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  1. 1
    281129

    Examining changes in the status of women and gender as predictors of fertility change issues in intermediate-fertility countries.

    Cosio-Zavala ME

    In: Expert Group Meeting on Completing the Fertility Transition, New York, 11-14 March 2002, [compiled by] United Nations. Department of Economic and Social Affairs. Population Division. New York, New York, United Nations, Department of Economic and Social Affairs, Population Division, 2004. 91-103.

    The 1994 Cairo Conference on Population and Development (ICPD) focused attention on the role of women’s empowerment in influencing reproductive behavior. However, there is no complete agreement on how this concept should be defined and measured. Because women’s authority can be measured in different ways as well as reproductive attitudes or practices, results of empirical studies are different depending on the indicators used. This has been pointed by the discussion by Kritz and Makinwa-Adebusoye of a Mason and Smith’s article. This debate must be linked to the general debate over the causes and trends of fertility decline in developing countries. In this paper, we propose the introduction of a gender perspective in explaining fertility transitions, as a theoretical point of view that has been missing in the debate. Gender relations have an important role in explaining fertility behavior, a critical and neglected process in explaining fertility transitions. We also present some empirical findings in large intermediate fertility countries as Nigeria, Mexico and India. (excerpt)
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  2. 2
    181701

    It takes 2: partnering with men in reproductive and sexual health. UNFPA programme advisory note.

    Cohen SI; Burger M; Dairo AE; Mbugua W

    New York, New York, United Nations Population Fund [UNFPA], 2003. 46, 6 p. (UNFPA Programme Advisory Note)

    This document is intended to help UNFPA country staff plan national programmes, develop strategies and projects, review progress made, and assess the soundness of their strategies. It illustrates how one can increase men’s involvement in reproductive health issues through research, advocacy, behaviour change communication and education, policy dialogues and well-tailored and innovative reproductive health services. It starts by defining partnering with men and providing a rationale for this approach from the standpoint of the International Conference on Population and Development (ICPD). A framework for selecting essential elements of such a programme is then described. Examples are provided of ways in which UNFPA has supported a partnering approach, followed by a summary of lessons learned. A matrix of sample outputs and their indicators provides options for defining and measuring results. Additional resources are also provided for information on gender, masculinities, adolescent boys, education, services, working with special populations, and research on partnering with men. (excerpt)
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  3. 3
    181569

    Peer approach in adolescent reproductive health education: some lessons learned.

    UNESCO. Asia and Pacific Regional Bureau for Education. Regional Clearing House on Population Education and Communication

    Bangkok, Thailand, UNESCO, Asia and Pacific Regional Bureau for Education, 2003. ix, 69 p.

    This document focuses on what research says is the impact of peer education in promoting the necessary changes among adolescents in attitudes and behaviour with regard to reproductive and sexual health. There is an increasing effort in countries in the region and elsewhere to employ a peer approach in their adolescent programmes and activities to facilitate delivery of the message and acceptance. From these initiatives, experiences in the use of peer approach have grown which has in turn generated a number of materials that document key strategies and lessons learned. This particular booklet synthesises these experiences and shares lessons learned, as well as offering guidelines to enable policy makers and programme implementers to learn from others and possibly to adopt/adapt those strategies that will have the great at potential to succeed in their own setting. (excerpt)
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  4. 4
    030964

    The state of the world's women 1985: World Conference to Review and Appraise the Achievements of the United Nations Decade for Women, Equality, Development and Peace, Nairobi, Kenya, July 15-26, 1985.

    New Internationalist Publications

    [Unpublished] 1985. 19 p.

    This report, based on results of a questionnaire completed by 121 national governments as well as independent research by UN agencies, assesses the status of the world's women at the end of the UN Decade for Women in the areas of the family, agriculture, industrialization, health, education, and politics. Women are estimated to perform 2/3 of the world's work, receive 1/10 of its income and own less than 1/100 of its property. The findings revealed that women do almost all the world's domestic work, which combined with their additional work outside the home means that most women work a double day. Women grow about 1/2 the world's food but own very little land, have difficulty obtaining credit, and are overlooked by agricultural advisors and projects. Women constitute 1/3 of the world's official labor force but are concentrated in the lowest paid occupations and are more vulnerable to unemployment than men. Although there are signs that the wage gap is closing slightly, women still earn less than 3/4 of the wage of men doing similar work. Women provide more health care than do health services, and have been major beneficiaries of the global shift in priorities to primary health care. The average number of children desired by the world's women has dropped from 6 to 4 in 1 generation. Although a school enrollment boom is closing the gap between the sexes, women illiterates outnumber men by 3 to 2. 90% of countries now have organizations promoting the advancement of women, but women are still greatly underrepresented in national decision making because of their poorer educations, lack of confidence, and greater workload. The results repeatedly point to the major underlying cause of women's inequality: their domestic role of wife and mother, which consumes about 1/2 of their time and energy, is unpaid, and is undervalued. The emerging picture of the importance and magnitude of the roles women play in society has been reflected in growing concern for women among governments and the community at large, and is responsible for the positive achievements of the decade in better health care and more employment and educational opportunities. Equality for women will require that they have equal rights, responsibilities, and opportunities in every area of life.
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  5. 5
    137532

    Cairo Programme of Action: male participation.

