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Reproductive health: a key to a brighter future. Biennial report 1990-1991. Special 20th anniversary issue.
Geneva, Switzerland, World Health Organization [WHO], 1992. xiii, 171 p.WHO established its Special Programme of Research, Development, and Research Training in Human Reproduction in 1972 to promote, coordinate, conduct, and evaluate research in human reproduction in both developed and developing countries. Its aim is to assist developing countries meet the reproductive health needs of their populations. The first section of the biennial report discusses the reproductive health status in the world including fertility regulation, sexual health, infertility, and safe motherhood since 1972. Despite considerable progress in the last 20 years, unmet needs remain substantial. New environmental concerns related to population growth and maternal and child health concerns, women's status, and human development all dictate a sense of urgency. The second section covers specific activities of the Programme in the last 20 years. It includes the results of an external evaluation of the effect the Programme has had. It found the Programme's effect to be most successful due to its collaborating centers and multicenter trials and studies, epidemiologists, clinicians, and laboratory scientists. This section also includes viewpoints from China, Kenya, and Mexico. 2 former directors of the Programme present a historical account of the Programme's accomplishments. The third section discusses progress the Programme had made during 1990-91. It specifically covers development and assessment of fertility regulation technologies, prevention of infertility, improving family planning choices through systematic introduction and proper management of contraceptive methods, epidemiologic research, social measurements of reproductive health, and improving capacity for key national reproductive health research.
CEYLON MEDICAL JOURNAL. 1990 Dec; 35(4):136-42.The story of the Sri Lankan Family Planning movement is told from its inception in 1953, prompted by a visit by Margaret Sanger 1952. The Family Planning Association of Sri Lanka was founded with the health of women and children, and both contraception and infertility treatment as its policies. The first clinic, called the "Mothers Welfare Clinic," treated women for complications of multiparity: one woman was para 26 and had not menstruated in 33 years. The clinic distributed vaginal barriers, spermicides and condoms, but the initial continuation rate was <5% year. Sri Lanka joined the IPPF in 1954. In 1959, after training at the Worcester Foundation, and a personal visit by Pincus, the writer supervised distribution of oral contraceptives in a pilot project with 118 women for 2 years. Each pill user was seen by a physician, house surgeon, midwife, nurse and social worker. In 1958 Sweden funded family planning projects in a village and an estate that reduced the birth rate 10% in 2 years. The Sri Lankan government officially adopted a family planning policy in 1965, and renewed the bilateral agreement with Sweden for 3 years. In 1968 the government instituted an integrated family planning and maternal and child health program under its Maternal and Child Health Bureau. This was expanded in 1971 to form the Family Health Bureau, instrumental in lowering the maternal death rate from 2.4/1000 in 1965 to 0.4 in 1984. During this period IUDs, Depo Provera, Norplant, and both vasectomy and interval female sterilizations, both with 1 small incision under local anesthesia, and by laparoscopic sterilization were adopted. Remarkable results were being achieved in treating infertile copies, even from the beginning, often by merely counseling people on the proper timing of intercourse in the cycle, or offering artificial insemination of the husband's semen. Factors contributing to the success of the Sri Lankan planned parenthood program included 85% female literacy, training of health and NGO leaders, government participation, approval of religious leaders, rising age of marriage to 24 years currently, and access of all modern methods.