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Psychoanalytic Review. 1998 Aug; 85(4):639-658.This article will explore some of the issues of resilience in the child population of Bosnia during the recent war there. It will also look at similar issues in the humanitarian aid workers who came from outside the country as representatives of relief agencies. I, myself, worked for UNICEF, and it was my job to train members of the local population to work with Bosnian children in an attempt to increase their resilience under intense wartime stress and to reduce the traumatic impact to those children already harmed. (author's)
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (KEN-13)For the past 20 years, Chogoria Hospital has run a steadily expanding clinic and community-based health service program in Meru District. This hospital, with its 32 satellite clinics and its catchment area, has been renowned for its high contraceptive prevalence and low fertility rate compared to the Kenyan national average and that of many sub-Saharan countries. Several factors have contributed to this success, including community-based distribution by family health educators (FHEs) and community health workers (CHWs). Through these community-based distributors, family planning (FP), child welfare, and antenatal clients who fail to turn up for appointments within a month after the default date are followed-up and encouraged to visit a clinic. Financial support for this default tracking system has been ensured through donor funds. Lately, however, the longterm sustainability and usefulness of the tracking system have been questioned. In response to this concern, the management at Chogoria Hospital asked The Population Council to evaluate the default tracking system. This study, which cost US $15,080, determined the extent to which the default tracking system is effective in identifying, tracking, and bringing defaulters back to the program. In addition, the cost of tracking down and bringing back a client was determined. A third component involved assessing the attitude of clients towards this activity and their consequent behavior when they visit Chogoria or other clinics. Data were collected from interviews with 654 defaulting clients using a general questionnaire and 3 other ones specific to FP, child welfare, and antenatal issues. 4 teams composed of local school teachers, with heads of schools acting as supervisors, identified and interviewed the defaulters over a period of 13 days. The teams, who had substantial previous experience in interviewing and data collection, received a week-long training session which included 2 days of fieldwork. A different questionnaire was used to collect information from CHWs. These data were supplemented by information received from field team observations. True defaulters were few, and the impact of CHWs and FHEs in bringing back these clients was low (11-17%). The benefits derived from bringing back a defaulter were negligible compared to the high cost of deploying the CHWs and FHEs. As a result, it was recommended that the default tracking system be discontinued. In addition, it was suggested that the CHWs and FHEs be supervised more effectively and that they concentrate their efforts on other community health activities such as primary health care counseling.
[Berne], Switzerland, Aide Suisse contre le SIDA, 1988 Apr.  p. (Documentation 1)This document contains 12 brief and nontechnical articles by experts on different aspects of AIDS diagnosis and control. The 1st 3 articles, on AIDS information and communications, include a discussion of the international exchange of information on AIDS, an outline of worldwide activities of the World Health Organization Special Program Against AIDS, and a discussion of information policy on AIDS. The next several articles, on AIDS transmission, include articles explaining why mosquitoes do not transmit AIDS and why AIDS is not spread by kissing. An article calls for fighting AIDS instead of using it as a vehicle for social control or discrimination against marginal groups. 3 others call for greater understanding and compassion rather than fear in dealing with AIDS patients. A more detailed article on means of contamination and the unlikelihood of infection through casual contact is followed by a work suggesting that screening for HIV be limited primarily to blood donors and individuals with symptoms suggesting HIV infection. The final article analyzes why Switzerland has the highest per capita prevalence of AIDS in Europe and explores the epidemiology of AIDS in Switzerland.
