Your search found 24 Results

  1. 1

    Developing and testing strategies for increasing awareness of the IUDas a contraceptive option.

    Vernon R; Khan ME; Birungi H; Askew I; Stones W

    [Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2007 Dec. 21 p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00)

    Much of the programmatic and research experience gained over the past two decades has focused on increasing understanding of supply-side factors that limit the provision and use of the IUD, for example, developing training programs, demonstrating the ability of lower level medical staff to provide the method, and assessing the interaction between IUDs, STIs and, more recently, HIV. There is now sufficient empirical evidence from a range of settings to allow program managers and technical assistance organizations to develop guidelines and plans for strengthening the systems necessary to support country-level introduction or 'rehabilitation'; of the IUD within a program offering a range of contraceptive choices. The objectives were: To conduct a meeting of researchers and program managers from three continents and several international organizations to review reasons for under-utilization of the IUD and recent experiences in increasing awareness about the IUD; To develop proposals for operations research projects to test the most promising interventions to introduce and expand access to IUD services and to implement the projects with national partner organizations; To disseminate results of the successful strategies. (Excerpts]
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  2. 2

    UNESCO and HIV / AIDS: ten lessons.

    Hernes G

    In: The HIV challenge to education: a collection of essays, edited by Carol Coombe. Paris, France, UNESCO, International Institute for Educational Planning, 2004. 253-263. (Education in the Context of HIV / AIDS)

    Twenty years after the identification of AIDS, some 60 million people have been infected by HIV, a number corresponding to the entire population of France, the United Kingdom or Thailand. Those who have died equal the population of Norway, Sweden, Finland and Denmark combined. Those currently infected - more than 40 million - number more than the entire population of Canada. The number of children thought to be orphaned by HIV/AIDS - some 14 million - is already more than the total population of Ecuador. Over the coming decade their numbers may rise to a staggering 50 million worldwide. In other words, the extent of this pandemic is unprecedented in human history. And the worst is yet to come, for many millions more will be infected, many millions more will die, many millions more will be orphaned. On September 11 2001, more than 3,000 people died in the New York bombings. Every day, around the world, HIV infects at least five times that number. But it is not only individuals who are at risk. The social fabric of whole communities, societies and cultures is threatened. The disease is certain to be a scourge throughout our lifetime. (excerpt)
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  3. 3

    Does the world need another AIDS authority? [letter]

    Obasi A; Tovey D

    Lancet. 2006 Dec 2; 368(9551):1959.

    We are disappointed and concerned about inaccuracies and misinterpretations contained in Dan Billingham's World Report. In it, he discusses the clinical review project by BMJ Knowledge in collaboration with the Liverpool School of Tropical Medicine, and presented by one of us (DT) at the European Health Forum in Gastein, Austria. The purpose of our project was to apply systematic review methods, as used in the BMJ's Clinical Evidence, to address clinical questions relating to the management of HIV/AIDS in resource-poor countries. We feel that Billingham's report misrepresents this work and its objectives in several respects. First, the report relies heavily on an interview with Delon Human, a representative of Health Diplomats, which Billingham describes as an international pressure group. We want to make it clear that, contrary to the implication in the World Report, Human is not part of the BMJ Knowledge team and does not speak on their behalf. (excerpt)
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  4. 4
    Peer Reviewed

    Under the gaze of the 'big nations': refugees, rumours and the international community in Tanzania.

    Turner S

    African Affairs. 2004; 103:227-247.

    In most academic literature refugees are portrayed either as those who lack what national citizens have or as a threat to the national order of things. This article explores the effects of being excluded in such a way, and argues that Burundian refugees in a camp in northwest Tanzania find themselves in an ambiguous position, being excluded from the national order of things — secluded in the Tanzanian bush — while simultaneously being subject to state-of-the-art humanitarian interventions — apparently bringing them closer to the international community. The article explores the ways in which refugees in the camp relate to the international community. Ambiguous perceptions of the international community are expressed in rumours and conspiracy theories. These conspiracy theories create a kind of ontological surety by presenting the Hutu refugees as the victims of a grand Tutsi plot supported by ‘the big nations’. Finally, the article argues that refugees — being excluded from the nationstate and being subject to the government of international NGOs — seek recognition from the international community rather than any nationstate. This does not, however, destabilize the hegemony of the nation-state, as refugees perceive their own position as temporary and the international community as the guarantor of a more just international order in the long run. (author's)
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  5. 5
    Peer Reviewed

    Vaccine rumors, funding shortfall threaten to derail global polio eradication efforts.

