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Environment International. 2012 Oct 15; 47:17-22.There is an assumption that pyrethroid pesticides are converted to non-toxic metabolites by hydrolysis in mammals. However, some recent works have shown their bioaccumulation in human breast milk collected in areas where pyrethroids have been widely used for agriculture or malaria control. In this work, thirteen pyrethroids have been studied in human breast milk samples coming from areas without pyrethroid use for malaria control, such as Brazil, Colombia and Spain. The concentrations of pyrethroids ranged from 1.45 to 24.2 ng g- 1 lw. Cypermethrin, -cyhalothrin, permethrin and esfenvalerate/fenvalerate were present in all the studied samples. The composition of pyrethroid mixture depended on the country of origin of the samples, bifenthrin being the most abundant in Brazilian samples, -cyhalothrin in Colombian and permethrin in Spanish ones. When the pyrethroid concentrations were confronted against the number of gestations, an exponential decay was observed. Moreover, a time trend study was carried out in Brazil, where additional archived pool samples were analyzed, corresponding to years when pyrethroids were applied for dengue epidemic control. In these cases, total pyrethroid levels reached up to 128 ng g- 1 lw, and concentrations decreased when massive use was not allowed. Finally, daily intake estimation of nursing infants was calculated in each country and compared to acceptable WHO levels. The estimated daily intakes for nursing infants were always below the acceptable daily intake levels, nevertheless in certain samples the detected concentrations were very close to the maximum acceptable levels.
FHI's quick reference chart for the WHO medical eligibility criteria for contraceptive use. To initiate or continue the use of combined oral contraceptive (COC), Noristerat (NET-EN), Depo-Provera (DMPA), copper intrauterine device (Cu-IUD).
[Research Triangle Park, North Carolina], FHI, 2004 Mar.  p.I/C (Initiation/Continuation): A woman may fall into either one category or another, depending on whether she is initiating or continuing to use a method. For example, a client with current PID who wants to initiate IUD use would be considered as Category 4, and should not have an IUD inserted. However, if she develops PID while using the IUD, she would be considered as Category 2. This means she could generally continue using the IUD and be treated for PID with the IUD in place. Where I/C is not marked, a woman with that condition falls in the category indicated - whether or not she is initiating or continuing use of the method. (excerpt)
Geneva, Switzerland, WHO, 2002 Apr 3.  p.Whether use of oral contraceptives is causally associated with an increased risk of cervical cancer has long been debated and remains uncertain. On 11 March 2002, WHO’s Department of Reproductive Health and Research convened an international group of experts to review new information on the subject, including research findings from WHO’s International Agency for Research on Cancer (IARC) and several reviews commissioned by WHO. The reviews included a meta-analysis of existing published epidemiological data on the association between combined oral contraceptive use and the risk of cervical cancer; a summary of the biological basis for any association between oral contraceptives and cervical cancer; and a mathematical model assessing risks and benefits of different contraceptive methods. Questions about the relationship between oral contraceptive use and the risk of cervical cancer were addressed in 1990 as part of a comprehensive review of steroid hormone contraception and neoplasia. One of the main conclusions of the 1990 review was that use of oral contraceptives for more than 5 years was associated with a modest (1.3- to 1.8-fold) increased risk of cervical cancer, but that it was unclear whether the increased risk reflected a biological relationship or was attributable to other factors (such as lifestyle differences between users of different contraceptive methods, including differential risk of sexually transmitted infections, particularly Human Papillomavirus [HPV] infection). (excerpt)
World Health Organization Technical Report Series. 1981; (670):1-120.This report includes the collective views of a World Health Organization (WHO) Scientific Group on Research on the Menopause that met in Geneva during December 1980. It includes information on the following: 1) the endocrinology of the menopause and the postmenopausal period (changes in gonadotropins and estrogens immediately prior to the menopause and changes in gonadotropin and steroid hormone levels after the menopause); 2) the age distribution of the menopause (determining the age at menopause, factors influencing the age at menopause, and the range of ages at menopause and the definition of premature and delayed menopause); 3) sociocultural significance of the menopause in different settings; 4) symptoms associated with the menopause (vasomotor symptoms, psychological symptoms, disturbances of sexuality, and insomnia); 5) disorders resulting from, or possibly accelerated by, the menopause (osteoporosis, atherosclerotic cardiovascular disease, and arthritic disorders); 6) risks, with particular reference to neoplasia, of therapeutic estrogens and progestins given to peri- and postmenopausal women (endometrial cancer, breast cancer, and gallbladder disease); 7) fertility regulating methods for women approaching the menopause (fertility and