    IPPF AND CAIRO PLUS 5. 1998 Oct; (5):1.

    Male awareness, involvement and responsibility are crucial for the well being and development of women. In most societies men still exercise a great deal of power, whether as policy makers in government or as decision makers within families. The International Conference on Population and Development (ICPD) held in Cairo in 1994 went further than any previous UN meeting in promoting gender quality and urging men's participation in making it a reality. Chapter 4 of the ICPD Programme of Action calls on governments and nongovernmental organizations (NGOs) to encourage and enable men to take responsibility for their sexual and reproductive behavior and for their social and family roles in order to ease the burden on women. It also urges increased efforts to involve men in family planning and responsible parenthood. (full text)
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  6. 6
    133211

    Behavior affects consistent use.

    Finger WR

    NETWORK. 1998 Spring; 18(3):22.

    Condoms must be used correctly and consistently in order to prevent sexually transmitted diseases (STDs) and pregnancy. However, consistent use demands sustained behavior patterns. In a project with International Planned Parenthood Federation affiliates in Brazil, Honduras, and Jamaica, the counseling of women has moved away from emphasizing contraceptive methods, side effects, and correct use, to the more broad context of women's sexuality and risk of STD infection as a means of promoting behavior change. Providers use a sexuality-based approach in which they confer with women about their current sex partners, past partners, whether their partners travel for work, whether they think their partners may have other sex partners, and how those factors relate to the risk of STD infection. The project has also aggressively taught men about STDs and condom use, and involves men in counseling. One study has found that people who choose condoms as their main contraceptive method need more counseling than people who use condoms as a backup method, since primary users may have underestimated the difficulty of using condoms at every act of sexual intercourse. Furthermore, counseling appears to increase condom use when it involves both men and women in a monogamous relationship.
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  7. 7
    100011

    Study identifies socio-cultural factors affecting demographic behaviour.

    POPULATION EDUCATION IN ASIA AND THE PACIFIC NEWSLETTER AND FORUM. 1994; (40):4-5.

    The United Nations Educational, Scientific, and Cultural Organization (UNESCO) is undertaking a project that will produce a state-of-the-art paper on sociocultural factors affecting demographic behavior. Particular emphasis will be placed on reproductive behavior in Africa, Asia, Latin America, and the Arab states region. The extent to which this information is incorporated in current population policies and programs will also be examined, and recommendations will be made. The factors to be studied include family and kinship structure; gender status and role; patterns of sexual relations and procreation in general and adolescent sexual behavior and fertility; religion, beliefs, customs, and traditions concerned with sexual relations and procreation; child rearing, socialization, and education; status and role of women; and sociocultural change, change agents, and influentials. The literature search will provide an inventory of methodologies. Guidelines on the use of the methodologies will be drafted for use by project personnel. These will later be tested in pilot studies in rural and urban communities in selected developing countries. The goal is to design programs that will accelerate contraceptive acceptance and sustain contraceptive practice by being sensitive to the sociocultural influences on the reproductive behavior of different subpopulations.
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  8. 8
    071357

    Patterns of fertility behaviour among female students at the University of Zambia.

    Munachonga M; Johnston T

    In: African research studies in population information, education and communication, compiled and edited by Tony Johnston, Aart de Zeeuw, and Waithira Gikonyo. Nairobi, Kenya, United Nations Population Fund [UNFPA], 1991. 83-100.

