Your search found 76 Results

  1. 1
    322621
    Peer Reviewed

    Unsettling experiences: Internal resettlement and international aid agencies in Laos.

    Baird IG; Shoemaker B

    Development and Change. 2007 Sep; 38(5):865-888.

    A number of programmes and policies in Laos are promoting the internal resettlement of mostly indigenous ethnic minorities from remote highlands to lowland areas and along roads. Various justifications are given for this internal resettlement: eradication of opium cultivation, security concerns, access and service delivery, cultural integration and nation building, and the reduction of swidden agriculture. There is compelling evidence that it is having a devastating impact on local livelihoods and cultures, and that international aid agencies are playing important but varied and sometimes conflicting roles with regard to internal resettlement in Laos. While some international aid agencies claim that they are willing to support internal resettlement if it is 'voluntary', it is not easy to separate voluntary from involuntary resettlement in the Lao context. Both state and non-state players often find it convenient to discursively frame non-villager initiated resettlement as 'voluntary'. (author's)
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  2. 2
    273152

    Report on the seminar on incentive to natural breast feeding.

    Reproduction, Nutrition and Maternal and Infant Care [RENUMI]

    [Unpublished] [1977]. 8 p.

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  3. 3
    139680

    Country watch: Kenya.

    Miller RA

    SEXUAL HEALTH EXCHANGE. 1998; (3):5-6.

    The Family Planning Association of Kenya (FPAK), together with the Population Council's Africa Operations Research/Technical Assistance Project I, developed a program in rural coastal Kenya to gain insight into the relative effectiveness of reaching men with family planning services. The program sent trained teams of men only, women only, and both sexes to 3 comparable sites in Kilifi District, Coast Province, an area with a contraceptive prevalence lower than the national average, to reach out to men in places where they tend to congregate, and to include them in family planning discussions during home visits. The community-based agents were local people recommended by community leaders and aged 30-40 years, married with children, and with at least primary school educations. The agents were trained in a 10-day course and the fieldwork program lasted 18 months. Subsequent program evaluation determined that husband-wife communication on family planning improved in all 3 sites, with the most communication between spouses occurring in the program with both male and female agents. The all-male team distributed the most condoms and also did well distributing female methods such as foam tablets and oral pills. The most reported behavior change among men in response to AIDS education was a move toward having sex with only one's wife. Some concern was expressed, especially among men, about male agents making home visits and men were more likely to respond to educational activities when they were specifically targeted to men. Men also reported greater current use of modern contraceptive methods than women and a major positive change in behavior in response to HIV/AIDS education.
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  4. 4
    139679

    Country watch: Hong Kong.

    Pau A

    SEXUAL HEALTH EXCHANGE. 1998; (3):4.

    Two decades of Family Planning Association of Hong Kong (FPAHK) advocacy of husband-wife communication and cooperation in family planning led Hong Kong's population to finally accept the notion of male responsibility in family planning. Recent surveys have documented high rates of male contraceptive use. The FPAHK established its first clinic to provide men with birth control advice and services in 1960, then set up a vasectomy clinic and installed condom vending machines. Working against prevailing traditional beliefs that childbearing is the exclusive domain of women and that vasectomy harms one's health, the FPAHK began campaigns to motivate men to take a positive and active role in family planning and to correct misinformation on vasectomy. Successful FPAHK efforts to stimulate male support for family planning include the 1977 "Mr. Family Planning" campaign, the 1982 "Family Planning - Male Responsibilities" campaign, and the 1986-87 "Mr. Able" campaign. Although these campaigns ended in the 1980s, men may now be counseled on contraception at 3 of the 8 FPAHK-run birth control clinics.
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  5. 5
    080918

    Improving primary education in developing countries.

    Lockheed ME; Verspoor AM; Bloch D; Englebert P; Fuller B; King E; Middleton J; Paqueo V; Rodd A; Romain R

    Oxford, England, Oxford University Press, 1991. xix, 429 p.

