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Your search found 26 Results

  1. 1
    333971

    Programmatic and research considerations for hormonal contraception for women at risk of HIV and women living with HIV.

    World Health Organization [WHO]. Department of Reproductive Health and Research

    Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2012 May. [4] p. (Policy Implications; WHO/RHR/12.09)

    Between 31 January and 2 February 2012, the World Health Organization (WHO) convened a meeting of experts to discuss recent research on use of hormonal contraception by women at high risk of HIV and those currently living with HIV and its implications. The purpose of the meeting was to review all available published evidence on the relationship between the use of hormonal contraceptives and the risk of HIV acquisition, HIV disease progression, and HIV transmission to uninfected partners, and to determine whether any change in the WHO recommendations on hormonal contraceptive use by women at high risk of, or living with, HIV-infection was needed. During the discussion on the balance of risks and benefits of hormonal contraceptive use among women at high risk of, or living with, HIV infection, multiple programmatic and research issues emerged, including priority knowledge gaps. This brief serves to highlight actions that programmes providing sexual and reproductive health and HIV-prevention services should undertake, in order to complement the Consultation’s recommendations. Directions for future research to address current gaps are noted. (Excerpts)
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  2. 2
    180839

    A qualitative evaluation of the impact of the Stepping Stones sexual health programme on domestic violence and relationship power in rural Gambia.

    Shaw M

    [Unpublished] 2002. Presented at the 6th Global Forum for Health Research, Arusha, Tanzania, November, 2002. [6] p.

    The work presented here came from a preliminary evaluation and was followed up by several applications for funding to carry out a prospective community randomised trial. So far none have been accepted. This may be partly due to the fact that such an evaluation runs against current funding culture. Because of it's holistic approach and focus on core skills in couple communication, the Stepping Stones programme is neither just an HIV prevention or just a domestic violence prevention programme, but has something to contribute to both (and would see the two problems as inter-related). Funding on the other hand is often organised 'vertically' by problem, and evaluation criteria may differ from one problem to another. For example donors who fund evaluation of HIV prevention activities usually require a biological outcome, and hence concentrate on geographical areas with high HIV incidence where the epidemic is seen as most severe. Where sociological outcomes are used this tends to be either the use of quantitative tools to assist in risk factor analysis, or qualitative tools which can assist in replication of the intervention. As such they are usually considered secondary to the primary (biological) outcomes. The hope here is that these interventions may provide a 'blueprint' which can subsequently be applied in low prevalence areas. However by concentrating on proximal rather than distal determinants of infection these blueprints may only capture 'half the story', leading to locally inappropriate assumptions about which groups or behaviours HIV prevention programmes should target. An example would be the demand by some donors that interventions should have an exclusive focus on adolescents, when in a polygamous society adolescent's risk is often mediated by the older generation. On the other hand community interventions against domestic violence are forced to rely on self reported behaviour (perhaps backed up by participant observation) as an outcome. If the intervention is also a reflexive process then qualitative studies become essential to describe a process of change which contains empowerment, group dynamic and normative dimensions. The locally appropriate nature of such interventions is used to justify participatory interventions as being more effective than didactic approaches, but at the same time in the epidemiological-evaluation paradigm it can be seen as problematic, because (I would argue incorrectly) a participatory process is assumed to generate a wide spectrum of outcomes (low replicability), which mitigates against quantitative evaluation. (excerpt)
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  3. 3
    096820

    Contraceptive requirements and logistics management needs in Viet Nam.

    United Nations Population Fund [UNFPA]. Technical and Evaluation Division. Maternal and Child Health and Family Planning Branch

    New York, New York, United Nations Population Fund [UNFPA], 1994. ix, 92 p. (Technical Report No. 16)

