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World Federation policy statement. IV. Incentives and disincentives relating to voluntary surgical contraception.
[Unpublished] 1981 Nov. 3 p.The recommendations of the 1974 Symposium on Law and Population are endorsed including taking into account the value system and customs of a society to counteract family planning (FP), obstacles and urging that government-sponsored FP programs be considered basic human rights. The incentives and disincentives of the International Conference on Family Planning held in Jakarta in 1981 are also approved. These relate to ethical, social, and political issues and the availability of FP information, education, and services; evaluation of the effectiveness of incentives to enhance community improvement, peer recognition, and social rewards; and the minimalization of cash incentives because of the potential for abuse. The balancing of individual rights to collective rights is also accepted as declared by the 1977 Expert Group Meeting of the Economic and Social Commission for Asia and the Pacific. In addition, the World Federation advocates principles on contraception of Health Agencies for the Advancement of Voluntary Surgical incentives and disincentives in voluntary surgical contraception to limit family size; psychological and social incentives; fees for service; discouragement of immediate financial incentives for acceptors; and continuous institutional monitoring and education of these guidelines. Assistance of member countries of the World Federation is a primary objective in this effort.
Report on the Regional Scientific Working Group on Breastfeeding, Nicosia, Cyprus, 26 - 30 January 1981.
[Alexandria, Egypt], WHO, EMRO, 1981 May. 41,  p. (EM/MCH/155; EM/REG.SCT.WRK.GR.BRF/14)The Scientific Working Group on Breastfeeding was convened in Cyprus in 1981 by the Eastern Mediterranean Office of the World Health Organization (WHO) to develop a plan of action for the 1981-83 period. Although data on breastfeeding are scarce in the 23 Western Asia and North African countries that comprise the Eastern Mediterranean Region, there is concern about bottle-feeding following early, abrupt weaning under 3 months of age and mixed (bottle and breast) feeding patterns. Overall, prolonged breastfeeding does not appear to have decreased in rural communities as much as in other developing countries; however, there is no evidence of a resurgence of breastfeeding among women in the urban elite. The 2 most common factors mentioned by mothers as responsible for early weaning are milk inadequacy and pregnancy. Included among the recommendations of the Scientific Working Group were the following: 1) WHO should explore the possibilities on producing audiovisual material on breastfeeding, both for the public and health staff; 2) WHO should strengthen its support for surveys regarding breastfeeding and associated factors; 3) WHO technical support to seminars and conferences directed toward training health staff should be expanded; 4) a network of correspondents should be organized to monitor adoption of the Code of Marketing of Breastmilk Substitutes; 5) a review of the situation of working women who wish to breastfeed, as well as existing legislation on maternity leave, should be undertaken; 6) the role of women's organizations in the promotion of breastfeeding should be strengthened; 7) WHO should contact the Ministers of Health concerning the desirability of rooming in in the case of all normal deliveries; and 8) WHO should provide technical advice regarding 3 controversial issues--the adverse effects of oral contraceptives on lactation, the impact of powdered milks on infant nutrition, and the spread of infection in day care settings.
United Nations system of organizations, members of the United Nations, the specialized agencies and the International Atomic Energy Agency, and contracting parties to the general agreement on tariffs and trade and directory of senior officials.
New York, N.Y., Office of Secretariat Services for Economic and Social Matters, United Nations, 1981. 97 p.Add to my documents.
[Unpublished] 1981 Aug 28. 222 p. (AID/LAC/P-085)The background, goals, projected activities and beneficiaries, financial requirements, and implementation plans for a Family Planning Outreach Project in Haiti are detailed. The project is intended to assist the Government of Haiti to establish a cost-effective national family planning program. Population growth continues to accelerate in Haiti, despite high infant and child mortality, significant emigration, and declining fertility. The government does not have an articulated population policy. Although family planning and maternal and child health services have been in existence since 1971, there is no effective access to these services. This project is viewed as a means of achieving a substantial and sustained reduction in family size and improving health status. It is also a means of strengthening the Haitian family so it can participate more directly in the national development process. The purpose of the project will be accomplished through the following activities: 1) improvement of the organization and management of the national family planning program; 2) improvement of the quality and quantity of maternal and child health and family planning services; 3) expansion of the participation of private and voluntary organizations, other governmental, and local community groups in service provision; 4) increase in the availability of contraceptives at reasonable prices through rural and urban commercial channels; and 5) formulation of appropriate population and family planning policies. By the end of the project, all government health facilities and 75% of private facilities will actively counsel and provide family planning services; integrated models of community health and family planning services will have been developed to serve 60% of the population; basic drugs and contraceptives will be available at reasonable subsidized prices throughout the country; and 25% of women ages 15-45 at risk of pregnancy will be continuing users of effective contraceptive methods. The project will be implemented by the existing infrastructure of private and public organizations, primarily by the Department of Public Health and Population and its Division of Family Hygiene. The US Agency for International Development (USAID) is providing US$9.615 million (54%) toward the estimated US$17.980 million cost of the 5-year project. An additional US$6.555 million (36%) will be provided by the Government of Haiti.
