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Ann Arbor, Michigan, UMI Dissertation Services, 1995. , x, 124 p.The author of this doctoral dissertation states that population control refers to measures undertaken to reduce fertility, which, according to the "population establishment," is currently so high that it endangers planetary survival. A "crisis mentality" exists among advocates of population control, who thus support the use of coercive measures to contain the spectre of overpopulation. Coercion, manifested in the use of targets, incentives, and disincentives, is an inherent part of population control. It is used mainly against women in the Third World; the population establishment defines the "overpopulation problem" in terms of national, racial, class and gender boundaries. Moreover, as the experience of India demonstrates, coercion is ineffective in reducing fertility. Coercion is thus both unethical and ineffective, and must be abandoned. (author's)
Creating common ground in Asia: women's perspectives on the selection and introduction of fertility regulation technologies.
Geneva, Switzerland, World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction, 1994. 45 p.Participants from Bangladesh, India, Indonesia, the Philippines, and other countries with which WHO's Special Programme of Research, Development, and Research Training in Human Reproduction collaborates and in which women's groups are active attended the Asian regional meeting on Women's Perspectives on the Research and Introduction of Fertility Regulation Technologies in February 1991. The meeting aimed to establish a dialogue between women's groups and researchers, policymakers, and family planning service providers. Other objectives included defining women's needs and viewpoints on reproductive health and fertility regulating technologies and identifying appropriate follow-up activities which would form a basis for regional networking. WHO's Special Programme of Research, Development, and Research Training in Human Reproduction published a report of the meeting. The meeting consisted of plenary sessions, group work, and keynote presentations. Presentations addressed women's realities, policy considerations, research, and service provision. Topics concerning women's realities were community attitudes towards fertility and its control, women's autonomy, health status, and family planning services. Presentations on policy considerations covered: taking users into account, objectives of family planning programs, participation in decision making, and men's responsibility. Redefining safety and acceptability as well as research on female barrier methods were addressed during presentations on research. The report presents proposals for action for Bangladesh, India, Indonesia, and the Philippines. Meeting participants reached a consensus on recommendations addressing policy, research, services, and WHO. The report concludes with a list of participants and a list of papers presented.
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.
ADVANCES IN CONTRACEPTION. 1993 Jun; 9(2):129-39.Quality of care means that the needs of the clients should be the major determinant of the behavior of the providers and the goal of the programs. Quality of care can be considered a right of the clients, defining clients not only as those who approach the health care system for services but also as everyone in the community who is in need of services. Any member of the community who is of reproductive age should be considered a potential client for family planning (FP) services. The International Planned Parenthood Federation (IPPF) has outlined 10 rights of FP clients: rights to information, access, choice, safety, privacy, confidentiality, dignity, comfort, continuity, and opinion. Program managers and service providers should achieve fulfillment of the rights of the FP clients. This goal is directly related to the availability and quality of FP information and services. The responsibilities for quality of care are distributed throughout the whole FP program, but those who are actually seen as most responsible are the ones who are in direct contact with the clients; the service providers. The needs of the service providers can be enumerated as a need for training, information, infrastructure, supplies, guidance, back-up, respect, encouragement, feedback and self-expression. The interaction between clients and providers of contraceptive services could be an exchange of knowledge, needs, and experience that contributes to the personal growth of both. Quality of care involves physical, technical, and human aspects. When fulfilling the rights of the clients and needs of the service providers, both technical and human aspects should be taken into account.