    Researchers studied 62 pregnant women intending to not terminate their pregnancy and to continue their studies and 27 nonpregnant women to learn about female student fertility related behavior. They were all enrolled at the University of Zambia either during the 1987-1988 or 1989-1990 academic years. Methodology consisted of interviews, questionnaires, and focus group discussions. 68% of all women were single with 40% of them having at least 1 child. 75% of the women were sexually active. 42.7% knew traditional family planning methods with friends, grandmothers, and social aunts telling 25.9% of all the women about such methods. Yet mass media provided most women (49.4%) with knowledge about modern methods. 50.6% thought the pill to be the most effective method. >65% considered the 24-26 as the ideal age at marriage. The mean ideal family size was 3.5, somewhat less than family size for urban women in Zambia. 71.9% considered children to be assets since children are a means to social security (33%), self fulfillment (8%), and companionship (7%). 94.4% approved of family planning mainly for purposes of child spacing (29.2%), limiting (23.6), and spacing and limiting (32.6%). Even though they knew about and approved of family planning and claimed modern attitudes concerning ideal age at marriage and ideal family size, 62% of single pregnant students and 59% of married pregnant students did not use or regularly use contraception. This suggested that they considered early childbearing to be an asset. The leading reasons for contraception nonuse included perception of low pregnancy risk (40%) and desire for a child (28%). Only 3.2% claimed method failure. 64% of all women said partners did not approve of contraceptive use. Access to family planning and cost were not a problem. Only 22% of pregnant students said pregnancy would reduce their chances of marriage. In conclusion, many women became pregnant surreptitiously.
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  9. 9
    069355

    Adolescence education. Social aspects. Module two.

    UNESCO. Principal Regional Office for Asia and the Pacific

    Bangkok, Thailand, Unesco Principal Regional Office for Asia and the Pacific, 1991. [2], 73 p. (Population Education Programme Service)

    The revised UNESCO secondary school teaching manual provides lessons on family life education. Materials are based on the those available from the Population Education Clearing House. 4 Modules cover various aspects of adolescence education: Module 1, Physical Aspects; Module 2, Social Aspects; Module 3, Sex Roles; and Module 4, Sexually Transmitted Diseases. This report on the Social Aspects begins with a general discussion of the program and conceptual framework for the adolescence education package. 6 lessons are included in this module. Lesson 2.1 is devoted to adolescent sexuality or sexual behavior. Each lesson has a set of objectives, time required, and materials, and usually has procedures, information sheet, and suggested activities outlines. Lesson 2.2 is concerned with sexuality in childhood and adolescence. Lesson 2.3 deals with love. Lesson 2.4 consists of dating and relationships. Lesson 2.5 provides information on adolescent pregnancy in terms of the growing number and the consequences of adolescent pregnancy and parenting in the premarital and marital states. The other objective is to explore individual feelings and attitudes about adolescent pregnancy and sexual behavior. Lesson 2.6 is on a moral code of ethics, their roles and function. An example of the information sheet on love is as follows: several paragraphs describe various aspects of love as sharing, caring, action, time and sacrifice, not always agreement, a relationship, the glue to hold families together, and so on. There are different types of love: love for parents, love among siblings, love for friends, conjugal love. Mature love is differentiated from immature love by the degree of caring about the other person as more important to you than having the other person care for you. Immature love is the reverse where one is more concerned with having the other person care about you and involves more taking than giving. Communication is sometimes blocked in order to avoid hurting the other's feelings, is directed to another instead of directly to one's partner, or is misdirected to a small action instead of focusing on the larger concern. Partners must conscientiously work on getting through to each other. Spontaneity and mutual confidence will develop as each becomes more comfortable with the other.
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  10. 10
    203807

    Reproduction and family planning in Ethiopian society: a survey of existing knowledge and possible application in MCH/FP services.

    Negussie B

    [Unpublished] 1986. 23 p.

    The mission makes an exploratory study of existing knowledge of reproduction and reproductive control in the social context of Ethiopian society. The bibliography to be generated by the mission will contain much material about reproductive questions and attitudes toward child spacing. This material continuously shows that children have a high value, and that they are considered as the most important natural resource that the country has. The bibliography will also cover family planning in Ethiopia. The report then identifies the different government bodies dealing with population or family planning, including sections of the Office of the National Committee for Central Planning, the Ministry of Education, the educational mass media, the University of Addis Ababa, the Ministry of Agriculture, the Ministry of Labour and Social Affairs, and several non-governmental organizations. These units, their current activities, and their future roles in population activities are discussed. In addition to all activities which are mentioned, there is a need to intensify the collaboration between different sectors which deal with health as a subject and with health education. One of the main goals of the mission was to recommend actions to be taken by the Swedish International Development Authority (SIDA) in support of the Ethiopian government and non-government institutions in order to improve the conditions for their work in maternal and child health and family planning services.
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  11. 11
    045281

    Progress in the development of once-a-month injectable contraceptives.

    World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction

    PROGRESS. 1987 May; (2):9.

