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London, FPA, 1972. 48 p.Currently, public authorities pay for almost 2/3 of the family planning consultations conducted by the Family Planning Association, and this is the most significant development since the publication of the last Family Planning Association Report. Additionally, more local health authorities are operating direct clinic and domiciliary services. The Family Planning Association handed over the management of 39 clinics to public authorities in the 1971-1972 year. However, despite this progress, family planning service provision by public authorities throughout England continues to be uneven in quality and extent. Spending by local health authorities for each woman at risk varies from 1 penny per woman at risk in Burnley (excluding the city of London) to 179 pence at Islington. In addition to the problem of inconsistency in spending, there appears to be no immediate prospect of a comprehensive family planning service - one that is available to all, is free of charge, and is backed by an adequate education campaign. Although government help for the extension of domiciliary family planning service is impressive, it should not obscure the false economies in spending on other contraceptive delivery services such as general practitioners, specialist clinics, and specialized advisory centers. Until the government announces the details of its plans for family planning services within the National Health Service beginning April 1974, the Family Planning Association's own detailed planning cannot be exact. The Association's basic policy continues to be to turn over the responsibility for the management of clinic and domiciliary contraceptive services as quickly and as smoothly as possible to the public authorities. Already there is concern that some clinic services managed by public authorities may become less attractive, particularly to young people, and that differences in the quality of service will increase under local public management as well as that backup services will be neglected. Also existing is the realization that the public authorities do not do enough to attract people to the use of contraception.
[Unpublished] 1984 Jun. 10,  p.105 developing country projects dealing primarily or exclusively with adolescent fertility were analyzed in an attempt to determine the nature and level of adolescent fertility programming in the developing world. There were 37 projects in Asia, 21 in Sub-Saharan Africa, 8 in North Africa and the Middle East, 22 in the Caribbean, and 17 in Latin America. About 27% of the programs were exclusively urban, 16% exclusively rural, and the remainder operated in both rural and urban settings. Various types of organizations sponsored projects, but the majority were sponsored by International Planned Parenthood Federation affiliates and other private organizations. There were marked regional differences in sponsorship. Only 11 of the 105 programs were conducted by government agencies, but 14 programs received some support from national governments and local governments also sometimes contributed support. Family life education for both in and out of school youth was the predominant project activity in 66 of the 105 projects. 20 projects focused on training of professionals in family life education such as educators, counselors, and health personnel. Curricula primarily concentrated on sex education, responsible parenthood, the importance of delayed 1st birth and child spacing, and general population concerns. 25 projects conduct youth training sessions and teach teams to serve as peer counselors and cators, motivating their peers toward acceptance of family planning and the small family and providing accurate information on sexuality. About 21 projects have a specific counseling component, with most counseling services teaching family planning, distributing condoms, or referring clients to clinics. Only 16 projects had as a stated objective provision for adolescents of diagnostic or clinical health services related to contraceptive use, family planning, or venereal disease. 18 projects offered training in vocational or income-generating skills integrated with family planning, sex education, and family life education. Over 20 projects described educational materials preparation and production as an activity. Innovative approaches observed in the 105 projects included adoption of the multiservice center concept, integration of family planning education with self-help initiatives to improve young women's socioeconomic status, participation of adolescents in program decision making, and innovative promotional activities. Factors contributing to program success identified by project staff include conducting a needs assessment survey, securing parental and community support, solid funding, a flexible program design, skilled personnel, availability of adequate materials, good cooperation with other community agencies, active participation of young people in planning and running the program, good publicity, and use of innovative teaching methods. Projects are increasingly tending toward less formal kinds of communication in family life education.
