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FRONT LINES. 1987 Sep; 27(8):8-9, 11.The USAID's mission in Nepal is to assist development until the people can sustain their own needs: although the US contributes only 5% of donor aid, USAID coordinates donor efforts. The mission's theme is to emphasize agricultural productivity, conserve natural resources, promote the private sector and expand access to health, education and family planning. Nepal, a mountainous country between India and Tibet, has 16 million people growing at 2.5% annually, and a life expectancy of only 51 years. Only 20% of the land is arable, the Kathmandu valley and the Terai strip bordering India. Some of the objectives include getting new seed varieties into cultivation, using manure and compost, and building access roads into the rural areas. Rice and wheat yields have tripled in the '80s relative to the yields achieved in 1970. Other ongoing projects include reforestation, irrigation and watershed management. Integrated health and family planning clinics have been established so that more than 50% of the population is no more than a half day's walk from a health post. The Nepal Fertility Study of 1976 found that only 2.3% of married women were using modern contraceptives. Now the Contraceptive Retail Sales Private Company Ltd., a social marketing company started with USAID help, reports that the contraceptive use rate is now 15%. Some of the other health targets are control of malaria, smallpox, tuberculosis, leprosy, acute respiratory infections, and malnutrition. A related goal is raising the literacy rate for women from the current 12% level. General education goals are primary education teacher training and adult literacy. A few descriptive details about living on the Nepal mission are appended.
Oxford, England, Oxford University Press, 1990. xix, 136 p.The Commission on Health Research for Development is an independent international consortium formed in 1987 to improve the health of people in developing countries by the power of research. This book is the result of 2 years of effort: 19 commissioned papers, 8 expert meetings, 8 regional workshops, case studies of health research activities in 10 developing countries and hundreds of individual discussions. A unique global survey examined financing, locations and promotion of health research. The focus of all this work was the influence of health on development. This book has 3 sections: a review of global health inequities and why health research is needed; findings of country surveys, health research financing, selection of topics and promotion; conclusions and recommendations. Some research priorities are contraception and reproductive health, behavioral health in developing countries, applied research on essential drugs, vitamin A deficiency, substance abuse, tuberculosis. The main recommendations are: that all countries begin essential national health research (ENHR), with international partnership; that larger and sustained international funding for research be mobilized; and that larger and sustained international funding for research be mobilized; and that international mechanisms for monitoring progress be established. The book is full of graphs and contains footnotes, a complete bibliography and an index.
[Washington, D.C]., World Bank. 2010 May.  p.Reproductive health is a key facet of human development. Improved reproductive health outcomes -- lower fertility rates, better pregnancy outcomes, and fewer sexually transmitted infections -- have broader individual, family, and societal benefits. The benefits include a healthier and more productive work force, greater financial and other resources for each child in smaller families, and enabling young women to delay childbearing until they have achieved educational and other goals. Women's full and equal participation in the development process is contingent on accessing essential reproductive health services, including the ability to make voluntary and informed decisions about fertility. Reproductive health issues have only recently begun to be a priority in the development agenda. Even though Official Development Assistance (ODA) for reproductive health has increased, the share of health ODA going to reproductive health declined in the past decade. This document presents a detailed operationalization of the reproductive health component of the Bank's 2007 Health, Nutrition, and Population (HNP) strategy.
