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[Geneva, Switzerland], WHO, Global Programme on AIDS, Social and Behavioral Research Unit, .  p. (WHO File: Data on Social Issues; Report No. 2)The Social and Behavioural Research Unit has prepared its second international inventory of Knowledge, Attitude, Behaviour, and Practices surveys. The report reviews 80 projects drawing upon both published and unpublished materials dealing with 7 major study groups: adolescents and young people, the general public, health care workers, homosexual/bisexual men, drug injectors, prostitutes, and other groups. For each of these the inventory classifies the project concerned by selected key features such as when and where it was undertaken, sampling strategy used, and methodology and conclusions. (excerpt)
STATUTES OF THE NORTHWEST TERRITORIES. 1990; 23-6.This Canadian Act establishes a Status of Women Council to represent the women of the Northwest Territories. The objects of the Council are "a) to develop public awareness of issues affecting the status of women; b) to promote a change in attitudes within the community in order that women may enjoy equality of opportunity; c) to encourage discussion and expression of opinion by residents of the Northwest Territories on issues affecting the status of women; d) to advise the Minister on issues that the Minister may refer to the Council for consideration; e) to review policies and legislation affecting women and to report its findings to the relevant government departments or agencies; f) to provide assistance to the Minister in promoting changes to ensure the attainment of equality of women; and g) to provide the appropriate assistance to organizations and groups whose objectives promote the equality of women." Further provisions of the Act set forth rules on the composition, administration, organization, and financing of the Council, among other things.
[Unpublished] 1990 May. , 72 p.A study was conducted to aid in developing a contraceptive social marketing project for Turkey. While the project will promote birth control pills, condoms, and possibly IUDs, this study aimed to help guide exclusively in designing the marketing strategy of the project condom brand. Specifically, it was undertaken to obtain an estimate of the overall size of invoiceless condom sales in Turkey, to better understand the nature and quality of products passing through these unofficial channels, and to better understand how and why this distribution system works. Study results are based upon interviews of 105 respondents in 4 cities, including condom importers, wholesalers, and street vendors. Condoms for Turkish markets overall are largely imported legally by 5 principal firms. Illegal imports comprised only 1% of legal supplies in 1989. 81% of street vendors then secure condoms for public sale from wholesalers who purchase directly from importers or large wholesalers. An estimated 150 such street vendors are in Turkey, selling a total 94,650 condoms/week to largely middle-income, married men aged 20-35 years. Together, street vendor sales account for 13% of the nation's commercial condom market. Customers are thought to generally prefer purchasing from vendors due to their lower prices, higher brand variety, and greater sense of privacy. Vendors, on the other hand, are able to undercut pharmacy condom prices while realizing a larger average profit margin. Study findings suggest that street vendors will not be a source of competition, but that their presence and activity must be reckoned with in developing and conducting the project. Specific project design recommendations are provided in the report.
[Unpublished] 1990 Apr. , 103 p.This study was conducted to help guide the design of the marketing strategy component of a condom brand for a contraceptive social marketing project in Turkey. Specifically, it was undertaken to estimate category sales, brand sales, market shares, prices, inventory practices, type of outlets, and distributor coverage of the Turkish commercial condom market; and to better understand retailer margins, pricing structures, inventory practices, and in-store placements and promotions of condom products. Baseline information will therefore be obtained on the nature of the condom market before the introduction of the project product. The audit was conducted in 150 urban pharmacies over 6 cities. Pharmacies were found to be the major retial outlets for condoms, with over 90% of those audited selling condoms over the study period. 17-25 million/year are sold through these channels at the average price of 390TL/condom. High profit margins exist at each level of distribution. Jellia held the largest market share at 58%, with inadequate distribution generally observed for the major brands. Condoms were visible in 49% of selling pharmacies, though advertisement materials were found in only 2% of audited pharmacies. Some pharmacists are reluctant to display condom advertisements for fear of offending conservative customers. Finally, pharmacies generally do not maintain large inventories of condoms. Recommendations applicable to the development of the project are included in the report.