    The World Health Organization's Task Force on Long-acting Systemic Agents for Fertility Regulation is currently investigating several injectable steroidal contraceptives with a duration of action from 1-6 months. Nearing completion is a large Phase III clinical trial involving 2 monthly injectable preparations (HRP 102 and HRP 112), both of which involve a synthetic preparation in combination with an estrogen. To date, 2300 women from 17 centers around the world have participated in this trial. Efficacy rates have been high, with no pregnancies occurring in the HRP 112 group and only 2 in the HRP 102 group. Discontinuation rates for reasons related to disturbances of bleeding patterns have been 6.4% for HRP 112 and 7.4% for HRP 102 at 12 months. Compared to progestogen-only injectable preparations, fewer women discontinued because of amenorrhea. The only drawback to these new preparations is that monthly visits to a health center are required. On the other hand, injections are viewed by women in many developing countries as an acceptable, highly effective means of delivering medicines.
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  12. 12
    041926

    Association for Voluntary Sterilization - Consultant Team. Trip report: the People's Republic of China, Beijing, Chongqing, Wuhan, Guangzhou, June 19-30, 1985.

    Huber D; Fathalla M; Gojaseni P; Goldstein M; Lippes J; Minor K; Rauff M; Sciarra J; Rauff A

    [Unpublished] 1985. 41, [6] p.

    The Association for Voluntary Sterilization consultant team visited Beijing, Chongqing, Wuhan and Guangzhou, China in June 1985, to review innovative nonsurgical methods of male and female sterilization. There are 2 variations on vasectomy, performed with special clamps that obviate a surgical incision. The 1st is a circular clamp for grasping the vas through the skin, and the 2nd is a small, curved, sharp hemostat for puncturing the skin and the vas sheath, used for ligation. Vas occlusion with 0.02 ml of a solution of phenol and cyanoacrylate has been performed on 500,000 men since 1972. The procedure is done under local anesthesia, and is controlled by injecting red and blue dye on contralateral sides. If urine is not brown, vasectomy by ligature is performed. The wound is closed with gauze only. Semen analysis is not done, but patients are advised to use contraception for the 1st 10 ejaculations. Pregnancy rates after vasectomy by percutaneous injection were reported as 0 in 5 groups of several hundred men each, 11.4% in 1 group and 2.4% in another group. The total complication rate after vasectomy by clamping was 1.8% in 121,000 men. 422 medical school graduates with surgical training have been certified in this vasectomy method. Chinese men are pleased with this method because it avoids surgery by knife, and asepsis, anesthesia and counseling are excellent. Female sterilization by blind transcervical delivery of a phenol-quinacrine mixture has been done on 200,000 women since 1970 by research teams in Guangzhou and Shanghai. A metal cannula is inserted into the tubal opening, tested for position by an injection of saline, and 0.1-0.12 ml of sclerosing solution is instilled. Correct placement is verified by x-ray, an IUD is inserted, and after 3 months a repeat hysteroscopy is done to test uterine pressure. Pregnancy rates have been 1-2.5%, generally in the 1st 2 years. Although this technique is tedious, requiring great skill and patient cooperation, it can be mastered by paramedicals. The WHO is assisting the Chinese on setting up large studies on safety and effectiveness, as well as toxicology studies needed, to export the methods to other countries.
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  13. 13
    202588

    Background paper on 1985 annual country review of GOB/UNFPA collaboration in Bangladesh.

    United Nations Fund for Population Activities [UNFPA]

    Dhaka, Bangladesh, United Nations Fund for Population Activities, 1986. [v], 36, [1] p.

    Annual country Reviews (ACR) are held each year in countries where the UN Fund for Population Activities (UNFPA) has a major program of assistance. The objective of the ACR is to review the UNFPA-sponsored program in its entirety in relation to the country's population and development program. This background paper for the ACR contains summary information and comments on Bangladesh's national program and the UNFPA program. Outlines of the Family Planning projects that came to an end in 1985 follow. Finally the paper contains descriptions of the projects planned to make up UNFPA's Third Country Program under the Governments Third FIve Year Plan. Specific data on population growth in Bangladesh, contraceptive performance, and targets as provided by the government as well as data on project allocations and expenditures are included in annexes to the paper.
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  14. 14
    045568

    Sexuality and family planning: report of a consultation and research findings.

    Langfeldt T; Porter M

    Copenhagen, Denmark, World Health Organization, Regional Office for Europe, 1986. 62 p.