[Latin America. Regional Seminar on Contraceptive Prevalence Surveys. Proceedings. November 8-13, 1981] America Latina. Seminario Regional sobre las Encuestas de Prevalencia del Uso de Anticonceptivos. Actas. Noviembre 8-13 de 1981.
Columbia, Maryland, Westinghouse Health Systems, 1981. 65 p. (Las Encuestas de Prevalencia del Uso de Anticonceptivos II)This report of the proceedings of the Regional Seminar on Contraceptive Prevalence Surveys (CPSs) in Latin America, held in Lima, Peru, in November 1981, includes the schedule of events; list of participants; opening discourses and presentations by the sponsors, Westinghouse Health Systems and the US Agency for International Development; country reports for Colombia, Costa Rica, and Mexico; and brief summaries of the work sessions on data evaluation, cooperation between the technical survey staff and the program administrators who will use the findings, survey planning, questionnaire design, fieldwork, the phases of CPS work, data processing, sampling, use of CPS data, graphic presentation of findings, and determination of unsatisfied demand for family planning services. Representatives of 17 countries and 8 international organizations attended the conference, whose main objectives were to introduce the CPS program to participants unfamiliar with it, contribute to improvement of future surveys by sharing experiences and introducing new techniques of investigation, discuss the application of CPS findings, and encourage dialogue between the technical personnel involved in conducting the surveys and the administrators of programs utilizing the results. The introduction to the CPS program by Westinghouse Health Systems covered the goals and objectives of the program, its organization and implementation, dissemination of results, basic characteristics of the survey, the status of CPS surveys in Latin America and a list of countries participating in the program, and a brief overview of contraceptive use by married women aged 15-44 by method in countries for which results were available. The country reports detailed experiences in survey design, fieldwork methodology, organization and administration of the surveys, and other aspects, as well as highlighting some of the principal findings.
Asia Contraceptive Prevalence Surveys Regional Workshop Proceedings, Pattaya, Thailand, February 16-20, 1981.
Columbia, Maryland, Westinghouse Health Systems, 1981 Feb. 47 p.Papers and summaries of discussions from the Asia Contraceptive Prevalence Surveys Regional Workshop held in Pattaya, Thailand, in 1981 are presented. The report begins with 2 papers describing and tracing the history of the worldwide Contraceptive Prevalence Surveys (CPS) Project and explaining the interest of the US Agency for International Development in the surveys. The objectives of the workshop and its participants are then detailed. CPS country presentations for Bangladesh, Korea, Nepal, and Thailand are followed by summaries of small-group discussions of data problems. A diagram of the planning process established the framework for the remaining work. A general discussion of the assessment of country data needs is accompanied by brief statements of programs for which data are needed, purpose of data collection, data available and data needed in Bangladesh, Indonesia, Korea, Nepal, Malaysia, the Philippines, and Thailand. Reports of sessions on how to match a CPS to available resources and how to develop and implement CPS are then given. A discussion of the institutionalization of CPS is followed by final reports for the 7 participating countries. The workshop agenda and list of participants is included in the report.