IPPF Medical Bulletin. 1977 Oct; 11(5):1-2.Lancet recently published 2 papers which reported research fundings indicating that oral contraceptive users, over 35 years of age, are at greater risk of death from cardiovascular disease than nonusers. The findings also suggested that oral contraceptive users who have taken the pill for more than 5 years, who smoke, or who have diabetes, hypertension, or obesity are also at increased risk of death than nonusers. In view of these findings the Presidents of the Royal College of General Practitioners and of the Royal College of Obstetricians and Gynaecologists revised oral contraceptive prescribing recommendations. According to the new recommendations 1) women, who are under 30 years of age, can continue to use the pill but if they smoke they should be advised to quit smoking; 2) women, between 30-35 years of age, can continue to use the pill but if they have taken the pill for 5 or more years and if they smoke they should be advised to switch to other contraceptive methods; and 3) women, over 35 years of age, should be advised to use other contraceptive methods. The British Committee on Safety of Medicines did not issue new prescribing instructions. The International Planned Parenthood Federation, noting the findings of both U.S. and British studies, said that physicians should be aware that the risk of death from cardiovascular disease may be enhanced for oral contraceptive users over the age of 40. The Federation also recommended that couples with completed families should consider sterilization or other alternative forms of contraception.
Family Coordinator. 1973 Jul; 22(3):331-8.Data collected on behalf of the Planned Parenthood/World Population (PPWP) affiliate to be used in planning a vasectomy education program came from a survey of 387 men and women in Hayward, California, to ascertain the levels of knowledge and prevalence of vasectomy and attitudes toward the operation. The sample was comprised of men and women in 3 income categories, and households were not preselected on a random basis. The survey instrument was a 1-page set of questions, primarily of the closed-ended type which the respondent completed in the presence of the interviewer. The major findings were: 1) PPWP was not identified as a source of aid; 2) most men and women have discussed vasectomy with their spouses; 3) men and women are influenced by attitudes and practices of others with regard to vasectomy; 4) physicians are seen as the main source of information about vasectomy; 5) irreversibility is the major concern of the men and women; and 6) eligible couples can be reached only by a community-side education program. Implications of the survey for a community education program are put into concrete, programmatic terms, indicating lines of direction, points of departure, and crucial ideas sometimes overlooked in service programs. It is concluded that in all areas of a community education program vasectomy should be presented as 1 or a range of alternatives, thus assuring the couple that does elect vasectomy that they really did make a free choice.
In: Sai, F.T., ed. Family welfare and development in Africa. (Proceedings of the IPPF Regional Conference, Ibadan, Nigeria, August 29-September 3, 1976.) London, International Planned Parenthood Federation, 1977. p. 1-15The conference is unique in many respects, most importantly in that it is the 1st in which the Africa Regional Council of IPPF, representing a voluntary nongovernmental organization, has invited governments to sit together with volunteers as full participants to discuss issues of fundamental importance to family health and welfare, and socioeconomic development. The conference refused to accept that population itself is the root cause of Africa's development problems, but is has agreed that in many situations such rapid growth rates can stultify the best efforts of governments and peoples toward attainment of legitimate developmental objectives. There was complete agreement about the definition and reasons for family planning as encompassing a group of activities which ensure that individuals and couples have children when they are socially and physiologically best equipped to have them; that they are enabled to space them satisfactorily; and that they have the number they desire. Additional considerations were population policy; development; the integrated approach to family planning and family welfare activities; the status of women; sex education; the law and planned parenthood; and the role of Family Planning Associations (FPAs) in the Africa Region. It is necessary to ensure that in the selection of strategies and roles, FPAs take into consideration local realities by way of human and other resources; the traditions and cultural acceptances; and the sensibilities and potentials of governments. Compared to government, the FPAs must be the "jeep"--the 4-wheel drive that is able to go into the most inaccessible of places and deliver the services where they are needed.
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.
A retrospective analysis of family planning Papanicolaou smear data: lessons for the future. 2. Planned Parenthood's national experience, 1975.