    A Consultation on Sexuality was convened by the Regional Office for Europe of the World Health Organization (WHO) in Copenhagen in November 1983 to examine the sexual dimensions of health problems. Sexuality influences thoughts, feelings, actions, and interactions and thus physical and mental health. Since health is a fundamental human right, so must sexual health also be a basic human right. 3 basic elements of sexual health were identified: 1) a capacity to enjoy and control sexual and reproductive behavior in accordance with social and personal ethics; 2) freedom from fear, shame, guilt, false beliefs, and other psychological factors inhibiting sexual response and impairing sexual relationships; and 3) freedom from organic disorders, diseases, and deficiencies that interfere with sexual and reproductive functions. The purpose of sexual health care should be the enhancement of life and personal relationships, not only counseling or care related to procreation and sexually transmitted diseases. Barriers to sexual health include myths and taboos, sexual stereotypes, and changing social conditions. In addition, sexuality is repressed among groups such as the mentally handicapped, the physically disabled, the elderly, and those in institutions whose sexual needs are not acknowledged. Homosexuals are often stigmatized because their sexual expression is at variance with dominant cultural values. Sex education programs and health workers must broaden their traditional approach to sexual health so they can help people to plan and achieve their own goals. Family planning programs must expand from their traditional goal of avoiding unwanted births and help people balance the need for rational planning on the one hand and the satisfaction of irrational sexual desires on the other hand. Promoting sexual health is an integral part of the promotion of health for all.
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  15. 15
    044483

    Evaluation of Village Family Planning Program, USAID Indonesia Project: 497-0327, 1983-1986.

    Bair WD; Astawa IB; Siregar KN; Sudarmadi D

    Arlington, Virginia, International Science and Technology Insitute, Population Technical Assistance Project, 1987 Jul 15. ix, 66, [41] p. (Report No. 86-099-056)

    This evaluation of the village family planning program in Indonesia is prepared for USAID, which has supported the program for 15 years, and is to complete support in 1986. It is in general a positive evaluation, prepared by interviews, and visits to 7 out of 27 Provinces, 14 out of 246 Kabupatens (Districts), and 16 Villages. Village distribution centers have increased 38%, new acceptors by 38%, continuing user levels by 57%, and overall contraceptive prevalence by 38%. Access to varieties of contraceptives, especially longer acting methods, has improved, and costs per capita have decreased. Some problems were pointed out, generating several recommendations: physical conditions of the clinics need attention; motivation by consciousness raising has not been matched by better knowledge; the surgical program needs to be expanded; self-sufficiency in cost recovery should be fostered; operations research is needed on payment for field workers and volunteers; and social marketing should be expanded. USAID should continue support for the Outer Islands. In a final list of recommendations were the suggestions that USAID assist clinical programs further, support training of field workers, do more statistical review, continue to support the IEC program, operations research on community-based distribution, and program integration.
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  16. 16
    045078

    World contraceptive use. [Wallchart].

    United Nations. Department of International Economic and Social Affairs. Population Division

    [New York, New York], United Nations, 1987. [1] p.

    This wall chart, prepared by the United Nations, presents data on current contraceptive use among currently married women of reproductive age. The chart reflects the most recent data available as of May 1987. Information about contraceptive use was obtained largely from representative national sample surveys conducted by various governmental, intergovernmental, and nongovernmental agencies. The table that forms the bulk of this chart shows the total fertility rate and data on current contraceptive use for less developed countries in Africa, Asia and Oceania, and Latin America as well as in more developed regions. Pie charts graphically depict the contraceptive mix in the world and in various regions. In the less developed world regions, the total fertility rate averaged 4.1 in 1980-85 and 45% of married women of reproductive age were using contraception. The contraceptive mix in less developed regions was as follows: female sterilization, 15%; male sterilization, 5% ; oral contraceptives, 6%; IUD, 10%, condoms, 3%; other supply methods, 1%; and non-supply methods, 5%. In the more developed regions, the total fertility rate averaged 2.0 in 1980-85 and 70% of women of reproductive age were using a method of fertility control. The contraceptive mix was: female sterilization, 7%; male sterilization, 4%; oral contraceptives, 13%; IUD, 6%; condom, 13%; other supply methods, 2%; and nonsupply methods, 25%.
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  17. 17
    269805

    Field studies in human reproduction.

    Kessler A

    [Unpublished] 1968 Dec. 5 p. (HR/FS/68.5)

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  18. 18
    044837

    The importance of voluntarism.

    Sadik N

    POPULI. 1986; 13(4):14-22.

