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  1. 1

    The darker side of choice. Newspaper report.

    Geloo Z

    In: Report on International Public Hearing on Crimes Against Women Related to Population Policies, Cairo, Egypt, September, 1994, organised by: UBINIG and Asian Women Human Rights Council [AWHRC]. Manila, Philippines, AWHRC, 1994. 36-7.

    The story is told of a government family planning worker who persuaded a Bangladeshi woman in 1988 to accept sterilization in exchange for coupons for rice and wheat and money to build a small house. The woman has since been rejected by her husband and in-laws, is often sick, has no strength to work, and never received her coupons for rice and wheat. This woman testified, along with many others, at the Nongovernmental Organization (NGO) Forum public hearing on crimes against women related to population policies. The jury consisted of women from the Asian Women's Human Rights Council and UBINIG, a Dhaka-based radical feminist group. Women are arguing that the administration of family planning programs violates their inner core. In particular, developing countries with large and growing populations are eager to comply with donors, and will implement aggressive family planning campaigns which fail to respect women's rights to choose.
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  2. 2

    Best laid family plans sometimes go awry. Newspaper report.

    Stackhouse J

    In: Report on International Public Hearing on Crimes Against Women Related to Population Policies, Cairo, Egypt, September, 1994, organised by: UBINIG and Asian Women Human Rights Council [AWHRC]. Manila, Philippines, AWHRC, 1994. 33-4.

    The story is told of a government family planning worker who persuaded a Bangladeshi woman to accept sterilization in exchange for food, housing material, and US$4.50. A conference of nongovernmental organizations (NGOs) was held parallel to the 1994 International Conference on Population and Development (ICPD) during which participants argued that family planning programs have simply promoted unsafe contraceptive methods for women. The director of UBINIG, a Dhaka-based radical feminist group, argued at the meeting that aid agencies and governments allow women to suffer serious side effects in the name of stabilizing world population growth, while men are asked to do nothing to reduce fertility. Aid donors who support Bangladesh's family planning program counter that acceptance is voluntary and that it has sharply reduced birth rates, while many development agencies argue that contraceptives help millions of women by preventing them from bearing too many children. Many feminist NGOs nonetheless believe that women have little choice against government targets and incentive programs for health care workers. Several instances were cited at the NGO forum of what were described as unsafe contraception measures.
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  3. 3

    Dr Fred Sai speaks out.

    Sai F

    London, England, International Planned Parenthood Federation [IPPF], 1994. 112 p.

    This booklet contains a selection of nine speeches and articles written by Dr. Fred Sai since he assumed the presidency of the International Planned Parenthood Federation (IPPF) in 1989. The first article is an open letter to Pope John Paul II written on World Population Day, July 11, 1991, in which Sai points out that the values of IPPF mirror those of the Catholic Church, suggests that the Church misunderstands the family planning (FP) movement, and calls for the opening of a dialogue with the Church. Article 2 is adapted from Sai's acceptance speech on the occasion of receiving the UN Population Award in 1993. Sai dedicated his prize to the mothers in Africa who persist in trusting in the future despite terrible obstacles. In the third article, Sai describes political, religious, cultural, medical, technical, financial, and quality of service obstacles which hinder FP programs. Article 4 discusses the mother-child dyad as it applies to combatting maternal and neonatal health problems. The fifth article presents an African perspective on what works and what does not work in FP programs. Article 6 sets out the scenario for achieving economic and social development through successful population programs. The seventh article considers whether the Mexico City consensus has been implemented. Article 8 takes a look at politics and ethics in FP, and the last article provides a view from the South on the topic of working with parliamentarians.
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  4. 4

    Challenges from Cairo [editorial]

    Tamburlini G

    KANGAROO. 1994 Dec; 3(2):190-4.

    The Plan of Action approved at the 1994 International Conference on Population and Development seeks to ensure access to reproductive health care services to all couples through a process of female empowerment. However, this goal conflicts with current social and economic policies in many countries as well as with hegemonic international development strategies based on structural adjustment. The full realization of the goals outlined in Cairo and Beijing will depend on the willingness of the international community to ensure the development of broader conceptualizations of human rights as well as the strengthening of community-based initiatives. Critical will be implementation of a multisectoral approach and coordinated networking at the peripheral level. Channels to express needs and demands must be developed in countries burdened with cultural obstacles or disrupted by political strife. If health care systems are to achieve targeted improvements in maternal mortality, they must both demonstrate an interest in mothers as women with needs of their own and seek to involve men in reproductive health decisions. Although the development of a broader range of contraceptive options remains critical, the most important reproductive technology issue concerns improvements in the quality of the user-provider interaction.
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  5. 5

    Time for a new agenda. Looking to Cairo.

    Germain A

    POPULI. 1994 Jul-Aug; 21(7):4-6.