    The Education and Employment Division of the World Bank's Population and Human Resources Department conducted a four-year study on the effectiveness and efficiency of primary education in developing countries. The resulting book includes extensive reviews of the research and evaluation literature; consultations with policymakers in developing countries, representatives of donor agencies, and primary education specialists; and results of commissioned studies and of original research conducted in the division. Learning is the central theme of the book; it reminds people that learning occurs in schools and classrooms among teachers and children, not in government ministries of education or finance. It also tells readers that learning is foremost and that teacher training and instructional materials are important only if the children learn. Policymakers must consider the impact of the cost and financing of education on learning when making decisions. The goals of primary education include teaching children basic cognitive skills, developing attitudes and skills in children so they can function effectively in society, and promotion of nation-building. This publication examines five areas for improvement of primary education: inputs necessary for children to learn; methods for improving teachers and teaching; management requirements for promoting learning; ways to extend effective education to traditionally disadvantaged groups; and the means to afford enhanced education. The study reveals that there is limited research on children's learning and no research at all on change in learning. The chapters cover the following: primary education and development; a brief history of primary education in developing countries; improving learning achievement; improving the preparation and motivation of teachers; strengthening institutional capabilities; improving equitable access; strengthening the resource base for education; international aid to education; and educational reform: policies and priorities for educational development in the 1990s.
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  6. 6
    095691

    Natural family planning. Couples take chances [letter]

    Huezo C; Kleinman R; Walder R

    BMJ. British Medical Journal. 1993 Oct 16; 307(6910):1003.

    An author of an article about natural family planning (NFP) in an earlier issue of the British Medical Journal contends that NFP and modern contraceptive methods (e.g., oral contraceptives [OCs]) provide comparable effectiveness against pregnancy. He uses data from a WHO multicountry study and a study of 20,000 women in Calcutta to support his position that NFP is safe, reliable, and effective. IPPF staff agree with the author that health professionals would accept another inexpensive, reliable, and safe family planning method. The author misrepresented the studies' findings, however. He says that the pregnancy rate for the WHO study group was 1.5%. Yet, the women who participated in the study and conceived included not only the 1.5% but also another 19.4% who did not identify their fertile cycle or did not abstain as called for by NFP guidelines. The author failed to mention these women in his review. The actual NFP failure rate for the WHO study group was 20.9%--a much higher rate than that for modern contraceptive methods. The Calcutta study did not present enough information on the methodology or selection of cases to allow comment. When both partners are very motivated, when the woman can always recognize signs of her fertile period, and when the couple can truly avoid intercourse according to NFP guidelines, periodic abstinence is an effective family planning method. Otherwise the woman is at great risk of conceiving. Many couples gamble and do not abide by the guidelines. In reality, the author's assertion that NFP is as effective as OCs is clearly false. IPPF considers NFP as one of many family planning choices. Couples choosing NFP should be told of its real failure rates, the need to totally follow the abstinence rules, and the risk of pregnancy when those rules are not followed.
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  7. 7
    090127

    Natural family planning: effective birth control supported by the Catholic Church.

    Ryder RE

    BMJ. British Medical Journal. 1993 Sep 18; 307(6906):723-6.

    The Catholic Church approves the use of natural family planning (NFP) methods. Many people think only of the rhythm method when they hear NFP so they perceive NFP methods to be unreliable, unacceptable, and ineffective. They interpret the Catholic Church's approval of these methods as its opposition to birth control. The Billings or cervical mucus method is quite reliable and effective. Rising estrogen levels coincide with increased secretion of cervical mucus, which during ovulation is relatively thin and contains glycoprotein fibrils in a micelle like structure aiding sperm migration. Ultrasonography confirms that the day of most abundant secretion of fertile-type eggs white mucus is the day of ovulation. Once progesterone begins to be secreted, cervical mucus becomes thick and rubbery and acts like a plug in the cervix. Other symptoms associated with ovulation include periovulatory pain and postovulatory rise in basal body temperature. A WHO study of 869 fertile women from Australia, India, Ireland, the Philippines, and El Salvador found 93% could accurately interpret the ovulatory mucus pattern, regardless of education and culture. The probability of pregnancy among women using the cervical mucus method and having intercourse outside the fertile period was .004. The probability of conception increased the closer couples were to the fertile period when they had intercourse (.546 on -3 to -1 peak day and .667 on peak day 0), regardless of education and culture. The failure rate of NFP among mainly poor women in Calcutta, India, equal that of the combined oral contraceptive (0.2/100 women users yearly). Poverty was the motivating factor. NFP costs nothing, is effective (particularly in poverty stricken areas), has no side effects, and grants couples considerable power to control their fertility, indicating the NFP may be the preferred family planning method in developing countries. Prejudices about NFP should be dropped and worldwide dissemination of NFP information should occur.
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  8. 8
    064829

    Kenya at the demographic turning point? Hypotheses and a proposed research agenda.

