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Bethesda, Maryland, University Research Corporation, 1991 Apr. ix, 77,  p. (BAN-14; USAID Contract No. DPE-3030-C-00-5043-00; TvT No. BAN-SAS-04-10)Save the Children has a women's savings program (SAVE), which is an integral part of its comprehensive integrated rural development program. Women's savings groups were introduced in Bangladesh on an experimental basis in 1982. Over the years, these indigenous small groups have evolved from simple "savings" groups to dynamic forums to improve women's economic and social horizons and enable them to gain greater control over their lives and those of their children. An operations research study was undertaken, at a cost of US $35,874, to examine and document the impact of womens' savings groups on contraceptive use. The study was undertaken in 8 villages in Nasirnagar Upazila where SAVE programs were in operation: 5 villages where programs were initiated in 1982 (old villages) and 3 villages (new villages) where programs were begun in 1989. 2 comparison villages (without SAVE programs) were also selected at random from among the villages in the same geographic area. The experimental and comparison villages were similar in terms of household size, age, parity, and total fertility of the married women of reproductive age. The study employed a quasi-experimental design. Data were collected using a baseline survey and a mini-contraceptive prevalence survey conducted in both experimental and comparison villages as well as 2 rounds of individual and group interviews with selected savings group members and nonmembers in the experimental villages. Relevant cost data were obtained from SAVE/Dhaka. Selected variables from the SAVE project management information systems (PMIS) were also used for comparison with similar variables obtained in the baseline survey. Womens' savings groups, combined with family planning (FP) motivation, supplies, and services can be an effective strategy of raising contraceptive prevalence in rural Bangladesh. Contraceptive use, both ever and current, was higher in the experimental than in comparison villages and was higher in the old than in the new villages. Contraceptive use was higher among savings group members than among nonmembers, and contraceptive use was higher among the latter group than in the comparison villages, suggesting that the SAVE program helped raise contraceptive use among both members and nonmembers in the project villages. Current use at the baseline among members was 30.9 and 16.9% among members in old and new villages, respectively, and 7.3% in the comparison villages. Among nonmembers, current use was 17.9% in the old villages and 12.9% in the new villages. Current contraceptive use declined from 30.9 to 25.4% in the old villages over the life of the project. One of the main reasons reported for discontinuation was nonavailability of FP methods.
TIDSSKRIFT FOR DEN NORSKE LAEGEFORENING. 1991 May 30; 111(14):1729-33.The 4 cornerstones of reproductive health according to the WHO are family maternal care neonatal and infant care, and the control of sexually transmitted diseases. In recent years, the AIDS epidemic has caused concern in the world. The world's population doubled to 4 billion from 1927 to 1974, and it will reach 6 billion by the year 2000. The rate of growth is 1.4% in China and 2% in India vs. .3% in Europe. Contraceptive prevalence is 15-20% in Africa, 30% in South Asia, and 75% in East Asia. Shortage of contraceptives leads to abortion in eastern Europe. In 1985 in the USSR, there were 115.7 abortions/1000 women (mostly married) aged 15-44; and 6.4 million abortions for 5.5 million births in 1989. RU-486 or mifepristone combined with prostaglandin has produced abortion in 90% of first trimester pregnancies. After approval in France in 1987, it was used in 40,000 abortions in the following year. 90% of the estimated annual 500,000 maternal deaths occur in developing countries. In Norway, the rate is fewer than 10/100,000 births vs. 100/100,000 in Jamaica. In the mid-1980s, 26% of rural women in Thailand, 49% in Brazil, 54% in Senegal, and 87% in Morocco went without maternal care. In Norway, infant mortality is 6-8/1000 live births vs. 75-150/1000 in developing countries. A WHO investigation on causes of infertility in 25 countries found a 31% rate of tubal pathology in 5800 couples. In Africa, over 85% f infertility in women was infection related. Venereal diseases and infertility are associated with premarital sexual activity in young people. Various donor agencies and the WHO Special Program of Research, Development, and Research Training in Human Reproduction are providing help and resources including AIDS research.