the need for family planning in women approaching the menopause, problems of family planning in perimenopausal women, and considerations with regard to individual methods of family planning in women approaching the menopause); and 8) estrogen and the health care management of perimenopausal and postmenopausal women. At this time some controversy exists as to whether there is a menopausal syndrome of somatic and psychological symptoms and illness. There are virtually no data on the age distribution of the menopause and no information on its sociocultural significance in the developing countries. The subject of risks and benefits of estrogen therapy in peri- and postmenopausal women is of much importance in view of the large number of prescriptions issued for this medication in developed countries, which indicates their frequrnt use, and the different interpretations and opinions among epidemiologists and clinicians on both past and current studies on this subject. Specific recommendations made by the Scientific Group appear at the end of each section of the report. The following were among the general recommendations made: WHO sponsored research should be undertaken to determine the impact on health service needs of the rapidly increasing numbers of postmenopausal women in developing countries; uniform terminology should be adopted by health care workers with regard to the menopause; uniform endocrine standards should be developed which can be applied to the description of peri- and postmenopausal conditions and diseases; and descriptive epidemiological studies of the age at menopause should be performed in a variety of settings.
Geneva, World Health Organization, 1966. (Technical Report Series NO. 332).The value and possible hazards of IUDs are discussed. Grafenberg developed a metal ring IUD in 1928. There was initial enthusiasm about the device, but it became discredited and interest was not revived in the method until 1959. Today, various shapes, sizes, and materials are employed in making IUD'S. No single cause or mechanism of action of an IUD has so far come to light. In sub-human primates the IUD causes accelerated passage of ova through the tube and the rest of the reproductive tract appears to be the major, but not necessarily the only, mechanism, of action. In ruminants, the contraceptive action of the IUD is exerted, at least in part, at the ovarian level. In rats, mice, rabbits, and ferrets, the main effect of the IUD is suppression of the implantation. It is concluded that the action of the IUDs in the human species is exerted before the stage of implantation. The most effective devices are associated with an incidence of 1.8 to 2.9 pregnancies per 100 insertions during the first year of use. The frequency of spontaneous expulsion ranges from about 5% to over 20% depending on the type of device. About one half of all expulsions occur in the first 3 months and comparatively few after the first year. The incidence of removal for medical reasons ranges from approximately 10% to 25% of first insertions during the first year. The method can be used successfully by almost 3 out of every 4 women who adopt it. Side effect and complications include bleeding and pain and less frequently pelvic inflammatory disease and perforation. The only absolute contraindications to the use of IUDs are: (1) active pelvic inflammatory disease, and (2) pregnancy, proven or suspected. Research needs are noted.
PID risk for IUD users highest in first 20 days after insertion; risk then falls sharply and remains low.
Family Planning Perspectives. 1992 Sep-Oct; 24(5):235-6.Researchers analyzed data on 22,908 women obtained from randomized WHO studies from 23 countries to determine whether the IUD increases the risk of pelvic inflammatory disease (PID). 35% of the women used the TCu220C IUD, 39% other copper releasing IUDs, 16% a hormonal IUD, and 9% the Lippes Loop. The overall PID incidence rate was 0.4% of all IUD insertions or 1.6 cases/1000 woman years. The incidence was greatest during the 1st 20 days after insertion (9.7 cases/1000 women years) and then declined to 1.4/1000 woman years. In fact, the risk of PID was >6 times greater within 20 days after insertion than it was >20 days after insertion. This high risk immediately after insertion was evident in every region where PID existed, at all insertion times, and in all age groups. The higher risk within the 20 days after insertion was attributed to contamination of the uterus during insertion. Women who had an IUD inserted after 1980 experienced PID 50% less often than those who had had it inserted earlier, e.g., the rate ratio for 1977-80 was 1.5 but was 0.5 for 1981-83 and 0.34 for 1984 and after. This may have been due to physicians being more aware of contraindications for IUD use, particularly past infection with sexually transmitted diseases )STDs). The rate ratio was higher in Africa (2.6) than it was in Europe (1) but lower in Asia (0.46) and in the Americas (0.39). None of the subjects in China experienced PID. Older women were at lower risk of PID than 15-24 year olds (0.44 for 25-29 year olds, 0.38 for 30-34 year olds, and 0.35 for =or> 35 year olds). The researchers believed the higher risk life styles of the younger group accounted for this difference. Risk of PID decreased with family size (2.5 for 0 children, 0.56 for 2 children, and 0.39 for at least 4 children). The risk of PID did not differ with IUD type. The researchers concluded that the major determinant of PID is exposure to an STD rather than type of IUD.