PASSAGES. 1990 Summer; 10(2):1-3.Both others and young men themselves perceive boys and young men as being mischievous and interested only in sex from girls. These perceptions need to change in the interest of fostering male reproductive health. Several health service and education agencies have realized that a significant factor in the lack of male involvement in reproductive health decisions is that men have been excluded from the planning of relevant programs and services. Furthermore, there is only little information on the feelings and needs of young men. Programs which focus upon the many aspects of boys' lives will tend to be more successful than those which focus only upon their reproductive capacities. Programs which collaborate with families and other community resources help boys learn appropriate male roles and manly behavior, including the need to become fathers only at the proper, chosen point in their lives. New approaches to meeting young men's needs in New York, Africa, Mexico, and Costa Rica are described.
CHRISTIAN CENTURY. 1990 Feb 21; 107(6):180-4.Following the Webster decision of the Supreme Court, both sides of the abortion debate have stepped up their efforts to attain their goals. The abortion battle has become a full fledged political war. Currently the pro-choice side is winning as more and more politicians are discovering that an anti-abortion stance will not get them elected. Governors wilder (VA) and Florio (FL) both ran and won with pro-choice position. However the Catholic Bishops have announced that abortion is their top priority and their primary concern, not poverty, racism, or global conflict. They are using their 28 professional state wide lobbying offices to try to reverse or restrict Roe. The pro-choice side has found a new strategy by focussing attention from choice to government involvement in decision making. While this may be effective in gaining supporters, it does very little to help reach compromise with the anti-abortion groups. Pro-choice advocates must realize that fetal life has some value and that openly recognizing this will lead to an end of the abortion war. Policies must be supported by the pro-choice side that recognize the value of fetal life, but that do not restrict access to abortion. Currently any attempt to place value on the fetus is attacked by pro-choice advocates that feel threatened by such an action. Ultimately abortion will only go away when the problem of unwanted pregnancies goes away. Abortion is a symptom of a larger problem and the war is currently focussing on this symptom and ignoring the problem. Funding for counseling and contraception must be increased so that women do not have to have abortions. Funding for adoption and childbearing must also be increased so that when a women becomes pregnant she has the full spectrum of choices. These choices must be more or less equal so that abortion is not seen as a necessity. All this change would mean a significant departure from how our society is currently structures. But it is only through this kind of commitment to change that the abortion war will end.
HASTINGS CENTER REPORT. 1990 Jul-Aug; 20(4 Suppl):10-4.In the US religious groups have been active in voicing their bioethical concerns in the public discourse. The Roman Catholic Church and religiously motivated anti-abortion activists have been quite visible in the public discussion of issues ranging from abortion, infertility therapies, withdrawal of artificial nutrition, and direct euthanasia. While some might object to such particularistic groups having a voice in our pluralistic society, their legitimacy comes not from their religious origins, but from their moral convictions. The bioethical literature is full of opinions written from particular religious points of views, but rarely are these opinions grounded in appeals to particular religious beliefs. Rather they are grounded in particular moral convictions that may have originated from religious beliefs. Nonreligious moral convictions have their origins outside of religion, but in the literature it is often impossible to tell them apart. Directly religious appeals are rarely used in the literature since their scope would be limited only to those who shared a common religious belief. Instead, the opinions are grounded in substantive moral principles. It must be understood that theological contributions to bioethics overlap and coincide with philosophical ones more than they conflict. Based on a commitment of openness and dialogue, bioethics provides a forum for people with many different inspirations for their moral convictions to discuss the relevant issues. Theology must play a role in bioethics if only to clarify the issues for the religious community itself. And, since the inspiration and motivation for people's moral convictions can be either religious or not, theology need not be excluded from the public dialogue.
DEMOGRAPHY INDIA. 1990 Jan-Jun; 19(1):17-26.India is the 1st country to have embraced the notion of family planning at the national level. Provisions for programs were indeed included as components of the nation's 1st 5-year plan in 1951. India's population grew over the 1900s to reach a peak growth rate of 2.2%/year over the period 1961-81, then declined slowly to 2.04%/year in 1988. Zero population growth is, however, ultimately desired by the country's planners and policy makers. A midterm goal has been set to attain net reproduction rate of 1 by the year 2000. Declines in crude birth, crude death, and infant mortality rates will be required to reach this objective, in addition to an increase in the couple protection rate. National family planning efforts have met with only moderate success thus far, in large part due to the public perception of the program as a product of and for the Indian government. Voluntary organizations do, however, have great potential to contribute to the program's success. Their potential role is discussed. Specifically, non-governmental organizations (NGO) may help to make the program more community-oriented and accessible, with improved internal worker coordination. They may train functionaries, help supply spacing methods, provide follow-up acceptors, and help make family welfare education be more effective in the organized sector. The paper discusses the degree of current NGO involvement, collaborative experiences with government and how they may be increased in both quantity and effectiveness, and the need for full attention to NGOs for their effective involvement.
