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  1. 1

    WHO recommendations [letter]

    Mansour D

    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)
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  2. 2

    Nurses' manual, excerpted from PPACA clinic staff procedural manual.

    Planned Parenthood Association of Chicago

    Chicago, Illinois, Planned Parenthood Association of Chicago, 1966. 16 p.

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  3. 3

    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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  4. 4

    A major challenge. Entrepreneurship characterizes the work of the Soviet Family Health Association.

    Manuilova IA

    INTEGRATION. 1991 Sep; (29):4-5.

    The work of the Soviet Family Health Association (SFHA) is described. Created in January, 1989, the organization boasts 25 state-paid workers, and as of June 1991, membership of 15,000 corporate and individual members. Individual annual membership fee is 5 rubles, and entitles members to counseling and family planning (FP) services. The SFHA works in cooperation with the Commission on Family Planning Problems of the USSR's Academy of Sciences, and has been a member of the International Planned Parenthood Federation (IPPF) since 1990. Association activities include lectures for students, newly-weds, adolescents, and working women on modern contraceptive methods; research on attitude regarding sex, sex behaviors, and the perceived need for effective contraception; clinical trials of contraceptive suitability for women; and the training of doctors in FP and contraceptives. Problems central to the SFHA's operations include insufficient service and examination equipment, a shortage of hard currency, and the small number of FP specialists in the country. Solutions to these obstacles are sought through collaboration with the government, non-governmental organizations in the Soviet Union, and international groups. The SFHA has a series of activities planned for 1991 designed to foster wider acceptance of FP. Increased FP services at industrial enterprises, establishing more FP centers throughout the Soviet Union, and studying FP programs in other countries are among Association targets for the year. Research on and promotion of contraceptives has been virtually stagnant since abortion was declared illegal in 1936. Catching up on these lost decades and remaining self-reliant are challenges to the SPHA.
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  5. 5

    Trip report, Burundi, 21 - 24 July 1987.

    Ben Salem B

    [Unpublished] 1987. 7 p.

    During the July 21-24 trip to Burundi, discussions were held about possible Association for Voluntary Surgical Contraception (AVSC) assistance in creating a training center at the University Hospital which could serve as a site for training medical personnel from Burundi and other French-speaking African nations. Practical training is urgently needed at this time to allow health personnel to feel comfortable about dispensing a wide range of contraceptive methods/information. A great need exists for the training of nurses in IUD insertion and for copper-T commodities. Family planning method acceptance is growing steadily: the number is said to double every 6 months. As yet, voluntary surgical contraception plays a minor role and is available only at a limited number of centers. As previously reported, several donors, including the UN Fund for Population Assistance, World Bank, and the African Development Bank, are involved in activities/proposals related to maternal/child health and family planning. The major objective of AVSC assistance to the Ministry of Public Health is to increase access to VSC by integrating quality services into ongoing maternal/child health/family planning activities in 4 regional referral hospitals. The project is expected to last for 4 years with a total budget of slightly over $200,000. During this visit, the basics were worked out for a program in which AVSC would provide assistance for training 10 physicians/year in minilap (both postpartum and interval) using local anesthesia. Trainees would be residents and interns and, if possible, physicians from government facilities. It is hoped that a training program document can be developed for presentation at the December 1987 meeting of AVSC's International Committee. The site visit was useful to the effort of moving the pending project with the Ministry of Public Health along and for discussing possible cooperation with the University Hospital. Program success is likely for several reasons: the Ministry of Public Health generally is favorable and supportive; chances for "institutionalization" are good; the basic hospital infrastructure is sound; and the rising demand for VSC is recognized by health officials and service providers.
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  6. 6


    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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  7. 7


    Loomis SA

    Washington, D.C., U.S. Office of International Health, Division of Planning and Evaluation, 1976. 92 p. (Syncrisis: the dynamics of health, XVII)

