Your search found 28 Results

  1. 1

    Reclaiming the ABCs: the creation and evolution of the ABC approach.

    Hardee K; Gribble J; Weber S; Manchester T; Wood M

    Washington, D.C., Population Action International, 2008. [16] p.

    This report was developed through review of the early literature on HIV/AIDS policies and programs in non-industrialized countries and of media material promoting prevention of heterosexual transmission of HIV in those countries. Material from the early days of the epidemic was difficult to obtain. Most materials were long ago archived or are in personal files in "basements". While the report focuses on the experiences of three countries, it also examines the early responses of international organizations to HIV in many other developing countries. Additional data were obtained using a snowball sampling technique through which the authors contacted people who had worked in HIV/AIDS prevention strategies. The pool of respondents is not intended to be exhaustive, but the respondents provide important voices of those working in the developing world at the beginning of the epidemic.
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  2. 2

    AIDS fighter. Liberia.

    United Nations. Department of Economic and Social Affairs. Office of the Special Adviser on Gender Issues and Advancement of Women [OSAGI]

    New York, New York, OSAGI, [2004]. [2] p.

    Her name is Joyce Puta, a 48-year-old Zambian army colonel on secondment to the United Nations. An unabashed fighter, her enemy for the last ten years has been HIV/AIDS. Her latest battleground is Liberia, and by all accounts she has been waging a successful campaign. Working with the United Nations Mission in Liberia (UNMIL), Colonel Puta points out that any environment requiring peacekeepers is also a risky one for the spread of HIV/AIDS. In post-conflict situations, social structures crumble and economies are unstable. In order to survive, desperate young women may turn to commercial sex work, often around military bases. So how did a career Zambian army officer find herself on the frontlines in the fight against HIV/AIDS? Joyce Puta joined the army at eighteen. Six years later she became a registered nurse and midwife, and then nursing services manager for Zambia's main military hospital. (excerpt)
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  3. 3

    Churches in the lead on HIV prevention reinvigoration.

    Mane P

    Contact. 2006 Aug; (182):4-5.

    Saving lives is the paramount goal of all HIV programmes. Successful HIV prevention programmes utilize all approaches known to be effective, not implementing one or a few select actions in isolation. These include promoting sexual abstinence, fidelity among married couple and the use of condoms for those who are not in a position to abstain or be faithful. It also includes ensuring that injecting drug users have access to clean needles and syringes as well as programmes supporting them to stop drug use. The strategies also include assurance that HIV-positive pregnant women receive treatment to prevent HIV transmission to the child. These strategies (See insert) were endorsed by the UNAIDS board last year and provide the framework for re-energizing HIV prevention globally. (excerpt)
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  4. 4

    SIECUS PEPFAR country profiles: focusing in on prevention and youth. Zambia.

    Sexuality Information and Education Council of the United States [SIECUS]

    New York, New York, SIECUS, [2006]. [9] p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)

    Zambia is home to 11 million people, who represent more than 70 different ethnic groups, many sharing a common language, Bantu. Today roughly 35% of people live in urban areas. Although at one point the country was becoming increasingly urbanized, intense poverty on the rise since the 1970s has seen many people returning to rural areas. Religious beliefs in the country are varied. It is estimated that between half and three-quarters of Zambians practice Christianity, and that between a quarter and one-half practice Islam or Hinduism. A small minority practice indigenous faiths. Zambia gained its independence from Britain in 1964, and then was under one-party rule until the early 1990s. President Levy Mwanawasa was elected in 2001, although opposition parties claim the elections were marred by irregularities. Mwanawasa, however, has actively worked to rectify the perception of corruption in the government. For example, he lifted his predecessor Frederick Chiluba's immunity from investigation and prosecution regarding allegations of corruption. The next elections are scheduled for 2006. (excerpt)
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  5. 5

    SIECUS PEPFAR country profiles: focusing in on prevention and youth. Uganda.

