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London, FPA, 1972. 48 p.Currently, public authorities pay for almost 2/3 of the family planning consultations conducted by the Family Planning Association, and this is the most significant development since the publication of the last Family Planning Association Report. Additionally, more local health authorities are operating direct clinic and domiciliary services. The Family Planning Association handed over the management of 39 clinics to public authorities in the 1971-1972 year. However, despite this progress, family planning service provision by public authorities throughout England continues to be uneven in quality and extent. Spending by local health authorities for each woman at risk varies from 1 penny per woman at risk in Burnley (excluding the city of London) to 179 pence at Islington. In addition to the problem of inconsistency in spending, there appears to be no immediate prospect of a comprehensive family planning service - one that is available to all, is free of charge, and is backed by an adequate education campaign. Although government help for the extension of domiciliary family planning service is impressive, it should not obscure the false economies in spending on other contraceptive delivery services such as general practitioners, specialist clinics, and specialized advisory centers. Until the government announces the details of its plans for family planning services within the National Health Service beginning April 1974, the Family Planning Association's own detailed planning cannot be exact. The Association's basic policy continues to be to turn over the responsibility for the management of clinic and domiciliary contraceptive services as quickly and as smoothly as possible to the public authorities. Already there is concern that some clinic services managed by public authorities may become less attractive, particularly to young people, and that differences in the quality of service will increase under local public management as well as that backup services will be neglected. Also existing is the realization that the public authorities do not do enough to attract people to the use of contraception.
Geneva, World Health Organization, 1971. (Technical Report Series No. 483). 47 p.A WHO Study Group on Health Education in Health Aspects of Family Planning met in Geneva from December 15-21, 1970. A report of the group is presented. It is asserted that family planning contributes materially to 1 of the main aims of health services, by helping to ensure that every child, wherever possible, lives and grows up in a family unit with love and security in healthy surroundings, receives adequate nourishment, health supervision, and efficient medical attention, and is taught the elements of healthy living. The Study Group gave primary consideration to an analysis of the educational components fundamental to achieving the objectives of family planning services within the context of health services: the programming process, implementation, evaluation, methodology, coordination, and needs for studies and research. The Group noted that in many countries the integration of family planning care into health services not only has important educational implications but also brings many administrative and technical advantages. The contents of the report include sections on 1) family planning and its dependence on many services, 2) dependence of family planning on people, 3) some important requirements and difficulties, 4) objectives of education in health aspects of family planning, 5) a systematic approach to education in the health aspects of family planning, 6) importance of an organized health education service, 7) coordination of effort, 8) studies and research, and 9) recommendations.
In: Population policies and programmes. Proceedings of the United Nations Expert Group Meeting on Population Policies and Programmes, Cairo, Egypt, 12-16 April 1992. New York, New York, United Nations, 1993. 114-20. (ST/ESA/SER.R/128)The paper addresses: 1) national population principles and objectives; 2) the population dimension of national development policy; 3) national population programs; 4) the rationale, opportunities and needs for external donor support; and 5) processes for population program needs assessment based on the work of one bilateral donor, the United Kingdom Overseas Development Administration. The population dimension to national development policy formulation is most important in relation to policies on: 1) provision of social services (health, education, family planning); 2) environment; 3) development planning and resource allocation; 4) poverty alleviation; 5) labor force and human resource development (youth employment, child labor); 6) social security for the elderly; and 7) the status of women. A population program establishes the strategies to implement the national population policy. Effective family planning programs recognize diverse needs for contraception (youth adults, couples wishing to space their children, those who have completed their families). Ready access to family planning can be achieved through: 1) integrating family planning into clinic-based maternal and child health services; 2) community-based activities; and 3) the retail sector using social marketing. Other population activities include effective dissemination of data including population education in schools. United Kingdom development donor assistance and wider development policies includes: 1) public expenditure rationalization for structural adjustment; 2) civil service reform; 3) health system restructuring; and 4) decentralization. External assistance would include: 1) technical assistance, using local and international expertise; 2) training, in-country and overseas; 3) supplies, including contraceptives; 4) renovation of the existing health infrastructures; and 5) local costs, such as salaries. For donors, one model is the UNFPA program review and strategy development process.
