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Research on the regulation of human fertility: needs of developing countries and priorities for the future, Vol. 2, Background documents.
Copenhagen, Denmark, Scriptor, 1983. 2 986 p.Volume 2 of papers from an international symposium starts with chapter 7--available methods of fertility regulation; problems encountered in family planning programs of developing countries. Natural family planning is discussed here, as well as contraceptives and male and female sterilization. Chapter 8 covers research problems with regard to epidemiological, service, and psychosocial aspects of fertility regulation. Family planning is stressed in this chapter. Chapter 9 discusses future methods of fertility regulation: progress in selected areas. New contraceptive agents are discussed, such as luteinizing hormone releasing hormone and its analogues, gossypol for men, and immunological methods of fertility regulation. Chapter 10 also discusses future methods of fertility regulation, but from the point of view of research needs and priorities as viewed by program directors and advisers. Views and research priorities of the Population Council, and the Indian Council of Medical Research are given. Research needs and priorities in China are discussed, as is the role of the World Health Organization's Special Program of Reseach, Development and Reserch Training in Human Reproduction. Lastly, chapter 11 covers the role of governments, agencies and industry in reseach on fertility regulation. The role of the Agency for International Development, the US National Institutes of Health; and the World Bank, among others, are discussed.
Washington, D.C., Battelle Human Affairs Research Centers, 1983 May. 62 p. (Contract: AID/DSPE-C-0076)1 of a series of Population and Development Policy Final Country Reports, this report on Jordan provides an account of the rationale, procedures, and outcomes for PDP activities. After reviewing country background (population characteristics and trends, development trends and characteristics, population policies, family planning service and information, research capabilities, and opportunities and needs for population policies, family planning service and information, research capabilities, and opportunities and needs for population assistance) and the PDP Program of Battelle Human Affairs Research Centers, research findings and dissemination activities are reported and follow-up activities are recommended. Jordan's population size is small--an estimated 3 million in 1980, but various other characteristics made it a priority for PDP assistance. In 1979 the annual rate of growth was estimated to be anywhere between 3.5-4.8%. Fertility surveys indicate that over half of married women in Jordan surviving through their childbearing years have at least 7 children. Battelle PDP's Core Project in Jordan was designed to encourage the formulation of population policy. The project, titled Major Issues in Jordanian Development, was coordinated by the Queen Alia Welfare Fund. The project ran from July 1981 to April 1983 and encompassed 2 major types of activities: 6 2-person teams of researchers and government program managers collected and analyzed existing information on population and development issues, and 4 of the 6 research review papers prepared under the project directly addressed development issues of interest to the government i.e., education and training of women, social defense, income distribution, and demand for health services; and dissemination of the findings of the research review and analysis projects to national decision makers and opinion leaders in Jordan. The 6 research reviews were undertaken by pairs of authors, most of which included 1 government representative and 1 private or university researcher. Close monitoring and extensive technical assistance was provided to this project through several field visits and frequent correspondence. Brief descriptions are included of the 6 major issue papers. The paper on demographic trends in national planning reviews the literature on determinants of fertility and the effects of population growth and provides a historical analysis of the role of population variables in Jordan's past development plans. In the paper devoted to the education and training of women, women's schooling was found to be the most robust determinant of married women's fertility in the 1972 and 1976 Jordanian Fertility Surveys. The paper dealing with poverty and its implications for development reviews the extant data on per capita and poverty line data. The team that analyzed the demand for medical services proposed a regional plan for community-based health services. The topics of the final 2 papers were consequences of rapid population growth on development and social defense.
WHO Meeting on Maternal and Child Health Indicators for Health for All by 2000: Evaluation of Alternatives, Geneva, 8-12 November 1982.
Geneva, Switzerland, WHO, . 27 p. (WHO/HS/NAT.COM/83.383)The main objectives of the Maternal and Child Health (MCH) and Family Planning (FP) Indicators meeting, held in Geneva from November 8-12, 1982, were to: evaluate and critically review past data collection experiences; systematically review existing and new indicators for the evaluation and monitoring of MCH/FP programs; and to discuss the problems and alternative methods of obtaining the necessary data for indicators. The major part of the meeting was devoted to a review of indicators for assessing the progress of MCH/FP programs at the global, regional, and national levels and the consideration of possible sources of information for obtaining the data upon which to base these indicators. On the basis of this review, the meeting sought to arrive at a consensus on the types of information that might be collected for monitoring and evaluting MCH/FP programs under various health circumstances. Information is presented on the following: the experience of the World Health Organization (WHO) ad hoc surveys on infant and childhood mortality; other data collection experiences (World fertility Survey program, international MCH/FP Program of the Population Council, National Household Survey Capability Program, and a study of levels and trends of infant mortality in Mauritius); MCH/FP indicators (global and regional indicators, factors affecting national indicators, mortality and morbidity indicators, positive health indicators MCH and family planning, and sources of information); and future directions (health modules of household surveys and population censuses, innovative techniques, cluster sampling, record keeping systems, vital registration, training of all health workers, and MCH audit). With regard to the ad hoc surveys on infant and childhood mortality conducted in 5 countries in the early and mid 1970s and other data collection experience, the evaluation background paper found that the surveys were too ambitious. The goals were unclear, and the program was not well planned and managed. The shortcomings of these particular surveys were not intended to reflect on the ability of surveys to serve as important vehicles in development of databases for health planning purposes. The meeting heard from various national project directors who emphasized some of the more positive results of the survey for their country. The work of the WFS was particularly encouraging in showing how surveys can provide a whole set of complex data through household interviews. The meeting recognized the need to address the technical problem of data development, particularly the development of indicators for MCH/FP purposes and suggested several directions for the future. The approaches range from using health supplements and modules to national surveys and population censuses, to innovative approaches in the use of synthetic indirect estimation systems and expanded use of cluster sampling, to increased opportunities for training personnel in various aspects of data collection, use, and management.