    Kelley AC; Nobbe CE

    Washington, D.C., World Bank, 1990. xvi, 97 p. (World Bank Discussion Papers 107)

    The interactions within and between the determinants and consequences of rapid population growth in Kenya are analyzed with a view to fostering a research agenda and proving insights for the creation of a population strategy during the next decade. Despite Kenya's long-standing concern about checking its rapid population growth, annual growth rates reach 4%. However, Kenya may be entering a new demographic phase of declining growth rates. Population pressure, through both reduced benefits and increasing costs of children to the household, may be responsible for moderate demographic change. Fertility declines with an eventually sustainable balance between population numbers and the economy and the environment depend upon factors motivating parents to desire fewer offspring. These motivating factors, in turn, depend upon the interrelations among population growth, society, economy, and population policy and programming. While the time frame for demographic transition remains elusive, population programming undertaken thus far, though failing to effect change up to now, may hold the key to future successes. Health delivery and family planning systems are already in place and will influence the pace of population growth decline during future decades. Population and economic trends, population policies and programs for the period 1965-89, research, strategy, and recommendations are discussed at length.
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  9. 9
    083041

    Condoms becoming more popular.

    Manuel J

    NETWORK. 1993 May; 13(4):22-4.

    Social marketing is a strategy which addresses a public health problem with private-sector marketing and sales techniques. In condom social marketing programs, condoms are often offered for sale to the public at low prices. 350 million condoms were sold to populations in developing countries through such programs in 1992, and another 650 million were distributed free through public clinics. The major donors of these condoms are the US Agency for International Development, the World Health Organization, the UN Population Fund, the International Planned Parenthood Federation, the World Bank, and the European Community. This marketing approach has promoted condom use as prevention against HIV transmission and has dramatically increased the number of condoms distributed and used throughout much of Africa, Latin America, and Asia. Donors are now concerned that they will not be able to provide condoms in sufficient quantities to keep pace with rapidly rising demand. Findings in selected countries, however, suggest that people seem willing to buy condoms which are well promoted and distributed. Increasing demand for condoms may therefore be readily met through greater dependence upon social marketing programs and condom sales. Researchers generally agree that a social marketing program must change for 100 condoms no more than 1% of a country's GNP in order to sell an amount of condoms equal to at least half of the adult male population. Higher prices may be charged for condoms in countries with relatively high per-capita incomes. Since prices charged tend to be too low to cover all promotional, packaging, distribution, and logistical management costs, most condom distribution programs will have to be subsidized on an ongoing basis.
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  10. 10
    081879

    Male participation in family planning: a review of programme approaches in Africa.

    Hawkins K

    London, England, International Planned Parenthood Federation [IPPF], 1992 Sep. 93 p.

    20 participants from 9 sub-Saharan countries and the UK discuss men's negative attitudes towards family planning (the leading obstacle to the success of family planning in Africa) at the November 1991 Workshop on Male Participation in Family Planning in The Gambia. Family planning programs have targeted women for 20 years, but they are starting to see the men's role in making fertility decisions and in transmitting sexually transmitted diseases (STDs). They are trying to find ways to increase men's involvement in promoting family planning and STD prevention. Some recent research in Africa shows that many men already have a positive attitude towards family planning, but there is poor or no positive communication between husband and wife about fertility and sexuality. Some family planning programs (e.g., those in Sierra Leone, Nigeria, Ethiopia, and Zimbabwe) use information, education, and communication (IEC) activities (e.g., audiovisual material, print media, film, workshops, seminars, and songs) to promote men's sexual responsibility. IEC programs do increase knowledge, but do not necessarily change attitudes and practice. Some research indicates that awareness raising must be followed by counseling and peer promotion efforts to effect attitudinal and behavioral change. The sub-Saharan Africa programs must conduct baseline research on attitudes and a needs assessment to determine how to address men's needs. In Zambia, baseline research reveals that a man having 1 faithful partner for a lifetime is deemed negative. Common effective needs assessment methodologies are focus group discussions and individual interviews. Programs have identified various service delivery strategies to meet these needs. They are integration of family planning promotion efforts via AIDS prevention programs, income-generating schemes, employment-based programs, youth programs and peer counseling, male-to-male community-based distribution of condoms, and social marketing. Few programs have been evaluated, mainly because evaluation is not included in the planning process.
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  11. 11
    071358

    Switching back: an experimental intervention of family planning client remotivation and clinic staff retraining: impact upon reacceptance and continuity.

