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Contraception. 2011 Oct; 84(4):339-41.This editorial focuses on a strategy to expand contraceptive coverage through the development of a numerical International Statistical Classifications of Diseases (ICD) code for "unwanted fertility." It explains how this strategy would work, how to make the strategy happen through a revision process, and defining unwanted fertility as a medical problem. Copyright © 2011 Elsevier Inc. All rights reserved.
International Journal of Gynaecology and Obstetrics. 2010 Jul; 110 Suppl:S17-9.Unsafe abortion is a recognized public health problem that contributes significantly to maternal mortality. At least 13% of maternal mortality is caused by unsafe abortion, mostly in poor and marginalized women. The International Federation of Gynecology and Obstetrics (FIGO) launched an initiative in 2007 to prevent unsafe abortion and its consequences, building on its work on other major causes of maternal mortality. A Working Group was identified with collaborators from many international organizations and terms of reference provided direction from the FIGO Executive Board as to possible evidence-based interventions. A total of 54 member associations of FIGO, representing almost half its member societies, requested participation in the initiative, with 43 subsequently producing action plans that are country specific and involve the national government and multiple collaborators. Obstetrician/gynecologists have demonstrated the importance of the initiative by an unprecedented level of engagement in efforts to reduce maternal mortality and morbidity in country and by sharing experiences regionally. (c) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Kyiv, Ukraine, UNICEF, 2007. 100 p.The aim of this review is to document the experience of PMTCT in Ukraine to date, highlighting the strengths and weaknesses of lessons learned within the current PMTCT programme. The report is structured around the four pillars of PMTCT: primary prevention of HIV infection within the context of MTCT; prevention of unintended pregnancies among HIV positive women; prevention of transmission from HIV positive women to their child; providing care and support to HIV positive women, their infants and their family. Since the initiation of the first national PMTCT programme in Ukraine in 2001, Ukraine has made substantial progress towards prevention of HIV infection in infants. Evaluation of the first programme in 2003 by a national and international team, including WHO and UNICEF, allowed consolidation of effort and the development of the next phase of the PMTCT programme. Furthermore, the findings facilitated the development of 'The Strategic Framework for the Prevention of HIV Infection in Infants in Europe' (2004). This outlined strategies for the implementation of the prevention of HIV infection in infants at a national level, with the aim of achieving the Dublin Declaration PMTCT goals. (excerpt)
Reproductive Health Matters. 2006 Nov; 14(28):179.The female condom has been on the market for over ten years but despite a clear need it has not yet been adopted for wider use. In 2005 only 14 million female condoms were distributed compared to 6-9 billion male condoms around the world. However, studies in many countries have shown that the female condom is well accepted among both women and men, and that there is demand for it. One of the problems in achieving its widespread distribution in national programmes has been its cost. In an effort to address the problem of cost, the Female Health Company has developed a second generation female condom, FC2. This new version of the female condom has similar physical characteristics to the original female condom but is made of synthetic nitrile utilising a manufacturing process which allows greater efficiencies, particularly at higher volumes. The new device has been shown in studies to be equivalent to the original female condom and has the potential for wider acceptability and utilisation since it is expected to be more affordable for individuals and programmes. (excerpt)
Reproductive health emergency assistance - United Nations Population Fund airlift to Eritrea - Brief article.
