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Journal of Chinese Sexology. 1993 Mar; (1):26-27.It is widely known that viral hepatitis is transmitted through intestinal tract infection or blood infection. However, it has not aroused much attention that the disease can be transmitted through sexual behavior. WHO has listed this disease as one of sexually transmitted diseases. Blocking the infectious link of sexual behavior is an essential tool in preventing and curing hepatitis B. This article intends to detect signs of Hepatitis B through vaginal secretion of 51 pregnant and postnatal women of childbearing age and to discuss the relationship between sexual behavior of people with Hepatitis B and clinical infection. Discussion: In China, the positive rate of surface antigen in pregnant and postnatal women is 2% to 7%, depending on the region. 1. It is 6.5% in Shenyang, lower than that in men. Pregnant and postnatal women who are surface antigen negative and who exhibit Hepatitis B symptoms people account for 22% of all surface antigen-negative people. 2. According to statistics, this study holds that 100% vaginal secretions of people with indication of Hepatitis B carry the Hepatitis B virus, and 6.6% (1/6) is strongly infectious. This indicates that chances of vaginal secretions of average women of childbearing age carrying Hepatitis B virus are high. The link between sexual behavior and the transmission of the Hepatitis B virus must be cut. (excerpt)
A changing emphasis for feeding choices for HIV seropositive mothers in East, Central and Southern Africa.
SOCIETES D'AFRIQUE ET SIDA. 1997 Jul-Oct; (17-18):12-4.Since the first descriptions that HIV-1 can be transmitted from mother to infant by breast-feeding, infant feeding practices in HIV-1 seropositive mothers had to be re-evaluated. In developed countries, public health policies recommend artificial feeding. A workshop sponsored by the South African Department of Health and the World Bank in collaboration with the Department of Pediatrics & Child Health, University of Natal and the Commonwealth Regional Health Community Secretariat for East, Central and Southern Africa was held in Durban, South Africa (May 20-21, 1996) to address the question on breast-feeding infants with seropositive mothers. The presentations of the program included the epidemiology of mother to infant transmission of HIV with special emphasis on breast-feeding, the biological aspects of HIV transmission through breastmilk, a review of international studies on breast-feeding and mother to infant transmission of HIV and an exploration of the potential impact of breast-feeding on interventions against mother to child transmission of HIV by antiretrovirals. Thus, a shift in emphasis on the question of feeding choices for HIV seropositive women in developing and intermediate income countries has occurred. However, this statement has yet to be converted into policy.
Lancet. 1995 May 27; 345(8961):1358.Paul Livingstone Armstrong, 82, has sought to convince the medical profession and the general public of the known hazards of adolescent pregnancy since 1973. According to the "World Health Report" of the World Health Organization (WHO), maternal mortality rates at ages 15-19 are double those at 20-24; those at 10-14 are 5 times higher in some countries. In 14 African countries at least 50% of the women marry before age 18; in Niger, where nearly 50% marry before age 15, 2 out of 5 have one child by age 17. In China, due to family control, the maternal age range is 23-26; the paternal age range is 26-29. In Japan, 16% of women under 25 bear children; in the US, 43% do (1993 data). Livingstone Armstrong has produced demonstration kits with life-size plastic pelvises for ages 16, 19, and 23 for the Charing Cross and Westminster Medical School, London, UK. In 1985, the World Health Assembly (WHA), whose meetings Livingstone Armstrong has attended steadily, approved a resolution urging governments to promote a delay in child bearing until both parents, but especially the mother, are adults--fully grown, adequately nourished, and disease-free. However, some governments viewed the resolution as useless because of the social, economic, and religious circumstances of their populations. Livingstone Armstrong continued his efforts and donated his kits in a limited, judicious manner to places such as one of the refugee camps along the Thai-Cambodian border. The result was genuine interest by delegations to the most recent WHA meeting and orders from Tanzania, Uganda, Kenya, Zimbabwe, and Zambia for the kits, which are now being used in Gambia to train traditional birth attendants and village elders (all men).