Progress report on WHO Sponsored Service Research Project in Family Planning and Family Health: 80030--20 August 1982-28 February 1983.
[Unpublished] 1983 Mar 25. 35 p.Details of the progress made on the World Health Organization (WHO) Project 80030 from August 21, 1982 to February 28, 1983--the Baseline Studies and Evaluation of Health Benefits Attributable to Integrated Family Planning and Maternity/Infant Care Services--are presented. For the last 6 months, the project has been in the initial buildup stage of intervention with 12 personnel/months of midwives input in the intervention area. Crucial to the progress have been the efforts to strengthen the organizational capability of subhealth centers as an effective unit of primary care by: providing personnel resources such as midwives; supporting midwives' ahd health workers' activities; supervising and controlling the quality of work of health workers; and establishing the mechanism of community participation and conducting community education. Information is presented on personnel, quality control in family planning/maternal child health (FP/MCH) care, supportive activities, village health volunteer networks and their education, institution building, the project site as a teaching setting for community medicine, outcome, and finance. Currently, there are 3 nurses aides assigned in each subhealth center. Due to the shift of personnel and government pressure to achieve family planning targets by health workers, the inservice training of health workers has failed to proceed as fast as planned. Yet, 4 training sessions were conducted during this reporting period. The project has developed various record and statistics forms for family planning and maternal and child health services. Results indicate that there are some tendencies for overreporting or underrecording, depending on the kind of services, i.e., either quantitative or qualitative items. A need exists for systems for better accountability in order to obtain accurate recording. To support the activities of health workers, a motor cycle was selected as a means of transportation, 1 for each midwife and 1 for the public health nurse. The project currently has 60 village health volunteers who have been nominated by each township chief. Each village health worker is to report on pregnant women and to keep the village rosters current by reporting on births and deaths in the village. In addition to the village health worker training, active community health education at the village level is now in progress. A chronological development of the project is included.
Populi. 1983; 10(1):78-81.The World Health Organization's (WHO) aim is to achieve a level of health that will allow all the world's citizens to lead a socially and economically productive life by the year 2000. Peter D. O'Neill's book, "Health Crisis 2000," is based on WHO's European regional strategy for attaining "health for all" by the year 2000. Its goal is to enable a large audience to participate in a dialogue on the real issues. An analysis of trends in health and disease, made over the past 3 years by representatives of the medical profession, has produced ominous signs that current health policies have set a dangerous course. If "health for all" is to be realized by the year 2000, it will be necessary to implement a new strategy with 3 inseparable themes, i.e., health as a way of life, the prevention of ill health, and community care for all. While the book analyzes the 1st stage of work which the WHO European Region has drawn up for itself, it interprets the official strategy document and offers ample detail to draw ministers, parliamentarians, industrialists, and the media into the debate. Fakhruddin Iqbal reports that a recent study suggests that the Bangladesh family planning program neglected to consider age old social and cultural values. The study identifies 2 distinct cultural values that present obstacles to the program: the traditional preferences for age old treatment as opposed to modern medical practices and the persistent tradition of relegating women to the lowest rung of mass education; and the traditional family size perceptions of the people. Andrew Hamilton writes that the Jamaica Family Planning Association has employed 7 people to spread knowledge of family life education and family planning among youth. These 18-23 year old youth associates are part of a major national drive to keep Jamaica's population below 3 million by the year 2000. About traditional midwives Jan Steele writes that they deliver between 60-80% of babies in the developing world each year and provide support and care in environments commonly shunned by the medical profession. The IPS reports that according to the 1980 census the population of Brazil is 120 million. If the current demographic trends continue, the population will double by 2014. With the present unemployment level, there will be 41.5 million people underemployed and 15 million unemployed in 2014. Meena Panday writes that Nepal cannot seem to get its population program going. The Population Council reports that no evidence exists as yet that use of the copper bearing or nonmedicated IUD increases the risk of ectopic pregnancy.