UN Chronicle. 2000 Summer; 37(2): p..The United Nations Population Fund (UNFPA) on 22 June began airlifting life-saving motherhood and reproductive health supplies to help Eritreans displaced by the recent fighting with Ethiopia. UNFPA's emergency assistance, including home delivery kits and tools for blood transfusions, will help reduce maternal and child deaths and unwanted pregnancies for some 450,000 displaced persons for about three months. The reproductive health kit was first used in the Great Lakes region of Africa in 1996. Since then, UNFPA has responded to emergencies in 33 countries and territories. (excerpt)
Geneva, Switzerland, WHO, 1997.  p.Violence against women and girls is a major health and human rights issue. At least one in five of the world’s female population has been physically or sexually abused by a man or men at some time in their life. Many, including pregnant women and young girls, are subject to severe, sustained or repeated attacks. Worldwide, it has been estimated that violence against women is as serious a cause of death and incapacity among women of reproductive age as cancer, and a greater cause of ill-health than traffic accidents and malaria combined. The abuse of women is effectively condoned in almost every society of the world. Prosecution and conviction of men who beat or rape women or girls is rare when compared to numbers of assaults. Violence therefore operates as a means to maintain and reinforce women’s subordination. (excerpt)
New York, New York, Population Council, 2004 Apr. 40 p.Preventing unintended pregnancy among HIV-positive women through family planning services is one of the four cornerstones of a comprehensive program for prevention of mother-to-child HIV transmission (PMTCT). Reducing unintended pregnancies among HIV-positive women through family planning reduces the number of children potentially orphaned when parents die of AIDS-related illnesses. It also reduces HIV-positive women's vulnerability to morbidity and mortality related to pregnancy and lactation. In addition, family planning for both HIV-positive and -negative women safeguards their health by enabling them to space births. The global public health community––NGOs, governments, and international donors–– has mobilized to design and provide essential PMTCT services: voluntary counseling and testing (VCT), infant feeding counseling, outreach to communities and families, and a short course of antiretroviral therapy. In most cases, the implementation approach has been to incorporate PMTCT into services that already reach pregnant women and women of childbearing age: antenatal care, obstetrical care, and maternal/child health. Yet the complexity of introducing PMTCT into the real world—that is, existing health services in resource-poor settings—soon became clear. Population Council and its research partners have been addressing several key questions about PMTCT services and how well they function in field settings. This report reviews field experiences with the integration of family planning and PMTCT services. It is hoped that this review will provide evidence and information for developing effective strategies for appropriately promoting family planning within PMTCT programs. (excerpt)
Summary of evidence and research needs on the use of mifepristone in fertility regulation: consensus from the conference.
Contraception. 2003 Dec; 68(6):401-407.The conference on the use of mifepristone to reduce unwanted pregnancy, sponsored by the World Health Organization, Concept Foundation and the Rockefeller Foundation, took place in Bellagio, Italy, between 24 and 28 September 2001. The objective of the conference was to review the scientific information and to evaluate the use of mifepristone for emergency contraception, luteal contraception and menstrual induction. Mifepristone is highly effective for emergency contraception but its advantages and disadvantages in comparison with levonorgestrel need to be further studied. Data indicate that mifepristone alone or in combination with misoprostol has potential for occasional use for women seeking help following repeated unprotected intercourse and/or when the interval between intercourse and treatment is more then 120 h. Administration of mifepristone immediately after ovulation seems to be an effective contraceptive method. However, before it can be used commonly, there is a need for a simple and inexpensive method to identify the right time in the cycle. Once-a-month treatment with mifepristone and misoprostol at the expected time of menstruation is not a practical method due to bleeding irregularities and timing of treatment. Menstrual induction with mifepristone and a suitable prostaglandin analogue is highly effective. A randomized comparison with manual vacuum aspiration is, however, needed before it can be recommended for routine use. (author's)
The safety and feasibility of female condom reuse: report of a WHO consultation, 28-29 January 2002, Geneva.
Geneva, Switzerland, WHO, 2002. , 15 p.According to the recommendations of the first consultation, this second meeting (January 2002) was planned to review the resulting data and to develop further guidance on the safety of reuse of the female condom. The specific objectives and anticipated outcomes of this second consultation were to: Review the results and evaluate the implications of the recently completed microbiology and structural integrity experiments and the human use study; Develop a protocol or set of instructions for disinfecting and cleaning used female condoms safely; Outline future research areas and related issues for programme managers to consider when determining the balance of risks and benefits of female condom reuse in various contexts and settings. (excerpt)