    Oodit G; Johnston T

    In: African research studies in population information, education and communication, compiled and edited by Tony Johnston, Aart de Zeeuw, and Waithira Gikonyo. Nairobi, Kenya, United Nations Population Fund [UNFPA], 1991. 73-82.

    In 1990, the Mauritius Family Planning Association presented educational sessions for former clients allowing them to meet f amily planning personnel and other women with similar experiences. It used audiovisual aids to discuss use of modern contraceptives and the advantage of scientific family planning, to dispel myths and rumors, and to explain how different methods could be used to meet their and partners' needs. At the same time, 10 service providers from the experimental clinic underwent a 6 week sensitization and retraining program emphasizing organization for efficiency, counseling skills, and skills to build client self esteem. Researchers observed both the control and experimental clinic for 9 months in 1991. 36 remotivated clients (73% return rate) and 29 mainly former clients who did not attend a session reaccepted a contraceptive method at the experimental clinic. As for the control clinic, 24 remotivated clinics (46% return rate) and 7 mainly former clients reaccepted a method. Both clinics' staff said that the extra clients returned because the 93 remotivated clients recommended or referred them directly to the clinics. The 2 interventions therefore had a spread effect. The experimental clinic did have a much better retention rate than the control clinic (46 client vs. 28 clients), however. Further it had higher continuity rates throughout the study period. At the end of the study, the continuity rate was 93.8 for the experimental clinic and 53.8 for the control clinic. The researchers concluded that the improved clinic services of the experimental clinic due to staff retraining in skills and attentiveness were responsible for the superior retention record and rates of return and continuity. Thus IEC programs that attend to former and potential clients' needs and develop skills and attentiveness of providers improve acceptor and continuity rates.
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  12. 12
    070620

    Organizing and managing tropical disease control programs. Lessons of success.

    Liese BH; Sachdeva PS; Cochrane DG

    Washington, D.C., World Bank, 1991. x, 51 p. (World Bank Technical Paper No. 159)

    A World Bank report outlines the results of an empirical study. It lists institutional characteristics connected with successful tropical disease control programs, describes their importance, and extracts useful lessons for disease control specialists and managers. The study covers and compares 7 successful tropical disease control programs: the endemic disease program in Brazil; schistosomiasis control programs in China, Egypt, and Zimbabwe; and the malaria, schistosomiasis, and tuberculosis programs in the Philippines. All of these successful programs, as defined by reaching goals over a 10-15 year period, are technology driven. Specifically they establish a relevant technological strategy and package, and use operational research to appropriately adapt it to local conditions. Further they are campaign oriented. The 7 programs steer all features of organization and management to applying technology in the field. Moreover groups of expert staff, rather than administrators, have the authority to decide on technical matters. These programs operate both vertically and horizontally. Further when it comes to planning strategy they are centralized, but when it comes to actual operations and tasks, they are decentralized. Besides they match themselves to the task and not the task to the organization. Successful disease control programs have a realistic idea of what extension activities, e.g., surveillance and health education, is possible in the field. In addition, they work with households rather than the community. All employees are well trained. Program managers use informal and professional means to motivate then which makes the programs productive. The organizational structure of these programs mixes standardization of technical procedures with flexibility in applying rules and regulations, nonmonetary rewards to encourage experience based use of technological packages, a strong sense of public service, and a strong commitment to personal and professional development.
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  13. 13
    069594
    Peer Reviewed

    Solidarity and AIDS: introduction.

    Krieger N

    INTERNATIONAL JOURNAL OF HEALTH SERVICES. 1991; 21(3):505-10.