    This article uses available statistics to analyze health conditions in Bangladesh and their impact on the country's socioeconomic development. Background information on the country is first given, after which population characteristics, health status, nutrition, national health policy and adminstration, health services and programs, population programs, environmental sanitation, health sector resources, financing of health care and donor assistance are examined. Bangladesh's 3% annual population increase is expected to increase already great population pressure and to have a negative impact on the health status of the population. Although reliable health statistics are lacking, infant mortality is estimated at 140 per 1000, 40% of all deaths occur in the 0-4 age group, and maternal mortality is high. Infectious diseases exacerbated by malnutrition are the main causes of death. 4 key factors are responsible for the general malnutrition: 1) rapidly growing population, 2) low per capita income, 3) high incidence of diarrheal diseases, and 4) dietary practices that restrict nutrient intake. Most of the population has access only to traditional health services, and medical education is hospital oriental and curative, with minimal emphasis on public health. The level of environmental sanitation is extremely low.
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  8. 8

    Medical audit: a guarantee of quality.

    Oliva G

    ADVANCES IN PLANNED PARENTHOOD. 1979; 14(4):152-9.

    A quality control program, using the bi-cycle process of medical auditing as a model, was implemented in 1976 at 5 family planning clinics operated by the Alameda-San Francisco affilate of Planned Parenthood. Both the process of auditing and the quality of patient care improved during the 2 1/2 years of program operation. Steps in the bi-cycle process were 1) defining standards for patient care; 2) collecting data on actual practice; 3) comparing actual practices with the standards; 4) instituting changes to correct deficiences in regard to meeting the standards. and 5) reassessing the program after implementation of the changes. The affilate developed uniform procedures for charting patient care, and these procedures were instituted at all 5 clinics. Charts were checked by staff personnel prior to each patient visit, and any problems needing attention were flagged for the attending clinician. After each visit or laboratory procedure, the charts were routinely checked for completeness and returned to the responsible party if incomplete. Immediate improvement in charting was observed and charting procedures were continually improved. The information from the charts was problem coded and entered into a computerized system. Monthly printouts of incidence figures were made available. These printouts helped identify problem areas. For example, when the printout demonstrated a sudden decline in the gonorrhea rates, an investigation revealed that gonorrhea cases were going undetected due to improper laboratory procedures. When a problem was identified, the causes of the problem were investigated and procedures to correct the deficiency were instituted. Subsequent monthly printouts were used to evaluate the degree of improvement brought about by these changes. Staff personnel, especially the physicians, were actively involved in helping to establish new standards and in seeking solution to identified problems. This involvement helped reduce feelings of hostility toward the quality control program on the part of staff personnel. Included were charats which depicted changes in the degree of adherence to defined standards for patient care over time.
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  9. 9


    Haddad W

    In: Bloch LS, ed. The physician and population change: a strategy for Africa, the Middle East and Europe. Bethesda, Maryland, World Federation for Medical Education, 1979 Mar. 7-10.

    The Tri-regional Seminar on the Physician and Population Change was convened to consider the role of the physician in the field of population. The physician in collaboration with other family planning personnel; his position in an interdisciplinary team; his role in establishing structures and institutions that meet the needs of the community; and, the responsibility of medical schools in population education are discussed in terms of declining fertility and rising numbers of aging and populations with 40-50% of people under age 20. In more and less developed European countries the questions raised are: 1) desire to have or not to have children, and 2) family planning as an essential to the quality of life. Physicians must be able to deal with questions of sexuality, reproduction, and family counselling, but few have been trained in these areas. They must realize the importance of collaboration with those in other fields. This seminar was sponsored by the World Health Organization.
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  10. 10

    Yozgat MCH/FP Project: Turkey country report.

    Coruh M

    [Unpublished] 1979. Paper prepared for the Technical Workshop on the Four Country Maternal and Child Health/Family Planning Projects, New York, Oct. 31-Nov. 2, 1979. (Workshop Paper No. 2) 10 p.

