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  1. 1

    [Estimation of the rate of mother-to-child HIV transmission: methodological problems and current estimates. Report of 2 study workshops (Ghent, Belgium, 17-20 February 1992 and 3-5 September 1993)] Estimation du taux de transmission du VIH de la mere a l'enfant: problemes methodologiques et estimations actuelles. Rapport de deux ateliers de travail (Gand, Belgique, 17-20 fevrier 1992 et 3-5 septembre 1993).

    Groupe International de Travail sur la Transmission Mere-Enfant du VIH

    SANTE. 1994 Mar-Apr; 4(2):73-86.

    Many cohort studies since 1985-1989 have estimated the rate of mother-to-child transmission of HIV. Data collection and analysis problems in many of these studies made it hard to compare transmission rates between studies. The AIDS Task Force/European Community and WHO/Global Program on AIDS held workshops on methodological problems and actual estimations of mother-to-child transmission of HIV in February 1992 and September 1993 in Belgium. Researchers who have conducted studies in Central and Eastern Africa, Europe, Haiti, and the US participated. They examined enrollment and follow-up methods, diagnostic criteria and case definitions, measurement and comparison of mother-to-child transmission rates, and determinants of transmission. The reported transmission ranges varied from 13% to 32% in developed countries and from 25% to 48% in developing countries. Since the estimation methods differed, the participants could not make direct comparisons, so they developed a common methodology at the 1992 workshop. They agreed on definitions of HIV-related signs and symptoms, AIDS in children, and HIV-related deaths. They developed a classification system of children born to HIV-1 infected women based on probable HIV infection status during the first 15 months of life. This system let them define a direct method of computation of the transmission rate and an indirect method for studies with a comparison group of children born to HIV negative women. At the 1993 workshop, participants applied some data sets to these standardized methods to revise earlier estimates and to compare mother-to-child HIV-1 transmission rates in 13 different locations. The transmission rates, determined by the direct and indirect methods, ranged from 12.7% to 42.1% and from 20.7% to 42.8%, respectively. Using the direct method, those in industrialized countries and developed countries ranged from 14% to 25% and from 13% to 42%, respectively. Both methods attain a reasonable estimate of the true rate. Application of these methods to all studies would help researchers design and implement trials assessing interventions trying to reduce or prevent mother-to-child transmission of HIV.
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  2. 2

    Family planning or population control?

    Macintosh A

    LIVING MARXISM. 1994 Jul; (69):[6] p.

    In September 1994, hundreds of family planners, population experts, government officials, and charities from around the world will meet in Cairo to debate population concerns during the International Conference on Population and Development (ICPD), a platform for population experts who believe that the world's problems can be explained in terms of population statistics. These people believe that the poverty and hunger which are endemic throughout the world exist because there are too many people trying to get their share of limited resources. However, rather than critically examine the prevailing global economic system which causes poverty and food shortages, and trying to increase the amount of resources available for distribution, attendees at the 1994 ICPD will search for ways to check population growth. Conference delegates are also concerned about mass international population movements from poor countries to more affluent nations. Careful to not offend Third World leaders, populations, and sensitivities, and in an attempt to garner support for colonial-style interference in domestic population matters, population control is now being sold as a way of safeguarding people's health in developing countries and something positive for the reproductive health rights of women. In reality, however, all funds spent upon family planning in and for the Third World simply propagate the message that more Black children is bad and fewer Black children is good.
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  3. 3
    Peer Reviewed

    Blood safety in developing countries.

    Gibbs WN; Corcoran P

    VOX SANGUINIS. 1994; 67(4):377-81.