    In 1989, the UN Population Fund (UNFPA) began its "Global Initiative" to estimate "Contraceptive Requirements and Logistics Management Needs" throughout the developing world in the 1990s. After the initial study was completed, 12 countries were chosen for the preparation of more detailed estimates with information on program needs for logistics management of contraceptive commodities, options for local production, the involvement of nongovernmental organizations (NGOs) and the private sector in the supply of contraceptives, condom requirements for sexually transmitted disease (STD)/HIV/AIDS prevention, and financing issues. The fact-finding mission to Viet Nam took place in 1993. This technical report presents a consensus of the findings and conclusions of that mission. After an executive summary and introductory chapter, which discusses population and family planning and the AIDS epidemic in Viet Nam, chapter 2 covers contraceptive requirements including longterm forecasting methodology, projected longterm contraceptive commodity requirements, short-term forecasting and requirements, and forecasting of condom requirements for HIV/AIDS prevention. Logistics management is considered next, with emphasis on public and private organizations which participate in contraceptive distribution, procurement, and allocation to outlets; the reception, warehousing, and distribution of contraceptives; warehousing regulations; the logistics management information system; and monitoring. Chapter 4 deals with contraceptive manufacturing and discusses the regulatory environment and quality assurance, condoms, IUDs, oral and other steroidal contraceptives, and related issues. The fifth chapter presents the role of NGOs and the private sector and discusses mass organizations, social marketing, and future private-sector options, opportunities, and constraints. A financial analysis provided in chapter 6 relays sources and use of funds, trends in financial contributions for 1985-2000, future funding requirements, and contraceptive cost implications for individuals. The final chapter considers condom programming for HIV/AIDS prevention with information given on current status and patterns; projected trends; the National AIDS committee; an overview of international donor assistance; major condom distribution channels and outlets, condom demand-generation activities, forecasting requirements for 1993-2002, and condom supply activities. A summary of key knowledge, attitude, and practice findings about AIDS and condoms is appended as is additional information on contraceptive requirements and condom programming for HIV/AIDS prevention. The report contains 17 tables and 1 figure, and 18 specific recommendations are made for the topics covered.
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  4. 4
    096819

    Contraceptive requirements and logistics management needs in the Philippines.

    United Nations Population Fund [UNFPA]. Technical and Evaluation Division. Maternal and Child Health and Family Planning Branch

    New York, New York, United Nations Population Fund [UNFPA], 1994. x, 122 p. (Technical Report No. 17)

    In 1989, the UN Population Fund (UNFPA) began its "Global Initiative" to estimate "Contraceptive Requirements and Logistics Management Needs" throughout the developing world in the 1990s. After the initial study was completed, 12 countries were chosen for the preparation of more detailed estimates with information on program needs for logistics management of contraceptive commodities, options for local production, the involvement of nongovernmental organizations (NGOs) and the private sector in the supply of contraceptives, condom requirements for sexually transmitted disease (STD)/HIV/AIDS prevention, and financing issues. The fact-finding mission to the Philippines took place in 1993. In the introductory chapter of this technical report, the Global Initiative is described and the Philippine Population Program is presented in terms of the demographic picture, the population policy framework, the Philippine Family Planning (FP) Program, STD/AIDS control and prevention efforts, and an overview of donor assistance from 1) the UNFPA, 2) USAID, 3) the World Bank, 4) the Asian Development Bank, 5) the Australian International Development Assistance Bureau, 6) the Canadian International Development Agency, 7) the Commission of the European Community, 8) the International Planned Parenthood Federation, 9) the Japanese International Cooperation Agency, and 10) the Netherlands. The second chapter presents contraceptive requirements including longterm forecasting methodology, projected longterm commodity requirements, condom requirements for STD/AIDS prevention, total commodity requirements for 1993-2002, short-term procurement projections, and projections and calculations of unmet need. Chapter 3 covers logistics management for 1) the public sector, 2) condoms for STD/AIDS preventions, 3) NGOs, and 4) the commercial sector. The fourth chapter is devoted to a consideration of private practitioners and a detailed look at the ways that NGOs relate to FP groups. This chapter also covers the work of NGOs in STD/AIDS prevention and coordination and collaboration among NGOs. Chapter 5 is devoted to the private commercial sector and includes information on social marketing, the commercial sector, and duties and taxes. The issues addressed in chapter 6 are contraceptive manufacturing and quality assurance, including the potential for the local manufacture of OCs, condoms, IUDs, injectables, and implants. The national AIDS prevention and control program, the forecasting of condom requirements for STD/AIDS prevention, and policy and managerial issues are considered in chapter 7. The last chapter provides a financial analysis of the sources and uses of funds for contraceptives including donated commodities, the private commercial sector, cost recovery issues, and regulations and policies, such as taxes and duties on donated contraceptives, which affect commodities. 5 appendices provide additional information on contraceptive requirements, logistics management and costs, the private commercial sector, condoms for STD/AIDS prevention, and a financial analysis. Information provided by the texts and appendices is presented in tables and charts throughout the report.
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  5. 5
    093323

    Family planning hygiene project.

