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In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 189-210.This chapter addresses the full range of policies and programmes that bear directly on population patterns and trends and that guide and strengthen interventions in the broad field of population. While we will consider the impact of deliberate efforts to promote countries' adoption of national population policies, the adoption of formal population policies is but one facet of the much broader process of developing and implementing policies and programmes that guide and support population activities. (excerpt)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 137-150.This volume chronicles the remarkable success -- indeed, the reproductive revolution -- that has taken place over the last thirty years, in which the United Nations Population Fund (UNFPA) has played such a major role. Our purpose in this chapter is to contrast the situation at the century's end with the one that existed at the time of UNFPA's creation thirty years ago, and to project from the current situation to the new challenges that lie ahead. In many respects, the successful completion of the fertility transition that is now so far advanced will bring an entirely new set of challenges, and these will require a fundamental rethinking about the future mandate, structure, staffing and programme of UNFPA in the twenty-first century. Our purpose here is to identify those challenges and speculate about their implications. (author's)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 113-135.The remarkable originality and achievements of the International Conference on Population and Development (ICPD), held in Cairo in September 1994, have sometimes been disregarded in the years since. Most fair-minded people acknowledge that ICPD succeeded in its main aims. But for those of us who participated in earlier population conferences and in the preparations for Cairo, it can be said to have succeeded beyond our wildest dreams -- in terms of its intent and programmatic content at least. In addition, it helped mobilize the population, health, women's rights and allied communities to shape a broad agenda for the population and related development fields for the next two decades. Of the three international conferences organized by the United Nations to help build world consensus on the need to address population issues, ICPD was by far the most successful, measured by numbers attending, levels and quality of delegates, international media attention, and the quality of the final consensus -- and an important watershed. After long preparation and vigorous debate, more than 180 countries agreed to adopt the 16-chapter ICPD Programme of Action. The 115-page document outlines a 20-year plan to promote sustainable, human-centred development and a stable population, framing the issues with broad principles and specific actions. The Cairo Programme of Action was not simply an updating of the World Population Plan of Action (WPPA), agreed to at Bucharest and revised at Mexico City, but an entirely fresh and original programme, calling for a major shift in strategies away from demographic goals and towards more individual human welfare and development ones. ICPD was the largest intergovernmental conference on population ever held: 11,000 representatives from governments, non-governmental organizations (NGOs), United Nations agencies and intergovernmental agencies participated, 4,000 NGOs held a parallel forum, and there was unprecedented media attention. ICPD was not just a single event, but an entire process culminating in the Cairo meeting. There were six expert group meetings, and regional conferences in Bali, Dakar, Geneva, Amman and Mexico City. There were many formal and informal NGO meetings and three official Preparatory Committee (PrepCom) meetings. Other crucial influences came from the 1987 Safe Motherhood Conference, the 1990 World Summit for Children, the 1990 Jomtien World Conference on Education for All, and the 1993 Vienna Conference on Human Rights. (author's)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 95-112.This chapter will seek to review and assess, both globally and nationally, UNFPA's experience thus far in encouraging and building partnerships, analysing and reflecting on some of the successes as well as on the constraints and challenges that exist in broadening partnerships. It will also attempt to explore some specific measures that may be taken to nurture and protect effective partnerships that will endure over time. (excerpt)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 47-80.This chapter explains the various mechanisms for fostering compliance with different rights relating to reproductive and sexual health, and explores programming options for fostering such compliance. The chapter is not exhaustive, but exploratory; recognizing that much more discussion is needed to address this issue adequately. (excerpt)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 152-174.This document outlines the UNFPA's stance and involvement – financially and politically – in global conferences including those focusing on women (Mexico City, 1975; Copenhagen, 1980; Nairobi, 1985; and Beijing, 1995), and other issues related to the world’s population.