Coping with extra Poisson variability in the analysis of factors influencing vaginal ring expulsions.
STATISTICS IN MEDICINE. 1991 Feb; 10(2):241-54.Statistical modeling of variation in expulsion rates for levonorgestrel- releasing vaginal rings, employing 1st Poisson distribution, models for over-dispersion parameters, and then a truncated Poisson model to account for the variation. The data were a series of trials by WHO on 1005 women in 19 centers in 1 countries. The variables were number of involuntary expulsions, age, parity, ponderal index, number of days of ring use and health care center. In the WHO report, generalized linear models left a remaining variation greater than anticipated if the expulsion event were constantly distributed. The Poisson regression model initially tested here allowed for different number of days of use by women, and assumed that the mean number of expulsions directly proportional to the log of the duration of use. Analysis of deviance suggested that the data were over-dispersed, with a deviance exceeding the degrees of freedom. Possible explanations include: outlying points from women with high numbers of expulsions, variables not included in the data, an underestimated true variance, an incorrect functional form for "f", or an assumed variability between individuals that is not actually the same for all women. A model using an over-dispersion parameter was fitted into the Breslow model and was recomputed until the Pearson X squared statistic was close to the degrees of freedom. After fitting the resulting Poisson model, center and parity were significant. A truncated Poisson model, where centers reporting no expulsions were omitted, showed no over-dispersion. Women of parity 1, 2, or 3 has 1.7 times the rate of expulsion of women of 0 parity, and those with parity >4 has 2.80 times the expulsion rate, possible reflecting relaxation of the vaginal outlet. There was a trend toward higher expulsion during defecation for women from Asian countries, compared to those from Africa, Europe and Latin America.
Research Triangle Park, North Carolina, Research Triangle Institute and South East Consortium for International Development, 1979 Jun. 227 p. (Rural Development and Fertility Project; Contract AID/ta-CA-1)This document examines the available knowledge of migration and fertility, particularly among the rural poor. The chapters are as follows: "Who moves and why: an examination of current theory and evidence," "The cost-benefit model," "Non-economic theories," "Synthesis of the economic and non-economic approaches," "Migration and fertility: what do we know?" "Rural-urban migration: lower fertility for migrant women?" "Migration and fertility: change among women in the origin?" "Migration and fertility: proposed research items," "The likely migration and related rural fertility consequences of rural development programs," "Increased participation of the rural poor," "Expansion of off-farm employment opportunities," "Development of rural financial markets," "Extension of social services," "Development of rural marketing systems," and "Area development." Rural-urban migration can take any number of forms: migration to nearby or distant cities, to small, medium or large cities. Not all rural-urban migrants become unemployed in the capital city. All migrants do not permanently leave their rural villages; many leave and return several times. The different motives or structural situations underlying male vs. female migration may contribute to differential rural fertility responses to migration.
Integration of women in the development process and its impact on the wellbeing of children: A country paper: Afghanistan.
Washington, D.C., Educational Resources Information Center, 1979. 94 p. (ERIC ED184665)This report, prepared by the UNICEF office in Kabul, Afghanistan, 1) described the current status of women in Afghanistan; 2) traced trends in UNICEF support for programs aimed at improving the welfare of women and children in the country; 3) described the government's development plans; 4) described and assessed specific programs currently supported by UNICEF and aimed at improving the status of women; and 5) provided recommendations for national policies and for UNICEF program support which could contribute toward improving conditions for women. The status of women in Afghanistan is relatively low. 96% of the females, compared to 77% of the males, have no formal education. Only 12% of the labor force is female. Infant mortality for females is higher than for males, and the maternal mortality is high. Women and children receive less health care than males. The fertility rate is high and the average age at marriage for females is 14.3 years. The role of women in family and political decision making is highly restricted. The government is attempting to improve the status of women by outlawing bride price, increasing the minimum age of marriage, and establishing day care centers. The government is also establishing a number of educational and development programs which should indirectly raise the status of women. During the 1950s and 1960s UNICEF assisted in the development of health programs for women and children and during the late 1960s UNICEF supported educational programs for women. During the 1970s UNICEF supported a variety of sanitation and health programs which improved conditions for women. The goal of UNICEF's 1977-1979 plan of assistance is to promote the role of women in development activities. Specific programs currently supported by UNICEF were described and assessed. These programs included 1) a rural development program; 2) a literacy program; 3) a child care program; and 4) the establishment of hostels for women. The government should increase its efforts to integrate women into the development process. UNICEF should contribute toward this effort by encouraging the government to identify specific development targets for women. UNICEF should also provide assistance for programs in the area of health, sanitation, child care, and education.