    Mitka M

    JAMA. 2004 Apr 28; 291(16):1947-1948.

    Politics and rumors in Nigeria are threatening to derail efforts to finally eradicate poliomyelitis around the world. Smallpox is the only disease that has been completely banished from nature, and the goal of repeating such success with polio is tantalizingly close. In the past, polio paralyzed more than 350000 children in more than 125 countries annually. Last year, the disease was limited to just six countries-Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan-and affected only 758 individuals. But cases are now being reported in countries surrounding Nigeria that were previously free of the disease. The World Health Organization (WHO) blamed the spread of the infection on suspension of immunization campaigns last year in Nigeria's northern states. These areas are largely Islamic and, as reported by the British Broadcasting Channel and other media, some Muslim leaders suggested the vaccine was contaminated and would cause AIDS and infertility in women. Other published reports noted some Muslim leaders in northern Nigeria also believed that these vaccines were contaminated in an effort by the United States to decimate the Muslim population. (excerpt)
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  6. 6

    Programme review and strategy development report: Ecuador.

    United Nations Population Fund [UNFPA]. Technical and Evaluation Division; United Nations Population Fund [UNFPA]. Latin America and the Caribbean Division

    New York, New York, UNFPA, [1989]. ix, 78 p.

    The UN Population Fund, in cooperation with the Government of Ecuador, initiated a programme Review and Strategy Development (PRSD) exercise in July-August 1989. The results are presented in sections such as national population policy, institutional structure, environment, women, research and training, education, communication, health nongovernmental organizations, and outside technical cooperation, each shown in the format issue, objective(s), and strategy. The Ecuadoran government views the growth rate of 2.8% as manageable, and has a qualitative population policy stated as political goals, with an addendum that addresses a few issues such as women in development. Adequate quantitative and focused data on population and development are lacking. Similarly, national, public, and private institutions are not coordinated and would benefit by regular meetings and information networks. Systematic integration of population and development must begin with policy formulation, planning, and research on rural and urban growth and migration. Health services, now emphasizing individual curative care, must be targeted to women, adolescents, and children, by integrating comprehensive family planning and primary health care. Poor performance of prior maternal-child health/family planning programs must be improved. Suggested strategies include building institutions, improving the information system, dispelling myths about contraceptive methods, informing people about the relationship between family planning and health, and broadening population education. There is potential for population education in literacy and informal education programs for workers and women, and there is a need for enlightenment of journalists and media communicators about population and migration issues. Efforts for improvement of women's lives are nonfocused and fragmented: information on these projects must be systematized, and a policy on women should be consolidated.
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  7. 7

    Living with AIDS -- an unforgiveable crime?

    Ogunyombo D

    GROWING UP. 1999 Sep; 7(3):8.

    This article summarizes the plight of the people living with AIDS (PLWA) in South Africa. Stories of different individuals and the discrimination they have endured in South Africa were narrated. It was observed that PLWA were usually ostracized from the society and were sent out by their families due to misconceptions about AIDS. Others were murdered because of the disgrace they have brought to their community. Furthermore, this paper examines the role of the government in protecting these victims. It was observed that there is no existing government intervention for the protection of these victims and no efforts for the prevention of the spread of virus were undertaken. An urgent call for more AIDS awareness campaign was made by the Joint UN AIDS Programme and WHO in 1997 after an announcement of an estimated 15,000 individuals infected with HIV everyday. This report also calls upon the society to respect and uphold the rights of PLWA.
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  8. 8

    Determinants of induced abortion: the role of perceived and experienced contraceptive side effects and lack of counseling.

    Ringheim K

    [Unpublished] [1997]. [2], 30, [8] p.