In: Infant and childhood mortality and socio-economic factors in Africa. (Analysis of national World Fertility Survey data) / Mortalite infantile et juvenile et facteurs socio-economiques en Afrique. (Analyse des donnees nationales de l'Enquete Mondiale sur la Fecondite), [compiled by] United Nations. Economic Commission for Africa [ECA]. Addis Ababa, Ethiopia, United Nations, ECA, 1987. 1-4. (RAF/84/P07)After completion of the World Fertility Survey, the UN Economic Commission for Africa (ECA) held a workshop for representatives from 15 African countries to utilize the SPSS program for demographic data analysis to prepare reports on their own countries' infant and child mortality trends. The introduction to the report on the workshop highlights findings which include infant mortality rates around 90/1000 births in Kenya, Nigeria and Cameroon, and 100 or more in Benin, Ivory Coast, and Senegal. Mortality was less than 80 in Sudan and Mauritania, possibly reflecting serious deficiencies in the data. Childhood mortality was over 100/1000 in Benin, and lowest in Kenya and Ivory Coast, around 70. There were clear indications of decline in mortality in the last 20 years in Cameroon, Ivory Coast, Kenya, Nigeria and Senegal. Among the variables examined for their influence on mortality, maternal education and birth intervals clearly were the strongest, suggesting directions for policy.
Women's work and fertility, research findings and policy implications from recent United Nations research.
[Unpublished] 1986. Paper presented at the Rockefeller Foundation's Workshop on Women's Status and Fertility, Mt.Kisco, New York, July 8-11, 1986. 23 p.Using World Fertility Survey data from the developing countries, it has been found that the interval between 1st and last birth varies from roughly 14 years in several of the more developed countries of Latin America and Asia (Republic of Korea, Jamaica, and Trinidad and Tobago) to 20 years in several African countries (Kenya and Senegal). In most of these countries childbearing begins between ages 18 and 20 with the lowest median age of 1st birth found in Bangladesh (17 years old) and the highest in Yemen (22 years old). Ages at last birth vary more widely from 33 in Trinidad and Tobago to 40 in Yemen. At the age of last birth, life expectancy varies from 27 in Benin and Senegal to 44 in Trinidad and Tobago and 42 in Costa Rica, Jamaica, and Panama. Life expectancy at last birth varies with level of development with developing countries at the highest level of development having an average life expectancy at age of last birth of 40.5 ranging on down to 36.8 at a middle-high level of development, 32.6 at a middle-low level, and 29.7 at the lowest level of development. This is compared with a life expectancy at last birth which is now as high as 52.6 in Japan for women born in 1950-1959 and 51.6 in the Netherlands for women born in 1940-1949. Thus, the actual childbearing period is 2 to 5 times longer in the developing countries than it is in the developed countries. A life cycle approach to women's employment and childbearing is essential for a full understanding of the interrelationship between women's status and fertility. While work opportunities can improve women's status and create the motivation for low fertility, fertility control is essential to women's status. As long as the events of conception, pregnancy, and childbirth have a significant element of chance, the incentives for societal and individual investment in women's educational and job opportunities will remain limited.
Methodological problems in evaluation of family planning impact of programmes that are integrated with other development sectors.
In: Studies to enhance the evaluation of family planning programmes by United Nations Department of International Economic and Social Affairs. Population Division [DIESA] New York, New York, United Nations, 1985. 108-110. (Population Studies No. 87 ST/ESA/SER.A/87)Governments of developing countries began to undertake family planning in the 1960s thanks to a sudden availability of funds for programs exaggerating an already existing cleavage between program and general demography professionals. Discussion at the World Population Conference (WPC) in Bucharest recognized social and economic factors as an important element in the use of family planning and attempted to encourage better cooperation between program evaluators and demographers. Separation of family planning effects from development effects has been difficult. The WPC's World Population Plan of Action (WPPA) reiterated that population and population policies were interrelated with and should not be considered substitutes for socioeconomic development policies. Increasingly, governments have been integrating family planning with education and health programs as recommended by the WPPA. Family planning being a relatively new venture, it is necessary to develop a theoretical framework to justify assumptions that family planning and development are productively integrable and synergistic, determining demographic effects and their causal mechanisms, whether social or program related. A careful record of program inputs must be kept. Important issues in education, which generally speaking has an inverse effect on fertility, are: in which sex and age group of the population is education most effective for fertility control allowing for lag time; and what are the intervening effects--age at marriage, better knowledge, or change of attitudes? Some of the simplest integrated programs combine family planning with educational programs in schools, health programs, and agricultural programs. Thus teachers are trained to educate pupils in population problems; health workers educate family health consumers a logical diversity of function that is however limited by the scope of the health program. The benefits of small family size may be incorporated into rural development ideology. Critical evaluation will necessitate demonstration of integration's beneficial effects.