[People's perception of diseases: an exploratory study of popular beliefs, attitudes and practices regarding immunizable diseases]
Dhaka, Bangladesh, Worldview International Foundation, 1987 Nov.  p.Researchers interviewed 57 mothers and 27 heads of family in predominantly rural areas about 135km from the capital city of Dhaka, Bangladesh to learn about their perception of diseases. They also talked with 3 traditional healers and 8 influential people in the different locales, e.g., teachers and imams. They learned that each vaccine preventable disease has at least 1 local name rooted in popular beliefs, e.g., all local names for poliomyelitis are associated with an ominous wind. Generally, the local people believe that witches or evil spirits cause all the vaccine preventable diseases. These entities prefer attacking babies, but also are known to afflict women. A preventive measure practiced includes pregnant women never leaving the house in the evening, at noon, or at midnight since these are the times when they are most exposed to evil spirits. There exist 2 traditional healers--fakirs and kabiraj. Fakirs use mystic words with religious chants and perform various healing rituals. The kabiraj sometimes use healing rituals, but also prescribe indigenous medicines. This research provides some useful insights into WHO's Expanded Programme on Immunization in developing communication strategies which build on what people already know. For example, since the local people believe that evil spirits or witches attack the newborn immediately after birth may provide an incentive for early immunization. Since preventing illness and death in newborns is a goal of both modern and traditional medicine, it is likely that the local people are not so concerned with the real cause of illness and will accept any practice that keeps their infant healthy and that fits into their beliefs and perceptions.
Hospitals and health for all. Report of a WHO Expert Committee on the Role of Hospitals at the First Referral Level.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (744):1-82.The World Health Organization (WHO) Expert Committee on the Role of Hospitals at the First Referral Level met from December 9-17, 1985, to review the role of the hospital in the broader context of a health system. The Expert Committee recognized that different strategies could be used to define the role of hospitals in relation to primary health care and that, for example, it would be possible to begin by analyzing what hospitals currently are doing with respect to primary health care, describe the different approaches being used, and then formulate guidelines to be followed by hospitals that are seeking to strengthen their involvement in primary health care. A shortcoming of this strategy is that it is based on what hospitals are already doing in particular circumstances, rather than helping people to decide what is required in a wide range of different settings. Consequently, the Expert Committee undertook to provide an analysis of primary health care, particularly in relation to the principles of health for all, to specify the components of a district health system based on primary health care, and to use this information as a basis for describing the role of the hospital at the first referral level in support of primary health care. This report of the Expert Committee covers the following: hospitals versus primary health care -- a false antithesis (the need for hospital involvement, the evolution of health services, expanding the role of hospitals, delineation of primary health care, hospitals and primary health care, and the common goal of health for all); components of a health system based on primary health care (targeted programs, levels of service delivery, and the functional infrastructure of primary health care); role and functions of the hospital in the first referral level (patient referral, health program coordination, education and training, and management and administrative support); the district health system; and approaches to some persistent problems (problems of organization and function; problems of attitudes, orientation, and training; and problems of information, financing, and referral system). The report includes recommendations to WHO, to governments, to nongovernmental organizations, and to hospitals. The Expert Committee considered that the conceptual focal point for organizational and functional integration should be the district health system encompassing the hospital and all other local health services. Further, the Expert Commitee was convinced that organizational and functional interaction (focused on the district health system) is imperative if full and effective use is to be made of the resources of the hospitals at the first referral level and if the health needs of the population are to be met.
[Washington, D.C.], Interim Working Group on Reproductive Health Commodity Security, 2001 Apr. 4 p. (Meeting the Challenge: Securing Contraceptive Supplies)This paper was prepared by Population Action International for the UN Interim Working Group on Reproductive Health Commodity Security, which provides an overview of the need for security in reproductive health (RH) supplies. It notes that the last few decades have seen an enormous increase in the use of RH services around the world. However, as donors, nongovernmental organizations, private sector initiatives and program providers work to meet the need for all RH services, new demands continue to drain available resources. Four major factors contribute to the growing shortfall of contraceptive supplies: 1) growing interest in contraceptive use; 2) more people of reproductive age; 3) insufficient, poorly coordinated donor funding; and 4) inadequate logistics capacity in developing countries. Population projections indicate that in the coming decades, millions more men and women will need and want to use contraceptives. Thus, many actors in both the public and the private sectors, and both in-country and internationally, have important roles to play in attaining contraceptive commodity security throughout the developing world.
Gauging awareness, assessing concern: focus group findings on reactions to contraceptive supply shortages.