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 175-188.This analysis looks at the United Nations Population Fund's (UNFPA's) work in the area of population-environment-development linkages. It then analyses the collective effects of 6 billion people, their consumption patterns, and resource use trends, in six different critical resource areas. (excerpt)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 24-46.The solemn commitment that was made in Cairo in 1994 to make reproductive health care universally available was a culmination of efforts made by the United Nations Population Fund (UNFPA) and all those concerned about a people-centred and human rights approach to population issues. The commitment posed important challenges to national governments and the international community, to policy makers, programme planners and service providers, and to the civil society at large. The role of UNFPA in building up the consensus for the reproductive health approach before Cairo had to continue after Cairo if the goals of the International Conference on Population and Development (ICPD) were to be achieved. UNFPA continues to be needed to strengthen the commitment, maintain the momentum, mobilize the required resources, and help national governments and the international community move from word to action, and from rhetoric to reality. Reproductive health, including family planning and sexual health, is now one of three major programme areas for UNFPA. During 1997, reproductive health accounted for over 60 per cent of total programme allocations by the Fund. (excerpt)
In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 2-23.In demographic terms, the last thirty years have been quite distinct from the period that preceded it, or, indeed, from any other period in history. The global fertility level had been almost stable for at least twenty years prior to 1965-1969, with a total fertility rate just under 5 children per woman, and this stability did not hide countervailing forces in different parts of the world. The developed countries, whether they had participated or not in the post-World War II “baby boom,” showed no strong trends in fertility, with a total fertility rate remaining around 2.7. The same lack of change characterized the developing countries, but there the total fertility rate was well over 6, as it may well have been for millennia. (excerpt)
Report of the evaluation of UNFPA assistance to the National Family Planning and Sex Education Programme of Costa Rica.
[Unpublished] 1980 Mar. 89 p.This report of the evaluation of UN Fund for Population Activities (UNFPA) assistance to Costa Rica's National Family Planning and Sex Education Program covers the following: 1) project dimension and purpose of the evaluation, scope and methodology of the evaluation, composition of the mission, and constraints; 2) background information; 3) 1974-77 family planning/sex education program (overview, immediate objectives, strategy, activities and targets, and institutional framework); 4) planned and actual inputs and rephasing in 1978-79; 5) family planning activities (physical facilities and types of services provided, recruitment of new users, continuation of users within the program, distribution of contraceptive supplies, sterilizations, and indicators of program impact); 6) training and supervision; 7) education, information, and communication (formal and nonformal education, educational activities in the clinics, and the impact of the nonformal educational program); 8) maternal and child health (maternal health indicators, cytological examinations, and infant mortality); 9) program evaluation and research; 10) population policy; 11) program administration; 12) some general conclusions regarding the performance of the program; and 13) the program beyond 1979. UNFPA evaluations are independent, in depth analyses, prepared and conducted by the Office of Evaluation, usually with the assistance of outside consultants. The process of analysis used in the evaluation follows a logical progression, i.e., that which underlines the original program design. Evaluation assessment includes an analysis of inputs and outputs, an investigation of the interrelationship among activities, an indication of the effectiveness of activities in achieving the objectives, and an assessment of duplication of activities or lack of coverage and the effect of this on realization of the objectives. The program was able to expand the coverage of family planning activities but has been unsuccessful in having a population policy established. The number of hospitals, health centers, and rural health posts providing family planning services was tripled in the 1974-77 period. The program could not achieve its targets in number of new users, and it recruited in 1977, only 11% of the total population of the country, against the 20% planned. It has been estimated that between 1973-77 around 231,200 births or 44.4% of those possible had been averted. Training and supervision has been a weak area of the program. A large number of professors have been trained in sex education, but no evaluation has been undertaken of the likely impact of this trained staff at the school level. The information, education, and communication (IEC) program has been successful in taking information and education to the population on family planning/sex education concerns but less successful in motivating the political groups to formulate a population policy.
Assessing the impact of new contraceptive technologies on user satisfaction, use-dynamics, and service systems.
PROGRESS. 1989; (11):2-3.A summary of the recommendations stemming from conference on the Demographic and Programmatic Consequences of Contraceptive Innovations, sponsored by the U.S. National Academy of Sciences in 1988, is provided by the WHO. While typical research on introduction of new contraceptive methods concerns cohort studies of users' problems and perspectives, a larger view of use-dynamics, choice behavior and client satisfaction with overall care is lacking. It is popular to hypothesize that user satisfaction improves with numbers of contraceptive options, but the literature does not provide clear evidence on this point, and none at all on introduction of new methods. Three main issues should be addressed: what is the impact of a new method on client perception of overall care, on contraceptive behavior, and on operation of the family planning program. To get this information usually requires prohibitively costly, time-consuming research. Low cost approaches are available, however, taken from the type of large-scale, community-based repeat observation studies now used to monitor trials of pharmaceuticals for tropical diseases, and treatments of rare conditions, such as vitamin A. Statistical techniques have been developed to adjust for censoring bias. Another type of field research that can be adapted to this research is the epidemiological field research of the type used in the Matlab, Bangladesh cholera vaccine study, later utilized to study acceptance of family planning services. Without such studies, the social and programmatic rationale for introduction of new contraceptives will be open to debate.