London, England, International Planned Parenthood Federation [IPPF], 1992 Sep. 93 p.20 participants from 9 sub-Saharan countries and the UK discuss men's negative attitudes towards family planning (the leading obstacle to the success of family planning in Africa) at the November 1991 Workshop on Male Participation in Family Planning in The Gambia. Family planning programs have targeted women for 20 years, but they are starting to see the men's role in making fertility decisions and in transmitting sexually transmitted diseases (STDs). They are trying to find ways to increase men's involvement in promoting family planning and STD prevention. Some recent research in Africa shows that many men already have a positive attitude towards family planning, but there is poor or no positive communication between husband and wife about fertility and sexuality. Some family planning programs (e.g., those in Sierra Leone, Nigeria, Ethiopia, and Zimbabwe) use information, education, and communication (IEC) activities (e.g., audiovisual material, print media, film, workshops, seminars, and songs) to promote men's sexual responsibility. IEC programs do increase knowledge, but do not necessarily change attitudes and practice. Some research indicates that awareness raising must be followed by counseling and peer promotion efforts to effect attitudinal and behavioral change. The sub-Saharan Africa programs must conduct baseline research on attitudes and a needs assessment to determine how to address men's needs. In Zambia, baseline research reveals that a man having 1 faithful partner for a lifetime is deemed negative. Common effective needs assessment methodologies are focus group discussions and individual interviews. Programs have identified various service delivery strategies to meet these needs. They are integration of family planning promotion efforts via AIDS prevention programs, income-generating schemes, employment-based programs, youth programs and peer counseling, male-to-male community-based distribution of condoms, and social marketing. Few programs have been evaluated, mainly because evaluation is not included in the planning process.
[Unpublished] 1990 Mar 6. vi, 71 p.Men may impede broader use of family planning methods by women in many countries. Efforts have therefore been made to reach men separately in order to promote greater acceptance and use of male or female contraceptive methods. Typically, programs may encourage men to allow partners to use contraception; persuade men to adopt a more active, communicative role in decision making on contraceptive use; and/or promote the use of male methods. This paper presents findings from male involvement program initiatives in 60 developing countries since 1980. Male involvement programs are clearly needed, and condom use should be encouraged for protection against both pregnancy and HIV infection. Given their relatively low cost per couple-year of protection, social marketing programs should be encouraged to promote condom sales. Employment-based programs, despite relatively high start-up costs, have also generated large increases in condom use. Both condom and vasectomy use have been increased through mass media campaigns, yet more campaigns should address AIDS. Clinic services and facilities should be made more attractive to men, and new print materials are warranted. Community-based distribution programs have been found to be great sources of information and supplies, especially in rural areas, and male adolescents are especially in favor of telephone hotlines. Little information exits on the effectiveness and costs of programs targeting organized groups. Further, youth-oriented programs generally reach their intended audiences, but are relatively expensive for the amount of contraceptive protection provided. Finally, a positive image must be promoted for the condom through coordinated media presentations, user and worker doubts of efficacy must be eliminated, and regular condom supplies ensured. Recommendations are included for policy, research, public education, the World Health Organization, national AIDS prevention programs, and family planning agencies.
WORLD HEALTH. 1991 Nov-Dec; 22.The experiences of Romania show that legal decrees will not deter a woman determined to end her pregnancy, and that it is easier to switch from illegal to legal abortion than it is to introduce the practice of modern contraception. On Christmas Day 1989, Romania abrogated a 1966 that banned abortion and all modern contraceptive methods. Through the 1966 law, the former regime had hoped to raise the birth rate, which at the time stood at 15.6/1000. Succeeding briefly, the law ultimately failed to its objective, since by 1985 the birth rate had fallen to the initial 1966 level. If year following the abrogation of the decree, 992,265 abortions were carried out, 92% of them legally. The number of abortions is expected to top 1 million in 1991. Maternal death due to abortion has fallen by more than 60%. Romania has also witnessed the establishment of the Society for Education in Contraception, a private family planning association. UN and donor assistance has begun to arrive in Romania. 20,000 women attended family planning clinics in 1990, a figure that increased to nearly 50,000 in 1991. Nonetheless, the case of Romania illustrates the complexities involved in introducing the practice of modern contraception. In addition to commitment from national authorities, setting up a program of modern contraception will require the following: convincing physicians and clients as to the superiority of contraception over abortion; ensuring the training of health professionals; developing public information programs; creating acceptable conditions for women to seek services; and making contraceptives available and affordable. In order to facilitate the transition from abortion to contraception, UNFPA and the WHO have initiated an emergency family planning program.
