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New York, IP, 1980. 171 p. (Contract AID/pha-G-1128)With funds from a contract with the USAID, the International Prpject of the Association for Vuluntary Sterilization (IPAVS) has published this annual report to justify its expenditures and delineate its achievements as they relate to the contract goals. In 1979, the quantifiable program achievements were that: 1) voluntary sterilization services were provided to 78,873 men and women worldwide (30% increase over the previous year); 2) 674 physicians were trained in the techniques of surgical contraception (60% increase); 3) 249 health support personnel were trained by IPAVS auspices (4-fold increase); 4) IPAVS helped establish National associations based on its own philosophy in 28 developing countries in 1979; 5) 53 of 81 subgrants allotted included information service components; 6) 17 conferences on voluntary steilization or related health topics were attended by IPAVS, and the organization sponsored 1 regional, 3 national, and 1 international conference during 1979; 7) 57 of 73 countries attending the 4th International Conference on Voluntary Sterilization in Korea sponsored by IPAVS were developing nations; and 8) an IPAVS regional office for Asia was opened in Bangladesh. Other topics covered include grant management and policy development, program development, program accomplishments, information and education, and program support functions for management activities. This large volume publishes standards required by the IPAVS for medical procedures and minimal equipment.
New York, New York, United Nations, Dept. for Economic and Social Information and Policy Analysis, Population Division, 1994 Aug.  p. (ST/ESA/SER.A/143)This wall chart shows the 1994 level of contraceptive use (percentage) for the entire world. Data are presented for less developed and more developed regions and for individual countries grouped according to region. The number of couples of reproductive age is given in millions, and the data are broken down into year; age range represented; and percentage of the total, of female sterilization, of male sterilization, of oral contraceptive use, of IUD use, of condom use, and of use of other supply and non-supply methods. In addition, trends are indicated by showing the time period and the annual increase in percentage using any method. These data are further illustrated in pie charts indicating the entire world, more developed regions, and less developed regions as a whole and for Africa, Latin America and the Caribbean, Eastern Asia, and other countries in Asia and Oceania.
[Unpublished] . 10,  p.Based upon United Nations medium population projections, the population of developing countries will grow from 4,086 million in 1990, to 5,000 million by the year 2000. To meet this medium-level projection, 186 million contraceptive users must be added for a total 567 million in addition to increased contraceptive prevalence of 59% from 51%. This study estimates the number of contraceptive users, acceptors, and cost of contraceptive commodities needed to limit growth to this medium projection. Needs are estimated by country and method for 1990, 1995 and 2000, for medium, high, and low population projections. The number of contraceptive users required to reach replacement fertility is also calculated. Results are based upon the number of women aged 15-49, percent married, number married ages 15-49, and the proportion of couples using contraception. Estimation methodology is discussed in detail. Estimated users of respective methods in millions are 150 sterilizations, 333 IUD insertions, 663 injections, 7,589 cycles of pills, and 30,000 condoms. Estimated commodity costs will grow from $399 million in 1990 to $627 million in 2000, for a total $5.1 billion over the period. Pills will be the most expensive at $1.9 billion, followed by sterilizations at $1.4 billion, condoms $888 million, injectables $594 million, and IUDs $278 million. Estimated costs for commodities purchased in the U.S. show IUDs and condoms to be significantly more expensive, but pills as cheaper. With donors paying for approximately 25% of public sector commodity costs, developing country governments will need to pay $4.2 billion of total costs in the absence of increased commercial/private sector and donor support.
