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  1. 1
    063090

    [Community medicine in developing countries] La medicina di comunita nei paesi in via di sviluppo.

    Tarsitani G

    NUOVI ANNALI D IGIENE E MICROBIOLOGIA. 1987 Sep-Dec; 38(5-6):471-6.

    Community medicine (CM) addressing the global problems of human health has been intensifying in concert with primary health care (PHC) in developing countries, especially since the 1977 session of the WHO launched a program called "Heath for all by 2000" whose central component was PHC. An international conference in Alma Ata in 1978 on PHC stressed essential health care for all communities supported by practical methods that were scientifically valid and socially acceptable, assistance that was accessible to all members of the community. The objectives of PHC were: promotion of proper nutrition, safe water supplies, basic hygiene, maternal-child hygiene, vaccination against major infectious diseases, prevention and control of endemic local diseases, health education, and proper treatment of common diseases and injuries. A PHC post on the village level of Cm would have 1 community health worker (CHW) and 1 traditional birth assistant (TBA) providing health care for 500-1500 people. On the district level, a PHC unit would have 2 CHWs and 2 TBAs for 10,000 people. On the regional level, a PHC center would have 1 physician, 2 attendant nurses, 2 obstetricians, 1 technician, 1 pharmacist, and 1 administrator. Finally, on the national level, hospitals would take care of health needs. The lack of properly trained staff and resources poses the biggest problem in the organizational structure of Cm, but this could be overcome by collaborating with rural medicine and traditional medicine.
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  2. 2
    061938

    Global epidemiology. AIDS -- a global perspective.

    Von Reyn CF; Mann JM

    WESTERN JOURNAL OF MEDICINE. 1987 Dec; 147(6):694-701.

    This article describes AIDS case definitions and reporting and the problems with serologic studies of HIV antibody detection. These problems include technical limitations of HIV antibody testing, false positive results due to the presence of malaria antibodies, and cross reactions between HIV 1 and HIV 2. There is a summary of the three basic modes of transmission: sexual, perenteral, and perinatal. Geographic patterns of transmission differ with the frequency of the three modes of transmission and the ways in which HIV infection occurs in different cultures. Three patterns are identified. Pattern I involves homosexual and bisexual transmission with some heterosexual transmission and significant perenteral transmission through intravenous (IV) drug use. Population seroprevalence is 1%. Countries with this pattern are North America, Europe, some areas of South America, Australia, and New Zealand. Pattern II involves larger risk groups and heterosexual transmission. There is high seroprevalence among women, and, as a result, perinatal transmission is evident. Seroprevalence is >1%. Examples of this pattern are central, eastern and southern Africa and Haiti. In Pattern III, the phenomena is recent and transmission is homosexual and heterosexual, particularly among prostitutes or persons from known HIV endemic areas. Imported blood and blood products have contributed to parenteral transmission. Middle Eastern and Asian countries exemplify this pattern. The global epidemiology is discussed by region: the Americas, Europe, Africa, and Oceania. Case reports from 127 countries to WHO have totaled 62,811 in 1987. 70% of the cases reported are from the United States. The estimated number of AIDS cases worldwide is 100,000-150,000, and HIV infected people are thought by WHO to number 5-10 million. In the United States, reported AIDS cases continue to double every year. There is some evidence for stabilization in at least one homosexual population. Between 1985-86, there was a 130% increase in heterosexual the number of heterosexuals (mostly women) who acquired AIDS from contact with IV drug users or bisexual men. Brazil has the second largest number of cases and follows Pattern I. Europe reported 5687 cases by 1987 compared to 44,000 for the US. The highest rate of AIDS cases in Europe is from Switzerland at 34.9/million (which compares to 140.2/million in the US). 50% of the reported cases in Europe are in people from Africa or the Caribbean. African AIDS is distinguished by 50% of cases being in women. AIDS cases from transfusion are still a problem. Perinatal transmission occurs. Nonmedical parenteral transmission (ritual scarification, circumcision, and so on) and medical injections play a role in transmission of HIV infection among children. Surveillance has improved. Oceania reported 569 cases by 1987. Australia has the highest rate in Oceania at 23.8/million and a male to female sex ratio of 26:1; pattern I predominates. Other countries which have reported cases are Thailand, Japan, the Philippines, Israel, and 2 cases from China.
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  3. 3
    071886

    France.

