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Recommendations to Promote Safe and Effective Use of Contraceptives: World Health Organization [letter]
CHRISMED Journal of Health and Research. 2017 Oct-Dec; 4(4):291.The authors discuss the need to support and strengthen national family planning programs through more investment and better awareness to address the 220 million women who have an unmet need for family planning.
Policy brief on the case for investing in research to increase access to and use of contraception among adolescents.
Seattle, Washington, PATH, 2015 Mar. 4 p.This document outlines why governments and donors should invest now in research to help determine and implement the most effective and efficient ways to enable adolescents to access and use contraception. It summarizes the findings of a longer technical report.
Global Health: Science and Practice. 2015 Sep 10; 3(3):352-357.Contraceptive effectiveness is the leading characteristic for most women when choosing a method, but they often are not well informed about effectiveness of methods. Because of the serious consequences of “misinformed choice,” counseling should proactively discuss the most effective methods-long-acting reversible contraceptives and permanent methods-using the WHO tiered-effectiveness model.
Guttmacher Policy Review. 2015 Spring; 18(2):27-33.The U.S. overseas program for family planning and reproductive health has been under attack from policymakers who are antiabortion and increasingly anti-family planning. The two most notorious of these attacks are the blocking of U.S. funding for the United Nations Population Fund and the enforcement of the global gag rule, which prohibits aid to foreign nongovernmental organizations that engage in abortion services or advocacy with non-U.S. funds. In an ongoing counterproductive cycle, these restrictions have come in and out of effect depending on the political party in power -- a struggle that is expected to heat up again with a socially conservative Congress.
Contraception. 2011 Oct; 84(4):339-41.This editorial focuses on a strategy to expand contraceptive coverage through the development of a numerical International Statistical Classifications of Diseases (ICD) code for "unwanted fertility." It explains how this strategy would work, how to make the strategy happen through a revision process, and defining unwanted fertility as a medical problem. Copyright © 2011 Elsevier Inc. All rights reserved.
From advocacy to access: Uganda. The power of networks: How do you mobilize funds for reproductive health supplies? Fact chart.
London, England, IPPF, 2009 Nov.  p.In Uganda the IPPF Member Association, Reproductive Health Uganda (RHU) coordinated civil society and mobilized advocates and champions to increase the availability of RH supplies and family planning. Results to date include: The Government of Uganda increased funding for RH supplies in the 2010 budget; The Government of Uganda disburses funds directly to the National Medical Stores on an annual basis enabling the bulk purchase of contraceptives; 30 out of 80 districts have committed to increasing their resource allocation for family planning and RH supplies.
American Journal of Public Health. 2008 Oct; 98(10):1737.The 1994 Cairo International Conference on Population and Development helped governments, the organs and agencies of the United Nations system, and nongovernmental organizations move beyond the confines of traditional family planning approaches. This watershed event fostered and defined subsequent international and national reproductive and sexual health policies and programs as well as global efforts to realize reproductive and sexual rights. However, moving beyond history, or the "archeology of Cairo" (as a participant at a meeting I recently attended called it), are we now simply using the language of the Cairo conference with little attention to the conceptual and operational implications of its words? Has the politically charged notion of rights with its attendant government responsibility and accountability succumbed to the less controversial notion of health? As the public health community recognized even before the Cairo consensus, barriers to reproductive and sexual health operate on a number of levels-including legal, social, cultural, political, financial, attitudinal, and practical -- and interact in complex ways. What rights add to this mix is a framework for programming and for action and a legal rationale for government responsibility-not only to provide relevant services but also to alter the conditions that create, exacerbate, and perpetuate poverty, deprivation, marginalization, and discrimination as these affect reproductive and sexual health. By fixing attention on the responsibility and accountability of governments to translate their international-level commitments into national and subnational laws, policies, programs, and practices that promote and do not hinder reproductive and sexual health, the actions of governments are open to scrutiny to determine their influences-both positive and negative-on reproductive and sexual health, including barriers that affect the availability, accessibility, acceptability, and quality of reproductive and sexual health services, structures, and goods. Despite the framework that the Cairo conference helped put into place, work falling under the rubric of reproductive and sexual rights now includes everything from the provision of abortion services to the reduction of maternal mortality -- as though simply working on these issues is equal to working on rights. Consequently, one has to ask