    An integrated health care system which combined the maternal/child health with other services was undertaken in the Yozgat Province of Turkey from 1972-77. The objective was to train midwives in MCH/FP and orient their activities to socialization. The first 2 years of the program was financed by UNFPA. 52 health stations were completed and 18 more are under construction. The personnel shortage stands at 33 physicians, 21 health technicians, 30 nurses, and 67 midwives. Yozgat Province is 75% rural and has about a 50% shortage of roads. The project was evaluated initially in 1975 and entailed preproject information studies, baseline health practices and contraceptive use survey, dual record system, and service statistics reporting. The number of midwives, who are crucial to the program, have increased from an average 115 in 1975 to 160 in 1979. Supervisory nurses are the link between the field and the project managers. Their number has decreased from 17 to 6. Until 1977 family planning service delivery depended on a handful of physicians who distributed condoms and pills. The Ministry of Health trained women physicians in IUD insertions. The crude death rate in 1976 was 13.2/1000; the crude birth rate was 42.7/1000. The crude death rate in 1977 was 14.8/1000; birth rate, 39.9/1000. Common child diseases were measles, enteritis, bronchopneumonia, otitis, and parasitis.
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  11. 11

    Kenya's project for the improvement of rural health services and the maternal child health and family planning programme.

    Kanani S

    In: Korte R, ed. Nutrition in developing countries. Eschborn, Germany, German Agency for Technical Cooperation, 1977. 29-37.

    This report focusses on a project for the improvement of rural health services and development of 6 rural health training centers in Kenya. The Ministry of Health has the responsibility of managing the health centers and dispensaries throughout the country. After a study by experts and funding by international agencies, a project to provide postbasic training to health center staff was undertaken. The major health conditions affecting the community were: family health problems; communicable disease; inadequate sanitation diseases; and, malnutrition and undernutrition. The most overwhelming problem was family health which necessitated a maternal and child/family planning project. The program is directed at women aged 15-49 with a "Super-Market" approach whereby all services (antenatal care, maternity care, postnatal care, child welfare, family planning and health education) will be available on a daily basis in an integrated system. 5 new training schools for nurses are being built. Education in both health and family planning will be emphasized in the project in the future. With a view to uplifting the general quality of life, the Kenya projects are seen as part of the total socioeconomic development of the country as a whole.
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  12. 12

    Sao Paulo Family Planning Center.

    De Carvalho MA

    [Unpublished] 1979. Presented at the 4th CEFPA Course, Washington, D.C., 1979 Oct 1. 5 p.

    The Maternal-Infant Center in Sao Paulo, Brazil was established by funds from the Pathfinder Foundation to provide family planning services and personnel training for low-income families. Through research the center determines the demand for family planning, trains professionals, d volunteers in family planning, and provides medical assistance. The 1979-80 goal is assistance to 3535 families. The project cost $528,013. 16% of the budget was allotted to social and medical surveys, 21% to research, 20% to training programs, and 43% to assistance programs. There are 5 types of training programs: 1) physicians in minilaparotomy; 2) interns in IUDs, oral contraceptives; 3) midwives in oral contraceptives; 4) nursing students in oral contraceptives; and 5) foreign physicians. 3 children are used in the Center's emblem instead of 2 because the average family size in Brazil is 5 children and depicting only 2 as the goal would be too radical.
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  13. 13

    The International Confederation of Midwives: an overview.

    Hardy FM


    A brief summary of the historical development of the International Confederation of Midwives (ICM) and a review of the organization's recent activities was presented. Efforts to develop an international association of midwives began in 1922. The 1st World Congress of Midwives was held in 1954 and since that time the Congress has met once every 3 years. National midwife associations from 51 countries belong to the ICM. The goals of the organization are 1) to improve the knowledge, training, and professional status of midwives; 2) to promote improved maternal and child care in member countries; and 3) to further information exchange. Since 1961 the ICM and the International Federation of Gynecology and Obstetrics have cooperated in a joint study of midwife training and practice. In 1966 the study group completed its 1st report on the status of maternal care around the world and made a number of recommendations for improving the training of midwives and for establishing uniform licensing requirements. It soon became apparent that these problems could not be dealt with on a worldwide basis, and 12 working parties in different regions were established to investigate the problem at the local level and also to make recommendation in regard to providing family planning services in the context of maternal and child health programs. Each working party has a Field Director who seeks to implement the recommendations of the group. Field Directors have also arranged seminars in reproductive health for rural health workers and especially for traditional birth attendants. The ICM also works in cooperation with the European Economic Community, WHO, IPPF, and several other international agencies. The activities of the working parties have received financial support from USAID.
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  14. 14

    Past resolutions adopted by the IPPF.

