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Geneva, Switzerland, WHO, Department of Reproductive Health and Research, . 3 p.The development of new and improved methods of contraception for both women and men is a key component of the strategy to improve the quality of family planning programmes. Family planning clients are often restricted by the choice of methods offered to them, or are deterred from using contraception due to the side effects related to use of available methods. (excerpt)
Summary of evidence and research needs on the use of mifepristone in fertility regulation: consensus from the conference.
Contraception. 2003 Dec; 68(6):401-407.The conference on the use of mifepristone to reduce unwanted pregnancy, sponsored by the World Health Organization, Concept Foundation and the Rockefeller Foundation, took place in Bellagio, Italy, between 24 and 28 September 2001. The objective of the conference was to review the scientific information and to evaluate the use of mifepristone for emergency contraception, luteal contraception and menstrual induction. Mifepristone is highly effective for emergency contraception but its advantages and disadvantages in comparison with levonorgestrel need to be further studied. Data indicate that mifepristone alone or in combination with misoprostol has potential for occasional use for women seeking help following repeated unprotected intercourse and/or when the interval between intercourse and treatment is more then 120 h. Administration of mifepristone immediately after ovulation seems to be an effective contraceptive method. However, before it can be used commonly, there is a need for a simple and inexpensive method to identify the right time in the cycle. Once-a-month treatment with mifepristone and misoprostol at the expected time of menstruation is not a practical method due to bleeding irregularities and timing of treatment. Menstrual induction with mifepristone and a suitable prostaglandin analogue is highly effective. A randomized comparison with manual vacuum aspiration is, however, needed before it can be recommended for routine use. (author's)
International Journal of Gynecology and Obstetrics. 1999 Dec; 67 Suppl 2:S111-6.By building on the successful past and ongoing partnership with the Research Training in Human Reproduction in supporting researches relevant to reproduction and reproductive health, the Rockefeller Foundation and the World Health Organization are pushing another joint research initiative in the area of implantation. Issues addressed include the implantation process, options for the development of anti-implantation agents, and the rationale for using these agents as method of fertility regulation. This paper concerns the scientific and logistical objectives and focus of the initiative. The following are the proposed foci of the research: 1) the implantation window at the endometrial level in a primate; 2) the development and demise of the primate corpus luteum; and 3) the pre-implantation embryo-uterus-corpus luteum interaction. Six proposals were selected and recommended for support, including in vitro and in vivo basic research, mainly at the molecular level, research in appropriate animal models, and clinical trial in mechanisms of action of alleged anti-implantation and menses-inducing agents and infertility caused by endometrial or ovarian factors. The six centers are located in developed and developing countries. The principal investigators and areas of work of the selected proposals are outlined and offer a future direction of the initiative.
Leiden, Netherlands, Rijks Universiteit, Leiden, Wetenschapswinkel, 1995 Feb. 67 p.After initiating public debate in the Netherlands about how and to what extent UN Population Fund (UNFPA) policies respect women's autonomy and reproductive rights, the cooperating research groups investigated the UNFPA policy dealing with incentives and disincentives to accept family planning (FP) and goals for FP providers. Interviews were held in 1994 in Bangladesh with 125 women and men in rural Bogra and in suburban Dhaka to determine 1) the extent to which incentives influence contraceptive choice, 2) decision-making roles within families, 3) the extent to which health workers are rewarded and the amount of influence they exert over contraceptive choices, and 4) the extent to which service provider disincentives affect attempts to reach service goals. This report of that study provides background information on the research and on the development of population control policies in Bangladesh, the organization of the FP program, and contraceptive methods available. Part 2 traces the incentive program from its probable introduction in India in 1956 through the Bangladeshi Financial Incentive System starting in 1976. Arguments in favor of the use of incentives are summarized. The third part of the report provides an analysis of the data gained from focus group discussions and from interviews with potential users, with women who had undergone a tubectomy more than two years earlier, with vasectomized men, with IUD users, with longterm IUD users, with Norplant users, with women who rely on menstrual regulation, and with service providers. The final section compares findings from Bogra and Dhaka and provides a discussion of the findings in light of other reports in the literature in terms of such issues as quality of care, voluntary and informed choice, and women's status. Recommendations from the study include protecting the human and reproductive rights of women by prohibiting the use of incentives in favor of improving health care, contraceptive availability, and women's status.
PLANNED PARENTHOOD CHALLENGES. 1993; (1):34-5.To reduce the serious health consequences of illegal abortion, the Indonesian Planned Parenthood Association is providing menstrual regulation services. At present, the Association has 15 comprehensive family planning clinics located in 13 out of 27 province capitals. Initially, menstrual regulation was available only in cases of contraceptive failure, but indicators for this service were quickly broadened to meet the large demand for termination of unwanted pregnancies. The ambiguity of the 1992 health law's wording on abortion--abortion is not explicitly mentioned, in an apparent effort to alienate neither anti-abortion forces nor promoters of safe abortion--threatens to stalemate further gains for Indonesian women. Although abortionists are rarely prosecuted, family planning organizations must be cautious to avoid liability suits. The situation in Indonesia is an example of women's health being held hostage to political interests.