[Washington, D.C.], Interim Working Group on Reproductive Health Commodity Security, 2001 Apr. 8 p. (Meeting the Challenge: Securing Contraceptive Supplies)Population Action International held four focus groups on June 8, 2000 with 25 attendees of the UN Special Session known as Beijing +5: Women 2000. The objectives of these activities were: to gauge awareness of and concern about the impending shortage of donated and subsidized contraceptive supplies, and to explore ideas for addressing this shortage. This paper summarizes the focus group findings on reactions to contraceptive supply shortages. It notes that results revealed that almost none of the participants were aware of the impending shortage of contraceptive supplies. The reaction, in general, to this looming crisis was one of subdued resignation. Participants seemed to view contraceptive insecurity as just another challenge in the struggle to improve the lives of women in the developing world. In this perspective, nongovernmental organizations, donors, and advocates in developing and developed countries all have important roles to play in addressing the contraceptive supply crisis.
Network. 2001; 21(2):13.In many settings, domestic violence is accepted by both women and men, and will only be reduced as basic human rights are recognized. Since many health care workers do not have the time, training, resources, or support to help victims of domestic violence, the WHO recommends several ways that they may be able to perform their duties at a minimum. The provider's first priority should be to evaluate the woman's safety in terms of risk of recurrence of violence, adverse reproductive health outcomes, or death through homicide or suicide. They should also keep in mind the credo "do no harm." This includes not blaming a woman for the domestic violence she has suffered. In general, a provider who wishes to take the first step of trying to identify victims of domestic violence should have a specific goal either to give better care, counseling, or refer the victim to the appropriate services. One source of guidance on integrating gender-based violence into sexual and reproductive health is the International Planned Parenthood Federation/Western Hemisphere newsletter. In the winter 2001 and summer 2000 newsletters, it describes how to create a protocol for implementing screening and services for victims of domestic violence and tells how to create a referral network and begin implementing client screening and staff training, respectively.
Africa Recovery. 2001 Jun; 15(1-2):16-8.The rapid spread of HIV in Africa has been linked to war, but the degree to which conflict contributes to the spread of HIV remains uncertain. A study reveals that a soldier's risk of infection doubled for each year spent in deployment in conflict regions, suggesting a direct link between duty in the war zone and HIV transmission. In this regard, the African government, together with the UN and the international community, is investigating the link between the uniformed services and AIDS while expanding education and prevention programs. Military personnel has started to acknowledge the AIDS problem and that AIDS has begun to degrade the ability of the army to accomplish its mission. As such, African countries are focusing their resources on HIV education for the military and are formulating a plan of action. A UN Department of Peacekeeping Operations policy encourages member states to offer voluntary and confidential counseling and testing (VCCT) to peacekeeping personnel. However, the obstacles to VCCT are the issues of cost and confidentiality. While the debate on testing continues, UN is expanding its education and prevention programs among civil and military members of peace missions. Furthermore, it is stressed that changing the attitudes that lead to unsafe and unacceptable behavior is important in reducing HIV.
EQUILIBRES ET POPULATIONS. 2000 Jun-Jul; (59):4-5.A special UN session was held in New York during June 6-10, 2000, to evaluate the progress achieved since the Beijing Conference on Women. According to Françoise Gaspard, France’s representative to the UN Commission on Women’s Rights, negotiations at the special session were particularly difficult. It is always hard to create a satisfactory conference declaration when the rule of the day is consensus. A few countries always oppose such consensus. Latin American countries, however, abandoned their former position similar to that of Iran and the Vatican to instead adopt far more progressive stances upon reproductive rights. Progress is occurring slowly. While still not enough, the conference’s final statement marks a certain number of advances in the fight against violence, women’s role in decision-making, and education, with no steps back in the areas of contraception and abortion. The resulting declaration is therefore not regressive, even though it could have been stronger. It will hopefully serve as a reference statement which nongovernmental organizations will be able to cite when reminding countries of their obligations. Countries should get together to discuss the rising level of prostitution. The important roles of NGOs and French-country involvement were also recognized during the conference, as well as the priorities of education and funding.