    In 1989, the World Health Organization (WHO) Task Force for Social Science Research on Reproductive Health initiated 27 projects in 20 developing countries to identify the determinants and consequences of induced abortion. A significant proportion of women in these studies had used a modern contraceptive method (generally the pill) in the past, but had recently discontinued method use or switched to a less effective method. This finding appears consistent with Luker's postulate that women who have both knowledge of and access to modern methods but are not contracepting at the time of abortion have calculated the risk and found the cost of contraception-related side effects too high. Further analysis of the WHO studies suggests that a woman's day to day health is a more proximate concern for her than more distal concerns with the health consequences of unintended pregnancy and abortion. Women's negative perceptions of modern contraceptive methods--based on either personal experience or rumor--appear to be the most significant determinant of their contraceptive practice. The 1993 Turkish Demographic and Health Survey, which provided the first nationally representative evidence on abortion, confirmed these postulates. 47% of reported abortions were preceded by use of withdrawal or periodic abstinence, 34% by no method use, and 17% by failure of a modern method. 26% of one-time pill and IUD users had discontinued method use because of side effects. Persistence of the belief that pill use causes sterility or cancer indicates that women lack access to reliable information, while the high frequency of repeat abortion attests to the need for postabortion family planning counseling. On the other hand, more attention must be given to women's perceptions of the cultural significance of contraceptive side effects, especially those related to disruption of the menstrual cycle. A user perspective to family planning demands that every woman should have access to a method that maximizes her opportunity to avoid unwanted pregnancy while minimizing psychological or physiologic distress.
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  9. 9

    ["Fighting AIDS with song" -- an amplification (letter)] AIDS fordrives med sang -- en presisering.

    Kristensen PG

    TIDSSKRIFTET SYKEPLEIEN. 1997 Jun 3; 85(10):6-7.

    A comment is made concerning an article on the MEUSTA project, whose main goal is fighting AIDS in Tanzania. The article described the main components of the project well in a succinct manner but gave erroneous information about its financing. It was stated that 1 million crowns a year were expended plus salary and operating costs for the nurse and her family paid by the Norwegian Nursing Association (NNA). It is correct that NNA is responsible on the Norwegian side, but this responsibility is based on a contract between NNA and the Norwegian foreign assistance organization NORAD. As far as project costs are concerned, so far 80% of these have been covered by the Norwegian authorities, channeled through NORAD's support for the project activities of private organizations. In other words, NNA's share makes up 20%, a part of which is obtained through fund-raising actions and lotteries among the members. This year NNA manages 6 projects in African countries, Palestine, and Latvia. All projects are based on a contractual arrangement with the Norwegian authorities (NORAD and the Department of Foreign Affairs) and all are financed via the above-mentioned means.
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  10. 10
    Peer Reviewed

    The role of AIDS knowledge, attitudes, beliefs and practices research in Sub-Saharan Africa.

    Wilson D; Mehryar A

    AIDS. 1991; 5 Suppl 1:S177-81.

    This review gives greater weight to WHO/Global Program on AIDS (GPA)-supported knowledge, attitudes, beliefs, and practices (KABP) surveys that have been completed in several African countries, including the Central African Republic, Chad, Ivory Coast, Lesotho, Mauritius, Rwanda, Sudan, Togo, and Tanzania. The percentage of individuals who had heard of AIDS ranged from 60% in Chad to 98% in Rwanda. Over 75% of respondents knew that AIDS is sexually transmitted. A similar proportion (except in Sudan) knew about perinatal transmission. Misconceptions nevertheless endure: e.g., over 40% of individuals in the Central African Republic, Mauritius, Togo, and Tanzania believed that insect bites transmit HIV. At least 20% of respondents in the Central African Republic, Lesotho, Mauritius, Rwanda, Togo, and Tanzania believed that HIV was transmitted through touching or sharing utensils/food. 29% of respondents in Togo, 27% of interviewees from Chad, 21% of individuals in Rwanda, and 19% of participants from Lesotho asserted that AIDS was curable. Only 40% of interviewees from Chad and 25% or fewer of respondents from Lesotho, Mauritius, Sudan, Togo, and Tanzania perceived themselves to be susceptible to AIDS. 80% or more of respondents, except from Chad, where the figure was only 23%, believed that AIDS could be prevented by behavior change. WHO/GPA data indicate that, despite widespread awareness of AIDS, the proportion who have heard of condoms varies from 33% in Chad and 39% in Togo to 77% in Lesotho and 84% in Mauritius. Excluding Mauritius, less than 20% of respondents spontaneously mentioned condoms as a mode of protection against HIV and less than 20% had ever used a condom. Data from the World Fertility Survey and Demographic and Health Survey closely support these observations, confirming that women's knowledge and use of condoms is lower in sub-Saharan Africa than elsewhere. At present, condom use by women in union in Mauritius, Botswana, and Zimbabwe is 9%, 1%, and 1%, respectively, and under 1% elsewhere.
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  11. 11

    Funding family planning [letter]

    Senanayake P

    BMJ. British Medical Journal. 1994 Mar 12; 308(6930):718.