    As part of an effort to monitor the safety of global blood transfusion services, the World Health Organization circulates a questionnaire for use in a database on blood safety. In 1992, 67% of countries responding to the survey (100% of developed, 66% of developing, and 46% of less developed countries) were screening all blood donations for HIV antibodies and 87% of these countries (100% of developed, 92% of developing, and 63% of less developed countries) carried out supplementary testing to confirm positive results. All developed countries, 72% of developing, and 35% of less developed countries screen blood for hepatitis B surface antigen and 94%, 71%, and 48%, respectively, screen for syphilis. The primary reasons for inadequate blood testing are the cost of test kits and reagents and the unreliability of supplies. The proportion of safe donors is highest in systems where all donors are voluntary and nonremunerated--conditions that exist in 85% of developed countries but only 15% of developing and 7% of less developed countries. Blood safety would also be improved by more appropriate use of transfusions and the provision of alternatives such as saline and colloids. Other problems include insufficient blood supply (e.g., none of the less developed and only 9% of developing countries collect 30 units or more per 1000 population per year) and inadequate quality assurance in all aspects of preparatory testing.
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  4. 4

    Global population assistance report, 1992.

    United Nations Population Fund [UNFPA]

    New York, New York, United Nations Population Fund [UNFPA], 1994. 56 p.

    This is the sixth edition of a report on global population assistance first published by the UN Population Fund (UNFPA) in 1988. It provides information on the levels, trends, and nature of international population assistance for the period 1983-92, focusing upon the flow of funds in the form of grants or loans from developed countries to developing countries. In 1992, primary funds for international population assistance reached $926 million, $1033 million including World Bank loans. In 1983 dollars, however, total primary funds in 1992, not including those of the World Bank, were $657 million. Primary funds from 17 developed countries in 1992 totalled $766 million of which 50% came from the US and Japan, and 80% from the US, Japan, Germany, Sweden, Norway, and the UK. As a percentage of official development assistance, population assistance from each donor country was 1.37% on average in 1992. Final expenditures in 1992 were $211 million in Asia and the Pacific, $172 million in Africa, $97 million in Latin America and the Caribbean, $42 million in the Middle East and North America, and $6 million in Europe. In 1992, 69% of the final expenditures for population assistance were for family planning programs. Most data in the report were obtained through a questionnaire mailed in June 1993 to 392 countries and organizations involved in population activities. Survey respondents included donor countries, multilateral organizations and agencies, major private foundations, and other nongovernmental organizations (NGO). Responses were obtained from all donor countries and multilateral organizations and agencies, although only 113 of the 366 NGOs contacted responded. Survey data were supplemented by other sources, such as annual reports, UN specialized agencies' records, published secondary sources, and telephone interviews. The report notes the practical difficulty of defining population programs and of apportioning the population component of integrated projects.
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  5. 5

    New world order and West's war on population.

    Wilson A

    ECONOMIC AND POLITICAL WEEKLY. 1994 Aug 20; 29(34):2,201-4.

    The aim of US-promoted population policies is maintaining and securing the economic and political dominance of capitalist states. Governments of developed countries blame overpopulation in developing countries for destroying the planet and those of developing countries blame overconsumption, waste, and industrial pollution in the capitalist countries to be responsible. Developed countries and the UN profess that population control is in the interests of development and for the sake of women's rights. Many women's groups protest planned and already existing population policies and bear witness to the suffering women from developing countries experience, raising the question of choice of these policies. Sexism served as the smokescreen behind which US strategies of population control were implemented. The concept of sustainable development is also used to advance population policies in developing countries. Developed countries use this concept to maintain the status quo, agricultural countries as such, cash crop economies, dependency on food, foreign aid, and loans and to continue their exploitation in developing countries. USAID, UNFPA, and the World Bank are the major moneylenders for population control. The US targets Africa for population control because it produces 90-100% of four minerals vital to US industry. The new phase of capitalist development has shifted the state's role from its function as a nation state to facilitator of global capital. Population control policy, national security laws, and anti-trade union laws are used to create a docile and immobile pool of labor. The World Bank, the IMF, and the WTO, through their structural adjustment policies, provide the infrastructure to implement population policies and targets. Population policies focusing on targets take control away from women. People in developing countries will not accept these population policies until they have control of their lives. They need assurance of child survival and to be in a position to plan their future. The population control lobby now uses deception to thwart resistance.
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  6. 6

    World population 1994. [Wallchart].

