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CLINICAL REPRODUCTION AND FERTILITY. 1986 Dec; 4(6):393-4.Comments on the topic of selection of subjects for clinical trials of contraceptives, in response to a review on design of clinical trials, point out the inadvisability of restricting the study population to women of known high fertility. First, limiting the study group may make recruitment difficult. More important, however, most contraceptive trials look at other end point besides pregnancy: data are collected on use effectiveness, patient satisfaction and continuation rates. This information is best obtained from women representative of the whole community, such as those close to 45 years old. If a study group representative of the total population is used, results can be applied to field conditions with confidence.
An examination of the population structure of Liberia within the framework of the Kilimanjaro and Mexico City Recommendations on Population and Development: policy implications and mechanism.
In: The 1984 International Conference on Population: the Liberian experience, [compiled by] Liberia. Ministry of Planning and Economic Affairs. Monrovia, Liberia, Ministry of Planning and Economic Affairs, . 111-36.The age and sex composition and distribution of the population of Liberia as affected by fertility, mortality, morbidity, migration, and development are examined within the framework of the Kilimanjaro Program of Action and recommendations of the International Conference on Population held in Mexico City. The data used are projections (1984-85) published in the 2nd Socio-Economic Development Plan, 1980. The population of Liberia is increasing at the rate of 3.5% and will double in 23.1 years. 60% of the population is under 20 and 2% over 75. Projected life expectancy is 55.5 years for women and 53.4 years for men. The population is characterized by high age dependency; 47.1% of the people are under 15 and 2.9% are over 64, so that half of the population consists of dependent age groups, primarily the school-age children (6-11 years). If these children are to enter the labor force, it is estimated that 19,500 jobs will have to be created to employ them. Moreover, fertility remains at its constant high level (3.5%), so, as mortality declines, the economic problem becomes acute. Furthermore, high fertility is accompanied by high infant and maternal mortality. High infant mortality causes couples in rural areas to have more children. These interdependent circumstances point up the need for family planning, more adequate health care delivery systems, and increasing the number of schools to eradicate illiteracy, which is currently at 80%. Integrated planning and development strategies and appropriate allotment of funds must become part of the government's policy if the Kilimanjaro and Mexico City recommendations are to be implemented.
In: The 1984 International Conference on Population: the Liberian experience, [compiled by] Liberia. Ministry of Planning and Economic Affairs. Monrovia, Liberia, Ministry of Planning and Economic Affairs, . 9-17.The purpose of the National Seminar on Population is to disseminate in Liberia the results of the World Population Conference held in Mexico City in August 1984. Due to the complex interrelationships between population and development, one must conclude that rapid population growth has an adverse effect on development. Liberia has a high level of fertility (48-51 lives births per 1000 population) and a high mortality (18 per 1000 population). One result of these population trends is that the population is youthful, about 50% of the people being under 18. This high growth potential means that in future the resources necessary to support the population will be scarcer. Secondly, increasing rural to urban migration means that the cities will have more people than they have jobs, housing, education, or health facilities to support them and that the rural areas will be depopulated with attendant lowered agricultural production and rural poverty. Education is at least partly responsible for the rural-urban migration because it alerts young people to the increasing opportunities in the towns. The current trend of increasing fertility and declining mortality means decreased economic growth and a lower standard of living. To reduce this trend people must be made aware of the necessity to lower the birth rate as well as of the means to do it. People regard a large family as a status symbol and children as a source of labor and support in old age. These attitudes will not change until people trust that the Government is committed to the socioeconomic changes that will make practicable the shift from large households with low productivity to small families with high productivity. As part of this effort, the National Committee on Population is being expanded into a National Population Commission, responsible for coordinating population programs and drafting a national population policy.