    Brian Harradine calls for an end to "population control programmes" funded by, among others, the International Planned Parenthood Federation "because of their coercive nature and the negative effect they have on women's health." The aim of the International Planned Parenthood Federation is to provide women and their families with information and services that will allow them to live healthier and longer lives. Through its worldwide network of autonomous national family planning associations the federation responds to family planning needs and reproductive health needs expressed by local people, particularly women. Currently more than 120 million women in the developing world are not using contraception although they say that they want to avoid pregnancy. As many as 500,000 women die every year from causes related to pregnancy. An African woman has a 1/22 likelihood of dying from a cause related to pregnancy. These figures are well known to those working with reproductive health issues. On paper, however, they do not necessarily reflect the suffering and ill health that each of those women may encounter in her desire to practice the right to regulate her own fertility. The International Planned Parenthood Federation agrees with Harradine's hope that family planning programmes will continue to concentrate on the individual needs of users. It enjoys a close relationship with the Australian International Development Assistance Bureau and hopes for the bureau's continuing support in its work. (full text)
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  12. 12
    Peer Reviewed

    Damage to immunisation programmes from misinformation on contraceptive vaccines.

    Milstien J; Griffin PD; Lee JW

    Reproductive Health Matters. 1995 Nov; (6):24-8.

    Neonatal tetanus is responsible for 550,000 neonatal deaths globally each year. In an effort to reduce the incidence of such mortality, the World Health Organization (WHO) and UNICEF supply tetanus toxoid vaccines to national immunization programs around the globe. Rumors apparently started by anti-abortion groups have recently surfaced in Mexico, Tanzania, Nicaragua, and the Philippines that instead of providing programs and women with tetanus toxoid vaccine, WHO and UNICEF are actually supplying a contraceptive vaccine still in its developmental phase. These rumors are completely false. The tetanus toxoid vaccines provided by WHO and UNICEF are manufactured and controlled under strict standards. They contain neither contraceptive vaccines nor any other substance which interferes with fertility. The product labelling accurately describes their actual contents. These false claims made by anti-abortion groups have had an adverse impact upon immunization programs in each of these countries.
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  13. 13

    Nigerians divided on AIDS prevalence. International / case rates.

    AIDS WEEKLY. 1994 Oct 10; 12-3.

    The World Health Organization (WHO) estimates that more than half a million people in Africa had AIDS in 1993 alone. According to the WHO, another 10 million Africans now carry HIV, including more than half a million in Nigeria. But some Nigerian scientists charge that their counterparts in the industrialized world deliberately inflate the figures to create the impression that Africa is as poor in health as it is economically. On the other hand, some feel AIDS has been killing more people in Nigeria than official reports show. Professor Akande Abdulkarim, a biochemist of the University of Khartoum, Sudan, argued that AIDS is not as pandemic as the Western scientists maintain. Abdulkarim wondered how AIDS, first discovered among homosexual communities in the United States, had suddenly become an African scourge. He added that body slimness as one of the manifestations of AIDS could be deceitful since Africa has about 11 diseases which cause weight loss, including tuberculosis. Since the discovery of AIDS, Nigerian health officials have alerted the nation, quoting very high figures even though not many people go for AIDS screening in the country. The Health and Social Services Minister announced early in 1994 that AIDS prevalence had risen from 300 reported cases in 1992 to 962 in 1993. More than 600,000 Nigerians had tested HIV-positive since 1986, when the disease was first diagnosed in the country. As of December 1993, only 100 Nigerians were officially deemed to have died from AIDS. But another scientist cautioned Nigerians against being deluded by the low AIDS-mortality figure reported; the low death rate was misleading because some deaths have been wrongly attributed to some other ailments.
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  14. 14

    Uganda takes the AIDS drama to its schools.

    AIDS ANALYSIS AFRICA. 1993 Nov-Dec; 3(6):6.