[Unpublished] 1980. Presented at the Annual Meeting of the Population Association of America, Denver, Colorado, April 10-12, 1980. 34 p.The Calabar Rural Maternal and Child Health/Family (MCH/FP) Project ran from July 1975 to December 1980 funded by the Cross River State Government Ministry of Health with assistance from the Population Council (New York) and the UN Fund for Population Activities. Calabar met the following requirements: it is rural; population between 200,000-500,000; family planning and maternal and child health is integrated from the top level of administration to the delivery of services to the clients; the target population is all women who deliver within the area and their children up to 5 years; services are at levels that can be expanded to larger areas of the country; and attention is given to evaluation of both health benefits and results of family planning services. As a model of health care delivery services to be used throughout the developing world, maternal health services are most important because the level of preventable deaths is highest in preschool children and in women at childbirth and MCH is the most appropriate an effective vehicle for introducing family planning. At the end of the Calabar Rural MCH/FP Project, the office will be closed but the services will continue under the direction of the local governments in Cross River State. 6 health centers and 1 hospital served 275 villages. Knowledge of contraception was low but positively associated with education.
PRACTITIONER. 1979; 223(1337):611-2.Since the term "family planning" was 1st introduced into medical terminology approximately 50 years ago, the movement has grown and expanded. What was originally intended as contraceptive services for married women, usually of high parity and low socioeconomic status, has spread to unmarried women. When family planning clinics were taken over by and incorporated into the National Health Service, the original role of the Family Planning Association became less clearly defined. Family planning services today include sex education, sexual sterilization, research into reversible methods of sterilization, research into the effect of oral contraceptives on general sex behavior, and infertility clinics. New technological advances in the field of fertility, e.g., artificial insemination, cannot be justified by the health needs of the parents or the social need to lower population. There is some question as to whether public funds should be spent to gratify what are sometimes selfish parental concerns.
[Unpublished] 1979. Presented at the International Symposium Medicated IUDs and Polymeric Delivery Systems, Amsterdam, Holland, 1979 June 27-30. 23 p.After almost 20 years of worldwide availability and use of IUDs, assessment of their future role for family planning remains difficult. There are differences concerning the success of IUDs in different programs, and there is also wide variation among individual women in the acceptability and utility of the IUD. Successful IUD use seems to depend upon a complex interplay of factors which include the technology of the IUD itself, biological variation among women, individual and cultural differences in tolerance of IUD caused side effects, and the nature and quality of the available medical care and follow-up services. The principal difficulties encountered in IUD use are discomfort and increased bleeding, spontaneous expulsions, increased frequency of uterine and pelvic infection, and pregnancy failures. In the early years of mass programs for family planning in developing countries the IUD was often emphasized. Inadequate data exists to obtain an accurate world picture of IUD usage and demographic impact at this time. IUDs are available in most countries through a number of channels, and figures on distribution and usage through sales and service programs are incomplete. The best measurement of prevalence of use of IUDs comes from special surveys selected in order to provide a representative sample of the nation's or an area's population. The usage of IUDs in China and India is reviewed. When fertility effects on acceptors are examined, the experience with the IUD seems to be favorable compared with other means of fertility control, but the programmatic impact of IUD use has not been so favorable. Many countries have either added additional means of fertility control or switched emphasis to other methods.