[WHO Special Programme of Research, Development and Research Training in Human Reproduction (HRP). A summary] WHO Special Programme of Research, Development and Research Training in Human Reproduction (HRP). Eine zusammenfassende Darstellung.
GEBURTSHILFE UND FRAUENHEILKUNDE. 1991 Jan; 51(1):9-14.The WHO's Special Program of Research, Development, and Research Training in Human Reproduction (HRP) has been involved in a global research and development program since 1972 in the are of human reproduction with special regard to the needs of developing countries. HRP set up a worldwide network of cooperating institutes and organized task forces for carrying out priority research objectives/assignments. The goals of HRP include reducing population growth in developing countries by improving health care and by increasing the availability of contraceptives. HRP training and research activities have encompassed workshops, seminars, and training courses. Research and development have been concerned with contraceptive prevalence and use; risks of contraceptives (carcinogenicity, cardiovascular effects, and subdermal implants' side effects); the development of new and safe methods (1-2 month depot preparations; and the levonorgestrel-releasing vaginal ring); and efficacy of contraceptive methods (lactation for birth spacing and natural family planning). A multicentric study in 25 countries has examined infertility caused by infections and sexually transmitted diseases. The extension of research capacity in developing countries was enabled by long-term institutional development grants, capital grants, labor cost financing, training of scientists, and improvement of management. The social and individual determinants of family planning aims at increasing contraceptive prevalence from 11% in Africa, 24% in Southeast Asia, and 43% in Latin America to the level of industrial countries 68%. The structure and management, goal setting and priorities, international cooperation, and finances of HRP are further detailed.
Contraceptive source and the for-profit private sector in Third World family planning. Evidence and implications from trends in private sector use in the 1980s.
[Unpublished] 1991. Presented at the Annual Meeting of the Population Association of America, Washington, D.C., March 21-23, 1991.  p.Estimates by Family Health International and UNFPA predict that the annual cost of modern family planning in meeting the target overall contraceptive prevalence level of 52% will be between $5-9 billion by the year 2000. The number of couples using modern methods of contraception will increase dramatically in future years, incurring great cost to donors, governments, and users. Urbanization, rising incomes, and higher education levels are generally seen as positive factors in permitting an expanded private sector role in the provision of modern contraceptives, providing an alternative source to donor and government programs. The for-profit concerns within the private sector of developing countries, were studied using available 1978-89 data from 26 countries to examine private family planning sources of contraceptives. Also, hypothetical determinants of private family planning use are established and their interrelationship with the use of for-profit family planning services, is investigated. Contrary to result expectations, it was found that use of the major provider for-profit private sector is declining in the face of rising incomes, urbanization, and better education. Government services are crowding out the private sector. Additionally, results indicate a strong user desire for longer-term methods. Full comprehension of the private sector and the factors governing choice of contraceptive source should lead to more effective use of donor and government funding in efforts to achieve set population objectives. Policy and program development will more accurately reflect social needs. Policy implications of the results are discussed.
[Unpublished] . 10,  p.Based upon United Nations medium population projections, the population of developing countries will grow from 4,086 million in 1990, to 5,000 million by the year 2000. To meet this medium-level projection, 186 million contraceptive users must be added for a total 567 million in addition to increased contraceptive prevalence of 59% from 51%. This study estimates the number of contraceptive users, acceptors, and cost of contraceptive commodities needed to limit growth to this medium projection. Needs are estimated by country and method for 1990, 1995 and 2000, for medium, high, and low population projections. The number of contraceptive users required to reach replacement fertility is also calculated. Results are based upon the number of women aged 15-49, percent married, number married ages 15-49, and the proportion of couples using contraception. Estimation methodology is discussed in detail. Estimated users of respective methods in millions are 150 sterilizations, 333 IUD insertions, 663 injections, 7,589 cycles of pills, and 30,000 condoms. Estimated commodity costs will grow from $399 million in 1990 to $627 million in 2000, for a total $5.1 billion over the period. Pills will be the most expensive at $1.9 billion, followed by sterilizations at $1.4 billion, condoms $888 million, injectables $594 million, and IUDs $278 million. Estimated costs for commodities purchased in the U.S. show IUDs and condoms to be significantly more expensive, but pills as cheaper. With donors paying for approximately 25% of public sector commodity costs, developing country governments will need to pay $4.2 billion of total costs in the absence of increased commercial/private sector and donor support.