In: Population perspectives. Statements by world leaders. Second edition, [compiled by] United Nations Fund for Population Activities [UNFPA]. New York, New York, UNFPA, 1985. 116.The government of the Netherlands feels that is the duty and concern of all nations to provide favorable social and economic conditions. The 1984 International Conference on Population in Mexico provides the chance for nations to meet and discuss present day population phenomena. The government of the Netherlands, recognizing the basic rights of couples and individuals concerning birth control, supports a non- intervention policy. However, the Dutch government does give its support to in-depth studies on population control and program implementation in developing countries. The United Nations supports and assists governments implementing population programmes. Central to the U.N. population and development efforts is improving the status of women. However, many member states of the United Nations support the freedom of choice concerning family planning.
Assessing the demographic consequences of major development projects. Proceedings of a United Nations Workshop, New York, 1-4 December 1986.
New York, New York, United Nations, 1988. vi, 183 p. (ST/ESA/SER.R/81)Although considerable awareness of the behavioral relationships and interactions between demographic and socioeconomic processes has been established, analysis of the specific demographic impact of development projects has lagged behind. To remedy this situation, the United Nations has undertaken a project aimed at developing a practical, cost-effective methodology for assessing the demographic impact of development projects in a variety of settings and countries. The approach developed is based on available sources of data such as censuses and vital registration systems. The methodology was applied in particular to electrification and irrigation projects in selected developing countries and a workshop was convened in 1986 to review the approach developed. Background papers presented at the workshop (included in this volume) focused on both the experiences of other institutions with population impact analysis and on methodological and measurement issues. Workshop participants identified 2 types of problems in measuring the strength of the relationship between a development project input and its demographic effect: those encountered in measuring the observed relationship for a given development project, and those encountered in assessing the relative effects of different projects. It was recommended that changes at both the macro and micro levels should be compared, with an emphasis on how such factors affect demographic behavior. Ecological analysis can then be used to identify the factors that explained demographic differences between communities. There was also consensus that the ideal methodological approach should involve an experimental/control design and a longitudinal time frame. For planners, the utility of such impact studies lies no only in investment allocation or priority ranking of development projects, but in the improvement of project design as well.
New York, New York/Cambridge, England, Cambridge University Press, 1987. xxxviii, 357 p.This book is about the challenge posed by the unprecedented growth of the world's population and the response which has been made to that challenge by the United Nations and its system of agencies. It focusses in particular on the creation, in 1969, of the United Nations Fund for Population Activities (UNFPA) as the principal instrument for the United Nations' population programmes and on the work undertaken by the United Nations and its specialized agencies, including the World Bank, in this field. A substantial part of the book is devoted to discussing the actual achievements, in terms of demographic policies and falling birth rates, which have been realized in different parts of the developing world, with special emphasis being given to a discussion of recent events in selected countries of Asia (including China and India), Latin America and Africa. There are major chapters on the two international conferences on population which have been held during the period under consideration: namely the World Population Conference which took place in Bucharest in August 1974, and the International Conference on Population which was held in Mexico City ten years later. (EXCERPT)
Journal of Social and Political Studies. 1980 Winter; 5(4):183-90.A recently completed World Bank statistical study of family planning in 63 developing countries indicated that countries which experienced a large decline in birth rates between 1960-1977 were more likely to have a family planning program, an official population policy aimed at decreasing the birth rate, and a relatively high level of development than countries which experienced smaller or no decline in birth rates. The 65 countries represented 95% of the population of the developing world. Birth rate declines of 10% or more between 1960-1977 were experienced by: 1) 10 of the 26 countries which had a family planning program and a policy aimed at reducing the birth rate; 2) 6 of the 19 countries which had a family planning program but lacked clearly defined population objectives; and 3) 2 of the 18 countries without any population policy or program. Furthermore, the implementation of a family planning program and the adoption of a population policy were directly related to the development level of the country. This finding suggested that countries need to reach a certain level of development before they have the capacity to develop population programs and policies. When a country is sufficiently advanced to collect population data, awareness of population problems increases and they are more likely to adopt a population policy. In addition, government efficiency increases as development proceeds and governments must have a certain level of efficiency before they can implement effective programs.
