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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES. 1991; 626:1-10.WHO defines reproductive health as people having the ability to reproduce, to regulate fertility, and to practice and enjoy sexual relationships. It also means safe pregnancy, child birth, contraceptives, and sex. Procreation should include a successful outcome as indicated by infant and child survival, growth, and healthy development. 60-80 million infertile couples live in the world. Core infertility, i.e., unpreventable and untreatable infertility, ranges from 3% to 5%. Sexually transmitted diseases, aseptic abortion, or puerperal infection are common causes of acquired infertility. Sub-Saharan Africa has the highest prevalence of acquired infertility. In 1983, the world contraceptive use rate stood at 51% with the developed countries having the highest rate (70%) and Africa the lowest rate (14%). About 40 countries in Africa and the Arabian Peninsula practice female circumcision. The percent of low birth weight infants is greater in developing countries than in developed countries (17% vs. 6.8%). Intrauterine growth retardation is responsible for most low birth weight infants in developing countries while in developed countries it is premature birth. About 15 million infants and children die each year. Maternal mortality risk is highest in developing countries especially those in Africa (1:21) and lowest in developed countries (1:9850). Sexually transmitted diseases continue to be a major problem in the world especially in developing countries. Chlamydia afflicts 50 million people each year. The proportion of women with AIDS is growing so that between the 1980s and 1990s it will grow between 25% and 50%. More available contraceptive choices enhance safety in fertility regulation. Socioeconomic conditions that determine reproductive health are poverty, literacy, and women's status. Sexual behavior, reproductive behavior, breast feeding, and smoking are life style determinants of reproductive health. Availability, utilization, and efficiency of health care services and level of medical knowledge also determine women's reproductive health.
In: African research studies in population information, education and communication, compiled and edited by Tony Johnston, Aart de Zeeuw, and Waithira Gikonyo. Nairobi, Kenya, United Nations Population Fund [UNFPA], 1991. 83-100.Researchers studied 62 pregnant women intending to not terminate their pregnancy and to continue their studies and 27 nonpregnant women to learn about female student fertility related behavior. They were all enrolled at the University of Zambia either during the 1987-1988 or 1989-1990 academic years. Methodology consisted of interviews, questionnaires, and focus group discussions. 68% of all women were single with 40% of them having at least 1 child. 75% of the women were sexually active. 42.7% knew traditional family planning methods with friends, grandmothers, and social aunts telling 25.9% of all the women about such methods. Yet mass media provided most women (49.4%) with knowledge about modern methods. 50.6% thought the pill to be the most effective method. >65% considered the 24-26 as the ideal age at marriage. The mean ideal family size was 3.5, somewhat less than family size for urban women in Zambia. 71.9% considered children to be assets since children are a means to social security (33%), self fulfillment (8%), and companionship (7%). 94.4% approved of family planning mainly for purposes of child spacing (29.2%), limiting (23.6), and spacing and limiting (32.6%). Even though they knew about and approved of family planning and claimed modern attitudes concerning ideal age at marriage and ideal family size, 62% of single pregnant students and 59% of married pregnant students did not use or regularly use contraception. This suggested that they considered early childbearing to be an asset. The leading reasons for contraception nonuse included perception of low pregnancy risk (40%) and desire for a child (28%). Only 3.2% claimed method failure. 64% of all women said partners did not approve of contraceptive use. Access to family planning and cost were not a problem. Only 22% of pregnant students said pregnancy would reduce their chances of marriage. In conclusion, many women became pregnant surreptitiously.
ASIA-PACIFIC POPIN BULLETIN. 1991 Jun; 3(2):7-11.George Walmsley, UNFPA country director for the Philippines, discusses demographic and economic conditions in the Philippines, and present plans to revitalize the national population program after 20 years of only modest achievements. The Philippines is a rapidly growing country with much poverty, unemployment and underemployment, uneven population distribution, and a large, highly dependent segment of children and youths under age 15. Initial thrusts of the population program were in favor of fertility reduction, ultimately changing to adopt a perspective more attuned to promoting overall family welfare. Concurrent with this change also came a shift from a clinic-based to community-based approach. Fertility declines have nonetheless grown weaker over the past 8-10 years. A large gap exists between family planning knowledge and practice, with contraceptive prevalence rates declining from 45% in 1986 to 36% in 1988. Behind this lackluster performance are a lack of consistent political support, discontinuities in program implementation, a lack of coordination among participating agencies, and obstacles to program implementation at the field level. The present government considers the revitalization of this program a priority concern. Mr. Walmsley discusses UNFPA's definition of a priority country, and what that means for the Philippines in terms of resources nd future activities. He further responds to questions about the expected effect of the Catholic church upon program implementation and success, non-governmental organization involvement, the role of information and information systems in the program, the relationship between population, environment and sustainable development, and the status of women and its effect on population.