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POPULI. 1992 Nov; 19(5):10-1.In 1989, 1st trimester abortions were made legal in Mongolia. A multiparty government was elected in July 1990 which encouraged of 4 or fewer children per family, it discouraged childbearing under 20 and over 35 years of age, and it encouraged modern contraception. Years of pronatalist policies contributed to maternal mortality rates of up to 420 for 100,000 live births in some regions. The maternal mortality rate plummeted to around 160 deaths for 100,000 live births in 1985-89, and subsequently to around 110/100,000 live births. However, by 1991 the rate rose to around 120/100,000 despite the fact that 9 in 10 deliveries take place in a hospital or health center. More than half of the country's population lives in the vast interior: women often bled to death following childbirth because of transportation problems. Because of previous pronatalist policies, the number of Mongolians more than doubled since 1960 and tripled since the 1930s to an estimated 2.1 million in 1991. 70% of Mongolians are <35 years of age, and this number is growing by about 2.8% per year. Postpartum hemorrhage is the most common cause of death, because half of the pregnant women have some degree of anaemia attributable to iron deficiency and frequent childbirth. The total fertility rate decreased from an average of 7.5 children per women in the 1970s to around 3.8 now the current (United Nations estimate is 4.7). The United Nations Population Fund has provided more than 90,000 intrauterine devices, 1.2 a million condoms, and limited quantities of contraceptive pills in addition to obstetric and gynecological equipment and training. At the same time, nearly half of the country's maternal rest homes have been closed. Some 86% of women work, and more than 7 in 10 doctors are women. The election of 3 women to the national legislature gives women 4% of 76 legislative seats, as compared to 2.4% in the earlier People's Great Hural.
WORLD HEALTH. 1991 Nov-Dec; 22.The experiences of Romania show that legal decrees will not deter a woman determined to end her pregnancy, and that it is easier to switch from illegal to legal abortion than it is to introduce the practice of modern contraception. On Christmas Day 1989, Romania abrogated a 1966 that banned abortion and all modern contraceptive methods. Through the 1966 law, the former regime had hoped to raise the birth rate, which at the time stood at 15.6/1000. Succeeding briefly, the law ultimately failed to its objective, since by 1985 the birth rate had fallen to the initial 1966 level. If year following the abrogation of the decree, 992,265 abortions were carried out, 92% of them legally. The number of abortions is expected to top 1 million in 1991. Maternal death due to abortion has fallen by more than 60%. Romania has also witnessed the establishment of the Society for Education in Contraception, a private family planning association. UN and donor assistance has begun to arrive in Romania. 20,000 women attended family planning clinics in 1990, a figure that increased to nearly 50,000 in 1991. Nonetheless, the case of Romania illustrates the complexities involved in introducing the practice of modern contraception. In addition to commitment from national authorities, setting up a program of modern contraception will require the following: convincing physicians and clients as to the superiority of contraception over abortion; ensuring the training of health professionals; developing public information programs; creating acceptable conditions for women to seek services; and making contraceptives available and affordable. In order to facilitate the transition from abortion to contraception, UNFPA and the WHO have initiated an emergency family planning program.
In: World population policies. Volume III. Oman to Zimbabwe, compiled by United Nations. Department of International Economic and Social Affairs. Population Division. New York, New York, United Nations, 1990. 46-9. (Population Studies No. 102/Add.2; ST/ESA/SER.A/102/Add.2)Romania's 1985 population of 22,725,000 is projected to grow to 25,745,000 by the year 2025. In 1985, 24.7% of the population was aged 0-14 years, while 14.4% were over the age of 60. 18.4% and 20.9% are projected to be in these respective age groups by the year 2025. The rate of natural increase will have declined from 5.6 to 1.7 over the period. Life expectancy should increase from 69.6 to 77.1 years, the crude death rate will increase from 10.2 to 10.4, while infant mortality will decline from 26.0 to 7.0. The fertility rate will decline over the period from 2.2 to 1.9, with a corresponding drop in the crude birth rate from 15.8 to 12.2. The 1978 contraceptive prevalence rate was 58.0, while the 1977 female mean age at 1st marriage was 21.1 years. Urban population will increase from 49.0% in 1985 to 60.9% overall by the year 2025. Population growth, mortality, international migration, and spatial distribution are considered to be acceptable by the government, while too low fertility is not. Romania has an explicit population policy. Fully-integrated in socioeconomic policy, it aims to increase population growth rates to achieve a target total population of 30 million by the year 2000. The government will encourage higher fertility, lower mortality, a consolidated family, an adjusted age structure, and affirm the role of women as active participants in social development. Population policy as it related to development objectives is discussed, followed by consideration of specific policies adopted and measures taken to address above-mentioned problematic demographic indicators. The status of women and population data systems are also explored.