Vadodara, India, Centre for Operations Research and Training [CORT], 2000.  p.Street children live and work in conditions that are not conducive for healthy development. They are exposed to the street subculture such as smoking, drug, alcohol and substance abuse, gambling, engaging in sexual activities or selling sex for survival. The few studies that exist on the sexual behaviour of street children show that these children are more prone to high-risk behaviour and are sexually active at an early age. Often such relationships start as abusive. The circumstances in which they live and work increase their vulnerability also to sexual exploitation and abuse and put them at a higher risk of unintended pregnancies, sexually transmitted infections and even HIV/AIDS. The problem is further compounded by the lack of access to reproductive health information and services. UNICEF, recognising the magnitude of the problem, has undertaken to promote programmes to reduce children's vulnerability to HIV/AIDS, to diminish its impact on children, families and community and to take care of orphans and people living with AIDS. The present study is a situation analysis of children and adolescents carried out CORT to inform programme planning. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], Special Programme of Research, Development and Research Training in Human Reproduction, 2001. 50,  p. (WHO/RHR/01.8)Since the late 1980s, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (“the Programme”)has supported a number of social science research initiatives on under-investigated areas of sexual and reproductive health care. Four of these initiatives,on the dynamics of contraceptive use, the determinants and consequences of induced abortion, sexual behaviour, and the role of men, also covered the needs and perceptions of young people. These four initiatives comprised 146 research projects and, of these, 34 studies in 20 countries in Africa, Asia, and Latin America addressed young people, including adolescents (aged 10-19 years) and youth (aged 15-24 years). Fieldwork for these case studies was conducted chiefly between 1992 and 1996. A summary review of the studies is now available from the Programme. The studies cover a variety of sociocultural settings. In some, premarital sexual activity is taboo, using contraception is forbidden among unmarried youth, and abortion is viewed as the only solution to premarital pregnancy among adolescents. In others, premarital pregnancy may be condoned and childbearing among unmarried women is not unknown. Most studies focus on unmarried youth. However, some focus on special groups such as pregnant young women or those who have terminated a pregnancy, young reproductive health seekers in general, or young clients of services for sexually transmitted infections (STIs). Many common themes emerge from these studies. In every setting, sexual activity begins during adolescence among many young people. Much of this activity is risky, contraceptive use is often erratic, and unwanted pregnancy and unsafe abortions are observed in many settings. Sexual relations may be forced. There are wide gender-based differences in sexual conduct, and in the ability to negotiate sexual activity and contraceptive use. Despite this, relatively few young people think they are at risk of disease or unwanted pregnancy. Awareness of safe sex practices seems to be superficial, and misinformation regarding the risks and consequences of unsafe sex is wide- spread. This paper reviews these and other findings, discusses their implications for policies and programmes, and highlights research gaps. For the sake of consistency, the term, youth,is used to refer to young people of all ages between 10 and 24. A number of recommendations are offered on the basis of the summary review of these case studies. These include programmatic recommendations to build negotiation skills, dispel misconceptions, counter sexual violence, involve young people in programme design, tailor fertility regulation services to meet young people’s needs, and communicate the message that every unprotected sexual act risks disease and unwanted pregnancy. The review suggests a need for more in-depth behavioural research on the perspectives and experiences of youth in different settings. It points to the need to study positive outcomes, in addition to risk assessment, and stresses that research should explore the ways in which gender roles and power imbalances affect life skills among youth and how social constraints make young women particularly vulnerable and unlikely to exercise choices relating to their sexual and reproductive lives. Research is also needed to document how young women can exercise greater autonomy. (excerpt)
Proposals for a population programme of action for Africa following from the recommendations of the 1974 World Population Conference.
n.p., U.N. Economic and Social Council, March 1975. 18 pAdd to my documents.
Joint WHO / UNAIDS / UNFPA policy statement: Dual protection against unwanted pregnancy and sexually transmitted infections, including HIV.
[Unpublished] 2000 Sep 29.  p.Family planning programs have made significant progress in the provision of contraception to reduce unwanted pregnancies. However, sexually transmitted infections (STIs), including HIV, continue to spread epidemically throughout the world, especially in developing countries. This includes the transmission of HIV from mother to child in pre and post-natal settings. Given this reality, prevention of these infections must be reinforced in the context of the provision of reproductive health and family planning services, and the concept of dual protection, i.e., protection against both unplanned pregnancy and STIs/HIV, must be greatly expanded. (excerpt)
Adolescence Education Newsletter. 2001 Dec; 4(2):11.In Mongolia, incidence of unwanted pregnancies and abortions remain high despite legislation of contraceptives, family planning (FP) programs, and adoption of UN Population Fund's (UNFPAs) reproductive health approach. A research paper by the National Centre for Health Development was produced in an effort to undertake policy and program decisions to reduce unwanted pregnancies and abortions in this country. Moreover, the paper provides a basis for a qualitative survey to be conducted by the Ministry of Health. The study analyzes and defines abortion levels and trends as well as the social and economic characteristics of women who undergo abortion. Furthermore, it serves as a guide to ongoing research on unwanted pregnancies and abortions among adolescents. Lastly, the study recommends strengthening of FP services, improving logistics and management services to ensure timely and adequate supply of contraceptives, provision of counseling for all women and the production of information, education, and communication materials.
Bulletin of the World Health Organization. 2001; 79(1):81-2.In October 2000, WHO launched a campaign urging country health authorities to tackle the heavy toll of unsafe pregnancies. The campaign has three targets: 1) to provide couples with greater access to safe contraception for the reduction of unwanted pregnancies through unsafe abortion; 2) to increase the proportion of births assisted by qualified health personnel; and 3) to ensure that more women have access to proper hospital care for complications of pregnancy. The WHO campaign will focus mainly on Africa and Asia, where the vast majority of maternal deaths occur. Ethiopia, Mauritania, Mozambique, Nigeria, Uganda, Indonesia, Lao People's Democratic Republic, Sudan, and Bolivia will participate in an initial pilot phase.
