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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.
London, England, International Planned Parenthood Federation [IPPF], 1992 Sep. 93 p.20 participants from 9 sub-Saharan countries and the UK discuss men's negative attitudes towards family planning (the leading obstacle to the success of family planning in Africa) at the November 1991 Workshop on Male Participation in Family Planning in The Gambia. Family planning programs have targeted women for 20 years, but they are starting to see the men's role in making fertility decisions and in transmitting sexually transmitted diseases (STDs). They are trying to find ways to increase men's involvement in promoting family planning and STD prevention. Some recent research in Africa shows that many men already have a positive attitude towards family planning, but there is poor or no positive communication between husband and wife about fertility and sexuality. Some family planning programs (e.g., those in Sierra Leone, Nigeria, Ethiopia, and Zimbabwe) use information, education, and communication (IEC) activities (e.g., audiovisual material, print media, film, workshops, seminars, and songs) to promote men's sexual responsibility. IEC programs do increase knowledge, but do not necessarily change attitudes and practice. Some research indicates that awareness raising must be followed by counseling and peer promotion efforts to effect attitudinal and behavioral change. The sub-Saharan Africa programs must conduct baseline research on attitudes and a needs assessment to determine how to address men's needs. In Zambia, baseline research reveals that a man having 1 faithful partner for a lifetime is deemed negative. Common effective needs assessment methodologies are focus group discussions and individual interviews. Programs have identified various service delivery strategies to meet these needs. They are integration of family planning promotion efforts via AIDS prevention programs, income-generating schemes, employment-based programs, youth programs and peer counseling, male-to-male community-based distribution of condoms, and social marketing. Few programs have been evaluated, mainly because evaluation is not included in the planning process.
INTERNATIONAL JOURNAL OF HEALTH SERVICES. 1991; 21(3):505-10.This article asks the reader to carefully consider the personal implications of AIDS were either he or close friends and relatives afflicted with the syndrome. We are urged to acknowledge the limited capabilities of personal and social response to the epidemic, and recognize the associated degree of social inequity and knowledge deficiency which exists. Summaries of 3 articles are discussed as highly integrated in their common call for global solidarity in the fight against HIV infections and AIDS. Pros and cons of Cuba's evolving response to AIDS are considered, paying attention to the country's recent abandonment of health policy which isolated those infected with HIV, in favor of renewed social integration of these individuals. Brazil's inadequate, untimely, and erred response to AIDS is then strongly criticized in the 2nd article summary. Finally, the 3rd article by Dr. Jonathan Mann, former head of the World Health Organization's Global program on AIDS, on AIDS prevention in the 1990s is discussed. Covering behavioral change and the critical role of political factors in AIDS prevention, Mann asserts the need to apply current concepts and strategies, while developing new ones, and to reassess values and concepts guiding work in the field. AIDS and its associated crises threaten the survival of humanity. It is not just a disease to be solved by information, but is intimately linked to issues of sexuality, health, and human behavior which are in turn shaped by social, political, economic, and cultural factors. Strong, concerted political resolve is essential in developing, implementing, and sustaining an action agenda against AIDS set by people with AIDS and those at risk of infection. Vision, resources, and leadership are called for in this war closely linked to the struggle for worldwide social justice.
ACTA PAEDIATRICA SCANDINAVICA. 1988 Mar; 77(2):183-90.The acceptance of the World Health Organization (WHO) International Code for Marketing of Breastmilk Substitutes has stimulated governments to design programs for the more energetic promotion of breastfeeding, but promotional efforts in developing nations may not be getting through to the mothers or may not be designed to meet their specific needs. In a prospective study in Istanbul, it was observed that all infants, whether delivered in a hospital or at home, received not only mixtures of sugar and water and other mixtures soon after birth and for about 1 week thereafter, but also complementary foods now and then until this became a regular practice. This pattern can be defined as regular complementary feeding or partial breastfeeding. Yet, the mothers described it as exclusive breastfeeding. The early and haphazard introduction of water and food in those environments where contamination is common exposes the infants to concentrated amounts of microorganisms which may overwhelm the immunological protection provided by breastmilk and also reduces the milk supply through insufficient stimulation of the breast. Exclusive breastfeeding should be encouraged, and irregular complementary feedings during the early weeks of life should be strongly discouraged, unless there is a medical indication. When exclusive breastfeeding is no longer sufficient, i.e., at the age of about 5 months, complementary feeding should be promoted. Programs for the promotion of breastfeeding have been criticized for devoting too much attention to the infant and little or no attention to the needs of the mother. In a given society, it may be difficult to promote breastfeeding if women regard it as a means of preventing them from improving their socioeconomic situation. Women who want to breastfeed their children should not be prevented from doing so by their working conditions.