this: Are reproductive, and even sexual, rights becoming synonymous with reproductive, and sexual, health? Those who understand their work to be in the area of reproductive and sexual rights sorely need to discuss whether their efforts are aligned with the politics that underlie the words of the Cairo conference or whether, bluntly speaking, the politics are a historical artifact and it is simply time to move on. Bringing the political back into reproductive and sexual rights would require going beyond the technical dimensions of addressing reproductive and sexual health issues to the application of the norms and standards that are engaged by a human rights discourse. This includes attention to the basics of reproductive and sexual rights: the efforts that exist to ensure the sustained participation of affected communities; how discrimination that affects both vulnerability to ill health and access and use of services is being tackled; the extent to which any legal, political, and financial constraints are being addressed; how rights considerations are brought into policy and program design, implementation, and evaluation; and the existence of mechanisms that require government as well as intergovernmental and nongovernmental institution accountability. And so yes, in a word, words do matter. And they matter for the actions they inspire. (full-text)
Cambridge, Massachusetts, Belknap Press, 2008. xiv, 521 p.Rather than a conspiracy theory, this book presents a cautionary tale. It is a story about the future, and not just the past. It therefore takes the form of a narrative unfolding over time, including very recent times. It describes the rise of a movement that sought to remake humanity, the reaction of those who fought to preserve patriarchy, and the victory won for the reproductive rights of both women and men -- a victory, alas, Pyrrhic and incomplete, after so many compromises, and too many sacrifices. (Excerpt)
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)
Targeting access to reproductive health: Giving contraception more prominence and using indicators to monitor progress.
Reproductive Health Matters. 2007 May; 15(29):186-191.Unmet need for contraception represents a major failure in the provision of reproductive health services and reflects the extent of access to services for spacing and limiting births, which are also affected by personal, partner, community and health system factors. In the context of the Millennium Development Goals, family planning has been given insufficient attention compared to maternal health and the control of sexually transmitted infections. As this omission is being redressed, efforts should be directed towards ensuring that an indicator of unmet need is used as a measure of access to services. The availability of data on unmet need must also be increased to enable national comparisons and facilitate resource mobilisation. Unmet need is a vital component in monitoring the proportion of women able to space and limit births. Unmet need for contraception is a measure conditioned by people's preferences and choices and therefore firmly introduces a rights perspective into development discourseand serves as an important instrument to improve the sensitivity of policy dialogue. The new reproductive health target and the opportunity it offers to give appropriate attention to unmet need for contraception will allow the entry of other considerations vital to ensuring universal access to reproductive health. (author's)
New York, New York, International Planned Parenthood Federation [IPPF], Western Hemisphere Region [WHR], 2002 May 15.  p.On April 3, 2002, Steven Sinding, director-general designate of the International Planned Parenthood Federation, delivered a speech to the Commission on Population and Development in New York. The speech summarizes priorities for evaluating progress made in the implementation of the Program of Action adopted at the International Conference on Population and Developement in Cairo in 1994. I am making this statement today as director-general designate of the International Planned Parenthood Federation, the world's leading voluntary family planning organization. IPPF and its member associations are committed to promoting the right of women and men to decide freely the number, timing, and spacing of their children and the right to the highest possible level of sexual and reproductive health. Founded in 1952, it is a federation linking autonomous national Family Planning Associations working in more than 180 countries around the world, initiating, promoting and providing sexual and reproductive health and rights-based services. Celebrating its 50th anniversary this year, IPPF is proud to have an opportunity to address this meeting of the Commission on Population and Development (CPD). (excerpt)