    United Nations. Department for Economic and Social Information and Policy Analysis. Population Division

    New York, New York, United Nations, Dept. for Economic and Social Information and Policy Analysis, Population Division, 1994 Aug. [2] p. (ST/ESA/SER.A/142)

    This wall chart tabulates data from the medium variant of the UN population estimates and projections as revised in 1994. Figures are given for the world as a whole and for more developed, less developed, and least developed areas. Data are also provided for regions and for individual countries within those regions. The mid-year population is shown in thousands for 1994, 2015, and 2050. Figures are then detailed for percentage annual growth rate, crude birth rate, crude death rate, total fertility rate, life expectancy at birth, and infant mortality rate for 1990-95. Age distribution (under age 15 years and 65 years or older) and density data are also provided for mid-1994. In addition to the main table, a listing is given of the 10 largest countries in 1994, and bar graphs show world population in millions for 1950-2050 as well as the average annual increase in millions for 1950-2050.
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  7. 7

    World contraceptive use 1994. [Wallchart].

    United Nations. Department for Economic and Social Information and Policy Analysis. Population Division

    New York, New York, United Nations, Dept. for Economic and Social Information and Policy Analysis, Population Division, 1994 Aug. [2] p. (ST/ESA/SER.A/143)

    This wall chart shows the 1994 level of contraceptive use (percentage) for the entire world. Data are presented for less developed and more developed regions and for individual countries grouped according to region. The number of couples of reproductive age is given in millions, and the data are broken down into year; age range represented; and percentage of the total, of female sterilization, of male sterilization, of oral contraceptive use, of IUD use, of condom use, and of use of other supply and non-supply methods. In addition, trends are indicated by showing the time period and the annual increase in percentage using any method. These data are further illustrated in pie charts indicating the entire world, more developed regions, and less developed regions as a whole and for Africa, Latin America and the Caribbean, Eastern Asia, and other countries in Asia and Oceania.
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  8. 8
    Peer Reviewed

    Quinacrine sterilisation revisited.

    Kessel E

    Lancet. 1994 Sep 10; 344(8924):698-700.

    Benagiano of the World Health Organization's (WHO) Special Program of Research, Development, and Research Training in Human Reproduction (HRP) stresses that the high standards of safety demanded in the testing and use of contraceptives should apply whether the subjects recruited to the studies are from developed or developing countries. The author of this commentary, however, with particular regard to transcervical quinacrine pellet research for nonsurgical female sterilization, criticizes the ethical and professional stand of Benagiano and HRP. He instead argues that the only sensible global standard for contraceptive research is a risk-benefit one which will vary according to the circumstances of the country involved in the research. Benagiano's September 3 letter is criticized as omitting an historical perspective and failing to discuss the differences of opinion concerning the appropriateness of proceeding with current and expanded clinical trials concurrently with additional toxicology testing. The author argues that in applying a developed country standard for contraceptive research to a developing country, HRP is making a value judgement based upon neither science nor logic. To support his argument, the author points to a difference between HRP guidelines and those of the WHO Special Program for Research and Training in Tropical Disease (TDR). TDR, unlike HRP, favors a risk-benefit guideline which takes account of the circumstances in which research is conducted. Although both programs follow accepted procedures for phase I, II, and III clinical studies, TDR is more likely to encourage these to proceed concurrently when the benefits seem to outweigh the risks of the trial. Feminist concerns discussed in Geneva, the self-imposed regulations of donor agencies such as the US Agency for International Development, the use of quinacrine as an anti-malarial drug, and North-South differences in contraception research are discussed.
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  9. 9

    Family planning: a basic development need.

    IPPF OPEN FILE. 1994 Jun; 1.