    This article asks the reader to carefully consider the personal implications of AIDS were either he or close friends and relatives afflicted with the syndrome. We are urged to acknowledge the limited capabilities of personal and social response to the epidemic, and recognize the associated degree of social inequity and knowledge deficiency which exists. Summaries of 3 articles are discussed as highly integrated in their common call for global solidarity in the fight against HIV infections and AIDS. Pros and cons of Cuba's evolving response to AIDS are considered, paying attention to the country's recent abandonment of health policy which isolated those infected with HIV, in favor of renewed social integration of these individuals. Brazil's inadequate, untimely, and erred response to AIDS is then strongly criticized in the 2nd article summary. Finally, the 3rd article by Dr. Jonathan Mann, former head of the World Health Organization's Global program on AIDS, on AIDS prevention in the 1990s is discussed. Covering behavioral change and the critical role of political factors in AIDS prevention, Mann asserts the need to apply current concepts and strategies, while developing new ones, and to reassess values and concepts guiding work in the field. AIDS and its associated crises threaten the survival of humanity. It is not just a disease to be solved by information, but is intimately linked to issues of sexuality, health, and human behavior which are in turn shaped by social, political, economic, and cultural factors. Strong, concerted political resolve is essential in developing, implementing, and sustaining an action agenda against AIDS set by people with AIDS and those at risk of infection. Vision, resources, and leadership are called for in this war closely linked to the struggle for worldwide social justice.
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  14. 14
    069268

    The demand for family planning in Indonesia 1976 to 1987: a supply-demand analysis.

    Dwiyanto A

    [Unpublished] 1991. Presented at the Demographic and Health Surveys World Conference, Washington, D.C., August 5-7, 1991. 22 p.

    A supply-demand approach is used to estimate total and unmet demand for family planning in Indonesia over the last decade. The 1976 Indonesia Fertility Survey, the 1983 Contraceptive Prevalence Survey, and the 1987 National Contraceptive Prevalence Survey form the database used in the study. Women under consideration have been married once, are aged 35-44, have husbands who are still alive, have had at least 2 live births, and had no births before marrying. High demand was found for family planning services, with the proportion of current users and women with unmet demand accounting for over 85% of the population. Marked improvement in contraceptive practice may be achieved by targeting programs to these 2 groups. Attention to unmotivated women is not of immediate concern. Women in need of these services are largely rural and uneducated. Programs will, therefore, require subsidization. The government should gradually and selectively further introduce self-sufficient family planning programs. User fees and private employer service provision to employees are program options to consider. Reducing the contraceptive use drop-out rate from its level of 47% is yet another approach to increase contraceptive prevalence in Indonesia. 33% drop out due to pregnancy, 26% from health problems, 10% because of method failure, 10% from inconveniences and access, and 21% from other causes. Improving service quality could dramatically reduce the degree of drop-outs.
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  15. 15
    069113

    Programme review and strategy development report: Viet Nam.

    United Nations Population Fund [UNFPA]

    New York, New York, UNFPA, [1991]. ix, 81 p.

    Rapid population growth is an obstacle to Vietnam's socioeconomic development. Accordingly, the Government of Vietnam has adopted a population policy aimed at reducing the population growth rate through family planning programs encouraging increased age at 1st birth, birthspacing of 3-5 years, and a family norm of 1-2 children. TFR presently holds at 4, despite declines over the past 2 decades. Current mortality rates are also high, yet expected to continue declining in the years ahead. A resettlement policy also exists, and is aimed at reconfiguring present spatial distribution imbalances. Again, the main thrust of the population program is family planning. The government hopes to lower the annual population growth rate to under 1.8% by the year 2000. Achieving this goal will demand comprehensive population and development efforts targeted to significantly increase the contraceptive prevalence rate. Issues, steps, and recommendations for action are presented and discussed for institutional development strategy; program management and coordination and external assistance; population data collection and analysis; population dynamics and policy formulation; maternal and child health/family planning; information, education and communication; and women, population, and development. Support from UNFPA's 1992-1995 program of assistance should continue and build upon the current program. The present focus upon women, children, grass-roots, and rural areas is encouraged, while more attention is suggested to motivating men and mobilizing communities. Finally, the program is relevant and applicable at both local and national levels.
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  16. 16
    070355

    Sri Lanka. South Asia Region.

    International Planned Parenthood Federation [IPPF]

    IPPF COUNTRY PROFILES. 1992 Jan; 25-30.