    Philippines. Provincial Population Office; Philippines. Commission on Population

    In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar. [1] p. (PHI-01)

    In 1975, a USAID-Commission on Population (POPCOM) planning team reported that the key problem facing the National Family Planning (FP) Program in the Philippines was extending the program beyond its existing network of municipal-based clinics to the surrounding barrios. At that time, the number of new FP acceptors was declining, and there was a shift to less effective methods among current users. Because most clinics were urban-based, rural acceptors could not easily access FP services. The report recommended that supply depots be established in barrios and that motivators be used to distribute contraceptives and hygiene information and materials. An operations research project, which cost US $77,313, was developed to test the feasibility and cost-effectiveness of delivering FP/hygiene materials directly to households in rural areas. The Barrio Supply Point (BSP) operators were to visit and make available to every household free FP and hygiene materials. After the initial visit, BSP operators were to continue to serve as resupply agents. Although contraceptives were resupplied free, a nominal charge was required for hygiene materials. A quasi-experimental study design was employed. Pilot tests were conducted to determine what materials might be effectively distributed in addition to contraceptives. Project support was terminated in December 1978, before the project was fully implemented, because of the evolution of a national outreach program. Results of the pilot test showed that over 90% of households offered free condoms and oral contraceptives, or free contraceptives and bars of soap, accepted them. No data on use of these items were collected.
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  6. 6
    093251

    Family planning saturation project.

    American University in Cairo; American University

    In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar. [2] p. (EGY-01)

    Egypt's family planning (FP) program, active since 1966, has been facilitated by the country's population density, flat terrain, and extensive health infrastructure. Nevertheless, by the early 1970s, a substantial proportion of couples were still not using contraception because of minimal clinic outreach; high dropout rates for oral contraceptive (OC) users; lack of knowledge about side effects among clinic staff and clients; disruptions in clinical supplies; and unavailability of other methods, such as the IUD, especially in rural areas. In 1971, USAID supported the American University in Cairo's (AUC) FP research activities in rural Egypt, in which household fertility survey data, a follow-up of women attending FP clinics, the cultural context of FP, communication and education, and the implementation of services were studied. In 1974, AUC initiated a demonstration project (which cost US $224,000) of a low-cost way to provide FP services to all married women in a treatment population through a household contraceptive distribution system. The interventions were implemented in the Shanawan (rural) and Sayeda Zeinab (city of Cairo) communities of Menoufia Governorate. During an initial canvas in November 1974, married women 15-49 years of age, who were living with their husbands and were not pregnant or less than 3 months postpartum and breast feeding, were offered 4 cycles of OCs or a supply of condoms. During a second canvas in February 1975, acceptors were provided with an additional 4 cycles of OCs and referred to a local depot for resupply. Each distribution area was mapped, and each housing unit numbered. Data collected through canvassing consisted primarily of eligibility screening items and provided numbers of acceptors, refusals, ineligibles, not at homes, etc. To increase coverage, 2 attempts were made to reach women not at home. Of the 2,493 women canvassed in Sayeda Zeinab, 1713 (69%) were eligible to receive contraceptives. Of these, 58% accepted 4 to 6 cycles of OCs. At the time of initial household distribution, 45% of eligible women were already using OCs. As a result of the canvass, an additional 5% of the women became acceptors. The AUC did not expand the household distribution of contraceptives to other urban areas of Cairo, because women there evidently already had adequate access to FP information and supplies. In the 6,915 households canvassed in Shanawan, 1156 of the 1820 women (64%) were eligible to receive contraceptives. Of these, 45% accepted 4 to 6 cycles of OCs. 21% of eligible women were already using OCs at the time of initial household distribution. Although condoms were offered, few were accepted, apparently because it was not culturally acceptable for women to either distribute or accept condoms. One year after the initial household distribution, contraceptive use among married women of reproductive age had increased 69% from 18.4 to 31% among all age and parity groups and at all educational and occupational levels, and the incidence of pregnancy declined from 19.3 to 14.9%.
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  7. 7
    059074

    Annual report 88/89.

    Family Planning Association of Sri Lanka

    Colombo, Sri Lanka, Family Planning Association of Sri Lanka, 1989. 43 p.