    International Planned Parenthood Federation [IPPF]. Law and Planned Parenthood Panel

    Law File, International Planned Parenthood Federation. 1979 Oct; 10:20-3.

    Recently adopted policies of the IPPF Management and Planning Committee on voluntary sterilization, family sterilization, family planning services for adolescents, and the use of auxiliary personnel in the delivery of fertility regulation services are summarized. Sterilization services should be included in family planning programs whenever possible, and Family Planning Associations should promote sterilization awareness. Sterilizations should be performed only on patients who have given informed and unpressured consent, and procedures most amenable to reversibility should be used. The use of government incentives or disincentives to promote sterilization must take into account existing social values. The receipt of any government benefits or services normally accorded as a basic human right cannot be made dependent on the acceptance of sterlization. Fertility regulation services should be made available to adolescents whenever possible. Efforts to remove all barriers to the offering of these services should be promoted. Research should be undertaken to determine 1) the effect, if any, of contraceptive availability on the frequency of adolescent pre-marital intercourse; 2) the effects of unplanned pregnancy on adolescent mothers and their offspring; and 3) the most effective methods for promoting acceptance of adolescent family planning services. The use of trained health and auxiliary personnel in the delivery of fertility services should be encouraged through 1) increased use of standing orders and presigned prescriptions; 2) further delegation of duties by doctors to auxiliary personnel; 3) application of the most liberal interpretation of laws relevant to the use of auxiliary personnel; 4) the authorized use of auxiliary personnel whenever possible; and 5) the establishment of panels within each Association to develop auxiliary personnel training programs.
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  15. 15

    Health education manpower for family health and health aspects of human reproduction.


    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.
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  16. 16

    From here to 2000: a look at the population problem.


    Johns Hopkins Medical Journal 144(1):18-24. January 1979.

    The population problem is examined in terms of population policy in the U.S. over the past 25 years, the present status of population control, the future of population control, and the debate on strategy. In 1952 the Population Council was established, and this organization has provided significant leadership in the field ever since. Another milestone was passed in 1958 when Dr. Louis Hellman, then of Kings County Hospital, did battle with the New York City Commissioner of hospitals over his right as a doctor to fit a diabetic patient receiving welfare with a diaphragm. By the mid-1960s worldwide attention was directed to the problem of rapid population growth. Since the early 1970s the World Health Organization has increased its commitment to population. Nationally, the medical community, if not indifferent, has often taken an ultra-conservative view of the delivery of contraceptive services - kinds of personnel to deliver them, responsibilities of medical practitioners for the reproductive health of patients. Much headway has been made in reducing fertility. In the 1965-1975 period there have been declines of 20% or more in the crude birthrate. Declines occurred in such traditionally high-fertility areas as Costa Rica, the Dominican Republic, Panama, Thailand, Tunisia, North Vietnam, and the Indian Punjab. Countries that experienced declines ranging from 15-20% included Egypt, India, the Philippines, Sri Lanka, and Turkey. Yet, in other countries, little has happened to affect fertility even though the social and economic situation continues to deteriorate for the average family. There is no question that in time the effective regulation of fertility will spread around the world; the critical question is that of time. There are encouraging signs indicating that family planning programs can and do accelerate fertility decline. It is necessary to go beyond effective family planning and a rising age at marriage if birthrates are to come within the range of mortality rates.
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  17. 17

    [Facts and fantasy in personnel training in population activities] Hechos y fantasias en el estrenamiento de personal en actividades de poblacion.


    [Unpublished] [1979]. 4 p.

    The education and training of family planning personnel at every level in underdeveloped countries should be object of particular care and organization. Factors to be taken into consideration are the climate, means of transportation within the country, attitude of governments toward family programs, costs and funding. Help from international agencies should be accepted only through the country's scientific societies, or through existing family planning centers. Doctors should be specially trained on theoretical and practical aspects of biology and reproduction, and they should spend time working for existing programs. Midwives and nurses should take adequate courses in contraceptive technology; community leaders should be identified, and counselors given specific responsibilities.
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  18. 18

    Multi-year population strategy--Arab Republic of Egypt.

    United States. Agency for International Development [USAID]

    Egypt, USAID. 1978 March; 82.