IPPF COUNTRY PROFILES. 1992 Aug; SAR 19-24.In 1984 in Pakistan, the government's Council of Islamic Ideology banned contraception unless pregnancy would jeopardize a woman's life. The government soon realized that its 2.9% population growth rate was too high to achieve social and economic development, so it implemented a national population policy, hoping to reduce population growth to 2.5% by 2000. The policy calls for a multisectoral approach, emphasizing mobile services to promote birth spacing and maternal and child health and providing family planning services through the public and private sector and family welfare centers. The policy also aims to increase literacy, reduce unemployment, and improve health care. It targets rural areas where 72% of the population lives. In 1989, only 9.1% of 15-49 year old married women used contraceptives and 58.6% wanted to control their fertility but did not have access to family planning information and services. Pakistan depends greatly on the family planning services of the nongovernmental organization. Family Planning Association of Pakistan (FPAP). FPAP introduced family welfare centers, social marketing, and reproductive health centers to Pakistan. It continues to introduce new contraceptives. FPAP's major projects include educational programs in population, family planning, and nutrition; family planning training; promotion of family planning and maternal and child health; programs emphasizing male involvement in family planning; information, education, and communication; and lobbying Parliament for more funding for family planning and for improvement in women's status.
New York, New York, UNFPA, . ix, 66 p.This paper discusses Sri Lanka's population policy with special focus upon UNFPA's role in establishing and implementing a successful multi-sectoral family planning program for the country. Progress made in the past years must continue, while ongoing efforts are made to attain the goal of 2.1 TFR by year 2000. A suitable program must be better coordinated with a view to cutting waste and duplication, guarantee an adequate supply of appropriate contraceptive supplies, streamline research operation, more fully implement its educational programs, and recognize women's centrality in population programs, and recognize women's centrality in population programs. UNFPA assistance should be offered to effect such programmatic change and development, with service delivery needs addressed 1st. The Government of Sri Lanka lacks adequate resources to supply calls for an integrated approach focused upon creating a National Coordinating Council; developing a more sophisticated and targeted approach to information, education, and communication; providing contraceptive supplies, software for service delivery, and client counseling; training providers; and improving coordination with other multilateral programs for child care and human resource development. The present population and development situation, the national population program, proposed sectoral strategies for implementation, the role of technical assistance, and general recommendations for external assistance are discussed in detail.
Health aspects of population dynamics: report by the Director-General to the 21st World Health Assembly.
[Unpublished] 1968 Apr 24. 8 p. (A21/P and B/9)Add to my documents.
[Unpublished] 1984 Aug. Background note presented to the International Conference on Population held in Mexico City, August 6-13, 1984. 4 p.The United Kingdom's birth rate has been below replacement level since 1973. Average family size is becoming smaller; the most popular size is 2 children. Women are postponing births to a later date, and age at marriage has risen. Problems of providing support and services for the growing number of very elderly are being studied by the government. Size of population is of less concern than well-being to the government. They provide assistance with family planning through the National Health Service, but believe that decisions about fertility and childbearing are each couple's to make. Population figures are taken into account in making economic and social policy, but there is no attempt to influence overall size and components of change except in the area of immigration where they lose more people by emigration than they gain from immigration.
Statement by the Head of Delegation of the Republic of Korea at the International Conference on Population (ICP).
[Unpublished] 1984 Aug. Presented at the International Conference on Population, Mexico City, August 6-13, 1984. 3 p.In a 5-year plan, the Korean government has integrated family planning programs, including maternal and child health, medical insurance, and social welfare programs, into its primary health ervices in order to reach its hard-core low-income residents in both urban and rural areas. The Korea Women's Development Institute was established in 1982 to enchance the status of women, and the Labor Standard Law has been revised to try to overcome deep-rooted son-preference among Korean parenst. Migration out of rural areas is creating rural manpower problems, and stepped-up rural community development programs are planned. Population predictions by the mid-21st century stand at 61 million, too great for a country with such limited natural resources to support. Korea recommends an exchange of information on population and development between all countries, the setting aside of 1% of each country's annual budget for national population programs, and convening the world population conference every 5 instead of every 10 years so that more progress can be made in solving the problem.