[Unpublished] 1984 Jul. , 193 p.As of 1984, Lebanon had not yet formulated a clear and specific population policy because laws existed against contraception and political differences among the various ethnic groups also existed which culminated in a civil war. Nevertheless the government condoned the creation of the Lebanese Family Planning Association (LFPA) in August 1969 and its activities. The government also helped spread family planning through its own institutions such as the Ministry of Health and the Office of Social Development. Further some of LFPA's staff members have been part of the government itself. LFPA conducted a survey in June 1975 in Zahrani in rural south Lebanon and it showed that the people wished to limit their fertility, but could not since birth control was not available. Therefore LFPA established the 1st Community Based Family Planning Services Program in Zahrani which later spread to other villages. Wasitas (field workers) served as the major means of providing birth control and information to the women. They emphasized child spacing. The wasitas also served as a major adaptive and indigenous agent of social change and development. Initially they underwent intensive training lasting at least 1 week, but in 1979, LFPA hosted annual 1 month training sessions. The wasitas use of traditional communication methods resulted in not only an increase of contraceptive use, but also in meeting the elemental needs of the women for psychological comfort and self reliance. In some instances, however, some wasitas resorted to deception in encouraging the most uneducated women to use birth control because of strong incentives, e.g., the wasita received 50% of the money earned for the sale of each contraceptive. LFPA needed to reassess those measures which lead to possible encroachment of the dignity and freedom of choice of the women villagers.
WORLD WATCH. 1990 Sep-Oct; 3(5):29-34.In the early 1950s, the Soviet Union and several of its Eastern European satellites completed their transition from high to low fertility before the US and Western Europe. They did this even though there were not enough modern contraceptives available to meet the needs of its citizens. As late as 1990, the Soviet Union had no factories manufacturing modern contraceptives. A gynecologist in Poland described domestically produced oral contraceptives (OCs) as being good for horses, but not for humans. The Romanian government under Ceaucescu banned all contraceptives and safe abortion services. Therefore, women relied on abortion as their principal means of birth control, even in Catholic Poland. The legal abortion rates in the Soviet Union and Romania stood at 100/1000 (1985) and 91/1000 (1987) as compared to 18/1000 in Denmark and 13/1000 in France. All too often these abortion were prohibited and occurred under unsafe conditions giving rise to complications and death. Further, the lack of contraceptives in the region precipitated and increase in AIDS and other sexually transmitted diseases. On the other hand, abortion rates were minimalized in Czechoslovakia, East Germany, and Hungary due to the availability of modern contraceptives and reproductive health services. Hungary and East Germany even manufactured OCs. OC use in these 2 nations rated as among the world's highest. East Germany also treated infertility and sexually transmitted diseases. The region experienced a political opening in latecomer 1989. In 1989, IPPF gave approximately 15 million condoms and 3000 monthly OC packets to the Soviet Union to ease the transition. More international assistance for contraceptive supplies and equipment and training to modernize abortion practices is necessary.
In: Population perspectives. Statements by world leaders. Second edition, [compiled by] United Nations Fund for Population Activities [UNFPA]. New York, New York, UNFPA, 1985. 161-2.The government of the Ukrainian Soviet Socialist Republic deal with population policies on a scientific basis. Programs implemented provide for both material and spiritual well-being. The means of production are public owned ensuring an economic growth on par with the population. There is equality among men and women in education, pay and employment. The government provides for the well-being of its aged, war invalids and the families of those killed in battle. The population of the Ukraine increased significantly during the postwar era, due to high social and economic development. Of late, the government has seen to the improvement in the quality of life for its citizens. THe government of the Ukraine S.S.R. supports population programmes which encourage population growth in order to make the Republic more productive. In the coming years, the government looks to implement recommendations made in the World Plan of Action, 1984.
Impact of the Mexico City policy on family planning programs and reproductive health care in developing countries.