    A review of Egypt's population/family planning policy and assessment of the current population problem is included in a multi-year population strategy for USAID in Egypt, which also comprises: 1) consideration of the major contraints to expanded practice of family size limitation; 2) assessment of the Egyptian government's commitment to fertility control; 3) suggestions for strengthening the Egyptian program and comment on possible donor roles; and 4) a recommended U.S. strategy and comment on the implications of the recommendations. The text of the review includes: 1) demographic goals and factors; 2) assessment of current population efforts; 2) proposed approaches and action for fertility reduction in Egypt; and 4) implication for U.S. population assistance. Based on analysis of Egyptian population program efforts, the following approaches are considered essential to a successful program of fertility reduction: 1) effective management and delivery of family planning services; 4) an Egyptian population educated, motivated and participating in reducing family size; 5) close donor coordination; and 6) emphasis on the role of women.
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  19. 19

    Local responses to global problems: a key to meeting basic human needs.


    Washington, D.C., Worldwatch Institute, February 1978. (Worldwatch Paper No. 17) 64 p

    According to a World Bank estimate, large scale international efforts to improve social and economic conditions in developing countries would cost 47.1 billion dollars between 1980-2000. Since rich countries have not been disposed in the past to contribute heavily toward solving these problems, it is unlikely that they will commit themselves to this type of financial help in the future. Collective, self-help efforts on the local level may offer a feasible alternative for aleviating global problems of inadequate housing, food shortages, insufficient medical care, and energy shortages. Small scale efforts which enlist community involvement in the initiation, planning, and carrying out of projects are frequently more effective in creating uplift than are larger efforts controlled by individuals outside the community. Attempts to provide better housing for the poor through building large public housing complexes are costly and tend to create non-livable conditions for many of the poor; self-help efforts such as homesteading and rehabilitation, on the other hand, have been more successful. In developing areas massive national programs to relocate squatters have failed. Efforts to help squatters improve the dwellings they presently inhabit may be a more fruitful approach. The recent emphasis on garden plots for urban dwellers and small labor intensive family farms along with marketing cooperatives in the rural areas may reduce malnutrition and protect the poor from inflationary food prices. At the present time 1/5 of the world's population is still without medical care and many others have inadequate health care. The mobilization of individuals for self care, especially in regard to disease prevention, and the decentralization of health services through the establishment of neighborhood health centers, family planning clinics, and systems utilizing barefoot doctors can help overcome present health deficiencies. The energy problem can be partially solved by individual efforts to conserve resources. Many individuals and communities are developing local solar, wind, and water sources and are thus reducing reliance on the highly centralized energy industries.
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  20. 20

    Private medical practitioners expand family planning participation.

    ICARP Bulletin, No. 1, September 1978. p. 5-7.

    There is evidence from several Latin American and Asian countries that people prefer private medical practitioners, either Western-trained physicians or indigenous practitioners, to provide them with family planning information and supplies. There is a need to update the family planning training for these practitioners. The World Health Organization is currently developing such training programs for medical students in Mexico. There is a more pressing need to improve systems of delivery and distribution for family planning commodities. Government programs in some countries have worked out a family planning contract arrangement with private physicians. In other areas, subsidized purchasing and mail order of supplies has been tried successfully. When contraceptive supplies are distributed through the private sector, the government program should make an effort to improve record-keeping and reporting.
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  21. 21



    In: Watson, W.B., ed. Family planning in the developing world: a review of programs. New York, Population Council, 1977. p. 54-55

    The government of Honduras included a population policy in its National Development Plan for the period 1974-1979. This policy will be implemented by providing information regarding responsible parenthood, by using natural and technical resources to produce a well-nourished and creative population, and by applying the principles of voluntary participation in family planning programs. The 2 family planning programs in Honduras are the government maternal and child health program and the Family Planning Association of Honduras program. The government program, initiated in 1968, operates 34 clinics which offer family planning along with prenatal and postnatal care, child care, and nutrition education services. The Family Planning Association, established in 1961, operates 2 clinics and served 42,000 people during 1975. 9000 of this group were 1st acceptors. Oral contraceptives were chosen by 80% of the new acceptors; 13% chose IUDs and 5% chose injectables. The Association's information and education activities included conferences, talks, courses, seminars, and home visits. Additionally, the Association is operating a demonstration community-based distribution program with financial assistance from the International Planned Parenthood Federation. 40 workers in each of 2 cities provide contraceptives in their own neighborhoods.
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  22. 22

    Desexing birth control.