INTERNATIONAL HEALTH NEWS. 1988 Apr; 9(4):4-5.In the effort to realize Universal Child Immunization by 1990, an active search is underway to find ways to raise immunization coverage levels. The World Health Organization's (WHO) Expanded Program on Immunization (EPI) has developed excellent systems that develop such program components as supply management, equipment maintenance, disease surveillance, clinical practice, and supervision. Program performance has shown a steady improvement over the years in those countries which have adopted such systems, yet the trend has not been as marked as expected. Coverage levels in many countries have remained below 60%, and figures show a "dropout" with the multi-dose vaccines. The dropout figures suggest that parental acceptance of immunization is difficult to sustain throughout the entire series, which is spread over the first 9 months of life. To reduce dropout and boost coverage levels still further, recent program directions have emphasized social mobilization to increase the public response to immunization. It is tempting to conclude that with the implementation of improved management systems the final success will come from persuading parents to avail themselves of immunization services, but field reports suggest that this may not be the case. Health records show missed immunizations despite numerous visits to clinics, suggesting widespread problems in the implementation of the WHO systems. A combination of causes seem to ensure that children attending with their mothers do not get immunized, including errors and omissions on the part of field staff which reduce the chances for immunizations by families making return visits to the clinics. Few programs incorporate immunizations in daily practice. In a series of immunization coverage surveys conducted recently in 1 African country, the most striking fact was that the limitations of the data collected meant that the calculated contribution of clinical error could only be a gross underestimation of true clinical error contribution. This suggests that social mobilization to improve clinical attendance is likely to be ineffective until problems with the provision of services have been solved, but improving services has the potential to increase coverage levels as well as the potential to motivate parents to bring their children to the clinics.
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.
[The Church, the Family and Responsible Parenthood in Latin America: a Meeting of experts] Iglesia, Familia y Paternidad Responsable en America Latina: Encuentro de Expertos.
Bogota, Colombia, CELAM, 1977. (Documento CELAM No. 32.)This document is the result of a meeting organized by the Department of the Laity of the Latin American Episcopal Council on the theme of the Church, Family, and Responsible Parenthood. 18 Latin American experts in various disciplines were selected on the basis of professional competence and the correctness of their philosophical and theological positions in the eyes of the Catholic Church to study the problem of responsible parenthood in Latin America and to recommend lines of action for a true family ministry in this area. The work consists of 2 major parts: 12 presentations concerning the sociodemographic, philosophical-theological, psychophysiological, and educational aspects of responsible parenthood, and conclusions based on the work and the meetings. The 4 articles on sociodemographic aspects discuss the demographic problem in Latin America, Latin America and the demographic question in the Conference of Bucharest, maturity of faith in Christ expressed in responsible parenthood, and social conditions of responsible parenthood in Peruvian squatter settlements. The 3 articles on philosophical and theological aspects concern conceptual foundations of neomalthusian theory, pastoral attitudes in relation to responsible parenthood, and pastoral action regarding responsible parenthood. 2 articles on psychophysiological aspects discuss the couple and methods of fertility regulation and the gynecologist as an advisor on psychosexual problems of reproduction. Educational aspects are discussed in 3 articles on sexual pathology and education, education for responsible parenthood, and the Misereor-Carvajal Program of Family Action in Cali, Colombia. The conclusions are the result of an interdisciplinary effort to synthesize the major points of discussion and agreements on principles and actions arrived at in each of the 4 areas.
