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Obstetrics and Gynecology. 2007 Nov; 110(5):999-1002.Family planning plays a pivotal role in population growth, poverty reduction, and human development. Evidence from the United Nations and other governmental and nongovernmental organizations supports this conclusion. Failure to sustain family planning programs, both domestically and abroad, will lead to increased population growth and poorer health worldwide, especially among the poor. However, robust family planning services have a range of benefits, including maternal and infant survival, nutrition, educational attainment, the status of girls and women at home and in society, human immunodeficiency virus (HIV) prevention, and environmental conservation efforts. Family planning is a prerequisite for achievement of the United Nations' Millennium Development Goals and for realizing the human right of reproductive choice. Despite this well-documented need, the U.S. contribution to global family planning has declined in recent years. (author's)
POPULATION AND DEVELOPMENT REVIEW. 1994 Mar; 20(1):239-45.In January 1994, a meeting convened in Tokyo by the government of Japan of 15 experts in the field of population, development, and international cooperation resulted in adoption of a document entitled "Towards a Global Partnership in Population and Development: The Tokyo Declaration." This declaration prefigured the key issues and action recommendations of the September 1994 International Conference on Population and Development (ICPD). The Declaration (presented in this document in its entirety) opens with an introduction which describes the current (and changing) political climate in regard to population issues in which the ICPD will take place. Part 1 of the declaration includes a consideration of the relationship between population and sustainable development, women's role in decision-making and the status of females, reproductive health and family planning (FP), population distribution and migration, and south-south cooperation. The declaration contains specific recommendations for action in each area, with the recommendations addressed to governments, the UN, nongovernmental organizations (NGOs), donors, and the international community. Part 2 stresses a move from commitment to action and strongly recommends that by the year 2015 all governments 1) ensure the completion of the equivalent of primary school by all girls and boys and, as soon as that goal is met, facilitate completion of secondary educational levels; 2) in cases where mortality rates are highest, achieve an infant mortality rate below 50/1000 live births with a corresponding maternal mortality rate of 75/100,000 births; 3) in cases with intermediate levels of mortality, achieve an infant mortality rate below 35/1000, an under age 5 years mortality rate below 45/1000, and a maternal mortality rate below 60/100,000; and 4) provide universal access to a variety of safe and reliable FP methods and appropriate reproductive health services (with safe and effective FP methods available in all country's national FP programs by the year 2000). The international community is further urged to support the goals of the ICPD, and the international donor community is asked to support the participation of NGOs in the ICPD. Part 2 ends with an appeal to the international community to mobilize resources to meet these goals. Finally, the declaration calls upon the international community to stabilize world population and address the interrelated issues, and the participants of the Tokyo meeting pledged their individual support to this effort.
JOICFP NEWS. 1994 Jun; (240):6.In this interview (April 21) with Yoshio Koike, United Nations Population Fund (UNFPA) country director, the population situation in Sierra Leone is described. 4.5 million persons inhabit an area of 74,000 sq. km. Independence was achieved in 1961, but the country was under the patronage of the United Kingdom until April 1992 when a military coup occurred. The new leaders are young (22-29 years) and enthusiastic; a democratic general election will be held in 1996 and the municipal assembly election will occur in 1995. Sierra Leone was the ninth African country receiving aid from UNFPA to establish a population policy (1989). A National Population Commission, which has remained dormant, was also established. The population growth rate is 2.4% annually (average for west African countries); the total fertility rate is 6.8. The maternal mortality rate is estimated to be 1400-1700/100,000 live births. The infant mortality rate (IMR) is about 180; for those under 5 years of age, it is 275. Although the country has 470 clinics available on paper, only 25% are operational according to UNFPA. This is the third year of the MCH/FP project, but only 76 clinics provide family planning information and services. Through coordination of nongovernmental and governmental efforts, 20,000 newcomers and acceptors are being recruited for family planning annually. If expansion continues at this rate and repeaters are maintained for 5 years, the contraceptive prevalence rate (CPR) should reach 20%. Currently, it is 2% in rural areas and 9% in cities. The national average is about 4-6%. The CPR should approach the goal of 60% in 10 years. There is no serious objection to family planning on the basis of religion; however, people are not informed about the importance of birth spacing and about where they can obtain services. Information, education, and communication (IEC) activities are being improved.
