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Journal of Social and Political Studies. 1980 Winter; 5(4):183-90.A recently completed World Bank statistical study of family planning in 63 developing countries indicated that countries which experienced a large decline in birth rates between 1960-1977 were more likely to have a family planning program, an official population policy aimed at decreasing the birth rate, and a relatively high level of development than countries which experienced smaller or no decline in birth rates. The 65 countries represented 95% of the population of the developing world. Birth rate declines of 10% or more between 1960-1977 were experienced by: 1) 10 of the 26 countries which had a family planning program and a policy aimed at reducing the birth rate; 2) 6 of the 19 countries which had a family planning program but lacked clearly defined population objectives; and 3) 2 of the 18 countries without any population policy or program. Furthermore, the implementation of a family planning program and the adoption of a population policy were directly related to the development level of the country. This finding suggested that countries need to reach a certain level of development before they have the capacity to develop population programs and policies. When a country is sufficiently advanced to collect population data, awareness of population problems increases and they are more likely to adopt a population policy. In addition, government efficiency increases as development proceeds and governments must have a certain level of efficiency before they can implement effective programs.
A preliminary pharmacokinetic and pharmacodynamic evaluation of depot-medroxyprogesterone acetate and norethisterone oenanthate.
Fertility and Sterility. 1980 Aug; 34(2):131-9.2 populations attending WHO centers, one in Sweden and one in India, participated in a comparative, pilot trial of 2 increasingly popular injectable progestin-only female contraceptives, Depo-Provera and Norigest. The purpose of the study was to assess the pharmacokinetic and pharmacodynamic properties of the 2 formulations (depot medroxyprogesterone acetate and norethisterone enanthate). Differences were found between Swedish women and Indian women in their reactions to the 2 drugs: 1) Norigest was detectable in blood samples a significantly shorter time after injection of the agent in Indian women than in Swedish women; this difference was not apparent with Depo-Provera. 2) Although there was no difference at the 2 centers in the time of ovulation return for subjects receiving Norigest, 0 of 4 Swedish women ovulated more than 156 days after Depo-Provera injection, whereas all 4 Indian women ovulated within 73 days of Depo-Provera injection; in the Swedish women, the levels of medroxyprogesterone were undetectable at time of return to ovulation, whereas Indian women had levels of .6 ng/ml when ovulation resumed. 3) In both cultures, Depo-Provera users had significantly more episodes of bleeding and spotting than Norigest users. This preliminary report emphasizes the variety of responses possible to injection of different contraceptive progestins among various populations and points to the need for further culturally comparative studies.
Strengthening rural health service delivery project. First progress review meeting on the Diarrheal Disease Control Study.
Mansura, Egypt, [Westinghouse Health Systems], 1980 Jun 2. 38 p.This is the report on a study into the availability, utilization, effectiveness, and cost of sucrose/salt rehydration mixtures and prepackaged rehydrant solutions of glucose, potassium, and bicarbonate. A WHO-sponsored program was established in Egypt in 1977 to distribute prepackaged electrolytes for use in cases of diarrhea. Results have been unsatisfactory because there is distrust and, consequently, underuse of the product. In addition, it is only available at clinics, which are also underutilized by the population. Therefore, since 1978, the Ministry of Health has been conducting a pilot project to distribute the oral rehydrants through rural health care delivery. This program involves teaching home preparation and administration of a salt/sugar solution to mothers, providing packets through medical personnel at clinics, and intravenous treatment in hospitals in severe cases. A comparative study will be undertaken in 2-3 districts of the pilot project to assess the relative benefits of the home-prepared salt/sugar solutions and the prepackaged oral rehydrants. The methodology of the study, plus specific research outputs expected, are outlined. The 2 preparations will be compared as to effectiveness, availability, safety, acceptability, cost, and principal advantages.