[Unpublished] 1991. Presented at the Demographic and Health Surveys World Conference, Washington, D.C., August 5-7, 1991. 22 p.A supply-demand approach is used to estimate total and unmet demand for family planning in Indonesia over the last decade. The 1976 Indonesia Fertility Survey, the 1983 Contraceptive Prevalence Survey, and the 1987 National Contraceptive Prevalence Survey form the database used in the study. Women under consideration have been married once, are aged 35-44, have husbands who are still alive, have had at least 2 live births, and had no births before marrying. High demand was found for family planning services, with the proportion of current users and women with unmet demand accounting for over 85% of the population. Marked improvement in contraceptive practice may be achieved by targeting programs to these 2 groups. Attention to unmotivated women is not of immediate concern. Women in need of these services are largely rural and uneducated. Programs will, therefore, require subsidization. The government should gradually and selectively further introduce self-sufficient family planning programs. User fees and private employer service provision to employees are program options to consider. Reducing the contraceptive use drop-out rate from its level of 47% is yet another approach to increase contraceptive prevalence in Indonesia. 33% drop out due to pregnancy, 26% from health problems, 10% because of method failure, 10% from inconveniences and access, and 21% from other causes. Improving service quality could dramatically reduce the degree of drop-outs.
New York, New York, UNFPA, . ix, 81 p.Rapid population growth is an obstacle to Vietnam's socioeconomic development. Accordingly, the Government of Vietnam has adopted a population policy aimed at reducing the population growth rate through family planning programs encouraging increased age at 1st birth, birthspacing of 3-5 years, and a family norm of 1-2 children. TFR presently holds at 4, despite declines over the past 2 decades. Current mortality rates are also high, yet expected to continue declining in the years ahead. A resettlement policy also exists, and is aimed at reconfiguring present spatial distribution imbalances. Again, the main thrust of the population program is family planning. The government hopes to lower the annual population growth rate to under 1.8% by the year 2000. Achieving this goal will demand comprehensive population and development efforts targeted to significantly increase the contraceptive prevalence rate. Issues, steps, and recommendations for action are presented and discussed for institutional development strategy; program management and coordination and external assistance; population data collection and analysis; population dynamics and policy formulation; maternal and child health/family planning; information, education and communication; and women, population, and development. Support from UNFPA's 1992-1995 program of assistance should continue and build upon the current program. The present focus upon women, children, grass-roots, and rural areas is encouraged, while more attention is suggested to motivating men and mobilizing communities. Finally, the program is relevant and applicable at both local and national levels.
Study cites unmet world demand for contraceptives..House panel votes to increase Pop Aid funding, rescind program restrictions.
WASHINGTON MEMO. 1991 May 20; (8):1-2.In addition to increasing overseas family planning aid, the House Foreign Affairs Committee has voted to reverse restrictive policies begun during the Reagan administration. This decision comes after the publication of a UNFPA annual report entitled "The State of World Population," which indicates that the world's population could double to 10.2 billion with 60 years. Despite the Bush administration's opposition to earmarking funds for specific programs within the Agency for International Development (AID), the committee allocated funds specifically for population programs. For population assistance, it reserved $300 million for 1992 and $350 for 1993, up from $250 million the previous year. The committee also made available $100 million for family planning under the Development Fund for Africa, doubling the amount from the previous year. Besides increased funding, the committee also voted to renew funding to UNFPA and to reverse the "Mexico City" policy. In 1985, the Reagan administration ended all aid to UNFPA because the organization contributed money to China's family planning program. The administration viewed this as condoning coercive abortion practices. The Mexico City policy, named after the host city of the 1984 International Conference on Population, banned any US aid to family planning organizations in developing countries which provided abortion-related services or information, even if these programs were being funded without US money. Although just beginning to prepare its reauthorization bill, the Foreign Relations Committee in the Senate also appears ready to increase its support of population activities, including the reversal of the 2 policies. But critics of UNFPA and defenders of the Mexico City policy have threatened with a presidential veto if the measures are eventually adopted.