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  1. 1
    031138

    WHO Programme in Maternal and Child Health and Family Planning. Report of the second meeting of the WHO Programme Advisory Committee in Maternal and Child Health, Geneva, 21-25 November 1983.

    World Health Organization [WHO]. Division of Family Health. Maternal and Child Health Unit

    [Unpublished] 1984. 95 p. (MCH/84.5)

    The objectives of the 2nd meeting of the Program Advisory Committee (PAC) for the World Health Organization's (WHO's) Program in Maternal and Child Health, including Family Planning (MCH/FP) were to 1) assess the MCH/FP program's achievements since the 1st PAC meeting in June, 1982, 2) determine the level of scientific and financial resources available for the program, and 3) to examine the role of traditional birth attendants (TBAs) in the delivery of MCH/FP services. The committee reviewed the activities and targets of the program's 4 major areas (pregnancy and perinatal care, child health, growth, and development, adolescent health, and family planning and infertility), and developed a series of recommendations for each of these areas. Specific recommendations were also made for each of the major program areas in reference to the analysis and dessimination of information and to the development and use of appropriate health technologies. Upon reviewing the role of TBAs in the delivery of MCH/FP services, PAC recommended that all barriers to TBA utilization be removed and that training for TBAs should be improved and expanded. PAC's examination of financial support for MCH/FP activities revealed that for a sample of 26 countries, the average annual amount allocated to MCH activities was less than US$3/child or woman. This low level of funding must be taken into account when setting program targets. International funding agencies did indicate their willingness to increase funding levels for MCH programs. The appendices included 1) a list of participants, 2) an annotated agenda, 3) detailed information on the proposed activities of the program's headquarters for 1986-87, and 4) a description of the the function, organizational structure, and technical management of the MCH/FP program. Also included in the appendices was an overview of the current status of MCH and a series of tables providing information on infant, child, and maternal health indicators. Specifically, the tables provided information by region and by country on maternal, child, and infant mortality; causes of child deaths; maternal health care coverage; contraceptive prevalence; infant and child malnutrition; the number of low weight births; adolescent health; teenage births; breast feeding prevalence and duration; and the proportion of women and children in the population.
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  2. 2
    048361

    Laws and policies affecting fertility: a decade of change. Leis e politicas que afetam a fecundidade: uma decada de mudancas.

    Isaacs SL; Cook RJ; Pile JM; Smit L; Levitt L; Cairns G; Heckel N

    Population Reports. Series E: Law and Policy. 1984; (7):E105-E151.

    In the last decade over 50 countries have strengthened laws or policies relating to fertility. Approximately 40 developing countries have issued explicit statements on population policy emphasizing the relationship to national development. In several countries constitutional amendments have been passed reflecting a more positive attitude toward family planning. High-level units, e.g. small technical units, interministerial councils and coordinating councils have been established to formulate policies or coordinate programs. Other actions relating to fertility include: increased resources for family planning programs, both in the public and in the private sector; elimination of restrictions on family planning information, services and supplies; special benefits for family planning acceptors or couples with small families, and measures to improve the status of women, which indirectly affects childbearing patterns. The recognition that policies, laws and programs to influence fertility are an integral part of efforts to promote social and economic development was reaffirmed at the International Conference on Population in Mexico City in 1984. 147 governments expressed their support for voluntary programs to help people control their fertility. Governments cite at least 4 reasons for increased attention to policies affecting fertility and family planning. Some of these are the desire to slow population growth to achieve national development objectives, concern for maternal and child health, support for the basic human right to determine family size, and equity in the provision of health services. In addition to the strongest laws and policies to lower fertility in Asia, legal changes are occurring in Latin America, Africa, and the Middle East. Family planning programs, laws on contraceptives and voluntary sterilization, compensation, incentives and disincentives, the legal status of women and fertility and policy-making and implementation are reviewed, as well as equal employment, education, political and civil rights and equality of women within marriage and the family.
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  3. 3
    028322

    The Billings method of family planning: an assessment.

    Betts K

    Studies in Family Planning. 1984 Nov-Dec; 15(6/1):253-66.

