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  1. 1
    Peer Reviewed

    Long-acting and permanent contraception: An international development, service delivery perspective.

    Jacobstein R

    Journal of Midwifery and Women's Health. 2007 Jul-Aug; 52(4):361-367.

    Recent scientific findings about long-acting and permanent methods of contraception underscore their safety, effectiveness, and wide eligibility for individuals who desire them. This has led to new guidance from the World Health Organization to inform national policies, guidelines, and standards for service delivery. Although developing countries have made much progress in expanding the availability and use of family planning services, the need for effective contraception in general (and long-acting and permanent methods in particular) is large and growing because the largest cohorts in human history are entering their reproductive years. More than half a billion people will use contraception in developing countries (excluding China) by 2015, an increase of 200 million over levels of use in 2000. The health, development, and equity rationales that historically have underpinned and energized the international family planning effort remain valid and relevant today. Despite the other compelling challenges faced by the international health community, the need to make family planning services more widely available is pressing and should remain a priority. (author's)
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  2. 2

    The last whole earth, do-or-die vasectomy initiative.

    [Unpublished] 1988 Oct 14. [3] p.

    This concept paper discusses an initiative planned for 1989-91 to redirect family planning (FP) program efforts so that vasectomy increasingly becomes of a method choice. The availability and acceptance of vasectomy is considerably less than for female sterilization. It is thought that the reason for the decline in numbers of vasectomy may be unfamiliarity with the method and lack of knowledge on the part of doctors of the best methods to use when performing vasectomies. Internationally, there has been concern about increasing the role of the male in FP. New developments such as increased vasectomy use in Africa and other unlikely countries suggest that this is an appropriate time to begin this initiative. The Chinese "no scalpel technique" has been recognized as having distinct advantages over other techniques. The WHO has produced a program and technical guide on vasectomy services for FP program managers. The objectives are 1) to introduce the Chinese method systematically through training activities; with the cooperation of the Chinese; 2) to set up demonstration projects in vasectomy services in several countries where vasectomy is not available; 3) to develop and conduct operations research projects on the best way of introducing vasectomy services; 4) to encourage clinical research on factors affecting safety, effectiveness, and satisfaction; 5) to promote dialogue on vasectomy at country and regional and international levels; and 6) to encourage donor agencies to become involved in the effort. The plan for action is to be implemented in 3 stages during a period of 3 years and is directed toward solving unanswered questions, which will be generated during an idea generation period. The approach will be multidisciplinary and will involve service and training programs, social science research, and clinical research. Other agencies must be involved. An international symposium will occur at the end of the period to relate and synthesize the experiences of the preceding 3 years. Phase I will generate ideas at, for instance, the World Fertility Rio meeting. Phase II will involve implementation, and phase III the analysis and synthesis of the experiences.
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