    Sexuality Information and Education Council of the United States [SIECUS]

    New York, New York, SIECUS, [2006]. [13] p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)

    Uganda is home to over 26 million people, comprising at least 18 different ethnic groups. The largest group, the Baganda people, make up 17% of the population. Today, an increasing number of people practice some form of Christianity, roughly 66% of the population, with an equal number subscribing to Roman Catholic and Protestant teachings. Of the remaining 34%, half practice Islam and half practice traditional, indigenous religions. Uganda is struggling to emerge from a turbulent and violent political history. President Yoweri Museveni seized power through a military rebellion in 1986. In 1996, he became the country's first directly elected president and was re-elected in 2001. He is also the chair of the National Resistance Movement (NRM), the only fully and freely functioning political organization in the country. Although there are seven organizations that could be characterized as political parties, Museveni has declared that the NRM is not a political party but a movement that "claims the loyalty of all Ugandans."2 Presidential elections are scheduled for February 2006, and although the constitution limits presidents to two terms in office, Musevini is campaigning to alter the constitution to permit him to run for a third term. (excerpt)
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  6. 6

    SIECUS PEPFAR country profiles: focusing in on prevention and youth. Tanzania.

    Sexuality Information and Education Council of the United States [SIECUS]

    New York, New York, SIECUS, [2006]. [10] p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)

    The United Republic of Tanzania, which consists of the mainland and the island of Zanzibar, is home to 36.8 million people. The vast majority (99%) are native Africans, of which 95% are Bantu (an ethnic group consisting of more than 130 tribes). While mainland Tanzanians hold a variety of beliefs (35% Muslim, 35% indigenous, and 30% Christian), more than 99% of the inhabitants of Zanzibar practice Islam. Tanzania was formed through the merger of Tanganyika and Zanzibar in 1964, after the two nations gained independence from U.N. trusteeship administered by Britain. In 1995, one-party rule came to an end with the first democratic elections held in the country in nearly 30 years. Since that time, two contentious elections have been conducted, with the ruling party declaring victory despite claims of voting irregularities by international observers. (excerpt)
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  7. 7

    SIECUS PEPFAR country profiles: focusing in on prevention and youth. South Africa.

    Sexuality Information and Education Council of the United States [SIECUS]

    New York, New York, SIECUS, [2006]. [12] p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)

    South Africa is home to over 44 million people. South Africa's population is diverse-- the country officially recognizes 11 different languages and is home to a variety of ethnic groups and religions. Until 1991, South African law divided the population into four major racial categories: African (black), white, coloured, and Asian. Although this law has been abolished, many South Africans still view themselves and each other according to these categories. Black Africans from various ethnic groups comprise about 79% of the population. White people of European descent comprise about 10% of the population. Coloured people, who are mixed-race people primarily descending from the earliest settlers and the indigenous peoples, comprise about 9% of the total population. Asians, who descend from Indian workers brought to South Africa in the mid-19th century to work on the sugar estates in Natal, constitute about 2.5% of the population and still live primarily in the KwaZulu-Natal Province. Over half of South Africans identify as Christian, and 28.5% hold traditional, indigenous and/or animist beliefs. South Africans who identify as Muslim and Hindu (60% of whom are Indian) represent 2% and 1.5% of the population, respectively. (excerpt)
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  8. 8

    Silence is death: towards a woman-centred HIV/AIDS prevention.

    Kang N

    UN Chronicle. 2005 Dec; [2] p..