INTEGRATION. 1991 Sep; (29):4-5.The work of the Soviet Family Health Association (SFHA) is described. Created in January, 1989, the organization boasts 25 state-paid workers, and as of June 1991, membership of 15,000 corporate and individual members. Individual annual membership fee is 5 rubles, and entitles members to counseling and family planning (FP) services. The SFHA works in cooperation with the Commission on Family Planning Problems of the USSR's Academy of Sciences, and has been a member of the International Planned Parenthood Federation (IPPF) since 1990. Association activities include lectures for students, newly-weds, adolescents, and working women on modern contraceptive methods; research on attitude regarding sex, sex behaviors, and the perceived need for effective contraception; clinical trials of contraceptive suitability for women; and the training of doctors in FP and contraceptives. Problems central to the SFHA's operations include insufficient service and examination equipment, a shortage of hard currency, and the small number of FP specialists in the country. Solutions to these obstacles are sought through collaboration with the government, non-governmental organizations in the Soviet Union, and international groups. The SFHA has a series of activities planned for 1991 designed to foster wider acceptance of FP. Increased FP services at industrial enterprises, establishing more FP centers throughout the Soviet Union, and studying FP programs in other countries are among Association targets for the year. Research on and promotion of contraceptives has been virtually stagnant since abortion was declared illegal in 1936. Catching up on these lost decades and remaining self-reliant are challenges to the SPHA.
In: Country studies on strategic management in population programmes, edited by Ellen Sattar. Kuala Lumpur, Malaysia, International Council on Management of Population Programmes, 1989 May. 47-53. (Management Contributions to Population Programmes Series Vol. 8)Jordan is a country of 3 million people, with an annual growth rate of 3.5%. 52% of the population is under 15, and the average family consists of 6.7 persons. 65% of the population is urban. Life expectancy is 64 years, and the birth rate is 48/1000 population. The National Population Commission is mandated to advise the government on population matters. Family planning has been integrated with maternal-child health services since 1979, and the government tacitly supports the work of nongovernmental agencies, including the Jordan Family Planning and Protection Association, which was established in 1964 and is funded by the International Planned Parenthood Federation. The Jordan Family Planning and Protection Association carries out contraceptive services through its 8 clinics. In 1984 it implemented an information, education, and communication program with the Johns Hopkins University. The Association, in cooperation with the Margaret Sanger Center of New York, is establishing 3 new clinics in underserved areas. The Association's activities are planned and supervised by an ad hoc coordinating committee, but the staff is mainly voluntary. In 1987 a study was done to discover the attitudes of rural women toward family planning. Most women are opposed to early marriage and think that the ideal family should have between 3 and 5 children. Most of the women preferred the IUD as a contraceptive method and considered their physician as the best available source of information. The women approve of the family planning clinics, but feel that service should be free, and a doctor, preferrably female, should be available.
London, England, International Planned Parenthood Federation [IPPF], 1989. 68 p.The International Planned Parenthood Federation (IPPF) surveyed male involvement projects in 7 Family Planning Associations (FPAs) as a preliminary step for program development. Male involvement was defined as organizational activities aimed at men, with the objective of improving family planning practice of either sex. The 1987-1988 survey, which consisted of interviews of FPA staffers in Ghana and Nigeria, Cyprus, Thailand, 4 Caribbean islands, Mexico, Egypt and Nepal, sought to identify FPA activities directed at men; to examine their relative effectiveness, especially against other priorities of the FPAs; and to develop criteria for future male projects. The study concluded that male involvement activities make up a greater part of FPA programs than generally believed: programs included male-targeted community-based contraceptive distribution (CBD), community centers, education in the workplace, contraceptive social marketing (CSM), youth centers, vasectomy clinics, family life education, distribution of educational materials and promotional events. Male groups proved relatively easy to reach for educational work but the effectiveness of the education was uneven and evaluation largely nonexistent. The debate between encouraging CSM programs by independent marketing organizations or continuing more expensive smaller-scale CBD will need to be resolved. The study recommended greater attention to curriculum design; information, education and communication projects; adolescent counselling and contraceptive services; CSM to promote condom use; education and service delivery to the workplace; and in each of these areas, effective and continuous evaluation. An annex provides detailed country reports with the data for the survey.
