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World Health. 1978 Aug-Sept; 34-37.In 1965 an IUD clinic was opened at the Chulalongkorn Hospital in Bangkok, and 3 years later daily oral contraceptives and a 3-month injectable contraceptive were also made available to clinic patients. Questions soon arose about the suitability of these methods for use by Thai women, so in 1972 a WHO Research Team on Clinical Evaluation of Fertility Regulating Agents started work. The team established close ties with the Thai National Family Planning Program to insure that their research would support the national program. The multidisciplinary nature of the team was strengthened by the contribution of 22 experts from 9 countries. Hospital facilities were expanded in support of the research team which has carried out wide-ranging studies on such topics as the appropriate dosage of hormones in oral contraceptives for Thai women, the effects of the injectable depo medroxyprogesterone acetate in women infected with a prevalent liver parasite, and whether new types of IUDs are superior to those currently in use. The most significant finding to date is that the risk of thromboembolism with oral contraceptive use is less in Thai women than in British women. Family planning service research has shown that rural women prefer the injectable contraceptive to the IUD, whereas the opposite is true of urban women. The ability of medical students and nurses to perform sterilizations is also being carefully monitored. The team functions as a recognized national research resource directly supporting the national family planning program.
Geneva, Switzerland, WHO, 1974. 324 p. (HMD/74.5)A report of a Working Group of WHO, as part of the preparation of a program for improving and developing health services at the village level on the bais of the training and utilization of auxiliary health workers, is presented. An example list of the most common or most urgent problems encountered at the village or rural community level served as a basis for the program. The Working Group has used their assessment of needs and priorities in order to prepare problem outlines, described tasks, set educationl objectives, suggest teaching methods, and produce a practical guide to help the health worker learn his role. The health worker will help in the development of the outer reaches of the health services. The essential characteristics of the health worker, his role and tasks are outlined. The practical guide for health workers covers information on: communicable diseases, maternal care, child health, accidents, village and home sanitation, common requests, and community development. The components that contribute to the cost of this program are described as well as the logistics of the program. A summary of guidelines for adapting the proposed project to national situations is included. The appendices include: 1) a list of common priority health and community problems; 2) a list and estimated cost of reqired equipment, drugs, and supplies; 3) a few primary care technqiues; and 4) an explanation of key words.
IPPF Situation Report, June 1973. 10 p.The Indonesian Planned Parenthood Association (IPPA) was founded in 1957 and pioneered family planning services. It made little headway duri ng the pronatalist Sukarno regime, but in 1967 the present government announced an intensive family planning program and the IPPA was named as an implementing unit in 1971. 2 primary roles now are the training activities for fieldworkers and the development of community education and motivation programs. This complements the national mass media program. In 1970 the government took over all clinics except those in the Outer Islands (the islands outside Java, Bali, and Madura). The IPPA runs 150 clinics in the Outer Islands, is responsible for all supplies and maintenance, and has a number of model clinics in Java and Bali. The Community Education program has 8 components: speakers bureau, family planning clubs, mobile audiovisual units, exhibitions, tr aditional media, special events, local mass media support, and evaluatio n. In 1971 the 'ippa trained 2951 people; in 1972 this was increased by 25%. In 1973 the target is training 3000 fieldworkers with 16 centers for training and 16 field demonstration areas. An agreement with the U.N. Fund for Population Activities/International Development Association (UNFPA/IDA) will provide for building, equipping, and staffing. The research and evaluation function is also expanding to complement government activities. The government program aims to train 20,250 medical and paramedical personnel over 5 years and medical schools have incorporated the teaching of population and family planning. Government allowances are being curtailed for all children over 3 for government workers. An active clinic program aims to set up 1200 fully equipped and 1250 moderately equipped facilities by 1973. An active media campaign has been launched and for the 1st time in the population field the UNFPA and the IDA are helping to finance a project to expand a family planning program and broaden its activities. This su pport will provide for physical facilities, technical assistance, training, motivation, evaluation, research, and population education.
IPPF Situation Report, September 1972. 7 pHong Kong, with 3858 people/sq km, is 1 of the world's most densely populated areas. Family planning was introduced in 1936 by the Hong Kong Eugenics League and 5 clinics were operating by 1940. The Family Planning Association (FPA) was formed in 1950 and was a founder member of IPPF in 1952. Interest in family planning increased as massive immigration from China added to overcrowding. The government supports FPA (in 1972 the grant was U.S.$254,545) and houses 80% of the FPA clinics in government properties. At present there are 46 female clinics providing 189 sessions per week and 2 male clinics operating eac h week. The decline from 54 to 48 clinics is due to the new emphasis on full-time rather than part-time clinics. In 1971 there were 347,894 attenders, an increase of 18% over 1970, and 31,898 new acceptors, an increase of 4%. There has been continued increase in the number of patients requesting oral contraceptives (70.6% in 1971). The IUD began to decline after bad publicity surrounded a large number of loops which had broken in the uterus; in 1971 only 6% of acceptors asked for IUDs. Condoms account for 11.5% and injectables, 3.6%. FPA offers subfertility and marriage guidance services and is extending its Papanicolaou smear service. An active media campaign, exhibitions, and seminars are conducted. Until 1967 fieldwork consisted of random home visits. An efficiency study led to concentration on maternal and child health clinics, postnatal clinics, and follow-up home visits. Home visi ts are still made on request. A number of international trials for various contraceptives have been run in Hong Kong. Many church and international organizations are helping to finance family planning activities, both through FPA and through their own organizations.