[Unpublished] 1983 Mar 22. 9 p.Now an approved US Agency for International Development (USAID) document, this paper devoted to population sector strategy provides guidance on implementation of the Agency Population Assistance Policy. It is based on recent scientific knowledge and program experience and stresses the priority emphases of the Agency: host country policies; the private sector; institutional development; and technology development and transfer. USAID has 2 basic population policy objectives: to enhance the freedom of individuals in less developed countries (LDCs) to choose voluntarily the number and spacing of their children; and to encourage a rate of population growth consistent with the growth of economic progress and productivity. Service delivery, together with support for related research, are the highest priority population assistance activities. Implementation of AID's population policy involves both: programs in other development sectors which influence parents' desire to space or limit the number of children and enhance their ability to understand and use effectively modern contraceptive methods; and programs to ensure the widespread availability of high quality voluntary family planning services through which couples can regulate their fertility. Social and economic conditions that contribute to high birthrates and a low prevalence of family planning use include high infant mortality; status of women based on low educational and income earning prospects, early age of marriage, and high perference for sons; cultural and social barriers to limiting births; dependency on children for old age security; and institutional barriers to the provision of family planning services. Strategies for each of these areas are outlined. In regard to the institutional barriers to the provision of family planning services, the strategy is to identify the improvements in human and financial resources, delivery infrastructure, and management skills required for a broad range of family planning information and education activities directed at both women and men. In the initial stages of family planning program development, priority should be given to AID strategies that: provide information about the country's demographic situation; build consensus that couples have the right to choose voluntarily the number and spacing of their children; strengthen existing family planning information and service delivery facilities to address unmet needs for services; and provide training opportunities. Priority strategies are to establish awareness and create consensus on the importance of family planning and population issues and to assist existing family planning information and service delivery systems. Priority strategies in the stage of broad program assistance and phase out of external assistance are outlined along with strategies to advance scientific and technological knowledge in support of voluntary family planning programs.
Sources of population and family planning assistance. Fontes de assistencia populacional e de planejamento familiar.
Population Reports. Series J: Family Planning Programs. 1983 Jan-Feb; (26):J621-655.This document assesses the current status of population and family planning assistance throughout the world and provides brief sketches of the available sources including national governments, intergovernmental agencies such as the UNFPA and other UN entities, and nongovernmental funding, technical assistance, or funding and technical assistance organizations. The descriptions of aid-granting organizations describe their purposes, sources of funding, and activities, and give addresses where further information may be sought. At present about $100 million of the US $1 billion spent for family planning in developing countries each year comes from individuals paying for their own supplies and services, over $400 million is spent by national governments on their own programs, and about $450 million comes from developed country governments and private agencies. Over half of external assistance appears to be channeled through international agencies, and only a few countries provide a substantial proportion of aid bilaterally. In the past decade several governments, particularly in Asia, significantly increased the share of program costs they assumed themselves, and the most populous developing countries, China, India, and Indonesia, now contribute most of the funding for their own programs. Although at least 130 countries have provided population aid at some time, most is given by 12 industrialized countries. The US Agency for International Development (USAID) is the largest single donor, but the US share of population assistance has declined to 50% of all assistance in 1981 from 60% in the early 1970s. Governments of Communist bloc countries have made only small contributions to international population assistance. Most governmental asistance is in cash grant form, but loans, grants in kind, and technical assistance are also provided. Private organizations give assistance primarily to other private organizations in developing countries, and have been major innovators in research, training and service delivery. Loan assistance is provided by the World Bank for combined health, nutrition, and population projects as well as poupulation education. Although international population assistance from donor governments and private organizations increased from about $165 million in 1971 to about $445 million in 1980, the increase in constant value was only about 10% after inflation. About 2/3 of international assistance goes to family planning services and contraceptives; other activities receiving support are basic data collection, research, and IEC. Greatly increased expenditures will be needed if population stability is to be achieved.
[Unpublished] 1983. Presented at the International Conference on Population, 1984, Expert Group on Fertility and Family, New Delhi, January 5-11, 1983. 16 p. (IESA/P/ICP. 1984/EG.I/17)Significant changes have occurred in approaches to development and population issues since the 1974 World Population Conference, and this discussion focuses on those changes which have implications for fertility trends and for policies and programs designed to influence these trends as 1 important aspect of the topic "fertility and family." In the early 1970s there was a tendency to view population and development as mutually exclusive concepts, but in the last few years there has been a recognition of the interdependence of population and development issues. This recognition is exemplified in the Substantive New Program of Action adopted by the UN Conference on the Least Developed Countries in 1981. Over the same period both the process of development and approaches to realizing it were being reassessed. The record of development efforts has shown that despite enormous progress in many countries in accomplishing economic growth, the quality of life has failed to improve for the majority. It was recognized that economic development alone was insufficient to improve the quality of life for the individual. Consequently, more emphasis is now placed on the qualitative, rather than the purely quantitative, aspects of the development process. The concept of the participation of people in development has been adopted by almost all governments around the world, and already there are several successful experiments with this approach. The theme has also been expanded by a number of international and regional meetings. As far as family planning programs themselves are concerned, the International Conference on Family Planning in the 1980s, which was held in Jakarta, Indonesia, in 1981 spelled out some of the reasons why community participation is so important, along with some of the ways for achieving it. The Conference concluded that family planning programs needed to tailor their services and the contraceptive methods they offer to the needs and preferences of the users. A marked change in official and public attitudes to family planning has occurred over the past few decades. From only a handful in the early 1960s, the number of governments providing direct or indirect support to family planning has grown to over 120. Findings of the World Fertility Survey have confirmed the existence of a serious gap between formal commitments of support to family planning and actual access to services. Thus, finding alternative ways of meeting the needs of people who are not reached by services has a high priority in family planning in family planning programs. Educational programs for young people, and services designed to meet the needs of adolescents, are now a priority. Research into new contraceptive methods, which has never been a major priority in the scientific community, has declined over the past few years, and the total world budget for contraceptive research and development is, in real terms, below what it was 10 years ago.