World Health Organization Technical Report Series. 1981; (670):1-120.This report includes the collective views of a World Health Organization (WHO) Scientific Group on Research on the Menopause that met in Geneva during December 1980. It includes information on the following: 1) the endocrinology of the menopause and the postmenopausal period (changes in gonadotropins and estrogens immediately prior to the menopause and changes in gonadotropin and steroid hormone levels after the menopause); 2) the age distribution of the menopause (determining the age at menopause, factors influencing the age at menopause, and the range of ages at menopause and the definition of premature and delayed menopause); 3) sociocultural significance of the menopause in different settings; 4) symptoms associated with the menopause (vasomotor symptoms, psychological symptoms, disturbances of sexuality, and insomnia); 5) disorders resulting from, or possibly accelerated by, the menopause (osteoporosis, atherosclerotic cardiovascular disease, and arthritic disorders); 6) risks, with particular reference to neoplasia, of therapeutic estrogens and progestins given to peri- and postmenopausal women (endometrial cancer, breast cancer, and gallbladder disease); 7) fertility regulating methods for women approaching the menopause (fertility and the need for family planning in women approaching the menopause, problems of family planning in perimenopausal women, and considerations with regard to individual methods of family planning in women approaching the menopause); and 8) estrogen and the health care management of perimenopausal and postmenopausal women. At this time some controversy exists as to whether there is a menopausal syndrome of somatic and psychological symptoms and illness. There are virtually no data on the age distribution of the menopause and no information on its sociocultural significance in the developing countries. The subject of risks and benefits of estrogen therapy in peri- and postmenopausal women is of much importance in view of the large number of prescriptions issued for this medication in developed countries, which indicates their frequrnt use, and the different interpretations and opinions among epidemiologists and clinicians on both past and current studies on this subject. Specific recommendations made by the Scientific Group appear at the end of each section of the report. The following were among the general recommendations made: WHO sponsored research should be undertaken to determine the impact on health service needs of the rapidly increasing numbers of postmenopausal women in developing countries; uniform terminology should be adopted by health care workers with regard to the menopause; uniform endocrine standards should be developed which can be applied to the description of peri- and postmenopausal conditions and diseases; and descriptive epidemiological studies of the age at menopause should be performed in a variety of settings.
Bangkok, Thailand, Population Education Clearing House, 1981. 2 p.This pamphlet provides a listing of population education publications. The literature is listed in the following categories: manuals and resource materials; population education in Asia and the Pacific; bibliographies and documentation materials; information papers; reports and instructional materials; Unesco press publications; and publications scheduled for 1981. The Population Education Clearinghouse also has a large collection of population education materials from the countries of the region. A form is provided for requesting publications.
Washington, D.C., National Academy Press, 1981. 22 p. (Contract AID/ta-C-1428)2 essential direct interventions in management of acute diarrheal diseases, oral rehydration and continued feeding, are summarized. Recent estimates of the global problem are that more than 500 million episodes of diarrhea occur yearly in infants and children under 5 years of age in Asia, Africa, and Latin America. 5 million deaths from diarrhea have been reported each year. Dehydration is the major cause of the immediate morbidity and mortality of children with diarrhea. Oral rehydration techniques may assist and reverse progression to severe dehydration and thereby are highly efficient in managing diarrheal disease. Formula selection, preparation of ingredients, distribution of oral rehydration solution, economic considerations, and cost-effectiveness of therapy programs are the primary concerns for those using oral rehydration. Formula selection should take into account the quantity of sodium, potassium, bicarbonate, and glucose in the formula. Preparations should be made so they can be done in the household rather than in national agencies. Centralized national packaging is recommended to standardize the salt/sugar mix. Measuring spoons and containers are also important in the packaging. Distribution should be accomplished by government or private agencies. The home preparation is the most economical. The effectiveness of the program is an important consideration. It is recommended that 2 different formulas be introduced into the community: a simpler lower sodium formula for home preparation and the more complex World Health Organization solution for supervised use in the health center. Continuation of feeding is important during and after diarrheal illness. Anorexia, nausea, vomiting, and abdominal cramps, may accompany acute infection. Cow milk may help produce symptomatic fermentative diarrhea, however breastfeeding should be continued. Fruits, vegetables, and sources of protein should also be fed to patients with diarrhea. Deleterious effects may occur if a patient fails to continue eating. A community system of surveillance and education should be developed to control diarrheal disease.
London, England, Oxfam, May 1981. 439 p.This handbook was developed to provide field directors of Oxfam overseas projects with guidelines for managing and assessing the numerous aspects of their projects. Oxfam's philosophy, objectives, strategies, and resources are described, and a directory of Oxfam field offices and other agencies world wide is provided. Guidelines and strategies in the areas of agriculture, health, social development, humanitarian programs, and disaster relief are covered in individual sections, with a bibliography for each.
New York, International Planned Parenthood Federation, Western Hemisphere Region, April 1981. 10 p.This declaration on population and development was endorsed by the participants of the 1981 Meeting of the Regional Council of the Western Hemisphere Region of IPPF. It is affirmed that the population problem is part of a larger social problem, that individuals have the right to decide on the number and spacing of their children, and that it is the responsibility of governments particularly to promote social justice and education, and the means to exercise responsible parenthood. Some fundamental principles of population and development are noted, and priorities for population or development policy formulation are suggested, including developing the capacity at the government level to administer social welfare, providing information and education in family life and family planning, improving the roles of women and men, and making health care available to all. A list of participants is appended.
A prospective multicentre trial of the ovulation method of natural family planning. Pt. 2. The effectiveness phase.
