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  1. 1

    Where the female condom is no joke. A UN program has sold millions to African nations seeking to stem the tide of AIDS.

    Herman R

    WASHINGTON POST. HEALTH. 1998 Jun 16; 9.

    The female condom received criticisms and ridicule in the US when it debuted in 1994. However, in the developing world the UN AIDS Program has recently turned to the female condom with utmost seriousness because it not only prevents pregnancy but can also prevent transmission of HIV and other sexually transmitted diseases. Under a new UNAIDS initiative to promote the female condom, the cost has been lowered and African nations this year have bought millions of devices in the hope of slowing the spread of the AIDS virus that has devastated their population. Public officials find that when the female condom is offered as an option along with the male condom, more people act to protect themselves. Moreover, in promoting the female condom internationally, the Female Health Company and international family planning organizations have found differences in cultural attitudes toward sexuality and male-female relations. In Bolivia, for instance, women alone are the target and the goal is "empowerment", showing women that they have options and choices within the context of their sexual relations with men.
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  2. 2

    Assessing the impact of new contraceptive technologies on user satisfaction, use-dynamics, and service systems.

    Phillips J

    PROGRESS. 1989; (11):2-3.

    A summary of the recommendations stemming from conference on the Demographic and Programmatic Consequences of Contraceptive Innovations, sponsored by the U.S. National Academy of Sciences in 1988, is provided by the WHO. While typical research on introduction of new contraceptive methods concerns cohort studies of users' problems and perspectives, a larger view of use-dynamics, choice behavior and client satisfaction with overall care is lacking. It is popular to hypothesize that user satisfaction improves with numbers of contraceptive options, but the literature does not provide clear evidence on this point, and none at all on introduction of new methods. Three main issues should be addressed: what is the impact of a new method on client perception of overall care, on contraceptive behavior, and on operation of the family planning program. To get this information usually requires prohibitively costly, time-consuming research. Low cost approaches are available, however, taken from the type of large-scale, community-based repeat observation studies now used to monitor trials of pharmaceuticals for tropical diseases, and treatments of rare conditions, such as vitamin A. Statistical techniques have been developed to adjust for censoring bias. Another type of field research that can be adapted to this research is the epidemiological field research of the type used in the Matlab, Bangladesh cholera vaccine study, later utilized to study acceptance of family planning services. Without such studies, the social and programmatic rationale for introduction of new contraceptives will be open to debate.
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  3. 3
    Peer Reviewed

    Assessing changes in vaginal bleeding patterns in contracepting women.

    Machin D; Farley TM; Busca B; Campbell MJ; d'Arcangues C

    CONTRACEPTION. 1988 Aug; 38(2):165-79.

    Researchers recruited 1216 females to study changes in amenorrhea patterns with successive injections of the long acting injectable contraceptive depot-medroxyprogesterone acetate (DMPA). The women received an injection of either 100 mg or 150 mg DMPA on the day of randomization and 3 additional injections at 90 day intervals. 1151 (94.7%) women completed a menstrual diary that could be used, but only diaries of at least 60 days were considered in each reference period (90 days). Of the 99 who received only 1 100mg injection, 23 had amenorrhea. Of the 361 receiving 4 injections, 142 experienced no amenorrhea in any of the injection intervals and 30 had amenorrhea in all 4 intervals. Overall 281 women out of 576 who received 1-4 injections of 100 mg DMPA did not experience amenorrhea at all. For those in the 150 mg sample receiving 1-4 injections, 237 out of 575 women did not have amenorrhea. Analysis of change over time suggested an increase incidence of amenorrhea following the 2nd injection. In terms of the probability of a woman accepting a injection, women who experienced amenorrhea with the 1st injection were less likely to accept a 2nd, especially in the 150 mg DMPA group. Additionally, the trend in amenorrhea pattern demonstrated that a 3rd injection was adversely affected by amenorrhea in the 2nd injection interval in the 150 mg group but not the 100 mg group. Nevertheless, the decision to have a 4th injection appeared adversely affected by amenorrhea in the 3rd injection interval in both groups. The conditional probabilities used in this research can also be applied to examine continuation or survival rates in a follow-up study based on any prognostic factors.
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  4. 4

    Dominican Republic: Contraceptive Social Marketing Project.

    Futures Group. Social Marketing for Change [SOMARC]

    [Unpublished] 1987 Jun. [6] p.