    Family Planning Perspectives. November-December 1977; 9(6):286-292.

    When Margaret Sanger initiated the American birth control movement in the early twentieth century, she stressed female and sexual liberation. Victorian views on morality have since combined with the compromises necessitated to achieve legitimacy for the movement to lead to a desexualization of the birth control movement. The movement's communication now concentrates on reproduction and ignores sex; it emphasizes family planning and population control but does not mention sexual pleasure. Taboos against publicity concerning contraceptives are more powerful even than laws restricting the sale or distribution of contraceptives themselves in many countries. The movement must recover its earlier revolutionary stance.
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  23. 23

    Report on our observation trip to Thailand about Depo-Provera and mini-lap.


    [Unpublished] 1975. 21 p.

    Depo-Provera has not been used on a widespread basis in the Philippines because the Federal Drug Administration has not approved it, and a large share of their family planning budget is funded by USAID. Although Governor Luiz made Depo-Provera available to 800 acceptors; it was too expensive to compete with free contraceptives. On a trip to Thailand Governor Luiz witnessed the long-term effects of a Depo-Provera program begun in 1965: fewer children and better living conditions. Laparoscopy is too expensive an operation in training and instruments required to be used in the Philippines. Mini-lap is effective and inexpensive. A Thai doctor taught a Philippine doctor the procedure in only 2 operations. The Philippine doctor can train many others quickly, and equipment can be manufactured locally.
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  24. 24

    Family planning needs and services in nonmetropolitan areas.


    Family Planning Perspectives. September-October 1976; 8(5):231-240.

    At the end of fiscal year 1974, about 2.5 million low- and marginal-income nonmetropolitan women, or about 3/4 of all such women in the United States, had no access to family planning services from either private physicians or organized clinic programs. By this time, 3/4 of the counties in the U.S. had a family planning service center, but this included 91% of all metropolitan and only 72% of all nonmetropolitan counties. Although there are wide disparities in service levels among states, need was concentrated in nonmetropolitan counties of the South and the East North Central region. The statistics are tabulated, graphed, and mapped. Private physicians seemed to be supplying a small percentage of the nonmetropolitan family planning needs. Physician shortages mean that this trend will continue in the future. Health department programs and hospitals will have to meet the need. Coordinated action on the part of national, state, and local agencies will be necessary. Priority should be given to supplying the larger nonmetropolitan counties, perhaps with mobile units or paraprofessional personnel.
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  25. 25

    Islamic Republic of Pakistan.

    Furnia AH

    Washington, D.C., U.S. Government Printing Office, June 1976. (Syncrisis, The Dynamics of Health No. 18) 149 p

    There is no sector of Pakistani life which more graphically reflects the great sacrifice it took to make Pakistan a viable state than the health sector. Malaria, tuberculosis, and cholera continue to constitute threats to health. Gastrointestinal, infectious, and other parasitic diseases continue to contribute substantially to morbidity and mortality. These diseases are exacerbated by extremely primitive water supplies and waste disposal, bad housing, nutritional problems, and an increasingly heavy population growth. Public health resources to cope with these conditions have not previously been available. Pakistan's poor helth environment appears to result from widespread infectious and communicable diseases, poverty, and sociocultural attitudes which inhibit improving the environment, and ineffective policies administered by limited numbers of inadequately trained health workers, affecting both the urban poor and the rural population. In the latest 5-year plan, the 5th, 1975-1980, there is increasing attention to health. Regarding family planning, it has been suggested that the government has finally begun to recognize that urgent and dramatic steps are necessary to reduce Pakistan's population growth rate. The government has adopted a policy of using conventional contraceptives as the most acceptable method of contraception in Pakistan. A program of distributing the oral contraceptive without medical or paramedical constraints had been instituted, and the government has undertaken to subsidize the distribution of th oral contraceptive and the condom through some 50,000 outlets at 2.5 cents per monthly supply.
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