Fertility and Sterility. 1981 Nov; 36(5):591-98.A 5 country prospective study was undertaken to determine the effectiveness of the ovulation method of natural family planning. 869 subjects of proven fertility from 5 centers (Auckland, Bangalore, Dublin, Manila, and San Miguel) entered the teaching phase of 3-6 cycles; 765 (88%) completed the phase. 725 subjects entered a 13-cycle effectiveness phase and contributed 7514 cycles of observation. The overall cumulative net probability of discontinuation for the effectiveness study after 13 cycles was 35.6%, 19.6% due to pregnancy. Pregnancy rates per 100 woman-years calculated using the modified Pearl index were as follows: conscious departure from the rules of the method, 15.4; inaccurate application of instructions, 3.5; method failure, 2.8; inadequate teaching, 0.4; and uncertain, 0.5. Cycle characteristics included: 1) average duration of the fertile period of 9.6 days, 2) mean of 13.5 days occurred from the mucus peak to the end of the cycle, 3) a mean of 15.4 days of abstinence was required, and 4) a mean of 13.1 days of intercourse was permitted. Almost all women were able to identify the fertile period by observing their cervical mucus but pregnancy rates ranged from 27.9 in Australia and 26.9 in Dublin to 12.8 in Manila. Continuation was relatively high ranging from 52% in Auckland to 74% in Bangalore.
Geneva, Switzerland, WHO, 1981. 76 p. (WHO Technical Report Series No. 657)This report on the effect of female sex hormones on fetal health and development aimed to evaluate research on the specific types of sex hormones and their uses, to determine their safety with respect to fetal development and infant health, and to recommend further research in these areas. Theoretically, sex hormones can affect any stage of fetal development. Sex hormones appear to act by promoting synthesis of messenger ribonucleic acid (mRNA) in target tissues, so that research should focus on the specific proteins formed under the direction of newly synthesized mRNA to elucidate potential morphological and physiological effects of exogenous hormones. Following are some research avenues: cytogenetic research, microscopic and macroscopic examination, observations on births and later life, animal teratology, and epidemiological studies. Epidemiological studies not only help elucidate causal associations but also provide public health data. Studies of sex hormones and fetal development and infant health must be free of bias and often suffer from problems of defining pregnancy outcome. Also sex steroids are frequently administered at the same time as other drugs, leading to confounding effects of drug interactions. In order to assess existing data, it is necessary to disaggregate the data from different reports and then to regroup them according to the indications for use, i.e., infertility, contraception, pregnancy testing, supportive therapy during pregnancy, contraception during pregnancy, contraception during breast feeding. Likewise data must be disaggregated according to different types of exposure, i.e., preconception or postconception. The bulk of this monograph is spent disaggregating study data based on the above-stated rationales. The following recommendations are made for indications for use of sex hormones: 1) they should not be used as pregnancy tests; 2) diethylstilbestrol should not be prescribed to a suspected pregnant woman; 3) benefits of progestin therapies must first be proven before they can be recommended for use in supporting pregnancy; 4) oral contraceptives given before pregnancy seem to have no effect on subsequent pregnancy; and during lactation combined therapy should not be given.
In: Labour force participation and development. 2nd ed., [by] Guy Standing. Geneva, Switzerland, International Labour Office, 1981. 165-206.The constraining influence of fertility and the associated demand for childcare time have often been considered to be the principal determinants of female labor force participation. International organizations, academics, and planners in low-income countries have therefore tended to enthusiastically support policies designed to accelerate the growth of female labor force in hopes of slowing the rate of population growth. While much research has been conducted on the topic, recent research casts doubts on the inverse relationship between female labor force participation and fertility. Some hold that the relationship, if it exists, depends upon the type of employment. This paper explores whether fertility constrains female labor force participation and if so, when and to what extent; whether female participation depresses fertility and if so, what type of participation is most likely to do so; and what is the nature of the relationship, if any. Sections consider the theoretical framework of fertility, participation, and the opportunity costs of time; evidence on empirical relationships in industrialized economies; the effect of empirical relationships on the influence of female participation on fertility in low-income countries; and evidence from low-income countries on fertility as a constraint on female labor force participation. Analysis uncovered mixed evidence from empirical analyzes which are often methodologically questionable and based on inadequate data. It was nonetheless concluded that the general demand for childcare time is less constraining on female participation in rural areas and where domestic employment predominates; and an inverse relationship is more likely in urban-industrial areas although it remains unclear whether or not the effect is greater for women with relatively low opportunity wages.