[Washington, D.C., American Public Health Association, 1979.] 110 p. (Contract AID/pha/C-1100)This reports the Third Evaluation of the Thailand National Family Program and was prepared by the entire joint Thai-American evaluation team. The summary of findings states that the NFPP has successfully achieved its target to date. The population growth rate will reach the goal of 2.1% per annum set by the Fourth Economic and Social Development Plan. It was further recommended that if the record of achievement is to be maintained through the Fifth 5-year plan (1982-6), increasing levels of support are needed both from the government and international donors. Further recommendations state that the National Family Planning Program (NFPP) should continue to focus its efforts on all regions of the country, including Bangkok. The NFPP should prioritize those georgraphic areas and segments of the population where family planning acceptance is low and/or availability of information and services are not fully developed. Targets should be set in terms of a combination of new and continuing acceptors in the next 5-year plan. Greater emphasis should be given to management and supervision at the village and health center levels. The international donor community should give full recognition to the necessity of maintaining a level of direct support for the NFPP to assist the Royal Thai Government (RTG) in achieving the goals of the Fifth National Economic and Social development Plan (1982-6). The RTG and donor agencies should continue to support public and private sector activities in voluntary sterilization.
IMCH Newsletter. 1979 Sep; 10(120):1, 3-4.In appraising the current status, problems and approaches of the Philippines population program, initial focus is on providing a brief account of the program's development. A national family planning program that respected the religions beliefs and values of individuals was the 1st step. These early family planning efforts were physician oriented, clinic-based, and female-oriented, and the acceptance rates continued to be low. In response to this, population and family planning was made an integral part of the socioeconomic development of the country. This new orientation paved the way for the birth of the national population and family planning project which is currently the program's core project. The outreach project was intended to stregthen the programs' capability to reach out to the remote areas through its Full-Time Outreach Workers (FTOW) and Barangay supply points. This program is being implemented throughout the Philippines. About 2596 full-time outreach workers, 31,592 barangay supply points, and 3612 family planning clinics are making family planning information and services available to the population. Based on outreach reports, current users increased from 780,183 to 815,061 by March 1979. These accomplishments contributed greatly to the decline in the population growth rate from 3.01 in 1960-1970 to 2.78% in 1970-1975. Greater concerted efforts still need to be exerted to achieve target populations by the year 2000. The special committee to review the Philippine population program has recommended that the concept of family planning be redefined to include family welfare. The program continues to implement complementary and supplementary sets of projects which are termed phase 1 project, population planning 2 projects, and population loan 1 and 2.
[Bangkok, Thailand, PDA, 1979.] 23 p.The Community-Based Family Planning Services in Thailand is the major bureau and implementation arm of the Population and Community Development Association. It was established in 1974 with funding and contraceptives from the International Planned Parenthood Federation (IPPF) for the purpose of starting community-based family planning distribution activities primarily in Thai villages and some urban communities. By the end of 1978 these activities had reached 7200 villages in 75 districts and had become self-sufficient in cash. In 1979 no cash but some contraceptives are provided by IPPF. An explanation of the various elements and steps of the existing program is provided. The primary objective of the CBFPS was to test the possibility of using existing, local personnel and channels of distribution to markedly expand access to and demand for family planning. The backbone of the program is the village distributor. Someone from each village is selected and trained to be a motivator and distributor of contraceptives. The steps in implementing the program are simple and are carried out in the following order: preliminary contacts with local officials, development efforts, training, motivation, and supervision and retraining. The CBFPS program has provided a needed and acceptable local service. A cumulative total of 250,000 oral contraceptive users entered the village program. Independent surveys have shown that the percentage of pregnant women declined by 41% after two years, and practice rates increased by 30%.
[Unpublished] 1979. Presented at the International Symposium Medicated IUDs and Polymeric Delivery Systems, Amsterdam, Holland, 1979 June 27-30. 23 p.After almost 20 years of worldwide availability and use of IUDs, assessment of their future role for family planning remains difficult. There are differences concerning the success of IUDs in different programs, and there is also wide variation among individual women in the acceptability and utility of the IUD. Successful IUD use seems to depend upon a complex interplay of factors which include the technology of the IUD itself, biological variation among women, individual and cultural differences in tolerance of IUD caused side effects, and the nature and quality of the available medical care and follow-up services. The principal difficulties encountered in IUD use are discomfort and increased bleeding, spontaneous expulsions, increased frequency of uterine and pelvic infection, and pregnancy failures. In the early years of mass programs for family planning in developing countries the IUD was often emphasized. Inadequate data exists to obtain an accurate world picture of IUD usage and demographic impact at this time. IUDs are available in most countries through a number of channels, and figures on distribution and usage through sales and service programs are incomplete. The best measurement of prevalence of use of IUDs comes from special surveys selected in order to provide a representative sample of the nation's or an area's population. The usage of IUDs in China and India is reviewed. When fertility effects on acceptors are examined, the experience with the IUD seems to be favorable compared with other means of fertility control, but the programmatic impact of IUD use has not been so favorable. Many countries have either added additional means of fertility control or switched emphasis to other methods.