London, England, International Planned Parenthood Federation, 1985. 48 p. (IPPF Medical Publications.)This booklet, published by the International Planned Parenthood Federation (IPPF), discusses the mode of action of barrier methods of contraception--their advantages, disadvantages, and effectiveness. Each method is dealt with in detail under the headings of 'application,' 'instruction to users,' 'advantages,' 'disadvantages and side-effects' and 'effectiveness.' Areas of research and safety issues are also discussed. The various types of barrier contraceptives are: 1) spermicides--creams, jellies, melting suppositories, foaming suppositories or tablets, and aerosol foams; 2) unmedicated mechanical barriers--vagnial diaphrams and cervical caps, including cavity-rim, Vimule and vault caps; 3) medicated mechanical barriers--vaginal sponges; and 4) condoms. When used properly and conscientiously, the contraceptive agents are both safe and effective, although their mode of action may be more complex than has been assumed in the past. The function of barrier contraceptives is to block the passage of sperm into the cervical mucus; the condom prevents sperm from being deposited in the vagina, whereas the vaginal barriers interfere with sperm transport after semen has entered the vagina. In addition to blocking the intial wave of sperm form entering the cervix, the spermicidal preparations also kill the sperm within the vagina; most products now in use contain a nonionic surface active agent as a spermicide. Favorable attributes of barrier methods are: 1) few local side effects, 2) no highly skilled medical intervention is needed, 3) they are applied locally in the vagina, 4) they may inhibit sexually transmitted diseases, 5) there are few medical contraindications to their use, and 6) most are available without prescription. Disadvantages are: 1) they are generally less effective than most hormonal contraceptive and IUDs, 2) strong motivation is required for successful use, 3) they require manipulation of the genitalia, 4) some types are inconvenient or messy, and 5) most must be applied at or near the time of sexual intercourse. New spermicides, custom fitted cervical caps, and enzyme inhibitors are some of the new methods being researched and developed. The appendix includes the IPPF policy statement on barrier methods of contraception.
Report on the evaluation of various family life education projects with particular emphasis on youth in the English-speaking Caribbean: general conclusions and recommendations.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Nov. xii, 39,  p.Most family life education (FLE) projects included in this evaluation have the longterm objectives of reducing the incidence of teenage prognancy, and promotion of self-reliance and positive, responsible behavior among youth. The immediate objectives and project strategies are also very similar across projects, e.g., in-school and out-of-school FLE, comprehensive youth services, including family planning (FP) and training. The evaluation shows that project design has improved over the years (clearer and measurable formulation of objectives, more comprehensive workplans and better explanation of budgetary items) and projects have moved from addressing a wide variety of broad issues to a more focused consideration of adolescent fertility. However, the Evaluation Mission in concerned that due to the similarities in project design, country-and-time-specific factors have not always been adequately taken into consideration. Other concerns include the lack of systematic needs assessment and use of baseline data to guide implementation. All the projects evaluated have contributed to the training in FLE/FP of a large number of family life educators, teachers and nurses and have thus significantly strengthened professional national capability. Nevertheless, training needs still exist in motivational/attitudinal variables, sex roles, teaching/learning technics. The projects have made a significant contribution to the introduction of FLE into schools and teacher training institutions. The focus at present should be the institutionalization of FLE within the in-school sector, including the development of a policy approving FLE in schools. The development of community-based health centers was often the central activity of the out-of-school FLE component of the projects. These centers have contributed to shaping the countries' attitudes by creating an awareness of teenage pregnancy, by developing an acceptable strategy, by providing a focal point for discussing sensitive issues, and by becoming a mechanism for community mobilization. The projects have also contributed to making FP services available and specialized services for adolescents are being established. The emphasis has been more on education and awareness creation than on contraceptive distribution to adolescents. At present the need is to strengthen the service delivery components. The limited availability of data suggests that adolescent pregnancy remains an urgent problem in the region. Sustained and more focused FLE/FP program efforts directed to adolescents continue to be needed in the region. The most important general lesson learnt from the programs is that programs in adolescent fertility can be started and implemented in countries even prior to declaration of policy by governments. However, at a certain stage of implementation the programs cannot be carried further without explicit government policies and control.
Socio-economic development and fertility decline in Costa Rica. Background paper prepared for the project on socio-economic development and fertility decline.