STUDIES IN FAMILY PLANNING. 1991 Jan-Feb; 22(1):1-18.A study investigative the pros and cons of financial payments for sterilizations to clients, medical personnel, and agents who motivate and refer clients was conducted by the government of Bangladesh in conjunction with the World Bank. Results indicate that Bangladeshi men and women opt to be sterilized both voluntarily and after consideration of the nature and implications of the procedure. Clients were also said to be knowledgeable of alternate methods of controlling fertility. A high degree of client satisfaction was noted overall with, however, 25% regret among those clients with less than 3 children. Money is a contributing factor in a large majority of cases, though dominating as motivation for a small minority. Financial payments to referrers have sparked a proliferation of many unofficial, self-employed agents, especially men recruiting male sterilization. Targeting especially poor potential clients, these agents focus upon sterilization at the expense of other fertility regulating methods, and tend to minimize the cons of the process. Examples of client cases and agents are included in the text along with discussion of implications from study findings.
[Unpublished] 1988 Oct 26. Paper presented at the "Meet the Experts" panel sponsored by The World Federation for Voluntary Surgical Contraception, at the XII World Congress of Gynecology and Obstetrics sponsored by The International Federation of Gynecology and Obstetrics [FIGO], October 26, 1988, Rio de Janeiro, Brazil. 25 p. (ME62/ME21)Brazil, the largest country in area and population in Latin America, has not had the benefit of a government-sponsored family planning program and until recently such activities were sensitive and done with much constraint. The Centro de Pesquisas de Assistencis Integrada a Mulher e a Crianca (CPAIMC) which began offering family planning in its clinics in 1978, joined with Johns Hopkins Program for Education in Gynecology and Obstetrics (JHPIEGO), in 1980, to train medical doctors in the techniques of voluntary surgical contraception. It was followed by the support of the Association for Voluntary Surgical Contraception (AVSC) and Development Associates. During the years that followed the 1st project with JHPIEGO, AVSC and Development Associates, more than 125 courses were performed, 180 for nurses and 210 for auxiliary nurses and administrative personnel delivered by CPAIMC, ABEP and BEMFAM, and more than 350 institutions received technical assistance in voluntary surgical contraception. In recent national studies done by BEMFAM in contraceptive method prevalence, the most common methods were oral and surgical contraception. 65% of married women report they or their husbands are currently using contraceptives. Nationally, 27% of couples are using female sterilization and 25% oral contraceptives. Female sterilization is the most common method in all regions except the South, where pills are the most prevalent method. About 7% of the males have had vasectomies. Sterilization is more common in urban areas and increases in accordance with a woman's age, reaching prevalence rate of 73% between the age of 25 to 39. Average age was 31.4 years but 40% of the women were sterilized before age 29. Data is given on duration of marriage with sterilization, place of operation, complications, client profile, medical/surgical data, and sterilization failure. It was found that cumulative failure rates for sterilization in Brazil are comparable to or somewhat lower than those reported elsewhere; they decreased significantly as age at sterilization increases; failure during training periods are not significantly different, and cumulative failure rates increased, although not significantly, as the number of sterilizations per surgeon/day increased (author's modified)
Association for Voluntary Sterilization - Consultant Team. Trip report: the People's Republic of China, Beijing, Chongqing, Wuhan, Guangzhou, June 19-30, 1985.
[Unpublished] 1985. 41,  p.The Association for Voluntary Sterilization consultant team visited Beijing, Chongqing, Wuhan and Guangzhou, China in June 1985, to review innovative nonsurgical methods of male and female sterilization. There are 2 variations on vasectomy, performed with special clamps that obviate a surgical incision. The 1st is a circular clamp for grasping the vas through the skin, and the 2nd is a small, curved, sharp hemostat for puncturing the skin and the vas sheath, used for ligation. Vas occlusion with 0.02 ml of a solution of phenol and cyanoacrylate has been performed on 500,000 men since 1972. The procedure is done under local anesthesia, and is controlled by injecting red and blue dye on contralateral sides. If urine is not brown, vasectomy by ligature is performed. The wound is closed with gauze only. Semen analysis is not done, but patients are advised to use contraception for the 1st 10 ejaculations. Pregnancy rates after vasectomy by percutaneous injection were reported as 0 in 5 groups of several hundred men each, 11.4% in 1 group and 2.4% in another group. The total complication rate after vasectomy by clamping was 1.8% in 121,000 men. 422 medical school graduates with surgical training have been certified in this vasectomy method. Chinese men are pleased with this method because it avoids surgery by knife, and asepsis, anesthesia and counseling are excellent. Female sterilization by blind transcervical delivery of a phenol-quinacrine mixture has been done on 200,000 women since 1970 by research teams in Guangzhou and Shanghai. A metal cannula is inserted into the tubal opening, tested for position by an injection of saline, and 0.1-0.12 ml of sclerosing solution is instilled. Correct placement is verified by x-ray, an IUD is inserted, and after 3 months a repeat hysteroscopy is done to test uterine pressure. Pregnancy rates have been 1-2.5%, generally in the 1st 2 years. Although this technique is tedious, requiring great skill and patient cooperation, it can be mastered by paramedicals. The WHO is assisting the Chinese on setting up large studies on safety and effectiveness, as well as toxicology studies needed, to export the methods to other countries.
