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[Unpublished] 1978. Paper presented at National Workshop on Innovative Projects in Family Planning and Rural Institutions in Bangladesh, Dacca, Bangladesh, Feb. 1-4, 1978. 21 p.The author describes the establishment of a rural health service in Companigonj thana in Bangladesh done jointly by the government and international relief agencies. Provision was made for integrated health services including family planning, child health services, maternal health services, nutrition programs, and both curative and preventive medicine. Field workers, mostly female, were trained to provide medical services not requiring a doctor's presence. The author finds a marked increase in attendance at the health service over a period of years. The government should intensify its participation in the health service component for the program to have a chance of taking hold. Tables to illustrate the experience of the program in money expended; numbers of patients; cost per patient; clinic attendance by age, sex; hospital deliveries; new family planning acceptors; contraceptive usage; mortality and birth rate and causes of death by age; and antenatal follow up.
Studies in Family Planning. 1978 May; 9(5):89-147.A macroanalysis of the correlates of fertility decline in developing countries for the period 1965-75. The analysis focuses on how much of the fertility decline is associated with socioeconomic variables such as health, education, economic status, and urbanization, or with "modernization" as a whole, and how much with population policies and programs designed to reduce rates of growth. The data are examined in a variety of ways: 1) simple correlations among the variables; 2) multiple regression analysis using both 1970 values of socioeconomic variables and, for the alternative lag theory, 1960 values; 3) change in the socioeconomic variables over time; 4) a special form of regression analysis called path analysis; 5) a relatively new type of analysis called exploratory data analysis; 6) relation of socioeconomic level and program efforts to both absolute and percentage declines in fertility; 7) crosstabulations of program effort with an index of socioeconomic variables. Such data and analyses show that the level of "modernization" as reflected by 7 socioeconomic factors has a substantial relationship to fertility decline, but also that family planning programs have a significant, independent effect over and above the effect of socioeconomic factors. The key finding probably is that 2 (social setting and program effort) go together most effectively. Countries that rank well on socioeconomic variables and also make substantial program effort have had on average much more fertility decline than have countries with one or the other, and far more than those with neither. Finally, the relationship between predicted and observed crude birth rate decline for the 94 developing countries over this period is illustrated for different combinations of actors, and an attempt is made to estimate the quantitative impact of the major conditions upon the intermediate variables traditionally assumed to account for crude birth rate change.(AUTHOR ABSTRACT)
CBFPS (Community-based Family Planning Services) in Thailand: a community-based approach to family planning.
Essex, Connecticut, International Council for Educational Development, 1978. (A project to help practitioners help the rural poor, case study no. 6) 91 pThis report and case study of the Community-Based Family Planning Service (CBFPS) in Thailand describes and evaluates the program in order to provide useful operational lessons for concerned national and international agencies. CBFPS has demonstrated the special role a private organization can play not only in providing family planning services, but in helping to pioneer a more integrated approach to rural development. The significant achievement of CBFPS is that it has overcome the familiar barriers of geographical access to family planning information and contraceptive supplies by making these available in the village community itself. The report gives detailed information on the history and development of the CBFPS, its current operation and organization, financial resources, and overall impact. Several important lessons were learned from the project: 1) the successful development of a project depends on a strong and dynamic leader; 2) cooperation between the public and private sectors is essential; 3) the success of a project depends primarily on the effectiveness of community-based activities; 4) planning and monitoring activities represent significant ingredients of project effectiveness; 5) a successful project needs a sense of commitment among its staff; 6) it is imperative that a project maintain good public relations; 7) the use of family planning strategy in introducing self-supporting development programs can be very effective; 8) manning of volunteer workers is crucial to project success; and 9) aside from acceptor recruitment in the short run, the primary purpose of education in more profound matterns such as childbearing, womens'roles in the family, and family life should also be kept in mind. The key to success lies in continuity of communication and education.
(Description of the World Health Organization Special Programme of Research, Development, and Research Training in Human Reproduction.) (Statement, May 2, 1978))
In: United States. Congress. House of Representatives. Select Committee on Population. Population and development: research in population development: needs and capacities. Vol. 3. Hearings, May 2-4, 1978. Washington, D.C., U.S. Government Printing Office, 1978. p. 213-286The World Health Organization's Special Programme of research, Development, and Research Training in Human Reproduction is supported by 150 member governments spending over 15 million dollars on 5 specific areas of research: 1) effectiveness of existing birth control methods; 2) development of new methods; 3) psychosocial factors and health service delivery; 4) health rationale for family planning; and 5) infertility. A primary goal of the program is to strengthen fertility research within the developing country. Some results of WHO research on specific contraceptive practices found the following. Depo-Provera was frequently discontinued because the amenorrhea percentage over 90 days increased from 13% to 35% during the 4th injection interval. Male contraceptives are acceptable to 50% of men in Fiji, India, Korea, Mexico and the United States with a daily pill more desirable than a monthly injection. A majority of women believe that menstruation is the removal of impure blood, and that intercourse should not occur at that time.
New York, New York: United Nations fund for population activities, 1978. 8 pIn the 4 years following the World Population Conference at Bucharest, almost all U.N. member countries participate in the U.N. Fund for Population Activities as donors and/or recipients. This momentum must be maintained and the implications of demographic trends must be assessed. The lowest forecast for world population in the Year 2000 is 1.8 billion more than in 1975. This "giantism" should not be regarded as a spectre but as a probable reality which needs to be faced boldly in order to take into account increased demands on Earth's resources in making government policy and planning programs for development and deployment of those resources. There are clear signs that fertility will fall as much as 30% during the next 20 years. This, however encouraging it seems, should not obscure the reality that it is occurring at a very high level of actual numbers of people whose lives must be sustained. In the developing world life expectancy has risen from 42 to 54 years; in the developed world from 65 to 71. In the Third World, infant mortality continues to be the most important determinant of general mortality levels even though there are encouraging indications of a steep fall in this area. A resurgence of malaria is bound to have a serious effect on mortality as it is being found mainly in already malnourished areas. At current rates all cities are expected to grow in the next 20 years. Programs and national policy must be established to manage the problems accompanying these crowded cities. Migration is high because economic growth rates cannot sustain the growing populations of developing countries. The magnitude of this movement is causing problems for most countries in the developed world, with one suggested solution being to close the doors to all immigration. The developed and developing worlds share two population problems: 1) the number of youth is growing resulting in a potential for massive increases in fertility; and 2) the decline of fertility rates and increased life expectancy resulting in marked changes in the age structure. The most significant principle emerging from this paper is that changes taking place in demographic processes should be recognized as powerful determinants of relevance in the formulation of social and economic policy and plans in every major area of national concern.