    A country profile of demographic/statistical data, social and health aspects, and government policies and programs in Sri Lanka particularly as they relate to family planning is presented by the International Planned Parenthood Federation (IPPF). The government regards current population growth as too high, and provides subsidized clinics, contraceptives, and monetary incentives for sterilization. The Family Planning Association (FPA) of Sri Lanka was created in 1953, and became a member of the IPPF in 1954. It emphasizes motivation and contraceptive distribution, operates 2 clinics, a rural family health project, and provides for educational, contraceptive social marketing, and sterilization programs. The organization generally plays a limited role in the delivery of family planning, with these projects serving to supplement government programs. 62% of married women practice contraception, with 40% using modern methods. Female sterilization is the most popular method, followed by male sterilization and oral contraceptives. Abortion is legal only to save a woman's life. Family planning constraints, education, demographic trends, health issues, status of women, contraceptive availability and accessibility, and the operations and funding of the family planning association are fully discussed.
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  17. 17
    060875

    Developing a self-financing, factory-based contraceptive distribution project in St. Lucia.

    Logan D

    Washington, D.C., TvT Associates, MORE Project, 1990 Mar. [2], 26, [12] p. (USAID Contract No. DPE-3030-C-00-8167)

    A revitalized, nearly self-sufficient, factory-based contraceptive distribution project has existed in St. Lucia since the beginning of 1990. Seeded in 1981, with 1-year funding from the International Planned Parenthood Federation, the project was on shaky financial footing through the 1980s. The Family Planning Association (FPA) of St. Lucia, with the technical assistance of the Maximizing Results of Operations Research (MORE) project, has, however, turned the project into a viable distribution program financially-backed by factories employing almost 2,500 workers. This successful turnaround is due largely to the accomplishments of a MORE business consultant who made 2 field visits in 1989. In addition to helping the FPA expand the project, the consultant developed a business plan, and encouraged factory owners and business leaders to back the project. He held both individual meetings and a formal group presentation. The business plan, and activities and results of the field visits are presented in the report. The consultant found a 1-to-1 sales approach best in recruiting company members for the project, supports continued application of the formal presentation, suggests a hotel setting for business group meetings, and notes island-wide consensus for support of the project. Although not quite finalized, and expected to work on a restricted operating budget, the project's largest remaining obstacle is where to locate the nurse.
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  18. 18
    067400

    The promotion of family planning by financial payments: the case of Bangladesh.

    Cleland J; Mauldin WP

    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.
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  19. 19
    046452

    The educational activities of the ILO Population and Labour Policies Programme.

    International Labour Office [ILO]

    Geneva, Switzerland, ILO, 1986 Jan. 83 p.

    The educational activities of the International Labor Organization's (ILO) Population and Labor Policies Program was launched in the early 1970s. It's spectrum includes: promotion of information and education activities devoted to population and family planning questions at various levels, particularly by means of workers' education, labor welfare, and cooperative and rural institutions' programs; policy- oriented research on the demographic aspects of measures of social policy in certain fields, such as employment and social security; and efforts to stimulate participation by social security and enterprise- level medical services in the promotion of family planning. At the outset, the ILO explored the demand for and feasibility of educational activities in selected countries. Slowly, the concept of an ILO population-oriented program developed, and regional labor and population teams were established. At the next stage, regional advisers extended their activities to the national level. Project descriptions are included for the countries of India, Jordan, Kiribati, the Republic of Korea, Pakistan, Sierra Leone, Sri Lanka, Hong Kong, Jamaica, Nepal, Congo, Zambia, and the Philippines.
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  20. 20
    049982

    Breast-feeding and its promotion.

    Kocturk T; Zetterstrom R

    ACTA PAEDIATRICA SCANDINAVICA. 1988 Mar; 77(2):183-90.

    The acceptance of the World Health Organization (WHO) International Code for Marketing of Breastmilk Substitutes has stimulated governments to design programs for the more energetic promotion of breastfeeding, but promotional efforts in developing nations may not be getting through to the mothers or may not be designed to meet their specific needs. In a prospective study in Istanbul, it was observed that all infants, whether delivered in a hospital or at home, received not only mixtures of sugar and water and other mixtures soon after birth and for about 1 week thereafter, but also complementary foods now and then until this became a regular practice. This pattern can be defined as regular complementary feeding or partial breastfeeding. Yet, the mothers described it as exclusive breastfeeding. The early and haphazard introduction of water and food in those environments where contamination is common exposes the infants to concentrated amounts of microorganisms which may overwhelm the immunological protection provided by breastmilk and also reduces the milk supply through insufficient stimulation of the breast. Exclusive breastfeeding should be encouraged, and irregular complementary feedings during the early weeks of life should be strongly discouraged, unless there is a medical indication. When exclusive breastfeeding is no longer sufficient, i.e., at the age of about 5 months, complementary feeding should be promoted. Programs for the promotion of breastfeeding have been criticized for devoting too much attention to the infant and little or no attention to the needs of the mother. In a given society, it may be difficult to promote breastfeeding if women regard it as a means of preventing them from improving their socioeconomic situation. Women who want to breastfeed their children should not be prevented from doing so by their working conditions.
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  21. 21
    051839