Sterilizations by sex and percentages of: male to female sterilizations and total number of sterilizations as percentage of total new acceptors. 1979-1984.
[Unpublished] . 3 p.This is an International Planned Parenthood Federation (IPPF) collection of data detailing numbers of sterilizations in each country of the western hemisphere from 1979 to 1985. The table presents sterilizations among males and females, total number of sterilizations, ratio of male to female expressed in percentages, and ratio of sterilizations to new acceptors also expressed as percentages. The countries with the numbers over 10,000 in 1986 were Columbia, Guatemala and the Dominican Republic. Countries with 1000 to 9999 were U.S., Honduras, Mexico, El Salvador, Ecuador and Brazil, in order. Most nations reported 5 to 10 times more female than male sterilizations. The exception was the U.S., with 10 times more vasectomies in the latter years. The total reported ranged from 63,400 in 1980 to 94,448 in 1985.
[Voluntary sterilization in France and in the world] La sterilisation volontaire en France et dans le monde.
Paris, Masson, 1981. 277 p.This monograph, directed not only to medical and paramedical personnel but to sterilization seekers as well, touches upon all aspects of voluntary sexual sterilization. The history of sterilization is follwed by a review of female and male anatomy and physiology, and of present available and reversible methods of contraception. All surgical, laparoscopic, tubal, electrocoagulation, culdoscopic, or hysteroscopic methods of female sterilization are described, and results, including morbidity and mortality, complication rates, side effects, and failure rates are presented. This part of the monograph is illustrated with clear and schematic drawings. Problems related to demand for reversal of sterilization are discussed. The same is done for male sterilization, its techniques and complications. The monograph discusses the ever increasing demographic problem in the world , and the role and the extent of voluntary sexual sterilization in industrialized countries and in third world countries, stressing the efforts of those international agencies, such as WHO, IPPF, the Population Council, the European Council, UNFPA, and the World Federation of Associations for Voluntary Sterilization, which promote sterilization around the world, and offer sterilization services. The authors then investigate the role of the physician in the decision to recur to sterilization as a permanent contraceptive method, and in deciding the proper surgical technique. A special chapter discusses the psychological conflicts related to sterilization, especially those which arise before the intervention, and which may very well represent the strongest contraindication to sterilization. A final chapter is devoted to France and to the sociocultural aspects which make sterilization more or less acceptable, the existing legislation, and the professional problems linked to sterilization interventions.
Sequelae of vasectomy. Report of a Meeting on Vasectomy, organized by the Special Programme of Research, Development and Research Training in Human Reproduction held at WHO, Geneva, 3-6 August 1981.