New York, New York, United Nations, 1985. 118 p. (ST/ESA/SER.R/55)This summary of information on the development process in Costa Rica and its relation to fertility from 1950-70 is a revision of a study prepared for the Workshop on Socioeconomic Development and Fertility Decline held in Costa Rica in April 1982 as part of a UN comparative study of 5 developing countries. The report contains chapters on background information on fertility and the family, historical facts, and political organization of Costa Rica; the development strategy and its consequences vis a vis the composition of the gross domestic product, balance of trade, investment trends, the structure of the labor force, educational levels, and income; the allocation of public resources in public employment, public investment, credit, public expenditures, and the impact of resource allocation policies; changes in land tenure patterns; cultural factors affecting fertility, including education, women and their family roles, behavior in the home, women and politics, work and social security, and race and religion; changes in demographic variables, including nuptiality patterns, marital fertility, and natural fertility and birth control; characteristics and determining factors of the decline in fertility, including levels and trends, decline by age group, decline in terms of birth order, differences among population groups, how fertility declined, and history and role of family planning programs; and a discussion of the modernization process in Costa Rica and the relationship between demographic and socioeconomic variables. Beginning with the 1948 civil war, Costa Rica underwent drastic changes which were still reflected in national life as late as 1970. The industrial sector and the government bureaucracy have become decisive forces in development and the government has become the major employer. The state plays a key role in economic life, and state participation is a determining factor in extending medical and educational resources in the social field. The economically active population declined from 64% in 1960 to 55% in 1975 due to urbanization and migration from rural to urban areas, but there was an increase in economic participation of women, especially in urban areas. Increased educational level of the population in general and women in particular created changes in traditional attitudes and behavior. Although there is no specific explanation of why Costa Rica's fertility decline occurred, some observations about its determining factors and mechanisms can be made: the considerable economic development of the 1950s and 1960s brought about a rapid rise in per capita income and changes in the structure of production as well as substantial social development, increased opportunities for self-improvement for some social groups, and a rise in expectations. The size of the family became an aspect of conflict between rising expectations and increasing expenses. The National Family Planning Program helped accelerate the fertility decline.
London, England, IPPF, 1984 Feb. 20 p.The promotion of "Male Responsibility for and Practice of Family Planning" was established as a federation-wide Action Area in the IPPF 1982-84 Plan in response to recongizing the need for positive male involvement in family planning programs. Specific identified goals for this action area include the development of programs to educate men about family planning, the need to motivate them to use contraception, and changing the attitudes of male opinion leaders. Implementing the plan and promoting effective male involvement programs are in progress. The Secratariat is undertaking activities to identify Federation and regional strategies and directions and to develop support activities. Program Committee discussion and examination of the issue with subsequent publications are examples of Secretariat involvements. An International Staff Consultation on Male Involvement was held at the IPPF International Office in 1983 to review progress in developing male programs in IPPF; to analyze issues and problems in IPPF programs with regard to men's needs; to examine strategies for increasing male involvement in family planning and to formulate guidelines for program development; and to develop short and longer-term action plans to strengthen male programs within the Federation. The Consultation maded valuable contribution by identifying specific historical, economica, socio-cultural, legal, policy and technological perspectives on male involvement in family planning, as well as providing background papers presented by each participant. Working groups identified and developed a "Strategy for Action of Male Involvement in Family Planning" for the IPPF on 3 strategic levels: policy-makers, service providers and the community. Additionally, Consultation members reviewed audio-visual materials to assess their effectiveness as comunication means. Participants endorsed the need for program review and "strategic planning" by the IPPF. The value in the consultation in examining male programs and in promoting the exchange of ideas within the Federation was affirmed by both the Secretariat and association reoresentativees.
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.
London, IPPF, 1981 Aug. 13 p.The International Planned Parenthood Federation (IPPF) 1982-1984 Plan identifies the importance of male involvement in family planning and the problem of male opposition to family planning in many countries. The Plan calls for efforts to encourage men to accept joint responsibility for family planning and the practice of contraception. In most countries family planning programs are orientated towards women, but many family planning associations have some activities directed at men. A number of associations have developed experimental projects aimed at increasing male involvement, and these can be grouped as projects aimed at motivating male leaders, reaching men in the organized sector, promoting male family planning methods, and reaching adolescents. Each of these is reviewed. In identifying ways of increasing male involvement in family planning there are several aspects that Family Planning Associations (FPAs) might want to consider. These concern the current situation and local environment, the views of men, and the resources of the Association. Associations might want to consider the following suggestions for FPA program directions. These are arranged under the following categories: improving overall programming to include men; increasing availability of existing male methods; education program to promote male involvement; and increasing female support for male involvement in family planning. In countries where the concept of family planning is generally accepted, an "across the board" improvement in programs to increase their acceptability to men might result in increased male support for family planning. Although more governments and FPAs have made vasectomy available over the past decade, additional efforts could be made. The 4 principal objectives for education initiatives aimed at "male involvement" are identified. It is important that women educate and help their partners to participate in family planning. Family planning workers could do much to encourage women to involve their partners.