POPULATION EDUCATION NEWS. 1987 May; 14(5):6-9.Population education incentives, voluntary action, community participation, and improved program management are 5 family planning areas recently redefined by the government of India. Population education, integrated with the educational system, is important in influencing fertility behavior. The Adult Education program, and the nonformal educational system will be strengthened, with aid from UNFPA. Incentives, which are presently available to government employees, will be increased. Economic incentives, rural development program incentives, and insurance, lottery, and bond incentive schemes are being considered. Voluntary organizations will be encouraged to work in the family welfare sphere, and organized sector units will be urged to provide family welfare services to their employees. Cooperatives, which cover 95% of villages, will be used as a means of educating, motivating, and communicating population control objectives on the local level. Tax incentives will be offered to the corporate sector for providing integrated family welfare services. Community participation, which is crucial to the success of the programs, will be addressed on several levels. Popular committees, youth and women's groups, and medical students will increase community involvement through various means. In addition, political and community leaders will be involved in motivational work, and a village Women's Volunteer Corps is planned. Social marketing of contraceptives, although fairly extensive for the last 15 years, leaves much to be desired in creating a large demand. A marketing board will be created to ensure aggressive marketing, advertising, and promotion, with expansion to include oral contraceptives. Reorganization and reorientation toward modern program management will be undertaken, so that policy, planning, implementation, review, and evaluation are carried out efficiently. At the state, district, and the block level, more effective coordination is the goal, as well as strengthening the District Family Welfare Bureau.
Politics and population. U.S. assistance for international population programs in the Reagan Administration.
[Unpublished] .  p.US support for family planning programs in developing nations has become more and more controversial as the existing consensus on the rationale for these programs has been lost. This article discusses the major issues of the current debate on international family planning assistance and some of the reasons why bipartisan support for the program has eroded in recent years. During the 1960s, 2 factors contributed to the advent of the international family planning movement: the development of modern contraceptive technology in the form of the oral contraceptive (OC) and the IUD, technologies which, it was believed, could be made readily available and used easily, even in the poorest developing countries; and the growing realization that as mortality rates were declining rapidly due to improved health care in developing countries, the rate of population growth was increasing at a pace never before achieved. After some initial reluctance, efforts to stabilize population growth rates came to be accepted as in the US national interest, and by the 1970s both Republican and Democratic administrations and bipartisan congressional coalitions supported regular increases in funding for population programs as part of the foreign aid program. The US, together with several European countries, was instrumental in the development and early support for the UN Fund for Population Activities and the nongovernmental International Planned Parenthood Federation. In general, US support for international population programs was not a controversial issue in foreign aid debates until last year. Since President Reagan took office in January 1981, both the advocates and opponents of population programs have become more active and organized. Foreign aid in general and international family planning programs in particular are a favorite target for conservative groups, which include several antiabortion groups. Consequently, early in the Reagan administration efforts were made to slash the foreign aid budget. These efforts went so far as to propose eliminating all funding for international family planning programs. These efforts failed, and the US maintained its position as preeminent donor for family planning until 1984. In its final version, the US policy paper for the 1984 Mexico City Conference made 2 important revisions regarding US international population policy: the explanation of population growth as a "neutral phenomenon," caused by counterproductive, statist economic policies in poor countries, for which the suggested remedy is free market economic reform; and the assertion that the US does not consider abortion an acceptable element of family planning programs and will not contribute to nongovernmental organizations that perform or actively promote abortion as a family planning method in other nations. How this controversy over US International population policy is resolved depends largely on how Congress defines the issue.
London, England, Bodley Head, 1984. 286 p.This biography of the British family planning pioneer Helena Wright, who lived from 1887-1981, is based on her books, letters, and papers and on a series of personal interviews, as well as on the recollections and writings of her friends, colleagues, and critics. Considerable attention was given to her background and early life because of their strong influence on her later works and attitudes. Wright was the only physician among the small group of women who founded the British Family Planning Association, and was a founder and officeholder of the International Planned Parenthood Federation. She helped gain acceptance of the principle of contraception from the Anglican clergy and the medical establishment, and was an early worker in the field of sex education and sex therapy. Among Wright's books were works on sexual function in marriage, sex education for young people, contraceptive methods for lay persons and for medical practitioners, and sexual behavior and social mores. This biography also contains extensive material on the history of contraception and of the birth control movement, including the development of the British Family Planning Association and the International Planned Parenthood Federation, as well as important early figures in the movement.