Contraception. 1982 Feb; 25(2):119-23.In response to enquiries received by the World Health Organization (WHO) from several countries, the WHO Special Program of Research, Development and Research Training in Human Reproduction convened a meeting of experts in Geneva during August 1981 to review the available animal, clinical, and epidemiological data on vasectomy, with particular emphasis on clinical implications of longterm sequelae of vasectomy in cardiovascular disease. The occurrence of circulating antibodies to sperm antigens has been demonstrated after vasectomy in all animal species studied thus far by various techniques. Prospective clinical studies of vasectomized and nonvasectomized men have been conducted at 4 centers in the U.S. involving clinical and laboratory evaluation of subjects before surgery and at intervals thereafter. A total of 412 vasectomized men were enrolled in these studies; most were followed for 2, 3, or 4 years. The only significant finding was the development of antibody to sperm antigens. Alexander and Clarkson first reported that vasectomy increases the extent and severity of diet-induced atherosclerosis in cynomolgus monkeys. In a 2nd study, Clarkson and Alexander extended their previous findings to evaluate the effects of vasectomy on naturally occurring atherosclerosis in rhesus monkeys. The mechanism by which vasectomy exacerbates atherosclerosis in monkeys has not been defined. At present epidemiological data which have been published come from observations in the U.S. and United Kingdom and in particular from 2 studies involving 4830 and 1764 vasectomized men studied at about 5-6 years after surgery. No health risks of vasectomy were detected in these early years. Other epidemiological projects are in progress in the U.S. Various options were discussed for further epidemiological studies which might be conducted in developing countries where large numbers of men have been vasectomized. The cohort approach and the case control method, the 2 main study options, are briefly reviewed.
London, IPPF, 1981 Aug. 13 p.The International Planned Parenthood Federation (IPPF) 1982-1984 Plan identifies the importance of male involvement in family planning and the problem of male opposition to family planning in many countries. The Plan calls for efforts to encourage men to accept joint responsibility for family planning and the practice of contraception. In most countries family planning programs are orientated towards women, but many family planning associations have some activities directed at men. A number of associations have developed experimental projects aimed at increasing male involvement, and these can be grouped as projects aimed at motivating male leaders, reaching men in the organized sector, promoting male family planning methods, and reaching adolescents. Each of these is reviewed. In identifying ways of increasing male involvement in family planning there are several aspects that Family Planning Associations (FPAs) might want to consider. These concern the current situation and local environment, the views of men, and the resources of the Association. Associations might want to consider the following suggestions for FPA program directions. These are arranged under the following categories: improving overall programming to include men; increasing availability of existing male methods; education program to promote male involvement; and increasing female support for male involvement in family planning. In countries where the concept of family planning is generally accepted, an "across the board" improvement in programs to increase their acceptability to men might result in increased male support for family planning. Although more governments and FPAs have made vasectomy available over the past decade, additional efforts could be made. The 4 principal objectives for education initiatives aimed at "male involvement" are identified. It is important that women educate and help their partners to participate in family planning. Family planning workers could do much to encourage women to involve their partners.
UNFPA Newsletter. 1980 Jan 1; 6(1):1.A minimum bonus of Rs.100.00 ($6) will now be paid to any employed person voluntarily undergoing sterilization in Sri Lanka. Women will be given 7 days extra leave and men 3 days. The bonus is compensation for out-of-pocket expenses and time for recovery. Many public and private corporations, e.g., the tea industry, pay sterilization bonuses, sometimes in excess of Rs. 100. A bonus of Rs. 500 is awarded women and Rs. 300 is awarded men by rubber, tea, and coconut plantations owned by the state. It is hoped that all adults in Sri Lanka, including the unemployed, will soon be covered by a system of sterilization bonuses. A UNFPA-sponsored project will equip 85 of the country's 117 smaller hospitals and train their staff to perform vasectomies and mini-lap operations under local anesthesia. 7 out of 10 of 370,000 births per year occur in hospital or some other medical facility. Population committees have been set up in several districts with divisional and village committees backing them up. These committees will be used as centers for discussion, motivation, provision of services, and referral. The Ministry for Family Health and the Community Development Services Organization will expand the provision of Depo-Provera, which is increasingly popular in Sri Lanka, especially among Moslem communities.