    United Nations. Department of International Economic and Social Affairs. Population Division

    In: World population policies. Volume I. Afghanistan to France, [compiled by] United Nations. Department of International Economic and Social Affairs. Population Division. New York, New York, United Nations, 1987. 218-21. (Population Studies No. 102; ST/ESA/SER.A/102)

    France's 1985 population of 54,621,000 is projected to grow to 58,431,000 by the year 2025. In 1985, 21.3% of the population was aged 0-14 years, while 17.7% were over the age of 60. 17.8% and 25.9% are projected to be in these respective age groups by the year 2025. The rate of natural increase will have declined from 3.4 to 0.3 over the period. Life expectancy should increase from 74.5 to 77.6 years, the crude death rate will increase from 11.2 to 11.8, while infant mortality will decline from 9.2 to 5.2. The fertility rate will rise over the period from 1.9 to 2.0, with a corresponding drop in the crude birth rate from 14.5 to 12.1. The 1978 contraceptive prevalence rate was 79.0, while the 1982 female mean age at 1st marriage was 24.3 years. Urban population will increase from 73.4% in 1985 to 77.3% overall by the year 2025. Morbidity, mortality, emigration, and spatial distribution are considered to be acceptable by the government, while population growth, fertility, and immigration are not. France has an explicit population policy. Concerned over the low growth rate of the native-born population, policy aims to increase fertility an population growth by improving the socioeconomic status of families, lowering the mortality rate, and restricting most types of immigration. Population policy as it related to development objectives is discussed, followed by consideration of specific policies adopted and measures taken to address above-mentioned problematic demographic indicators. The status of women and population data systems are also explored.
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  4. 4
    071885

    Finland.

    United Nations. Department of International Economic and Social Affairs. Population Division

    In: World population policies. Volume I. Afghanistan to France, [compiled by] United Nations. Department of International Economic and Social Affairs. Population Division. New York, New York, United Nations, 1987. 214-7. (Population Studies No. 102; ST/ESA/SER.A/102)

    Finland's 1985 population of 4,891,000 is projected to grow to 4,994,000 by the year 2025. In 1985, 19.3% of the population was aged 0-14 years, while 17.2% were over the age of 60. 16.5% and 28.0% are projected to be in these respective age groups by the year 2025. The rate of natural increase will have declined from 3.4 to -2.4 over the period. Life expectancy should increase from 73.8 to 77.3 years, the crude death rate will increase from 9.9 to 13.3, while infant mortality will decline from 6.2 to 5.0. The fertility rate will rise over the period from 1.7 to 1.8, with a corresponding drop in the crude birth rate from 13.3 to 10.9. The 1977 contraceptive prevalence rate was 80.0, while the 1980 female mean age at 1st marriage was 24.6 years. Urban population will increase from 64.0% in 1985 to 83.5% overall by the year 2025. All of these trends and indicators are considered to be acceptable by the government. Comparatively high morbidity and mortality among males, however, is of concern. Causes for such excess mortality include cardiovascular diseases, cancer, accidents, and suicide. Finland does not have an explicit population policy. Attention is presently directed toward morbidity and mortality, promoting and supporting the family, and adjusting spatial distribution. Population policy as it relates to development objectives is discussed, followed by consideration of specific policies adopted and measures taken to address above-mentioned problematic demographic indicators. The status of women and population data systems are also explored.
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  5. 5
    071852

    Bulgaria.

    United Nations. Department of International Economic and Social Affairs. Population Division

    In: World population policies. Volume I. Afghanistan to France, [compiled by] United Nations. Department of International Economic and Social Affairs. Population Division. New York, New York, United Nations, 1987. 82-5. (Population Studies No. 102; ST/ESA/SER.A/102)