In: United Nations. Economic and Social Commission for Asia and the Pacific, World Fertility Survey, and International Institute for Population Studies. Regional Workshop on Techniques of Analysis of World Fertility Survey data: report and selected papers. New York, UN, 1979. 15-36. (Asian Population Studies Series No. 44)The World Fertility Survey provides data from national maternity history inquiries. Detecting trends and differentials is only as accurate as the data collected. Where evidence suggests error, the analysis may be restricted to obtaining only a measure of fertility level. The basic data is the date and order of birth of each live born child for a sample of women in the reproductive period, according to the current age of the women and their duration of marriage. The cohort marker is usually separated into 7 5-year classes determined by age at interview; sample of women is representative of the female population of childbearing age. Total births for each cohort are allocated to different periods preceding the survey date. Reading down the columns gives the births to different cohorts over different ranges in the same time interval preceding the survey. To detect omissions, check the overall sex ratio and the sex ratios by periods; examine the trends of infant mortality by cohorts and periods; an excess of male mortality over female indicates poor reporting of dead female children and/or of sex (a common omission). From data on age of mother and number of surviving children at the survey and estimates of mortality level, the numbers of births at preceding periods may be calculated.
New York, UN, 1979. 279 p. (Population studies No. 62)This report was prepared by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat on the basis of inputs by the Division, the International Labour Organisation, the Food and Agriculture Organization of the UN, the UN Educational, Scientific and Cultural Organization, and the World Health Organization. Tables are presented for sex compositions of populations; demographic variables; percentage rates of change of unstandardized maternal mortality rates and ratios; population enumerated in the United States and born in Latin America; urban and rural population, annual rates of growth, and percentage of urban in total population, the world, the more developed and the less developed regions, 1950-75; crude death rates, by rural and urban residence, selected more developed countries; childhood mortality rates, age 1-4 years; and many others. The world population amounted to nearly 4 billion in 1975, a 60% increase over the 1950 population of 2.5 billion. The global increase is about 2%. The average death rate in developing areas has dropped from 25/1000 in 1950 to about 15/1000, a 40% decline. Estimates of birth rates in developing countries are 40-45 for 1950 and 35-40/1000 for 1975. Most of the shifts in vital trends in the less developed regions are still at an early stage or of limited geographical scope.
World Health Organization, Technical Report Series.. 1970; 50.Add to my documents.
In: Mishell, D.R., Jr., and Martinez-Manautou, J., eds. Clinical experience with the progesterone uterine therapeutic system. (Proceedings of the Acapulco Workshop, Acapulco, Mexico, October 15-16, 1976.) Princeton, New Jersey, Excerpta Medica, 1978. p. 13-17There were 7323 first insertions, and 4177 subsequent insertions of the Progestasert intrauterine progesterone contraceptive (IPCS) in women all over the world. To obtain a diversity of testing situations private and public clinics were employed to evaluate the contraceptive efficiency and acceptability of the IPCS. 75% of patients were parous, and average exposure was 10 months. Portions of the study were monitored by WHO and by international and indigenous pharmaceutical companies. Results from the study suggest that consistency in pregnancy rate and in expulsion rates have been established. Removals are more likely to be cultural than physiological in nature. Up to now there are no indications that unforeseen complications due to the IPCS might be occurring.
[Unpublished] 1977 Jun. 169 p.Population and development policy decisions must be based on accurate demographic data in order to correctly formulate priorities in budgets and expenditures. Family planning as a public policy cannot be imposed upon private citizens; it must be freely chosen. The question remains: what determines fertility in the private sector and what can government do to align policy with performance? Research and analysis is needed to develop policy in keeping with local customs, standards, and individual sensibilities. Should more money be spent on education, health care, or development? Research from poor countries is spotty and disorganized. More money is spent on reduction of infant mortality than on family planning. Fertility control is still a controversial subject. Funds supplied for population and health are barely matched by many developing countries whose priorities lean toward agriculture and nutrition. In Haiti the 5-year development plan ignores the interactions between population growth and economic development. If the current level of fertility continues, it will act as a deterrent to development. A population impact analysis of El Salvador examines the effect AID policies and programs have on fertility control. Implementation of a policy in its first stages is described for Guatemala. Family models and global models show touchpoints where public policy might interface with private practice. Rural development implies increased production, equal opportunities, and a low fertility rate. All 3 are interrelated and affected by demographic events. Rising incomes, below a threshold level, has increased the fertility rate among the very poor.