Washington, D.C., Heritage Foundation, 1984 Aug 27. 16 p. (Backgrounder No. 376)The United Nations' 2nd World Population Conference (Mexico City, 1984) called for greatly expanding funding for family planning assistance worldwide. The United Nations Fund for Population Activities (UNFPA), the conference's chief sponsor, will no doubt receive the largest portion of any assistance increase. UNFPA plays a critical role in population-related programs worldwide. The central debate on population policy should be over the extent and adequacy of the natural resources base and how countries can humanely and voluntarily change family size preferences. In countries like Singapore and South Korea, success has been achieved by combining social and economic incentives to discourage large families. Although couples in developing countries report wanting contraceptive service programs, they also want families of 4 to 6 children. So far UNFPA has been ineffective in changing the population situation. This overview of its activities reveals that UNFPA loses ultimate reponsibility for implementation of many of its own programs. UNFPA does not advocate a reduction in population growth within a single country, but rather helps couples have the number of children they desire. UNFPA's specific population and family programs are divided into functional areas: basic data collection, population change study, formulation and implementation of population policies, support for family planning/maternal child health programs and educational and communication programs. UNFPA stresses the importance of using contraceptives but not of achieving the small family norm. UNFPA's projects in some of the largest less developed nations are described, illustrating how the UN agency spends its assistance funds. From 1971 to 1982, the UNFPA spent almost US $230 million in the 10 largest less developed countries without any significant change in population growth. UNFPA program administrators are far from resolving the serious population problems facing developing countries and generally oblivious to new directions in which population policies should move. No progress will be made until UNFPA recognizes the need to approach the problem from a different perspective, working to change attitudes toward small families.
London, England, IPPF, 1984 Feb. 20 p.The promotion of "Male Responsibility for and Practice of Family Planning" was established as a federation-wide Action Area in the IPPF 1982-84 Plan in response to recongizing the need for positive male involvement in family planning programs. Specific identified goals for this action area include the development of programs to educate men about family planning, the need to motivate them to use contraception, and changing the attitudes of male opinion leaders. Implementing the plan and promoting effective male involvement programs are in progress. The Secratariat is undertaking activities to identify Federation and regional strategies and directions and to develop support activities. Program Committee discussion and examination of the issue with subsequent publications are examples of Secretariat involvements. An International Staff Consultation on Male Involvement was held at the IPPF International Office in 1983 to review progress in developing male programs in IPPF; to analyze issues and problems in IPPF programs with regard to men's needs; to examine strategies for increasing male involvement in family planning and to formulate guidelines for program development; and to develop short and longer-term action plans to strengthen male programs within the Federation. The Consultation maded valuable contribution by identifying specific historical, economica, socio-cultural, legal, policy and technological perspectives on male involvement in family planning, as well as providing background papers presented by each participant. Working groups identified and developed a "Strategy for Action of Male Involvement in Family Planning" for the IPPF on 3 strategic levels: policy-makers, service providers and the community. Additionally, Consultation members reviewed audio-visual materials to assess their effectiveness as comunication means. Participants endorsed the need for program review and "strategic planning" by the IPPF. The value in the consultation in examining male programs and in promoting the exchange of ideas within the Federation was affirmed by both the Secretariat and association reoresentativees.
Sex education and family planning services for adolescents in Latin America: the example of El Camino in Guatemala.
