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HRP Task Force evaluation. Summary of conclusions regarding intrauterine devices and female sterilization.
In: Assessment of the WHO Special Programme of Research, Development and Research Training in Human Reproduction [HRP]. II. Task Force reports. Country reports, [compiled by] Sweden. Swedish Agency for Research Cooperation with Developing Countries [SAREC]. Stockholm, Sweden, SAREC, 1983 Apr. 4 p.The promotion of contraceptive methods is a high priority in developing countries. IUDs are effective, but the misfortune with the Lippes Loop in the 1960s has detrimentally impacted the use of IUDs in South East Asian countries. Complications can include bleeding, uterine cramps, perforations, expulsions, infections, and the risk of intrauterine and ectopic pregnancy. These can be alleviated by modifying the shape of the devices, by professional evaluation and fitting of IUDs on the part of maternal-child health (MCH) services, and by an assessment of psycho- social implications of IUD use. Unipurpose crash family planning programs have failed. The WHO's IUD research program is concerned with the reduction of side effects and contraceptive safety. Research on female sterilization has the objective of reducing maternal and child morbidity and mortality in grand multiparity. On the other hand, sterilization has been misused in several developing countries. It is imperative to ensure informed and voluntary consent to minimize misuse and to secure adequate health care for the living children of the sterilized client (immunization and infectious disease control). Economic reasons for promoting sterilization are unacceptable. Sterilization infrastructure development is indispensable (trained staff, equipment, and anesthesia). Simple but safe sterilization procedures need further development, and adverse psychological effects require further research. Attitudinal studies are needed on providers and acceptors, targets, incentives, and disincentives. Sterilized couples have to have access to MCH services, and the WHO research program on human reproduction should incorporate sterilization and its ramifications.