Lancet. 2004 Oct 30; 364:1566-1567.Since 1974, the UN has held meetings every 10 years to consider population and development. The last meeting took place in September, 1994, in Cairo. Thousands of government officials, health providers, activists, young people, and a few heads of state hammered out a Programme of Action, which reshaped the way we think about population. Instead of viewing population through a narrow lens, as something to be controlled by reducing fertility by widespread contraceptive use, population was recast as reproductive health, or “the state of complete physical, mental and social well-being”, implying, among other things, the ability for everyone to have a safe and satisfying sex life. There was no 2004 international conference on population and development. Instead, 700 people, mostly from non-governmental organisations, met in London, in September, 2004, to recapture the spirit of Cairo. One less UN meeting rarely gives cause for remorse. Yet, the reasons behind the decision not to hold a meeting on reproductive and sexual health are troubling. Potential organisers and supporters feared that the USA and ultraconservative governments and activists would use the meeting as a staging point to launch an attack against the consensus reached by 179 countries in Cairo. (excerpt)
New York, New York, United Nations, Department of Economic and Social Affairs, Population Division, 2005. 57 p. (ST/ESA/SER.A/248)Part one of this report provides a global overview of demographic trends for major areas and selected countries. It reviews major population trends relating to population size and growth, urbanization and city growth, population ageing, fertility and contraception, mortality, including HIV/AIDS, and international migration. In addition, a section on population policies has been included, in which the concerns and responses of Governments to the major population trends are summarized. The outcomes of the United Nations conferences convened during the 1990s set an ambitious development agenda reaffirmed by the United Nations Millennium Declaration in September 2000. The 1994 International Conference on Population and Development, being one of the major United Nations conferences of the decade, addressed all population aspects relevant for development and provided in its Programme of Action a comprehensive set of measures to achieve the development objectives identified. Given the crucial importance of population factors for development, the full implementation of the Programme of Action and the key actions for its further implementation will significantly contribute to the achievement of the universally agreed development goals, including those in the Millennium Declaration. Part two discusses the relevance that particular actions contained in those documents have for the attainment of universally agreed development goals, including the Millennium Development Goals. It also describes the key population trends relevant for development and the human rights basis that underpins key conference objectives and recommendations for action. (excerpt)
[Unpublished] 1983. Presented at the International Conference on Population, 1984, Expert Group on Fertility and Family, New Delhi, January 5-11, 1983. 22 p. (IESA/P/ICP. 1984/EG.I/8)The World Health Organization (WHO) has been studying several national surveys with regard to certain health related aspects of fertility. The primary purpose of these studies was to stimulate the use of data by the national health authorities for an improved care system for maternal and child health, including family planning. Some preliminary results are reported in this discussion, in particular those relating to contraception, the reproductive health of adolescents, infertility and subfecundity, and breastfeeding. The national surveys concerned are those of Bangladesh, Indonesia, the Republic of Korea, the Philippines, and Sri Lanka. The methods of analysis were simple and traditional, except for 2 points: some of the data had to be obtained by additional tabulation of the raw data tapes and/or the recode tapes since the standard tabulations of the First Country Reports did not include the needed information; and Correspondence Analysis was used in an effort to stimulate and facilitate the use of the findings for improvements of national health programs. Methods of contraception vary widely, from 1 country to another and by age, parity, and socioeconomic grouping. The younger women tend to choose more effective modern methods, such as oral contraception (OC); the older women, i.e., those over age 35, tend to seek sterilization, if available. It is evident that the historical development of family planning methods has greatly influenced the current "mix" of methods and so has the current supply situation and the capacity of the health care system (particularly in regard to IUD insertions and sterilizations. Use of contraception among adolescents to postpone the 1st birth was practically unknown. The risk of complications at pregnancy and childbirth, including maternal and infant death, is known to be particularly high for young mothers, and the results clearly showed that the infant mortality rate is highest for the youngest mothers. All the women who suffer from infertility do not recognize their condition, but the limited data still point to the need to consider the health needs of women who suffer from unwanted fecundity impairments. This may require medical intervention to cure infections or the offer of relevant sexual counseling. Some infecundity may require the improvement of nutritional and personal hygienic levels before meaningful achievements are made. The prevalence of breastfeeding has declined in some population groups, and the consequences can be expected to be deleterious and to involve serious increases in specific morbidity and mortality.
Laws and policies affecting fertility: a decade of change. Leis e politicas que afetam a fecundidade: uma decada de mudancas.
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.
Lessons from China: excerpts from the Interim Report on the IPPF Mission to China, September 23-October 15, 1977.
Africa Link. 1977 Dec; 4(2):3, 26.In China today, family planning has a strong ideological commitment within the ruling party and the nation, so a strong ideological commitment is necessary for a family planning program to yeild results in a short time. Family planning in China is inseparable from socioeconomic development and anecessary component of social reconstruction, integral with the general way of living. The Maoist effort to equalize opportunities and living levels between urban and rural areas promotes family planning, and since the party is overtly committed to birth control at the highest level, it means family planning is propagated at every social level. Hence, the family planning policy is elaborated and pronounced by the party, but the total operations, while having general central direction and a central core of principles, are greatly decentralized, relying on family planning education to promote the small family norm at all social and geographic levels. Despite the emphasis on education, information on actual methods for fertility control are delayed until the period of marriage, but at that time a broad range of contraceptive devices and agents becomes available to the women in their workplaces, homes and farms at minimal fees. 2 areas of specific study in China are recommended: 1) the delivery system, and 2) the rural motivation--both areas are relevant to the IPPF system, and techniques may be cross-cultural.