    Uganda claims success with using drama as a means of educating school age children and teenagers about HIV and AIDS. The drama program was organized by UNICEF and the Ugandan ministry of health. In all, 593 primary schools with 237,200 pupils took part out of the 12,000 schools and 2 million pupils in the country. Some 326 secondary schools, 47 teacher training colleges and 16 technical colleges took part in the program. In Uganda children begin to be sexually active at the age of 14. So they need awareness of AIDS and community outreach programs. Research after the school drama festivals featuring a play entitled Riddle showed that 50-60% of the pupils learnt about AIDS transmission, its worldwide spread, and methods of prevention. A different play, entitled Hydra was written, after taking account of the known lifestyles of this age group (peer pressures, role of parents). Groups of actors are currently performing the play throughout the country. It has been translated into 25 dialects, and has been an instant success. But the demonic appearance of the character representing AIDS caused over half the audience to say that they would shy away from reading or talking about AIDS. Similarly, over half said they would give material support to AIDS sufferers, but would not talk to them. About three-quarters said that AIDS was only of concern to the medical profession. A ministry of health survey indicated that some 84% believed that AIDS was transmitted only by women. The advice to love carefully directed at men, to wear condoms was interpreted that men must protect themselves from infection by women. Another misconception was that some 68% thought that a person who was happy and strong could not be carrying the HIV virus. Nevertheless, the ministry concludes that drama has shown promise as a supplementary instructional method in AIDS education.
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  15. 15

    An overview of teenage pregnancy in the Caribbean.

    Jagdeo TP

    In: I International Meeting on Sexual and Reproductive Health in Teenagers and Young Adults. Proceedings. Mexico City, Mexico, Academia Mexicana de Investigacion en Demografia Medica, 1986. 38-45.

    The International Planned Parenthood federation (IPPF) and the Caribbean Family Planning Affiliation (CFPA) Ltd. have made concerted efforts to help young people in the Caribbean where women traditionally gave birth at an early age. As a result, data on age-specific fertility rates for teenagers for 1950, 1970, and 1980 showed that for each Caribbean country, adolescent fertility rates were higher 30 years ago than they are today. Since the 1950s adolescent fertility rates declined steadily in most countries except for Dominica, Jamaica, Montserrat, and St. Lucia where the rates increased somewhat in the 1960s before dipping below the levels observed in 1950. However, adolescent fertility rates still exceed 100/1000. Adolescent fertility rates in 1980 were as high as 120 in Guyana, 125 in Grenada, 133 in Jamaica, 143 in St. Kitts- Nevis, 157 in St. Lucia, and 164 in St. Vincent. Teenagers account for almost 60% of all first births, and half of these are to women 17 or younger. Adolescents are more prone to have prolonged labor, cervical laceration, Cesarean section, and toxemia. Their babies are more likely to be underweight, small-for-date, and premature. Pregnancy is the major reason for dropping out of school. Social and cultural institutions did not support teenage pregnancy; the church preached against it; parents discouraged and published it; and schools expelled pregnant girls. Yet, it occurred because a Caribbean community pattern of conforming to peers was replicated. This is especially true among lower income families where visiting unions and common-law liaisons predominate early and premarital pregnancies are the norm. Studies showed that the children of lower income families are raised within fragile primary social support systems. Misconceptions also proliferate including the idea that an adolescent can be too young to get pregnant, that pregnancy is the result of frequent and regular intercourse and that withdrawal and rhythm are reliable methods of contraception. Fewer than 3 out 10 sexually active adolescents were using a contraceptive in all countries except Trinidad and Tobago and Montserrat. This means that 7 out of every 10 sexually active teenagers are running the risk of having a child too early in their lives.
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  16. 16

    Attitudes, regulations hinder use of the pill.

    Townsend S

    NETWORK. 1993 Mar; 13(3):6-10.

    70 million women worldwide now use oral contraceptives (OCs), but many more women could use them if it were not for some medical attitudes, regulations, or practices preventing them from using OCs. For example, in the US, adolescents may need their parent's permission, even though the services cost nothing. 30 years of research on OCs, the most studied family planning method ever, show that they are a convenient, effective contraceptive. These medical practices and attitudes which limit access to OCs cannot be justified scientifically, particularly when weighing the risk of pregnancy. In fact, the only group of women at high risk of using OCs are smokers older than 35 years. Prescribing practices and safeguards when OCs were first marketed were necessary because the medical community knew little about them, but today they are needless barriers to access. Some unnecessary precautions are restricting OCs to women who have already experienced childbirth and OC users needing a rest period. Today's OCs have much lower doses than the earlier OCs. Many conditions once considered to be absolute contraindications should now be considered signs to closely monitor OC users. Moreover, present US guidelines for progestin-only OCs list contraindications which actually apply to combined OCs that contain estrogen and not to progestin-only OCs, e.g., lactation, yet progestin-only OCs are ideal for lactating women. WHO and other groups have joined together to standardize eligibility criteria for OCs at the international level. INTRAH has already produced some guidelines to get rid of the complicated method of classifying contraindications. Other barriers to OC use are requirements of undergoing a physical examination of having blood drawn. Adequate counseling can screen for contraindications as well as, or perhaps better than, exams and blood tests.
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  17. 17

    Norplant: conflicting views on its safety and acceptability.

