Demography, Population, and Ecology Commons^™

Update - March 1995, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Cabbages and Condoms: Population Control in a Crowded World
-- On Conundrums, Condoms and Cabbages: "Prior Questions" on the Subject of Population Control
-- LLU offers Masters of Arts in Biomedical and Clinical Ethics

Community-Based Aids Prevention And Care In Africa—Dissemination Of Phase I Findings: Report Of Five National Workshops, Population Council

HIV and AIDS

Given the constraints faced by the health care infrastructure in responding to the AIDS crisis in sub-Saharan Africa, and the limitations of traditional educational approaches in motivating people to modify their sexual behavior within the African context, community-based efforts at AIDS prevention, and care of those affected, are the first lines of defense against the disease. Thus, they deserve greater scrutiny, to learn from the experiences and to continue and expand their efforts. The “Community-Based AIDS Prevention and Care in Africa: Building on Local Initiatives” project is being carried out by the Population Council with support from Glaxo Wellcome. The …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Jalaun, B.D. Mishra, U. Dosajh, Prateep Roy, T.D. Jose, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

The Ministry of Health and Family Welfare (MOHFW), with support from the United States Agency for International Development (USAID), has sponsored the Innovations in Family Planning Services (IFPS) Project under the management of the State Innovations in Family Planning Services Agency, Lucknow. The project aims to reduce fertility by increasing accessibility, improving quality, and generating demand for family planning services. The project attempts to achieve its objectives by supporting service innovations in the public and nongovernmental sector, and through social marketing of contraceptives. These intervention strategies are expected to increase the couple protection rate of the state in general and …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Agra, B.D. Mishra, U. Dosajh, Tilak Mukherjee, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

The Ministry of Health and Family Welfare, Government of India (MOHFW), with assistance from the United States Agency for International Development (USAID), launched a landmark project in India’s most populous state, Uttar Pradesh. The Innovations in Family Planning Services Project was implemented under the management of the State lnnovations in Family Planning Services Agency (SIFPSA), Lucknow. Conducting baseline surveys in 15 selected districts of Uttar Pradesh was the first step in the project. The Uttar Pradesh baseline survey provided critical input by generating important demographic and family welfare program data at the district level. Over and above the 15 districts …

A Model Of Costs Of A Cbd Programme, Saumya Ramarao, John Townsend, M.E. Khan

Reproductive Health

This study is a collaborative effort of the Population Council, New Delhi, and the Centre for Development and Population Activities, New Delhi. Cost analysis is an analytical tool that provides program managers and planners with information about existing and potential programs. Existing programs can be evaluated for efficiency and effectiveness, while the resource requirements of future programs can be estimated. In the context of family planning (FP) programs, cost analysis provides policymakers and program managers with sufficient data on efficient ways to meet the demand for FP services with available resources. As FP programs mature and requirements for the resources …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Pithoragarh, K. Satyanarayan, G. Giridhar, K.K. Gaur, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

In 1992, the Ministry of Health and Family Welfare and the United States Agency for International Development, New Delhi, began the Innovations in Family Planning Services Project (IFPS) under the management of the State Innovation in Family Planning Services Agency (SIFPSA), Lucknow. The goal was to reduce the fertility rate in Uttar Pradesh by expanding and improving family planning (FP) services. To achieve this, the IFPS project will support service innovations in the public sector and nongovernmental sectors and through contraceptive social marketing mechanisms. The Baseline Survey in Uttar Pradesh (BSUP) is being undertaken as one important component of the …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Kanpur, B.D. Mishra, U. Dosajh, Prateep Roy, T.D. Jose, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

The Ministry of Health and Family Welfare (MOHFW) with financial support from the United States Agency for International Development (USAID) has sponsored the Innovations in Family Planning Services Project (under the management of the State Innovations in Family Planning Services Agency, Lucknow). The project aims to reduce fertility through increasing accessibility, improving quality, and generating demand for family planning services. It attempts to achieve its objectives by supporting service innovations in the public and nongovernmental sector and through social marketing of contraceptives. These intervention strategies are expected to increase the couple protection rate of the state in general and of …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Jhansi, G. Narayana, N. Prem Kumar, Hanimi Reddy Modugu, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

Baseline surveys in 15 districts of Uttar Pradesh were conducted as part of the USAID-assisted State Innovations in Family Planning Services project. This effort helps create databases at the district level, an essential prerequisite for decentralized planning and strategy development. The Baseline Surveys in Uttar Pradesh (BSUP) were undertaken as part of the Innovations in Family Planning Services Project to reduce the fertility rate in Uttar Pradesh. The project’s objectives were to increase access to family planning (FP) services, improve quality of FP services, and promote contraceptive use. The Population Council was designated as the nodal organization to coordinate various …