    The 1994 Human Development Report from the United Nations Development Program (UNDP) proposes a 20-20 Human Development Compact based on shared responsibilities between poor and rich nations, whereby poor and rich nations would help unmet basic human development needs such as primary education, primary health care, safe drinking water, and family planning over the next 10 years. This would require an additional US $30 to US $40 billion annually. Developing countries would commit 20% of their budgets to human priority concerns instead of the current 10% by reducing military expenditure, selling off unprofitable public enterprises and abandoning wasteful prestige projects. Donor countries would increase foreign aid from the current average of 7% to 20%. The report will propose a new concept of human security at the World Summit for Social Development to be held in March 1995, calling widespread human insecurity a universal problem. On average, poor nations have 19 soldiers for every one doctor. Global military spending has been declining since 1987 at the rate of 3.6% a year, resulting in a cumulative peace dividend of US $935 billion from 1987 to 1994. But this money has not been expended on unmet human needs. India ordered fighter planes at a cost that could have provided basic education to the 15 million Indian girls now out of school. Nigeria bought tanks from the UK at a cost that could have immunized all 2 million unimmunized children while also providing family planning to nearly 17 million couples. UNDP proposes a phasing out of all military assistance, military bases, and subsidies to arms exporters over a 3-year period. It also recommends the major restructuring of existing aid funds, and proposes a serious study on new institutions for global governance in the next century.
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  10. 10

    What is at stake at the world conference on population and development: women's rights and responsibilities.

    de Oliveira RD

    PEOPLE'S PERSPECTIVES. 1994 Mar; (8):4-8.

    Planetary democracy is necessary and possible. T he world's citizens must participate in decision-making on global issues like the environment, development, and population. There is a recognition at the international level that almost everything in politics and culture has been decided by men. Women must speak out on the problems that afflict humanity in an endeavor to democratize human relationship and politics. At the UN Conference on Population and Development, women must fight to have their reproductive rights respected. Planeta Femea, the women's event during ECO'92, was a demonstration of this new stance taken by women. The Coalition of Brazilian Women that coordinated Planeta Femea addressed two issues: population and ethics. The Rio Conference unmasked the simplistic notion that it was the populous nations of the South that degraded the environment, polluted water, and burned forests, when the North's patterns of production and consumption were the principal culprits of environmental degradation and the depletion of natural resources. The North's technological innovations drive all those denied access to these resources further into underdevelopment. The majority of mankind is becoming less and less competitive. According to UNDP figures, worsening terms of international trade, the burden of foreign debt, and trade protectionism deprive developing countries of 500 billion dollars in resources every year. To continue with present policies that perpetuate disparities among countries is to increase poverty worldwide and risk making our planet unsustainable. Improving the quality of life for all mankind requires a global alliance, a shared responsibility by all nations in confronting squalor and inequality. Modifying patterns of consumption and lifestyle in the North as well as reviewing global patterns of use of capital, resources and technology are needed to implement a common North-South agenda to salvage the planet.
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  11. 11

    Hard realities of a crowded world.

    Mann J

    WASHINGTON POST. 1994 Aug 24; E13.

    The Turner Broadcasting's People Count programming is focusing attention on the global population explosion and the September 1994 United Nations Conference on Population and Development in Cairo. The documentary "The Facts of Life" presents a tour of overpopulated regions in both the developed and developing world. Los Angeles, once the city of citrus groves, is now a city of too many cars, too many people, stifling smog and not enough water. Its air quality is expected to violate federal standards for 20 more years. In a Sub-Saharan African village, a couple has 10 children. In such villages, children help families survive. Women in Ghana have an average of 6 children each. In Bangladesh women still have an average of 4 children each, despite the successes of Concerned Women for Family Planning, a group that has trained 30,000 health care workers for that country. Mexico City has run out of water. It has one of the lowest birth rates in the developing world--3 children per woman--yet thousands of people live in garbage dumps. 93 million people are added to the world's population each year. At the present rate of growth, the world total of about 5.6 billion is expected to double by the year 2035. The UN conference centers on a document that delineates how to curb population growth: give women and men access to contraceptives and good health care; educate girls so they will delay childbearing and so they will be able to provide for their children; and shore up the environment so people can support their families. Muslim interests have joined the Vatican in condemning the language that asserts women's rights to regulate their fertility and to terminate pregnancy. Nonetheless, Indonesia's family planning success story was accomplished with the support of the Muslim leaders. The media, a new and modern force, may erode ecclesiastical authority, as evidenced by CNN's examination of the population crisis to help find answers.
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  12. 12
    Peer Reviewed

    External assistance to the health sector in developing countries: a detailed analysis, 1972-90.