    Secretary-General Kofi Annan highlighted in a BBC interview that the largest demographic group to be targeted by the HIV/AIDS pandemic was women. Taking stock of this reality, he stated: "We've seen women's organizations at the grass-roots level and this is very important, because today in Africa AIDS has a woman's face.... Often they are the innocent victims." The United Nations Children's Fund reported that in sub-Saharan Africa, where prevalence of the disease is most severe, two girls for every boy (aged 15 to 24) are newly infected with the virus, while in the most affected countries the ratio is five to one among the 15-to-19-year-olds). The Joint United Nations Programme on HIV/AIDS (UNAIDS) reported in 2004 that worldwide women comprised nearly 50 per cent of adults living with the virus, almost 60 per cent of them in sub-Saharan Africa. In his report "In Larger Freedom: Towards Development, Security and Human Rights For All", Mr. Annan emphasized two imperatives: mobilization of greater political will to formulate and expedite policy decisions related to the disease; and increased financial support for the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria. Appropriate actions are therefore required to achieve the Millennium Development Goal (MDG) of combating HIV/AIDS and other diseases. Their reversal and eradication, as well as the overall reduction in mortality rates worldwide, by 2015 is the main goal. The report also encourages Member States to prioritize HIV/AIDS-related initiatives, which would require furthering awareness of the disease while attacking stigmatization. "If there is anything we have learned in the two decades of this epidemic, it is that in the world of AIDS, silence is death", the Secretary-General reflected at the launch of the Global Media AIDS Initiative in January 2004. Silence equals death has become something of a catchphrase with regard to AIDS awareness. (excerpt)
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  9. 9

    HIV / AIDS: the prioritization of prevention [editorial]

    Ratzan SC

    Journal of Health Communication. 2004; 9:385-386.

    Earlier this year, two major international meetings reminded us of the scourge of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Since HIV/AIDS was first recognized in 1981, this emerging disease has spread relentlessly throughout the world to more than 40 million HIV-positive people, 95% of whom live in developing countries. It now threatens to surpass in total fatalities both the fourteenth-century ‘‘black death’’ and the 1918–1919 influenza pandemic, which killed tens of millions of people. Now as HIV/AIDS is in its third decade the 2004 World Health Organization (WHO) report Changing History calls for a comprehensive HIV/AIDS strategy that links prevention, treatment, care, and long-term support. Similarly, the XV International AIDS Conference in Bangkok also endeavored to link community and science to galvanize the world’s response to HIV/AIDS through increased commitment, leadership, and accountability. In 2003 alone, 5 million new infections occurred—14,000 each day—with an estimated 3 million people with HIV/AIDS dying, 500,000 of whom were children. The growing numbers do not adequately represent the devastation to individuals, families, communities, and societies coping with HIV/AIDS. Further, they do not demonstrate the devastating impact on economies and political stability. (excerpt)
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  10. 10

    Bush's other war: the assault on women's sexual and reproductive health and rights.

    International Women's Health Coalition [IWHC]

    New York, New York, IWHC, 2003. 11 p.

    Internationally and domestically, in our courts and in our schools, at the UN and on Capitol Hill, it is no exaggeration to say that the White House is conducting a stealth war against women. This war has devastating consequences for social and economic development, democracy, and human rights—and its effects will be felt by women and girls worldwide. (excerpt)
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  11. 11

    Abstinence goes global: the U.S., the right wing, and human rights.

    Rothschild C

    American Sexuality Magazine. 2003; 1(6):[5] p..

    The right wing has been very effective at melding its domestic and global strategies. Progressive organizations and social movements must do the same, and with urgency. Using a human rights lens to critique abstinence-only programs and the manipulation of valid scientific data would go a long way in fostering effective coalitions. Coalitions of human rights organizations, and sexual and reproductive health and rights organizations, must increasingly take their fight to global and UN levels to protect gains already won. (excerpt)
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  12. 12

    Family planning based on periodic abstinence. A preliminary glossary (draft).

    World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Methods for the Determination of the Fertile Period

    [Unpublished] [1978]. 11 p.

    This glossary, prepared by the Task Force on Methods for the Determination of the Fertile Period of the World Health Organization (WHO) Special Program of Research, Development and Research Training in Human Reproduction, defines 79 terms and concepts central to the understanding of family planning based on periodic abstinence. The glossary was the result of awareness that the absence of standardized terminology has resulted in misunderstandings regarding the teaching and practice of natural family planning methods, errors in the overall interpretation of data and evaluation of effectiveness, and communication difficulties between family planning programs and investigators. The glossary is primarily intended to provide technical language for the natural family planning instructor as a tool for communication with couples who intend to practice family planning based on periodic abstinence. Efforts were made to use simple and precise language, and it is expected that the glossary will be translated from English and adapted to local vernacular and cultures. The glossary in not intended to replace a manual of instruction on natural family planning planning.
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  13. 13

    Research on the menopause.