Advances in Planned Parenthood. 1978; 12(3):144-148.In 1975, 96,254 Papanicolaou smears were submitted by Planned Parenthood clinics in 9 of the 10 Health, Education, and Welfare regions to a single laboratory. Smears were interpreted and classified as I (negative), II (negative, benign reactive changes), II+ (minimal dysplasia), IIIA (mild dysplasia), III (moderate dysplasia), III+ (moderate to severe dysplasia), IV (severe dysplasia and/or carcinoma in situ), V (invasive carcinoma), or 0 (inadequate for evaluation). Of the 95,907 smears suitable for cytologic evaluation, 4572 (5.3%) showed evidence of dysplastic or neoplastic changes. Histopathologic specimens were obtained for 242 women with abnormal cervical cytology. Mild to moderate dysplasia was noted in 86 (35.5%), severe dysplasia in 34 (14%), carcinoma in situ in 54 (22.3%), and invasive cancer in 4 (1.7%). 64 (27.2%) tissue specimens proved to be normal. 75% of smears demonstrating at least moderate dysplasia were obtained from women under 25. Since the pap smear is only a screening procedure, abnormalities detected by this method require diagnostic confirmation and follow-up. The low response rate of local affiliates to laboratory requests for information on cytology/histology correlates of their patients makes it impossible to determine if this was provided. In addition, the "false negative" rate of the pap smear screening program could not be determined as biopsies were not obtained for women with Class I or II smears. While lessening clinic autonomy, the standardization of medically relevant protocols for follow-up and computerized methods of data collection would increase factual information and knowledge of the cost-effectiveness of services provided.
PP News. 1978 Jun-Sep; 1(3):4.One of Planned Parenthood of America's 1st formal clinic courses in the ovulation method of birth control has seen more than 350 clients, and has resulted in encouraging preliminary figures on contraceptive success, in addition to winning the support of the clinic staff, and a favorable community reaction. The ovulation method utilizes periodic abstinence from coitus, based on the way the woman's cervical mucus varies at different stages in the menstrual cycle. Clients were 1st given background information and a chart, and after recording a complete cycle, returned for a follow-up interview. From January-September 1978, out of 292 women attending the 1st session, 120 continued through the 2nd follow-up. Of these 120, there were 3 pregnancies, but no method failures because all 3 women knew they were fertile at the time of coitus. The role of the man in the program is emphasized and supported. The author, who was also the instructor, concludes that Planned Parenthood clinics should be aware and take advantage of growing interest in this form of fertility awareness.
In: Watson, W.B., ed. Family planning in the developing world: a review of programs. New York, Population Council, 1977. p. 54-55The government of Honduras included a population policy in its National Development Plan for the period 1974-1979. This policy will be implemented by providing information regarding responsible parenthood, by using natural and technical resources to produce a well-nourished and creative population, and by applying the principles of voluntary participation in family planning programs. The 2 family planning programs in Honduras are the government maternal and child health program and the Family Planning Association of Honduras program. The government program, initiated in 1968, operates 34 clinics which offer family planning along with prenatal and postnatal care, child care, and nutrition education services. The Family Planning Association, established in 1961, operates 2 clinics and served 42,000 people during 1975. 9000 of this group were 1st acceptors. Oral contraceptives were chosen by 80% of the new acceptors; 13% chose IUDs and 5% chose injectables. The Association's information and education activities included conferences, talks, courses, seminars, and home visits. Additionally, the Association is operating a demonstration community-based distribution program with financial assistance from the International Planned Parenthood Federation. 40 workers in each of 2 cities provide contraceptives in their own neighborhoods.
IPPA-News Letter, No. 1. September 1977. p. 2-3.There are 5 important aspects related to family planning (FP) in Indonesia: 1) The large population. It is the 5th largest country in the world in terms of population. 2) The rapid increase in population (2.4%/annum). 3) The uneven distribution - most live in Java and Bali where land area is only 8% of total. 4) Age composition - 45% of the population is under age 15. 5) Mobility - there is little mobility and communication despite urbanization. In 1957 the IPPA cautiously began counseling. In 1968 the Suharto administration declared FP a national program. In 1970 the National FP Coordinating Body was established to oversee action of government institutions and private organizations with the goal of bringing down population increase from 2.4 to 1.2 by the year 2000. The 1st 5-year program (from 1969 to 1974) included Bali and Java, the 2nd (1974-1979) added 10 other provinces, and the 3rd will include the remaining 11 provinces.