Report of the evaluation of UNFPA assistance to Colombia's Maternal, Child Health and Population Dynamic's Programme, 1974-1978.
New York, United Nations Fund for Population Activities, July 1981. 181 p.This report for UNFPA (United Nations Fund for Population Activities) on Colombia's Maternal and Child Health and Population Dynamics (MCH/PD) program was prepared by an independent team of consultants which spent 3 weeks in Colombia in February 1980 reviewing documents, interviewing key personnel and observing program services. The report consists of 8 chapters. The 1st describes the terms of references of the evaluation mission. The 2nd chapter provides background information on Colombia and identifies some of the principal environmental factors that affect the program. Chapter 3 describes the organizational context within which the program operates. The chapter also includes a discussion of the UNFPA funding and monitoring mechanism and how that affects program planning and operations. Chapter 4 is a description of the program planning process; goals, strategies and objectives, and of the UNFPA and government inputs to the program between 1974-1978, the period under review. A large part of the report is devoted to describing and assessing each program activity. Chapter 5 consists of descriptions of management information; maternal care; infant, child and adolescent care; family planning; supervision; training; community education; and research and evalutation studies. Chapter 6 is an analysis of the program's impact on: maternal morbidity and mortality; infant morbidity and mortality; and fertility. Chapter 7 summarizes the Mission's conclusions and lists its recommendations. The final chapter deals with the Mission's position in relation to the 1980-1983 proposal. Appendices provide statistical data on medical activities, contraceptive distribution and use, content of training courses, target population, total expenditures, and norms for care, as well as organizational charts, individuals interviewed, and UNFPA assistance to other agencies in Colombia. (author's modified)
M. A. thesis, Univ. of Chicago, Division of the Social Sciences, Dec. 1973. 90 p.In the summer of 1971 the Planned Parenthood Federation of Korea (PPFK), with the concurrence of the Korean government, launched a new phase in the Korean family planning program--"Stop at Two" movement. With this step the 10 year old family program became the 1st in the world to openly advocate and propogate through communications the 2-child family norm. Since then the movement has been vigorously pressed through all communications channels in spite of traditional norms and the need for major outside funding. The decision to actively bring the "Stop at Two" idea to the public was based largely on the implications for the future of the success of the 1st 10 years of the national family planning program. The Korean government has set an optimistic population growth rate target for the next 5 years--1.5 to be achieved by 1976. To reach these goals it is estimated that 45% of the eligible population will have to be regularly using some form of contraception. At 1 time or another the PPFK, supporting the national program, has used every conceivable method of communication to inform, motivate, and persuade the Korean population to adopt family planning. An attempt has been made to carefully analyze problem areas in the family planning program for which communication research is needed or would be relevant. An effort is made to show how the information obtained could be used to deal effectively through communication with the conditions presented by the problem. Communication research and evaluation techniques which would be most valuable to Korea are described. A research and evaluation design which spells out the components of a program of research intended to support the already published communication strategy of the Korean family planning over the next 3 years is included.
[Washington, D.C., American Public Health Association, 1979.] 110 p. (Contract AID/pha/C-1100)This reports the Third Evaluation of the Thailand National Family Program and was prepared by the entire joint Thai-American evaluation team. The summary of findings states that the NFPP has successfully achieved its target to date. The population growth rate will reach the goal of 2.1% per annum set by the Fourth Economic and Social Development Plan. It was further recommended that if the record of achievement is to be maintained through the Fifth 5-year plan (1982-6), increasing levels of support are needed both from the government and international donors. Further recommendations state that the National Family Planning Program (NFPP) should continue to focus its efforts on all regions of the country, including Bangkok. The NFPP should prioritize those georgraphic areas and segments of the population where family planning acceptance is low and/or availability of information and services are not fully developed. Targets should be set in terms of a combination of new and continuing acceptors in the next 5-year plan. Greater emphasis should be given to management and supervision at the village and health center levels. The international donor community should give full recognition to the necessity of maintaining a level of direct support for the NFPP to assist the Royal Thai Government (RTG) in achieving the goals of the Fifth National Economic and Social development Plan (1982-6). The RTG and donor agencies should continue to support public and private sector activities in voluntary sterilization.