    Bulgaria's 1985 population of 9.071,000 is projected to grow to 10,070,000 by the year 2025. In 1985, 22.3% of the population was aged 0-14 years, while 17.33% were over the age of 60. 20.0% and 22.2% are projected to be in these respective age groups by the year 2025. The rate of natural increase will have declined from 4.7 to 1.9 over the period. Life expectancy should increase from 71.6 to 76.8 years, the crude death rate will increase from 11.0 to 11.6, while infant mortality will decline from 17.6 to 7.2. The fertility rate will decline over the period from 2.2 to 2.1, with a corresponding drop in the crude birth rate from 15.7 to 13.5. The 1976 contraceptive prevalence rate was 76.0, while the 19890 female mean age at 1st marriage was 221.6 years. Urban population will increase from 66.5% in 1985 to 83.4% overall by the year 2025. Morbidity, mortality, immigration, emigration, and spatial distribution are considered to be acceptable by the government, while too low population growth and fertility are not. Bulgaria has an explicit population policy. Demographic policy aims to maintain moderate and stable population growth, provide for individual health, increase job opportunities, and improve living conditions and spatial distribution. Higher fertility and subsequent population growth are encouraged. Population policy as it relates to development objectives is discusses, followed by consideration of specific policies adopted and measures taken to address above-mentioned problematic demographic indicators. The status of women and population data systems are also explored.
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  6. 6
    071875

    Denmark.

    United Nations. Department of International Economic and Social Affairs. Population Division

    In: World population policies. Volume I. Afghanistan to France, [compiled by] United Nations. Department of International Economic and Social Affairs. Population Division. New York, New York, United Nations, 1987. 174-7. (Population Studies No. 102; ST/ESA/SER.A/102)

    Denmark's 1985 population of 5,122,000 is projected to shrink to 4,690,000 by the year 2025. In 1985, 18.7% of the population was aged 0-14 years, while 20.1% were over the age of 60. 14.1% and 29.7% are projected to be in these respective age groups by the year 2025. The rate of natural increase will have declined from -0.6 to -5.3 over the period. Life expectancy should increase from 74.5 to 77.5 years, the crude death rate will increase from 11.3 to 14.4, while infant mortality will decline from 8.0 to 5.0. The fertility rate will rise of the period from 1.5 to 1.6, with a corresponding drop in the crude birth rate from 10.7 to 9.1. The 1975 contraceptive prevalence rate was 63.0, while the 1982 female mean age at 1st marriage was 26.1 years. Urban population will increase form 85.9% in 1985 to 91.8% overall by the year 2025. All of these trends and indicators are considered to be acceptable by the government. Denmark does not have an explicit population policy. The government aims to affect neither birth rate nor population growth. Health policy is in place to improve the quality of life, while other measures are being adopted to develop rural areas. Population policy as it relates to development objectives is discussed, followed by consideration of specific policies adopted and measures taken to address above-mentioned problematic demographic indicators. The status of women and population data systems are also explored.
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  7. 7
    071871

    Czechoslovakia.

    United Nations. Department of International Economic and Social Affairs. Population Division

    In: World population policies. Volume I. Afghanistan to France, [compiled by] United Nations. Department of International Economic and Social Affairs. Population Division. New York, New York, United Nations, 1987. 158-61. (Population Studies No. 102; ST/ESA/SER.A/102)

    Czechoslovakia's 1985 population of 15,579,000 is projected to grow to 18,157,000 by the year 2025. In 1985, 24.5% of the population was aged 0-14 years, while 16.3% were over the age of 60. 19.9% and 21.5% are projected to be in these respective age groups by the year 2025. The rate of natural increase will have declined from 3.5 to 2.8 over the period. Life expectancy should increase from 71.0 to 76.7 years, the crude death rate will decrease from 12.0 to 11.0, while infant mortality will decline from 15.9 to 6.5. The fertility rate will remain static over the period of 2.1, and the crude birth rate will drop from 15.4 to 13.8. The 1977 contraceptive prevalence rate was 95.0, while the 1980 female mean age at 1st marriage was 21.6 years. Urban population will increase from 65.3% in 1985 to 76.3% overall by the year 2025. All of these trends and indicators are considered to be good by the government. Czechoslovakia has an explicit population policy. The government of Czechoslovakia finds social and economic development to be centrally important in solving population-related problems. Policy therefore shies away from attempting to directly affect population size, and aims instead to improve the age structure, state of health, level of education, and socio-professional composition of the population. Population policy as it relates to development objectives is discussed, followed by consideration of specific policies adopted and measures taken to address above-mentioned problematic demographic indicators. The status of women and population data systems are also explored.
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  8. 8
    052132

    [Breastfeeding in developing countries -- our challenge] Amning i U-land -- var utmaning.

    JORDEMODERN. 1987 Jun; 100(6):172-3.