Family Coordinator. 1973 Jul; 22(3):331-8.Data collected on behalf of the Planned Parenthood/World Population (PPWP) affiliate to be used in planning a vasectomy education program came from a survey of 387 men and women in Hayward, California, to ascertain the levels of knowledge and prevalence of vasectomy and attitudes toward the operation. The sample was comprised of men and women in 3 income categories, and households were not preselected on a random basis. The survey instrument was a 1-page set of questions, primarily of the closed-ended type which the respondent completed in the presence of the interviewer. The major findings were: 1) PPWP was not identified as a source of aid; 2) most men and women have discussed vasectomy with their spouses; 3) men and women are influenced by attitudes and practices of others with regard to vasectomy; 4) physicians are seen as the main source of information about vasectomy; 5) irreversibility is the major concern of the men and women; and 6) eligible couples can be reached only by a community-side education program. Implications of the survey for a community education program are put into concrete, programmatic terms, indicating lines of direction, points of departure, and crucial ideas sometimes overlooked in service programs. It is concluded that in all areas of a community education program vasectomy should be presented as 1 or a range of alternatives, thus assuring the couple that does elect vasectomy that they really did make a free choice.
Law File, International Planned Parenthood Federation. 1979 Oct; 10:20-3.Recently adopted policies of the IPPF Management and Planning Committee on voluntary sterilization, family sterilization, family planning services for adolescents, and the use of auxiliary personnel in the delivery of fertility regulation services are summarized. Sterilization services should be included in family planning programs whenever possible, and Family Planning Associations should promote sterilization awareness. Sterilizations should be performed only on patients who have given informed and unpressured consent, and procedures most amenable to reversibility should be used. The use of government incentives or disincentives to promote sterilization must take into account existing social values. The receipt of any government benefits or services normally accorded as a basic human right cannot be made dependent on the acceptance of sterlization. Fertility regulation services should be made available to adolescents whenever possible. Efforts to remove all barriers to the offering of these services should be promoted. Research should be undertaken to determine 1) the effect, if any, of contraceptive availability on the frequency of adolescent pre-marital intercourse; 2) the effects of unplanned pregnancy on adolescent mothers and their offspring; and 3) the most effective methods for promoting acceptance of adolescent family planning services. The use of trained health and auxiliary personnel in the delivery of fertility services should be encouraged through 1) increased use of standing orders and presigned prescriptions; 2) further delegation of duties by doctors to auxiliary personnel; 3) application of the most liberal interpretation of laws relevant to the use of auxiliary personnel; 4) the authorized use of auxiliary personnel whenever possible; and 5) the establishment of panels within each Association to develop auxiliary personnel training programs.
CRP Population Research. 1978 Nov; 33-34.The Contraceptive Development Branch (CDB) program conducts research in 2 areas: 1) reproductive processes and 2) product development. Research on reproductive processes improved the understanding of gamete transport and has better identified corpus luteum functions and the role of prostaglandins. The biology and biochemistry of the ovum has been studied, and in vitro fertilization investigated. The mechanism of spermatogenesis, sperm maturation, and subsequent fertilization have been observed. Moreover, CDB has participated in the distribution of a variety of reagents to the scientific community, to stimulate research on the antipregnancy vaccine. In the area of product development, the CDB continues experimenting with the synthesis of new chemicals to regulate human fertility, the issue of safety being the primary motivation of the program. Approximately 1100 new chemicals have been synthesized and tested on laboratory animals. A drug testing program was initiated in 1972, providing feedback of biological data, and representing the major drug testing effort in the U.S. Considerable progress has been made in the area of implantable and oral contraceptives, and in the area of devices for fertility regulation, and for sexual sterilization. Clinical studies sponsored by CDB are ongoing.