    The Family Planning Association of Sri Lanka (FPASL) is a member of the International Planned Parenthood Federation (IPPF). According to the FPASL the family planning (FP) acceptor rate in 1988 declined by 22% compared to 1987 and is primarily the result of civil war and an election year. Because of complex political and sociological factors, people have been more concerned with staying alive, than with FP. District level programs designed to improve the quality of life for mothers and children were often halted during the end of the year because of terrorist activities and counter security measures. The following contraceptive methods experienced declines in acceptors: sterilization 48%, IUD 12%, pill 12%, injectables 8%, foam tablets 22%. In 1988 there were 629 vasectomies, and 393 tubectomies. Of the new acceptors of temporary methods 57.8% chose depo provera, 21.3% IUD, 15.9% orals, and 5% Norplant. Sales of contraceptives have changed with condom sales down 3.6%, orals up 7.5%, and foam down 78.25%. The Community Managed Integrated Rural Family Health Programme (CMIRFH) has been recognized globally as a story of success. Since 1980 over 45,000 people have volunteered to help this program. In 1988 1676 programs were carried out by these enthusiastic young volunteers. Of the 25,000 estimated villages in Sri Lanka, the FPASL and CMIRFH program had reached 1689 villages through the end of 1988. The Youth and Population Committee is trying to reach the young people with the message that the population is growing out of hand. In July a seminar was conducted when the population of Asia reached 3 billion.
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  8. 8
    724425

    Fortieth report and accounts, 1971-1972.

    Family Planning Association [FPA]

    London, FPA, 1972. 48 p.

    Currently, public authorities pay for almost 2/3 of the family planning consultations conducted by the Family Planning Association, and this is the most significant development since the publication of the last Family Planning Association Report. Additionally, more local health authorities are operating direct clinic and domiciliary services. The Family Planning Association handed over the management of 39 clinics to public authorities in the 1971-1972 year. However, despite this progress, family planning service provision by public authorities throughout England continues to be uneven in quality and extent. Spending by local health authorities for each woman at risk varies from 1 penny per woman at risk in Burnley (excluding the city of London) to 179 pence at Islington. In addition to the problem of inconsistency in spending, there appears to be no immediate prospect of a comprehensive family planning service - one that is available to all, is free of charge, and is backed by an adequate education campaign. Although government help for the extension of domiciliary family planning service is impressive, it should not obscure the false economies in spending on other contraceptive delivery services such as general practitioners, specialist clinics, and specialized advisory centers. Until the government announces the details of its plans for family planning services within the National Health Service beginning April 1974, the Family Planning Association's own detailed planning cannot be exact. The Association's basic policy continues to be to turn over the responsibility for the management of clinic and domiciliary contraceptive services as quickly and as smoothly as possible to the public authorities. Already there is concern that some clinic services managed by public authorities may become less attractive, particularly to young people, and that differences in the quality of service will increase under local public management as well as that backup services will be neglected. Also existing is the realization that the public authorities do not do enough to attract people to the use of contraception.
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  9. 9
    081879

    Male participation in family planning: a review of programme approaches in Africa.

    Hawkins K

    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.
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  10. 10
    077929

    Male involvement programs in family planning: lessons learned and implications for AIDS prevention.

    Green CP

    [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.
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  11. 11
    066745
    Peer Reviewed

    Role of planned parenthood for enrichment of the quality of life in Sri Lanka.

    Chinnatamby S

    CEYLON MEDICAL JOURNAL. 1990 Dec; 35(4):136-42.

    The story of the Sri Lankan Family Planning movement is told from its inception in 1953, prompted by a visit by Margaret Sanger 1952. The Family Planning Association of Sri Lanka was founded with the health of women and children, and both contraception and infertility treatment as its policies. The first clinic, called the "Mothers Welfare Clinic," treated women for complications of multiparity: one woman was para 26 and had not menstruated in 33 years. The clinic distributed vaginal barriers, spermicides and condoms, but the initial continuation rate was <5% year. Sri Lanka joined the IPPF in 1954. In 1959, after training at the Worcester Foundation, and a personal visit by Pincus, the writer supervised distribution of oral contraceptives in a pilot project with 118 women for 2 years. Each pill user was seen by a physician, house surgeon, midwife, nurse and social worker. In 1958 Sweden funded family planning projects in a village and an estate that reduced the birth rate 10% in 2 years. The Sri Lankan government officially adopted a family planning policy in 1965, and renewed the bilateral agreement with Sweden for 3 years. In 1968 the government instituted an integrated family planning and maternal and child health program under its Maternal and Child Health Bureau. This was expanded in 1971 to form the Family Health Bureau, instrumental in lowering the maternal death rate from 2.4/1000 in 1965 to 0.4 in 1984. During this period IUDs, Depo Provera, Norplant, and both vasectomy and interval female sterilizations, both with 1 small incision under local anesthesia, and by laparoscopic sterilization were adopted. Remarkable results were being achieved in treating infertile copies, even from the beginning, often by merely counseling people on the proper timing of intercourse in the cycle, or offering artificial insemination of the husband's semen. Factors contributing to the success of the Sri Lankan planned parenthood program included 85% female literacy, training of health and NGO leaders, government participation, approval of religious leaders, rising age of marriage to 24 years currently, and access of all modern methods.
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  12. 12
    057942

    Global strategy for the prevention and control of AIDS. Report.