(Description of the World Health Organization Special Programme of Research, Development, and Research Training in Human Reproduction.) (Statement, May 2, 1978))
In: United States. Congress. House of Representatives. Select Committee on Population. Population and development: research in population development: needs and capacities. Vol. 3. Hearings, May 2-4, 1978. Washington, D.C., U.S. Government Printing Office, 1978. p. 213-286The World Health Organization's Special Programme of research, Development, and Research Training in Human Reproduction is supported by 150 member governments spending over 15 million dollars on 5 specific areas of research: 1) effectiveness of existing birth control methods; 2) development of new methods; 3) psychosocial factors and health service delivery; 4) health rationale for family planning; and 5) infertility. A primary goal of the program is to strengthen fertility research within the developing country. Some results of WHO research on specific contraceptive practices found the following. Depo-Provera was frequently discontinued because the amenorrhea percentage over 90 days increased from 13% to 35% during the 4th injection interval. Male contraceptives are acceptable to 50% of men in Fiji, India, Korea, Mexico and the United States with a daily pill more desirable than a monthly injection. A majority of women believe that menstruation is the removal of impure blood, and that intercourse should not occur at that time.
New York, International Planned Parenthood Federation, Western Hemisphere Region, September 1975. 149 pThe primary focus in this 4th edition in the series of annual "overviews" of the contraceptive services in the Western Hemisphere Region of the International Planned Parenthood Federation is on clinical facilities, medical and paramedical services, and on the delivery of contraceptive methods by family planning programs. Family planning services link information on methods for spacing or limiting children to their availability, and they provide education on the advantages of contracepting. They seek to motivate acceptors to continue their chosen method. Counseling and information and education activities, although an integral component of family planning programs, are not included among the topics considered in the "Overview." In the Western Hemisphere Region, the most notable innovation has involved the community-based distribution of contraceptives (CBD), and for the 1st time, non-clinical distribution of contraceptives by associations in the region is a part of the "Overview." The Annual Reports submitted by IPPF affiliates and published and unpublished data from other programs are the primary sources of statistics for this report. Information for 1973 encompassed 29 associations related to IPPF and 4 other programs, and for 1974, 28 associations and 5 other programs could be covered. As for clinical input of family planning programs, the affiliates reported to the Regional Office of IPPF the number and types of clinics, weekly session hours, hours of medical and paramedical personnel. Data on the output of clinical activities of family planning programs for the calendar year were limited to 1st visits or new acceptors by methods, 1st revisits of the year or continuing (old) acceptors by method, number of revisits by old and new acceptors by method, demographic characteristics of new acceptors by method, and voluntary male and female sterilization performed or referred. Data on contraceptive services and clinical activities are summarized and presented in the form of tables.
New York, International Planned Parenthood Federation, Western Hemisphere Region, Medical Division, September 1975. 49 pThis is a compilation of family planning services provided by associations operating in the Western Hemisphere Region. Separate tables are compiled for 1973 and 1974. A list of each family planning program included in the study is appended to the report. The report does not guarantee the completeness or accuracy of the data; problems with reliability of data point up the necessity for a system of standardized record-keeping. Tables cover program input in the form of clinical facilities, medical and paramedical services, and the delivery of contraceptive methods by family planning programs and community-based distribution systems. Charts on program output include information on acceptor characteristics, numbers of new and continuing acceptors, numbers of voluntary sterilizations, and percentages of other methods in use.
Honolulu, Hawaii. 1974. n.p.A series of charts produced by Hawaii Planned Parenthood, Inc., provide statistical data on the numbers of minors given contraceptive assistance and counseling by 15 Planned Parenthood clinics. Information provided by the charts includes: 1) Patient characteristics; 2) Method of contact preferred by the patients; 3) Contraceptive methods, past and present; 4) Levels of education; 5) Family size and income of patients; 6) Numbers of fetal deaths and live births; 7) Patients' marital status; 8) Clinic medical services; 9) Patient load by clinic, age, and length of residence in Hawaii; 10) Welfare status of patients; and 11) Reasons given by patients for and against the practice of contraception.
Singapore, 1972 (xi). 60 pThis report presents a detailed analysis of the demographic situation in Singapore, tracing trends in birthrates, fertility rates, and population growth. Family planning services available during 1970 are thoroughly explored, including their funding, birth control methods, and organization and administration. Detailed analyses are given of acceptors of birth control methods by method accepted as well as by acceptor characteristics such as age, parity, education, and race. The Family Planning and Population Board recruited 162,485 acceptors between 1966 and 1970. During that period there was a dramatic decline in the crude birthrate, which was 28.6/1000 in 1966 and 22.1/1000 in 1970. Fertility continued to decline in all age groups and in all ethnic groups during 1970.
