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Lancet. 1984 Jul 21; 2(8395):144-5.The objective of the World Health Organization (WHO) project, an international, prospective study conducted by centers in England, India, Columbia, Nigeria, and the Philippines, was to investigate the effects of tubal occlusion on the mental and physical health and psychosexual and menstrual functioning of women choosing to undergo the procedure for contraceptive purposes only. A subsequent report presents details and results of the English component of the study. 2 groups of healthy multiparous women having either interval sterilization (at least 6 months since an obstetric event) or postpartum sterilization (within 72 hours of delivery) were recruited. For each group, a control group was recruited from women using or planning to use nonpermanent contraceptive methods. All women were interviewed preoperatively and again 6 weeks and 6 months after the operation by standardized techniques. The results showed that sterilized women did not differ from the control samples in mental state, as assessed by the Present State Examination or in subjectively assessed mental or physical health or abdominal pain. More sterilization subjects than control subjects reported improvement in sexual satisfaction at the later follow-up. Many of the subjects reporting adverse effects at follow-up had revealed disturbances at the initial asssessment. All these women had at least 2 living children. They were women living in stable marriages or other relationships that had lasted an average of over 9 years. They were free from physical or mental ill health before sterilzation. They had their sterilizations voluntarily and solely for the purpose of keeping their families small. It comes as no surprise that, relative to a general population sample, the mental state of sterilized women in the study actually seemed to improve. A need exists for methodoloically sound studies that would identify social and psychological conditions under which sterilization might have ill effects.
Planned parenthood and women's development in the Indian Ocean Region: experience from Bangladesh, India and Pakistan.
London, England, International Planned Parenthood Federation, 1984 Sep. 43 p.The Indian Ocean Region (IOR) of the International Planned Parenthood Federation (IPPF) has been involved in Planned Parenthood and Women's Development (PPWD) since the program was launched in 1976. This paper, which brings together the experience of the projects and approaches from 3 countries of the region -- Bangladesh, India, and Pakistan, aims to help the region analyze the progress made and assess strategies which can be more widely replicated. The Bangladesh Family Planning Association (BFPA) initiated PPWD projects in mid-1977, the majority in collaboration with well-established women's organizations. These projects generally provide income-generating activities, including training and assistance in the marketing of the products resulting from such activities. In 1979, together with the Mahila Samity (the national women's organization), the FPA was able to integrate women's development into its programs in 19 unions. Each union has a population of 20,000 and the FPA undertakes family planning motivation and services committees. Since 1977 the FPA has collaborated with the Chandpur Dedicated Women to promote family planning and women's development activities. A project to reach women through child-centered activities was initiated by the FPA in 1979 in response to the International Year of the Child. A case study is included of the Sterilized Women's Welfare Samity Project in Mymensingh. For some years the Family Planning Association of India (FPAI) has worked through existing women's clubs or Mahila Mandals as a way of reaching rural and semirural women. The Mahila Mandals have been instrumental in involving young women in development activities and in establishing youth clubs and also have been a focal point for mobilizing community resources. The use of government facilities by the integrated projects in Malur and Karnataka and the cooperation with various extension services is noteworthy. In 1977 the FPAI decided to launch a number of specific projects, including as the Pariwar Pragati Mandals (family betterment clubs) popularly know as PPM, and the Young Women's Development Program. Project case studies are included. The Family Planning Association of Pakistan launched its PPWD program in 1978 with the objective of creating conditions within which responsible parenthood could become a way of life, particularly among underprivileged rural women, and to strengthen links between family planning and other individual and community problems. Most of the original PPWD projects were initiated in 1978 and were conducted with other community development and womens's organizations. Since 1978, the PPWD program has undergone several changes and more emphasis is now placed on family planning and on involving young women. Case studies are included. Common features of the PPWD programs of Bangladesh, India, and Pakistan are identified.
Geneva, WHO, 1984 Dec. ix, 152 p.88 recommendations were formulated by the International Conference on Population held in Mexico City in 1984. 4 of these dealt specifically with research requirements in the population field and are reproduced in this report in their entirety. As a result of the changing perspectives and requirements of the scientific fields in which the Special Program of Research, Development and Research Training in Human Reproduction operates and taking into account the various suggestions resulting from recent reviews of the Program, several new developments have occurred. First is the attempt to distinguish more clearly between activities related to research and development and those related to resources for research. These 2 distinct but closely connected activities will be reorganized to interact in a complementary fashion. In the research and development component, the most notable changes relate to the creation of new Task Forces on the Safety and Efficacy of Fertility Regulating Methods and on Behavioral and Social Determinants of Fertility Regulation. The Program has been actively promoting coordination with other programs which support and conduct research in human reproduction. The research and development section of this report provides a technical review of the activities and plans of the various task forces, covering the following: new and improved methods of fertility regulation (long-acting systemic methods, oral contraceptives, post-ovulatory methods, IUDs, vaccines, plants, male methods, female sterilization, and natural methods), safety and efficacy of fertility regulating methods, infertility, and service and psychosocial research. The section devoted to resources for research describes some features of the network of centers, reviews the Program's institution strengthening activities in the different regions, and also considers research training and the program of standardization and quality control of laboratory procedures. The section covering special issues in drug development focuses on relations with industry, patents, and the role of the Special Program in the drug regulatory process.