    World Health Organization [WHO]. Director-General

    Geneva, Switzerland, WHO, 1989 Apr 11. 46 p. (A42/11)

    Global AIDS surveillance data indicate that, of the 141,894 cases reported to the World Health Organization (WHO) as of March 1, 1989, 21,322 were in Africa, 99,752 were contained in the Americas, 338 were in Asia, 19,196 were in Europe, and 1286 were in Oceania. There remain only 3 documented modes of transmission of AIDS: heterosexual or homosexual sexual intercourse; exposure to blood, blood products or donated organs, and semen; and perinatal transmission from an infected mother. By late 1988, all countries had become aware of the extensive social, political, economic, and cultural implications of AIDS and most had established national AIDS committees to control disease transmission. There has also emerged greater awareness of the need to integrate AIDS activities into health and social welfare services and for program coordination. WHO's Global Program on AIDS has collaborated with countries to support and strengthen development, resource mobilization, implementation, monitoring and evaluation of national programs. WHO is further collaborating with the United Nations Fund for Population Activities in a project to develop strategies to optimize interactions between AIDS programs, maternal-child health and family planning programs, and programs for the control of sexually transmitted diseases. To reduce the sexual transmission of the AIDS virus, WHO is promoting the inclusion of condom and virucide services in national AIDS programs. Also supported are measures to reduce disease risks in the behavior of self-injecting drug users. At present, the Global Program on AIDS is working to concretize policies to ensure that the dignity and human rights of AIDS victims are respected.
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  13. 13
    057866

    Male involvement in planned parenthood: global review and strategies for programme development.

    Meredith P

    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.
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  14. 14
    042305

    Acquired immune deficiency syndrome (AIDS).

    International Planned Parenthood Federation [IPPF]. International Medical Advisory Panel [IMAP]

    IPPF MEDICAL BULLETIN. 1987 Feb; 21(1):4.

    The International Planned Parenthood Medical Advisory Panel has developed recommendations to assist family planning associations in playing a more active role in the prevention and control of acquired immunodeficiency syndrome (AIDS). Of primary importance is an effective program of information and education aimed at communicating the following facts: AIDS is a fatal disease for which there is no cure; AIDS is spread by sexual intercourse, contaminated blood, and contaminated needles; an infected woman can transmit AIDS to her fetus during pregnancy; a monogamous sexual relationship is the surest way to avoid AIDS infection; condom use is good protection; an infected person can look and feel well, yet still be able to transmit the AIDS virus; and AIDS is not spread by ordinary contact with an infected person. Family planning associations should include information on AIDS in all existing IEC projects, as well as develop new materials. Among the target audiences for IEC activities are family planning workers, family planning clients, and the general public including youth, teachers, parents, employers, and national leaders. Special attention should be given to high-risk groups such as homosexual and bisexual men, hemophiliacs, male and female prostitutes, clients of sexually transmitted disease clinics, people with many sexual partners, illegal users of intravenous drugs, and the sexual partners of those in any of these groups. Wide promotion of condom use is a priority activity for family planning organizations.
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  15. 15
    006640

    Community family planning services in IPPF.

    International Planned Parenthood Federation [IPPF]

    London, IPPF, 1981 Dec. 24 p.