YOUR HEALTH DAILY. 1998 Apr 24;  p..This article highlights the acceptability of the female condom among countries in eastern and southern Africa. The meeting of the UN Joint Program on HIV/AIDS (UNAIDS) in Pretoria, South Africa on April 20-22, 1998, was devoted exclusively to the female condom and accelerating its use in developing countries. The results of the meeting were a unanimous decision from the 80 delegates of the 15 southern and eastern African countries to increase availability and accessibility of the female condom in the region. This decision was based on several studies conducted in the region, which revealed high acceptability of the female condom. Moreover, both men and women find female the condom to be satisfactory method of contraception and prevention of sexually transmitted diseases (STDs) and HIV. Furthermore, the UNAIDS has stated that female condom sales exceeded 4 million units in 1998 and that it is gaining recognition for its effectiveness. It has been reported that the female condom decreases the susceptibility to STDs by 34% compared with the use of the male condom. Thus, the female condom has been considered another method of dual protection and the only product controlled by a woman in the protection against STDs, HIV/AIDS, and unwanted pregnancy.
PROGRESS IN HUMAN REPRODUCTION RESEARCH. 1997; (41):1.20% of the world's population is aged 10-19 years. Annually, almost 15 million young women under age 20 become mothers. However, surveys in developing countries show that 20-60% of the pregnancies and births to women under age 20 are mistimed or unwanted. While later marriage age in many places has provoked a decline in birth rates among young women, levels of sexual relations before marriage are increasing. Such sexual behavior opens sexually active young women to the risks of unwanted pregnancies, unsafe abortion, and sexually transmitted diseases (STDs). Millions of young people become infected with STDs annually. Among all age groups in the US, young women aged 15-19 have the highest incidence of gonorrhea among females and young men aged 15-19 have the second highest incidence among males. At least half of all people infected with HIV are under age 25. The UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction (HRP) completed 9 studies in 1996 on adolescent reproductive health. 14 studies were completed before 1996, and 18 are still underway.
Washington, D.C., World Bank, Human Development Department, 1995. 11 p.The objectives of the World Bank's investments in reproductive health include: providing access to family planning; caring for women before, during, and after pregnancy; preventing sexually transmitted diseases (including HIV); preventing and treating cervical cancer; promoting the health of adolescents; and supporting positive health practices. The problems are widespread and serious. 1) Illness and death from unwanted pregnancies. Birth rates are still very high in much of the world, and one in five births is unwanted. Between 60,000 and 200,000 deaths from unsafe abortions occur annually, most in developing countries. 2) Illness and death from complications of pregnancies. One-third of the 200 million women who become pregnant each year experience complications and one in ten requires hospitalization. 3) Sexually transmitted diseases are a major cause of serious illness and death. 4) Illness and death from preventable cancers. Cervical cancer, which is preventable, causes 183,000 deaths a year. 5) Traditional practices harmful to health. 2 million young girls are subjected to circumcision and other forms of genital mutilation every year. The solutions are cost effective and feasible. 1) Value for money--for example, providing STD management and prenatal care services, or postpartum family planning and infant care reduces service delivery costs. 2) Cost effective interventions--quality family planning services can eliminate the health risks of unwanted pregnancies. 3) Benefits to the society--reproductive health is fundamental to improving human welfare, reducing poverty, and promoting economic growth. Over the past 25 years, the Bank has lent more than $2.5 billion to support reproductive health activities through more than 130 projects in nearly 70 countries. Research sponsored by the Bank and other institutions provides the analytical basis for policy and action. The Bank's Economic Development Institute organizes training activities that strengthen national capacities. The Bank supports collaboration among donor agencies and local nongovernmental organizations to improve the effectiveness of projects with reproductive health components.