[Unpublished] 1984. ix, 54,  p.This report examines the organizational development of Centro del Adolescente "El Camino," an adolescent multipurpose center which offers sex education and family planning services in Guatemala City. The project is funded by the Pathfinder Fund through a US Agency for International Development (USAID) population grant from 1979 through 1984. Information about the need for adolescent services in Guatemala is summarized, as is the organizational history of El Camino and the characteristics of youngg people who came there, as well as other program models and philosophies of sex education in Guatemala City. Centro del Adolescente "El Camino" represents the efforts of a private family planning organization to develop a balanced approach to serving adolescents: providing effective education and contraceptives but also recognizing that Guatemalan teenagers have other equally pressing needs, including counseling, health care, recreation and vocational training. The major administrative issue faced by El Camino was the concern of its external funding sources that an adolescent multipurpose center was too expensive a mechanism for contraceptive distribution purposes. A series of institutional relationships was negotiated. Professionals, university students, and younger secondary students were involved. Issues of fiscal accountability, or the cost-effectiveness of such multipurpose adolescent centers, require consideration of the goals of international funding agencies in relation to those of the society in question. Recommendations depend on whether the goal is that of a short-term contraception distribution program with specific measurable objectives, or that of a long-range investment in changing a society's attitudes about sex education for children and youth and the and the provision of appropriate contraceptive services to sexually active adolescents. Appendixes are attached. (author's modified)
World population and the United States: the development of an idea, statement made at the United States in the World International Conference, Washington, D.C. 28 September 1976.
New York, N.Y., UNFPA, . 20 p.A history of United States attitudes toward population problems is presented. In 1954, it seemed that the UN and its agencies were precluded from involvement in population action programs. In the US, the battles of Margaret Sanger and Abraham Stone were still fresh in the memory. The forces that would change this situation were already at work. American demographers, economists and campaigners articulated them. At the World Population Conference that year papers presented by Americans were crucial. Abraham Stone presented a paper on new developments in contraception. It has been feared that any discussion of contraception at the Conference could prevent its success. By the early 1950s, anxiety had grown that the prophecies of Thomas Malthus were about to be realized. In some Asian countries, notably India, death rates combined with high birth rates had caused some concern for years. Biologists, economists, agriculturists, and sociologists were also concerned with the quality of life in the US. During the 50s, the considerable resources of the US research and development began to turn toward improvements in contraceptive methods. By the end of the decade, a viable contraceptive pill had been developed and tested, and the earliest IUD had been considerably improved. At the same time, means of improving the delivery of contraceptive services were sought. Marketing and promotion were applied to family planning campaigns. In 1965-66, the US government finally turned around on the population issue. A firmly established action program within the UN system did not end the controversy over the place of population in development. The women's movement in this country has coincided with heightened consciousness in the international community of the importance of women as agents rather than mere recipients.
[Unpublished] July, 1979. 49 p.This study assesses the effectiveness of family planning education in the Republic of Korea over the past 2 decades. Target populations in various metropolitan areas were studied regarding attitudes toward family planning knowledge, contraceptive behavior, media and personal contacts on family planning, number and gender preferences, and spacing preferences. Socioeconomic and demographic factors were taken into account. Statistics were compiled by area and analyses are presented. Use of more mass media is suggested to get information on family planning across to more people. It is important to extend the range and quality of family planning services, most especially to provide the best information about contraceptive methods.
London, IPPF, 1981 Aug. 13 p.The International Planned Parenthood Federation (IPPF) 1982-1984 Plan identifies the importance of male involvement in family planning and the problem of male opposition to family planning in many countries. The Plan calls for efforts to encourage men to accept joint responsibility for family planning and the practice of contraception. In most countries family planning programs are orientated towards women, but many family planning associations have some activities directed at men. A number of associations have developed experimental projects aimed at increasing male involvement, and these can be grouped as projects aimed at motivating male leaders, reaching men in the organized sector, promoting male family planning methods, and reaching adolescents. Each of these is reviewed. In identifying ways of increasing male involvement in family planning there are several aspects that Family Planning Associations (FPAs) might want to consider. These concern the current situation and local environment, the views of men, and the resources of the Association. Associations might want to consider the following suggestions for FPA program directions. These are arranged under the following categories: improving overall programming to include men; increasing availability of existing male methods; education program to promote male involvement; and increasing female support for male involvement in family planning. In countries where the concept of family planning is generally accepted, an "across the board" improvement in programs to increase their acceptability to men might result in increased male support for family planning. Although more governments and FPAs have made vasectomy available over the past decade, additional efforts could be made. The 4 principal objectives for education initiatives aimed at "male involvement" are identified. It is important that women educate and help their partners to participate in family planning. Family planning workers could do much to encourage women to involve their partners.