Accra, Ghana, Marketing and Social Research Institute, 1990 Jul. , 58 p.Consumers of Ghana Social Marketing Program (GSMP) products were questioned to determine their socioeconomic, demographic, attitudinal, and behavioral characteristics, measure GSMP product advertising awareness levels among them, and determine the impact of GSMP promotional efforts on their adoption of these products. Products include the Panther condom, Kamal vaginal foam, Norminest oral pill, and oral rehydration solution (ORS). Study findings are summarized per product for user profile, product knowledge, attitudes, usage, distribution, availability, quality, image, and price, purchasing pattern, brand loyalty, and advertising awareness. The Panther condom has met with great success as the major condom product on the market. It does, however, suffer the reputation of tearing among some users. Kamal's market share is growing at the expense of a government-sponsored competitor and the pill, while Norminest users demonstrated inadequate product knowledge of compliance issues and contraindications. ORS is also successful, but with much potential to expand its market share. Recommendations targeted to each product are provided.
Impact of the 1988-89 national AIDS communications campaign on AIDS-related attitudes and behaviors in Jamaica.
[Unpublished] 1990 Jun. iii, 61,  p. (USAID Contract No. DPE-3051-Z-00-8043-00)1,124 questionnaires were completed in order to assess the impact of a national AIDS communications campaign upon knowledge, attitudes, and practices (KAP) related to the prevention of HIV transmission and AIDS in Jamaica. Awareness of AIDS was high at baseline, and remains so after the campaign. Significantly more persons understand that AIDS is preventable, yet many still think that changes in personal behavioral will do little to protect them from infection. A high degree of negative public sentiment exists against those with AIDS, with none of the popular AIDS myths having been completed eradicated. As for condoms, they enjoy a positive image, and are widely known of in the country. Their use is comparatively high in Jamaica, slightly up from baseline levels, and chosen especially among youth and singles. Occasional condom use is high largely with primary partners, while regular use is high with secondary partners. Overall, more effective behavioral change has taken place since the baseline survey. An increased number of persons have sexual relations with only 1 faithful partner. The campaign was widely seen and memorable, albeit with retention of key preventive measures low to moderate among the campaign audience. Quantitatively, these measures seem to have gotten through to a larger audience than that reached in an earlier round of the campaign. Efforts should be made to further dispel popular myths, stress the importance and effect of behavioral changes, promote the consistent practice of correct behaviors, develop revised motivational messages, and consider the role of interpersonal communication in campaigns all with a fresh, new approach.
ASIA-PACIFIC POPULATION JOURNAL. 1990 Jun; 5(2):73-8.Technology and population rely on each other for sustenance and growth. Technology has helped produce more food, provide better health care, better communication, faster modes of travel, better consumer durables, greater amenities, and increased the quality of life for millions of people. There has been a price in terms of the widening gap between the technology of the developed and developing countries. There has also been rapid population growth that has resulted in a host of ills. Further, technology itself has produced toxic wastes and consumed a large amount of natural resources. This situation is easily seen as a dilemma between the limitless promises of technology and the limited resources created by large populations. The solution to the dilemma is sustainable development, a concept often talked about but seldom realized. The 90s will be a crucial decade for sustainable development as population is growing by 90 million/annum. 90% of the increase is occurring in developing countries. Within each country there is a trend towards urbanization. By 2000, 75% of Latin Americans, 42% of Africans, and 37% of Asians will live in urban environments. By 2050 there should be 100s of millions of migrants running from the slowly rising sea. The survival equation is sustainability S equals resources R time ingenuity 1 over population P. This is a conceptual equation, but it does illustrate that the impact of human ingenuity is just as important as resources. World commitment must come before any meaningful change will occur. The almost universal acceptance of human rights and fundamental freedoms exceeds the will to change in decision makers and expert consultants.
ISSUES IN REPRODUCTIVE AND GENETIC ENGINEERING. 1990; 3(1):13-21.Examining newspaper and magazine articles, the author compares the media treatment of in-vitro fertilization (IVF) with sex determination tests in India. Analysis found general media support and glorification of IVF and related technologies, but only mixed opinions regarding sex- determination testing. Mixed support for the latter form of new reproductive technologies is attributed to the debate and campaigning of women's groups, health activists, and some political leaders against amniocentesis. While public opinion regarding IVF from the feminist's perspective is just gaining ground, the author points to the classic, racist, eugenic, and patriarchal nature of both types of new reproductive technology. Anti-women in nature, they reinforce fertility as an important indicator of women's status, and will be used in population control in the future.