In: World Health Organization (WHO). Special programme of research, development and research training in human reproduction. Sixth annual report. Geneva, Switzerland, WHO, November 1977. 100-112.The objective of the Task Force research team is to develop a data base that would provide specific recommendations for increasing the acceptability of family planning methods and services. Research areas focus on consumer perception of method attributes (e.g., route of administration, duration of action, side effects) and attributes of services (e.g., convenience of clinic hours, degree of privacy and embarrassment, courtesy of personnel). Psychosocial issues relating to family planning are also being considered. Methodologies of Task Force research consist of field surveys; monitoring decision-making process of the population under study; clinical trials; assessment of clinic records; anthropological participants observation; diary cards; and, case studies. Thus far, studies on male contraceptive methods suggest that there is a market for new and improved male methods, and that men are increasingly viewing contraception as a shared responsibility. Findings from 5 countries (Mexico, Korea, Iran, rural India and Fiji) suggest that with the exception of a middle socioeconomic strata in Mexico, most men find vasectomy unacceptable relative to the condom, daily pill and monthly injections. An ongoing multicentered study started in 1975 with respect to pattern and perception of menstrual bleeding is now on its final phase and is expected to provide data on sociocultural variations. Findings of a pilot study on routes of administration of contraceptives showed that although routes of administration affect the products' acceptability, the attributes of the method are more important to the respondents than how it is administered. Other acceptability research projects are ongoing and will be publishing their findings in the near future.
London, England, IPPF, 1977. 428 p.This report describes IPPF's world-wide program from 1975-77. Financial and statistical statements are accompanied by narrative texts. In 1975 the number of family planning acceptors increased by about 5% or 1.8 million reached directly by IPPF-funded service programs. Between 1971 and 1974 the overall acceptance rate for organized family planning programs in countries with government programs was about 35/1000 women aged 15-44. The acceptance rate of IPPF-supported programs increased from 2.1 to 2.7/1000. IPPF's contribution was about 8% of the 1974 total. As a distributing and purchasing agency for contraceptive supplies and medical equipment, IPPF purchased $8.5 million worth of commodities in 1975, $7.5 million in 1976, and $7 million in 1977. About 2/3 represent oral contraceptives and condoms. The world summary of projected expenditures, 1977, includes 20.7%/information and education, 21.6%/medical and clinical, 20.4%/administration, 14.2%/commodities, 7.6%/community-based distribution, 6.2%/training, 3.2%/evaluation, and 1.6%/fund raising. Regional reports include a program description of the regional office, financial statements, clinic service statements, program descriptions of grant receiving associations, and a brief summary of expenditure.
Guide to equipment selection for M/F sterilization procedures. Guide du materiel utilise pour les procedures de sterilisation des hommes et des femmes.
Population Reports. Series M: Special Topics. 1977 Sep; (1): p.This is a guide to aid in selecting and maintaining the proper equipment used in the following sterilization procedures: 1) minilaparotomy, 2) laparoscopy, 3) conventional laparotomy, 4) colpotomy, 5) culdoscopy, and 6) vasectomy. Prototype, experimental, or infrequently used instruments are not discussed. Colpotomy, minilaparotomy, and conventional vasectomy are low-technology procedures requiring relatively simple, locally produced instruments, e.g., retractors, forceps, and scalpels. High-technology equipment consists of specialized items, e.g., laparoscopes and culdoscopes. These are produced in a limited number of technically advanced countries. Equipment donor agencies are discussed. The following factors must be considered in selecting equipment: 1) suitability for the intended procedures, 2) quality of the instrument, 3) ease of repair, and 4) initial cost. Each type of equipment is pictured, diagrammed, described, and charted against others of its kind. Maintenance and repair guidelines are provided.
FPOP Bulletin 9(3): 7. May-April 1977.A new statement which spells out in detail IPPF's belief in the right of the individual to make a voluntary choice has been drawn up by the Central Medical Committee and the Law and Planned Parenthood Committee and approved by the Management and Planning Committee. The 8-point resolution states that sterilization as a method of limiting family size, should be a completely voluntary choice made in full knowledge of alternative methods of contraception and the risks and benefits associated with sterilization. Both male and female methods should be regarded as irreversible; however, at time of sterilziation the method offering greatest hope of reversiblity should be used. Counseling and follow-up should be an integral part of any sterilization program. Incentives should not be discriminatory nor involve withholding of services from families. They also should not be so high as to be unduly influential on the poor. Doctors used by Family Planning Associations should use the best possible techniques and should be remunerated on the basis of quality of care, not the number of cases. In order to keep close watch on use of sterilization, full data should be collected and analyzed.