Addressing Women's Reproductive Health Needs: Priorities For The Family Welfare Programme, Shireen J. Jejeebhoy

Reproductive Health

India's national family welfare program has two objectives—to address the needs of families, notably women and children, and to reduce population growth rates. In reality, the program has been disproportionately focused on achieving demographic targets by increasing contraceptive prevalence. In this process, women's needs have been overlooked, in terms of poor reproductive health (RH). There is a need to reorient program priorities to focus more holistically on RH needs and on woman-based services that respond to health needs in ways sensitive to the sociocultural constraints women and adolescent girls face in acquiring services and expressing health needs. This report presents …

Development Of Approaches To Community Based Family Planning Outreach In Egypt: Assessment Of Raidats Rifiats Program, Population Council

Reproductive Health

Egypt’s family planning program officially began in 1965. Impressive gains in contraceptive use have been made since 1980, and the contraceptive prevalence rate increased from 24 percent in 1980 to 47 percent in 1992. Egypt’s National Population Policy addresses the nation’s population growth through multiple interventions designed to reduce fertility, including family planning (FP) services. FP accessibility is promoted through a network of public and NG0 FP clinics. A number of years ago, the Egyptian Family Planning Program began using the Raidats Rifiats program to extend services into rural communities. There is concern regarding the program’s ability to recruit women …

Families In Focus: New Perspectives On Mothers, Fathers, And Children, Judith Bruce, Cynthia B. Lloyd, Ann Leonard, Patrice L. Engle, Niev Duffy

Poverty, Gender, and Youth

Despite the rhetoric of recent years lamenting the loss of the "traditional family," families have never fit nicely into any single model. "Family" may refer to people linked by marriage or kinship or to people claiming descent from common ancestors. People may form and extend families by adopting or fostering children, defining nonrelatives as family, or establishing consensual partnerships. Families are as adaptable as they are diverse, reconfiguring themselves over their life cycles and evolving to accommodate the myriad pressures of the external world. This book focuses on families with dependent children specifically—on the roles of mothers, fathers, and children, …

What We Do And Do Not Know About The Menstrual Cycle Or, Questions Scientists Could Be Asking, Sioban D. Harlow, Sara A. Ephross

Reproductive Health

The objective of this paper is to consider from a public health perspective the types of questions researchers might be asking about the relationship between menstrual function and women’s health, and to evaluate to the extent to which these questions have or have not been addressed by the scientific community. Based on the findings in this report, it is obvious that a comprehensive program of research is needed in order to begin filling the myriad gaps in scientific knowledge about the menstrual cycle. Given the lack of knowledge about many fundamental aspects of menstrual function and about linkages between the …

Sexual Coercion And Reproductive Health: A Focus On Research, Lori L. Heise, Kirsten Moore, Nahid Toubia

Reproductive Health

Gender-based violence is ignored or denied in most societies and neglected by health professionals and researchers, yet it persists in almost all societies, and, in some, it is on the increase. This report is aimed at those in the family planning/reproductive health field who desire to conduct research or implement programs to address sexual violence and its impact on women's reproductive health. Furthermore, it contributes to a better understanding of the context of sexual coercion as well as its causes and consequences. The ideas presented herein are derived largely from a two-day meeting jointly organized by the Ebert Program in …

Women's Status And Family Planning In Bangladesh: An Analysis Of Focus Group Data, Ruth Simmons, Rezina Mita

Reproductive Health

This study involved secondary analysis of a substantial set of 1987–88 focus group data from Bangladesh’s Matlab Thana, where the Family Planning and Health Services Project was underway since 1977. The project was highly successful in increasing family planning (FP) acceptance and provided a rich research base for studying the diffusion of FP and its effects. The study involved 36 focus groups with fieldworkers, community women, husbands, educated women, and community leaders. The intent of the present study is to examine the effect of FP on women's status in Bangladesh, and to prepare papers on that topic. Following leads in …

An Investigation Of Alternative Approaches To Contraceptive Logistics Management At The Peripheral Level, Abu Yusuf Choudhury, Iqbal Ahammed, Amy Gale Dunston

Reproductive Health

In Bangladesh, contraceptive commodities are received at the peripheral level (thana and below) from thana stores on a monthly basis by using the “pull” system. It is expected that at any point in time a worker or a center at the peripheral level will have a two-to-three-month stock of contraceptives. Many surveys/studies have indicated, however, that stockouts of contraceptives are quite frequent. To investigate an improved system of contraceptive distribution, a three-cell experimental study was undertaken. In the first two cells, contraceptives were delivered following two methods of the “push” system, while in the third cell contraceptives were distributed following …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Ghaziabad, V.S. Sridhar, P. Subramaniyam, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

