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The Planned Parenthood Association of Thailand: prevention of domestic violence against women and children in Thailand through the promotion of reproductive health.
Innovations: Innovative Approaches to Population Programme Management. 2001; 9:73-100.Thailand is the third largest country among the Southeast Asian nations with an area of approximately 513,000 square kilometres. It has a total population of about 62 million with 95 percent of the population embracing Buddhism. Known for having a soft-spoken society rich in culture and high in spirituality, the general assumption is that domestic violence is rare. Yet such a state of security does not exist regardless of the culture that one belongs to. On many occasions domestic violence not only involves women, but children usually suffer the consequences as well. It is not unusual that such acts of violence are considered a family affair and thus many cases go unreported or unpublicised, perhaps out of the victims’ fear or simply from ignorance of their rights. The Thai government has come a long way in countering the prevalence of domestic violence through on-going efforts to amend its legal system and constitution. Demonstrating commitment to protect women and children from discrimination and violence, it has acknowledged various international treaties and even incorporated the rights and welfare of women and children in its National Plan framework. (excerpt)
Arlington, Virginia, Camp Dresser and McKee International, Environmental Health Project, 2004 Mar. vi, 80 p. (Activity Report No. 128; USAID Contract No. HRN-I-00-99-00011-00)The tools presented in this report relate to technical support provided by USAID through the Environmental Health Project (EHP) to the Public Private Partnership (PPP) for Handwashing with Soap Initiative, which was started by UNICEF and implemented with financial assistance from USAID and the World Bank. As part of USAID/EHP’s technical support, EHP worked with Howard Delafield International (HDI) and prepared a series of program/planning tools used in the preparation of the first-phase of the Nepal Handwashing with Soap Initiative. These tools were based on a literature review of “lessons learned” from the Central American Handwashing Inititiative, as well as a review of other background material prepared for other handwashing with soap activities, and were developed in partnership with UNICEF /Nepal during 2003. The planning tools can be used and/or adapted by other organizations, public or private sector, interested in initiating a PPP in their country. For more information on PPP initiatives, please refer to www.globalhandwashing.org. (excerpt)
Indian Journal of Medical Sciences. 2002 Feb; 56(2):73-78.Tuberculosis remains a global problem inspite of the excellent drugs available to cure it. According to an estimate in 1995 there were 9 million cases of tuberculosis worldwide and 3 million deaths. Tuberculosis was declared a global emergency by WHO in 1990 as it had reemerged in countries where it was supposed to be on a decline. Global explosion of HIV infection coupled with chaotic treatment of tuberculosis, the world today is threatened with untreatable epidemic of tuberculosis. Inappropriate and inadequate treatment leads to acquired drug resistance, which may result in treatment failure and spread of resistant organisms to other persons. The only way to prevent this is uniformity in the treatment of such patients both in governmental programs and private practice. In India under national tuberculosis control program 1.5 million cases are detected every year but still 1200 cases die due to it daily. The reason for this could be lack of compliance by the patients, faulty drug distribution, emergence of MDR-TB and inappropriate prescriptions of anti TB drugs due to lack of knowledge regarding the guidelines. Our study was aimed at finding out the knowledge, attitude and practice of resident doctors and consultants treating tuberculosis in two medical institutes in two different states of India. (author's)
[People's perception of diseases: an exploratory study of popular beliefs, attitudes and practices regarding immunizable diseases]
Dhaka, Bangladesh, Worldview International Foundation, 1987 Nov.  p.Researchers interviewed 57 mothers and 27 heads of family in predominantly rural areas about 135km from the capital city of Dhaka, Bangladesh to learn about their perception of diseases. They also talked with 3 traditional healers and 8 influential people in the different locales, e.g., teachers and imams. They learned that each vaccine preventable disease has at least 1 local name rooted in popular beliefs, e.g., all local names for poliomyelitis are associated with an ominous wind. Generally, the local people believe that witches or evil spirits cause all the vaccine preventable diseases. These entities prefer attacking babies, but also are known to afflict women. A preventive measure practiced includes pregnant women never leaving the house in the evening, at noon, or at midnight since these are the times when they are most exposed to evil spirits. There exist 2 traditional healers--fakirs and kabiraj. Fakirs use mystic words with religious chants and perform various healing rituals. The kabiraj sometimes use healing rituals, but also prescribe indigenous medicines. This research provides some useful insights into WHO's Expanded Programme on Immunization in developing communication strategies which build on what people already know. For example, since the local people believe that evil spirits or witches attack the newborn immediately after birth may provide an incentive for early immunization. Since preventing illness and death in newborns is a goal of both modern and traditional medicine, it is likely that the local people are not so concerned with the real cause of illness and will accept any practice that keeps their infant healthy and that fits into their beliefs and perceptions.