    Poor immunization coverage--a problem of supply or demand?

    Pointer AE

    INTERNATIONAL HEALTH NEWS. 1988 Apr; 9(4):4-5.

    In the effort to realize Universal Child Immunization by 1990, an active search is underway to find ways to raise immunization coverage levels. The World Health Organization's (WHO) Expanded Program on Immunization (EPI) has developed excellent systems that develop such program components as supply management, equipment maintenance, disease surveillance, clinical practice, and supervision. Program performance has shown a steady improvement over the years in those countries which have adopted such systems, yet the trend has not been as marked as expected. Coverage levels in many countries have remained below 60%, and figures show a "dropout" with the multi-dose vaccines. The dropout figures suggest that parental acceptance of immunization is difficult to sustain throughout the entire series, which is spread over the first 9 months of life. To reduce dropout and boost coverage levels still further, recent program directions have emphasized social mobilization to increase the public response to immunization. It is tempting to conclude that with the implementation of improved management systems the final success will come from persuading parents to avail themselves of immunization services, but field reports suggest that this may not be the case. Health records show missed immunizations despite numerous visits to clinics, suggesting widespread problems in the implementation of the WHO systems. A combination of causes seem to ensure that children attending with their mothers do not get immunized, including errors and omissions on the part of field staff which reduce the chances for immunizations by families making return visits to the clinics. Few programs incorporate immunizations in daily practice. In a series of immunization coverage surveys conducted recently in 1 African country, the most striking fact was that the limitations of the data collected meant that the calculated contribution of clinical error could only be a gross underestimation of true clinical error contribution. This suggests that social mobilization to improve clinical attendance is likely to be ineffective until problems with the provision of services have been solved, but improving services has the potential to increase coverage levels as well as the potential to motivate parents to bring their children to the clinics.
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  22. 22
    048153

    New approaches to Family Planning Programme.

    POPULATION EDUCATION NEWS. 1987 May; 14(5):6-9.

    Population education incentives, voluntary action, community participation, and improved program management are 5 family planning areas recently redefined by the government of India. Population education, integrated with the educational system, is important in influencing fertility behavior. The Adult Education program, and the nonformal educational system will be strengthened, with aid from UNFPA. Incentives, which are presently available to government employees, will be increased. Economic incentives, rural development program incentives, and insurance, lottery, and bond incentive schemes are being considered. Voluntary organizations will be encouraged to work in the family welfare sphere, and organized sector units will be urged to provide family welfare services to their employees. Cooperatives, which cover 95% of villages, will be used as a means of educating, motivating, and communicating population control objectives on the local level. Tax incentives will be offered to the corporate sector for providing integrated family welfare services. Community participation, which is crucial to the success of the programs, will be addressed on several levels. Popular committees, youth and women's groups, and medical students will increase community involvement through various means. In addition, political and community leaders will be involved in motivational work, and a village Women's Volunteer Corps is planned. Social marketing of contraceptives, although fairly extensive for the last 15 years, leaves much to be desired in creating a large demand. A marketing board will be created to ensure aggressive marketing, advertising, and promotion, with expansion to include oral contraceptives. Reorganization and reorientation toward modern program management will be undertaken, so that policy, planning, implementation, review, and evaluation are carried out efficiently. At the state, district, and the block level, more effective coordination is the goal, as well as strengthening the District Family Welfare Bureau.
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  23. 23
    042029

    [The Church, the Family and Responsible Parenthood in Latin America: a Meeting of experts] Iglesia, Familia y Paternidad Responsable en America Latina: Encuentro de Expertos.

    Consejo Episcopal Latinoamericano [CELAM]

    Bogota, Colombia, CELAM, 1977. (Documento CELAM No. 32.)