In: Diczfalusy, E. and Borel, U., eds. Control of human fertility. Proceedings of the Fifteenth Nobel Symposium, Sodergarn, Lidingo, Sweden, May 27-29, 1970. New York, Wiley, 1971. 39-51.A drug delivery system providing for a controlled release of progestogen and affecting ovulation and steroidogenesis minimally would deal effectively with some of the problems associated with contraception. 2 systems being developed which fit these criteria are the primary topics of discourse in this article. In 1 system an implant consists of a polymer membrane of polydimethylsiloxane (PDS) and contains the progestogen in crystalline form. Major problems with the PDS implants include a lack of intraindividual constance of release and interindividual variation in the slope of the decay in release. In the second system the implant consists of a lipid-steroid membrane containing a steroid. In this implant the concentration of the steroid in the membrane and the nature of the lipid phase may be important in determining the pattern of release. In vivo metabolic studies with lipid-steroid pellets are limited, but the patterns of output may be similar to those seen with PDS implants. Because of rate problems, a shorter regime slow-release implant seems more feasible than a longer lasting system. Surgical difficulties associated with the implantation and removal of the PDS implant make the choice of a lipid-steroid micropellet preparation more feasible for a short-term regimen. The discussion, following the main body of the article, focuses primarily on problems associated with implants.
Boulder, Colorado, Westview, 1982. 262 p. (Westview Special Studies on Women in Contemporary Society)This book provides a descriptive analysis of the historical, cultural, and environmental causes of women's current status in rural Asia. This analysis is requisite to improving the quality of these women's lives and enabling them to contribute to the economy without excessive disruption of family life and the social structure of the rural communities. Many studies of rural areas have ignored this half of the population. Analyzed in detail are social and economic status, family and workforce roles, and quality of life of women in the rural sectors of monsoonal and equatorial Asia, from Pakistan to Japan, where life often is characterized by unemployment, underemployment, and poverty. It has become increasingly necessary for rural women in this region to contribute to family budgets in ways beyond their traditional roles in crop production and animal husbandry. Many women are responding by taking part in rural industries, yet the considerable disadvantages under which they labor--less opportunity for education, lower pay, and poor access to resources and high status jobs--render them much less effective than they could be in their efforts to increase production and reduce poverty. A review of the activities of national and international agencies in relation to the status of women is also included, as well as an outline of major needs, and current indicators of change.
[Unpublished] 1983. Presented at the International Conference on Population, 1984, Expert Group on Fertility and Family, New Delhi, January 5-11, 1983. 22 p. (IESA/P/ICP. 1984/EG.I/8)The World Health Organization (WHO) has been studying several national surveys with regard to certain health related aspects of fertility. The primary purpose of these studies was to stimulate the use of data by the national health authorities for an improved care system for maternal and child health, including family planning. Some preliminary results are reported in this discussion, in particular those relating to contraception, the reproductive health of adolescents, infertility and subfecundity, and breastfeeding. The national surveys concerned are those of Bangladesh, Indonesia, the Republic of Korea, the Philippines, and Sri Lanka. The methods of analysis were simple and traditional, except for 2 points: some of the data had to be obtained by additional tabulation of the raw data tapes and/or the recode tapes since the standard tabulations of the First Country Reports did not include the needed information; and Correspondence Analysis was used in an effort to stimulate and facilitate the use of the findings for improvements of national health programs. Methods of contraception vary widely, from 1 country to another and by age, parity, and socioeconomic grouping. The younger women tend to choose more effective modern methods, such as oral contraception (OC); the older women, i.e., those over age 35, tend to seek sterilization, if available. It is evident that the historical development of family planning methods has greatly influenced the current "mix" of methods and so has the current supply situation and the capacity of the health care system (particularly in regard to IUD insertions and sterilizations. Use of contraception among adolescents to postpone the 1st birth was practically unknown. The risk of complications at pregnancy and childbirth, including maternal and infant death, is known to be particularly high for young mothers, and the results clearly showed that the infant mortality rate is highest for the youngest mothers. All the women who suffer from infertility do not recognize their condition, but the limited data still point to the need to consider the health needs of women who suffer from unwanted fecundity impairments. This may require medical intervention to cure infections or the offer of relevant sexual counseling. Some infecundity may require the improvement of nutritional and personal hygienic levels before meaningful achievements are made. The prevalence of breastfeeding has declined in some population groups, and the consequences can be expected to be deleterious and to involve serious increases in specific morbidity and mortality.