    Hardon A

    In: Issues in reproductive technology I: an anthology, edited by Helen Bequaert Holmes. New York, New York, Garland Publishing, 1992. 11-30. (Garland Reference Library of Social Science Vol. 729)

    The progestin, levonorgestrel, suppresses ovulation and thickens the cervical mucus. The 1-year pregnancy rate is 0.2/100 users and the 5-year rate is 3.9/100 users. Contraindications of Norplant include abnormal bleeding, cardiovascular conditions, liver tumors, and breast cancer. The most frequent side effect is changes in bleeding patterns. A main concern of women's health advocates is that women are dependent on the medical establishment for insertion and removal of Norplant which affects the provider-client relationship. Family planning programs that do not recognize a woman's right to free choice of existing contraceptives and her right to have Norplant removed at any time may abuse Norplant. Health workers still do not know the long term effects of Norplant and Norplant's effect on the fetus in case of method failure or insertion while pregnant. Most acceptability studies occurred at university-based health clinics or at clinics in urban areas. The clinic environment may affect women's answers. These studies should occur in the community and home of users and nonusers. Another bias of these studies was clinic staff chose women who would tend to continue using Norplant. Thus subjects were not representative of the population. Researchers did not attempt to understand the women's perception of reproduction physiology and mode of action, the women's cost benefit analysis used to determine what method to use, or the consequences of menstruation changes. They also did not report on the information women received about contraceptive choices. The issue of abuse has arisen in Kansas where a state legislator proposed paying any mother on welfare US$500 if she uses Norplant. In California, a judge ordered a woman convicted of child abuse to use Norplant after release from jail and throughout her probation period.
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  18. 18

    Programme review and strategy development report: Bolivia.

    United Nations Population Fund [UNFPA]

    New York, New York, UNFPA, [1991]. vi, 66 p.

    The UN Population Fund (UNFPA) reviewed the process of population policy formulation in Bolivia in May-June 1990 in a Programme Review and Strategy Development Report. Faced with high external debt and falling output but a population growing at 2.8%, Bolivia lacks the luxury of a vital registration system or a population policy. It is generally believed that the population density is too low for adequate production, and that a population policy means demographic birth control. An opinion survey of national leaders in 1989 showed an emerging realization of the need for a population policy, but ignorance of what such a policy entails. Bolivia has a National Social Policy Council (CONAPSO) which has produced important research and policy guidelines in other areas, but has neglected population issues. There is no research or statistical data since the Census of 1976, except for a few sample surveys; what information exists is global, and none of it is used for designing development plans. Maternal/child health (MCH) is poor in Bolivia, with significant malnutrition, infant mortality, deaths from preventable disease, tetanus, and respiratory infections, as well as excessive childbearing, nonmedical abortion, and malnutrition in women. An MCH Action Plan for 1990 has 6 clear goals and actions. No IEC program is in place. There is no appreciation of the magnitude of women's economic contribution in existing national data. Most donor funds and technical cooperation have been devoted to job creation and small projects involving health and education, such as sanitation and water projects in 11 small towns. The report ends with 9 general strategies covering such topics as population-development policy, MCH/family planning services, IEC, education of leaders, national statistics, women's issues, and increasing and coordinating international assistance.
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  19. 19
    Peer Reviewed

    To prescribe or not to prescribe: on the regulation of pharmaceuticals in less developed countries.

    Hammer JS

    Social Science and Medicine. 1992 May; 34(9):959-64.

    Insufficient information contributes to failure in markets. Government officials also use it to justify intervention in the health sector in the developing countries. Further, in these countries,health care workers have misused pharmaceuticals considerable as well as make improper diagnoses. Moreover both health practitioners and the general public do not always follow instructions on drug use. A shortage of information on appropriate use may indeed cause these problems. A staff member of the World Bank proposes a methodology to use to balance 2 competing risks. Either public health officials allow drugs to be available to consumers over the counter or they require a prescription from a licensed health professional. The risks include obvious diagnostic errors made my consumers untrained in medicine and patients not receiving needed, potentially life saving, drugs. Since there is a shortage of medical personnel in most developing countries, people face considerable obstacles (e.g., travel time and expense) when it comes time to go to a licensed medical facility. The proposed methodology to evaluate the tradeoff between the 2 risks involves looking at the problems as one of determining the value of a more accurate diagnosis through the intervention of a skilled professional as a specific and costly mechanism for acquiring an accurate diagnosis. The article applies the model to illustrative examples to identify the information to answer the regulatory issue question. Further the model also allows public health policy makers to determine the appropriate level of training needed for medical professionals and to evaluate projects which improve public access to information on the use of drugs.
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  20. 20

    Adolescence education. Sexually transmitted diseases. Module four.