[Unpublished] 1981. 27 p. (LAB/81.7)WHO guidelines for the laboratory diagnosis of diphtheria are described in this booklet. The guidelines cover only selected laboratory methods that have been proved reliable. The health significance of diphtheria and the importance of the laboratory in diphtheria diagnosis are emphasized, because it is a frequently misdiagnosed disease. Procedures for the isolation and identification of Corynebacterium diphtheriae are outlined. Collection and transport of throat and nasopharyngeal swab specimens, including directions for taking swabs in skin diphtheria, are described. Processing recommendations, with instructions regarding the minimum culture media required for C. diphtheriae isolation, requirements for inoculation and incubation of culture media, and primary plating of specimens is provided. Examination of cultures for the presence of beta hemolytic streptococci and time frames for examination of plates are given, with a description of the method of obtaining pure cultures. A diagram depicts the primary plating of swabs, and the cellular morphology and toxigenicity testing of C. diphtheriae are explained. Biochemical testing and biotyping guidelines for C. diphtheriae, with notes on interpretation are offered in the final section. The appendix describes various reagents and culture media, with directions for preparation and transport.
[Unpublished] 1981. 9 p. (EPI/CCIS/81.14)81% of developing countries responding to a 1981 cold chain survey carried out for UNICEF reported that preparations for the Expanded Program on Immunization (EPI) were complete. 64% of the responding countries indicated that Central Store facilities were adequate for the needs of the current national population, but only 28% reported that UNICEF or government purchases for new facilities were in progress. The largest discrepancy was recorded in the African region, where 44% of countries believed that central storage facilities were inadequate and only 31% had purchase orders. Overall, 61% of countries considered Regional Store facilities to be adequate, with a range from 44% in the African Region to 83% in Southeast Asia. The majority of countries of countries reported problems in terms of the quality and availability of power and fuel supplies. The most prominent problem, however, was poor transport for the cold chain, cited by 60% of countries. Specific transport problems mentioned included poor distribution of vehicles, inadequate vehicle maintenance facilities, inappropriate choice of vehicles for peripheral areas, and inefficient utilization of existing transport.
[Expanded Programme on Immunization: stability of freeze dried measles vaccine] Programme Elargi de Vaccination: stabilite du vaccin antirougeoleux lyophilise.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1981 Jun 12; 56(23):177-9.This report brings up to date those data summarized previously regarding the stability of freeze-dried measles vaccine and is based on information obtained from the London School of Hygiene and Tropical Medicine. The World Health Organization (WHO) intends to establish a requirement for the stability of freeze-dried measles vaccine, and a draft of such a requirement is represented along with an analysis of how such a requirement would influence WHO acceptance of the vaccine included in this report. A plaque assay method was used to determine the potency of measles vaccine which had been stored in a freeze-dried state at 37 degrees Centigrade for varying intervals. Vaccine containers were exposed at 37 degrees Centigrade in a water bath and duplicate samples transferred to -70 degrees Centigrade at intervals ranging from 1 to 28 days. The residual infectious virus was determined by the plaque assay method in parallel with vaccine that had not been incubated. The results from 16 patches produced by 9 manufacturers are summarized in a table, which includes recent data a well as the results from the previous report. 2 criteria of stability are included: the number of days required for the live virus titer to drop to an acceptable minimum level when stored at 37 degrees Centigrade (Criterion 1); and the loss of live virus titer when stored for 7 days at 37 degrees Centigrade (Criterion 2). Neither criterion is sufficient on its own. A quite unstable vaccine might still have the required potency after being stored for a week at 37 degrees Centigrade if the vaccine had a high virus titer initially. Yet, a product with satisfactory stability might still fail the potency requirement if its initial virus titer was borderline. A figure shows how the vaccines would be rated according to the proposed requirements. The proposed requirement for the stability of freeze-dried measles vaccine will be presented to the Expert Committee on Biological Standardization during its meeting in September 1981. If accepted, it would become effective by March 1982.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1981 Nov 13; 56(45):353-8.As a result of the May 1980 recommendation of the 33rd World Health Assembly that smallpox vaccination should be discontinued in every country, except for investigators at special risk, vaccination of the general public had been abandoned in 144 countries as of November 1981. Vaccination remains obligatory in 5 countries (Burma, Chad, Egypt, Kuwait, and Tunisia); present vaccination policy is unknown in an additional 7 countries. However, as recommended, WHO has continued surveillance of suspected cases and maintains an international smallpox rumor registry. Between January 1978-November 1981, 168 cases of suspected smallpox were reported to WHO from 59 countries, including 24 reported in 1981. All 167 cases investigated to date have not been smallpox; 60% have proved to be chicken pox, measles, or other skin diseases. WHO does not recommend initiation of preventive vaccination on the basis of a smallpox rumor until a presumptive diagnosis of smallpox has been established.