    As long as breast-feeding in the developing and developed countries is threatened by bottle-feeding and too early introduction of supplementary diets, the discussion about how breast-feeding is best protected must be kept alive within the organizations and the mass media. Representatives of the Swedish private organizations' foreign assistance programs participated in a seminar on April 3, 1987 in Stockholm, arranged by the Nordic Work Group for International Breast-Feeding Questions in cooperation with International Child Health (ICH). Breast-feeding increased strongly in Sweden during the 1970s, but bottle-feeding is still the norm in large parts of Europe and continues to increase in the developing countries. 6 years have passed since the international code for marketing of breast milk substitutes (even called the child food code) was approved by WHO, in 1981. It contains rules that limit companies' marketing efforts and establish responsibilities and duties that apply to health personnel. The application of these rules is slow and differences between company policies and practice exist. In a larger perspective, we are dealing with the position and significance of woman and children within the family and society. During a WHO meeting in 1986, a resolution was adopted that reinforces the content of the code, e.g., it stops the distribution of free breast milk substitutes to the hospital, where free samples are often given to leaving mothers. The WHO countries also expressed negative feeling toward marketing child food during a period where breast-feeding may be affected negatively. How the resolution is going to be implemented in Sweden is not yet known. There are signs that even in Sweden the existence of the code is being forgotten. The seminar participants recommended that the Social Board issue a simplified and easily read reminder about the code for wider distribution in Sweden.
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  9. 9
    051614
    Peer Reviewed

    [AIDS in Africa] AIDS i Afrika.

    Sommer B

    UGESKRIFT FOR LAEGER. 1987 Sep 7; 149(37):2493.

    Danida, a Danish medical assistance program for developing countries, was the earliest support organization of the World Health Organization's Special Program on AIDS (SPA). Danida is today the largest donor to the health sector in the east African countries where AIDS has its greatest extent outside the USA: Kenya, Tanzania and Uganda, and to a lesser degree Zambia, Malawi and Zimbabwe. Without coordination there is a great risk that these resources will be used for investments not thoroughly examined such as, in Uganda, for an $11 million blood transfusion center, or in Kenya, a national data communications network so that AIDS statistics could be collected rapidly from every district in the country. With respect to the danger of the spread of human immunodeficiency virus (HIV) by vaccination or injections, the wide distribution of hepatitis B virus has always been the stimulus toward tight precautions in sterilizing cannulas and syringes. The risk of vaccinating HIV-positive children with living vaccine is felt to be very small, but it is not ignored. Danida has therefore taken the initiative, together with the Danish researchers and WHO, to carry out a prospective study in a highly endemic area in order to clear up this question.
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  10. 10
    054996

    The world population plan of action and the regional commissions.

    United Nations. Department of International Economic and Social Affairs

    POPULATION BULLETIN OF THE UNITED NATIONS. 1987; (23-24):76-86.

    Since their establishment, the regional commissions of the United Nations have been devoting particular attention to population and development concerns. Each commission with its unique social, demographic, economic and political characteristics, has contributed to the international debate on population issues. The commissions have provided a suitable forum for the discussion of those issues, have established programs and activities to respond to them, and, with growing experience and expertise, have contributed to a better understanding of them. National Governments, international organizations, private groups, and the public in general have benefited from their regional activities. This article deals with the substantive contributions of the regional commissions to the last 2 population conferences, the World Population Conference (Bucharest, 1974), where the World Population Plan of Action was adopted, and the International Conference on Population (Mexico City, 1984), where the experience in applying Plan of Action was assessed and a set recommendations for the further implementation of the Plan adopted. (author's)
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  11. 11
    205796
    Peer Reviewed

    Improving comparability of international migration statistics: contributions by the Conference of European Statisticians from 1971 to date.

    Kelly JJ

    INTERNATIONAL MIGRATION REVIEW. 1987 Winter; 21(4):1017-37.

    This article summarizes the 3 main types of interrelated activities which the Conference of European Statisticians has worked on to improve the measurement and international comparability of international migration flows. The work has encompassed collaborating with the UN Statistical Commission on the preparation and implementation of the revised international recommendations on statistics of international migration, organizing a regular exchange of data on immigration and emigration flows among the UN Economic Commission for Europe countries and selected countries in other regions, and conducting bilateral studies on international migration within the framework of the Conference's program of work in this field of statistics. The bulk of the work which has been carried out to date by the conference has been conducted rather anonymously and even unobtrusively by the staff of national statistical offices in Economic Commission for Europe countries; they have achieved a modest but important amount of progress during the past 15 years. There is reason to expect that further progress will be made over the next decade, particularly if national statistical offices in the region continue to undertake bilateral studies and endeavor to improve their migration statistics. However, more substantial progress could be achieved if additional countries and organizations established projects aimed at achieving these ends (author's modified).
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  12. 12
    046926

    Belgium.