    Michaud C; Murray CJ


    The examination of the external assistance to the health sector quantified the sources and recipients of such assistance in 1990 by analyzing time trends for external assistance to the health sector over the preceding two decades, and, by describing the allocation of resources to specific activities in the health sector. The health sector external assistance data were collected through a questionnaire and follow-up visits to all major bilaterals, multilaterals, and large nongovernmental (NGO) agencies. The three major databases on development assistance were also used: the Organization for Economic Cooperation and Development (OECD) Development Assistance Committee (DAC) annual tables, the Creditor Reporting System (CRS) from OECD, and the Register of Development Activities of the United Nations system. From 1972 to 1980, there was a sustained increase in external assistance by 14% per year. Beginning in 1986, the pace of increase was lower than in the 1970s but had averaged 7% per year in both bilateral and multilateral agencies. In 1990 in developing countries, health external assistance totaled $4800 million, or only 2.9% of total health expenditures in developing countries. 82% of this sum originated from public coffers in developed countries and 18% from private households. Resources to the health sectors of developing countries included: 40% through bilateral development agencies, 33% through United Nations agencies, and 8% through the World Bank and banks such as the Asian Development Bank. Nongovernmental Organizations (NGOs) accounted for 17%, and 1.5% came from foundations. The USA accounted for 27.5% of all assistance, France for 12.9%, and Japan for 11.5%. One quarter of all health sector assistance was paid for by Sweden, Italy, Germany, and the United Kingdom. The study confirms prior findings that health status variables per se are not related to the amount of aid received. Comparing investments to the burden of disease shows tremendous differences in the funding for different health problems. A number of conditions are comparatively underfinanced, particularly noncommunicable diseases and injuries.
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  13. 13

    [Plan International Guatemala] Plan Internacional Guatemala.

    Castillo E

    HABLEMOS DE VITAMIN A. 1994 Aug-Nov; 3(2):5.

    Plan International is a nonsectarian, nonprofit international organization that provides assistance to needy children, their families, and their communities through ninety-eight local offices in twenty-seven developing countries. Donors from Australia, Belgium, Canada, Germany, Holland, Japan, the United Kingdom, and the United States sponsor children in the countries. Communication between the child and the sponsor is a vital element of Plan International. Sponsored children always remain with their families, which are fortified by health, educational, community development, and income-generating programs. Plan projects are designed to assure community participation, long-term sustainability, and tangible results. Plan International is a consulting member of UNICEF and is recognized by UNESCO. Plan International was created in 1937 to provide food, housing, and educational services to children victimized by the Spanish Civil War. During World War II the program provided assistance in England to expatriate children from throughout Europe. After the war, the organization extended its assistance to children in several other European countries and for a short time to Poland, Czechoslovakia, and China. As Europe recovered from the war, Plan International gradually withdrew from these countries and began new programs in developing countries. In Guatemala, Plan International began work in Amatitlan in 1979 and in Villa Nueva in 1990. It promotes measures to prevent diarrhea, respiratory disorders, and nutritional problems, and to encourage growth monitoring and vitamin A supplementation. The Child Survival Project provides vitamin A to children under five in educational visits made twice yearly through the community health committees, with participation of health volunteers and promoters and Ministry of Health and Social Security Institute personnel. Home visits are made to provide health information, Mebendozole, ferrous sulfate, and vitamin A.
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  14. 14

    [And after Cairo? It is now that the difficulties begin] Le Caire, et apres? C'est maintenant que les difficultes commencent.