    World Health Organization. Scientific Group

    World Health Organization Technical Report Series. 1981; (670):1-120.

    This report includes the collective views of a World Health Organization (WHO) Scientific Group on Research on the Menopause that met in Geneva during December 1980. It includes information on the following: 1) the endocrinology of the menopause and the postmenopausal period (changes in gonadotropins and estrogens immediately prior to the menopause and changes in gonadotropin and steroid hormone levels after the menopause); 2) the age distribution of the menopause (determining the age at menopause, factors influencing the age at menopause, and the range of ages at menopause and the definition of premature and delayed menopause); 3) sociocultural significance of the menopause in different settings; 4) symptoms associated with the menopause (vasomotor symptoms, psychological symptoms, disturbances of sexuality, and insomnia); 5) disorders resulting from, or possibly accelerated by, the menopause (osteoporosis, atherosclerotic cardiovascular disease, and arthritic disorders); 6) risks, with particular reference to neoplasia, of therapeutic estrogens and progestins given to peri- and postmenopausal women (endometrial cancer, breast cancer, and gallbladder disease); 7) fertility regulating methods for women approaching the menopause (fertility and the need for family planning in women approaching the menopause, problems of family planning in perimenopausal women, and considerations with regard to individual methods of family planning in women approaching the menopause); and 8) estrogen and the health care management of perimenopausal and postmenopausal women. At this time some controversy exists as to whether there is a menopausal syndrome of somatic and psychological symptoms and illness. There are virtually no data on the age distribution of the menopause and no information on its sociocultural significance in the developing countries. The subject of risks and benefits of estrogen therapy in peri- and postmenopausal women is of much importance in view of the large number of prescriptions issued for this medication in developed countries, which indicates their frequrnt use, and the different interpretations and opinions among epidemiologists and clinicians on both past and current studies on this subject. Specific recommendations made by the Scientific Group appear at the end of each section of the report. The following were among the general recommendations made: WHO sponsored research should be undertaken to determine the impact on health service needs of the rapidly increasing numbers of postmenopausal women in developing countries; uniform terminology should be adopted by health care workers with regard to the menopause; uniform endocrine standards should be developed which can be applied to the description of peri- and postmenopausal conditions and diseases; and descriptive epidemiological studies of the age at menopause should be performed in a variety of settings.
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  14. 14

    Biology of fertility control by periodic abstinence: report.

    World Health Organization [WHO]. Scientific Group on the Biology of Fertility Control by Periodic Abstinence

    Geneva, Switzerland, WHO, 1967. 20 p. (WHO Technical Report Series No. 360)

    In this report of a World Health Organization (WHO) Scientific Group on the Biology of Fertility Control by Periodic Abstinence, convened in Geneva during May and June 1966, existing knowledge of the menstrual cycle, ovulation, and fertility is outlined relevant to the objective of understanding the mechanisms of fertility control by periodic abstinence. Discussion is limited to physicological and arithmetical analyses of the subject to the relative effectiveness of different methods for determining the necessary period of abstinence. Attention is directed to genital and extragenital changes associated with the menstrual cycle as possible aids in detecting ovulaion and the demarcation of that part of the cycle that is potentially the fertile period. Studies of the use effectiveness of the calendar methods have given failure rates that vary from 14 to almost 40 pregnancies/100 woman-years of use. In 4 studies in Western Europe of the use effectiveness of the temperature method, the failure rate was 0.8 to 1.4 pregnancies/100 woman-years of use. The most common causes of failure, i.e., pregnancy, with the various forms of fertility control by periodic abstinence are probably lack of accurate knowledge regarding the method used and lack of motivation. Recommendations regarding research needs are included.
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  15. 15

    Natural family planning. Couples take chances [letter]

    Huezo C; Kleinman R; Walder R

    BMJ. British Medical Journal. 1993 Oct 16; 307(6910):1003.