[Unpublished] . iv, 70,  p.To strengthen project development and reinforce the links between the United Nations Family Planning Association (UNFPA) and specialized agencies, it has been proposed to convene a series of meetings between UNFPA Policy and Technical Division/Program Division staff and staff working in the area of population communication. These meetings are further intended to improve ongoing monitoring of UNFPA communication activities, improve the flow of data on new developments in the field, and upgrade the quality of technical project documents. The background documentation and papers in this manual were prepared to serve as a basis for discussion at the meetings. Material is presented in 5 categories: review of trends and changes in population communication, examples of population communication programs assisted by UNFPA, UNFPA policy guidelines, project formulation and evaluation, and UNFPA basic need assessment guidelines. Supplementary papers focus on changes in development models, population communication research, preproject research, and ongoing projects in population communication and education. The documents stress that many IEC activities in developing countries have been based on research models derived from western mass communications research. It is essential that new models of communication research be developed for use in population programs that reinforce the role of community participation in development. UNFPA's main consideration in providing assistance for population education is to develop and strengthen national resources and programs and to improve local capacity for sustained action.
Report of a WHO Meeting on Adolescent Sexuality and Reproductive Health: Educational and Service Aspects, Mexico City, 28 April - 2 May 1980.
[Unpublished] 1981. 69 p. (MCH/RHA/81.1)In 1977, the Maternal and Child Health Unit of the World Health Organization (WHO) collaborated with the International Planned Parenthood Federation in the design and implementation of a cross-cultural survey in an effort to fill the gaps in available country-specific information on the reproductive health needs of adolescents and the information, education, and services available to them. The premise was that the use of a well-designed survey instrument would provide a global picture of the issues surrounding adolescent sexuality and reproductive health. The surveys were used as background information for the WHO Meeting on Adolescent Sexuality and Reproductive Health: Educational and Service Aspects, held in Mexico in May 1980. The objectives of the meeting were: to review the needs and problems related to sexuality and reproductive health of adolescents; to identify priority research issues related to these needs; to identify appropriate approaches including strategies and channels to meet these needs, including education, health, and social services; and to suggest specific follow-up activities to the recommendations of the meeting. To establish a working outline for the discussions which were to take place during the meeting, extensive background material was presented by some of the participants. These papers, included in an annex, focused on the health and social aspects of pregnancy in adolescents and on adolescents in a changing society, especially in the context of their sexuality and reproductive behavior. A system of plenary sessions and small group discussions took place during the meeting. Based on the background papers and the reports of the 4 working groups, the full meeting developed 4 issues for specific consideration: an adolescent overview; a conceptual model; strategies for action; and specific recommendations. These 4 issues are covered in detail in this report of the meeting. The meeting participants repeatedly emphasized the need to involve adolescents, policy makers, and potential service providers in a program which is not predetermined and sufficiently flexible to permit the participation of all concerned. Meeting participants recommended the development of a series of community-based pilot projects on educational and service programs in sexuality and reproductive health for and with adolescents, action research to support the development of the pilot projects, a focus on youth participation in programs addressed to meet the specific needs of adolescents, and attention directed to encouraging youth to assume responsibility in program development. Summary reports of the cross-cultural survey are included in this report.