New York, New York, United Nations, 1978. v, 72 p. (ST/ESA/66 (Vol. IV))This manual (volume 4) produced by the UN presents a number of practical training techniques that can be incorporated into the popular participation training to achieve specific objectives and to create a more varied and interesting experience. It also contains 5 elements essential in the evaluation of each technique, which includes objectives, settings, process, discussion and comments or preparation. Chapter 1 discusses the techniques for problem recognition, which include: 1) first steps in group activities; 2) perception exercises; 3) entering your own space and entering another's space; 4) force field analysis; 5) polling; 6) differences in perception; and 7) serialized posters. Chapter 2 describes the techniques for capacity building, which consist of: 1) village planner; 2) problem-solving posters; 3) the impertinent PERT chart; 4) need identification; 5) choosing a color; 6) inter-group competition in plan preparation; 7) inter-group collaboration in program implementation and 8) challenging conflicts within the Iwo village. Chapter 3 presents the techniques for attitude and value development through role playing, development of community, awareness of hidden motives, the fishbowl approach, difference between clear and unclear goals, charting group participation, application of empathy and ring-toss.
SEXUAL HEALTH EXCHANGE. 1998; (3):4.Two decades of Family Planning Association of Hong Kong (FPAHK) advocacy of husband-wife communication and cooperation in family planning led Hong Kong's population to finally accept the notion of male responsibility in family planning. Recent surveys have documented high rates of male contraceptive use. The FPAHK established its first clinic to provide men with birth control advice and services in 1960, then set up a vasectomy clinic and installed condom vending machines. Working against prevailing traditional beliefs that childbearing is the exclusive domain of women and that vasectomy harms one's health, the FPAHK began campaigns to motivate men to take a positive and active role in family planning and to correct misinformation on vasectomy. Successful FPAHK efforts to stimulate male support for family planning include the 1977 "Mr. Family Planning" campaign, the 1982 "Family Planning - Male Responsibilities" campaign, and the 1986-87 "Mr. Able" campaign. Although these campaigns ended in the 1980s, men may now be counseled on contraception at 3 of the 8 FPAHK-run birth control clinics.
Interview schedule for Knowledge, Attitudes, Beliefs and Practices on AIDS. Phase I: African countries. A. Household form. B. Community characteristics. C. Individual questionnaire.
[Unpublished] 1989 Feb. 28 p.The household interview form has spaces in which to designate a household's location and track interviewer visits with notation of visit results. Basic information can be recorded about the people over age 10 years who usually live in the household or who slept in the household on the preceding night. Data are then taken on the community characteristics form on the type of locality, travel time to the nearest large town, and facilities available in the community. The individual questionnaire is for people aged 15-64 years who slept in the household on the preceding night and is comprised of the following sections: identification; individual characteristics; awareness of AIDS; knowledge on AIDS; sources of information; beliefs, attitudes, and behavior; knowledge of and attitudes toward condoms; sexual practices; injection practices; locus of control; IV drug use; and drinking habits.
INTELIHEALTH NEWS (ON-LINE). 1997 Apr 10; 2 p.In April 1997, the UN announced that the UN Children's Fund, the World Health Organization, and the UN Population Fund have mounted a joint effort to create the crucial momentum to achieve elimination of female genital mutilation. Each year, 2 million girls undergo female genital mutilation, which involves partial or total excision of the external female genitalia usually by traditional practitioners wielding crude instruments. Female genital is a deeply-rooted traditional practice, which many communities believe is essential to initiate girls into womanhood. Other misconceptions include the notion that Islam requires such mutilation and that the practice increases fertility and the healthiness of offspring. The effects of female genital mutilation include pain, infection, urine retention, hemorrhage, death, sexual dysfunction, and psychological trauma.