Operational responses to the World Population Plan of Action in programmes of the United Nations Fund for Population Activities in the areas of fertility, family and family planning.
[Unpublished] 1983. Presented at the International Conference on Population, 1984, Expert Group on Fertility and Family, New Delhi, January 5-11, 1983. 15 p. (IESA/P/ICP. 1984/EG.I/30)The experience of UN Fund for Population Activities (UNFPA) supported programs related to family, fertility and family planning in developing countries are reviewed on the basis of an analysis of the World Population Plan of Action (WPPA) recommendations and corresponding UNFPA programs. Among the many recommendations and guidelines of the WPPA, those dealing with protection of the family, with the improvement of the status of women, with modernization and fertility, and with the right of individuals and couples to plan their families are of particular importance to family and fertility. The WPPA recognizes the family as the basic unit of society and recommends that governments enact legislation and policy to protect the family and conduct periodic reviews of national legislation with direct bearing on the family and its members. The Plan urges governments to ensure the full participation of women in the educational, social, economic and political life of their countries on an equal basis with men. The role of family planning in realizing desired fertility goals is clearly noted in the WPPA, which recommends that countries encourage appropriate education concerning responsible parenthood and make available advice and the means of family planning. The Plan also calls for a broad approach to family planning, including the elimination of involuntary sterility, and invites governments which have family planning programs to consider integrating and coordinating those services with health and other services. During the 1969-81 period, the Fund has supported a total of 1240 projects on family, fertility and family planning in 92 countries, of which 31 are in sub-Saharan Africa, 24 in Asia and the Pacific, 25 in Latin America and the Caribbean, and 12 in the Middle East and Mediterranean. This totals about $394 million, 50.2% of total program resources, or 64% of total assistance to country activities. UNFPA has supported both research and action programs related to the family, several activities designed to improve women's position in the family and to bring about a better understanding of fertility. Many UNFPA activities touch on the reduction of infant, child, and maternal mortality and the improvement of role and status of women. Recognizing the different needs of countries for the provision of family planning services, the Fund supports all effective means of delivery of family planning services and the provision of all ethods of fertility regulation technically approved by the World Health Organization. Changes in ways of thinking about population and experiences that have implications for the future are reviewed and areas in need of further action are identified.
People. 1983; 10(2):6-9.The main findings of the World Health Organization (WHO) recent global review of the progress that has been made in the Health for All campaign are presented. The attempt was made to assess progress on the basis of the following 12 global indicators: endorsement of Health for All as a policy at the highest official level; establishing mechanisms for involving people in Health for All strategies; spending at least 5% of the gross national product (GNP) on health; a reasonable percentage of national health expenditures devoted to local health care; primary health resources equitably distributed; the number of developing countries with well-defined strategies for Health for All, accompanied by explicit resource allocations and sustained outside support; primary health care available to the whole population; adequate nutritional status for children; infant mortality rate to be below 50/1000 live births; life expectancy at birth of over 60 years; adult literacy for men and women over 70%; and gross national product per head over $500. 39 of the 70 countries have signed regional charters pledging themselves to strive to achieve Health for All by the Year 2000. Another 9 countries have committed themselves through other policy statements. 31 countries have reported on efforts to involve communities, half of them by adopting policies and half through actual mechanisms, although not necessarily on a national scale. 26 of the 70 countries are spending more than $5 a head each year on health care. Many countries are placing more emphasis on providing resources for local care, but the shift is nowhere near what is required. WHO has been unable to establish the per capita spending on primary health since it permeates so many levels and sectors of the health services. Activities to increase food supply and improve nutrition are being integrated into primary health care in the form of nutritional surveillance, preventing and controlling deficiency disorders, promoting breastfeeding, direct treatment of malnutrition, oral rehydration therapy, food supplements, immunization, and the addition of iodine to salt. Only 7 of the 54 countries reporting infant mortality rates were below 50/1000, and these included 3 developed countries. Rates in the remaining 47 ranged from 56/1000, to 250/1000. Of the 70 countries, 51 had life expectancy rates varying between 40 and 59; in 1979, 13 had rates over 60 and 6 did not report. Only 4 countries reported male and female literacy rates over 70%. Over 60% of the countries reviewed had a per capita GNP of less than $500.