In: Molnos A, ed. Social sciences in family planning. (Proceedings of the Meeting of the IPPF Social Science Working Party, Colombo, Sri Lanka, June 10-13, 1977) London, International Planned Parenthood Federation, 1978 Dec. 43-5.Thailand's first 5-year family planning program for the 1972-1976 period has been acclaimed as 1 of the most successful. New program acceptors exceeded the target by 26.2%. The program's goal of reducing the annual population growth rate from over 3% in 1972 to about 2.5% has been more or less achieved. The National Family Planning Program now has as its objective the recruitment of 3 million new acceptors for the 1977-1981 period. In an effort to achieve the various goals, a series of new methods of service delivery and new contraceptive methods along with a more intensive campaign has been devised. At this stage it is important to learn why people practice family planning, why they use particular programs, why some remain in programs for a long time, and why others drop out. The experience of Thailand's family planning programs indicates that information and motivation from trusted individuals is 1 of the most decisive factors for use of a particular family planning program. Several studies have shown that users and friends can account for up to 50% of the reasons given for using particular family planning programs. The face-to-face form of contact seems to be the most effective means of inducing people to enter a family planning program. A strong desire to avoid pregnancy or another birth appears to be the most important reason for continuing in the program. Studies of women who have dropped out of programs tend to show that side effects of the particular contraceptive method used are the primary reason, with the 2nd most cited cause being the desire for another child.
In: Molnos A, ed. Social sciences in family planning. (Proceedings of the Meeting of the IPPF Social Science Working Party, Colombo, Sri Lanka, June 10-13, 1977). London, International Planned Parenthood Federation, 1978 Dec. 9-14.Kenya has a fairly well developed family planning program at the official government level along with an active voluntary Association. It is estimated that over 50,000 women are visiting family planning clinics annually, but as many women drop out of the program in each given month as are recruited. This discontinuation rate presents a major problem for family planning programs, and the underlying causes need to be determined. It is believed that, with the exception of those women who are highly motivated to use contraceptives on a continuous basis, the majority of women, particularly in rural areas, will fail to use contraceptives for long periods of time if the significant others in their lives do not support the idea. It is also probable that many women drop out of family planning programs due to the lack of reliable transport, high transport costs, varying weather conditions, and the family planning program policy which, with the exception of the IUD, provides only sufficient contraceptives to last for 3 months. There are several other reasons why a woman might want to stop using contraceptives: 1) a desire to become pregnant; 2) social pressure to withdraw from the family planning program; 3) the side effects of her method and without a suitable alternative method; 4) difficulty in obtaining contraceptive supplies; and 5) reaching menopause. A family planning campaign which ignores the men is destined for failure in Africa, for the women do not make many of the important decisions. The male must be persuaded to participate in decision-making concerning the use and non-use of contraceptives. Family planning programs should deliberately reduce their drop-out rates even if that means lowering acceptor rates.
Family Planning Perspectives. November-December 1977; 9(6):286-292.When Margaret Sanger initiated the American birth control movement in the early twentieth century, she stressed female and sexual liberation. Victorian views on morality have since combined with the compromises necessitated to achieve legitimacy for the movement to lead to a desexualization of the birth control movement. The movement's communication now concentrates on reproduction and ignores sex; it emphasizes family planning and population control but does not mention sexual pleasure. Taboos against publicity concerning contraceptives are more powerful even than laws restricting the sale or distribution of contraceptives themselves in many countries. The movement must recover its earlier revolutionary stance.
IPPF Situation Report, January 1974. 5 p.All the demographic statistics and the cultural, economic, and geogr aphical situation of the Gilbert and Ellice Islands, a British colony in the South Pacific, are presented. The history of interest in family planning and the current personnel of the Family Planning Association (FPA) are presented. The FPA was established in 1969 and the government is now integrating family planning into its Maternal and Child Health Services. Public opinion generally favors family planning and family planning education. Charts of services provided over a period of years by the FPA show increasing numbers of acceptors, with the IUD the contin ually increasing favorite. Current educational, research, and evaluation work is summarized. Other organizations have aided in the campaign for family planning.