People. 1977; 4(3):39.The Management and Planning Committee of the International Planned Parenthood Federation has reiterated its belief in the principle of voluntary sterilization as a means of family limitation. The Committee asserts that counseling and follow-up sessions should be provided for all sterilization patients as well as information regarding risks involved and alternatives to sterilization. All incentives to sterilization should supplement basic human rights, no disincentives should tamper with such rights, and both incentives and disincentives should harmonize with prevailing social values and mores.
Indonesian Association for Voluntary Sterilization. Perkumpulan Untuk Sterilisasi Sukarela Indonesia.
Presented at the World Federation of Associations for Voluntary Sterilization General Assembly Meeting, Tunis, February, 1976. 2 pIn this report by the president of the Indonesian Association for Voluntary Sterilization, Perkumpulan Untuk Sterilisasi Sukarela Indonesia (PUSSI), he notes that at present time, both male and female sterilization is in demand in an ever increasing volume in his country. In 1957, the Indonesian Planned Parenthood Association was founded; and since 1970 the country has had its own national family planning program under the guidance of the National Family Planning Coordination Board. By the end of its first 5-year development plan, 1970-1975, a total of 5 million new acceptors had been registered. The IUD and oral contraception have been accepted. The present increased demand for sterilization is perhaps due to the fact that more and more people have become family planning conscious, especially since 1974 when the government adopted the following policy: government officials shall henceforth receive allowances for a maximum of 3 children. This policy has been followed by private business. Sterilization must be on a strictly voluntary basis, with the express consent of the spouse. And though it has not yet been accepted officially as a family planning method, PUSSI was established in 1974; and various sterilization centers are located throughout Indonesia. PUSSI maintains that the propagation of the sterilization method to the Indonesians helps the prevention of their exposure to the adverse effects of oral contraceptives and IUD for too long a period of time.
New York, International Planned Parenthood Federation, Western Hemisphere Region, September 1975. 149 pThe primary focus in this 4th edition in the series of annual "overviews" of the contraceptive services in the Western Hemisphere Region of the International Planned Parenthood Federation is on clinical facilities, medical and paramedical services, and on the delivery of contraceptive methods by family planning programs. Family planning services link information on methods for spacing or limiting children to their availability, and they provide education on the advantages of contracepting. They seek to motivate acceptors to continue their chosen method. Counseling and information and education activities, although an integral component of family planning programs, are not included among the topics considered in the "Overview." In the Western Hemisphere Region, the most notable innovation has involved the community-based distribution of contraceptives (CBD), and for the 1st time, non-clinical distribution of contraceptives by associations in the region is a part of the "Overview." The Annual Reports submitted by IPPF affiliates and published and unpublished data from other programs are the primary sources of statistics for this report. Information for 1973 encompassed 29 associations related to IPPF and 4 other programs, and for 1974, 28 associations and 5 other programs could be covered. As for clinical input of family planning programs, the affiliates reported to the Regional Office of IPPF the number and types of clinics, weekly session hours, hours of medical and paramedical personnel. Data on the output of clinical activities of family planning programs for the calendar year were limited to 1st visits or new acceptors by methods, 1st revisits of the year or continuing (old) acceptors by method, number of revisits by old and new acceptors by method, demographic characteristics of new acceptors by method, and voluntary male and female sterilization performed or referred. Data on contraceptive services and clinical activities are summarized and presented in the form of tables.