SEXUAL HEALTH EXCHANGE. 1998; (3):4.Two decades of Family Planning Association of Hong Kong (FPAHK) advocacy of husband-wife communication and cooperation in family planning led Hong Kong's population to finally accept the notion of male responsibility in family planning. Recent surveys have documented high rates of male contraceptive use. The FPAHK established its first clinic to provide men with birth control advice and services in 1960, then set up a vasectomy clinic and installed condom vending machines. Working against prevailing traditional beliefs that childbearing is the exclusive domain of women and that vasectomy harms one's health, the FPAHK began campaigns to motivate men to take a positive and active role in family planning and to correct misinformation on vasectomy. Successful FPAHK efforts to stimulate male support for family planning include the 1977 "Mr. Family Planning" campaign, the 1982 "Family Planning - Male Responsibilities" campaign, and the 1986-87 "Mr. Able" campaign. Although these campaigns ended in the 1980s, men may now be counseled on contraception at 3 of the 8 FPAHK-run birth control clinics.
Ann Arbor, Michigan, UMI Dissertation Services, 1995. , x, 124 p.The author of this doctoral dissertation states that population control refers to measures undertaken to reduce fertility, which, according to the "population establishment," is currently so high that it endangers planetary survival. A "crisis mentality" exists among advocates of population control, who thus support the use of coercive measures to contain the spectre of overpopulation. Coercion, manifested in the use of targets, incentives, and disincentives, is an inherent part of population control. It is used mainly against women in the Third World; the population establishment defines the "overpopulation problem" in terms of national, racial, class and gender boundaries. Moreover, as the experience of India demonstrates, coercion is ineffective in reducing fertility. Coercion is thus both unethical and ineffective, and must be abandoned. (author's)
In: Resource material on HIV / AIDS in Vietnam, [compiled by] Care International in Vietnam. Hanoi, Viet Nam, CARE International in Vietnam, . 58-65.Although acquired immunodeficiency syndrome (AIDS) is relatively new to Viet Nam, socioeconomic realities such as increasing urbanization, demand for commercial sex, low condom use, injecting dug use, and expanded transportation movements presage a future epidemic unless immediate steps are taken. Viet Nam's National AIDS Committee, established in 1989, targets commercial sex workers, sexually transmitted disease clients, injecting drug users, youth, and blood donors. Problematic have been the government's designation of prostitution and drug addiction as "social evils" and the tendency to view AIDS as a foreign disease rather than one related to specific behaviors of the Vietnamese people. CARE Viet Nam has developed a model of the cycle of AIDS-related culture, values, attitudes, and behaviors. The values of paternalism must be replaced by empowerment-related values, including self-reliance, compassion, and honesty. The hegemonic views that women must be submissive and passively accept men's behavior and that it is men's nature to have sex with multiple partners can be modified through IEC. A televised soap opera serial being developed by CARE Viet Nam seeks to catalyze such change in AIDS-related attitudes and behaviors.
Creating common ground in Asia: women's perspectives on the selection and introduction of fertility regulation technologies.
Geneva, Switzerland, World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction, 1994. 45 p.Participants from Bangladesh, India, Indonesia, the Philippines, and other countries with which WHO's Special Programme of Research, Development, and Research Training in Human Reproduction collaborates and in which women's groups are active attended the Asian regional meeting on Women's Perspectives on the Research and Introduction of Fertility Regulation Technologies in February 1991. The meeting aimed to establish a dialogue between women's groups and researchers, policymakers, and family planning service providers. Other objectives included defining women's needs and viewpoints on reproductive health and fertility regulating technologies and identifying appropriate follow-up activities which would form a basis for regional networking. WHO's Special Programme of Research, Development, and Research Training in Human Reproduction published a report of the meeting. The meeting consisted of plenary sessions, group work, and keynote presentations. Presentations addressed women's realities, policy considerations, research, and service provision. Topics concerning women's realities were community attitudes towards fertility and its control, women's autonomy, health status, and family planning services. Presentations on policy considerations covered: taking users into account, objectives of family planning programs, participation in decision making, and men's responsibility. Redefining safety and acceptability as well as research on female barrier methods were addressed during presentations on research. The report presents proposals for action for Bangladesh, India, Indonesia, and the Philippines. Meeting participants reached a consensus on recommendations addressing policy, research, services, and WHO. The report concludes with a list of participants and a list of papers presented.
