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Washington, D.C., World Bank, 1989. 55 p. (World Bank Technical Paper No. 102)After a brief explanation of the impact of breastfeeding on fertility worldwide, inaccurate assumptions about the decline of breastfeeding are explored to point out the need for renewed promotion of breastfeeding by World Bank projects. Breastfeeding, by inhibiting fertility through lactational anovulation, is one of the most important determinants of fertility, especially for 83% of couples in developing countries who do not use modern contraception. Many believe that breastfeeding does not need promoting in areas where it is the norm, yet this belief does not take into account the need for supporting breastfeeding women, teaching them to breastfeed exclusively and frequently for the 1st 4 months. The belief that declines in breastfeeding are inevitable is belied by recent evidence in developed countries. The reliability of breastfeeding as a contraceptive for individual women varies: poor, undernourished women who breastfeed extensively may be protected up to 21.7 months (Bangladesh). Advantages of breastfeeding include significant savings of money, foreign exchange, scarce contraceptive supplies, medical treatment of diarrhea and malnutrition in infants, and possibly mothers' time. In contrast, other caregivers can prepare milk substitutes, but breastfeeding can be encouraged in the work setting, or milk expressed for later use. A review of 68 World Bank Projects revealed that 37% of all Population, Health and Nutrition projects, enumerated in an appendix, contained explicit actions to promote breastfeeding. 10 recommendations for promoting breastfeeding end the report.
Populi. 1983; 10(1):78-81.The World Health Organization's (WHO) aim is to achieve a level of health that will allow all the world's citizens to lead a socially and economically productive life by the year 2000. Peter D. O'Neill's book, "Health Crisis 2000," is based on WHO's European regional strategy for attaining "health for all" by the year 2000. Its goal is to enable a large audience to participate in a dialogue on the real issues. An analysis of trends in health and disease, made over the past 3 years by representatives of the medical profession, has produced ominous signs that current health policies have set a dangerous course. If "health for all" is to be realized by the year 2000, it will be necessary to implement a new strategy with 3 inseparable themes, i.e., health as a way of life, the prevention of ill health, and community care for all. While the book analyzes the 1st stage of work which the WHO European Region has drawn up for itself, it interprets the official strategy document and offers ample detail to draw ministers, parliamentarians, industrialists, and the media into the debate. Fakhruddin Iqbal reports that a recent study suggests that the Bangladesh family planning program neglected to consider age old social and cultural values. The study identifies 2 distinct cultural values that present obstacles to the program: the traditional preferences for age old treatment as opposed to modern medical practices and the persistent tradition of relegating women to the lowest rung of mass education; and the traditional family size perceptions of the people. Andrew Hamilton writes that the Jamaica Family Planning Association has employed 7 people to spread knowledge of family life education and family planning among youth. These 18-23 year old youth associates are part of a major national drive to keep Jamaica's population below 3 million by the year 2000. About traditional midwives Jan Steele writes that they deliver between 60-80% of babies in the developing world each year and provide support and care in environments commonly shunned by the medical profession. The IPS reports that according to the 1980 census the population of Brazil is 120 million. If the current demographic trends continue, the population will double by 2014. With the present unemployment level, there will be 41.5 million people underemployed and 15 million unemployed in 2014. Meena Panday writes that Nepal cannot seem to get its population program going. The Population Council reports that no evidence exists as yet that use of the copper bearing or nonmedicated IUD increases the risk of ectopic pregnancy.