Ann Arbor, Michigan, UMI Dissertation Services, 1995. , x, 124 p.The author of this doctoral dissertation states that population control refers to measures undertaken to reduce fertility, which, according to the "population establishment," is currently so high that it endangers planetary survival. A "crisis mentality" exists among advocates of population control, who thus support the use of coercive measures to contain the spectre of overpopulation. Coercion, manifested in the use of targets, incentives, and disincentives, is an inherent part of population control. It is used mainly against women in the Third World; the population establishment defines the "overpopulation problem" in terms of national, racial, class and gender boundaries. Moreover, as the experience of India demonstrates, coercion is ineffective in reducing fertility. Coercion is thus both unethical and ineffective, and must be abandoned. (author's)
In: Resource material on HIV / AIDS in Vietnam, [compiled by] Care International in Vietnam. Hanoi, Viet Nam, CARE International in Vietnam, . 58-65.Although acquired immunodeficiency syndrome (AIDS) is relatively new to Viet Nam, socioeconomic realities such as increasing urbanization, demand for commercial sex, low condom use, injecting dug use, and expanded transportation movements presage a future epidemic unless immediate steps are taken. Viet Nam's National AIDS Committee, established in 1989, targets commercial sex workers, sexually transmitted disease clients, injecting drug users, youth, and blood donors. Problematic have been the government's designation of prostitution and drug addiction as "social evils" and the tendency to view AIDS as a foreign disease rather than one related to specific behaviors of the Vietnamese people. CARE Viet Nam has developed a model of the cycle of AIDS-related culture, values, attitudes, and behaviors. The values of paternalism must be replaced by empowerment-related values, including self-reliance, compassion, and honesty. The hegemonic views that women must be submissive and passively accept men's behavior and that it is men's nature to have sex with multiple partners can be modified through IEC. A televised soap opera serial being developed by CARE Viet Nam seeks to catalyze such change in AIDS-related attitudes and behaviors.
Some lessons from the World Health Organization Global Programme on AIDS (WHO / GPA) sexual behavior surveys and knowledge, attitudes, beliefs, and practices (KABP) surveys.
In: AIDS in the world II: global dimensions, social roots, and responses. The Global AIDS Policy Coalition, edited by Jonathan M. Mann and Daniel J.M. Tarantola. New York, New York, Oxford University Press, 1996. 140-5.Sexual behavior surveys were conducted during 1980-94 among the general population of specific population groups in 67 countries. 15 of the sexual behavior and knowledge, attitude, behavior, and practices (KABP) surveys conducted during 1989-90 in developing countries were reviewed and summarized by the World Health Organization's Global Program on AIDS. While not all of publishable quality, the studies nonetheless shed light upon HIV/AIDS KABP. For example, while there was considerable awareness of HIV/AIDS during the late 1980s, incorrect beliefs on the modes of HIV transmission were quite prevalent. The large majority of women and 66% of men claimed to be faithful to one regular sex partner, although there was considerable variability among sites. 0-11% of men reported having five or more extramarital sex partners within the preceding 12 months, 20-50% of whom reported not feeling at risk of contracting HIV. The survey data failed to support the assumption that towns and cities are more conducive than rural areas to nonregular sexual relationships. Large variations were identified in the levels of condom awareness and use.
Washington, D.C., World Bank, 1995. xi, 112 p. (World Bank Technical Paper No. 298; Africa Technical Department Series)A review of the literature indicates that the access of girls and women to education in sub-Saharan Africa is being hindered by socioeconomic and cultural factors, aspects of the school environment, and political and institutional forces. Among these factors are direct and opportunity costs, parental attitudes toward investments in female schooling, social class, child labor demands, an emphasis on the woman's roles as wife and mother, scheduling of initiation ceremonies, Islamic beliefs, teachers' negative attitudes about girls' learning potential, early pregnancy, sexual harassment, and the overall low status of women. Strategies with the potential to increase female participation in education include: more flexible and efficient use of teacher and school resources to increase supply; increases in the number of female teachers, especially in science and mathematics; improvements in teachers' gender-stereotyped attitudes; widened curriculum choices for girls; introduction of simple technological innovations that reduce the demand for child labor; increased coverage through initiatives with nongovernmental organizations, religious groups, and families; and review of fiscal and administrative policies that restrict female educational and employment opportunities. Given the complexities of issues related to female education, multiple simultaneous interventions on both the supply and demand sides may be required. Also needed are stronger linkages between research findings, policy formulation, and program design and implementation.