In: Molnos A, ed. Social sciences in family planning. (Proceedings of the Meeting of the IPPF Social Science Working Party, Colombo, Sri Lanka, June 10-13, 1977) London, International Planned Parenthood Federation, 1978 Dec. 43-5.Thailand's first 5-year family planning program for the 1972-1976 period has been acclaimed as 1 of the most successful. New program acceptors exceeded the target by 26.2%. The program's goal of reducing the annual population growth rate from over 3% in 1972 to about 2.5% has been more or less achieved. The National Family Planning Program now has as its objective the recruitment of 3 million new acceptors for the 1977-1981 period. In an effort to achieve the various goals, a series of new methods of service delivery and new contraceptive methods along with a more intensive campaign has been devised. At this stage it is important to learn why people practice family planning, why they use particular programs, why some remain in programs for a long time, and why others drop out. The experience of Thailand's family planning programs indicates that information and motivation from trusted individuals is 1 of the most decisive factors for use of a particular family planning program. Several studies have shown that users and friends can account for up to 50% of the reasons given for using particular family planning programs. The face-to-face form of contact seems to be the most effective means of inducing people to enter a family planning program. A strong desire to avoid pregnancy or another birth appears to be the most important reason for continuing in the program. Studies of women who have dropped out of programs tend to show that side effects of the particular contraceptive method used are the primary reason, with the 2nd most cited cause being the desire for another child.
In: Molnos A, ed. Social sciences in family planning. (Proceedings of the Meeting of the IPPF Social Science Working Party, Colombo, Sri Lanka, June 10-13, 1977) London, International Planned Parenthood Federation, 1978 Dec. 37-42.An approach is outlined which should help to explain some of the implications of family planning in a country like Mexico. Since the new official family planning programs have been introduced, reproductive patterns in Mexico have been changing. In Mexico contraception appears to be advantageous and acceptable in the following cases of existing fmaily structure: 1) urbanized middle-class families of the nuclear type; 2) highly integrated and egalitarian families; 3) families in extreme situations which are highly integrated and egalitarian or are on the verge of disintegrating; 4) families at the advanced or final stage of their procreative cycle; and 5) families who are within a social security system which protects them from the contingencies of life. The following types of families will not spontaneously recognize contraception as being to their advantage: families belonging to the traditional or folk culture which are not yet urbanized; marginal working class families; families of the extended type; families with a strong imbalance between the sexes; families in the initial or middle stages of the procreative cycles; families lacking any institutional social security; and families which function as a unit of economic production. Until this time the direct and indirect effects of contraception on family and community life have not been adequately studied. It is important to study family planning in relation to the family unit. Programs need to be designed with full knowledge of the type of families to which potential clients belong and established accordingly. Programs should distinguish between families at various stages of their procreative cycles and offer them various contraceptive methods.
In: Molnos A, ed. Social sciences in family planning. (Proceedings of the Meeting of the IPPF Social Science Working Party, Colombo, Sri Lanka, June 10-13, 1977). London, International Planned Parenthood Federation, 1978 Dec. 15-21.It is argued that in Pakistan the more children (particularly sons) families have the better the chances that the parents can export them to urban markets and to the middle East for lucrative work, and the better the chances that the extra labor force can handle the family's business of the family so that they can conduct their daily business. In societies like Pakistan the answer to the question as to why people practice or fail to practice family planning needs to be analyzed in the context of kinship structure. The motives, ideologies and exchange relationships are assumed to be derivatives of such systems. Focus is on social and economic factors affecting family planning decisions (education, family income, socioeconomic status, family type, age at marriage, ideal number of children, fate orientation of wife, and egalitarianism), social structural factors affecting family planning decisions, and social and economic exchange factors. In addition to these social and economic considerations the issues of the nature and scope of contraceptive technology itself needs to be considered. The family planning program in Pakistan is a little over 10 years old, and the birthrate of the country has not declined. This fact should not be depressing, for it is the administrative enthusiasm of the planners in the early phase that is partly responsible for the current disappointment. The 10 years has been used to do the ground work. Program planning should consider the type of kinship structure to which potential clients belong, and the programs should be designed to encourage the adoption of a complex package of changes rather than to combat the resistance against contraception.