Delhi, D.K. Publishing House, . 130 p.The population program of India was examined from a descriptive analytical perspective. The organizational layout was examined and methods of operation were scrutinized from the standpoint of program policy. The 8 chapters of the monograph deal with the following: management and population; role of public administration; family planning system; an appendage of health; the law of sinecure and success; international assistance; population mangement; resume and results. The systems concept is a useful approach to the job of management, for it provides a framework for visualizing internal and external environmental factors as an integrated whole. The systems concept also permits recognition of the proper place and function of subsystems. Public administration in India suffers from several problems: 1) too many levels and positions to effect any rapid program decision and implementation; 2) too many boards and committees with vague or obscure duties and lack of responsibility on the part of any single individual or group; control orientation; and 4) generalist administration.
World Conference of the United Nations Decade for Women: equality, development and peace, Copenhagen, Denmark, July 14-30, 1980.
New York, UN, 1980. 32 p. (A/CONF. 94/9)This report reviews and evaluates efforts at the national level to implement the world Plan of Action for the Implementation of the Implementation of the Objectives of the International Women's Year and is based on replies of 86 governments to questionnaires prepared by the Advancement of Women Branch in the Centre for Social Development and Humanitarian Affairs. It contains an analysis of the progress made and obstacles overcome in the field of health. Using as indicators increases in female life expectancy and declines in maternal and infant mortality rates, improvements have occurred in the health status of women. However, wide disparities are seen between high and low socioeconomic groups, between rural and urban women, and between minority groups and the rest of the population. Lack of financial resources is a major obstacle, compounded by inflation. The excessive physical activity of working rural women not only precludes their participation in health programs but also adversely affects their health. Additional problems are inadequate training and supervision of health administrative personnel, a lack of defined policies, and a lack of coordination between agencies. Social, religious, and cultural attitudes that no longer have validity, lack of political commitment, and an inadequate perception of the long-term health benefits of family planning, rather than its demographic aspects, restrict access to family planning for many groups of women.
ASIAN AND PACIFIC POPULATION PROGRAMME NEWS. 1980; 9(1-2):10-1.In 1976 the United Nations's Economic and Social Commission for Asia and the Pacific launched a comparative study on integrated family planning programs in a number of countries in the region. In November 1979 the study directors from the participating countries meet in Bangkok to discuss the current status of the studies in their countries. The Korean and Malaysian studies were completed, the Bangladesh study was in the data collecting phase, and the Pakistani research design phase was completed. The meeting participants focused their attention on the findings and policy implications of the 2 completed studies and also discussed a number of theorectical and methodological issues which grew out of their research experience. The Malaysian study indicated that group structure, financial resources, and the frequency and quality of worker-client contact were the most significant variables determining program effectiveness. In the Korean Study, leadership, financial resources, and the frequency and quality of contact between agencies were the key variables in determining program effectiveness. In the Malaysian study there was a positive correlation between maternal and child health service performance measures and family planning service performance measures. This finding supported the contention that these 2 types of service provision are not in conflict with each other but instead serve to reinforce each other. Policy implications of the Korean study were 1) family planning should be an integral part of all community activities; 2) family planning workers should be adequately supported by financial and supply allocations; and 3) adequate record keeping and information exchange procedures should be incorporated in the programs.
Washington, D.C., U.S. Office of International Health, Division of Planning and Evaluation, 1976. 144 p. (Syncrisis: the dynamics of health, XIX)This report uses available statistics to examine health conditions in Senegal and their interaction with socioeconomic development. Background data are presented, after which population, health status, nutrition, environmental health, health infrastructure, facilities, services and manpower, national health policy and planning, international organizations, and the Sahel are discussed. Diseases such as malaria, measles, tuberculosis, trachoma and venereal diseases are endemic in Senegal, and high levels of infant and childhood mortality exist throughout the country but especially in rural areas. Diarrhea, respiratory infections, and neonatal tetanus contribute to this mortality and are evidence of the poor health environment, and lack of basic services including nutrition assistance, health education, and potable water. Nutrition in Senegal appears to be good in general, but seasonal and local variations sometimes produce malnutrition. Lowered fertility rates would reduce infant and maternal mortality and morbidity and might slow the present decline in per capita food intake. At present the government of Senegal has no population policy and almost no provisions for family planning services. Health services are inadequate and inefficient, with shortages of all levels of health manpower, poor planning, and overemphasis on curative services.
