of developing countries to allocate more funds to primary education and to the fight against social and economic imbalances. Donors should continue to focus on investing in all sectors that have a bearing on economic development.
COMMUNIQUE. 1987 Nov; 8(2):13.8 countries reported in 1987 on what they are doing to meet the terms of the Convention on the Elimination of All Forms of Discrimination Against Women, and 2 of the countries covered voluntary sterilization in their report. The countries made their reports to the UN body responsible for monitoring the implementation of the convention -- the Committee on the Elimination of Discrimination against Women (CEDAW). This convention is the 1st international treaty that requires countries to remove biases against women in their laws and practices and to ensure that women have equal access to family planning services. All 8 countries -- Bangladesh, Colombia, France, Greece, the Republic of Korea, Poland, Spain, and Sri Lanka -- have constitutional or legal provisions on the right to health care, but only the reports from Colombia and Spain specifically addressed voluntary sterilization as a choice in health services. In 1983 Spain established tubal occlusion and vasectomy as legal medical procedures, and since that time voluntary sterilization has been somewhat more accessible. In Colombia, PROFAMILIA, the national nongovernmental family planning association, has performed over 59,000 tubal occlusions and over 2000 vasectomies, but the government is not active in this field. Under the terms of the convention, a government's failure to support family planning services can be interpreted as impairing women's access to health care. The French delegation did not mention voluntary sterilization in its report, but a member of CEDAW noted that, under French law, an individual's right to voluntary sterilization is not guaranteed. Physicians and hospitals in France have been confused about the legality of sterilization and often are reluctant to provide the service. The French delegation responded that voluntary sterilization is permitted only for therapeutic reasons and only after the individual has consented. Otherwise, the procedure is considered illegal. Family planning associations and other groups have begun to use the annual CEDAW meeting as a forum to discuss barriers to contraceptive services. The 92 countries that have ratified the convention are required to report to CEDAW within 1 year of ratification and every 4 years thereafter.
In: Planned parenthood in Europe: a human rights perspective, edited by Philip Meredith and Lyn Thomas. London, England, Croom Helm, 1986. 135-62.This paper documents patterns, trends, and developments relating to the legal and de facto situation of planned parenthood in Belgium. An attempt is made to grasp the socioeconomic and cultural roots that characterized Belgian society in the past and the influence they have at present. Using census data, empirical data from the national surveys on family development, and information from opinion polls, the fertility and fertility-regulating behavior of the population is documented. Belgium may be characterized in the 19th and early 20th century by a high degree of heterogeneity: cultural, economic, and social. The Catholic Church in Belgium, which maintained a strong moral authority, took the lead at that time in the western European drive against contraception. Substantial changeds occurred in Belgian society after World War II. Still, the Belgian legal attitude to the sexual behavior of the population may be characterized as conservative, coercive, marriage-centered, linking sexuality to procreation, as reflected in the Civil and Penal Codes. Compared with other issues, planned parenthood in Belgium has received meagre attention. There are 3 interconnected areas of conflict in Belgian society: 1) the ideological, 2) the linguistic, and 3) the socioeconomic. The involvement of Belgian authorities in planned parenthood affairs has stemmed from 2 concepts: the need to combat crimes and misbehavior against the order of the family and pubic morals, and 2) fear over the slow but steady decline in the birth rate. As planned parenthood issues became more the responsibility of the communities, the prospect of increased attention and sound policy-making emerged.