AMERICAN MEDICAL NEWS. 1990 Oct 19; 7-8.The mission of the Media Project of the Center for Population Options is to encourage the entertainment industry to provide adolescents with positive and realistic message about sexuality and family planning. The project has specifically targeted television as a way to reach teens because they not only watch TV but what they see influences their behavior. According to the project's director, "they emulate their favorite characters." A 1986 Louis Harris poll found that teen-agers ranked TV as the 4th most important source of information, out of 11 choices, on sex and birth control. A study of the 1986 prime-time television season discovered a tremendous amount of sexual references and innuendo in the programs. They found touching behaviors (24.5 times/hour); suggestions and innuendo (16.5 times/hour); sexual intercourse (implied 25 times/hour); and socially taboo behaviors such as sadomasochism and masturbation (intimated 6.2 times/hour). In contrast, education information was only given 1.6 times/hour. There are few references to birth control or responsible conversations about sexual intimacy. The Los Angeles-based media project has 3 program components. These components include a media advisory service that provides creative and technical assistance, an information series designed for consciousness raising, and an awards program. The advisory service sends out background sheets on health-related issues and provides story and script consultation. The information series has inspired industry professionals to integrate messages about teenage sexuality and responsible sex into the TV dramas. The project received 380 requests for information during 1990. The project has also sponsored an annual media awards program since 1983. The awards program is a forum where producers get positive attention for a job well done.
Ann Arbor, Michigan, University Microfilms International, 1990. xv, 279 p. (Order No. 9023517)The determinants of family size preferences and traditional child-spacing practices in West Africa were examined. The working hypothesis is that there is a difference in the locus of control over decisions about family size in contrast with the locus of control in decision about traditional child spacing practices. While individual women perceive a powerful cultural and religious pressure for continued childbearing, nevertheless they have considerable flexibility in determining length of breastfeeding and postpartum abstinence. Data were from the World Fertility Surveys of Senegal (1978), Cote d'Ivoire (1990), Ghana (1979), and Cameroon (1979). An empirical analysis defined socioeconomic, cultural and institutional factors of ethnic groups, and ethnographic descriptions were also consulted. First multiple regression analysis, then REML/Bayesian multilevel estimation were employed. Economic modernization had an impact on desired family size, limited to the elite classes. Societies with higher gender inequalities have larger desired family sizes; while those where female status is high have greater individual control over childbearing, so that modernization has more impact over costs and benefits of fertility. Because the locus of control regarding desired family size is external, neither Islamic religion nor kinship ties have a significant effect on desired family size. In contrast, traditional spacing practices of women at all economic levels were affected by modernization: all reduced length of breastfeeding and abstinence, with larger impacts on the lower classes. Matrilinear/double descent societies have shorter durations of breast feeding than patrilinear societies. There was no difference in length of breast feeding between Islamic and non-Islamic societies. In societies where female status is high, economic modernization is a more important determinant of desired family size, but inequalities were less important regarding child-spacing. The results were discussed in terms of the adverse effect of modernization in Western Africa on population growth rate and maternal and child health.
POPULATION AND ENVIRONMENT. 1990 Fall; 12(1):5-8.Cornucopians such as Julian Simon and Ben J. Wattenberg hold the opinion that the population explosion will lead to a better quality of life for everyone in the long run. They contend that hardships should be viewed as merely the incentive to attain economic prosperity through less expensive and more abundant resources. A necessary part of this argument is that the human population must continue to grow or it will begin to decline economically. In terms of the U.S., this includes birth, prolongation of life, and immigration. Support for this type of thinking is growing in the media and in the political halls of our country. Starting with demographic data up to 1960 and then predicting the future has shown some interesting results. The equation predicted a human population in 1980 of 3.969 billion (The actual was 445 million higher). The prediction for 1990 was 5.033 billion (in 1987 the population passed this figure). The time for the human population to double has been getting shorter each time it happens. It took from 1880 to 1950 to go from 1.25 billion to 2.5 billion--but only 37 years to get to 5 billion. The equation predicts another doubling in 20 years. However, if we take a linearly decreasing doubling times to its mathematical conclusion, then the world will end in 40 years. The process will have reached a region of instability well before 2026 when the human population will become infinite. So it seems that the cornucopian's theory is doomed to failure.