    Speidel J


    The international community and the UN should be congratulated for adopting a strategy and a very clear action plan at the International Conference on Population and Development in Cairo. The process leading up to and during the conference allowed all member nations, even the most conservative members, to communicate their interest in problems associated with population and development and their approaches to solving the problems. The members reached consensus and adopted the program of action. Conference delegates finalized the program of action by concentrating on a global vision of population policy. They recognized the need for unrestricted access to high quality family planning services and the right of women. The document calls for improved reproductive health in developing countries. Specifically, it pronounces the need for improved sanitary conditions during childbirth, access to safe abortion where it is legal, and successive steps to reduce sexually transmitted diseases, including AIDS. Implementation of the program of action poses some difficulties, however. Will the most developed countries provide the necessary financial resources to meet the needs of family planning and reproductive health? Many such countries have promised to contribute US$ 17 billion to meet these needs in developing countries. The US plans to contribute US$ 600 million in 1995. Japan will contribute US$ 3 billion over the next 7 years, 33% of which will go to family planning. Germany plans to give US$ 2 billion over the same period. The European Union plans to give US$ 400 million each year. Other countries also plan to contribute (UK and Belgium). We must make sure that the words adopted in Cairo become reality for the men and women of the planet.
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  15. 15

    Population, environment and development.

    Karkal M

    HEALTH FOR THE MILLIONS. 1994 Jun; 2(3):8-10.

    Western development models label subsistence economies, which do not participate in the market economy on a grand scale and do not consume commodities produced for and distributed through the market, to be poor. Yet, subsistence does not always indicate a low quality of life. The Western development process has destroyed wholesome and sustainable lifestyles. In India, the Green Revolution caused many small farmers to lose their land. In comparison to traditional economies, industrial economies have longer technological chains dependent on higher energy and resource inputs and exclude large numbers of people without power to buy goods. Further, they generate new and artificial needs, necessitating increased production of industrial goods and services. They erode resource bases for survival. This erosion is marginalizing people who were traditionally in nature's economy. Developed countries did not deliver 0.15% of their GNP to development projects in developing countries as promised. The US made population growth in these countries its cause. The UN and other multinational agencies during 1962-1972, at the US's request, began to support population and family planning programs in developing countries. These countries opposed the 1st draft at the 1974 Bucharest Population Conference, but by the conference in Mexico City, most supported the need for family planning. Yet, the US politicized this conference and had a greater say in the recommendations than did developing countries. Structural adjustments and external debt repayments required of developing countries in the 1980s set them back. In fact, the number of developing countries increased from 31 to 42. The UN recognizes the right to development, but social inequalities are barriers to this right. If environmental degradation continues, poverty will only increase. Women's groups are playing a great role in preparations for the International Conference on Population and Development in Cairo in September 1994.
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  16. 16

    From comparison to choices. The voice of the voiceless.

    Geary J

    ORGYN. 1994; (4):10-3.

    The International Planned Parenthood Federation [IPPF] was established in 1952. It promotes and supports family planning services in more than 130 countries worldwide. It also educates people and governments about the benefits of family planning. IPPF's Assistant Secretary General, Dr. Pramilla Senanayake, will be chairing the FIGO symposium entitled From Comparison to Choices. An advantage of her chairing the symposium is that, being a pediatrician, she approaches family planning from the child's point of view, while obstetrician/gynecologists approach it from the woman's point of view. Contraceptive choice is very important since no method is ideal for all couples and one's contraceptive needs change at each life stage. New contraceptive methods and improved service delivery of both existing and new methods are essential to bring effective contraceptives to everyone who needs them. The newer oral contraceptives (OCs) provide better cycle control and efficacy and fewer side effects than the most recent older OCs. Breast feeding women need a contraceptive 4-6 months after childbirth and one that does not decrease lactation. No current contraceptive fits the lifestyle of female teens because they have intercourse irregularly and are most in need of contraception. No really effective reversible method exists for men. Family planning methods are crucial to women and children's health and to achieving zero population growth. They are essential to avert environmental catastrophe, since population growth is straining natural and social resources. IPPF is a pioneer in targeting marginalized populations (refugees, males, migrants, and adolescents). IPPF serves as an advisor to local staff and volunteers who know the problems and needs of their own people, so they develop programs that are culturally sensitive and culture-specific. People in the US consume 15 times more natural resources than do Indians. Family planning is a way to prevent war, famine, and disease.
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  17. 17

    A bill of health for the IUD: where do we go from here?