FAMILY PLANNING NEWS. 1994; 10(2):5.Prime Minister Benazir Bhutto of Pakistan, while noting her desire for all pregnancies to one day be planned and all children loved, publicly rejected abortion at the 1994 UN International Conference on Population and Development as a method of family planning. She stressed that serious flaws exist in the draft program of action and reaffirmed the Islamic principle of the sanctity of life and the emphasis of the family unit. Pakistan will be guided in its policies by the laws of Islam even though family planning is now being encouraged in the country. Norway's Prime Minister Gro Brundtland, a practicing doctor for 10 years, however, was more realistic on abortion. Women abort unwanted fetuses the world over through whatever means available and regardless of the legality of the procedure. Antiabortion legislation makes many of these abortions highly unsafe for the pregnant women. Prime Minister Brundtland called upon the leaders of all countries to provide legal and safe abortion services to women in need. After abortion became legal in Norway, the number of abortions remained the same and the country now has one of the lowest such rates in the world. Contrary to the claims of conservative and uninformed detractors in some countries, sex education does not promote promiscuity, but helps reduce levels of fertility. Brundtland pointed to the successes of programs in Thailand, Indonesia, and Italy as evidence. In Norway, sex education also promotes responsible sexual behavior and even abstinence. Finally, Prime Minister Brundtland encouraged governments to allocate much more of their budgets to family planning programs. Norway in 1991 allocated 4.55% of its official development assistance to family planning, the only country to surpass the 4% level in this area.
HEALTH FOR THE MILLIONS. 1993 Jun; 1(3):8-10.India has massive problems and is in need of improving and expanding non governmental organization (NGO) programs by broadening the scope of NGO activities, identifying successful NGO activities, and by moving closer to the community to participate in their activities. The problems and experience in the last few decades indicate that with expansion bureaucratization takes place. The institution begins to depend on donors and follows donor-driven agendas. As more money is given by the government, many more so called GONGO or Government-NGO projects materialize. Another problem is that the government almost always approaches the NGOs for the implementation of a project, and there is complete lack of cooperation at the planning stage. The government is considering a loan from the World Bank and UNICEF to launch a mother and child health program, but there has not been any discussion with the dozens of people who have worked on issues concerning mother and child health issues for many years. There is a need to be more demanding of the government about the various programs that are implemented for the government. Very few NGO health and family welfare projects are run by ordinary nurses or ordinary Ayurvedic doctors under ordinary conditions. Since successful NGO work has to be extended to other parts of the country, they will have to be run by ordinary people with very ordinary resources. Over the years, the NGO community has become preoccupied with its own agenda. Today, despite very sophisticated equipment and infrastructure, they are not able to reach the 60,000-70,000 workers and employees. Some of the ideas with respect to the strengthens and weaknesses of community participation have to be shared. NGOs should include all the existing non governmental organizations throughout the country, and have a dialogue with other nongovernmental bodies such as trade unions. The challenge is to adjust the current agenda, prevailing style, and present way of operating and move closer to the people.
Epidemiological studies on measles in Karachi, Pakistan -- mothers' knowledge, attitude and beliefs about measles and measles vaccine.