MARHIA. 1990 Jan-Jun; 3(1-2):27-8.The Institute for Social Studies and Action of the Philippines is endeavoring to encourage the public and the Catholic Church to Recognize the differences between contraception (which prevents the union of the sperm and ovum) and abortion (which terminates pregnancy long before the fetus is viable). Nonetheless, widespread opposition to contraceptives, especially the IUD, persists because they are considered abortifacients. In terms of the IUD, there is accumulating research evidence that the device works primarily by preventing fertilization and, less frequently, by interfering with implantation. The injectable contraceptive, Depo-Provera, which is banned in the Philippines, suppresses ovulation, as does the pill. Despite the evidence that the most widely available contraceptives are not abortifacients, debate over this issue obscures a far more central issue--the right of each woman to plan her family size and the interval between births. Screening and counseling provided by well-trained health personnel can enable women to choose the contraceptive method that best suits their needs and protects their health. A lack of access to contraception is in part responsible for the 2000 maternal deaths that occur in the Philippines each year during pregnancy or delivery.
DANISH MEDICAL BULLETIN. 1990 Feb; 37(1):95-105.This article presents a historical and statistical explanation of the Danish family planning services delivery system. This system has evolved to accommodate the country, people and opinions that make up Denmark. The descriptions of the laws and regulations is given in a historical context and the operation of the system reflects the will of the people. Health care, including family planning is something that the Danish government gives to every Danish citizen, regardless of income. While abortion is legal it is at an unacceptably high rate. As in other Nordic countries, sex is viewed pragmatically, not morally. Sex is seen as a normal natural function, like eating or sleeping. The desire to control pregnancy is clear. 82% of women seeking abortions in Copenhagen were under 20 or over 34, unmarried or not living in a stable partner relationship, or has 2 or more children. Abortion is not a controversial issue in Denmark, it is viewed as a necessary backup to regular contraception. Sex education was practiced for years before compulsory primary school education was integrated in 1970. The article proposes solutions to the problem of the high rate of abortion: improve sex education and family planning teaching abilities for physicians, health nurses, mid-wives, teachers and social workers; revise teacher's guidelines on sex education and intensify sex education in schools; intensify information to risk groups such as teenagers and single women; organize school trips to visit family planning clinics.
[Opinions and attitudes with regard to demographic development in the Federal Republic of Germany: results of representative opinion polls initiated by the Federal Institute for Population Research in 1984 and 1989] Meinungen und Einstellungen zur Bevolkerungsentwicklung in der Bundesrepublik Deutschland: Ergebnisse reprasentativer Umfragen des Bundesinstituts fur Bevolkerungsforschung 1984 und 1989.
ZEITSCHRIFT FUR BEVOLKERUNGSWISSENSCHAFT. 1990; 16(2):237-57.This article tries to describe the prevailing public opinion about questions of demographic development in the Federal Republic of Germany in...light of the results of two representative demographic opinion polls carried out by the Federal Institute for Population Research in 1984 and 1989....The results give evidence of a relatively constant public opinion with regard to the general judgment of demographic development and the assessment of the reasons of the birth decline and its consequences for the social development. Changes are more evident, however, in the assessment of the immigration and integration of foreigners. Evaluation of some questions newly included in the 1989 poll shows that the German population clearly differentiates when assessing the consequences of the immigration of foreigners, Germans from the GDR and ethnic Germans from Eastern European countries. (SUMMARY IN ENG AND FRE) (EXCERPT)
[The unclear status of the fetus is an ethical dilemma. Neonatal care can save the fetus when abortion is still legally possible] Fostrets oklara status ett etiskt dilemma. Neonatalvard raddar foster vid abortgransen.