    United States. Department of State. Bureau of Public Affairs

    BACKGROUND NOTES. 1987 Sep; 1-8.

    The Kingdom of Belgium which borders on the nations of France, the Netherlands, Luxembourg, and the Federal Republic of Germany, is one of the smallest European countries and is a parliamentary democracy under a constitutional monarch. The branches of its government are the executive (with a king, a prime minister, and a Council of Ministers), the legislative (a bicameral Parliament and various regional and cultural assemblies), and the judicial (a Court of Cassation modelled on the French system). 30% of Belgium's gross national product comes from machinery, iron and steel, coal, textiles, chemicals, and glass. During the 80 year period which preceded WWI, Belgium remained neutral in an era of intra-European wars until German troops overran the country during their attack on France in 1914. Some of the worst battles of that war were fought in Belgium. Again in 1940, Belgium was occupied by the Germans. There was a government-in-exile in London; however the King remained in Belgium during the war. The course of Belgian politics was determined largely by the division of the Belgian people into 2 major language groups--the Dutch speakers and French speakers. Regional and language rivalries are taken into account in all important national decisions. The 3 major political parties representing the main ideological tendencies are the Socialists, the Socialist Christians, and the Liberals. Belgium is one of the most open economies in the world and is a densely populated, highly industrialized country in the midst of a highly industrialized region. An economic austerity program was instituted at the beginning of this decade which included devaluation of the Belgian franc, reduction of government expenditures, a partial price freeze, etc. Improvements have been seen as a result of this program. Although US investment has declined in recent years, total US direct investment is estimated at $5.28 billion and there are 899 US companies currently operating in Belgium. As a member of NATO, Belgium's armed forces are part of the NATO integrated military structure. Belgium is a proponent of close cooperation with the US and they seek improved East-West relations. In this vein, Belgium works closely with the US both bilaterally and multilaterally to liberalize trade, and to foster economic and political cooperation and assistance to developing countries.
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  13. 13
    044969

    Turkey's workforce backs family planning.

    Fincancioglu N

    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.
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  14. 14
    270438

    Ovulation method satisfaction is relative to abstinence required.

    Burger HG; Pinol AP; Farley TM; Van Look PF

    INTERNATIONAL REVIEW OF NATURAL FAMILY PLANNING. 1987 Winter; 11(4):319-25.

    To determine whether the degree of satisfaction experienced by a couple in the practice of the Ovulation (or rhythm) Method of natural family planning was related to the required duration of sexual abstinence, data from the 13-cycle effectiveness phase of a WHO study involving 725 women subjects in 5 countries (New Zealand, India, Ireland, the Philippines, and El Salvador) was analyzed. For both subjects and partners the length of the fertile phase was significantly longer in those expressing poor satisfaction than for those in whom satisfaction was classified as good, very good, or excellent. A similar correlation existed between the number of days of abstinence and satisfaction, whereas the total duration of the infertile phase was less strongly related to the degree of satisfaction. Length of fertile phase is the most significant determinant of the degree of satisfaction.
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  15. 15
    200983

    FPIA: 1987-1989; a strategic plan.

    Planned Parenthood Federation of America [PPFA]. Family Planning International Assistance [FPIA]

    New York, New York, Family Planning International Assistance, 1987. 143 p.