AIDS. 1991; 5 Suppl 1:S177-81.This review gives greater weight to WHO/Global Program on AIDS (GPA)-supported knowledge, attitudes, beliefs, and practices (KABP) surveys that have been completed in several African countries, including the Central African Republic, Chad, Ivory Coast, Lesotho, Mauritius, Rwanda, Sudan, Togo, and Tanzania. The percentage of individuals who had heard of AIDS ranged from 60% in Chad to 98% in Rwanda. Over 75% of respondents knew that AIDS is sexually transmitted. A similar proportion (except in Sudan) knew about perinatal transmission. Misconceptions nevertheless endure: e.g., over 40% of individuals in the Central African Republic, Mauritius, Togo, and Tanzania believed that insect bites transmit HIV. At least 20% of respondents in the Central African Republic, Lesotho, Mauritius, Rwanda, Togo, and Tanzania believed that HIV was transmitted through touching or sharing utensils/food. 29% of respondents in Togo, 27% of interviewees from Chad, 21% of individuals in Rwanda, and 19% of participants from Lesotho asserted that AIDS was curable. Only 40% of interviewees from Chad and 25% or fewer of respondents from Lesotho, Mauritius, Sudan, Togo, and Tanzania perceived themselves to be susceptible to AIDS. 80% or more of respondents, except from Chad, where the figure was only 23%, believed that AIDS could be prevented by behavior change. WHO/GPA data indicate that, despite widespread awareness of AIDS, the proportion who have heard of condoms varies from 33% in Chad and 39% in Togo to 77% in Lesotho and 84% in Mauritius. Excluding Mauritius, less than 20% of respondents spontaneously mentioned condoms as a mode of protection against HIV and less than 20% had ever used a condom. Data from the World Fertility Survey and Demographic and Health Survey closely support these observations, confirming that women's knowledge and use of condoms is lower in sub-Saharan Africa than elsewhere. At present, condom use by women in union in Mauritius, Botswana, and Zimbabwe is 9%, 1%, and 1%, respectively, and under 1% elsewhere.
In: Sexual behaviour and AIDS in the developing world, edited by John Cleland and Benoit Ferry. London, England, Taylor and Francis, 1995. 208-28. (Social Aspects of AIDS)The authors explain that results from the previous chapters of the text of which this summary forms a part come from nine sites in continental sub-Saharan Africa, four in Asia, and two from elsewhere. Twelve of the samples had national coverage, while the remaining three were restricted to capital cities. It is stressed that even though the wide distribution of research locations prevents the generalization of results to developing countries overall, one should not discount the magnitude of new evidence obtained in the surveys. Previously, no national surveys on sex behavior had ever been undertaken in developing countries, and surveys on AIDS-related knowledge and attitudes were few in number. The research findings presented in this volume represent the start of a new domain of scientific information on a long neglected topic. This contribution of new information is especially marked with regard to sex behavior. The authors outline what has been learned about behavior and discuss results on cognitive and attitudinal dimensions. Key policy implications, methodological lessons, and future directions for AIDS-related surveys of general populations are presented.
In: Sexual behaviour and AIDS in the developing world, edited by John Cleland and Benoit Ferry. London, England, Taylor and Francis, 1995. 124-56. (Social Aspects of AIDS)Primitive forms of the condom were used to prevent pregnancy more than 3000 years ago. The widespread use of condoms to prevent sexually transmitted diseases (STD), especially syphilis, however, over the past two centuries has made condoms highly controversial. In many countries since the beginning of the AIDS pandemic, condoms have come to connote illicit sex. Their widespread use as a contraceptive has therefore been impeded by the historical association with STD prevention. This chapter summarizes survey findings on the awareness, use, and attitudes toward condoms. It is divided into the following sections: awareness of condoms and access to supplies, condom use, and perceived attributes of the condom. The implications of survey findings are discussed.
In: Sexual behaviour and AIDS in the developing world, edited by John Cleland and Benoit Ferry. London, England, Taylor and Francis, 1995. 43-74. (Social Aspects of AIDS)Data derived from surveys conducted in 1989 and 1990 on the levels of awareness of HIV and AIDS, the accuracy of specific areas of knowledge regarding transmission routes, the perceived severity of the condition, views on the appropriate ways in which to care for people who are HIV-seropositive, and attitudes toward testing are presented. There was some variation between study populations with regard to the proportions of people who had heard of AIDS, with a trend toward lower figures in francophone central and west Africa. Within populations, the groups less likely to have heard of AIDS were women, those with lower levels of education, those in rural areas, and those with lower media exposure. Generally, levels of accuracy concerning actual routes of HIV transmission were high. Accuracy levels regarding transmission through casual routes, however, tended to be very poor. The implications of these findings are discussed.