    This paper discusses Community-Based Distribution (CBD) programs as a strategy for delivering family planning services at the community level whether through health and other extension workers or lay distributors. Commercial marketing is not discussed. IPPF member family planning associations (FPAs) have been pioneers in establishing CBD programs. In 1979, approximately 40 FPAs were involved in CBD, representing about 80 projects and accounting for 34% of all new acceptors. About half of the projects and half of the new acceptors were in the Western Hemisphere region, where 95% chose oral contraceptives (OCs). OCs were selected by 68% of all new nonclinical clients. The cost per new acceptor in 1979 in CBD programs (with one exception) ranged from 78Z in Thailand to $16.50 in Mexico. Program issues involving the availability of CBD services include: 1) a comprehensive approach to service delivery including adequate and appropriate back up; 2) community participation in the design and delivery of CBD programs; 3) expanding coverage to reach less accessible and disadvantaged populations; and 4) monitoring and evaluating the impact of CBD programs through data collection and constant communication with program participants. The credibility of the distributor in the community is a key factor in ensuring the program's success. The report recommends that OCs of 50 mcg or less be used. Screening of potential acceptors by checklist is adequate; pelvic examination is not needed. CBD projects in Brazil, Colombia, India, Lebanon, South Korea, Thailand, China, Egypt, and the Philippines are described as are projects for 1979. The November 1981 IPPF policy statement supporting community-based family planning services is included.
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  16. 16
    004912

    Male involvement in family planning: some approaches for FPAs.

    International Planned Parenthood Federation [IPPF]. Programme Development Department

    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.
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  17. 17
    762112

    Senegal.

    Menes RJ

    Washington, D.C., U.S. Office of International Health, Division of Planning and Evaluation, 1976. 144 p. (Syncrisis: the dynamics of health, XIX)

    This report uses available statistics to examine health conditions in Senegal and their interaction with socioeconomic development. Background data are presented, after which population, health status, nutrition, environmental health, health infrastructure, facilities, services and manpower, national health policy and planning, international organizations, and the Sahel are discussed. Diseases such as malaria, measles, tuberculosis, trachoma and venereal diseases are endemic in Senegal, and high levels of infant and childhood mortality exist throughout the country but especially in rural areas. Diarrhea, respiratory infections, and neonatal tetanus contribute to this mortality and are evidence of the poor health environment, and lack of basic services including nutrition assistance, health education, and potable water. Nutrition in Senegal appears to be good in general, but seasonal and local variations sometimes produce malnutrition. Lowered fertility rates would reduce infant and maternal mortality and morbidity and might slow the present decline in per capita food intake. At present the government of Senegal has no population policy and almost no provisions for family planning services. Health services are inadequate and inefficient, with shortages of all levels of health manpower, poor planning, and overemphasis on curative services.
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  18. 18
    796526

    Intravaginal contraception: United Nations Fund for Population Activities.

    Donayre J

    In: Zatuchni FI, Sobrero AJ, Speidel JJ, Sciarra JJ, eds. Vaginal contraception: new developments. New York, Harper and Row, 1979. 338-52. (PARFR Series on Fertility Regulation)

    Only about 4.5% of all UNFPA population program expenditures for 1969-1978 were used to purchase and distribute contraceptives. Total population expenditures have increased greatly since the fund was established in 1969. Accumulated expenditures by the end of 1977 amounted to $312.6 million, and for 1978 alone, projected expenditures totaled $125.5 million. Approximately 45% of the expenditures since 1975 were allocated to family planning programs; most of the remaining funds were used to collect population data and to support educational activities. Most of the family planning services are provided in the context of maternal and child health services; therefore, only a portion of these funds are used for the purchase and distribution of contraceptives. Approximately 10.5% of all family planning funds or 4.5% of all population program funds were used to purchase contraceptives from 1969-1978. In 1974, 88.5% of these contraceptive expenditures were allocated for purchasing oral contraceptives, IUDs, and injectables and 11.5% for purchasing condoms and spermicides. In 1978 the respective figures were 79.7% and 20.3%. Bar graphs, depicting UNFPA expenditures for 1969-1978, show: 1) total projected expenditures for all population programs; 2) family planning expenditures as a % of total expenditures; 3) contraceptive expenditures as a % of total family planning expenditures; 4) family planning expenditures as a % of total expenditures by major geographical areas; and 5) contraceptive expenditures as a % of total family planning expenditures by major geographical areas.
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  19. 19
    772039

    Family planning helps in Sri Lanka.

    CHINNATAMBY S

    Draper World Population Fund Report. 1977 Summer; 4:23-25.

    Sri Lanka has undergone a classic demographic transition over the last 30 years. In 1971, the country was 1 of the most densely populated agricultural countries in the world. By 1975, Sri Lanka's birthrate had declined to 27.2, the lowest rate in South Asia. This decline in fertility is attributed to increased contraceptive use, due to a greater awareness of modern family planning methods and easier access to contraceptive facilities. A brief history of the family planning movement in the country is presented. The Sri Lanka family planning program today illustrates a cooperative venture between private organizations and government programming. High levels of celibacy and late marriage in Sri Lanka, caused by demographic, economic, and educational factors, have also resulted in a declining percentage of married women in the under-30 age group.
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  20. 20
    770452

    Compulsory sterilization: the change in India's population policy.