    Family Planning International Assistance (FPIA), the international division of Planned Parenthood Federation of America (PPFA), responds to the family planning assistance needs of developing countries through the provision of funds (from USAID), commodities, and technical assistance. In 1989, FPIA will have 140 active projects, funding projects in a minimum of 37 developing countries. As of December 31, 1989, FPIA will have developed 30 family planning/maternal and child health projects, 20 adolescent and/or women's projects, 15 training projects, 10 IEC projects, and 5 other projects. It will increase its number of family planning service clients by 5% per year for 1987-1989. In 1987, 10 countries (Bangladesh, Brazil, Egypt, India, Indonesia, Kenya, Mexico, Nigeria, Thailand, and Sri Lanka) were allocated 72% or $4.8 million of FPIA's projected subgrant budget of $6.7 million. Also, in 1987, 35% of the projected budget was allocated to 5 priority countries in which USAID has no bilateral programs: Brazil, Colombia, Mexico, Nigeria, and Turkey. The report includes individual country plans for 24 countries: Ghana, Guinea, Haiti, Honduras, India, Indonesia, Kenya, Malawi, Mexico, Nepal, Nigeria, Pakistan, Papua New Guinea and South Pacific, Peru, Philippines, Sierra Leone, Sri Lanka, Sudan, Swaziland, Tanzania, Thailand, Turkey, Zaire, and Zambia.
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  16. 16
    046109

    Fertility awareness methods. Report on a WHO workshop, Jablonna, Poland, 26-29 August 1986.

    World Health Organization [WHO]. Regional Office for Europe

    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.
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  17. 17
    043359

    AIDS: an African viewpoint.

    Kibedi W

    DEVELOPMENT FORUM. 1987 Mar; 15(2):1, 6.

    The author presents arguments to refute what he considers alarmist, unsupported generalizations about the origin and soread of AIDS (acquired immune deficiency syndrome) in Africa. The first myth is that AIDS originated in Africa, after a green monkey bit a man. There is no concrete evidence to support this theory. Moreover, if it were true, AIDS would have been known for years; there would be effective herbal remedies and folk traditions about the danger of green monkey bites. The syndrome is so distinctive, for example the oral candidiasis and striking wasting disease, called "slim" disease, that it would have been recognized long ago. Finally, numbers of cases have peaked in America first, a few years ago, and are now beginning to surge in some areas of Africa. A second myth is that countries are not reporting cases out of embarrassment. The author claims that reports to the WHO show far more cases of AIDS in the U.S. and Europe, and even if the 1000 cases in Africa as of 1986 were 1000-fold underestimated, they would be nowhere near the 5 or 10 million often printed. The third myth, that AIDS is out of control in Africa, is unsupported when the efforts of countries like Uganda are considered. Uganda has an extensive media campaign, significant funds relegated to fighting AIDS, foreign experts called in, blood testing equipment on order and in use in 2 hospitals. AIDS is only a problem in a few urban areas.
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  18. 18
    047220

    The population problem in Turkey (as seen from the perspective of a foreign donor).

    Holzhausen W

    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.
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  19. 19
    046195

    Voluntary sterilization and discrimination against women: breaking down barriers.

    Plata MI

    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.
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  20. 20
    200865

    Asylum seekers: a schematic model and case study.

    Wood WB

    [Unpublished] 1987. 15, [1] p.

    Asylum-seekers from Third World countries are an important subgroup of international migrants; their increasing number has led to reevaluations of asylum policies in Western Europe and Canada. This paper proposes a conceptual framework for the study of how asylum-seekers manipulate international migration channels and national asylum policies. The framework is applied to the case of the Tamil "boat people". Although the US is an ocean away from Europe's asylum troubles, the arrival of the Tamil boat people on Canada's shores highlights the point that physical barriers are not enough to deter asylum seekers. If the influx of asylum seekers into Western Europe remains high while European governments restrict the numbers given asylum, more asylum seekers will attempt to follow the Tamils to North America. On a more global scale, restrictive asylum policies in Europe could be used--particularly by Turkey, Thailand, Pakistan, and the Sudan--to justify refoulement (forced repatriation) of asylum seekers and even UN High Commissioner for Refugees (UNHCR) registered refugees. The 2 models presented in this paper, one on the migration process experienced by asylum seekers and the other on the consequences of a "beggar thy neighbor" approach to asylum policies, illustrate the complex interaction between international migration and immigration laws. The international migration channels used by asylum seekers and the asylum laws and policies they try to manipulate are products of a fundamental conflict between an increasingly interdependent global economy and national government attempts to control territorial sovereignty.
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  21. 21
    042255

    AIDS: diagnosis and control [letter]

    Deinhardt F; Domok P; Smithies A; Leparski E; Bytchenko B; Mann J

    Lancet. 1987 Apr 18; 1(8538):930.