Johns Hopkins Medical Journal 144(1):18-24. January 1979.The population problem is examined in terms of population policy in the U.S. over the past 25 years, the present status of population control, the future of population control, and the debate on strategy. In 1952 the Population Council was established, and this organization has provided significant leadership in the field ever since. Another milestone was passed in 1958 when Dr. Louis Hellman, then of Kings County Hospital, did battle with the New York City Commissioner of hospitals over his right as a doctor to fit a diabetic patient receiving welfare with a diaphragm. By the mid-1960s worldwide attention was directed to the problem of rapid population growth. Since the early 1970s the World Health Organization has increased its commitment to population. Nationally, the medical community, if not indifferent, has often taken an ultra-conservative view of the delivery of contraceptive services - kinds of personnel to deliver them, responsibilities of medical practitioners for the reproductive health of patients. Much headway has been made in reducing fertility. In the 1965-1975 period there have been declines of 20% or more in the crude birthrate. Declines occurred in such traditionally high-fertility areas as Costa Rica, the Dominican Republic, Panama, Thailand, Tunisia, North Vietnam, and the Indian Punjab. Countries that experienced declines ranging from 15-20% included Egypt, India, the Philippines, Sri Lanka, and Turkey. Yet, in other countries, little has happened to affect fertility even though the social and economic situation continues to deteriorate for the average family. There is no question that in time the effective regulation of fertility will spread around the world; the critical question is that of time. There are encouraging signs indicating that family planning programs can and do accelerate fertility decline. It is necessary to go beyond effective family planning and a rising age at marriage if birthrates are to come within the range of mortality rates.
Unpublished, 1974. 59 pRecommended program strategy for the Ford Foundation in West Africa would concentrate upon delivery of integrated maternal-child health services including nutrition, immunizations, preventive and curative care for mothers and children. As a means of child spacing, family planning would be approved by the population, but population control programs per se at present run counter to West African ideals, and political resistance would probably result. In the context of high West African child mortality rates (e.g. from birth to 15 years a rate of 400-750 deaths per 1000 live births) a small family norm may be undesirable. Maternal-child health services are difficult to implement and little progress has been made in providing any component of maternal/child health or family planning on a nationwide level. Constraints on planning include the lack of preparation of medical and nursing practitioners for health planning, the problem of carrying out and interpreting research and small trials, the lack of a functioning interdisciplinary communications network for practitioners, lack of funds, and lack of appropriately trained manpower. Contraints on the production of action-oriented research are similar to contraints on planning of maternal-child health services. An optimal strategy for the Ford Foundation should cover many facets. Research and training should be developed in phases, and training should be reoriented to provide training within Africa for a critical mass of practitioners who concentrate on applied skills and can work in an interdisciplinary setting. Research should focus on developing a data base, creating tools for health planning, and improving the skills of researchers. Institution building, while necessary, should be undertaken cautiously, with the goal of developing a coordinating mechanism. The activities of the Population Council, USAID, UNFPA, WHO, IDRC, and the Dutch and Belgian governments in the area should be considered in the Ford Foundation's plans. An intensive effort in a limited geographic area is preferable to spreading resources too thinly over the whole region.
Population Bulletin. 1977 Feb; 31(5):1-39.All but 8 percent of the developing world's population now lives in countries which support activities designed explicitly or implicitly to reduce high rates of fertility. This Bulletin describes the indispensable role of planned communication in the rapid expansion of these activities from the emphasis on making contraceptives accessible to those ready to receive them, typical of early family planning programs, to promotion of a full range of "beyond family planning" measures aimed at creating a climate in which small families are viewed as desirable by people everywhere. Current approaches to planned population and family planning communication, as illustrated by numerous country examples, range from the use of field workers, volunteers, midwives and the like, who deliver their messages on a person-to-person basis, to full-scale mass communication campaigns which may employ both traditional folk media and modern advertising and social marketing techniques. Also discussed are population education as a somewhat different approach, not necessarily aimed at reduced fertility, and the recent rapid shift in the U.S. climate for population and family planning communication. (author's)