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Nairobi, Kenya, Family Planning Association of Kenya, 1980. , 164 p.The proceedings of the Second Management Seminar for senior volunteers and staff of the Family Planning Association of Kenya (FPAK), held in December 1979, with appendices, are presented. The 1st 3 days consisted of lectures and plenary discussions on topics such as communication strategies, family guidance, youth problems, and contraceptive methods; the last 2 days were group discussions, reports and summary evaluations. 40 participants took part in the evaluation, expressing satisfaction with knowledge gained in communications, family life education, and IPPF organization and skills. They expressed the need to learn more about family counseling, youth problems, population, and integrated approaches. The seminar recommended that FPAK be more innovative to retain volunteers, plan its communication strategy more carefully, train and involve volunteers in programming, study traditional family planning methods, provide family counseling services, fully exploit the media, and use it to clarify misconceptions and introduce community-based distribution.
Working Group on Adolescent Fertility Management, Manila, Philippines, October 13-17, 1980. Final report.
Manila, Philippines, WHO Regional Office of the Western Pacific, 1980 Dec. 42 p.The objectives of the Working Group on Adolescent Fertility Management, meeting in Manila during October 1980 under the World Health Organization (WHO) Regional Office for the Western Pacific, were the following: to review the current situation in the Region with regard to adolescent pregnancies, use of contraception on the part of adolescents, and the services available; 2) to identify the biological, social and psychological aspects of adolescent fertility management; and 3) to recommend appropriate approaches and programs in relation to the problems created by adolescent pregnancies. For working purposes, it was decided that adolescence covered the age period 10-19 years. The country-specific information provided by participants representing 11 countries regarding the size and the nature of the problems related to adolescent sexuality and fertility are summarized. In discussing the possible preventive approaches and programmatic solutions to the problems related to adolescent sexuality and fertility, the Working Group identified the following gaps and problems: 1) a significant lack of relevant and country-specific data regarding the adolescent population and their current sexual and reproductive behavior; 2) a lack of awareness by responsible government bodies of the increasing problem and of commitment to seek appropriate solutions; 3) a lack of knowledge about health and health-related issues of the adolescent development period; and 4) a lack of appropriate and acceptable services regarding fertility management for adolescents. Education and information constitute a major need in the area of adolescent sexuality and fertility.
Advances in Planned Parenthood. 1980; 15(3):77-81.In 1977 the PPAN (Planned Parenthood Association of Nashville) began providing minilaparotomy sterilization services on an outpatient basis. The experience of 218 women who received sterilizations at the clinic between 1977-1979 indicated that it was feasible and safe to provide this service on an outpatient basis. The historical development of the program, the procedures and instruments used to perform the sterilizations, and the sterilization outcomes for the 218 patients were described. Prior to program initiation, the Medical and Executive Directors of PPAN attended a workshop on outpatient female sterilizations conducted by AVS (Association for Voluntary Sterilization) and the Planned Parenthood Federation of America. Subsequently a protocol for minilaparotomy sterilization was submitted to the National Medical Office of the Federation by the PPAN. The protocol was approved and the program was implemented. Based on the success of the 1st 18 months of operation PPAN received a grant from AVS to train personnel from other clinics to provide similar services. During the 1st clinic visit patients are thoroughly counseled and given a pelvic examination. During the 2nd visit the patient is given a complete physical examination and laboratory tests, including a pregnancy test, are performed. During the 3rd visit the patient receives additional counseling and the sterilization is then performed. A modified Pomeroy procedure is performed under local anesthesia. Patients were discharged 2 hours after surgery. 96% of the patients returned for suture removal and 50% returned for a later recommended check-up. A follow-up survey indicated that more than 90% of the patients were satisfied with the service. For 4 of the 218 patients the sterilization was not completed. In 2 cases the round ligament was mistaken for the tube and sterilization was not achieved, in 1 case the patient became upset and the procedure was halted, and in another case adhesions prevented ligation. At the time of the operation it was discovered that 2 patients had luteal phase pregnancies. There were no major immediate complications but there were 1) 2 cases of subcutaneous hematomas; 2) 1 brief episode of postoperative thrombophlebitis, 3) 2 cases of wound abscesses; and 4) 3 cases of mild cystitis and endometritis.
Geneva, Switzerland, WHO, 1980. 47 p. (WHO Offset Publication No. 26)This report outlines the World Health Organization's guidelines for female sterilization techniques. The following conclusions and recommendations concerning individual techniques are discussed: 1) laparotomy, particularly immediately postpartum, is the basic sterilization technique since it can be made available in any surgically equipped facility without extra requirements. 2) minilaparotomy is more demanding in skills and training requirements. However, it is a simple procedure on outpatient basis which makes it suitable for large-scale programs. 3) Colpotomy requires specialized training in obstetrics and gynecology. It has the same advantages as minilaparotomy, but it cannot be used postpartum. 4) Laparoscopy is the most complex sterilization form, and the most expensive. It can be used for sterilization, but its primary role is in diagnosis. 5) Culdoscopy costs slightly less than laparoscopy but has all of the same limitations as laparsocopic method (i.e., expensive, sophisticated university of facilities and training. 6) Hysterectomy is not recommended for sterilization. The need for adequate counseling services in addition to technical expertise is underlined.