    An author of an article about natural family planning (NFP) in an earlier issue of the British Medical Journal contends that NFP and modern contraceptive methods (e.g., oral contraceptives [OCs]) provide comparable effectiveness against pregnancy. He uses data from a WHO multicountry study and a study of 20,000 women in Calcutta to support his position that NFP is safe, reliable, and effective. IPPF staff agree with the author that health professionals would accept another inexpensive, reliable, and safe family planning method. The author misrepresented the studies' findings, however. He says that the pregnancy rate for the WHO study group was 1.5%. Yet, the women who participated in the study and conceived included not only the 1.5% but also another 19.4% who did not identify their fertile cycle or did not abstain as called for by NFP guidelines. The author failed to mention these women in his review. The actual NFP failure rate for the WHO study group was 20.9%--a much higher rate than that for modern contraceptive methods. The Calcutta study did not present enough information on the methodology or selection of cases to allow comment. When both partners are very motivated, when the woman can always recognize signs of her fertile period, and when the couple can truly avoid intercourse according to NFP guidelines, periodic abstinence is an effective family planning method. Otherwise the woman is at great risk of conceiving. Many couples gamble and do not abide by the guidelines. In reality, the author's assertion that NFP is as effective as OCs is clearly false. IPPF considers NFP as one of many family planning choices. Couples choosing NFP should be told of its real failure rates, the need to totally follow the abstinence rules, and the risk of pregnancy when those rules are not followed.
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  16. 16

    New IPPF statement on breastfeeding, fertility and post-partum contraception.

    International Planned Parenthood Federation [IPPF]. International Medical Advisory Panel [IMAP]

    IPPF MEDICAL BULLETIN. 1990 Apr; 24(2):2-4.

    The International Planned Parenthood Federation International Medical Advisory Panel drew up the following statement in November, 1989. Breastfeeding is good for the infant. Antibodies passed to it from the mother protect it from infection. Patterns of breastfeeding are changing. Therefore, the risk of pregnancy is increased. Postpartum amenorrhea plays a major role in natural fertility regulation. Studies from around the world show a positive correlation between the length of breastfeeding and the length of lactational amenorrhea. Amenorrhea lasts longer in those who breastfeed more often at night and during the day. There is controversy over the effect of nutrition on postpartum infertility. Pregnancy and the puerperium are a good time for counseling on maternal nutrition, child spacing, breastfeeding, and contraceptive methods. Counseling nursing mothers about potential fertility during lactation should be based on local information. All women should be advised to fully breastfeed. Family planning programs should cooperate with maternity services in providing counseling and education for postpartum women who need contraception, for providing referral services, for producing educational resources, and in training health personnel. Postpartum contraception should be included in the training of traditional birth attendants. Women who do not breastfeed can select any contraceptive method. Mothers who nurse must not hurt success of lactation or the infant's health. Nonhormonal contraception should be the 1st choice for lactating women. IUDs do not harm infant growth or lactation. Postpartum insertions are appropriate, though care must be taken. Female sterilization can be conveniently done at this time. Barrier methods are reliable when used regularly. The failure rate should be lower when used after delivery. Progestagen-only contraception consists of progestagen-only pills, injectables, and Norplant. These do not affect quality and quantity of breast milk or length of lactation. They are suitable for those who do not wish nonhormonal methods. There are possible consequences, however, of the transfer of the steroid to breast milk. Hormonal methods should not be used earlier than 6 weeks postpartum. High and low dose oral contraceptives adversely affect the quality and quantity of breast milk. They also reduce duration of lactation. They should be withheld until 6 weeks after delivery, or until the infant is weaned--whichever comes first. The efficacy or periodic abstinence in nursing women requires further analysis.
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  17. 17

    New IPPF statement on breast feeding, fertility and post-partum contraception.

    International Planned Parenthood Federation [IPPF]. International Medical Advisory Panel [IMAP]

    IPPF MEDICAL BULLETIN. 1990 Apr; 24(2):2-4.