    This document is the result of a meeting organized by the Department of the Laity of the Latin American Episcopal Council on the theme of the Church, Family, and Responsible Parenthood. 18 Latin American experts in various disciplines were selected on the basis of professional competence and the correctness of their philosophical and theological positions in the eyes of the Catholic Church to study the problem of responsible parenthood in Latin America and to recommend lines of action for a true family ministry in this area. The work consists of 2 major parts: 12 presentations concerning the sociodemographic, philosophical-theological, psychophysiological, and educational aspects of responsible parenthood, and conclusions based on the work and the meetings. The 4 articles on sociodemographic aspects discuss the demographic problem in Latin America, Latin America and the demographic question in the Conference of Bucharest, maturity of faith in Christ expressed in responsible parenthood, and social conditions of responsible parenthood in Peruvian squatter settlements. The 3 articles on philosophical and theological aspects concern conceptual foundations of neomalthusian theory, pastoral attitudes in relation to responsible parenthood, and pastoral action regarding responsible parenthood. 2 articles on psychophysiological aspects discuss the couple and methods of fertility regulation and the gynecologist as an advisor on psychosexual problems of reproduction. Educational aspects are discussed in 3 articles on sexual pathology and education, education for responsible parenthood, and the Misereor-Carvajal Program of Family Action in Cali, Colombia. The conclusions are the result of an interdisciplinary effort to synthesize the major points of discussion and agreements on principles and actions arrived at in each of the 4 areas.
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  24. 24
    270284

    The story of two mothers.

    Wallace W; Penn C

    PEOPLE. 1988; 15(1):7-12.

    The stories of 2 Kenyan mothers and their families, the subjects of an IPPF film, illustrate the health benefits to women and children of family planning. 1 woman, aged 40, lives on a small farm with her 9 children. She is very resourceful but must constantly struggle to feed her children. She must also cope with the effects of polygamy; her husband has moved away to live with another wife. She was denied the benefit of education, and repeated pregnancies with little space between them have damaged her health. Now that she has contraceptive injections and has not had a child for 2 years, she feels her health has benefited and that she has regained her strength. The 2nd woman, aged 32, educated, and better off than the first, nevertheless knew little about contraception until after her 1st pregnancy. Her desire to limit the size of her family so that she might give more time to each child, her husband's consciousness of family planning, and her health difficulties during pregnancy contributed to effective spacing and contraception past the birth of her 3rd child. Now she is happy about her decision for tubal ligation surgery and has been able to develop as a gospel singer and songwriter.
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  25. 25
    268651

    Policy directions for rural water supply in developing countries.

    Burton I

    [Washington, D.C.], U.S. Agency for International Development, Bureau for Program and Policy Coordination, 1979 Apr. 43 p. (A.I.D. Program Evaluation Discussion Paper No. 4)

    The current state of knowledge on design, installation and maintenance of rural water supply systems is surveyed. Present statistics suggest that it may be possible to provide safe water for everyone during the 1980-1990 period designated as the International Drinking Water Decade. The results on a regional basis are uneven. Africa is making rapid progress in providing rural water supply and may equal Latin America, which had been far ahead. Southeast Asia, however, represents a major problem. More than 60% of the world's population without reasonable access to water is in this area. There are a number of evaluations underway, including studies by OECD, UNICF-WHO, IBRD, International Research Center, and a number of bilateral agencies like AID. All these evaluations have a non-hardware component of rural water programs in common. Maintaining the system once it is installed is one of the key elements in the long term success or failure of rural water schemes. There are 3 reasons for failure: 1) the technology; 2) the capability; and 3) the motivation. In many cases, lack of spare parts and motivation are to blame for system failure. There remains a need to strengthen the capacity of national water programs. Unless this takes place, there will be no sustained progress. Commitment on all levels will help insure continual success of rural water efforts. Successful programs will also require balance between hardware, community involvement, and repair and maintenence. One useful approach would be to fund programs, not projects. There are 2 activities that AID should consider: rehabilitation of existing systems and development of methodologies to measure consumer satisfaction with water systems. A need to: 1) keep abreast of technological development; 2) assess the need for manpower training; 3) encurage local manufacturers; 4) evaluate and strengthen the ability of national organizations and programs; 5) provide materials for health community involvement guidelines; and 6) collabotate and coordinate with other agencies exists.
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