LAKARTIDNINGEN. 1990 May 9; 87(19):1689-90.A striking situation occasionally occurs in Swedish hospitals: a fetus survives late abortion and then all available intensive care resources are employed to keep it alive. The law permits free abortion through the 18th week of pregnancy, but with permission from the social service authorities, the limit for abortion can be stretched to the end of the 22nd week. At the same time it is possible to save the life of a premature birth down to the 23rd or 24th week. The development of a neonatal advanced care is based upon the assumption that it is desirable to save the life of a human fetus no matter how young it may be. At the same time, legislation which legitimizes free abortion up to a certain period of time expresses the view that the life of the fetus up through that time possesses little or no real value. A recent report by a government commission on the individuality of the pregnant woman and the fetus should have dealt with this ambivalence but did not. One possible way out of this dilemma is for society to take an active role in offering the woman economic compensation for bearing the child to term with a view toward giving it up for adoption. The commission's report compromised in not presenting this alternative as an official suggestion because it is too unpopular politically. The result is that tens of thousands of humans in Sweden every year are denied a chance for normal life because the public allows itself to be represented by politicians who lack the courage or the insight to accept the moral consequences of this decision.
CONTINUITY AND CHANGE. 1990 Aug; 5(2):199-224.This paper arises from a larger study of fertility control and population policy in Germany, 1910-1928, concerned with the tension between state population programmes and individual attempts to obtain reproductive choice. The aspect examined here is the medical ideology and its influence on abortion law and regulation. Consideration is given to the political climate and to the significant differences in opinion among male and female doctors. (SUMMARY IN FRE AND GER) (EXCERPT)
AMERICAN JOURNAL OF PUBLIC HEALTH. 1990 Mar; 80(3):269-70.Trends toward increasing restrictions on abortion in the U.S. since the Reagan administration are summarized, and implications for adolescent pregnancy noted. Although abortion was legalized in 1973 by the Supreme Court, federal administrative tactics sine 1982 have cut funding for Title X of the Public Health Service Act 15% from 1981-1989, required parental permission for adolescent abortion--"squeal rule", forbid informing, referring or counseling women about the possibility of abortion--"gag rule", and appointed Supreme Court justices such that cases concerning restriction on abortion are being decided restrictively. Public backlash has resulted in reversal of the parental notification requirement in publicly funded clinics and election of several "pro-choice" candidates. Research studies have shown that early childbearing is not beneficial to individuals or to society, and that parental notification does not improve family communication but delays abortion by as much as 23 days and encourages women to travel to other states for abortion. Restrictive policies regarding access to the public funding of abortion affect the poor, young and underprivileged disproportionately. Denying that the U.S. has the highest teen pregnancy rate in the developed world will not reverse the problem: only effective sexuality education, social intervention and complete, compassionate adolescent health care can prevent teen pregnancy and abortion.
NEW AFRICAN. 1990 Feb; (269):28.In October 1989 midwives and nurses held mass demonstrations in Benin city, the capital of Bendel State, Nigeria, to protest against female circumcision. This practice, which is firmly entrenched in the area, may involve cutting off the clitoris or more extensive removal of girls' genitalia, either in infancy or at puberty. Nigerian hospitals no longer perform circumcision, so people do it themselves or have traditional practitioners do so. Recent demonstrations reflect outrage on the part of Western-trained health care activists regarding aesthetic and obstetric complications, as well as added risk of spreading tetanus and AIDS by unsanitary procedures.
Design and implementation of a citywide breastfeeding promotion program: the New York City approach.
FAMILY AND COMMUNITY HEALTH. 1990 Feb; 12(4):71-8.Breastfeeding has regained more popularity in the US since 1970, but there has been a definite disparity in its resurgence among minority, poor, and less educated mothers. This article outlines the history of breastfeeding prevalence in the US and New York City as an introduction to explaining the design and implementation of New York City's breastfeeding promotion program. In 1982, the Steering Committee to Promote Breastfeeding in New York City was generated and it designed task forces to address each of their defined barriers to breastfeeding promotion (e.g. lack of relevant data, centralized compilation, data analysis, health care professional education, inhibitory practices by hospitals and ambulatory services, public misinformation, and unsupportive public policy). The Research Task Force, Professional Education Task Force, Hospital Practices Task Group, Policy and Legislation Task Group, and Public Information Task Group were outlined and some policies, strategies, and practices they have enacted were described. Some of their accomplishments include: educational kits on breastfeeding for health care professionals, guidelines for work-site health and nutrition programs for pregnant and lactating workers, research on the economics of breastfeeding, breastfeeding information posters on the subway, and establishment in 1984 of a breastfeeding coordinator in each municipal hospital. These strategies demonstrate a successful model for breastfeeding promotion in large urban areas as seen by the rise in breastfeeding at the time of newborn discharge from New York City hospitals.