London, England, IPPF, 1983. 19 p.This paper reviews the policies of the International Planned Parenthood Federation (IPPF), assesses the lessons learned, raises key issues influencing policy formulation and program development, and identifies the options available at all levels of IPPF to meet the fertility related needs of young people, be they boys or girls. (IPPF considers young people to range from ages 10 to 25). Young people are an increasing percentage of the world's population and are perplexed by profoundly changing social enviornments and by how to deal with pregnancy. IPPF programs include fertility related services such as counseling and contraceptive services, and education in family planning. The paper stresses that sex education needs to start before young people become sexually active. It is essential that youth participate in the family planning movement; 1 major problem is that parents and many other adults feel that provision of family planning services for adolescents encourages promiscuity. The report documents IPPF collaboration with kindred international nongovernmental organizations. It recommends that family planning associations mobilize community resouces by lobbying policy and decision makers to get them to respect the rights of youth for family planning services. Future directions for the IPPF include youth related activities, influence on government policies and programs, pilot projects, and research data collection.
In: Del Mundo F, Ines-Cuyegkeng E, Aviado DM, ed. Primary maternal and neonatal health: a global concern. New York, Plenum, 1983. 455-60.There exists a substantial unmet need for family planning at this time, and the number of couples of reproductive age is expected to increase by 70% between 1980 and 2000. The family planning horizon is surveyed, reviewing how the sector has evolved and identifying directions for the future. Focus is on the orientation, experience, and accomplishments of the UN Fund for Population Activities (UNFPA) in its support for the various aspects of family planning in the different regions of the world. The acceptability of the family planning concept has increased markedly during the last 20 years. Of 158 countries responding to the UN "Fourth Inquiry Among Governments on Population and Development," 118 had adopted laws or policies favorable to family planning or supporting family planning either through the public or the private sector. 66 of the 132 developing countries had family planning programs. 35 had adopted programs for demographic purposes and 13 for health or humanitarian reasons. Approximately 92% of the population of the developing world live in countries which support family planning. Several changes have occurred in the administrative and delivery system dimensions of family planning. Single purpose, vertical programs have given way to more thorough integrations in the health network. Efforts have been made to include family planning components in various development initiatives. From a demographic perspective, there is considerable evidence that family planning programs have had a marked impact. Countries which have implemented effective programs have achieved substantial fertility declines even in the absence of advances in economic development. The health and human rights aspects of family planning have also been recognized over the past decade. In view of the health and demographic benefits as well as the human rights dimension, it is critical that family planning be within the reach of all couples desiring such services, yet this is hardly the case. UNFPA has emphasized the need for neutrality, flexibility, and innovation in its dealings with recipient countries. Rather than endorsing any particular approach to population problems, UNFPA has provided assistance to those aspects that a requesting country deemed important and which were within the bounds of its mandate. During the course of its 12-year existence, UNFPA has followed two major principles in extending assistance for population activities: every nation has the sovereign right to determine its own population policy; and each individual couple has the right to determine its family size. UNFPA, which has supported the conventional and the innovative, has extended assistance in family planning at the global, national, and local level.
New York, New York, UNFPA, 1983. 39 p. (Report No. 52)Samoa's major population problem is a high rate of natural population increase. The crude birth rate from 1971-1976 is estimated at 37.4/1000. The total fertility rate was estimated at 6.7 for the same period. Emigration has compensated for much of the natural population increase. The infant mortality rate is low; life expectancy is 64.3 years for females and 61 for males. A maternal and child health program with integrated child-spacing services is government supported. In 1979, 13% of all women of reproductive age used contraception. Samoa's 4th Five-Year National Devlopment Plan (1980-1984) includes a review of population trends. There is a need to develop a broad-based population policy. The Mission recommends that, to assist in the formulation and implementation of this policy, a high-level government office be appointed to coordinate population efforts, and a post of Population Coordinator created. Considerable data exist, although more information on specific development-related topics would be helpful. The Mission recommends that a survey unit should be set up. Service delivery of the maternal and child health and family planning activities should be improved. Traditional village social institutions should be included. The government plans to integrate population and family life education into the educational system through teacher training and curriculum development. Assistance in the produciton of materials would be helpful. The Mission recommends that women's activities be better coordinated.
New York, New York, UNFPA, 1983. 59 p. (Report No. 53)An estimated 53.7 million people lived in Vietnam in 1980. The government wants to lower the rate of population growth as soon as possible. Its short-term goal, to lower the annual rate to 1.7% by 1986, is to be met through the national family planning program. The government wishes to get more married women in the reproductive age group to use contraception--from 20% at present to 50-65% by the year 2000. 2nd major population goal is resettle 10 million people from the northern to the southern part of the country by the end of the century. Efforts should be made to improve the vital registration system. Population research is concentrated in the State Planning Committee, the research arms of various ministries, and in Government research agencies. This research needs to be strengthened. Overseas training and study tours should be provided for strengthening staff capabilities. Assistance should be provided for the government's primary health care approach with emphasis on community participation. Urgently needed are essential drugs and contraceptives--especially condoms. A factory for testing and packing condoms should be built, once the quality of locally produced latex improves. The Mission recommends that a systematic manpower development analysis be undertaken to aid the government in determining training needs of health personnel; their curricula should include more population and family planning content, and motivational and communication techniques. An audiovisual (AV) center was established in Hanoi; however the information, education, and communication (IEC) program needs strenthening. Aid should also be given for low-cost media production in the AV subcenter being started in Ho Chi Minh City. Perservice training of primary and secondary teachers will include population education. Women's activities should be promoted.