ACTA PAEDIATRICA JAPONICA. 1992 Jun; 34(3):290-4.In Pakistan, the Accelerated Health Program has greatly improved the immunization coverage rates, and local area monitoring revealed a marked decrease of measles between 1974 and 1984. In October 1988, 287 randomly selected mothers living in Karachi who took their children to the Civil Hospital or to the Abbasi Shahid Civil Hospital were interviewed by means of a questionnaire about their knowledge of the clinical manifestations of measles, their own children's history of morbidity and mortality, and any history of immunizations, and attitude and beliefs about measles and measles vaccine. In 1989 and 1990, in a community-based survey visits were conducted in Neelam Colony, Karachi, with a population of about 3000, and infantile mortality rate of 153/1000 births, and an immunization acceptance rate up to 1 year of age of about 35%. More than half of the women mentioned serious complications of measles, including diarrhea and malnutrition. Of 1076 children whose parents gave usable answers, only a few had repeated episodes of measles. The age of contraction of measles varied widely from 4 months to 12 years with high prevalence: 89% of them contracted it before 6 years of age, primarily between 9 and 18 months of age. The vaccine efficacy rate was 72%. The severity of the illness and complications were well known and immunizations were appreciated. In traditional families, grandparents had made the decision about immunization, but many mothers were starting to assume that responsibility. The vaccine acceptance rate had increased sharply in recent years, as a result of local health educators' activities in clinics providing regular health checks and especially owing to TV programs. The importance of promotion of primary heath care by collaboration of motivated mothers and community health workers is emphasized.
FAR EASTERN ECONOMIC REVIEW. 1992 Feb 20; 29-30.AIDS and HIV infection are in the early stages in Indonesia. 21 AIDS cases have been reported, and 30 persons have tested HIV-seropositive. Given the relatively low number of cases, and the presumed slow spread of HIV in the population, the government may yet be able to react in timely fashion to thwart epidemic spread. A rigorous education campaign and early detection of infected individuals are elements central to such intervention. The World Health Organization set a 1992 budget of US$500,000 for AIDS efforts in Indonesia. Research is young, awareness is minimal, and the campaign has barely commenced. AIDS cases have emerged in Jakarta, Surabaya, Bandung, and Denpasar. It is especially in cities that the government is concerned over checking the spread of AIDS. In these populations, many engage in extramarital sex, visible transvestite communities exist, and commercial sex districts thrive. Low condom use among sex workers, and relatively high rates of untreated STDs prevail in the general population. From March, blood donated in 15 cities, including these 4, will be compulsorily screened for HIV. Socially, moral and religious attitudes must be recognized and accommodated in mounting an effective AIDS prevention and education campaign in Indonesia. While religious sensibilities may be offended by the discussion of sex and sexual practices, such discussion is necessary and must be supported by the well-organized religious groups in this overwhelmingly Muslim country. Hopefully, Indonesia will bring to bear against AIDS the same cultural pragmatism exhibited to effect population control in the 1970s and 1980s.
Bangkok, Thailand, Unesco Principal Regional Office for Asia and the Pacific, 1991. , 73 p. (Population Education Programme Service)The revised UNESCO secondary school teaching manual provides lessons on family life education. Materials are based on the those available from the Population Education Clearing House. 4 Modules cover various aspects of adolescence education: Module 1, Physical Aspects; Module 2, Social Aspects; Module 3, Sex Roles; and Module 4, Sexually Transmitted Diseases. This report on the Social Aspects begins with a general discussion of the program and conceptual framework for the adolescence education package. 6 lessons are included in this module. Lesson 2.1 is devoted to adolescent sexuality or sexual behavior. Each lesson has a set of objectives, time required, and materials, and usually has procedures, information sheet, and suggested activities outlines. Lesson 2.2 is concerned with sexuality in childhood and adolescence. Lesson 2.3 deals with love. Lesson 2.4 consists of dating and relationships. Lesson 2.5 provides information on adolescent pregnancy in terms of the growing number and the consequences of adolescent pregnancy and parenting in the premarital and marital states. The other objective is to explore individual feelings and attitudes about adolescent pregnancy and sexual behavior. Lesson 2.6 is on a moral code of ethics, their roles and function. An example of the information sheet on love is as follows: several paragraphs describe various aspects of love as sharing, caring, action, time and sacrifice, not always agreement, a relationship, the glue to hold families together, and so on. There are different types of love: love for parents, love among siblings, love for friends, conjugal love. Mature love is differentiated from immature love by the degree of caring about the other person as more important to you than having the other person care for you. Immature love is the reverse where one is more concerned with having the other person care about you and involves more taking than giving. Communication is sometimes blocked in order to avoid hurting the other's feelings, is directed to another instead of directly to one's partner, or is misdirected to a small action instead of focusing on the larger concern. Partners must conscientiously work on getting through to each other. Spontaneity and mutual confidence will develop as each becomes more comfortable with the other.