    Chi IC

    ADVANCES IN CONTRACEPTION. 1994 Jun; 10(2):121-31.

    The World Health Organization's prospective IUD study at 47 centers in 23 (mostly developing) countries among 22,908 women found an elevated IUD-related risk of pelvic inflammatory disease (PID) during the 1st 20 days after IUD insertion. It also showed that the likely major determinant of PID among IUD users is the risk of exposure to sexually transmitted diseases (STDs). Long-term IUD use is related to a uniformly low PID risk. These findings support measures already practiced by most service providers: aseptic conditions and techniques during IUD insertion, close monitoring of women for signs of infection during the early stage of IUD use, IUDs not recommended for women at risk of STDs, use of long-lasting IUDs, and removal before the end of the IUD's life span. Additional research is recommended to strengthen the validity of the findings, to further reduce IUD-related PID incidence, and to expand indications for IUD use. Cohort IUD studies should ascertain women's sexual behavior at baseline and during the study period. Other cohort studies should examine the natural history of IUD insertion-related PID. Clinical trials should examine the protective effects of antibiotics administered during IUD insertion against PID. IUD use in nulliparous and nulligravid women should be studied. Studies should clarify the link between IUD use and nongonorrheal infections (chlamydial infection, HIV infection, and actinomycosis). Research is needed to examine IUDs that claim to protect against PID (e.g., levonorgestrel-releasing IUDs). After family planning researchers clear IUD use from its alleged association with PID and its sequelae, they can advance to studies on how to improve the quality of life of IUD users (e.g., reducing distressing symptoms such as bleeding) and to increase access to IUDs by removing the programmatic and medical barriers.
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  18. 18

    Global burden sharing.

    Brundtland GX

    INTEGRATION. 1994 Jun; (40):11-3.

    The Prime Minister of Norway discusses issues of population growth and sustainable development. Months before the 1994 International Conference on Population and Development, she establishes the basis upon which a global compact on population and development can be built. Individuals and groups in developed countries increasingly implore people in developing countries to reduce their levels of fertility in the interest of environmental protection and sustainable development. People in developing countries, however, point out that the industrialized developed countries have a disproportionately large role in polluting the environment. Fertility declines, lower consumption levels in the North, and less waste are all needed to safeguard the long-term health and survivability of the planet. The world simply cannot sustain a Western level of consumption for all. Accordingly, a commitment by the South to reduce population growth should be coupled with an equal commitment from the North to reduce the strain of consumption and production patterns on the global environment. Individual attitudes and habits must change while internationally coordinated political decisions are also made about the course and content of the world economy. Norway hosted a meeting January 1994 to address changing consumption patterns in hopes of launching a qualitatively new debate on sustainable consumption in the North and to demonstrate to the South that we are serious about our responsibility. As we move ahead, the author stresses the need to recognize the importance of providing education to both men and women, and paying the bill for necessary global reforms.
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  19. 19

    Donors promise increased support for population, reproductive health.

    ICPD 94. 1994 Aug; (18):3.

    Increased support is needed from the international community to implement the actions proposed in the 1994 International Conference on Population and Development (ICPD) program of action. Some countries have already indicated their willingness and plans to provide additional funds for population-related programs. For example, the Group of Seven major industrial nations strongly endorsed the ICPD at their July 8-9 summit in Naples. The group called on the World Bank and regional development banks to reinforce private capital flows to developing countries while providing growing resources for health, education, family policies, and environmental protection. The summit in 1995 will focus specifically upon the challenge of providing sustainable development and prosperity for the world's peoples and nations. Most striking, however, is the European Union pledge to increase by fifteen-fold the amount of aid it already gives for population-related development activities in developing countries. Its contribution will total a pledged $347 million/year by the year 2000, with an increased percentage going to sub-Saharan Africa.
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  20. 20

    [The World Conferences on Population] Les Conferences mondiales sur la population.