SAFE MOTHERHOOD NEWSLETTER. 1994 Mar-Jun; (14):10.Recent studies conducted by the World Health Organization's Special Program of Research, Development, and Research Training in Human Reproduction reveal high rates of unwanted pregnancy and illegal abortion in selected developing countries. In a Colombian study, 30% of women undergoing illegal abortion could not explain why they became pregnant, 40% believed that a woman bears sole responsibility for contraception, and almost 50% did not know when the likelihood for conception was greatest. In a study of pharmacists and herb vendors in Mexico, only 35% of those in the former group and none of those in the latter group could describe the mechanism of action of modern contraceptives, despite the fact that they were frequently consulted about pregnancy prevention. 25% of abortion seekers in a Cuban study had used no contraceptive method and the abortion ratio was highest (2 for every live birth) among women under 20 years old. The majority of the unwanted pregnancies occurring to contraceptive users involves use of an IUD that is not appropriate for young, nulliparous women. Finally, a study conducted in Tanzania found that a third of illegal abortions involved women under 17 years of age. 90% of whom had no knowledge of a family planning method.
Paris, France, Centre International de l'Enfance, 1992. 96 p.The risk-taking and sexual experimentation norms of adolescence place adolescents at risk of AIDS and other sexually transmitted diseases of increasing prevalence. Young people experience high rates of unwanted pregnancy and unsafe abortion, and others prostitute themselves and/or are sexually abused by adults and/or peers. While it is imperative that the reproductive and sexual health needs of youths be addressed and met, most societies around the world fail to meet service demand. Moreover, adults typically fail to convey clear and unbiased messages to adolescents about sexuality. Adolescents need to be empowered to make their own decisions about their individual sexuality. Messages and care about sexuality should realistically endorse sex as a natural and enjoyable part of life. A 4-day workshop on youth and sexuality was jointly organized by the French Foundation International Children Center (CIE), the International Planned Parenthood Federation (IPPF), and the German Agency for Technical Cooperation (GTZ). It was held as a forum in which experiences from projects involving or addressing youths in various countries with different economic, cultural, and religious environments and in various settings could be shared and analyzed. It is hoped that workshops proceedings will ultimately help in the development of strategies to expand and improve services for youths worldwide. This publication of workshop proceedings includes abridged versions of the 14 papers presented, main issues addressed in the plenary and working group discussions, participant recommendations, and open questions which will require further research in the future. Youth, culture, and sexuality, baseline research, service delivery, sexuality education, evaluation, and policy issues of program development are considered, followed by a description of the organizations and a participant list. Authors may be contacted directly for additional information should the reader be so inclined. Furthermore, CIE, IPPF, and GTZ invite reader feedback on the publication.
NURSING STANDARD. 1992 Feb 12-18; 6(21):17.The UN Children's Fund (UNICEF) has demanded a radical change in the distribution of foreign aid to developing countries. A 10-point strategy for action has been generated to place priority on allocations to the basic needs of the poor for health, education, clean water supplies, and family planning (FP). The primary emphasis is on preventing unwanted births through responsible birth planning, which is the least expensive way to improve the quality of life. It is estimated that FP could prevent 50,000 illegal abortions; if all unwanted pregnancies were prevented, population growth would fall 30%. Another strategy emphasizes the role of nursing in hospitals in promoting breast feeding of newborns for the 1st 4-6 months of life. Powdered milk is considered inferior in quality and a primary contributor to diarrheal disease and death. The cause is attributed to overdilution of milk with unclean water in unsterile bottles. The estimate of lives saved if breast feeding was used exclusively is 1 million/year. Immunization is another strategy which during the 1980s saved 3 million lives. Another 2 million could be saved through expanded immunization in eastern and southern Africa in the 1990s; the target is 90% immunization in every district. The impact of vaccine preventable diseases on malnutrition and disability would also be reduced.
ZPG BACKGROUNDER. 1991 Oct; 1-4.During the 1990's 1.5 billion children will be born, more than in any other decade. 10% of them will not reach their 5th birthday. The causes of these deaths are contaminated drinking water, poor sanitation, common diseases, environmental pollution, and malnutrition. None of these are mysterious problems; the solution is only a matter of will. Even the US which ranks 6th in per capita gross national products suffers from these problems as it does not even make the top 10 in any significant measure of child welfare. The US ranks 18th in child mortality rates and 21st in < 5 mortality rates. In the US, 101 cities, containing 50% of the US population, have failed to meet Environmental Protection Agency standards for ground level ozone. Child labor is also an international problem that exists in the US as well. The average fine for a child labor violation is $170. In cases involving permanent injury or death to a child the average fine is only $750. Clearly even the US does not place a very high value on children. In every nation, including the US, family size is a very accurate predictor of child poverty, mortality, disease, and abuse. The more children there are in a family the more likely they are to be poor, get sick, be physically abused, or die. Families with 5 or more children are 3 times more likely to be poor than families with only 2 children. Child survival programs alone are hot as successful as a combined program of child survival and family planning. Thus family planning programs should be in place in every country that is currently having trouble keeping its children healthy, well fed, and prosperous. If every tax payer in the industrialized world contributed 1 penny a day, or US3.65 annually, to family planni ng assistance, there would be enough resources to ensure that all the children of the world would be wanted and cared for properly.