[Unpublished] 1988. 6,  p.Field interviews in 10 developing countries concerning response to the U.S. Mexico City policy--no USAID support of programs that counsel or support abortion--suggest that the policy is counter-productive. Access to safe medical abortion has been curtailed and associated contraceptive services have suffered. In some places even treatment of septic abortion has ceased, while in others, the rate of septic abortion cases is escalating. There is no evidence that total numbers of abortions are declining, as is the stated intention of the policy. Public information about abortion has suppressed, and epidemiological and biomedical research on abortion and related contraceptive methods have been curtailed. Hospital and library files have been expunged, and in 1 country, thousands of medical textbooks have been destroyed. This self-censorship appears to err on the side of caution, because of fear that whole programs will be closed down. Family planning assistance has been cut to large 3rd world countries and to organizations known for providing high quality services. Some nationals voiced the opinion that the U.S. has lost face as a reliable world power, and that the U.S. policy might undermine the world consensus on family planning. The new restrictions have increased the cost of family planning programs by requiring certification of sub-grantees on their lack of abortion-related activities. In countries where abortion is illegal but is increasingly provided by semi-autonomous private agencies, the policy is impossible for grantees to monitor.
In: Population perspectives. Statements by world leaders. Second edition, [compiled by] United Nations Fund for Population Activities [UNFPA]. New York, New York, UNFPA, 1985. 109-10.The fundamental concern of every society must be the right of people to work, to participate actively in productive and social life, and to improve their material and spiritual circumstances. This principle forms the basis of the population policy of the People's Republic of Mongolia. Toward this end, the government has carried out a cultural revolution to overcome the backwardness left behind by the previous feudal-theocratic regime and has created a modern system of health care, education, and social security based on the dynamic development of the country's economy. Among the country's goals for the year 2000 are a general plan for the development and deployment of labor and material resources; programs for food and agriculture, rational energy use, housing, and manpower allocation; and programs for scientific and technical progress. Increasing the size of the population remains a central focus of Mongolia's population policy. Imperialist economic policies and the consequent hunger, malnutrition, and poverty are the main obstacles to development in poor countries--not overpopulation. Despite successes in increasing life expectancy, improving school attendance rates, and increasing per capita income and social consumption, Mongolia has faced several problems in recent years. The increasingly young population has required large expenditures for social needs; in addition, industrialization and consequent urbanization have produced labor shortages in agriculture. The fact that the population is scattered over such a wide area creates obstacles for cultural and educational work. Mongolia is in full support of United Nations population activities aimed at removing obstacles to solving the problems of developing countries and views ensuring peace and security as a necessary 1st step.
In: Population perspectives. Statements by world leaders. Second edition, [compiled by] United Nations Fund for Population Activities [UNFPA]. New York, New York, UNFPA, 1985. 78-9.The Hungarian Government awards great importance to demographic issues. World population problems are inextricably linked to other vital issues such as peace, security, disarmament, protection of the natural environment, and energy resources. Each country must strive to achieve a demographic balance in harmony with social and economic progress. However, this goal can be achieved only under conditions of peace, disarmament and security, and cooperation among the world's nations. At the same time, the formulation and implementation of demographic policies is a sovereign right of each nation and there should be no outside interference in this process. Hungary, which seeks to adjust demographic measures to the constantly shifting demographic and socioeconomic situation, currently seeks to continue to moderate its population decline until it is curbed. Other goals are to improve and stabilize the age composition of the population, improve health conditions, and increase family stability.
New York, New York, PPFA, 1987. 16 p.This brochure published by the Planned Parenthood Federation of America, (PPFA) tells the story of the dismemberment of the U.S. international family planning policy from 1961 to 1987. Official family planning policy began in the U.S. in 1961 with Kennedy's endorsement of contraceptive research. In 1968 Congress first allotted foreign aid funds for family planning. By 1973, the tide turned with Helms' amendment to the foreign assistance act prohibiting use of funds to support abortion. In 1983, USAID cut funds for the prestigious journal International Planning Perspectives, because the agency's review board chairman objected to an article on health damage of illegal abortion and mention of legal abortion. It took a court ruling to restore funds. In the same year, the Pathfinder Fund was pressured to accept the U.S. policy articulated in 1984 as the "Mexico City Policy." This ideology states that the U.S. would no longer support any program that performs, advocates, refers or counsels women about abortion, even if those activities are legal and funded by non-U.S. sources. Next, USAID pulled support from the International Planned Parenthood Federation (IPPF). The U.S. has multiplied support for natural family planning 10-fold to $8 million, and permitted organizations to counsel clients in this method without offering conventional alternatives. In 1986, the U.S. dropped support for the U.N. Fund for Population Activities, claiming alleged Chinese compulsory abortions as a reason. The PPFA has sued for a reversal of the policy of withholding USAID funds from FPIA, the international division of PPFA. The main arguments are presented, along with a list of typical FPIA projects.