Family planning and national development: proceedings of the conference of the International Planned Parenthood Federation, Bandung, 1-7 June 1969.
London, England, International Planned Parenthood Federation [IPPF], 1969. 260 p.Add to my documents.
In: Third Asian and Pacific Population Conference (Colombo, September 1982). Selected papers. Bangkok, Thailand, Economic and Social Commission for Asia and the Pacific, 1984. 9-40. (Asian Population Studies Series No. 58)This report summarizes the recent demographic situation and considers prospective trends and their development implications among the 39 members and associate members of the Economic and Social Commission for Asia and the Pacific (ESCAP). It presents data on the following: size, growth, and distribution of the population; age and sex structure; fertility and marriage; mortality; international migration; growth and poverty; food and nutrition; households and housing; primary health care; education; the working-age population; family planning; the elderly; and population distribution. Despite improvements in the frequency and quality of demographic data collected in recent years, big gaps continue to exist in knowledge of the demographic situation in the ESCAP region. Available evidence suggests that the population growth rate of the ESCAP region declined between 1970 and 1980, as compared with the preceding decade, but that its rate of decline was slow. Within this overall picture, there is wide variation, with the most developed countries having annual growth rates around 1% and some of the least developed countries having a figure near 3%. The main factors associated with the high growth rates are the past high levels of fertility resulting in young age structures and continuing high fertility in some countries, notably in middle south Asia. The population of countries in the ESCAP region is expected to grow from 2.5 billion in 1980, to 2.9 billion in 1990, and to 3.4 billion persons by the year 2000. This massive growth in numbers, which will be most pronounced in Middle South Asia, will occur despite projected continuing moderation in annual population growth rates. Fertility is expected to continue its downward trend, assuming a more widespread and equitable distribution of health, education, and family planning services. Mortality is expected to decline further from its current levels, where life expectancy is often at or around 50 years. In several countries, more than 10 in every 100 babies born die before their 1st birthday. The extension of primary health care services is seen as the key to reducing this figure. Rapid population growth and poverty tend to reinforce each other. Low income, lack of education, and high infant and child mortality contribute to high fertility, which in turn is associated with high rates of natural increase. High rates of natural increase feed back to depress socioeconomic development. High population growth rates and their correlates of young age structures and heavy concentrations of persons in the nonproductive ages tend to depress production and burden government expenditure with high costs for social overhead needs. Rapid population growth emerges as an important factor in the persistence of chronic undernutrition and malnutrition. It increases the magnitude of the task of improving the educational system and exacerbates the problem of substandard housing that is widely prevalent throughout Asia.
WHO Meeting on Maternal and Child Health Indicators for Health for All by 2000: Evaluation of Alternatives, Geneva, 8-12 November 1982.