    GULHATI K

    Science. March 25, 1977; 195(4284):1300-1305.

    India's official advocacy of compulsory sterilization has caused dismay among those who think voluntary birth control services were never provided on a mass scale and that compulsory measures will cause resistance to family planning in general, but it has also brought relief to those who felt India's stand at the World Population Conference in 1972 was not nearly antinatalist enough. The new policy is in effect an admission that education and economic development will not bring about a drop in fertility soon enough. The timing of the policy shift can be explained by the state of emergency declared in June 1975. Prior to that, it would have been politically impossible for Mrs. Gandhi to make any strong statements in favor of birth control. Since the family planning program's inception in 1952 sterilization has been an important part, and incidence increased significantly every year until 1974 when budget cuts did not allow for program expansion. There are various possible explanations for the government's rethinking of its priorities but what was clear was that there was no clamor from the people to reinstate the services. The motivation to have small families seemed to be lacking, perhaps because it is connected to a certain socioeconomic threshhold which had not been reached by the populace when the focus shifted from sterilization to economic development as the best contraceptive. The 5 states that appear to have had a significant decline in fertility have also done well in economic development, while the family planning performance of the poorest states, Bihar and Uttar Pradesh, has been dismal. The problem of motivation is further complicated by a tradition and culture that require large families. The current population contains a huge growth potential for the future; all projections of the population show substantial increases. The Chinese example in family planning cannot be followed without fundamentally changing the structure of the entire economic and political system. Only the most economically prosperous states have the personnel and facilities to enforce a compulsory sterilization law. 1 of those, Maharashtra, is on the point of passing such a law. The experience of the state will be important for future consideration of compulsory sterilization nationwide.
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  21. 21
    755319

    A brief summary of the community-based distribution of contraceptives project in Korea.

    Planned Parenthood Federation of Korea [PPFK]

    October. 1975; 7.

    A project for the community-based distribution of oral contraceptives (OCs) and condoms in Korea is outlined. The project is to run from October 1975 to September 1978, in 3 areas (to test the 3 models of government-, mothers'-club-, and commercial-centered delivery systems). The target population for the 1st year is 14,900; after expansion in the 2nd year, it will be 24,000. The project is to mobilize members of family planning mothers' clubs and other rural organizations as distributors, to correct negative popular attitudes toward contraceptives, and to devleop a self-supporting and expanding organized supply system. The condoms and OCs will be sold, but about 10% of them may be given free of charge to those who cannot pay. The project is conducted under the auspices of the Planned Parenthood Federation of Korea.
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  22. 22
    746473

    The condom: increasing utilization in the United States.

    Redford MH; Duncan GW; Prager DJ

    San Francisco, San Francisco Press, 1974. 292 p.

    Despite its high effectiveness, lack of side effects, ease of use, and low cost, condom utilization has declined in the U.S. from 30% of contracepting couples in 1955 to 15% in 1970. The present status of the condom, actions needed to facilitate its increased availability and acceptance, and research required to improve understanding of factors affecting its use are reviewed in the proceedings of a conference on the condom sponsored by the Battelle Population Study Center in 1973. It is concluded that condom use in the U.S. is not meeting its potential. Factors affecting its underutilization include negative attitudes among the medical and family planning professions; state laws restricting sales outlets, display, and advertising; inapplicable testing standards; the National Association of Broadcasters' ban on contraceptive advertising; media's reluctance to carry condom ads; manufacturer's hesitancy to widen the range of products and use aggressive marketing techniques; and physical properties of the condom itself. Further, the condom has an image problem, tending to be associated with venereal disease and prostitution and regarded as a hassle to use and an impediment to sexual sensation. Innovative, broad-based marketing and sales through a variety of outlets have been key to effective widespread condom usage in England, Japan, and Sweden. Such campaigns could be directed toward couples who cannot or will not use other methods and teenagers whose unplanned, sporadic sexual activity lends itself to condom use. Other means of increasing U.S. condom utilization include repealing state and local laws restricting condom sales to pharmacies and limiting open display; removing the ban on contraceptive advertising and changing the attitude of the media; using educational programs to correct erroneous images; and developing support for condom distribution in family planning programs. Also possible is modifying the extreme stringency of condom standards. Thinner condoms could increase usage without significantly affecting failure rates. More research is needed on condom use-effectiveness in potential user populations and in preventing venereal disease transmission; the effects of condom shape, thickness, and lubrication on consumer acceptance; reactions to condom advertising; and the point at which an acceptable level of utilization has been achieved.
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  23. 23
    745602

    Republic of Korea (Family planning).

