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[Unpublished] 1989. Presented at the First International Symposium on No-Scalpel Vasectomy, Bangkok, Thailand, December 3-6, 1989. 10 p.The paper describes the introduction and use of the no-scalpel vasectomy in the United States. Vasectomy is popular in the U.S., with 336,000 of them performed in 1987 almost exclusively buy urologists, family practitioners, and surgeons. Receiving no government funding for the new procedure's introduction in the U.S., the Association for Voluntary Surgical Contraception (AVSC) turned to family planning clinics, Planned Parenthoods, and medical schools to reach experienced vasectomists interested in co-sponsoring orientation seminars for other doctors. Programs were held in 1988, in California, Massachusetts and New York, in which attendees were provided self-training packages, and asked to report their experiences with the new technique. Field reports were received from 25 physicians on 2,237 vasectomies, and included both positive and negative comments. Even though the technique is uncomplicated, physicians generally found the technique difficult to master with only teaching materials. Accordingly, the U.S. training model was modified to include a rubbermodel f the scrotal skin and underlying was with the training packet, visits to practitioners' offices by clinical instructors, a compressed training period of 1 day, and hands on training. A minimum of 6-9 cases is generally required to properly learn the technique. 3-4 training seminars will be conducted over the next year in different regions of the U.S. in addition to other efforts aimed at meeting demand for training from interested doctors. Care is taken in choosing instructors and participants, with interest especially strong in training of trainers. Of central concern to the AVSC is their ability to keep pace with growing demand for training, while ensuring 6-12 month follow-up and high-quality instruction and practice of the technique.
The role of international agencies, governments, and the private sector in the diffusion of modern contraception.
TECHNOLOGY IN SOCIETY. 1987; 9(3-4):497-520.This paper views diffusion as encompassing three processes: the acceptance of the idea and practice of contraception by consumers; the establishment of the institutions or programs to provide services; and the development of technical capability in research and development and in the production of contraceptives. The historical development of the family planning movement is described, and the contribution of international agencies, governments, and private sectors is discussed in the context of changing development approaches. Substantial achievements have been made, but, in view of future needs and the uncertainty of political and financial commitment to family planning on the part of donors, the future presents a continuing challenge. (EXCERPT)
Mount Sinai Journal of Medicine 42(4): 269-276. July-August 1975.The way in which family planning associations have affected policy and the development of government programs and the way government family planning programs have affected private family planning associations is examined. The typical evolution of voluntary family planning association in countries throughout the world is: 1) an initial interest in the unhealthy effects of excess childbearing by physicians and prominent women; 2) development of a local family planning association; 3) provision of family planning services to women of average means; 4) f avorable public response; 5) support and funding provided by internation al organizations; and 6) government entrance onto the family planning scene. Generally, voluntary family planning groups encourage a trend whose time has already come through various changes in the national way of life. Family planning associations flourish with government involvement because there is need for the expertise developed by the voluntary associations. Private organizations are especially active in training, education, youth work, research, and innovation. Voluntary groups can monitor the quality of government family planning programs.