Geneva, Switzerland, WHO, . 27 p. (WHO/HS/NAT.COM/83.383)The main objectives of the Maternal and Child Health (MCH) and Family Planning (FP) Indicators meeting, held in Geneva from November 8-12, 1982, were to: evaluate and critically review past data collection experiences; systematically review existing and new indicators for the evaluation and monitoring of MCH/FP programs; and to discuss the problems and alternative methods of obtaining the necessary data for indicators. The major part of the meeting was devoted to a review of indicators for assessing the progress of MCH/FP programs at the global, regional, and national levels and the consideration of possible sources of information for obtaining the data upon which to base these indicators. On the basis of this review, the meeting sought to arrive at a consensus on the types of information that might be collected for monitoring and evaluting MCH/FP programs under various health circumstances. Information is presented on the following: the experience of the World Health Organization (WHO) ad hoc surveys on infant and childhood mortality; other data collection experiences (World fertility Survey program, international MCH/FP Program of the Population Council, National Household Survey Capability Program, and a study of levels and trends of infant mortality in Mauritius); MCH/FP indicators (global and regional indicators, factors affecting national indicators, mortality and morbidity indicators, positive health indicators MCH and family planning, and sources of information); and future directions (health modules of household surveys and population censuses, innovative techniques, cluster sampling, record keeping systems, vital registration, training of all health workers, and MCH audit). With regard to the ad hoc surveys on infant and childhood mortality conducted in 5 countries in the early and mid 1970s and other data collection experience, the evaluation background paper found that the surveys were too ambitious. The goals were unclear, and the program was not well planned and managed. The shortcomings of these particular surveys were not intended to reflect on the ability of surveys to serve as important vehicles in development of databases for health planning purposes. The meeting heard from various national project directors who emphasized some of the more positive results of the survey for their country. The work of the WFS was particularly encouraging in showing how surveys can provide a whole set of complex data through household interviews. The meeting recognized the need to address the technical problem of data development, particularly the development of indicators for MCH/FP purposes and suggested several directions for the future. The approaches range from using health supplements and modules to national surveys and population censuses, to innovative approaches in the use of synthetic indirect estimation systems and expanded use of cluster sampling, to increased opportunities for training personnel in various aspects of data collection, use, and management.
New York, UNFPA, 1978 Jun. 53 p. (Report No 3)The present report presents the findings of the Mission which visited Afghanistan from October 3-16, 1977 for the purpose of assessing the country's needs for population assistance. Report focus is on the following: the national setting (geographical, cultural, and administrative features; salient demographic, social, and economic characteristics of the population; and economic development and national planning); basic population data; population dynamics and policy formulation; implementing population policies (family health and family planning and education, communication, and information); and external assistance (multilateral and bilateral). The final section presents the recommendations of the Mission in detail. For the past 25 years Afghanistan has been working to inject new life into its economy. Per capita income, as estimated for 1975, was $U.S. 150, a relatively low figure and heavily skewed in favor of a very small proportion of the population. The country is still predominantly rural (85%) and agricultural (75%). In the absence of reliable data, population figures must be accepted tentatively. According to the 7-year plan, the population in 1975 was 16.7 million and the rate of growth around 2.5% per annum. The crude birth rate is near 50/1000 and the crude death rate possibly 25/1000. The Mission endorses the priority given by the government to the population census and recommends continued support on the part of the United Nations Fund for Population Activities (UNFPA) to help the Central Statistical Office in the present effort and in building up capacity for future work. The Mission recommends that efforts be concentrated on the reduction of infant, child, and maternal mortality levels and that assistance be continued to the family health services and to programs of population education. Emphasis should be on services to men and women in rural areas. The Mission also recommends a training program for traditional birth attendants.
INTERNATIONAL JOURNAL OF HEALTH EDUCATION. 1974; 17(4):235-47.Extracts from the backgound paper for the Consultation Meeting of the World Health Organization and the Pan American Health Organization are presented. The meeting's purpose was to obtain specific recommendations that might be used by WHO, PAHO, and the member countries in developing educational personnel for programs dealing with family health and health aspects of reproduction. After reviewing the problems in Latin America and the Caribbean, the various kinds of constraints which have implications for health problems are examined, and key issues relating to family health are analyzed. Many health experts maintain that the family planning approach is the most effective and least expensive means of reducing maternal and infant mortality and morbidity, yet in most countries it is perceived primarily as a means of containing or reducing population growth. In most family planning programs the number of new acceptors appears to be the criterion for measuring success; little if any emphasis is given to continuation of use, teaching the health reasons for regulating reproduction, or increasing acceptance among women with high health risks. In some programs, eligibility requirements are such that many women of high health risk cannot be served. Thus far, research and studies to promote the development of the educational component of family planning programs or to orient selection of educational methodology have had minimal support. In most countries the full potential of the resources invested to achieve improvements in maternal and child health is not being realized. This is partly because of the fact that there is no explicit national policy giving direction to the development of an integrated approach. Few countries have policies and plans for health manpower development and utilization that are based on a careful analysis of priority health needs.