[Unpublished] 1987. 13,  p.Africa's colonial legacy is such that countries contain not only a multiplicity of nations and languages, but their governments operate on separate cultural and linguistic planes, remnants of colonial heritage, so that neighboring peoples often have closed borders. Another problem is poor demographic data, although some censuses, World Fertility Surveys, Demographic Sample Surveys and Contraceptive Prevalence Surveys have been done. About 470 million lived in the region in 1984, growing at 3% yearly, ranging from 1.9% in Burkina to 4.6% in Cote d'Ivoire. Unique in Africa, women are not only having 6 to 8.1 children, but they desire even larger families: Senegalese women have 6.7 children and want 8.8. This gloomy outlook is reflected in the recent history of family planning policy. Only Ghana, Kenya and Mauritius began family planning in the 1960s, and in Kenya the policy failed, since it was begun under colonial rule. 8 countries made up the African Regional Council for IPPF in 1971. At the Bucharest Population Conference in 1974, most African representatives, intellectuals and journalists held the rigid view that population was irrelevant for development. Delegates to the Kilimanjaro conference and the Second International Conference on Population, however, did espouse the importance of family planning for health and human rights. And the Inter-Parliamentary Union of Africa accepted the role of family planning in child survival and women's status. At the meeting in Mexico in 1984, 12 African nations joined the consensus of many developing countries that rapid population growth has adverse short-term implications on development. Another 11 countries allow family planning for health and human rights, and a few more accept it without stating a reason. Only 3 of 47 Sub-Saharan nations state pro-natalist policies, and none are actively against family planning.
[Ivory Coast: report of the Mission on Needs Assessment for Population Assistance] Cote d'Ivoire: rapport de Mission sur l'Evaluation des Besoins d'Aide en Matiere de Population.
New York, New York, UNFPA, 1984 Sep. viii, 57 p. (Report No. 69)Conclusions and recommendations are presented of the UN Fund for Population Activities (UNFPA) Mission which visited the Ivory Coast from February 20-March 15, 1983 to assess population assistance needs. Ivory Coast officials believe that the population, estimated at 8,034,000 in 1980, is insufficient given the country's economic needs. Its very rapid rate of growth is estimated at over 4.5%/year, of which 1.5% is due to foreign immigration. 42% of the population is urban. The country has undergone exceptional economic growth in the past 2 decades, and the per capita income is now estimated at over $US1000 annually. Social development does not seem to have kept pace, however, and the mortality rate of 15.4/1000 is that of a country with only 1/2 the per capital income. The 1981-85 Ivory Coast Plan proposes a change from a growth economy to a society in which individual and collective welfare is the supreme goal. Up to date data on the size, structure, and dynamics of the population will be needed to aid in preparation of the 1986-90 and 1991-95 plans. A 2nd national population census is planned for 1985. Until the present, rapid population growth had been considered a boon, but problems are arising of massive rural exodus, high rates of urban unemployment coupled with manpower shortages in agriculture, and growing demographic pressure on health, educational, and social infrastructures, especially in the cities. The government has maintained its pronatalist stance, and government health programs have been directed only to mortality and maternal and child health. The need to control fertility and to use birth spacing as a tool to combat maternal and infant mortality is being increasingly felt, and a private family welfare association was able to form in 1979. A policy of maternal and child health encouraging spacing to improve family welfare would probably be welcomed in the Ivory Coast. The Mission recommended that a population policy be formulated which would correspond to the national demographic reality and development objectives. Basic demographic data collection should focus on the 1985 general census, which should have high priority. The civil registration system should be reorganized. A planned migration survey should cover the whole year to take into acconnt seasonal variations, but preparations should not begin until the census is completed. A multiple objective survey could be undertaken in 1988 to determine the nature and scope of interrelationships between demographic variables and economic and sociocultural variables, and a survey of infant mortality on a small sample could be done in 1989. The planned manpower and employment survey should be completed. Population research should receive high government priority. In regard to maternal and child health, the government should take an official position on the problem of birth spacing as a means of combatting maternal and infant deaths. IEC activities should be expanded, and efforts should be made to encourage the participation of women in development.
In: Population in the global arena; actors, values, policies, and futures, by Parker G. Marden, Terry L. McCoy and Dennis G. Hodgson. New York, N.Y., Holt, Rinehart and Winston, 1982. 37-59.Add to my documents.