DEVELOPMENT POLICY REVIEW. 1994 Jun; 12(2):165-91.The author reviews research in population and development since the mid-1980s and how it has affected attitudes toward population issues and population policies prior to the International Conference on Population and Development held in Cairo, Egypt, in September 1994. (ANNOTATION)
[Unpublished] 1990 Oct. iii, 29 p.This summary provides key background information for the design and development of a contraceptive social marketing (CSM) project in Venezuela. The country situation is described by providing a map; graphs illustrating population growth, age structure, total fertility rate, and infant mortality rate; the demographic characteristics of the population; the social situation; and leading economic indicators and factors. The population/family planning (FP) environment is then described in terms of the national population policy and goals, the legal and regulatory environment, the media, other international donor agencies and nongovernmental organizations active in the field of population, and the commercial contraceptive market. Available data are then presented on contraceptive usage by methods, the most available methods in the country, discontinuation, abortion, maternal age, needs, desired family size, and contraceptive awareness. The summary lists the following implications for project design from the point of view of the consumer: 1) the most recent data (1977) indicated an unmet need for FP, but more recent data must be obtained to access current demand; 2) more data are needed on the benefits and barriers to oral contraceptive and condom use; 3) data are needed on current use rates, sources of supply, and knowledge of correct use of oral contraceptives (OCs); 4) a significant target population exists for OCs and condoms; 5) marketing strategies should influence women to use modern contraceptives instead of abortion to limit family size. Project implications resulting from the market situation are that 1) despite the fact that commercial distribution networks within urban centers (83% of the population) are well-developed, contraceptives are not widely available at the retail level and are expensive; 2) obstacles to the commercial contraceptive industry exist at the importer, retailer, and consumer levels; and 3) most homes have radios and televisions, but all advertising must be government-approved, and the government has never approved contraceptive advertising. Appended to this document are charts showing 1) fertility rates by region, 2) urban and rural population growth, 3) an analysis of the urban population, 4) the incidence of abortion among current contraceptive users, 5) an analysis of the female population of reproductive age, 6) the age breakdown of women who desire no more children, 7) the contraceptive method used by women who desire no more children, and 8) desired family size.
AIDS SURVEILLANCE REPORT. 1995 Jan; (4):3, 5-6.More than forty studies were reviewed in 1995 on the knowledge, attitudes, beliefs, and practices of individuals with respect to HIV/AIDS in American Samoa, Cambodia, China, Cook Islands, Fiji, French Polynesia, Guam, Hong Kong, Japan, Lao People's Democratic Republic, Malaysia, Palau, Papua New Guinea, Philippines, Republic of Korea, Samoa, Singapore, Solomon Islands, Tonga, Vanuatu, and Vietnam. In all but one of the twenty studies which inquired, more than 80% of respondents had heard of AIDS. In a number of countries, correct knowledge about the sexual transmission of HIV/AIDS was found to be at least 80%. A similar level of knowledge was found about needle transmission of HIV/AIDS, although comparatively lower levels of knowledge about HIV transmission via sexual intercourse, needle use/reuse, and maternal-child exchange was, however, identified in Cambodia, Fiji, Malaysia, Solomon Islands, and the high-risk populations of Vietnam and French Polynesia. Relatively high levels of incorrect answers were observed for the incorrect modes of HIV transmission. Moreover, 20% of respondents in each of the eight studies are in favor of exiling or isolating HIV-infected persons; in two countries, support for isolation or exile was 60% or greater. Overall, risk behaviors appear to exist at levels which will support an HIV epidemic in the countries studied. Levels of other sexually transmitted diseases and reported levels of extramarital and premarital sex, especially among males, support this conclusion. Commercial sex appears to occur at a substantial level in most of the societies studied, while condom use in casual and commercial sexual encounters seems to be the exception rather than the rule.