American Universities Field Staff Reports. East Africa Series. 1971; 10(2):1-15.Kenya was one of the 1st sub-Saharan countries to develop a national family planning program and has made considerable progress in promoting contraception; however, the program is beset with many staffing, administrative, and political problems. In 1965 the government requested the Population Council to conduct a demographic survey in Kenya and to develop recommendations for establishing a family planning program. The Ministry of Health subsequently instituted most of these recommendations and established 220 family planning clinics in various facilities across the nation. The program receives funding and other forms of assistance from a large number of outside organizations and relies on a large number of foreign advisors for planning, operating, andevaluating the program. One of the major problems confronting the program is the lack of strong and consistent program support from high level government officials. Many officials fear that they will lose political support if they issue strong family planning directives. This lack of commitment weakens the program at all levels and reduces the effectiveness of the educational component of the program. Other problems include 1) inadequate coordination and communication between the various organizations which contribute to the program; 2) internal conflicts between medical and administrative personnel; 3) high reliance on foreign advisors who tend to be insensitive tolocal issues and concerns; and 4) an insufficient number of staff personnel. Despite these problems the outlook for family planning in Kenya is good. Future funding is assured, staff increases are contemplated, and plans call for less reliance on foreign personnel.
A working paper on status, present and future utilisation of the TBA in 15 countries in the Middle East and Asia and a Regional Summary of the Far East and Africa.
[Unpublished] 1979. 27 p.Data on status and present and future utilization of the traditional birth attendants in countries of East and South Asia and Africa were collected through a questionnaire sent to countries of the Middle East and North Africa Region of the International Planned Parenthood Federation. There are 2 categories of traditional birth attendants (TBAs) in the Middle East and Asia: these are the "untrained midwife" who practices midwifery for a living and the birth attendant who is usually an elderly relative or neighbor and who does not earn her living from midwifery. The urban TBA fits into the 1st category; the rural TBAs are a mixture of both categories. The information provided by the questionnaire indicated that TBAs exist in all but 1 country of the region. The TBAs are employed mostly by the pregnant woman directly, and both rural and urban women use them. In most of the countries training facilities are available. The majority of the countries train only those TBAs who are already practicing midwives. Training duration ranges from 1 week to 1 year. Illiteracy appears to be the primary problem related to training. In regard to training, there needs to be careful selection, proper training, and good supervision and follow-up. Existing curricula are in need of revision.
Washington, D.C., U.S. Office of International Health, Division of Planning and Evaluation, 1976. 92 p. (Syncrisis: the dynamics of health, XVII)This article uses available statistics to analyze health conditions in Bangladesh and their impact on the country's socioeconomic development. Background information on the country is first given, after which population characteristics, health status, nutrition, national health policy and adminstration, health services and programs, population programs, environmental sanitation, health sector resources, financing of health care and donor assistance are examined. Bangladesh's 3% annual population increase is expected to increase already great population pressure and to have a negative impact on the health status of the population. Although reliable health statistics are lacking, infant mortality is estimated at 140 per 1000, 40% of all deaths occur in the 0-4 age group, and maternal mortality is high. Infectious diseases exacerbated by malnutrition are the main causes of death. 4 key factors are responsible for the general malnutrition: 1) rapidly growing population, 2) low per capita income, 3) high incidence of diarrheal diseases, and 4) dietary practices that restrict nutrient intake. Most of the population has access only to traditional health services, and medical education is hospital oriental and curative, with minimal emphasis on public health. The level of environmental sanitation is extremely low.
A report on UNFPA/EWPI Technical Working Group Meeting on Integration of Family Planning with Rural Development, East-West Center, Honolulu, Hawaii 15-18 February 1978.