New York, New York, UNFPA, 1982. 53 p. (Report No. 54)There is no comprehensive national population policy in Kiribati. Migration from the outer islands to urban South Tarawa is a problem. Overcrowding on the island will soon be severe. The National Development Plan aims at maintaining a balance between population and natural resources. The Mission proposes aid for population-related projects. The Central Planning Office coordinates the development activities. A National Population and Development Co-Ordinating Committee has been established. The government needs more staff to deal with overcrowding. The country's data base needs to be strengthened and upgraded. The Mission recommends that 1) another census be carried out in 1983; and 2) an inventory of research relating to Kiribati be maintained. The government has made efforts to provide an adequate health services network. The Mission recommends that a consultant be provided who specialized in health education and community participation. The family planning program has been diminishing in effectiveness. The Mission recommends support for: 1) a 3-year In-School Population Education Project; and 2) a project to focus on using communications programs to increase outer-island participation in population-related and development activites. The government has set up a Women's Interest Section to coordinate and develop policies and programs. The Mission recommends support for a 3-year project to aid the National Women's Federation. The United Nations Fund for Population Activities Youth Training Program should be supported. Protestants and Roman Catholics have promoted family life, health education and community-based activities.
London, England, IPPF, Feb. 1983. 11 p. (IPPF Fact Sheet)Describes the International Planned Parenthood Federation's complex relationship with the United Nations. Since 1974, IPPF involvement with the United Nations system has grown rapidly at international, regional, and country levels. IPPF's role is that of a professional body dedicated to planned parenthood and that of a voluntary organization fostering community development and self-help. The IPPF brings to the United Nations the expression of public views and concerns and the benefit of its experiences, standards, and practices. Nongovernmental organizations, such as the IPPF, contribute to the work of the United Nations through their consultative status. The IPPF has a consultative status with ECOSOC. It also has consultative status with UNICEF, UNESCO, FAO, WHO, ILO, and less formal relationships with other UN commissions. It is predicted that the future will see a closer collaboration between IPPF and the United Nations at every level. Governments are increasingly recognizing the importance of nongovernmental organizations in ensuring popular participation in development programs. Attempts are being made to give such organizations more prominence in conferences, and to recognize and encourage their contributions to achieving the UN's aims and objectives. The IPPF is also frequently called upon by the UN as an authoritative professional body in its specialized field. IPPF recognizes that to meet the needs of family planning and to ensure adequate funds for family planning, it will have to work closely with the United Nation agencies involved in such programs.
Novum. 1983 May; (23):10-1.To encourage family planning, a mobile health clinic will be sent to a village when child clinics are held in the Gambia, so that women may receive family planning advice. All methods are used; the Pill is the most popular. There are around 3000 family planning acceptors. The Gambia Family Planning Association (GFPA) supplies condomes and pessaries were needed. The Association sells contraceptives to private doctors at a discount. Supplies are also available in hospitals. The average family has 6 children. Seminars on family planning have been held. The GFPA trains extension workers in family planning. The infant mortality rate is 217/1000 live births; 40% of the children die before the age of 5. Breastfeeding has been a problem. Many children are malnourished. The GFPA is staffed by 1 doctor; a senior nursing sister, a nursing sister, clinical assistants, and rural fieldworkers. There are 5 main clinics. The GFPA's staff teach family life education to schoolchildren. Planned parenthood/women's development projects are also taking place. The GFPA is largely funded by the IPPF.
Evolution of and prospects for U.S. funding of international population and family planning programs.
[Unpublished] 1983. Paper presented to the 111th Annual Meeting of the American Public Health Association, Dallas, Texas, November 15, 1983. 12 p.At this time US population assistance is experiencing one of the most challenging periods in its 20 year history. Increasing developing country acceptance of population programs and expanding needs for external assistance are coinciding with resource scarcities that result in serious shortfalls of US and other major donor assistance. 15 years of US Agency for International Development (USAID) program experience offer useful lessons that can improve the efficiency and the effectiveness of US assistance in coming years. The lessons which emerge reflect the various forces that have shaped US involvement in population assistance during this period. During 1965-74, the USAID program was preoccupied with getting activities underway. The principal critics of population assistance at this time viewed foreign assistance in the field of family planning as evidence of "demographic imperialism." The 1974-78 period was a time of program consolidation. Direct support for government programs increased as a proportion of total USAID population assistance as more countries adopted official family planning programs, especially after the World Population Conference of Bucharest. Meanwhile, the central program of the Office of Population became better established. The period 1979 to the present has been a time of increasingly urgent questions regarding resources and future funding. A new generation of critics expressed misgivings similar to those encountered 2 decades earlier, i.e., is population assistance really necessary to achieve development goals; is it a legitimate area of government concern; and is it effective. At least 6 useful findings deserve attention in the design of future US assistance programs--programs which are likely to be funded somewhat less abundantly than in years past: family planning programs address real needs in developing countries, and they can work effectively; successful population programs usually occur where there is a combination of favorable socioeconomic setting, strong program management, and sustained political support; private sector activity is critical for initiating programs and for stimulating innovation; resident field staffs can significantly increase the effectiveness of population assistance; program growth eventually plateaus; and plateaus on assistance can contribute to declining program performance. The following points of emphasis are considered essential for the successful implementation of USAID's strategy in future years: facing performance plateaus; allocation priorities; measures of success; management and training emphasis; and coordination with other donors. It is unclear at this time whether resources will be adequate to apply the lessons learned and to address the needs and opportunities in the years ahead.