[Unpublished] 1981. 8 p. (EPI/GEN/81/9)It is necessary to explore the potential of the 2 types of poliomyelitis vaccine-- the live Oral Poliomyelitis Vaccine (OPV) and the Inactivated Poliomyelitis Vaccine (IPV)--for use in the Expanded on Immunization (EPI). The proposed study is part of a program of investigation that is planned to determine the best ways of realizing reduction in the incidence of poliomyelitis under developing country conditions. The program includes: studies on dosage schedules using either or both types of vaccine; studies on the effect of the 2 vaccines on gut immunity; studies on the circulation of wild poliovirus; and program studies. The primary objective is to determine the cost effectiveness of IPV and OPV in terms of reduction in the incidence of paralytic poliomyelitis under developing country operational conditions. Subsidiary objective include: to determine the effect of known levels of immunization coverage of IPV or OPV on the incidence of poliomyelitis under known operational conditions in a developing country; to determine the effect of known levels of immunization coverage on the circulation of wild polioviruses in the population; to develop methods for continuous clinical surveillance of poliomyelitis that are sensitive and appropriate to development countries; to further develop objective indicators of efficiency for cold chain systems; and to further develop methods of clinical surveillance of measles, whooping cough, and neonatal tetanus that are appropriate to developing countries. The trial envisaged would observe the effect on the incidence of paralytic poliomyelitis of the use by EPI programs of the 2 types of poliomyelitis vaccine in 2 separate populations over a period of 4-6 years. A total population of not less than 2 million and not more than 5 million will be required in each area. From the point of view of comparability of political and health care delivery systems. the trial areas should ideally be part of the same country yet must be geographically discrete from each other. 3 phases are envisaged for the trial: presurveys and planning; program implemention and evaluation; and final analysis and recommendations. Once the study areas have been selected and agreed, epidemiological information can be collected. This information is required both to provide denominators for the evaluation of changes over the trial period and to assist in the design of appropriate immunization schedules and coverage targets. To provide information on the age of infection and the intensity of transmission of serotypes of poliovirus, sample serological surveys of young children will be undertaken. In order that the findings of the trial should have relevance to other programs, it will be necessary for the basic procedures in both trial areas to be similar to those used in other areas and countries participating in the EPI. And, as an essential part of the planning stage, the EPI programs in the trial area will develop quantifiable objectives to determine the end point of the trials.
Summary of vaccine hand carrier and cold box testing, December 1980, Consumers' Association, United Kingdom.
[Unpublished] 1981. 9 p. (EPI/CCIS/81.3)This document summarizes the results of testing of vaccine hand carriers and cold boxes carried out at the Consumers' Association Laboratories in the UK in December 1980. These tests were conducted in order to provide information for the Expanded Program on Immunization (EPI) staff to make knowledgeable dicisions about the choice of cold chain equipment. Performace test were carried out on 11 containers with a full load of vaccine in controlled temperatures of 32 degrees C and 43 degrees C. It was observed that cold boxes supplied with icepacks especially designed for that box provided a longer cold life than boxes that did not come with icepacks. Durability testing (drop test) revealed that some boxes had problems with lid fastenings coming undone upon impact. In some cases, this could be overcome by padlocking the fastenings. A table in this document divides cold boxes tested into 6 size ranges (from less than 2 liters to over 30 liters) and presents the results of testing, data on special features of the cold box, and approximate cost.
[Unpublished] 1981 Jun 19. 46 p. (A/36/215)The Advisory Committee for the International Youth Year, established by the General Assembly of the UN in 1979, met in Vienna, Austria, from March 30-April 7, 1981 to develop a program of activities to be undertaken prior to and during the UN designated 1985 International Youth Year; this report contains the draft program of activities adopted by the committee at the 1981 meeting. The activities of the International Youth Year will be undertaken at the national, regional, and international level; however, the major focus of the program will be at the national level. Program themes are development, peace, and participation. The objectives of the program are to 1) increase awareness of the many problems relevant to today's youth, (e.g., the rapid increase in the proportion of young people in the population; high youth unemployment; inadequate education and training opportunities; limited educational and job opportunities for rural youth, poor youth, and female youth; and infringements on the rights of young people); 2) ensure that social and economic development programs address the needs of young people; 3) promote the ideals of peace and understanding among young people; and 4) encourage the participation of young people in the development and peace process. Program guidelines at the national level suggest that each country should identify the needs of their young people and then develop and implement programs to address these needs. A national coordinating committee to integrate all local programs should be established. Specifically each nation should 1) review and update legislation to conform with international standards on youth matters, 2) develop appropriate educational and training programs, 3) initiate action programs to expand nonexploitive employment opportunities for young people, 4) assess the health needs of youth and develop programs to address the special health needs of young people, 6) transfer money from defense programs to programs which address the needs of young people, 7) expanding social services for youths, and 8) help young people assume an active role in developing environmental and housing programs. Activities at the regional and international level should be supportive of those at the national level. At the regional level, efforts to deal with youth problems common to the whole region will be stressed. International efforts will focus on 1) conducting research to identify the needs of young people, 2) providing technical assistance to help governments develop and institute appropriate policies and programs, 3) monitoring the program at the international level, 4) promoting international youth cultural events, and 5) improving the dissemination of information on youth. Young people and youth organizations will be encouraged to participate in the development and implementation of the program at all levels. Nongovernment agencies should help educate young people about development and peace issues and promote the active participation of youth in development programs. The success of the program will depend in large measure on the effective world wide dissemination of information on program objectives and activities. A 2nd meeting of the advisory committee will convene in Vienna in 1982 to assess progress toward implementing the adopted program. A 3rd and final meeting in 1985 will evaluate the entire program. This report contains a list of all the countries and organizations which participated in the meeting as well as information on program funding.