Bangkok, Thailand, Population Council, Regional Office for South and East Asia, Aug. 1982. 152 p.Summarizes the Population Council's review of Indian population policy and programs, including their recommendations to USAID concerning future assistance over the next 5 years in this area. The review starts with the assumption that there are no simple or universally applicable approaches for achieving desired demographic objectives. Approaches suitable to local needs and social, economic, and political realities must be found and applied. The report analyzes both the family planning program and nonprogram elements in the Indian development process, assesses the past and present state of population policies and programs in India, examines program and nonprogram constraints, discusses direction for the future and makes recommendations regarding future USAID involvement including the role of other U.S.-based institutions. The population of India has nearly doubled in the past 34 years. The past performance in reducing the growth rate has been disappointing. However, there seems to be a renewed political commitment to reducing population growth rates. The need for continued and if possible, increased USAID support is stressed.
[Child health in Chile and the role of the international collaboration (author's transl)] Salud infantil en Chile y el rol de la colaboracion internacional.
Revista Chilena de Pediatria. 1982 Sep-Oct; 53(5):481-90.Assuring the rights sanctioned by the UN Declaration on the Rights of Children requires the participation of the family, community, and state as well as international collaboration. Health conditions in Chile have improved significantly and continuously over the past few decades, as indicated by life expectancy at birth of 65.7 years, general mortality of 9.2/1000 in 1972 and 6.2/1000 in 1981, infant mortality of 27.2/1000 in 1981. Although the country has experienced broad socioeconomic development, due to inequities of distribution 6% of households are indigent and 17% are in critical poverty. The literacy rate in 1980 was 94%, but further progress is needed in environmental sanitation, waste disposal, and related areas. Enteritis, diarrhea, respiratory ailments, and infections caused 60.4% of deaths in children under 1 in 1970 but only 37.8% in the same group by 1979. Measures to guarantee the social and biological protection of children in Chile, especially among the poor, date back to the turn of the century. Recent programs which have affected child health include the National Health Service, created in 1952, which eventually provided a wide array of health and hygiene services for 2/3 of the population, including family planning services starting in 1965; the National Complementary Feeding Program, which supervised the distribution in 1980 of 25,195 tons of milk and protein foods to pregnant women and small children; the National Board of School Assistance and Scholarships, which provides 300,000 lunches and 750,000 school breakfasts; and programs to promote breastfeeding and rehabilitate the undernourished. Health services are now extended to all children under 8 years in indigent families. Bilateral or multilateral aid to health services in Chile, particularly that offered by the UN specialized agencies and especially the World Health Organization, Pan American Health Organization, and UNICEF, have contributed greatly to the improvement of health care. The Rockefeller, Ford, and Kellogg Foundations have contributed primarily in the areas of teaching and basic and operational research. Aid from the US government assisted in the development of health units and in nutritional and family health programs. The International Childhood Center in Paris rendered educational aid in social pediatrics. (summary in ENG)
Novum. 1983 May; (23):10-1.To encourage family planning, a mobile health clinic will be sent to a village when child clinics are held in the Gambia, so that women may receive family planning advice. All methods are used; the Pill is the most popular. There are around 3000 family planning acceptors. The Gambia Family Planning Association (GFPA) supplies condomes and pessaries were needed. The Association sells contraceptives to private doctors at a discount. Supplies are also available in hospitals. The average family has 6 children. Seminars on family planning have been held. The GFPA trains extension workers in family planning. The infant mortality rate is 217/1000 live births; 40% of the children die before the age of 5. Breastfeeding has been a problem. Many children are malnourished. The GFPA is staffed by 1 doctor; a senior nursing sister, a nursing sister, clinical assistants, and rural fieldworkers. There are 5 main clinics. The GFPA's staff teach family life education to schoolchildren. Planned parenthood/women's development projects are also taking place. The GFPA is largely funded by the IPPF.