[Unpublished] 1978. Presented at the WHO Seminar on Public Health and Clinical Aspects of Human Reproduction, Sofia, Bulgaria, September 25-27, 1978. 25 p.At the 21st World Health Assembly (WHA) it was decided that the Director General of the World Health Organization (WHO) should give support to member countries in realizing the integration of fertility regulation into public health services. WHO does not endorse any particular population policy, but does fully recognize the health rationale of family planning in terms of adequate timing and spacing of pregnancies, avoidance of unwanted pregnancies, and limitation of the number of births. During the last decade WHO has rapidly increased its efforts to assist countires in the establishment of programs and services for family planning, with emphasis on the developing countries. The relationships between family building, family health, and socioeconomic and other variables are very complex, and a close correlation exists among these variables themselves as well as socioeconomic conditions. Attention is directed to risks of unplanned pregnancies (risks for the mother and maternal age); influences on children; birth intervals; genetic aspects; high risk groups; integration of family planning into the public health services; fertility regulating methods and their utilization; and organization and availability of services. The identification of, and concentration on, high risk groups in the community is of great importance for efficient utilization of scarce resources in integrated health and family planning services. Some examples of such high risk groups are pregnant adolescents, primigravida, grand multipara, newborns, and children during the weaning period. The success of fertility regulation depends on the acceptability of methods. It depends on attitude of users and of medical personnel, availability of counseling centers and contraceptives, information and education of the people, and legislation. Acceptance and practice of contraception essentially depends on the level of service for the people. One of the major thrusts of the health professions today should be increased involvement in family planning and not as a population control movement but as an integral part of the medical responsibility to improve the quality of human life and to guard the health of the people.
New York, UN, 1974. 26 p. (E/CONF. 60/CBP/5)The U.N. Charter and other international documents have stated a clear policy of raising the status of women and promoting equality between the sexes in various aspects of life. This is a consideration of the determiniants and consequences of population trends as they are affected by and as they, in turn, affect the degree of equality between men and women within a society. The status of women in public and private life is measured primarily in number of years of schooling, their representation in the paid labor force, their participation in political life and political decision-making, their age at marriage, and their rights and duties within the family. It is seen that many of the relationships are 2-way. For example, women who defer their marriage or their childbearing in order to pursue an education will tend to have lower fertility. On the other hand, women with more education may be influenced by their cultural environment to have fewer children. Equal educational and political rights, although an ideal, have not generally been achieved by women in the developing countries. The type of employment a woman engages in is more influential for her fertility than mere employment. General consideration is also made of the way in which population trends have affected and are likely to affect the exercise of basic human rights, especially for women.
World Health Organization, Technical Report Series.. 1970; 50.Add to my documents.
Washington, D.C., U.S. Government Printing Office, June 1976. (Syncrisis, The Dynamics of Health No. 18) 149 pThere is no sector of Pakistani life which more graphically reflects the great sacrifice it took to make Pakistan a viable state than the health sector. Malaria, tuberculosis, and cholera continue to constitute threats to health. Gastrointestinal, infectious, and other parasitic diseases continue to contribute substantially to morbidity and mortality. These diseases are exacerbated by extremely primitive water supplies and waste disposal, bad housing, nutritional problems, and an increasingly heavy population growth. Public health resources to cope with these conditions have not previously been available. Pakistan's poor helth environment appears to result from widespread infectious and communicable diseases, poverty, and sociocultural attitudes which inhibit improving the environment, and ineffective policies administered by limited numbers of inadequately trained health workers, affecting both the urban poor and the rural population. In the latest 5-year plan, the 5th, 1975-1980, there is increasing attention to health. Regarding family planning, it has been suggested that the government has finally begun to recognize that urgent and dramatic steps are necessary to reduce Pakistan's population growth rate. The government has adopted a policy of using conventional contraceptives as the most acceptable method of contraception in Pakistan. A program of distributing the oral contraceptive without medical or paramedical constraints had been instituted, and the government has undertaken to subsidize the distribution of th oral contraceptive and the condom through some 50,000 outlets at 2.5 cents per monthly supply.