HEALTH FOR THE MILLIONS. 1991 Aug; 17(4):20-3.Until recently, the only sustained AIDS activity in India has been alarmist media attention complemented by occasional messages calling for comfort and dignity. Public perception of the AIDS epidemic in India has been effectively shaped by mass media. Press reports have, however, bolstered awareness of the problem among literate elements of urban populations. In the absence of sustained guidance in the campaign against AIDS, responsibility has fallen to voluntary health activists who have become catalysts for community awareness and participation. This voluntary initiative, in effect, seems to be the only immediate avenue for constructive public action, and signals the gradual development of an AIDS network in India. Proceedings from a seminar in Ahmedabad are discussed, and include plans for an information and education program targeting sex workers, health and communication programs for 150 commercial blood donors and their agents, surveillance and awareness programs for safer blood and blood products, and dialogue with the business community and trade unions. Despite the lack of coordination among volunteers and activists, every major city in India now has an AIDS group. A controversial bill on AIDS has ben circulating through government ministries and committees since mid-1989, a national AIDS committee exists with the Secretary of Health as its director, and a 3-year medium-term national plan exists for the reduction of AIDS and HIV infection and morbidity. UNICEF programs target mothers and children for AIDS awareness, and blood testing facilities are expected to be expanded. The article considers the present chaos effectively productive in forcing the Indian population to face up to previously taboo issued of sexuality, sex education, and sexually transmitted disease.
CURRENT SCIENCE. 1990 Jul 25; 59(13-14):710-3.The Government of India (GOI) founded the National Diarrhoea Management Programme in 1985 to address a leading public health problem which kills >1.5 million children every year. GOI and UNICEF based the program on 3 assumptions: rural Indian mothers do not perceive diarrhea as a serious problem; they do not give food and fluids to their child during diarrhea; and they do not refer their ill child to a medical practitioner. It has since conducted various studies to look at current knowledge, attitudes, and practices of mothers towards diarrhea. Research revealed that indeed mothers did not consider diarrhea a problem until after 4-5 loose stools. Further they did not believe diarrhea could cause death. They only took action when the child with diarrhea did not improve. On the other hand, research showed that 98% of the mothers continued to breast feed or give their child fluids during a diarrhea episode. Nevertheless 70% only gave their child <100 ml or fluid at a time, <3 times/day. Most also fed their child, but usually in smaller quantities. 1 study indicated that most mothers (65%) consulted a medical practitioner, usually a private practitioner, during the most recent diarrhea episode. The medical practitioner was not necessarily a qualified physician and usually prescribed antidiarrheals, even though he knew of ORS. GOI and market research agencies have considered the results of these studies to design advertising and education campaigns that would persuade and convince caretakers and medical practitioners to treat diarrhea in children with oral rehydration solution (ORS) or a sugar salt solution. Moreover the program has restructured its plan to include reinforcing the use of well known home available fluids and foods and promoting the ORS packet as the 1st response to the 1st response to the 1st loose stool.
London, England, International Planned Parenthood Federation [IPPF], 1989. 68 p.The International Planned Parenthood Federation (IPPF) surveyed male involvement projects in 7 Family Planning Associations (FPAs) as a preliminary step for program development. Male involvement was defined as organizational activities aimed at men, with the objective of improving family planning practice of either sex. The 1987-1988 survey, which consisted of interviews of FPA staffers in Ghana and Nigeria, Cyprus, Thailand, 4 Caribbean islands, Mexico, Egypt and Nepal, sought to identify FPA activities directed at men; to examine their relative effectiveness, especially against other priorities of the FPAs; and to develop criteria for future male projects. The study concluded that male involvement activities make up a greater part of FPA programs than generally believed: programs included male-targeted community-based contraceptive distribution (CBD), community centers, education in the workplace, contraceptive social marketing (CSM), youth centers, vasectomy clinics, family life education, distribution of educational materials and promotional events. Male groups proved relatively easy to reach for educational work but the effectiveness of the education was uneven and evaluation largely nonexistent. The debate between encouraging CSM programs by independent marketing organizations or continuing more expensive smaller-scale CBD will need to be resolved. The study recommended greater attention to curriculum design; information, education and communication projects; adolescent counselling and contraceptive services; CSM to promote condom use; education and service delivery to the workplace; and in each of these areas, effective and continuous evaluation. An annex provides detailed country reports with the data for the survey.