    Breast milk provides infants with their nutritional requirement plus antibodies to combat certain infections. Prolonged breast feeding and concurrent postpartum amenorrhea contribute to natural infertility, but considerable variability occurs among different populations. Further, certain variables exist that contribute greatly to the length of amenorrhea and infertility. They include nutritional status of the mother; length of breast feeding; giving supplements to the infant; frequency and duration of suckling; and geographic, social, and cultural factors. Many studies indicate that the longer a woman breast feeds, the longer she will experience amenorrhea. Anovulation is contingent on the frequency and distribution of nursing episodes day and night and the time of the infant feeds at the breast. Feeding an infant supplementary milk or food also reduces the inhibitory affect of breast feeding on ovarian activity and fertility, especially when supplements are introduced early. Educating mothers about the value of child spacing, breast feeding, maternal nutrition, and contraception should be done during pregnancy and the postpartum period, the times when mothers most often visit health clinics. Mothers should also be informed that it is not possible to anticipate how long they will be infertile while breast feeding, so contraceptive use should be encouraged. If possible, nursing mothers should avoid using hormonal contraceptives because they can interrupt lactation or pose a risk to the infant. IUDs are highly efficacious. If a woman is in a hospital to deliver, postpartum sterilization is another option. Barrier methods are effective, if used regularly, especially during this time of reduced fertility. Since the reoccurrence of menses is unpredictable and the efficacy is not know, nursing mothers should not rely on periodic abstinence.
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  18. 18
    Peer Reviewed

    Contraceptive failure of the ovulation method of periodic abstinence.

    Trussell J; Grummer-Strawn L

    Family Planning Perspectives. 1990 Mar-Apr; 22(2):65-75.

    Previously published estimates of probabilities of method and user failure for all contraceptive methods suffer from a serious methodological error and are biased downward, with the extent of bias unknown. Data from a World Health Organization clinical trial of the ovulation method of periodic abstinence were used to provide the first correctly calculated measures of method and user efficacy and to determine the characteristics that distinguish women who consciously take risks from those who do not. Probabilities of pregnancy during the 1st year are 3.1% during perfect use (method failure) and 86.4% during imperfect use (user failure). Thus, if used perfectly, the ovulation method is very effective. However, it is extremely unforgiving of imperfect use. Because perfect compliance is difficult for many couples who desire intercourse when it is forbidden by ovulation method rules, and because the risk of pregnancy during imperfect use is so great, the ovulation method cannot be considered an ideal contraceptive method for the typical couple, who are likely to be less compliant than couples who volunteer for a clinical trial. The probability of an accidental pregnancy is greatest when any of the 3 most serous rules--no intercourse during mucus days, within 3 days after the peak fecundity or during times of stress--are broken. Those who have a poor attitude toward the rules are more likely to take risks, including serious risks. Those who get away with taking a risk (i.e., do not get pregnant) are very likely to take risks again. Because breaking the most serious rules entails a 28% risk of pregnancy per cycle, those likely to take risks should be counseled about the probable consequences. The World Health Organization has 5 centers that teach the ovulation method: 1) Auckland, New Zealand; 2) Bangalore, India; 3) Dublin, Ireland; 4) Manila, the Philippines and 5) San Miguel, El Salvador. (Author's modified).
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  19. 19

    Ovulation method satisfaction is relative to abstinence required.

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


    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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  20. 20

    Is it o.k. for PPFA to say "no way"?

    Newcomer S

    New York, New York, Planned Parenthood Federation of America, 1986. 5 p.

    The Planned Parenthood Federation of America's (PPFA) best-selling pamphlet has been the one that tells teens how to say no to sex, but teens uniformly find it preachy and patronizing. Adults like the pamphlet, but teenagers are still having sex. US adults have difficulty in deciding whether it is best for teenagers to not have babies, not get pregnant, or not have intercourse. About half of US teens have had intercourse by the age of 18, and about half have not. The current political climate indicates that PPFA should promote abstinence. However, sexual behaviore is not rare. Abstinence from intercourse is an important component of human sexuality. Being able to say no to intercourse without being hurtful to oneself or others is a valuable skill, but PPFA should teach such skills within the context of sexuality education not instead of it. Teaching only abstinence may keep teens away from PPFA clinics, instead of bringing them in. What PPFA can and should do is to help schools, school systems, and states implement the provision of sexuality education for all students, and to work to assure that contraceptive services are accessible to young people.
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  21. 21

    [The Billings method] El metodo de Billings.