Uttar Pradesh is the most populous state in India with 139 million individuals, per the 1991 census. The Sample Registration System in 1992 indicated a high population growth rate of 2.3 percent and a very high birth rate of 36.2 per 1,000. Several measures have been taken to contain the growth and bring a rapid decline in the fertility rate. The Government of India and USAID began the Innovations in Family Planning Services Project under the management of the State Innovations in Family Planning Services Agency. The goal was to reduce the fertility rate in Uttar Pradesh by expanding and …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Gorakhpur, P.N. Kapoor, P.K. Chopra, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

The state of Uttar Pradesh (UP) in India had a population of 139 million, as of the 1991 census. The socioeconomic profile is characterized by relatively low levels of per capita income and literacy. Further, assessment of the family planning program and the demographic status as measured by Couple Protection Rate (CPR) and Mortality/Fertility rates marks UP as one of the country’s more demographically disadvantaged states. UP has a relatively higher infant mortality rate, crude death rate, birth rate, and total fertility rate than the country as a whole, whereas CPR is much too low. The district of Gorakhpur falls …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Jaunpur, P.N. Kapoor, P.K. Chopra, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

Uttar Pradesh (UP) is the most populous state in India, with a population of 139 million, as of the 1991 census. The socioeconomic profile is characterized by relatively low levels of per capita income and literacy. Further, assessment of the family planning program and the demographic status as measured by Couple Protection Rate (CPR) and Mortality/Fertility rates mark UP as one of the country’s more demographically disadvantaged states. UP has a relatively higher Infant Mortality Rate, crude death rate, birth rate, and total fertility rate than the country as a whole, whereas CPR is much too low. The district of …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Meerut, P.K. Jain, Ramal Pasricha, Hanimi Reddy Modugu, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

The Government of India and USAID began the Innovations in Family Planning Services Project (IFPS) in Uttar Pradesh under the State Innovations in Family Planning Services Agency (SIFPSA). The goal was to reduce the fertility rate in India’s most populous State of Uttar Pradesh by accelerating family planning (FP) services at the district level through innovative approaches. IFPS’s main objectives were to increase access to FP services, improve quality of FP services, and promote contraceptive use. Initially 15 districts were selected for the Baseline Surveys in Uttar Pradesh (BSUP). The baseline information collected will be used to plan FP interventions …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Lalitpur, G. Narayana, N. Prem Kumar, Hanimi Reddy Modugu, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

Baseline surveys in 15 districts of Uttar Pradesh were conducted as part of the USAID-assisted State lnnovations in Family Planning Services project. This effort helps create databases at the district level, an essential prerequisite for decentralized planning and strategy development. The Baseline Surveys in Uttar Pradesh (BSUP) were undertaken as part of the innovations in Family Planning Services Project, which aimed to reduce the fertility rate in Uttar Pradesh. The specific objectives of the project were to increase access to family planning (FP) services, improve quality of FP services, and promote contraceptive use. The Population Council has been designated as …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Nainital, K. Satyanarayan, G. Giridhar, K.K. Gaur, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

In 1992, the Ministry of Health and Family Welfare and the United States Agency for International Development, New Delhi, began the Innovations in Family Planning Services Project (IFPS) under the management of the State Innovation in Family Planning Services Agency (SIFPSA), Lucknow. The goal was to reduce the fertility rate in Uttar Pradesh by expanding and improving family planning (FP) services. To achieve this, the IFPS project will support service innovations in the public and nongovernmental sectors and through contraceptive social marketing mechanisms. The Baseline Survey in Uttar Pradesh (BSUP) is being undertaken as one important component of the IFPS …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Sitapur, P.K. Jain, Ramal Pasricha, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

The Government of India and the United States Agency for International Development began the Innovations in Family Planning Services Projects (IFPS) in Uttar Pradesh under the management of the State Innovations in Family Planning Services Agency (SIFPSA). IFPS’s objectives are to increase access to family planning (FP) services, improve the quality of health care services, and promote contraceptive use. While achieving these goals, the IFPS project will support service innovations in the public and nongovernmental sectors, and contraceptive social marketing mechanisms. Baseline information being sought includes desired family size and sex preference among mothers, utilization of health services and immunization …

Technical Assistance For Expanding Contraceptive Choice In India, John Townsend

Reproductive Health

One of the roles of the ANE OR/TA Project in India was to participate in policy dialogues with national counterparts, in the public sector and among NGOs, about expanding contraceptive choices, and to provide technical assistance for facilitating changes in service-delivery procedures. The public sector provides five contraceptive methods through its 11,500 hospitals and primary health care facilities. NGOs, private physicians, and pharmacies have access to a broader range of brands. While India is one of the world's leaders in contraceptive research, in recent years products have come to market slowly. New technology is often embraced, however the cost of …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Tehri Garhwal, V.S. Sridhar, P. Subramaniyam, K.K. Gaur, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