[Unpublished] 1983 Sep 30. 4 p.The Chinese government began its family planning program in the 1970s, in response to the country's rapid population growth. Over the 1949-70 period, China's population increased by 280 million. The program resulted in the transformation to a population growth pattern of low birthrate, low mortality rate, and low natural growth rate. The natural growth rate declined from 26% in 1970 to 14.5% in 1982, providing evidence of the remarkable achievements China has obtained in population control. These achievements can be attributed primarily to the increasing awareness of population problems on the part of the Chinese Communist Party and the Chinese government. Family planning is a basic policy. Due to the existing demographic situation, arduous tasks still lie ahead. Due to the large population base figure--1,031,880,000--the net annual population increase is considerable. The age composition of the population is relatively young, with children under age 14 constituting 33.6% of the total. This will have a formidable impact on the population growth rate in forthcoming years. China continues to advocate among the young people late marriages, late births, fewer births, and healthier births in line with the population policy of limiting the size of the population and improving its quality. It is beneficial that the UN and its population organs, particularly the UN Fund for Population Activities (UNFPA) have been of assistance to developing countries by providing cooperation and encouraging people to engage in population activities and to contribute to the solution of population problems.
[Manual of questions and answers on family planning] Manual de preguntas y respuestas sobre planificacion familiar.
New York, International Planned Parenthood Federation, Western Hemisphere Region, 1983. 89 p. (Population Information for Policy Makers (PIPOM))This manual of questions and answers on family planning, based on an issues manual and a public affairs manual of the International Planned Parenthood Federation Western Hemisphere Region, is intended for consultation by family planning personnel who interact with policymakers, government leaders, legislators, and the mass media. The manual contains 2 major sections, 1 of which describes the process of communications with leaders and mass media while the other contains information on contraception, sterilization, other medical services, medical examinations, services for adolescents, sex education, publications, financing, international family planning, and population. Each of the 11 sections has 5 parts: an index, a perspective which places the topic in a general context, the position of the Associations on the particular topic, questions and answers regarding frequent objections raised about the topic, and suggested additional readings. The manual is contained in a 3-ring notebook intended to facilitate incorporation of pertinent local information. A brief introductory statement explains the purpose of the manual in making available information that will allow family planning personnel to respond to attacks on the program by opponents of birth control, and provides general suggestions for dealing with such attacks.
African Population Newsletter. 1983 Jul-Dec; (44-45):17-8.The U.N. Fund for Population Activities (UNPFA) has conducted Needs Assessment Missions in many developing countries as a means of identifying population and related areas in which individual countries would need assistance to achieve self-reliance in formulating and implementing population policies and programs. This exercise is still going on in some of the countries. In ECA member States these needs missions have been conducted in the following countries: Burundi, Cameroon, Comoros, Ethiopia, the Gambia, Guinea, Ivory Coast, Liberia, Madagascar, Malawi, Mauritania, Morocco, Niger, Rwanda, Sierra Leone, Senegal, Somalia, Sudan, Swaziland, Tanzania, Zambia, and Zimbabwe. The areas identified for assistance vary from country to country, however, in some cases the needs are similar. Data collection and analysis is still 1 of population needs for which many countries require assistance. This includes conducting of national population censuses and demographic surveys and establishing or improving the civil registration systems on vital events. Training of nationals in data collection and analysis is another area in which ECA member States need assistance. It was identified that there is lack of integration of population variables in socioeconomic development planning. The various missions recommended assistance to help ECA member States to integrate population variables in development planning. Creation of Population units in ministries of planning and/or other departments was recommended as a means to help this integration. The various missions also identified the need to create or to enhance the awareness of the interrelationship between population and sociodevelopment and their implications. To this end the missions on needs assessment recommended assistance in population information and communication activities, including the introduction of population education in formal and nonformal education, conducting of seminars and workshops on population and development etc. To help formulation of population policies, the establishment of National Population Commissions at the highest level was recommended. Such commissions would examine population issues in detail and formulate suggestions for policy decisions and measures. Other common population related areas which require greater assistance include health programs of maternal and child health care, health education activities, and family planning activities. Last but not least is the need to improve the role and status of women in Africa so that they can be integrated to take a more active part in the various economic and social activities in national development. (full text)
Humanist. 1983 Sep-Oct; 43(5):18-24, 34.The writer's purpose is to document why an American confrontation with the Vatican over its anti-family planning efforts is a prerequisite to removal of this obstruction. The role of the Roman Catholic Church is seen as an important factor in thwarting organized family planning efforts; it is a variable which must enter population scientists' search for the determinants of fertility. Reasons for which communication with the leadership of the Church will not occur are discussed. Among those is the introduction, under President Reagan, of an administration which is the most Catholic in American history. In addition, international agencies' "population moneys" are being spent for "general development" and not on family planning. It is argued that Catholics have been primarily responsible for propagating the strategy "development will take care of population growth". The decline of the world population growth control effort in the past couple of years has coincided with the activities of the Pope and his position that immoral contraception must be fought. It is claimed that until this stronghold on predominantly Catholic countries is reduced, and the Vatican's strong influence on international donor agencies is eliminated, very little improvement in world efforts to control population growth can be expected. The Vatican's control over governments in predominantly Catholic countries is illustrated by excerpts from a study by a Canadian sociologist who points out that the world is faced with Vatican imperialism to some extent. This article concludes that nothing significant is likely to happen in population control efforts until the United States confronts the Vatican on this issue as the weak governments of most nations would not survive such as effort.