    Temas de Poblacion. 1981 May; 7(12):14.

    The World Health Organization (WHO) has financed a study of the Billings method of family planning in 3 developing and 2 developed countries to obtain objective data on the effectiveness of the method. Although 40% of the 870 couples had previously used another abstinence method and all were highly motivated to use the technique, the life-table pregnancy rate for the year following training in the method reached 20%. 11 studies of the cervical mucus method have been carried out in India, Tonga, Colombia, and Chile and in the US and Australia, often in new programs which did not employ uniform teaching methods. 2 Indian studies showed pregnancy rates of under 6/100 woman years, while 2 studies in developed countries showed rates under 15 and 2 showed rates over 30/100 woman years. Most of the studies have attributed the high pregnancy rates to the failure of couples to observe abstinence. Pregnancy occurred in the 5 countries partcipating in the WHO studies primarily as a result of the failure of couples to abstain from sexual relations during periods identified as fertile, despite active promotion of natural family planning and assistance from instructors at monthly intervals. Other reasons for the high failure rate were late occurrance of mucus flow relative to the time of ovulation, overly early appearance of mucus, and failure to observe or to interpret correctly the mucus symptom. Mucus patterns and facility of interpretation can be affected by various physiological or psychological factors, such as vaginal or cervical infection, vaginal secretion due to sexual stimulation, medicines, tension, and illness. The common observation of higher pregnancy rates among couples who wish to postpone rather than prevent a birth appears to be particularly important in the case of abstinence methods.
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  22. 22

    NFP internationally: an overview.

    Lanctot CA

    In: Ireland. Dept. of Health, World Health Organization [WHO]. International Seminar on Natural Methods of Family Planning, Dun Laoghaire, County Dublin, Ireland, October 8-9, 1979. [Dublin, Ireland, Dept. of Health, 1979]. 166-76.

    This paper summarizes the international development of National Family Planning (NFP) over the last 25 years in view of: 1) recent developments, 2) status of NFP in various countries, 3) popularity of NFP in terms of use, effectiveness, and acceptibility, and 4) the potential of NFP. 3 phases are outlined: 1) Clinical phase before 1955 when basic discoveries in reproductive physiology were achieved, the rhythm method was popularized, and experiments for measuring basal body temperature (BBT) were developed; 2) pioneer phase (1955-70) when NFP centers developed empirical tests of monitoring techniques, the Billings or ovulation method (OM) was developed, and sympto-thermal methods became popular; 3) popularization phase (1970-present) when NFP methods were popularized. Current research includes clinical trials for effectiveness, education, NFP instruction, and basic research into operating procedures and psychosocial factors of NFP. Major programs include the World Organization of the Ovulation Method by Billings (WOOMB), a program devoted to OM methods of NFP, and the International Federation for Family Life Promotion (IFFLP), a program devoted to the development of natural associations of NFP interests. IFFLP now has members in over 70 countries (in Africa, Asia, Australia, North America, Central and South America, and Europe). IFFLP devotes itself to knowledge or technology transfer projects in centers which hold workshops and work towards developing national organizations worldwide. 80-90% of the NFP programs are Catholic inspired although more than 50% of the users of NFP are non-Catholic. The popularity of NFP has been limited, if not declining, in some countries, although 50% of the family planning population in Japan practice the Ogino method of NFP. This is because of the advances in other contraceptive devices and the limits of NFP in terms of effectiveness and perceptions about the method. Recent developments in NFP suggest that: 1) effectiveness is 1-5 conceptions/100 women, 2) education and instruction may reduce the risk, 3) side effects of other contraceptive techniques are increasingly found to be damaging, and 4) behavioral insights into NFP is increasing because of ecological, health, and other concerns. The potential of NFP programs is compared to the natural childbirth movement in maternity care. Development of the potential is related to education, instruction, and perceptions about the value of NFP. Measures need to be taken to develop culturally appropriate out-reach programs, quality standards for NFP teachers, standardized service records, follow-up guidelines, health referrals, and administrative frameworks.
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  23. 23

    Family fertility education: educational handbook, objectives and glossary.