Reproductive Health Matters. 2005; 13(25):106-108.The year 2005 is a pivotal year for ensuring that sexual and reproductive health are fully addressed in the implementation and monitoring of the Millennium Development Goals (MDGs). When the MDGs were developed following the Millennium Summit in 2000, no goal was included on sexual and reproductive health, for reasons that are now history. Matters that have an impact on, or are components of, sexual and reproductive health were included – maternal and child health, HIV/AIDS, gender equality and education – but sexual and reproductive health were left out. This year, however, there are real opportunities to redress the imbalance and to ensure that sexual and reproductive health are there for the rest of the time earmarked for the implementation of the MDGs, i.e. in the ten years to 2015. Targets and indicators were set shortly after the MDGs were agreed. As far as maternal health was concerned the target set was the reduction of maternal mortality by two-thirds and for HIV/AIDS of halting and beginning to reverse the spread of HIV/AIDS, both by 2015. Whole other areas are not included, however, especially access to contraceptive services. There is an increasing trend among donor governments to tie development aid to the MDGs, and to use monitoring of implementation of the MDGs for this purpose. Hence, implementation of the Programme of Action of the International Conference on Population and Development 1994 would be more easily achieved if targets for achieving sexual and reproductive health were fully integrated into the MDG process. (excerpt)
Journal of Family Planning and Reproductive Health Care. 2004 Apr; 30(2):131.May I congratulate the Journal and the Clinical Effectiveness Unit for continuing to produce excellent Guidance for those of us working in the field of reproductive health. The wide dissemination of these articles will ensure uniformity and quality in contraception provision in primary and secondary care. I have, however, one concern. This has been alluded to in a recent article describing the consensus process for adapting the World Health Organization (WHO) Selected Practice Recommendations for UK Use. As a result of the relaxation of some of the more cautious rules a very small number of women may become pregnant. An obvious example is giving Depo- Provera injections 2 weeks late (i.e. at 14 weeks) without any precautionary measures. The Selected Practice Recommendations for Contraceptive Use were developed to improve and extend contraceptive provision in developing countries. In developed countries, however, those becoming pregnant may take a more litigious view particularly when patient information leaflets and the Summaries of Product Characteristics (SPCs) state contrary and more cautious advice. In addition, new evidence regarding follicular development potential suggests that more, rather than less, caution may be advisable. Could the Faculty of Family Planning and Reproductive Health Care or the University of Aberdeen be sued? (excerpt)
Reuters AlertNet. 2004 Jan 14;  p..Thoraya Obaid, first Arab woman to head a major United Nations agency, on Wednesday urged U.S. President George W. Bush to drop his controversial ban on funding for the family planning programmes she runs around the world. Giving people, especially women, in developing countries the chance to decide when they have children can help limit global population growth and be at least as effective as free trade in tackling poverty, she told Reuters in an interview. "We hope and plead for the United States to come back as a major donor," said Obaid, a 58-year-old U.S.-educated campaigner for women's rights from Saudi Arabia, who has headed the United Nations Population Fund (UNFPA) for the past two years. Obaid, a U.N. under-secretary general who officials say has recently had problems entering the United States, was speaking during a conference on population issues at which the United States has come under heavy fire. Bush stopped the annual $34 million funding for the New York-based UNFPA when he came to office in 2000, arguing that by working in China it was sustaining a Beijing policy of forced abortion in pursuit of its "one child per family" programme. (excerpt)
Population 2005: News and views on further implementation of Cairo Program of Action. 2003 Sep; 5(3):5.Family Planning Association of Kenya is greatly honored by having been selected by the committee to receive this year's United Nations Population Award in the institutional category. This is indeed a memorable occasion for the Family Planning Association of Kenya on whose behalf and on behalf of the Government and people of Kenya I am standing here to receive the prestigious 2003 United Nations Population Award. It is true to say that the Family Planning Association of Kenya over the years has contributed significantly to increased awareness of population and reproductive health problems in Kenya. From its inception, the association pioneered the family planning movement, investing all its resources in advocating for planned parenthood. With time, and in the spirit of the International Conference on Population and Development, the scope of her work has to encompass integrated sexual and reproductive health. This has enabled women, men and youth to have access to sexual and reproductive health information and services. These services include family planning, maternal and child health, maternity, papsmear tests, laboratory investigations, pharmacy, Voluntary Counseling and Testing (VCT) for HIV/AIDS, outpatient treatment and referral. (excerpt)
[The role and responsibility of volunteers in context of APFs] Papel e responsabilidade dos voluntarios no contexto das APFs.
Sexualidade e Planeamento Familiar. 2001 Jan-Jun; (29-30):37-9.The International Planned Parenthood Federation (IPPF) is considered the primary organization in the world in the area of sexual and reproductive health, however, potential donors have viewed it as too rigid. The IPPF organized a task force to confront this charge and come up with recommendations for improvement. Their proposal was that IPPF should be comprised of a diverse collection of volunteers in terms of age, sex, socioeconomic origin, occupation, performance, race, creed as well as linguistic and geographical representation in such a way that this can represent the communities in which they function.