Uttar Pradesh (UP) is the most populous state in India, with a population of 139 million, as of the 1991 census. The Sample Registration System in 1992 indicated a high population growth rate accompanied by a very high birth rate. The authorities have been taking several measures to contain the growth and bring a rapid decline in fertility rates. It is in this context that the Government of India and the United States Agency for International Development reached an agreement to begin the Innovations in Family Planning Services Project (IFPS) under the management of the State Innovations in Family Planning …

District Level Baseline Survey Of Family Planning Program In Uttar Pradesh: Shahjahanpur, S.K.G. Dastidar, Tausif Alam Khan, B.P. Thiagrajan, R.B. Gupta, Bella C. Patel, M.E. Khan, John Townsend

Reproductive Health

The Government of India and the United States Agency for International Development began the Innovations in Family Planning Services Projects (IFPS) in Uttar Pradesh under the management of the State Innovations in Family Planning Services Agency (SIFPSA). IFPS’s objectives are to increase access to family planning (FP) services, improve the quality of health care services, and promote contraceptive use. While achieving these goals, the IFPS project will support service innovations in the public and nongovernmental sectors, and contraceptive social marketing mechanisms. Baseline information being sought includes desired family size and sex preference among mothers, utilization of health services and immunization …

A Qualitative Study Of Quality Of Care In Rural Karnataka, P.H. Reddy

Reproductive Health

The Third Five-Year Plan (1961–66) aimed at reducing the crude birth rate in India to 25 per 1,000 population by 1973, however this goal has not been achieved. Several other demographic goals were set later, to be achieved by specified years, but they were deferred or revised. One major reason for the failure to achieve these goals was thought to be the lack of adequate infrastructural facilities for the family welfare program, thus it was decided to improve the institution–population ratio. The primary objective of this study is to assess the quality of interaction between clients and providers, and the …

Lessons Learned From A Community-Based Distribution Programme In Rural Bihar, S. Parveen, M.E. Khan, John Townsend, Bella C. Patel

Reproductive Health

The state of Bihar in North India ranks near the bottom of the Indian states in terms of its demographic situation. The infant mortality rate as of 1991 was 69 per 1,000, and the contraceptive prevalence rate as of 1990 was 26 percent. Bihar ranks near the bottom among other states of India in almost all indicators of social and economic development. One reason for its low performance is weak management. Besides poverty, a poor communications network and lack of proper infrastructure further make the implementation of programs difficult. Workers have misconceptions about FP methods, and educational activities are poorly …

Improvements In Knowledge Of Norplant® Implants Acceptors: An Intervention Study In West Sumatra And West Java, Anthony Tan, Eman Mahdar, Faisal R. Djamal, Hafni Bachtiar, Jayanti Tuladhar, R. Hasan, R. Hasan, M. Hoesni

Reproductive Health

Previous studies on Norplant® implants in Indonesia have shown that there are a substantial number of implant acceptors, providers, fieldworkers, and volunteers who are unaware of the basic facts about Norplant. In addition, information, education, and communication materials are lacking for providers, fieldworkers, volunteers, and clients. With these issues in mind, the Training and Development Center for Biomedical and Human Reproduction Studies of the National Family Planning Coordinating Board launched an Operations Research intervention study with Study Groups on Human Reproduction from Andalas University, Padang, West Sumatra, and Padjajaran University, Bandung, West Java, with support from the Population Council. The …

Experience With The Dmpa Injectable Contraceptive: Findings From A Survey Of Dmpa Acceptors, Maria Carmela Patron, Marilou P. Costello

Reproductive Health

This report presents the results of a survey of 899 DMPA acceptors who availed of injectable contraceptive services from public health facilities under the Philippine Department of Health's (DOH) DMPA Reintroduction Program. The survey is part of the DMPA Monitoring and Follow-up Studies sponsored by the Population Council’s Manila office in response to a request by the DOH to provide operations research support to the program. Depot-medroxyprogesterone acetate (DMPA), commonly known as Depo-Provera, is a three-month injectable contraceptive. It was recently officially endorsed as a family planning (FP) program method by the DOH, following its approval by the Philippine Bureau …

Report On Norplant® Implants In Indonesia, Andrew A. Fisher, Soledad Diaz, Alejandro N. Herrin, Joedo Prihartono

Reproductive Health

At the request of the Indonesian National Family Planning Coordinating Board, the Population Council’s consultant team reviewed issues related to Norplant® implant service delivery in Indonesia and recommended specific areas for new initiatives, improvements, and further research. The team reviewed secondary sources on the subject and visited Indonesia from April 17–28, 1995. They talked with family planning (FP) officials and observers and made field visits to West Java and Yogyakarta. This report reviews important issues facing the national FP program, particularly regarding Norplant insertions and removals. Program approaches are included, as are an outline for a national assessment study that …