    An agenda for significant change is proposed for the International Conference on Population and Development (ICPD). Current progress toward the agenda is viewed as insufficient unless there are resource reallocations, political will, vision, and the adoption of the agenda at the ICPD. The ICPD goals also should be accepted by the World Summit for Social Development and by the Fourth World Conference on Women in 1995 in order to achieve human security and development. Population agencies must 1) increase investments in health, education, water, sanitation, housing, and social services; 2) enact and enforce legislation empowering women in sexual, social, and political ways; 3) provide credit, training, and income development so women can have decent lives; 4) involve women's advocates at all levels of decision making; and 5) eliminate the gender gap in education, prevent violence against girls, and eliminate sex role stereotypes. The literature in the population field has neglected sexuality, gender roles, and relations and has concentrated on unwanted pregnancy, sexually transmitted diseases, and contraceptive efficacy. Many family planning (FP) programs reinforce gender roles. Improvement in the quality of services must be a top priority for FP programs. Quality of care is conceptualized differently by FP providers and women's health advocates. Basic program management and logistics systems could be changed with modest investments in staff motivation and revised allocations of human and financial resources. Clients must be treated with dignity and respect. Programs should not concentrate on married, fertile women to the neglect of adolescents and other sexually active women. Preventive health should include those sexually active beyond the reproductive age. Men's responsibility in FP is viewed as fashionable but problematic in terms of actual program change.
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  6. 6

    The paradox of progress [editorial]

    Ketting E


    During the last 25 years, the number of people, worldwide, seeking family planning services has increased. Due to the efforts of national governments, international donor agencies, and volunteer organizations, more of these people are able to fulfill their needs. Between the early 1960s and 1990, in developing countries, the percentage of couples practicing family planning rose from 10% to more than 50%. However, research indicates that there is still a large need for information and services among clients. This need will increase if international efforts are not intensified. Global spending on family programs will have to double; international donor aid will have to quadruple; and the percentage of development aid spent on population activities will have to increase from 1% to 4%. Since the rate of acceptance of family planning has been faster than the rate of expansion of services, a paradox of increasing success and growing need has occurred. A concerted international effort is required to remedy this situation. Providing more services is insufficient; quality services that are acceptable to clients, particularly women, are needed, as are programs designed for marginalized populations (refugees, and persons living in occupied territories, remote rural areas, or poor conditions).
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  7. 7

    Not high cost, only cost effective.

    FAMILY PLANNING NEWS. 1994; 10(2):2.

    The World Bank is currently one of the world's largest financiers of family planning and reproductive health services with education and family planning figuring as two cornerstones of the organization's action plan on population. It directs approximately $200 million annually to family planning programs and $2 billion to those in education. Budgets for family planning are slated to increase by 50% over the next two years. The bank currently supervises more than 80 projects in 59 countries, at a cost of $1.3 billion. $17 billion has been estimated in the draft program of the 1994 International Conference on Population and Development as required to hold world population at 7.8 billion by the year 2000. Contradicting naysayers, the president of the World Bank, Lewis T. Preston, argues that neither the goal nor the ability to appropriate the requisite funds is a pipe dream. Much of the money required can be generated by redirecting resources toward priorities and ensuring that they are used efficiently. Approximately $5 billion per year is spent on family planning in developing countries, less than 5% of military expenditures. A basic preventive healthcare package including maternal and child care services can be provided at an annual cost of about $8/person in the poorest countries, while providing education to girls at the same rate as to boys would cost just under $1 billion, 2% of annual education spending by the developing world.
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  8. 8

    Despite moral dilemmas at the heart of the ICPD, "consensus" is achieved.

    FAMILY PLANNING NEWS. 1994; 10(2):5.

    Prime Minister Benazir Bhutto of Pakistan, while noting her desire for all pregnancies to one day be planned and all children loved, publicly rejected abortion at the 1994 UN International Conference on Population and Development as a method of family planning. She stressed that serious flaws exist in the draft program of action and reaffirmed the Islamic principle of the sanctity of life and the emphasis of the family unit. Pakistan will be guided in its policies by the laws of Islam even though family planning is now being encouraged in the country. Norway's Prime Minister Gro Brundtland, a practicing doctor for 10 years, however, was more realistic on abortion. Women abort unwanted fetuses the world over through whatever means available and regardless of the legality of the procedure. Antiabortion legislation makes many of these abortions highly unsafe for the pregnant women. Prime Minister Brundtland called upon the leaders of all countries to provide legal and safe abortion services to women in need. After abortion became legal in Norway, the number of abortions remained the same and the country now has one of the lowest such rates in the world. Contrary to the claims of conservative and uninformed detractors in some countries, sex education does not promote promiscuity, but helps reduce levels of fertility. Brundtland pointed to the successes of programs in Thailand, Indonesia, and Italy as evidence. In Norway, sex education also promotes responsible sexual behavior and even abstinence. Finally, Prime Minister Brundtland encouraged governments to allocate much more of their budgets to family planning programs. Norway in 1991 allocated 4.55% of its official development assistance to family planning, the only country to surpass the 4% level in this area.
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  9. 9

    Expanding family planning options through the systematic introduction and appropriate management of contraceptive methods.

    In: Challenges in reproductive health research: biennial report 1992-1993, edited by J. Khanna, P.F.A. Van Look, P.D. Griffin. Geneva, Switzerland, World Health Organization [WHO], Special Programme of Research, Development and Research Training in Human Reproduction, 1994. 151-60.

    The UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction over 1992-93 continued researching the introduction of new and underused methods of fertility regulation into family planning programs with the goal of helping governments expand the selection of available contraceptive options. The program first researched introducing the once-a-month injectable contraceptive, Cyclofem, in several developing countries based upon the introduction of Norplant. This study led to a new introduction strategy based on the realization that product-specific approaches do not necessarily help family planning programs assess the ability of the service system to provide new methods with the appropriate quality of care under routine conditions. The new three-stage strategy implemented at the country level is described. It is designed to assist decision making by focusing upon users' needs for fertility regulation methods and the capability of services to provide these methods with appropriate quality of care, addressing the interfaces between use, the service delivery system, and technology. The three stages are as follows: assessment of user needs and service delivery needs and capabilities, service delivery and other introductory research, and use of the research findings for decision-making, policy formulation, and strategic planning. Closing sections consider regional centers and technical assistance; information, education, and communication; and product management and the transfer of technology.
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