    UNESCO. Principal Regional Office for Asia and the Pacific

    Bangkok, Thailand, Unesco Principal Regional Office for Asia and the Pacific, 1991. [2], 45 p. (Population Education Programme Service)

    Adolescence Education is developed in 4 modules for secondary school teachers and other family life education persons by UNESCO. Materials are based on the Population Education Clearing House collection and are revised for use in Asian and Pacific areas, with the understanding that attitudes vary. The package consists of the following modules or volumes: Module 1, Physical Aspect; Module 2, Social Aspect; Module 3, Sex Roles; and Module 4, Sexually Transmitted Diseases. This Module 4 volume begins with a general introduction to the project and a description of the conceptual framework. The module itself is based on 3 lessons which require 30-45 minutes/lessons. Each lesson has a set of objectives, the time required, and materials, and usually the procedure, information sheets, and suggested activities. Lesson 4.1 deals with sexually transmitted diseases (STDs) in order to increase knowledge on the symptoms and prevention of STDs, to increase understanding of the seriousness of STD's as a medical problem, and to convince students to seek treatment for STDs immediately. Lesson 4.2 is on venereal disease (VD) information as a review and an outline of basic information. Lesson 4.3 is concerned with the VD Myth Game in order to correct misinformation and open up discussion. An example of a suggested activity is the VD Myth Game. 18 statements about VD are written on 18 note cards and distributed among groups of 4-6 people. Each group discusses the statement and decides whether it's a myth or truth. 1 minute is given per card. Team answers are written down and passed on to the next group. The teachers reads the correct answers. Groups that have incorrect answers must continue discussion of that statement. Some of the statements are that birth control pills prevent VD; people can get VD from doorknobs, toilet seats, drinking fountains; if symptoms go away, you don't need to see a doctor; homosexuals don't get VD, and so on.
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  21. 21

    A case for promoting breastfeeding in projects to limit fertility.

    Berg A; Brems S

    Washington, D.C., World Bank, 1989. 55 p. (World Bank Technical Paper No. 102)

    After a brief explanation of the impact of breastfeeding on fertility worldwide, inaccurate assumptions about the decline of breastfeeding are explored to point out the need for renewed promotion of breastfeeding by World Bank projects. Breastfeeding, by inhibiting fertility through lactational anovulation, is one of the most important determinants of fertility, especially for 83% of couples in developing countries who do not use modern contraception. Many believe that breastfeeding does not need promoting in areas where it is the norm, yet this belief does not take into account the need for supporting breastfeeding women, teaching them to breastfeed exclusively and frequently for the 1st 4 months. The belief that declines in breastfeeding are inevitable is belied by recent evidence in developed countries. The reliability of breastfeeding as a contraceptive for individual women varies: poor, undernourished women who breastfeed extensively may be protected up to 21.7 months (Bangladesh). Advantages of breastfeeding include significant savings of money, foreign exchange, scarce contraceptive supplies, medical treatment of diarrhea and malnutrition in infants, and possibly mothers' time. In contrast, other caregivers can prepare milk substitutes, but breastfeeding can be encouraged in the work setting, or milk expressed for later use. A review of 68 World Bank Projects revealed that 37% of all Population, Health and Nutrition projects, enumerated in an appendix, contained explicit actions to promote breastfeeding. 10 recommendations for promoting breastfeeding end the report.
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  22. 22

    Global AIDS into the 1990s.