    To increase knowledge and proper use of low-dose oral contraceptives and increase availability of affordable contraception for low-income populations in the Dominican Republic, Profamilia (an IPPF affiliate) launched a communications/promotional campaign for Microgynon aimed at men and women under age 35. While strengthening Profamilia's marketing and organizational capabilities so that the program could be maintained without donor subsidies, the Profamilia name was used to communicate the idea of quality at low price. The message that Microgynon is a safe, effective, easily used, temporary method of birth control was relayed through a television commercial aired in 1986; through press releases; on display posters, stickers, matchbooks, memo pads, and bag inserts distributed to pharmacies; by educational/promotional meetings with the medical community; and by orientation sessions with pharmacy employees. Schering Dominica's sales network placed Microgynon in 83% of pharmacies in the Dominican Republic. It was priced significantly below comparable products. Of 500 randomly selected residents, 68% remembered seeing the television commercial. In interviews with 252 Microgynon purchasers, 65% said that they had started using Microgynon after the television advertising campaign. The campaign was successful in reaching the target group of women.
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  5. 5

    Social marketing.

    Munroe HW

    [Unpublished] 1987. 55, [8] p.

    Marketing is a branch of economics which includes the analysis, planning, implementation, and control of promotional programs designed to encourage a target population to accept an organization's product or service. Social marketing (SM) is the application of marketing technics to alter the behavior of a target population toward the acceptance of a social project. Early efforts in social marketing involved public service or "social" advertising via mass media; and early projects were directed toward family planning, health and nutrition in developing countries. Several lessons were learned from these early projects: 1) Persuasive technics must be geared to the specific project; 2) Pilot projects should be limited in scope; 3) Target populations are variable and must be precisely defined; 4) Constant feedback is essential; 5) In developing countries mass media campaigns must be directed, not only at the end-user population, but also at the intermediary government officials, health workers, teachers, and food distributors; 6) Maximum use must be made of the small amount of media time available; 7) In poor, underdeveloped countries persuasion technics must take account of cultural and psychological barriers to behavior modification; 8) Social marketing is not competitive in the commercial sense; 9) Careful market research must be done in order to avoid mistakes due to failure to understand cultural barriers; 10) Health education efforts must address the whole health environment, not merely one aspect of it because the different aspects are interrelated, e.g., the relation of food hygiene to the cleanliness of the water supply; 11) Social marketing cannot overcome basic economic and political barriers to the reception of a new project. Some recent examples of social marketing include the experience of SOMARC (Social Marketing for Change), a private voluntary organization which worked with the Indonesian government to distribute condoms; HEALTHCOM, which worked with oral rehydration therapy in 8 countries; the Johns Hopkins Population Communication Services, which used popular music to "sell" chastity to young people in Latin America; and China's "one child" program. The present project involves a cooperative effort among the General Foods Corporation, the International Chamber of Commerce, the International Advertising Association, the Industry Council for Development, and the World Health Organization Consultation of Health Education in Food Safety. This project will test the adaptability of commercial food marketing technics for use with a target population which buys different foods, largely unpackaged and unlabelled. The effort must be coordinated with local health workers and will involve training of local food handlers and technicians and the use of some give-away item such as a calendar to serve as a reminder and hold the attention of the target population. Similar cooperative ventures, involving pharmaceutical firms, local organizations, local governments, and the World Health organization have shown the effectiveness of social marketing in reaching target populations in developing countries.
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  6. 6

    [Needs of youth in family planning: the problem in Latin America. A equivocal policy: putting the cart before the horse] Necesidades de los jovenes en planificacion familiar: el problema en America Latina. Una politica equivocada: poner la carreta delante de los bueyes.

    Gomensoro A

    [Unpublished] May 1983. Presented at the Meeting of the Regional Council of the FIPF-RHO, Mexico City, May 14, 1983. 9 p.

    The increasingly young ages at which sexual activity begins and the rising rates of adolescent pregnancy with its severe physical, social, and economic problems are by now well known in Latin America. The explanation of the problem and the near impossibility of resolving it stem from the social unacceptability of contraceptive use by adolescents, a factor which foredooms to failure most programs to curb adolescent pregnancy. The unacceptability of contraceptive use by adolescents should, therefore, be defined as the problem and struggled against. The lack of acceptability of contraceptive use is the practical expression of a repressive ideology which condones sexual discrimination against women. Latin American society, which has always validated recreational sex for males of any age and is recently permitting recreational sex for adult women, roundly refuses to permit it for young women. Such a double standard shows how far discrimination against women has survived, despite all the rhetoric about equality of rights and opportunities. Young women will not use contraception until their social and cultural surroundings validate contraceptive usage. The required policy for dealing with adolescent pregnancy will move from recognizing the fact of early sexual experience, to acceptance of the fact, to social validation of the fact. Only when the undeniable and unchangeable fact of early sexual experience is recognized, accepted, and socially validated will contraceptive programs for adolescents become viable. The task of the International Planned Parenthood Federation should be to do everything possible to promote this decisive ideological change from repression of sexuality in young women to validation of it. The priority of programs to prevent adolescent pregnancy is part of a larger priority: that of struggling on all fronts for an effective liberation of women, questioning of traditional roles and achieving for women the same status and personal dignity enjoyed by males in their sexual and procreative lives.
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