In: Morris, N. and Arthure, H. Sterilization as a means of birth control in men and women. London, Peter Owen, 1976. p. 80-100Vasectomy was 1st used at the start of the 20th century and became prominent in the 1950s in family planning programs in Asian countries. The secondary sex characteristics do not change after vasectomy, and there is normal erectile power, libido, orgasm, and ejaculatory volume. Spermatogenesis continues normally in men following vasectomy, and plasma testosterone levels remain unchanged. Vasectomy involves cutting both vasa deferentes through an incision in the scrotum which is usually performed with local anesthesia without hospitalization. Preliminary counseling is necessary so that both partners understand the nature and effects of the operation. Semen banks may be used when available for men undergoing vasectomy. There is no evidence for the greater efficiency of 1 technique over the other. Patients must submit sperm samples for examination after 8-12 weeks and then every 4 weeks until 2 consecutive specimens are negative. Possible complications include: 1) a vasovagal reaction; 2) skin discoloration; 3) edema of the scrotal skin, 4) postoperative pain, 5) infection; 6) ulceration and gangrene of the scrotal skin, and 7) hydrocele or epididymo-orchitis. Successful reanastamosis of the vas deferens with reappearance of sperm can be accomplished in 50-80% of the patients, and the semen is not of quality to insure impregnation in 1/4 of these cases.
In: Schima, M.E. and Lubell, I., eds. New advances in sterilization. Proceedings of the 3rd Internaitonal Conference on Voluntary Sterilization, Tunis, Tunisia, February 1-4, 1976. New York, Association for Voluntary Sterilization, 1976. p. 12-14Voluntary sterilization is 1 of the most effective, least troublesome, and least expenxive methods of contraception yet developed. Sterilization serves health, demographic, and human rights concerns in the contraceptive field. Voluntary organizations are needed to provide sterilization in areas where government family planning programs do not yet provide it. The World Federation of Associations for Voluntary Sterilization was founded to bring together all the national organizations working for the same goal. The Federation provides a framework for coordinating national organizations and for cooperating with international health organizations.
Conclusions and recommendations of the IPPF Central Medical Committee (CMC) and its panel of experts on sterilization.
In: Kleinman, R.L., ed. Male and female sterilization. A report of the meeting of the IPPF Panel of Experts on Sterilization, Bombay, January 11-14, 1973. London, International Planned Parenthood Federation, 1973. p. 8-12The conclusions and recommendations fall into 3 categories, i.e., policy, administrative and technical. Important points in the 1st category include; that sterilization be available and avilable on request, that it be voluntary, and that facilities for reversal procedures be free and avilable. Administrave recommendations include; that no arbitrary hospital stay be assinged to vasectomy patients, that no arbitrary selection criteria concerning previous training or surgical skill be used in accepting personnel for vasectomy patients, that no arbitrary selection criteria concerning previous training or surgical skill be used in accepting personnel for vasectomy training, and that endoscopic techniques should not be done without an anesthetist. Among the technical recommendations were: that postpartum sterilization under local anesthesia by laparotomy be encouraged, as that is the simplest of all female procedures; taht vaginal procedures should only be done with proper operative and anathestic facilities; that division of the uteirne tubes by the Pomeroy technique using 0 chromic catgut should be employed in mass programs of female sterilization; the removal of part of the uterine tube for biopsy and histological examination as a check on the success of the operation should not be done; general anesthesia should never be used for a simple vasectomy unless there are complications; and that tetanus toxoid should not be given to avoid infection.
New York, International Planned Parenthood Federation, Western Hemisphere Region, Medical Division, September 1975. 49 pThis is a compilation of family planning services provided by associations operating in the Western Hemisphere Region. Separate tables are compiled for 1973 and 1974. A list of each family planning program included in the study is appended to the report. The report does not guarantee the completeness or accuracy of the data; problems with reliability of data point up the necessity for a system of standardized record-keeping. Tables cover program input in the form of clinical facilities, medical and paramedical services, and the delivery of contraceptive methods by family planning programs and community-based distribution systems. Charts on program output include information on acceptor characteristics, numbers of new and continuing acceptors, numbers of voluntary sterilizations, and percentages of other methods in use.