Bangkok, Thailand, ESCAP, 1988. , 16, 31 p. (Asian Population Studies Series, No. 86-A; ST/ESCAP/648)In China, grassroots family planning workers were surveyed on their attitudes toward contraceptive methods. The project was supported by the United Nations Population Fund (UNFPA) and was organized by the Economic and Social Commission for Asia and the Pacific (ESCAP). India, the Philippines, Sri Lanka and Viet Nam were included in the project. The primary objective of the survey was to better understand family planning workers' attitudes about contraceptives, to better inform the workers on the advantages and disadvantages of various contraceptive methods. Although China offers a large variety of choices, certain methods such as the IUD and sterilization have been predominantly used. Choices vary greatly among regions. The study design, a profile of the respondents, and a discussion of knowledge and attitudes are explored. Charts representing the respondents' choices are presented; the choices demonstrate both knowledge and unsubstantiated bias. Also found, are misconceptions about certain method choices such as the pill and the injectable. The condom and the methods of rhythm and withdrawal were more commonly understood. The reasons for a good general knowledge of contraceptive methods among China's grassroots family planning workers are given. An English translation of the questionnaire used is appended to the text.
POPULATION EDUCATION NEWS. 1987 May; 14(5):6-9.Population education incentives, voluntary action, community participation, and improved program management are 5 family planning areas recently redefined by the government of India. Population education, integrated with the educational system, is important in influencing fertility behavior. The Adult Education program, and the nonformal educational system will be strengthened, with aid from UNFPA. Incentives, which are presently available to government employees, will be increased. Economic incentives, rural development program incentives, and insurance, lottery, and bond incentive schemes are being considered. Voluntary organizations will be encouraged to work in the family welfare sphere, and organized sector units will be urged to provide family welfare services to their employees. Cooperatives, which cover 95% of villages, will be used as a means of educating, motivating, and communicating population control objectives on the local level. Tax incentives will be offered to the corporate sector for providing integrated family welfare services. Community participation, which is crucial to the success of the programs, will be addressed on several levels. Popular committees, youth and women's groups, and medical students will increase community involvement through various means. In addition, political and community leaders will be involved in motivational work, and a village Women's Volunteer Corps is planned. Social marketing of contraceptives, although fairly extensive for the last 15 years, leaves much to be desired in creating a large demand. A marketing board will be created to ensure aggressive marketing, advertising, and promotion, with expansion to include oral contraceptives. Reorganization and reorientation toward modern program management will be undertaken, so that policy, planning, implementation, review, and evaluation are carried out efficiently. At the state, district, and the block level, more effective coordination is the goal, as well as strengthening the District Family Welfare Bureau.
ECONOMIC AND POLITICAL WEEKLY. 1986 Apr 12; 21(15):670-2.Central to the position taken in "Case for Injectable Contraceptive," made by the World Health Organization (WHO), the International Planned Parenthood Federation (IPPF), by the Medical Association of Britain, Sweden, and other European countries, and by major research establishments, including the Johns Hopkins University, are 2 points: no contraceptive is perfect, but experience and research strongly indicate that the injectable is more effective than most means of contraception and safer than the oral contraceptive (OC); and compared with other contraceptives, the injectable can be more easily managed in a family planning program and in one's personal life. Das and Sarkar argued these points, supporting the position against the injectable contraceptive taken by Padma Prakash in "Retreat on Depo-provera?" Das and Sarkar challenged the use of the contraceptive and raised basic questions about the validity of family planning programs generally and the integrity of the Indian programs specifically. In regard to their statements on family planning programs, there is some uncertainty as to the meaning of much of what they write. In this writer's view, there needs to be differentiation between a family planning program and a population program. The former focuses on the family and planning the number and timing of children born to a couple. A population program sets as its goal the control of the population growth rate. More importantly, their arguments return to the questions about the injectable contraceptive. Das and Sarkar raise questions about its safety and its convenience. The WHO report "Facts about Injectable Contraceptives" supports the view of the Indian Council of Medical Research (ICMR) that the injectable has no life-threatening side effects. Years of research on medroxy-progesterone (DMPA) and norethindrone enanthate (NET-EN) have shown fewer, not more, health problems than with other types of hormonal contraceptives. Das and Sarkar maintain that providing the injectable to women is an inconvenient and complicated procedure. They base their claim on the ICMR Research Protocol which describes the actions to be taken by medical staff and recipients when research is to be conducted on the injectable contraceptive. The use of this document is puzzling, because the ICMR document is a set of directions for conducting research. The complicated procedures are those needed to obtain detailed data for statistical analysis. It is a research guide and not, as Das and Sarkar imply, a set of instructions for implementing a social service program. THe implementation of a family planning service program offering the injectable contraceptive would follow the steps recommended in the WHO publication "Injectable Contraceptives: Technical and Safety Aspects."