New York, UNFPA, 1979. 37 p. (Policy Development Studies No. 1)Unifunctional family planning programs have proven limited in dealing with the multifaceted nature of fertility regulation. Effective fertility regulation must be accompanied by improvement of socioeconomic conditions for the rural population. The organizational arrangements for the integration of family planning into other services is the main topic of this report. Many questions of integration of services cannot be answered in generalities; specific guidelines need to be applied to specific situations. Under certain circumstances family planning integration with rural development can improve the program and advance development. The partners in integration should be chosen with consideration for the conditions in each location. It is preferable to link specialized services at the point of service delivery. Plans which create large umbrella agencies should be viewed with caution. Integration in the form of community-based family planning programs can often help increase popular participation and acceptance to make family planning more successful. In the initial stages of integration, voluntary agencies or neutral government agencies can be helpful in coordinating specialized government agencies when jurisdictional concerns preclude effective intragency exchanges. Integration programs may be efficient and cost-effective in the long run, but they may require a sizeable initial investment.
London, IPPF, 1979 Oct. 47 p.The development of family planning programs in Colombia is outlined in this IPPF (International Planned Parenthood Federation)-sponsored report. Introductory demographic data are provided including information on the geography, economy, population dynamics, and available health services; this section is followed by a discussion of the government policy, which first became evident in 1968 with the inception of the national Maternal Child Health (MCH) program; the development of this program was in the face of active Catholic opposition and active leftwing proponents. Through 1979 the MCH program is still functioning with 100,000 new acceptors/year; in addition, the government only minimally inhibits the actions of nongovernment programs, such as PROFAMILIA, and allows for liberal regulations on such matters as prescription of contraceptives. The report then details the developments of individual family planning programs, some of which failed to survive the politically turbulent 1970s, e.g., ASCOFAME (Asociacion Colombiana de Facultades de Medicina), and others of which remain viable, e.g., PROFAMILIA; both of these programs are basically medical and have resulted in the following statistics of contraceptive protection from .1 in 1965 (per 1000 woman/years)-484.2 in 1975. Details of funding are provided, and expenditures and costs are presented tabularly. In addition to clinic programs, rural programs such as CBD (an adjunct of PROFAMILIA) were pioneered in Colombia, the structure of which has been emulated by all other field programs. Aspects of marketing (social marketing and mail order, e.g.,) are described and the personnel structure of PROFAMILIA is outlined. External funding of PROFAMILIA represents about 65% of its funding, and locally derived income provides the additional 35%.
In: International Labor Office. Family planning in industry in the Asian region. Pt. 3. Field experiences. 1st edition. Bangkok, Thailand, ILO Regional Office for Asia, 1979 Jun. 55-67.Rapid population growth on the large Indian tea plantations, where people are afforded an economic security they seldom leave, first became a problem in the 1940's when infant morbidity and disease began to decline because of the conquest of malaria. The campus-style environment and system of medical and welfare services, as stipulated by the Plantation Labour Act, makes the rendering of family planning services quite easy. The Indian Tea Association's family planning program began in 1957; by 1963 the birth rate had dropped to 38.6/1000 from 43.4/1000 in 1960. Services are free; methods are by choice; cash incentives are granted those who accept sterilization. The United Planters' Association of Southern India began its family planning/health programs in 1971 on 3 estates. The program, known as the No Birth Bonus Scheme, was initiated after a series of 3 surveys and enacted a deferred incentive for motivating employees. The program was extended until 250,000 workers were covered under the Comprehensive Labour Welfare Scheme. The organizational structure includes liaison with State medical and health services and the District Health and Family Welfare officials of the Central Government. CLWS also has support from the Family Planning Association of India, which provides backup clinical services.
In: International Labor Office. Family planning in industry in the Asian region. Pt. 3. Field experiences. Bangkok, Thailand, ILO Regional Office for Asia, 1979 Jun. 1-9.The per capita income in Bangladesh is $72 per year; the infant mortality rate is 140/1000. The rate of literacy is 24%. Family planning and population policy is one of the government's first priorities. The Population Planning Unit in the Directorate of Labour implements and coordinates all population activities in the labor sector. 3 pilot projects are being conducted with the technical and financial aid of ILO/UNFPA and IDA/IBRD: 1) Family Planning Motivation and Services in Industry and Plantation; 2) Population Education and Training for Labour Welfare Officers, Trade Union Officials, and Personnel; and, 3) Pilot Project for Population Planning in the Organized Sector. The government allows 3 days leave with full pay for those workers orspouses who undergo sterilization. Some industrial managements give additional benefits: housing, bonuses, medical care, education, and employjent opportunities to spouses. The long range objectives of the projects are to support the national program; facilitate the use of existing medical services; and to promote the concept of providing family planning services as part of other labor welfare services. The immediate objectives are to create an awareness of the population problem and family planning methods among industrial and plantation workers and encourage small family norms; and, to use existing services for family planning.