New York Times on the Web. 2002 Jul 24;  p..In this letter, the authors criticize the Bush administration for withholding the funds for United Nations Population Fund family planning services.
Real Lives. 2002 Jan; (7):3-4.The Family Planning Association of India, a founding member of the International Planned Parenthood Federation (IPPF) in 1952, has suffered cuts of more than 50% in core funding from IPPF over the last four years. It is noted that despite the commitments made at the International Conference on Population and Development in 1994 to provide increased support for sexual and reproductive health programs, most international donors have abridged their contributions, not increased them. The consequences of these relatively sudden cutbacks are considerable: they are leading to the loss of 369 staff members across 43 branches, 38 clinics, 6 community-based projects and 36 outreach facilities, and an inevitable reduction in services. One of the more worrying fears associated with cuts in IPPF core funding is the loss of autonomy and the tendency for remaining staff to become discouraged. There are also serious doubts about being able to replace retiring medical doctors and staff nurses at the low wages being offered. In conclusion, it is hard to come up with recommendations when lack of funding is the main problem.
New York Times on the Web. 2002 Jan 25;  p..The UN Population Fund (UNFPA) is the world's biggest agency focused on women's reproductive health. In third world countries, it fights AIDS, provides sterile delivery kits in rural areas, offers guidance on birth control and helps nations develops policies promoting equality and well-being of girls and women. As part of US foreign aid budget, the Congress allotted US$ 34 million for UNFPA that amounts to some 12 or 13% of the fund's annual budget. However, the Bush administration is considering blocking the funds because of allegations that the fund has supported forced abortions and sterilizations in China. However, it is noted that the allegations are baseless, and the work of the UN fund in crucial areas of women's health around the world deserves full American support.
Guidelines require comprehensive steps. Effective use of national family planning guidelines includes dissemination and regular updating.
Network. 1998 Fall; 19(1):6 p..Nearly 50 developing countries have begun developing new or revised national guidelines on family planning (FP) services. This is a collaborative process, involving providers, government officials, technical experts, and others. In developing guidelines for contraception, many national health officials have relied on recommendations developed by the WHO and US Agency for International Development. These recommendations are designed to make services more accessible, more uniform, and of higher quality. Studies also indicate that guidelines affect provider practices. However, effective use of FP guidelines includes dissemination and regular updating. It is noted that significant improvement in the process of care has been found after the introduction of guidelines. Nevertheless, successful introduction of clinical guidelines is dependent on many factors, including the methods of developing, disseminating and implementing these guidelines. Despite the challenges faced in the effective use of national FP guidelines, progress has been made in standardizing national policies that have the potential to improve access and quality.
Lancet. 2002 Feb 16; 359:539.President George W. Bush has frozen the allocated US$34 million that the US Congress appropriated for the UN Population Fund (UNFPA), the largest internationally funded source for education and services of family planning (FP) in developing countries. This move was prompted by reports implying that the UNFPA budget supports coercive policies, like abortions, of developing countries such as China. UNFPA officials, however, have long denied they condone or support such coercive policies, which UNFPA policy holds to be a violation of human rights. The loss of the US contribution will cut UNFPA's budget by 10%, forcing the agency to significantly reduce its FP services, which, in turn, will lead to 800,000 abortions that otherwise could have been avoided. Reducing the number of abortions in the world requires the increase of US funding to international FP programs that can persuade Chinese officials and the likes that humane voluntary FP is a better answer to their population problems.
[World Population Conference: planning and democracy] Conferencia Mundial de Poblacion: planificacion y democracia.