In: Asia. Contraceptive Prevalence Surveys Regional Workshop. Proceedings. [Columbia, Maryland], Westinghouse Health Systems, 1981 Feb. 4-7. (Contraceptive Prevalence Studies 2)This paper presents the views of the Agency for International Development (AID) on Contraceptive Prevalence Surveys, focusing on why the agency supports them, what the agency wants to get out of them, and how they fit into the AID program. Both the developing countries and the donor community needed data bases that serve several purposes. There was a clear need for data on what was happening in countries with active family planning programs. Fairly substantial resources were being programmed into efforts to slow population growth, and it was important to ensure that these resources were used effectively and efficiently. There were also obvious time pressures. The longer the delay before slowing population growth, the more serious the problem would become. Clearly, timely data were needed. To respond to the varied data needs, early in its history AID's Population Office initiated a broad program of support for data collection, including censuses, surveys, civil registration systems, and family planning program statistics. There was also support for efforts to ensure that these data were evaluated, analyzed, and interpreted to facilitate their use. In 1971, AID along with the UN and the International Statistical Institute, began to develop what became the World Fertility Survey (WFS). The effort was launched more as a research than an administrative tool. During the course of developing the WFS, there was much reluctance on the part of many demographers and social scientists to clarify the link between fertility change and family planning action programs. In 1976, WFS carried out some field trials on a series of questions on perceived family planning availability and accessibility and thereafter developed a set of questions on availability, which were added to the core questionnaire. When the Contraceptive Prevalence Survey (CPS) project was initiated with Westinghouse, AID asked that availability information be collected for all methods requiring a source. These data have been very valuable as a means of gaining insight into the role of availability in contraceptive use. The CPS was specifically designed to collect a limited set of highly program-relevant data quickly and to make these data available to program administrators and policy makers. First, CPS has been an important data source for documenting trends in contraceptive knowledge and use. Second, since many of the WFS, as well as the CPS, have included questions on perceived availability of family planning, it is possible to examine trends in availability. Regarding how the CPS might be improved, the CPS Workshop provides a good opportunity for an exchange of ideas. A description of the Workshop objectives are outlined.
Billings, Montana, Planned Parenthood of Billings, 1981. 15 p.Using a population of 59 minor women who came to the Planned Parenthood Clinic of Billings, Montana in 1980 and 1981 for the first time, this paper isolates factors which are critical in the decision making process the minor experiences before coming to the clinic. In depth interviews were conducted on each adolescent ranging from 13 years to 17 years. Background information shows that: 1) 1/2 of the adolescents interviewed have parents who are divorced; 2) only 50% live with their father while 72% live with their mother; and 3) most of the parents do not have much education. Counselors can never assume that an adolescent comes from any particular kind of household. Characteristics of sexual experiences reveal that: 1) 96% of the adolescents had already had sexual intercourse before they came to the Planned Parenthood Clinic for the first time; 2) the average age of 1st sexual intercourse is 15.18; 3) for all but the 16 year age group, the greatest percentage of adolescents have intercourse for the first time during the year that they 1st come to the clinic; 4) 62% of the adolescents have intercourse with more than 1 person, and usually within a few months to 4 years before they come to Planned Parenthood; 5) most adolescents have an unpleasureable sexual experience their first time; 49% were reported as violent experiences; and 6) the significance of sex as expressed by the adolescent women is that of an expression of closeness and love for their boyfriend. When the adolescents come to the clinic for the 1st time they already know what kind of contraceptive they want to use; 88% specifically requested oral contraceptives. Data demonstrate that people or an individual person in the adolescent woman's social network play a key part in the decision of the adolescent to come to the clinic for the 1st time; the adolescent herself, the adolescent and her boyfriend, a parent, a boyfriend alone, a girlfriend, and a sibling, in this descending order, are the persons who initiate the idea. Recommendations for more effective birth control of adolescents are: 1) males should be educated to encourage and show approval towards their partner's contraceptive use; 2) educational programs for parents to deal directly with their child's sexual experiences; 3) all children in the family should be talked to about sex and birth control; and 4) adolescents who do come to clinics should be encouraged by counselors to tell their friends about their experiences there. Studies show that there are direct correlations between high self esteem and adolescent contraceptive use; counselors can link the pragmatic concerns of adolescents for future prospects with the consequences of pregnancy. This, along with workshops which help prepare mothers to talk to their daughters about sex and contraceptives, can help adolescent women get the contraceptive information they need in order to achieve their future goals by reducing the risk of pregnancy.