Development: Seeds of Change. 1984; 4:80-1.A strategy, developed by the Women's Programme of the Social Development Division of the Economic and Social Commission for Asia and the Pacific (ESCAP) to promote women's participation in the development process, is described. Although recommendations of international conferences invariably call for the inclusion of women in all levels of development planning, efforts to involve women in planning at the national level have met with little success. Even if women received sufficient training and education to qualify them as planners, their impact on development planning would be minimal due to deficiencies within the national planning process. Top planning units in most Asian and Pacific countries are composed of highly trained expatriots who lack an understanding of the needs of the population in general and of women in particular. The strategy developed by the Women's Programme is based on expanding the role of women in development planning at the local level and gradually sensitizing the planning hierarchy to women's needs and to women's abilities. This awareness building can be facilitated by developing links between government agencies and women's organizations. Application of this strategy revealed that it was much more difficult to build awareness among government officials and planners then to involve women in development at the local level. The planning process is constantly subject to personnel and policy changes because of changing political situations, and planners remain isolated from the public. At the community level, women's efforts to promote development are highly successful. Programs developed by women tend to benefit the entire community, and women's roles in these activities are highly visible. These successful efforts will contribute toward building an awareness of women's capacities to promote development. Conditions which are conducive to local level involvement of women include the political will to promote participation, the provision of appropriate training to prepare community members for participation, and the existence of an adequate infrastructure and sufficient resources to carry out programs.
In: Zatuchni GL, Goldsmith A, Shelton JD, Sciarra JJ, ed. Long-acting contraceptive delivery systems. Philadelphia, Pa., Harper and Row, 1984. 1-19. (PARFR Series on Fertility Regulation)Depo-Provera (depomedroxy-progesterone acetate, or DMPA) and NORPLANT (the Population Council's registered trade name for subdermal implants) are focused on in this literature review. Over the past 17 years, more than 1 million individual doses of Depo-Provera have been supplied in Thailand. Currently 6,000 women a month use the method. Depo-Provera has proved outstandingly successful in Bangladesh for years. The basic disadvantage of long-acting steroid systems is that return to fertility is slow and unpredictable. Other disadvantages include menstrual distrubances and weight gain. Acceptability of injectable contraceptives has been studied primarily by the World Health Organization (WHO). In 1976, the Task Force on Acceptability of Research and Family Planning explored preferences among 3 routes of contraceptive administration: 1)oral; 2)intravaginal; and 3)injection. The study was conducted in Indonesia, Korea, Pakistan, and Thailand. Although the oral route was generally preferred by most women, many respondents still chose the injectable. A WHO III multicentered trial comparing the use, effectiveness, side effects and bleeding patterns of Depo-Provera and norethisterone enanthate (NET-EN) was terminated after only 1 year because of excessively high pregnancy rates with NET-EN. A total sample of about 250 women in Manila and Alexandria were interviewed. Results indicated that the 2 most important considerations were effectiveness and menstrual bleeding. Depo-Provera did not affect menstruation. Various types of subdermal implants releasing a contraceptive Silastic implant, is placed beneath the skin of the forearm or upper arm and provides 5 or more years' protection against pregnancy. The 6 capsules are not biodegradable and require surgical removal under local anesthesia.