    This paper critically analyzes claims for the effectiveness of the Billings method of natural family planning and raises questions about the wisdom of actively promoting this method. The Billings method, developed in Australia, is based on client interpretation of changing patterns of cervical mucus secretion. Evaluation of the method's use-effectiveness has been hindered by its supporters' insistence on distinguishing between method and user failures and by the unreliability of data on sexual activities. However, the findings in 5 large studies aimed at investigating the biological basis of the Billings method provide little support for the claims that most fertile women always experience mucus symptoms, that these symptoms precede ovulation by at least 5 days, and that a peak symptom coincides with the day of ovulation. Although many women do experience a changing pattern of mucus symptoms, these changes do not mark the fertile period with sufficient reliability to form the basis for a fully effective method of fertility control. In addition, the results of 5 major field trials indicate that the Billings method has a biological failure rate even higher than the symptothermal method. Pearl pregnancy rates ranged from 22.2-37.2/100 woman-years, and high discontinuation rates in both developed and developing countries were found. Demand for the method was low even in developing countries where calendar rhythm and withdrawal are relatively popular methods of fertility control, suggesting that women of low socioeconomic status may prefer a method that does not require demanding interaction with service providers and acknowledgment of sexual activity. The Billings method is labor-intensive, requiring repeated client contact over an extended time period and high administrative costs, even when teachers are volunteers. It is concluded that although natural family planning methods may make a useful contribution where more effective methods are unavailable or unacceptable, many of the claims made for the Billings method are unsubstantiated by scientific evidence.
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  4. 4
    027019

    World Health Day 1984. Children's health--tomorrow's wealth.

    Mahler H

    Who Chronicle. 1984; 38(3):109-15.

    The theme of the 1984 World Health Day--children's health, tomorrow's wealth--provides an occasion to convey to a worldwide audience the message that children are a priceless resource, and that any nation which neglects them does so at its peril. World Health Day 1984 spotlights the basic truth that the healthy minds and bodies of the world's children must be safeguard, not only as a key factor in attaining health for all by 2000, but also as a major part of each nation's health in the 21st century. An investment in child health is a direct entry point to improved social development, productivity, and quality of life. Care of child health starts before conception, through postponement of the 1st pregnancy until the mother herself has reached full physical maturity, and through spacing of births. It continues from conception on, through suitable care during pregnancy, childbirth, and childhood. In the developing countries the child must be protected by all available means, particularly from the killer diseases. What happens in the immediate family and community around the mother and child, and even far away in the world, can have a direct impact on the health and security of both of them. The mother and child need to be placed in an environment that will ensure their health by protecting the overall setting in which they live. This means providing clean water, disposing of waste, and helping to improve shelter. Nothing can diminish the importance of good food, enough food, and proper nutrition for children and their mothers. Beyond the immediate physical needs are the equally important needs for love and understanding which stimulate the healthy development of the child. The emergence of new health problems of mothers and children in developing and developed countries should be kept in mind. Better health services must be made available to all who need them. The World Health Organization (WHO) provided resource material on World Health Day issues for dissemination throughout the world. Extracts from 4 articles on this year's theme are reproduced. The articles report on the success of the Rural Health Center in Ballabhgarh (India) in reducing maternal and infant mortality, the value of breastfeeding as 1 of the simplest and safest ways of ensuring adequate spacing of births, Tunisia's integration of a program of immunization into the routine activities of the health care system, and the needs of the healthy child.
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  5. 5
    024731

    Adolescent fertility: report of an international consultation, Bellagio 1983.

    McKay J

    London, England, IPPF, 1984 May. ii, 59 p.

    The Bellagio consultation was held in July, 1983 on the initiative of the Programme Committee of International Medical Advisory Panel to consider more closely what the needs of adolescents are and what more should be done to meet them. Participants from several countries--within and outside of IPPF--were invited. Before the Consultation, participants exchanged information, experience and ideas in writing as a basis for their discussion. 3 topics were focused on: 1) needs and problems; 2) information, education, and counselling; and 3) reproductive health management. An action plan for the next 3 to 5 years was drawn up. It offers broad suggestions about the kind of activities that would be appropriate for family planning associations and IPPF to take. Adolescents all over the world are in need of much better education and health care related to fertility, these are not the same in each society. A comprehensive approach to adolescent needs is favored. The recommendations form part of a broad discussion about how adolescents can best be helped to behave responsibly. Adolescent fertility has implications for health, psychological, social and economic well being. General program and operational guidelines are given, as are 8 areas for action: 1) creation of awareness and advocacy; 2) youth leadership and participation in adolescent programs; 3) information and education; 4) counseling; 5) fertility-related services; 6) sharing of experience, information and resources; 7) training and skill development; and 8) research. A list of participants and background papers is given.
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  6. 6
    025280

    Acceptance speech.