    World Health Organization [WHO]

    Geneva, WHO, [1981] 184 p.

    This packet of learning materials was developed by the British Life Assurance Trust for Health Education for WHO's Special Programme of Research, Development and Research Training in Human Reproduction. The materials were designed to train natural family planning method trainers. At present, the manual is being tested in field trials organized and supported by WHO. Following evaluation, the revised manual will be widely available. The information in the manual deals with the 2 most commonly used methods based on ovulation detection and periodic abstinence--the ovulation method and the sympto-thermal method. Those wishing to use the basal body temperature method can do so by modifying the facts given for the sympto-thermal method. The manual was based upon learning objectives established after consultation with major natural family programs in 19 countries. The packet consists of 4 modules: 1) fertility awareness; 2) sexuality and responsibility; 3) the ovulation method; and 4) the sympto-thermal method. Each module states its objectives, teaches how to teach as well as what to teach, and provides audiovisual aids to use concurrent with the teaching. Common terminology and evaluative methods are also included.
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  24. 24

    [Ovulation prediction and detection] [Letter]

    Moghissi KS

    Fertility and Sterility. 1981 Jan; 35(1):101.

    Variations in the menstrual cycle and ovulation time among women, even in the same woman, make the development of a reliable technique for ovulation prediction or detection extremely difficult. The same hormonal events which cause variability of the menstrual cycle and ovulatory pattern are reflected on peripheral and target tissue responses such as changes in cervical mucus and vaginal cytology. Recognition and interpretation of these changes may be difficult and at times impossible, even after adequate indoctrination. The primary purpose of developing an objective method of ovulation detection and prediction will be to improve upon subjective techniques rather than replacing them altogether. A reasonably reliable and simple self-administered method of ovulation prediction based on hormonal events surrounding ovulation time or changes in peripheral tissue response when added to currently existing subjective techniques, will improve the acceptability and effectiveness of periodic abstinence as a method of family planning. Recent studies under the auspices of the World Health Organization Task Force on Methods for Determination of the Fertile Period represent a promising step in this direction.
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  25. 25

    Compulsory sterilization: the change in India's population policy.


    Science. March 25, 1977; 195(4284):1300-1305.

    India's official advocacy of compulsory sterilization has caused dismay among those who think voluntary birth control services were never provided on a mass scale and that compulsory measures will cause resistance to family planning in general, but it has also brought relief to those who felt India's stand at the World Population Conference in 1972 was not nearly antinatalist enough. The new policy is in effect an admission that education and economic development will not bring about a drop in fertility soon enough. The timing of the policy shift can be explained by the state of emergency declared in June 1975. Prior to that, it would have been politically impossible for Mrs. Gandhi to make any strong statements in favor of birth control. Since the family planning program's inception in 1952 sterilization has been an important part, and incidence increased significantly every year until 1974 when budget cuts did not allow for program expansion. There are various possible explanations for the government's rethinking of its priorities but what was clear was that there was no clamor from the people to reinstate the services. The motivation to have small families seemed to be lacking, perhaps because it is connected to a certain socioeconomic threshhold which had not been reached by the populace when the focus shifted from sterilization to economic development as the best contraceptive. The 5 states that appear to have had a significant decline in fertility have also done well in economic development, while the family planning performance of the poorest states, Bihar and Uttar Pradesh, has been dismal. The problem of motivation is further complicated by a tradition and culture that require large families. The current population contains a huge growth potential for the future; all projections of the population show substantial increases. The Chinese example in family planning cannot be followed without fundamentally changing the structure of the entire economic and political system. Only the most economically prosperous states have the personnel and facilities to enforce a compulsory sterilization law. 1 of those, Maharashtra, is on the point of passing such a law. The experience of the state will be important for future consideration of compulsory sterilization nationwide.
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