IPPF OPEN FILE. 1992 Jun; 1.On may 8, 1992, IPPF's Western Hemisphere Regional Office exhibited, at UN headquarters in New York City, 500,000 flowers representing the same number of women who die each year from pregnancy complications. Indeed 99% of these maternal deaths occurred in developing countries, especially Africa. 50 UN ambassadors and representatives attended this event which was endorsed by 40 health and development organizations. Film celebrity Lauren Hutton also attended to show her support. IPPF hoped this event would bring attention to the ongoing need to reduce unwanted pregnancy by providing family planning information and services. The Regional Director of IPPF noted that family planning is the most cost effective means to do so. The Regional Office's Programme Support Director also emphasized the need for trained birth attendants, emergency obstetric care, and proper nutrition. In 1990, the number of unwanted births was about 30 million. For each maternal death, 10-15 women are disabled during childbirth and 25 million pregnant women face serious childbirth complications. A World Bank study showed that if governments would invest just US$1.50/person/year to include prenatal care and family planning into primary health care programs, maternal deaths would fall considerably within 10 years. This amount had been invested during the last 15 years, IPPF would have only needed to display 167,000 flowers. If governments do not take action soon, IPPF will need to display 650,000 flowers in 2000. The Western Hemisphere Regional Office of IPPF has therefore established the Planned Motherhood Fund to expand and strengthen family planning and appropriate health services for women at highest risk of pregnancy-related death, especially teenagers and women in rural areas and urban slums.
NEW AFRICAN. 1991 Sep; (288):43-4.This article, which explains the severe need for family planning in Africa, serves as an introductory piece to a supplement dealing the problems faced by the medical community in dealing with the health of families in the continent. The articles in the supplement are written by medical staff workers of the Deutsche Gesellschaft fur Technische Zusammenarbeit (GTZ) GmbH, an agency of the German government designed to assist in the planning and execution of health development projects. As the article explains, Africa has the highest maternal mortality in the world, ranging anywhere from 400/100,000 live births to 1000/100,000 live births. The risk is greatest among very young or very old women. Maternal mortality rate among women aged 15-19 is twice that of women 20-24. And for girls under 15, the risk is 5x to 7x greater. The risk is also very high among women over 35. Furthermore, a high frequency of birth endangers the health of the mother and infant. Unwanted pregnancies often result in illegal abortions, which can cost the life of the mother. Many couples in Africa say that they would like to limit family size to 2 or 3 children. Also, knowledge of modern contraceptive methods runs as high as 80-90%. Yet most couples do not have access to family planning services, and in the instances when they do have access, services are often ill-equipped to handle the demand. In order to address these concerns, GTZ has supported family planning programs throughout Africa.
In: World population crisis: the United States response, by Phyllis T. Piotrow. New York, New York, Praeger, 1973. vii-ix. (Law and Population Book Series No. 4)In this article, George H. Bush, Jr., the US Representative to the UN, expresses his support for family planning and fertility control at both the national and international level. Long aware of birth control as a public policy issue, Bush recalls how in 1950 his father lost a US Senate race when his opponent disclosed that the elder Bush supported Planned Parenthood, a family planning organization. But the previously taboo subject of birth control now demands public discussion, says Bush. With a 2% annual increase, the world's population of 4 billion is increasing by 80 million every year. Higher birth rates in poor countries have widened the income gap between developed and developing countries. While a member of the US House of Representative during the 1960s, Bush faced such disturbing issues as famine, unwanted pregnancies, and poverty. Finding it ridiculous that clinics and hospitals were prohibited from discussing birth control, Bush and other members of the House Ways and Means Committee took the lead in Congress to make family planning available to all women. Bush also helped repeal a law barring the mailing of birth control information and birth control devices. And when he moved to the UN, Bush saw that though the population issue was high on the agenda, it lacked some of the urgency it deserved. But having planned the 1974 World Population Conference, the UN is ready to tackle the population problem. Individual choice and responsible government represent the framework within which individuals and organizations must work. This work will be difficult, considering the large number of countries, races, and religions around the world. But addressing the population problem may help resolve such issues as peace, prosperity, and individual rights.