    Foly A

    [Unpublished] 1984. Presented at the 11th Annual NCIH International Health Conference: International Health and Family Planning: Controversy and Consensus, Arlington, Virginia, June 10-13, 1984. 2 p.

    Upon acceptance of the National Council of International Health's International Health Award, Ayele Foly discussed the methodology she has used to teach family health to village women in Africa. By training local village leaders to teach health care, nutrition, prevention of diseases, and family planning, the information is more easily accepted than if introduced from the outside. Some women were taught the Billings Ovulation Method to make them more aware of their reproductive process, but there is need for more sure contraceptive methods for village women. In the village of Dampion in northern Togo, a woman who was already growing soybeans and preparing them for her family led a workshop to train other women from neighboring villages to enrich their families' diets with soybeans. The villagers of Kati in southern Togo learned to eliminate a large part of the guinea worm problem by filtering their water through cloth, installing pumps in their village, and building new wells. Through visual aids produced by World Neighbors and demonstrations of the connection between guinea worm and stagnant pond water, the villagers were motivated to take responsibility for their own health.
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  7. 7
    024816

    Family planning and health: an evaluation.

    Pomeroy R

    Planned Parenthood Review. 1984 Spring-Summer; 4(1):9-10.

    The Planned Parenthood Federation of America supports international family planning efforts through its affiliation with the International Planned Parenthood Federation (IPPF) and the activities of its own International Division, Family Planning International Assistance (FPIA). FPIA is founded on the beliefs that family planning is a basic human right; family planning programs benefit individuals, families, communities, and nations; and family planning along with other needed socieconomic programs can have a major impact on development. Careful timing, spacing, and limiting of births is directly and causally related to improved infant and maternal survival through readily observed and easily explained mechanisms. Mothers in developing countries are anywhere from 10 to 20 or 30 times as likely to die in childbirth as mothers in developed countries. Risks are greatest for mothers under 18 years old, over 30, for those having births within 2 years of a previous birth, and 4th or later deliveries. The differences occur for women at all levels of affluence and access to medical care in all societies, but are particularly sharp in developing countries. Among the poorest countries, 200 or more of every 1000 liveborn infants may die in their 1st year compared to fewer than 10/1000 live births in some wealthy egalitarian countries. The infant mortality rate is so closely related to the overall level of well-being in a country or region that it is regarded as 1 of the most revealing measures of how well a society is meeting the needs of its people. Many of the risk factors for maternal mortality also contribute to infant mortality. Infant mortality in developing countries drops appreciably when women practice family planning and reduce the number of high risk pregnancies. Throughout the developing world, the higher risk infants born to very young or older mothers, mothers with recent previous pregnancies, and mothers with 3 or 4 previous births are 3-10 times more likely to die in their 1st year. Too short birth intervals may threaten the life of the older child through early weaning and resulting increased susceptibility to malnutrition and infection. Careful planning of births through contraception can result in a population better able to contribute economically and less likely to strain the medical resources.
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  8. 8
    020489

    Breast feeding: fertility and contraception.

    Kleinman RL; Senanayake P

    London, International Planned Parenthood Federation, 1984. 43 p. (IPPF Medical Publications)

    This booklet, for health care workers in developing countries, reviews the fertility-controlling effects of breastfeeding, its strengths and limitations as an element in family planning, and how to provide modern methods of contraception to lactating women. Breastfeeding currently provides about 30% more protection against pregnancy in developing countries than all of the organized family planning programs. The recent trend toward a falling off in the practice of breastfeeding poses a threat to infant welfare and a danger of increased fertility. Health workers are urged to reach pregnant women in the community with knowledge about the value of breastfeeding versus bottle feeding. Each country must set its own policies concerning contraception for lactating women. It is preferable for lactating women to use nonhormonal methods, but if selected, they should not be used too early. Lowest-dose preparations, especially progestogen-only pills, are preferable. Determination of when to start contraception during lactation should be based on breastfeeding patterns in the community, the age at which supplementary foods are introduced, usual birth spacing intervals, and the mean duration of lactation amenorrhea. If the usual time of resumption of menstruation in a given community is known, a rough guide to the optimal time for starting contraception is returning menstruation minus 2 months.
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