In: Addendum. Manual IX: The methodology of measuring the impact of family planning programmes on fertility, by the Population Division of the Department of International Economic and Social Affairs of the United Nations. New York, New York, United Nations, 1986. 9-14. (Population Studies No. 66; ST/ESA/SER.A/66/Add.1)This chapter describes and applies a new methodology for estimating the fertility impact of contraception obtained through a family planning program. This approach is called the prevalence method because the principal data required for its application are estimates of the prevalence of contraceptive use at a given point in time. It is the objective of the prevalence method to estimate the number of births averted as well as the reduction in the crude birth rate that results form the use of program contraception. A single application of the procedure produces these estimates for 1 year, but repeated applications for different years can yield a time-series of births averted or other impact measures. The procedure for calculating births averted by program users consists of 6 parts to obtain, consecutively, estimates of: natural fertility, potential fertility, fertility impact of program use, births averted, birth rate impact, and method-specific results. Each of these steps is described in some detail. This new approach provides a simple and straightforward alternative to existing methods for estimating the gross fertility impact of program contraception. In contrast to several of the other procedures, the prevalence method does not require detailed input data on numbers of past acceptors and continuation rates. Instead, estimates of the prevalence of program and non-program contraception by age and method are required as principal input data. While such data were rarely available in the past, prevalence estimates are now routinely obtained from national surveys in many developing countries, thus making the application of the prevalence method possible.
In: A census of one billion people. Papers for International Seminar on China's 1982 Population Census, edited by Li Chengrui. Boulder, Colorado, Westview Press, 1986. 37-52.This paper examines how the 1982 China census met the standards prevalent in the world at large and formulated by the international community into recommendations under UN guidance. It also examines to what extent the China census met the recommendations, what alternatives were adopted and why, and what methods it used to carry them out. China's 1982 census met the criteria of individual enumeration, universality, simultaneity, and defined periodicity. The 1982 census was a register-based de jure census in which the field interview and its checks determined the final content of census information. It was necesary to restrict the number of census questions to fewer than would have been desirable. The questionnaire included 5 household and 13 individual topics. Questions on live births and deaths in the household since 1981 were included, although not generally recommended. Age data is unusually accurate due to people's awareness of what animal sign they were born under. Housing questions were not asked in this census, but may be included in the next census. Sampling was used only in the small-scale post-enumeration survey. In China, the administrative network is so complete and reaches down to so small a unit that no further subdivision for census purposes is needed at all. A most unconventional feature of the censuses of China has been the virtually complete absence of mapping. An extensive program of 4887 pilot censuses ensured the success of the full census. The publicity effort involved 2-way communication from the national office to the public and back. The issue of confidentiality was felt to be problematical in China and best solved by not asking questions that people would be reluctant to answer. The method of enumeration differed greatly from the usual ones in that it centered on enumeration stations with home visits used to a lesser extent. Several questions were precoded, but the enumerator had to write in the number as well as circle the correct item. 10% advance tabulations were made for all units and found to be very representative.
An evaluation of Pathfinder's early marriage education program in Indonesia, November-December 1984.
Chestnut Hill, Massachusetts, Pathfinder Fund, 1986 Feb. 41 p. (Pathfinder Fund Working Papers No. 4)Indonesian government officials determined in the early 1970's that an increase in marriage age as well as in the use of contraceptives would be needed to reduce the country's growth rate. In 1974, the Marriage Law Reform Act increased the minimun marriageable age, but compliance was rare. In 1981, Pathfinder initiated a campaign to address this. The 1st objective was to educate influentials (e.g. religious leaders). The 2nd objective was to gather information and promote discussion of societal norms that lead to early marriage and childbearing. The underlying assumptions were that non-compliance arose from a lack of knowledge about the marriage law and that norms promoting early marriage and fertility were amenable to change. The program reviewed in this working paper covers 6 projects with 5 prominent Indonesian organizations--3 women's groups, a national public health association, and a branch of the Family Planning Coordinating Board. The activities began with national seminars to discuss objectives. National and local-level activities followed, ranging from the publication of a national bulletin to training marriage counselors. Women's groups incorporated the education program into their ongoing functions. Program effects were widespread. Evaluators' assessment in 1984 found that the controversial topic of adolescent fertility has been intensively discussed at national and local levels. Their recommendations include: focusing work on large-impact organizations, evaluation of certain projects, support for various projects, concentrating on key issues. The training project management should be integrated into Pathfinder's schedule. Studies should be performed to make sure this desin is not too ambitious. Baseline data should be incorporated. The 2-year approach should be extended to 5, since the impact of marriage age legislation will not be felt for several years.