    The United Nations Fund for Population Activities (UNFPA) and other concerned parties in the field of development see family planning as a vital and inherent part of development planning. In almost all countries, there exists a large proportion of women, particularly women in rural areas, whose need for access to family planning remains unmet. The UNFPA has supported efforts for the acceptability and adoption of voluntary family planning in 122 developing countries. For family planning programs to succeed, they must be responsive to the needs of the people and must win understanding and support. Uncontrolled, unwanted female fertility prevents women from being able to participate more fully in the development process of their communities and societies. To make a free and informed decision on family planning a woman must be aware of the powerful influence that her own fertility exerts on the family health and welfare. Inducements to reduce fertility range in degree of voluntarism from those that allow complete free choice to those that seem to place quite strong pressures on individuals. Governments have the responsibility to protect the interests of both individuals and society as a whole. Despite the problems that are faced in defining what specifically constitutes voluntarism, there is widespread agreement that couples' rights of choice should not be compromised.
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  19. 19
    249872

    The International Population Conference: a personal perspective

    Papps TO

    New Zealand Population Review. 1985 Oct; 11(3):196-208.

    The author presents an account of the U.N. International Conference on Population held in Mexico City, August 6-14, 1984. Comments are made on New Zealand's representation and documentation of its position, how the conference was run, and the key issues debated. The author discusses the implications for New Zealand policy objectives and the following areas of concern: health, morbidity, and mortality; reproduction and the family; population distribution and internal migration; international migration; the role and status of women; population structure; and promotion of knowledge and policy.
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  20. 20
    033362

    Discussion: long-acting vaginal contraceptive delivery systems.

    Johansson ED

    In: Long-acting contraceptive delivery systems edited by Gerald I. Zatuchni, Alfredo Goldsmith, James D. Shelton, John J. Sciarra. Philadelphia, Harper and Row, 1984. 246-7.

    2 principles govern the major methods of vaginal-ring release of steroids: to suppress ovulation and, the route followed by the World Health Organization (WHO), not to suppress ovulation. When ovulation is not suppressed, as with the minipill, high rates of ectopic pregnancy have been associated with the progestin-only method. Also, high rates of ectopic pregnancy have been found for an IUD that does not suppress ovulation and works as a progestin-only device. In the phase 3 ongoing study of the WHO ring in a number of centers, no ectopic pregnancies have been reported thus far. It is unclear whether the RS 37367 enters the circulation and is then secreted in the cervical mucus or whether it is taken up by osmotic, capillary, or other action into the cervical mucus. If an effect on the cervical mucus occurs after the ring has been removed from the vagina, the RS 37367 may be stored in cervical mucus and then released slowly. It appears unlikely that the compound is absorbed systemically and resecreted into mucus because the compound is rapidly metabolized by the liver, and, although radiolabeling indicates that large amounts of radioactivity are circulated in the blood by HPLC, there is no intact compound. In regard to use, there may be more expulsion of vaginal rings in cultures with squatting toilet habits. Also, there may be poor cultural acceptance of a method that requires genital manipulation. In areas where prevailing hygiene conditions are poor, a ring that has to be removed monthly or every 3 months may increase the danger of introducing infection.
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  21. 21
    033322

    Why menstruate?

    Short RV

    Healthright. 1985 Aug; 4(4):9-12.

    The pattern of reproductive activity displayed by early hunter-gatherer ancestors, before the dawn of civilization, must have been vastly different from today's pattern. In the absence of contraception such women would have spent the greater part of their reproductive lives either pregnant or in lactational amenorrhea. In developing these ideas further it was estimated that a hunter-gatherer woman would have spent about 15 years in lactational amenorrhea, whereas just under 4 years would have been occupied by her 5 pregnancies, and she would only have had about 4 years of menstrual cycles. The total number of menstrual cycles she would experience in her entire life would be no more than about 50. This is in marked contrast to the situation today in a typical Western woman using contraceptives and experiencing menarche at 13 and the menopause at 50. Allowing her 2 years' respite from cycles during her 2 pregnancies, each followed by only a token period of breastfeeding, this leaves 35 years during which she would experience about 420 menstrual cycles. The conclusion is that an excessive number of menstrual cycles is an iatrogenic disorder of communities practicing any form of contraception. Thus, it is important to note that even the condom or vasectomy have important repercussions on the female's reproductive cycle. Since 99.9% of human existence has been spent living a nomadic hunter-gatherer life, this high frequency of menstrual cycles is a new experience, one that humans may be genetically ill-adapted to cope with. In fact, there are a number of "diseases of nulliparity" whose incidence is markedly increased in women with few or no children and who are therefore experiencing an increased number of menstrual cycles. These diseases include carcinoma of the breast, endometrium and ovaries, and endometriosis. As part of the effort to develop contraceptives that promote a healthy state of fertility, it is necessary to ask the question, "is a period really necessary?" To learn if women women accept a contraceptive method that reduced the frequency of menstruation, a clinical trial of an oral contraceptive was conducted. The OC was administered in such a way as to produce a withdrawal bleed only once every 3 months. This was termed the tricycle pill regimen. 196 women attending a family planning clinic in Edinburgh, Scotland, volunteered to participate, although 89 of them subsequently withdrew from the trial for a variety of reasons before it was completed at the end of a year. Overall, 82% of the women positvely welcomed the reduction in the number of periods; 91% of the women who completed the trial even refused to revert to a standard monthly OC regimen thereafter. The findings were in complete contrast to the results of a World Health Organization survey of patterns and perceptions of menstruation. But the WHO sample was highly biased in favor of women having regular menstrual cycles, and hence quite unrepresentative of the population as a whole. In sum, even the most pessimistic estimate of the WHO's menstruation survey shows that a proportion of women in every country investigated were prepared to accept amenorhea as a by-product of contraception. Reversible amenorrhea might become an increasingly popular form of contraception, and it might also confer significant health benefits.
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  22. 22
    268209