Social Biology. 25(2):145-163, Summer 1978.This paper reviews and compares the methodologies of some 70 investigations of the effect of family planning programs on fertility levels. Differences among the studies include variations in questions asked, research methods used, program type investigated, and made of program action assumed. Programs can affect fertility by providing means of fertility control, education, legitimation, incentives/disincentives or any combination of these but the actual effect of these modes is unclear. Comparison is usually made between the effects on fertility of a program as a whole and a hypothetical estimate of what fertility rates would have been without the program. This hypothetical estimate is in fact not subject to empirical measurement, and a variety of methods have been developed largely to attack this methodological problem. The article compares the characteristics of several methods and provides a matrix comparing their strength, limitations and applications. The methods discussed include: 1) decomposition of change which identifies several factors affecting changes in crude birth rate; 2) correspondence between program activity and fertility trends over time to across areas or groups, which often takes close statistical association as evidence of causality; 3) matching studies, which try to remove the influence of nonprogram factors by controlling the characteristics of the subject; 4) experimental and control areas, comparing presumably similar groups with and without family planning programs; 5) multiple regression across areal units which provides some information on areal trends but requires extensive data for many statistical areas; 6) calculation of national effects of births averted among acceptors; and 7) simulation, which compares data to mathematical projection models, such as the TABRAP/CONVERSE and POPSIM models. No one method is best but certain methods are best to answer certain questions. All of the methods have difficulty establishing actual causality between the program studied and fertility trends and ruling out alternative explanations. Recent studies encouraged by the U.N. Population Division are seeking cross-method and cross-program evaluation.
Genus. 1976; 32(1-2):45-70.Add to my documents.
In: International Population Conference of the World Population Society, Wash., D.C., 1975. Wash., D.C., World Population Society, 1976. pp. 143-147Add to my documents.
Planned parenthood reconsidered: contribution of family planning to demographic, economic and social goals.
Panel contribution presented at IPPF 21 - Planning for the Future, Brighton, England. 1973 Oct; 7.Add to my documents.
In: Rockefeller Foundation. Bellagio 4 population conference. A conference sponsored by The Rockefeller Foundation, Ulvshale, Denmark, June 7-9, 1977. New York, Rockefeller Foundation, November 1977. p. 114-127Government attitudes on population questions will tend to be strongly influenced by the perceptions of the elites as to the effect of population growth on structural shift that is taking place - i.e., expansion of employment in the modern sector is faster than the rate of overall population growth. 2 contrasting situations may be distinguished: situations in which development is succeeding and situations in which it is slow or faltering. These situations imply quite different perspectives on the role of population in the development process, and, consequently, require different responses from the donor community. The actual and potential roles of the donor community in affecting population policies in the countries that experience rapid population growth and whose development is slow or faltering are large. Much assistance has been provided to poor countries that wanted to launch family planning programs and such assistance may expand in the future. In supporting these programs, more donor attention should be given to 2 major issues. The 1st is to give more consideration to alternative institutional solutions for health and family planning supply systems rather than to the current dominant model of centralized pyramidal bureaucracies. 2nd, the donors should prepare themselves to anticipate and face the difficult issues that will arise if recipient governments move toward the use of coercive methods.
Subcommittee on Foreign Operations and Related Agencies, Committee on Appropriations, U.S. House of Representatives, March 15, 1977.. 11.The U.S. Agency for International Development (AID) had provided 1 billion dollars of population program assistance worldwide in the decade since 1965. A summary of the AID population program during the decade is provided. In addition to providing family planning aid to many countries on a bilateral basis, AID has funded research, program administration, and data collection. Demographic results in the 10-year period are tabulated. Particular attention is paid to family planning achievements in India and China. In countries with vigorous family planning programs, especially recipients of large-scale AID funding, fertility decreases have been effected. Technology has been developed. The AID program has shown that the majority of women in underdeveloped countries want and will try to control their fertility.