In: Bloch LS, ed. The physician and population change: a strategy for Africa, the Middle East and Europe. Bethesda, Maryland, World Federation for Medical Education, 1979 Mar. 149-67.The family planning program in Pakistan began in 1953 with the formation of the Family Planning Association of Pakistan. In 1960 the Second 5-Year Plan allocated 30.5 million rupees and attempted to provide services to 600,000 couples. The 1965 Plan attempted to reduce the crude birth rate from 50/1000 to 40/1000. 148.2 million rupees was allocated and indigenous midwives were incorporated into an autonomous 3-tiered administration with the district the main unit of operation. This program was the most successful, and the basic structure continues unchanged, with the addition of a "Continuous Motivation System" which has male-female teams assigned to local areas who contact clients and prospective clients. Population education has been introduced into school curricula. The 5th Plan hopes to deliver more services to rural areas. All MCH centers are involved in motivation, education, and providing contraceptives. Family planning clinics have been set up in established hospitals. Paramedical personnel man clinics in rural areas where services include family planning, MCH, and treatment of minor ailments. In 1978 the population of Pakistan was 75.6 million; the crude birth rate was 43.6, the death rate, 13.6. The sex ratio is 876 females to 1000 males. Approximately 19% of women are in the reproductive age group. The maternal mortality rate is 6.0/1000 females giving birth; the infant mortality rate is 115/1000 live births.
World Health. 1979 Aug-Sep; 6-9.The United Nations General Assembly adopted and proclaimed in their Universal Declaration of Human Rights that everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services. Also, motherhood and childhood are entitled to special care and assistance. Under certain conditions in developing countries food is not available for each child or adult to receive minimum requirements. Women often labor long hours in the field, which, coupled with the responsibility of family raising, leaves them tired and susceptible to disease affecting the entire family. 1975 was offically declared the International Year of the Woman by the United Nations. The objectives were equality of men and women, women's full involvement in societal development, and women's contributions to world peace. Economic development has become the top priority in the last 2 decades, but development cannot be accomplished by unhealthy individuals. The World Plan of Action of 1975 calls for governments to pay special attention to women's special health needs by provideng prenatal, postnatal, and delivery services; gynecological and family planning services during the reproductive years.
[Unpublished] 1979. Paper prepared for the Technical Workshop on the Four Country Maternal and Child Health/Family Planning Projects, New York, Oct. 31-Nov. 2, 1979. (Workshop Paper No. 2) 10 p.An integrated health care system which combined the maternal/child health with other services was undertaken in the Yozgat Province of Turkey from 1972-77. The objective was to train midwives in MCH/FP and orient their activities to socialization. The first 2 years of the program was financed by UNFPA. 52 health stations were completed and 18 more are under construction. The personnel shortage stands at 33 physicians, 21 health technicians, 30 nurses, and 67 midwives. Yozgat Province is 75% rural and has about a 50% shortage of roads. The project was evaluated initially in 1975 and entailed preproject information studies, baseline health practices and contraceptive use survey, dual record system, and service statistics reporting. The number of midwives, who are crucial to the program, have increased from an average 115 in 1975 to 160 in 1979. Supervisory nurses are the link between the field and the project managers. Their number has decreased from 17 to 6. Until 1977 family planning service delivery depended on a handful of physicians who distributed condoms and pills. The Ministry of Health trained women physicians in IUD insertions. The crude death rate in 1976 was 13.2/1000; the crude birth rate was 42.7/1000. The crude death rate in 1977 was 14.8/1000; birth rate, 39.9/1000. Common child diseases were measles, enteritis, bronchopneumonia, otitis, and parasitis.