Family Planning Digest. 1972; 1(3):13-15.According to a WHO report Health Aspects of Family Planning family planning is assumed to have beneficial health results. Although reproductive changes do not exist in economic and social isolation, there is a link between maternal mortality and morbidity with increasing parity. An interval of at least 2 years between pregnancies results in the lowest rates of fetal loss and neonatal mortality. The question remains of how family planning services may be integrated with existing health services, such as postpartum care. Personnel involved in other health services, such as auxiliary nurse-midwives, can assume increasing responsibility in handling family planning matters. Further research is needed to understand how family planning affects health.
[Unpublished] 1983. Presented at the International Conference on Population, 1984, Expert Group on Fertility and Family, New Delhi, January 5-11, 1983. 22 p. (IESA/P/ICP. 1984/EG.I/8)The World Health Organization (WHO) has been studying several national surveys with regard to certain health related aspects of fertility. The primary purpose of these studies was to stimulate the use of data by the national health authorities for an improved care system for maternal and child health, including family planning. Some preliminary results are reported in this discussion, in particular those relating to contraception, the reproductive health of adolescents, infertility and subfecundity, and breastfeeding. The national surveys concerned are those of Bangladesh, Indonesia, the Republic of Korea, the Philippines, and Sri Lanka. The methods of analysis were simple and traditional, except for 2 points: some of the data had to be obtained by additional tabulation of the raw data tapes and/or the recode tapes since the standard tabulations of the First Country Reports did not include the needed information; and Correspondence Analysis was used in an effort to stimulate and facilitate the use of the findings for improvements of national health programs. Methods of contraception vary widely, from 1 country to another and by age, parity, and socioeconomic grouping. The younger women tend to choose more effective modern methods, such as oral contraception (OC); the older women, i.e., those over age 35, tend to seek sterilization, if available. It is evident that the historical development of family planning methods has greatly influenced the current "mix" of methods and so has the current supply situation and the capacity of the health care system (particularly in regard to IUD insertions and sterilizations. Use of contraception among adolescents to postpone the 1st birth was practically unknown. The risk of complications at pregnancy and childbirth, including maternal and infant death, is known to be particularly high for young mothers, and the results clearly showed that the infant mortality rate is highest for the youngest mothers. All the women who suffer from infertility do not recognize their condition, but the limited data still point to the need to consider the health needs of women who suffer from unwanted fecundity impairments. This may require medical intervention to cure infections or the offer of relevant sexual counseling. Some infecundity may require the improvement of nutritional and personal hygienic levels before meaningful achievements are made. The prevalence of breastfeeding has declined in some population groups, and the consequences can be expected to be deleterious and to involve serious increases in specific morbidity and mortality.
In: Current problems in obstetrics and gynecology, Vol. 5, No. 6, edited by John M. Leventhal. Chicago, Illinois, Year Book Medical Publishers, 1982. 4-41.This article addresses the medical aspects of population growth, with specific focus on a demographic overview, population policies, family planning programs, and population issues in the US. The dimensions of the population problem and their implications for social and economic development are reviewed. The world's response to these issues is discussed, followed by an assessment of what has been accomplished, particularly as it relates to the record of national family planning programs in developing countries. The impact of population growth on such issues as education, available farm land, deforestation, and urban growth are discussed. Urban populations are growing at an unprecedented rate, posing urgent problems for action. From a public health perspective, data are reviewed which demonstrate that having children at short intervals (2 years) or at unfavorable maternal ages (18 or 35) and/or parity (4) has a negative impact on maternal, infant and childhood morbidity and mortality, particularly in developing countries. Increasing the age of marriage, delaying the 1st birth, changing and improving the status of women, increasing educational levels and improving living conditions in general also are important in reducing population growth. Probably the most important, but most controversial intervention, has been the development of national family planning programs aimed at increasing the public's access to modern contraceptive and sterilization methods. India was the 1st country to declare a formal population policy (in the 1950s) with the goal of reducing population growth. Currently, close to 35 countries have formal policies. The planned parenthood movement, with central support from the London office of the International Planned Parenthood Federation (IPPF), has played a most important role in making family planning services available. 2 population issues in the US today are reviewed briefly in the final section: teenage pregnancy and the changing age structure.