New York, International Planned Parenthood Federation, Western Hemisphere Region, September 1975. 149 pThe primary focus in this 4th edition in the series of annual "overviews" of the contraceptive services in the Western Hemisphere Region of the International Planned Parenthood Federation is on clinical facilities, medical and paramedical services, and on the delivery of contraceptive methods by family planning programs. Family planning services link information on methods for spacing or limiting children to their availability, and they provide education on the advantages of contracepting. They seek to motivate acceptors to continue their chosen method. Counseling and information and education activities, although an integral component of family planning programs, are not included among the topics considered in the "Overview." In the Western Hemisphere Region, the most notable innovation has involved the community-based distribution of contraceptives (CBD), and for the 1st time, non-clinical distribution of contraceptives by associations in the region is a part of the "Overview." The Annual Reports submitted by IPPF affiliates and published and unpublished data from other programs are the primary sources of statistics for this report. Information for 1973 encompassed 29 associations related to IPPF and 4 other programs, and for 1974, 28 associations and 5 other programs could be covered. As for clinical input of family planning programs, the affiliates reported to the Regional Office of IPPF the number and types of clinics, weekly session hours, hours of medical and paramedical personnel. Data on the output of clinical activities of family planning programs for the calendar year were limited to 1st visits or new acceptors by methods, 1st revisits of the year or continuing (old) acceptors by method, number of revisits by old and new acceptors by method, demographic characteristics of new acceptors by method, and voluntary male and female sterilization performed or referred. Data on contraceptive services and clinical activities are summarized and presented in the form of tables.
New York, International Planned Parenthood Federation, Western Hemisphere Region, Medical Division, September 1975. 49 pThis is a compilation of family planning services provided by associations operating in the Western Hemisphere Region. Separate tables are compiled for 1973 and 1974. A list of each family planning program included in the study is appended to the report. The report does not guarantee the completeness or accuracy of the data; problems with reliability of data point up the necessity for a system of standardized record-keeping. Tables cover program input in the form of clinical facilities, medical and paramedical services, and the delivery of contraceptive methods by family planning programs and community-based distribution systems. Charts on program output include information on acceptor characteristics, numbers of new and continuing acceptors, numbers of voluntary sterilizations, and percentages of other methods in use.
Honolulu, Hawaii. 1974. n.p.A series of charts produced by Hawaii Planned Parenthood, Inc., provide statistical data on the numbers of minors given contraceptive assistance and counseling by 15 Planned Parenthood clinics. Information provided by the charts includes: 1) Patient characteristics; 2) Method of contact preferred by the patients; 3) Contraceptive methods, past and present; 4) Levels of education; 5) Family size and income of patients; 6) Numbers of fetal deaths and live births; 7) Patients' marital status; 8) Clinic medical services; 9) Patient load by clinic, age, and length of residence in Hawaii; 10) Welfare status of patients; and 11) Reasons given by patients for and against the practice of contraception.
Singapore, 1972 (xi). 60 pThis report presents a detailed analysis of the demographic situation in Singapore, tracing trends in birthrates, fertility rates, and population growth. Family planning services available during 1970 are thoroughly explored, including their funding, birth control methods, and organization and administration. Detailed analyses are given of acceptors of birth control methods by method accepted as well as by acceptor characteristics such as age, parity, education, and race. The Family Planning and Population Board recruited 162,485 acceptors between 1966 and 1970. During that period there was a dramatic decline in the crude birthrate, which was 28.6/1000 in 1966 and 22.1/1000 in 1970. Fertility continued to decline in all age groups and in all ethnic groups during 1970.