    Tabah L

    Population et Societes. 1994 May; (290):1-3.

    The first international population conference was organized in 1927 by the League of Nations, and led to creation of the International Union for the Scientific Study of Population. At the time, the concept of family planning as an exercise of individual freedom was controversial in countries such as France which were intent on raising their low birth rates. After the war, the UN created a Population Commission and a Population Division for demographic study. The first director general of UNESCO, Julian Huxley, recommended that each country develop a population policy to be integrated into a world policy. His proposed World Population Conference finally was held in Rome in 1954. It was a conference of experts, not of government representatives, but the debates were as much political and ideological as scientific. The concept of population explosion was at the time replacing the notion of overpopulation. In 1962, Sweden announced that it would include family planning in the population programs it financed. The willingness of the UN to respond to all requests for population and family planning assistance was announced at the 1965 World Population Conference in Belgrade. The idea that rapid population growth had negative effects on economic development was becoming prominent. In December 1966, twelve heads of government signed a Population Declaration affirming the right of couples to knowledge and means of family planning. The UN Fund for Population Activities was created; its annual budget has grown from $5 million in 1969 to $240 million at present. The 1974 World Population Conference at Bucharest was a meeting of governments and not of experts. The Plan of Action finally adopted declared demographic variables to be dependent on development and social justice. Fertility regulation was related to family welfare and contraception to maternal and child health, female education, and regulation of age at marriage. The Bucharest Conference legitimized the concept of population policies. By the 1994 World Population Conference in Mexico City, a deceleration of demographic growth was occurring in many countries due to the combined effects of economic progress and family planning programs. The gap between countries better integrated into the world economic system and those especially in sub-Saharan Africa that were failing to achieve integration was widening. The European countries began calling attention to their own population problems of aging, low fertility, and international migration. Abortion was debated but did not appear in the final conference document. The eighty-eight recommendations were adopted by acclamation. The upcoming 1994 Cairo Conference, like the Bucharest and Mexico City conferences, was preceded by expert meetings and regional conferences. The proposed World Population Plan of Action is more elaborate than its predecessors, and the range of problems to be addressed is daunting. The Cairo Conference will have been useful if it advances international cooperation even slightly.
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  21. 21

    Should we re-invent WHO, or bury it?

    Nyakunu T


    By restructuring the World Health Organization (WHO) and instituting some basic changes in policy priorities, the effectiveness of the organization would be increased. Instead of assigning resources to combating the health-related issues of individual choice which exist in rich nations, such as wearing seat belts, smoking, or consuming alcohol, WHO should concentrate its funding on developing countries which continue to suffer from preventable diseases like cholera, typhoid, and malaria. Providing public health assistance to third-world countries was the original mission of WHO, but the organization was given great flexibility when it was set-up. Therefore, while WHO dollars address such issues as the medical effects of nuclear war or developing essential drug lists for circumpolar regions, people in developing nations die from preventable communicable diseases. Like other large bureaucracies, WHO is mired in a cycle of "talk, talk, talk," instead of simply tackling the problems which are pressing and evident. The resources devoted to endless meetings, conventions, and coordinating sessions prove that talk is no longer cheap, and WHO must respond positively to the demands of its poorer member states that it reorient its efforts to help those who really need help. WHO's scarce resources can no longer be stretched to fund "fashionable" issues in countries which have already achieved a longer life span and better health than is possible for citizens of African nations. By abolishing its European office and programs, WHO could increase the country budget for Africa by two-thirds. Proper use of its 1994-95 budget of approximately US $1.8 billion would go a long way towards fulfilling the goal of vaccinating every child in the world against the major childhood diseases. Instead of continuing to help those who can help themselves, WHO should direct its efforts to saving lives in the Third World.
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