In: Diczfalusy, E. and Borel, U., eds. Control of human fertility. Proceedings of the Fifteenth Nobel Symposium, Sodergarn, Lidingo, Sweden, May 27-29, 1970. New York, Wiley, 1971. 39-51.A drug delivery system providing for a controlled release of progestogen and affecting ovulation and steroidogenesis minimally would deal effectively with some of the problems associated with contraception. 2 systems being developed which fit these criteria are the primary topics of discourse in this article. In 1 system an implant consists of a polymer membrane of polydimethylsiloxane (PDS) and contains the progestogen in crystalline form. Major problems with the PDS implants include a lack of intraindividual constance of release and interindividual variation in the slope of the decay in release. In the second system the implant consists of a lipid-steroid membrane containing a steroid. In this implant the concentration of the steroid in the membrane and the nature of the lipid phase may be important in determining the pattern of release. In vivo metabolic studies with lipid-steroid pellets are limited, but the patterns of output may be similar to those seen with PDS implants. Because of rate problems, a shorter regime slow-release implant seems more feasible than a longer lasting system. Surgical difficulties associated with the implantation and removal of the PDS implant make the choice of a lipid-steroid micropellet preparation more feasible for a short-term regimen. The discussion, following the main body of the article, focuses primarily on problems associated with implants.
[Unpublished] 1982. Paper prepared for Conference on Vasectomy, Colombo, Sri Lanka, Oct. 4-7, 1982. 21 p.Discusses the factors responsible for the decline of male acceptance of vasectomy over the past decade. The Association for Voluntary Sterilization (AVS) is a nonprofit organization working in the United States which helps funding of similar programs in other developed and developing countries. Reasons for the decline of vasectomy acceptance include the lack of attention paid to male sterilization in countries with family planning programs, the introduction of new technology for female sterilization, the introduction of new effective methods of contraception, and the exaggerated sexual role of the male and the need to protect his virility. The author reviews successful vasectomy programs and finds that, to be successful, a program should have strong leadership, a focussed design, clinic hours that would not interfere with patients' working schedules, and should pay attention to the needs of men, e.g., emphasizing that vasectomy does not cause impotency. The program should also have a community-based orientation, since all the services are not hospital-based and can be brought to the client's home, thereby emphasizing the minor nature of the surgery. AVS believes that vasectomy as a means of family planning can be effective. It is safe, inexpensive, simple, and deliverable. A special fund was allocated in 1983 to stimulate the development of several pilot and demonstration projects in a variety of countries.
Washington, D.C., World Bank, 1982. 68 p. (World Bank Staff Working Papers No. 551)This paper outlines the inclusion of communication support in various lending sectors of the World Bank, describes how communication support activities should be designed and carried out during the project cycle, and addresses some common problems and issues that should be kept in mind when developing and implementing these activities. Communication support refers to information, motivation, or education activities which are designed to help achieve the objectives of a parent project through creating a favorable social climate for change. Usually such activities are financed under the same loan as the parent project. By fiscal year 1979 the World Bank had lent some US$183 million for communication support, usually for education, agriculture and rural development, and population, health, and nutrition. Potential benefits of communication support include facilitating change among project populations, helping create an effective implementing agency, coping with negative behavior or attitudes, and helping prevent negative impact. The World Bank experiences with communication support in 7 sectors of Bank lending are briefly described, including education; population, health and nutrition; agriculture; urban projects; water and wastes; transportation; and telecommunications. Various steps in the design process are then detailed, including identification of institutional arrangements, definition of objectives, identification and segmentation of the people to be reached, identification of the timing and time frame, selection of channels, decisions on communication style, technique and content, design of pretesting, monitoring and evaluation arrangements, and costing. Among issues in the design of communication support programs that are discussed are inclusion of communication support versus managerial complexity; centralization versus decentralization; single agency versus multi-agency responsibility; in-house responsibility versus contracting out; mass media versus personal channels; and overdesign versus underdesign.
[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.
[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.