In: D'Souza AA, de Souza A, ed. Population growth and human development. New Delhi, India, Indian Social Institute, 1974. 27-31.The actions undertaken by UNFPA on population matters have been guided by 3 basic principles. 1st is the emphasis on the right of the individual to have access to knowledge and facilities on the basis of which he/she could decide freely on the family size and child spacing. 2ndly, population has always been viewed by the UN in the larger context of development. 3rdly, the responsibility for action on population questions is considered to be within the sovereign domain of national governments. The increasing involvement of national governments in population activities and the increasing role of the UN system in providing assistance for such programs led to the designation of World Population Year in 1974. The Year provides an opportunity for increasing the awareness and understanding of population questions among people around the world. Community groups have an important role to play in promoting awareness and understanding of the population question among people everywhere. The community accepts ideas more easily if they can be shown to have already acquired a degree of social acceptability. The population question touches the standards of moral and ethical behavior in a personal way. If it can be shown that the new patterns of family life are related in a significant way to well established norms of ethical behavior, it will be so much easier for individuals to follow new patterns of behavior. The role of education in promoting and deepening awareness of population issues should be included in the development of population information.
Report of the Task Force II on research inventory and analysis of family planning communication research in Bangladesh.
[Dacca, Bangladesh, Ministry of Information and Broadcasting] Oct. 1976. 85 p.Topics relevant to family planning such as interpersonal relationships, communication patterns, local personnel, mass media, and educational aids, have been studied for this report. The central theme is the dissemination of family planning knowledge. The methodology of education and communication are major factors and are emphasized in the studies. While the object was to raise the effectiveness of approaches, the direct concern of some studies was to examine a few basic aspects of communication dynamics and different human relationship structures. Interspouse communication assumes an important place in the family planning program and a couple's concurrence is an essential precondition of family planning practice. Communication between husband and wife varies with the given social system. A study of couple concurrence and empathy on family planning motivation was undertaken; there was virtually no empathy between the spouses. A probable conclusion is that there was no interspouse communication on contraception and that some village women tend to practice birth control without their husband's knowledge. Communication and personal influence in the village community provide a leverage for the diffusion of innovative ideas and practices, including family planning. Influence pattern and flow of communication were empirically studied in a village which was situated 10 miles away from the nearest district town. The village was found to have linkage with outside systems (towns, other villages, extra village communication network) through an influence mechanism operative in the form of receiving or delivering some information. Local agents--midwives, "dais," and female village organizers are in a position to use interpersonal relations in information motivation work if such agents are systematically involved in the family planning program and are given proper orientation and support by program authorities. These people usually have to be trained. 7 findings are worth noting in regard to the use of radio for family planning: folksongs are effective and popular; evening hours draw more listeners; the broadcast can stimulate interspouse communication; the younger groups can be stimulated by group discussions; a high correlation exists between radio listening and newspaper reading; most people listen to the radio if it is accessible to them; approximately 60% of the population is reached by radio. A positive relationship was found to exist between exposure to printed family planning publicity materials and respondents' opinions toward contraception and family planning. The use of the educational aid is construed as an essential element to educating and motivating people's actions.
[Society and procreation: the social factors that affect them] Societe et procreation: les facteurs sociaux qui l'influencent
Brussels, Belgium, Editions de l'Universite de Bruxelles, 1981. 291 p. (In series: Etudes sur la Famille)This volume contains a collection of papers by members of the Study Group for Family Roles, an organization of scholars which pursues studies on family roles from both historical and analytical perspectives. The theme of the present volume is the control imposed by the collectivity on individual fertility behavior through mores, laws, sterotypes, and other means, and which is apparent in widely varying historical situations. The 10 articles concern Malthusian problems in archaic societies; voluntary birth control in the Roman empire; aspects of birth limitation in traditional Jewish society; Islam and contraception; social pressure and material incentives in Chinese demographic policy; social aspects of procreation in the Soviet Union; social aspects of precreation in Rumania and Hungary; procreation and education; attitudes of family planning personnel toward contraception in Belgium; and the role of the UN in family planning.
[Unpublished] July, 1979. 49 p.This study assesses the effectiveness of family planning education in the Republic of Korea over the past 2 decades. Target populations in various metropolitan areas were studied regarding attitudes toward family planning knowledge, contraceptive behavior, media and personal contacts on family planning, number and gender preferences, and spacing preferences. Socioeconomic and demographic factors were taken into account. Statistics were compiled by area and analyses are presented. Use of more mass media is suggested to get information on family planning across to more people. It is important to extend the range and quality of family planning services, most especially to provide the best information about contraceptive methods.