    Mann JM

    [Unpublished] 1989. Presented at the 5th International Conference on AIDS, Montreal, Canada, June 4-10, 1989. 7 p. (WHO/GPA/DIR/89.2)

    Based on AIDS statistics reported to WHO, as of June 1, 1989, 149 nations reported 157,191 AIDS cases. 69% of these cases lived in 43 countries in the Americas, 16% in 47 countries in Africa, 14% in 28 European countries, and 1% in 31 countries of Asia and Oceania. Yet WHO estimated that the actual number was probably 480,000. Further, a Delphi study showed that >3 times the number of new HIV infections will occur during the 1990s than did in the 1980s. The global AIDS epidemic followed 3 courses in the 1980s. The 1st consisted of markedly rising HIV infection cases in areas already affected by HIV. In 1987, HIV seroprevalence among intravenous drug users stood at almost 1% in Bangkok; in 1988, 20%, and in June 1989, >40%. The 2nd involved the appearance of AIDS in areas that either had not been affected or only slightly so. In Abidjan, Cote d'Ivoire, HIV-1 seroprevalence rose to 4% form <1% within 2 years. Finally, complex and diverse social, economic, and cultural situations at national, provincial, and community levels served to further the extent of AIDS. The proportion of AIDS cases related to intravenous drug use jumped from 3%-13% in 1 year in Brazil and from 6%-34% in 4 years in Europe. To prevent the spread of AIDS, WHO founded the Global Programme on AIDS in 1987. As of June 1, 1989, it gave >US$60 million to 127 nations and arranged technical support for >1000 assignments to assist nations in developing national AIDS programs. WHO expected such programs to be developed in all the world's 187 countries by the end of 1989. To prevent the spread of AIDS, these programs must form linkages with other health and social programs. They also need to concentrate their efforts on health and social problems unique to their nation. They must take the lead in finding new approaches to prevent the spread of AIDS, caring for AIDS patients, and to guarantee equity in the provision of services.
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  23. 23

    A demographic perspective on developing Asia and its relevance to the Bank.

    Pernia EM

    Manila, Philippines, Asian Development Bank, Economics Office, 1987 May. 28 p. (Economics Office Report Series No. 40)

    Even though population growth rates continue to decline in developing member countries (DMCs) of the Asian Development Bank, they will experience absolute population increases larger than those in the past. More importantly, the labor force continues to grow and absolute increases will be greater than any other time in history. Family planning education and access to contraceptives have contributed to the decline in population growth rates, but nothing can presently be done to decrease the rates of increase of the labor force because the people have already been born. Since most of the DMSs' populations are growing at 2% or more/year, much needed economic growth is delayed. For example, for any country with a growing population to maintain the amount of capital/person, it must spread capital. Yet the faster the population grows the lesser the chances for increasing that amount. The Bank's short to medium term development policy should include loans for projects that will generate employment using capital widening and deepening and that develop rural areas, such as employment in small industries, to prevent urban migration. Other projects that engulf this policy are those concerning primary, secondary and adult education; health; food supply; and housing and infrastructure. The long term development policy must bolster population programs in DMCs so as to reduce the growth of the economically active segment of the population in the 21st century. In addition, the Bank should address fertility issues as more and more women join the work force. The Bank can play a major role in Asian development by considering the indirect demographic and human resource impacts of each project.
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  24. 24

    A simple cure for diarrhoea.

    Borra A

    WORLD HEALTH. 1989 Nov; 14-5.

    Diarrheal diseases continue to be the major causes of death for children in 4 Western Pacific Region nations: the Lao People's Democratic Republic, Papua New Guinea, the Philippines, and Viet Nam. They are also among the most frequent childhood illnesses in 18 of 35 countries and areas of the region. Many children die because physicians, health workers, and mothers do not know that oral rehydration therapy (ORT) is the single most effective treatment for diarrhea. All too often, older or hospital based physicians prescribe antidiarrheal drugs or antibiotics. ORT can successfully treat 90-95% of acute diarrheal cases. The oral rehydration salts (salt, glucose, sodium bicarbonate, and potassium chloride) are mixed with potable water so the child with diarrhea can drink it. The mixture replaces the water and salts removed from the body during diarrheal episodes. The 1st Diarrhoeal Training Unit (DTU) of the WHO Global Diarrhoeal Diseases Control programme in the region was found in Manila, the Philippines in December 1985. Its purpose continues to be the provision of hands-on training for health professionals in hospitals to convince them that ORT is effective. In 1988, 12 DTUs existed in such countries as China, the Lao People's Democratic Republic, Papua New Guinea, the Philippines, and Viet Nam. They will soon also operate out of medical, nursing, and midwifery schools. Even though 60% of the population in the Western Pacific Region has access to ORT packets, too many mothers still do no use them to treat their children with diarrhea. Further, they do not know that they should continue to feed them. In 1988 in the region, an estimated 50,000 children lived who would have died without ORT.
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