    International Planned Parenthood Federation [IPPF]

    IPPF Situation Report, February 1974. 10 p.

    The Planned Parenthood Federation of Korea (PPFK) was founded in 196 1 to act as a pressure group to persuade the government to set up a family planning program. In 1962 the Korean government became 1 of the 1st in the world with such an official program. PPFK has a permanent staff of 62 at headquarters and 135 at branch offices to implement the information/education program. It was formerly responsible for the training for the government effort and it continues to initiate research and pilot projects. It also indirectly supports the clincs at Seoul National University and Yonsei University Medical colleges, runs 14 demonstration clincs, and has a mobile team unit in Taegi City and surrounding rural areas. Since 1968 it has organized "Mothers' Classes" which have been integrated into the rural community development program. Special projects include a "Stop at 2" campaign which the government officially adopted. The "Two Child Family" club was started in Seoul in 1971 and is expanding. UNFPA is funding an information, education, and communication campaign that will explore various uses of mass media. Pilot telephone consultation was begun in 1973. Vasectomy information is being given to the Homeland Reserve Force, an education project has been started for civil servants, and student newspapers are being used to reach the student population. PPFK has national responsib ility for clinical trials of new contraceptives. Tests on Minovlar ED continue and the results of Neovlar trials are being analyzed. Details of the government organizations are given. Research being carried on at various universities and in other agencies is also capsuled.
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  24. 24
    735203

    Indonesia (Family planning).

    International Planned Parenthood Federation [IPPF]

    IPPF Situation Report, June 1973. 10 p.

    The Indonesian Planned Parenthood Association (IPPA) was founded in 1957 and pioneered family planning services. It made little headway duri ng the pronatalist Sukarno regime, but in 1967 the present government announced an intensive family planning program and the IPPA was named as an implementing unit in 1971. 2 primary roles now are the training activities for fieldworkers and the development of community education and motivation programs. This complements the national mass media program. In 1970 the government took over all clinics except those in the Outer Islands (the islands outside Java, Bali, and Madura). The IPPA runs 150 clinics in the Outer Islands, is responsible for all supplies and maintenance, and has a number of model clinics in Java and Bali. The Community Education program has 8 components: speakers bureau, family planning clubs, mobile audiovisual units, exhibitions, tr aditional media, special events, local mass media support, and evaluatio n. In 1971 the 'ippa trained 2951 people; in 1972 this was increased by 25%. In 1973 the target is training 3000 fieldworkers with 16 centers for training and 16 field demonstration areas. An agreement with the U.N. Fund for Population Activities/International Development Association (UNFPA/IDA) will provide for building, equipping, and staffing. The research and evaluation function is also expanding to complement government activities. The government program aims to train 20,250 medical and paramedical personnel over 5 years and medical schools have incorporated the teaching of population and family planning. Government allowances are being curtailed for all children over 3 for government workers. An active clinic program aims to set up 1200 fully equipped and 1250 moderately equipped facilities by 1973. An active media campaign has been launched and for the 1st time in the population field the UNFPA and the IDA are helping to finance a project to expand a family planning program and broaden its activities. This su pport will provide for physical facilities, technical assistance, training, motivation, evaluation, research, and population education.
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  25. 25
    723681

    Iran (Profile).

    Friesen JK; Moore RV

    Country Profiles. 1972 Oct; 19.

    The estimated population of Iran in 1972 was 31,000,000, with an estimated rate of natural increase of 3.2% per year. In 1966 61% of the population lived in rural areas, male literacy was 41% and female literacy 18%. Coitus interruptus is the most common form of contraception used in Iran, followed by condoms. Because of the rapid rate of population growth, the government has taken a strong stand in support of family planning. The Ministry of Health coordinates family planning activities through the Family Planning Division. Contraceptive supplies are delivered free of charge through clinics. The national family planning program also is involved in postpartum programs, training of auxiliary personnel, communication and motivation for family planning population education, evaluation and research. The overall goal of the program is to reduce the growth rate of 2.4% by 1978, and to 1% by 1990.
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