    Population Commission: report on the twenty-second session, 18-20 January 1984.

    United Nations. Economic and Social Council

    New York, New York, United Nations 1984. 45 p. (Official Records, 1984, Supplement No. 2 E/1984/12 E./CN. 9/1984/9)

    The report of the 22nd session of the United Nations Population Commission includes the opening statements by the Under Secretary General for International Economic and Social Affairs, the Under Secretary General for Technical Cooperation for Development, the Director of the Population Division, and the Assistant Executive Director of the United Nations Fund for Population Activities. These are followed by a description of the actions taken by the United Nations to implement the recommendations of the World Population Conference, 1974. A report on the progress of ongoing work in the field of population summarized for the following categories: 1) world demographic analysis; 2) demographic projections; 3) population policies; 4) population and development; 5) monitoring of population trends and policies; 6) factors affecting patterns of reproduction; 7) dissemination of population information; 8) technical cooperation; and 9) demograpahic statistics. Programs of work in the field of population for the biennium 1984-1985 and medium-term plan for the period 1984-1989 are provided for each of the 9 preceding categories as well as a consideration of draft proposals and a report on the continuity of work. The report concludes with the organization, attendance, and agenda of the session.
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  23. 23
    031241

    Family health in Zambia, Ministry of Health.

    Siatwinda SM

    [Unpublished] 1984. Presented at the Union of National Radio and Television Organisations of Africa [URTNA] Family Health Broadcast Workshop (Nairobi, 19-23 November, 1984). [16] p.

    Statistical information on Zambia's population is provided, and the activities, goals, and achievements of the country's family health, maternal and child health (MCH), and expanded immunization programs are described. Zambia is a tropical country and has a 1-party participatory democratic form of government. The country is inhabited by 73 tribes speaking 62 languages. In 1983, the population size was 6,425,000, and 48.6% of the population was under 15 years of age. Population size, area, and density information for each province is provided. The general fertility rate was 220/1000 women of reproductive age. Life expectancy was 50 years for women and 46.7 years for men. The 6 major causes of death among women and children in 1979 were measles, malnutrition, pneumonia, malaria, diarrhea, and respiratory infection. The Ministry of Health is actively working to expand immunization and MCH services in the rural areas. The family health program is a training program charged with the task of providing training in family health for 600 enrolled nurses and midwives. Sessions include 6 weeks of classroom instruction followed by 6 weeks of clinical or field experience. Topics covered in the training sessions are health education, teaching and communication skills, management skills, child health, nutrition, immunization, prenatal and postnatal care, and child spacing. Graduates of the program are assigned to rural health facilities where they supervise the delivery of immunization and MCH services and initiate child spacing services. The family health program, initiated in 1980, is funded by the UN Fund for Population Activities and is guided jointly by the Ministry of Health and the World Health Organization. As of 1983, 19 registered nurse midwives and 442 enrolled nurse midwives were trained under the program. Information on the family health program is disseminated via radio, television, a Ministry of Health magazine, the World Health Day Exhibition, and agricultural shows. The development of MCH services in rural areas is emphasized by the 1980-84 national development plan. The major components of the MCH program are prenatal and postnatal care, family planning, children's clinics, vitamin and protein supplementation, immunization, and school health services. The Expanded Immunization Program (EIP) is integrated into the primary health care system and covers remote areas not as yet covered by MCH services. The specific goals of the program are to increase immunization coverage, establish a cold chain for vaccines, reduce vaccine wastage, and train health personnel to use and maintain cold chain equipment. The program is funded by various UN agencies and the national government. Family planning was introduced into Zambia by the Family Planning Association. The organization's name was later changed to the Planned Parenthood Association to overcome the mistaken impression that family planning meant the complete cessation of childbearing. In 1973, child spacing was integrated into the MCH program and family planning was assigned a high priority in the 1980-84 national development plan. Between 1980-84, the number of family planning acceptors increased from 49,412 to 101,803. In 1984, a number of evaluations were made of the MCH, EPI, and family health programs. The results of these evaluations will be available in the near future. Tables provide information on contraceptive usage, the Ministry of Health budget for 1983, the number and type of health staff in 1982, and the number and type of health facilities in the country.
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  24. 24
    030137

    Socio-economic development and fertility decline in Costa Rica. Background paper prepared for the project on socio-economic development and fertility decline.