    At a meeting convened by the World Health Organization (WHO) regional office for Europe in March 1987 and attended by representatives of 27 member states, it was agreed that human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) pose a major threat to the health of all nations in the world. The most effective means of reducing the transmission of the virus remains intensive, frank education for the entire population about the nature of HIV infection, its modes of transmission, and the precautionary measures available. More epidemiologic data on the distribution of HIV infection and the development of AIDS within the population are needed, but should be obtained, wherever possible, by voluntary, targeted surveys rather than through compulsory testing or mandatory reporting by name. In addition, there was recognition of the need for further improvement in diagnostic tests for HIV infection to make them simple, less expensive, and more specific. Tests are also needed to detect HIV or its antigen directly during the early period after infection. Epidemiologic models can be helpful in making short-term predictions, but cannot at present be used for the long-term since they are dependent on inaccessible or unreliable data about prevalence and shifts in life-style. Finally, there was strong support at the meeting for AIDS research to be identified as a national priority. Funding should be provided to increase the number of basic and clinical research institutes, to develop cooperation among scientists from different regions, and to establish a collaborative network for clinical trials.
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  22. 22
    050345

    AIDS diagnosis and control: current situation, report on a WHO meeting, Munich 16-18 March 1987.

    World Health Organization [WHO]. Regional Office for Europe

    Copenhagen, Denmark, WHO, Regional Office for Europe, 1987. 36 p. (ICP/CDS 026; EUR/HFA target 4)

    A WHO meeting on the diagnosis and control of acquired immunodeficiency syndrome (AIDS) was attended by 74 participants including 15 temporary advisers and representatives of 26 European countries. The global spread of AIDS was described and clinical and lab diagnosis, therapy and the social, psychological, financial, legal and ethical aspects of the AIDS epidemic were addressed. Prevention and control measures were discussed, and surveys and mathematical models for predicting increases in the number of people infected were considered. Participants described the epidemiological situation in their countries and strategies adopted to prevent the spread of infection. The 8 working groups formed to consider specific aspects of the epidemic and made conclusions and recommendations were: surveillance and serological surveys; control of infection; quality control of biological materials; provision of care and counseling facilities; prediction of epidemiological trends; social aspects of infection and health education and information; public health measures and legislation; and supporting research.
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  23. 23
    050362
    Peer Reviewed

    What help can the U.K. give?

    Pollock M

    JOURNAL OF TROPICAL PEDIATRICS. 1987 Jun; 33(Suppl 1):13-7.

    The development problems of sub-Saharan Africa remain acute. Despite improvements in mortality over the past 40 years, the region has high mortality and morbidity from infectious and communicable diseases. Large populations, especially of children, are subject to malnutrition, a problem further exacerbated by high fertility rates. The British government has provided assistance for all the elements to WHO's primary health care (PHC) approach within its various country assistance programs, and through support for multilateral health and population programs. Britain is contributing about 90 million pounds towards the costs of drinking water and sanitation schemes in about 28 developing countries, and many of these activities are in Africa. WHO and UNICEF child immunization campaigns receive regular contributions, and Britain accords high priority to population-related activities within its aid programs. The nation was a founding member of WHO's Diarrheal Diseases Control Program. British aid is also helping to make essential drugs available, stimulating community self-health programs, and supporting manpower development. The Overseas Development Administration (ODA) is trying to increase the effectiveness of health expenditure through improved financial and management practices. The more general aims of ODA's Aid Program will have a significant impact on the health of individuals, families, and communities throughout Africa and the rest of developing world.
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  24. 24
    040810

    Global estimates and projections of population by sex and age: the 1984 assessment.

    United Nations. Department of International Economic and Social Affairs

    New York, New York, United Nations, 1987. ix, 385 p. (ST/ESA/SER.R/70.)

    The report presents the estimated and projected sex and age distributions according to the medium, high, and low variants for population growth for 1950-2025 for countries and areas generally with a population of 300,000 and over in 1980. The data for smaller countries or areas are included in the regional population totals and are not given separately. This report supplements the report on the WORLD POPULATION PROSPECTS: ESTIMATES AND PROJECTIONS AS ASSESSED IN 1984, which presents methods, data, assumptions, and a summary of major findings of the estimates and projections, as well as selected demographic indicators for every country or area of the world. The sex and age distributions of population in this report are based on the 10th round of the global demographic assessments undertaken by the UN Secretariat. They are derived from data that were available to the UN generally by the beginning of 1985; therefore, the figures presented supercede those that were previously published by the UN.
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