LINEA ABIERTA. 1994 Jan 8; (1): p..One of the basic principles of the draft document on Population and Development on which consensus has been achieved is the need to guarantee human rights, with emphasis on elimination of discrimination against women as a prerequisite for eliminating poverty and promoting sustained economic development. Recognition of the capacity of all persons to make decisions about their bodies is an element of human rights. (APROPO) is a nonprofit institution assisting population programs that improve the quality of life of all Peruvians. Family planning has been its first line of action because of its impact on health of women and children, on the couple’s relations, and on the general welfare of the family. APROPO educates clients by explaining the different medically recognized methods including periodic abstinence, and allows them to make their own choices in accordance with their moral beliefs, religion, health status, and economic situation. APROPO imposes no method. Given these characteristics, it is interesting to analyze why serious sex education should be demonized. Sexuality has a value in itself, and responsibly practiced can contribute to improving and enriching a couple’s relationship. APROPO approaches the themes of sexuality and reproductive health from the perspective of improving quality of life. It may be asked whether a tendency does not exist to penalize sexuality, despite the human right to its free exercise. The International Conference of Population and Development should be the occasion for reaffirmation of universally recognized principles of human rights and national sovereignty.
REAL LIVES. 2001 Feb; (6):40.In this article, Michael Vlassoff, former UN Population Fund representative for India, examines the way changes brought about by the 1994 International Conference on Population and Development (ICPD) were deemed important for the South Asia region. Vlassoff notes that ICPD has changed the way contraception, sexual and reproductive health, women's empowerment, and the use of targets and incentives are viewed. ICPD brought development back into the discussions on population, although unequivocal statements on population-development linkages are missing from the ICPD document. However, ICPD was able to give more emphasis to meeting client needs and be more responsive to community perspectives. It can therefore be said that what ICPD adopted was a reflection of the changing needs, perceptions, and priorities already acknowledged in India, making the population programs more focused and responsive.
In: Report from the Meeting on Changing Communication Strategies for Reproductive Health and Rights, December 10-11, 1997, Washington, D.C., [compiled by] Working Group on Reproductive Health and Family Planning. [New York, New York], Population Council, Health and Development Policy Project, . 21.As the 1994 International Conference on Population and Development (ICPD) recommended, the provision of IEC (information, education, communication) and its interface with the community should focus on informing individuals, promoting their rights, and enabling individuals and communities to adopt self-determined behavior changes in response to self-identified needs. This will result in creation of reproductive health communication programs that 1) value the unique needs of women and adolescents rather than demographic or economic concerns, 2) support women in gaining control of their bodies, 3) challenge men to be responsible for their behavior in relation to women and adolescents, 4) seek to eliminate the pressure on women to have undesired sexual intercourse, 5) equip women to assert their right to accept or initiate desired intimacy based on informed decision-making, and 6) stimulate increased equity in gender-power relations. Communities can be empowered to play a critical advocacy role, and donors, national or international agencies, nongovernmental organizations, and governments should act as catalysts to community mobilization. Organizations involved in reproductive health should develop internal consistence between programs and the principles of the ICPD Program of Action, promote facilitation of informed choice rather than target-driven behavior, and incorporate gender sensitivity in communications. After this is accomplished, objectives and measures should be made consistent with the ICPD principles and actions.
In: Report from the Meeting on Changing Communication Strategies for Reproductive Health and Rights, December 10-11, 1997, Washington, D.C., [compiled by] Working Group on Reproductive Health and Family Planning. [New York, New York], Population Council, Health and Development Policy Project, . 9-12.International Planned Parenthood Federation Family Planning Associations (FPAs) in St. Lucia, Guyana, and Belize participated in a process to facilitate community participation in efforts to achieve social and organizational changes so communities could control their own sexual health. The program involved institution building, expansion of clinical services, creation of user friendly services for adolescents, networking, and documentation and evaluation. In order to reorient their services from a top-down flow of information, the FPAs had to 1) listen to the community, 2) engage in a dialogue on sexual and reproductive health, 3) allow the community to take some responsibility for the process, and 4) have faith in the community's ability to know its needs and validate its capacity to devise solutions. The tools for social change included adoption of a participatory approach that facilitated broad-based thinking and a commitment to making sexual health a central focus in the minds of community members. In this case, sexual health was defined as including an understanding of the basic norms and beliefs that influence gender relations, human sexuality, and sexual decision-making. In addition to making a discernable impact on the community, the project inspired the FPAs to engage in institution building, expansion of services, creation of new protocols, peer counseling, networking, and more rigorous evaluation. The project demanded a significant investment of time and requires flexibility and patience, but it is effective, gender sensitive, and sustainable.