    Denton C; Acuna O; Gomez M; Fernandez M; Raabe C; Bogan M

    New York, New York, United Nations, 1985. 118 p. (ST/ESA/SER.R/55)

    This summary of information on the development process in Costa Rica and its relation to fertility from 1950-70 is a revision of a study prepared for the Workshop on Socioeconomic Development and Fertility Decline held in Costa Rica in April 1982 as part of a UN comparative study of 5 developing countries. The report contains chapters on background information on fertility and the family, historical facts, and political organization of Costa Rica; the development strategy and its consequences vis a vis the composition of the gross domestic product, balance of trade, investment trends, the structure of the labor force, educational levels, and income; the allocation of public resources in public employment, public investment, credit, public expenditures, and the impact of resource allocation policies; changes in land tenure patterns; cultural factors affecting fertility, including education, women and their family roles, behavior in the home, women and politics, work and social security, and race and religion; changes in demographic variables, including nuptiality patterns, marital fertility, and natural fertility and birth control; characteristics and determining factors of the decline in fertility, including levels and trends, decline by age group, decline in terms of birth order, differences among population groups, how fertility declined, and history and role of family planning programs; and a discussion of the modernization process in Costa Rica and the relationship between demographic and socioeconomic variables. Beginning with the 1948 civil war, Costa Rica underwent drastic changes which were still reflected in national life as late as 1970. The industrial sector and the government bureaucracy have become decisive forces in development and the government has become the major employer. The state plays a key role in economic life, and state participation is a determining factor in extending medical and educational resources in the social field. The economically active population declined from 64% in 1960 to 55% in 1975 due to urbanization and migration from rural to urban areas, but there was an increase in economic participation of women, especially in urban areas. Increased educational level of the population in general and women in particular created changes in traditional attitudes and behavior. Although there is no specific explanation of why Costa Rica's fertility decline occurred, some observations about its determining factors and mechanisms can be made: the considerable economic development of the 1950s and 1960s brought about a rapid rise in per capita income and changes in the structure of production as well as substantial social development, increased opportunities for self-improvement for some social groups, and a rise in expectations. The size of the family became an aspect of conflict between rising expectations and increasing expenses. The National Family Planning Program helped accelerate the fertility decline.
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  25. 25
    031396

    The changing roles of women and men in the family and fertility regulation: some labour policy aspects

    Oppong C

    In: Family and population. Proceedings of the "Scientific Conference on Family and Population," Espoo, Finland, May 25-27, 1984, edited by Hellevi Hatunen. Helsinki, Finland, Vaestoliitto, 1984. 62-83.

    There is growing evidence that labor policies, such as those advocated by the International Labor Organization (ILO), promote changes in familial roles and that these changes in turn have an impact on fertility. A conceptual model describing these linkages is offered and the degree to which the linkages hypothesized in the model are supported by research findings is indicated. The conceptual model specifies that: 1) as reliance on child labor declines, through the enactment of minimum age labor laws, the economic value of children declines, and parents adopt smaller family size ideals; 2) as security increases for the elderly, through the provision of social security and pension plans, the elderly become less dependent on their children, and the perceived need to produce enough children to ensure security in old age is diminished; and 3) as sexual equality in job training and employment and the availability of flexible work schedules increase, sexual equality in the domestic setting increases, and women begin to exert more control over their own fertility. ILO studies and many other studies provide considerable evidence in support of these hypothesized linkages; however, the direction or causal nature of some of the associations has not been established. Development levels, rural or urban residence, and a number of other factors also appear to influence many of these relationships. Overall, the growing body of evidence accords well with ILO programs and instruments which promote: 1) the enactment of minimum age work laws to reduce reliance on child labor, 2) the establishment of social security systems and pension plans to promote the economic independence of the elderly, 3) the promotion of sexual equality in training programs and employment; 4) the promotion of the idea of sexual equality in the domestic setting; and 5) the establishment of employment policies which do not unfairly discriminate against workers with family responsibilities.
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