Geneva, Switzerland, WHO, 1983 Nov. 167 p.As the main instrument within WHO for promoting and coordinating international research and development relating to family planning, the Special Programme aims to improve the health status of the populations of developing countries by: devising improved approaches to the delivery of family planning care in the primary health care context; assessing the safety of existing methods of fertility regulation; developing new birth control technology; and generating the knowledge and technology required for the prevention and treatment of infertility. The 2nd and related objective of the Programme is to promote national self-reliance for research in family planning by collaborating with national authorities in building up manpower and facilities that will enable developing countries to plan and carry out research, adapt technology, and contribute fully to the advancement and application of science. The major topics under review are research and development, institution strengthening, dissemination of information, and relations with industry and patents. The chapter on research and development includes a discussion of: delivery of family planning care; current methods of fertility regulation; development of new methods such as new intrauterine devices, sterilization and birth control vaccines; infertility; and interagency coordination on biomedical research in fertility regulation.
Kuala Lumpur, Malaysia, International Committee on the Management of Population Programmes [ICOMP], 1983. x, 193 p. (Management Contributions to Population Programmes Series Vol. 1)This book is a review of progress of management improvements of population and family planning programs and also an assessment of the roles and activities of the International Committee on the Management of Population Programmes (ICOMP), which was established in 1973. It was agreed at this conference that quality of management is a significant variable in the performance of any program and that external support for management from donor agencies and management institutes has started to decline at a time when program leaders have started to take the initiative in this area. Some recommendations made were: 1) each program should evolve a management development plan based on systematic management assessments; 2) serious consideration should be given to development of local and custom-made management training programs through emphasis on appropriateness; 3) ICOMP should widen its scope to management of population related health care activities; 4) ICOMP should decentralize its activities; 5) ICOMP should co-opt more institutions having requisite expertise in management; 6) ICOMP should convene a joint meeting of donor agencies and program managers to review various questions relating to the need for external assistance; 7) ICOMP can assist programs facing declining external assistance by developing estimates of financial resources needed over the longterm, create an environment for additional allocation of resources from international agencies and national governments by organizing a meeting of donor agencies and program managers, and help develop more effective financial management systems; 8) ICOMP should develop and disseminate studies on community participation; 9) ICOMP should encourage management and related institutions to undertake research, training, and consulting in community participation; 10) ICOMP should help in developing strategies for training of supervisors and field workers in integrated programs; 11) ICOMP should encourage longterm planning through the documentation of successful experience, and should test methodologies of evaluation, supervision, and human resources development; 12) ICOMP should help country programs conduct management assessments and management training; and 13) should attain a certain degree of financial stability by assessing annual contributions from its members. Papers were presented in ICOMP projects in Bangladesh, China, Colombia, Ecuador, Egypt, Ghana, India, Indonesia, Malaysia, Nepal, Pakistan, Sierra Leone, Sri Lanka, Thailand, Tunisia, and Turkey.
[Unpublished] 1983. Paper presented at International Conference on Voluntary Sterilization, 5th, Santo Domingo, Dominican Republic, December 5-8, 1983. 5 p.This paper discusses the needs in surgical contraception for the 80's. Specifically, in order to meet the population increase in 1990, 163,150,000 sterilizations will have to be done in the developing countries, nearly 5 times the number of sterilized women by 1980. A total of 10.8 billion dollars will be needed to carry out this enormous task. Of this total sum, 58% of this amount will be to pay salaries and social benefits, the rest will be for expendable materials, equipment, remodelling of operating rooms, training, supervision, communications, repair, and maintenance. Also discussed is the building of international commitments regarding surgical contraception. The role of Planned Parenthood, World Federation, UNFPA, and WHO are emphasized in recommending influencial strategies for governments in order to favor family planning, maternal and child health, and promotion of contraceptive research.