Integrating parasite control and family planning

A pilot project started recently in 4 locations by the Family Planning Organization of the Philippines in cooperation with the Japanese Organization for International Cooperation in Family Planning and the Asian Parasite Control Organization uses de-worming as an entry point to establish credibility for family planning workers among the target population. The ultimate goal of the project is to encourage community participation to such an extent that family planning and related efforts are sustained by the community itself and the field worker is no longer needed. Integrated parasite control/family planning projects have already gone through the 4 principal developmental stages of strategic planning, project design and development, implementation and assessment, and program maintenance in some areas since their beginnings in 1976. Support for such programs has been obtained from 3 international bodies working in family planning, and 2 others have recently indicated interest. Activities to develop criteria for project expansion are now underway. The 4 projects in the Philippines, located in Binakayan, Cavite; San Pedro, Laguna; Caramoan, Camarines Sur; and Davao City, are each staffed by a project manager, doctors, nurses, and medical technologists. The projects, especially the Caramoan project, have been quite successful, and efforts are being made to include nutrition in the integrated program.     

Natural family planning works in a Bukidnon town

Natural family planning is being actively promoted in a pineapple plantation of the Philippine Packing Corporation (PPC) located in northern Bukidnon province. Prospective acceptors attend 4 seminars which cover sex education and instruction on natural family planning methods. The goal of the program is family life and marriage enrichment rather than family size limitation. Thus, there is no target number of acceptors. Early acceptors used the basal body temperature method, but this was subsequently replaced by the sympto-thermal method. Participants report that the close observation of physical changes required by the natural family planning method has enabled them to be more aware of their bodies and more appreciative of themselves. Laypersons work closely with acceptor couples. There are 6 fulltime grassroots motivators and 23 camp motivators. Affiliated with the Family Life Commission of the Catholic Bishops Conference of the Philippines, the program is also supported by the Phillips Memorial Hospital and is part of the PPC's barrio assistance program. The corporation actively supports self-help projects in the plantation areas.     

Pop-ed programs for the out-of-school youth

39% of the Philippines youth are not in school and these youths receive no training for responsible parenthood and community life. A number of agencies try to reach these members of society, including the Bureau of Youth Welfare (BYW), the Family Planning Organization of the Philippines (FPOP), the Foundation for Youth Development in the Philippines (FYDP), the Rizal Youth Development Foundation (RYDF), the Philippine Rural Reconstruction Movement (PRRM), and the Philippine Youth Welfare Coordinating Committee. BYW conducts informal group sessions including discussions among 13-24 year old members who have started self-employment projects. FPOP's youth program, SIGLA, aims at developing out-of-school youths social y and having them disseminate information to other out of school youths. This information includes family development, family planning, and population-related information, and is disseminated through activities and workshops. FYDP aims at functional literacy but also disseminates family planning information to out-of-school youths. RYDF conducts week-long seminars in topics such as birth processes, family relations, and care of babies. PRRM integrates population and family planning into its nonformal education program for out-of-school youth and adults in Nueva Ecija Province. Problems encountered in these programs are 1) suspicion of parents, and 2) feelings of inadequacy on the part of teachers. While emphasis has been on unemployed youth, efforts should be made to reach those youth who are employed.     

Peer counseling: the young helping the young

Reports on the use of peer counseling in sex and fertility control for adolescents in the Philippines. Among the programs described are the early and innovative program at De La Salle University, which includes a telephone hotline; a similar phone service used by the Kapatiran sa Kaunlara Foundation in Manila; and the Catholic Education Association of the Philippines. Universitites in Manila and other cities have also developed programs. The types of problems peer counselors are likely to encounter and ways in which they are frequently handled are noted, the importance of sound training is stated, and the key role of experience in the development of good counselors is emphasized. Counselors are generally offered some kind of incentive (college credits or an honorarium) but the personal rewards are noted as being possibly more significant.     

Premarital information efforts under way

Premarital couples are among priority targets of family planning information in the Philippines national population program as they can serve a pivotal role in slowing population growth. Applicants for marriage licenses are required to attend a family planning session as a prerequisite. Following recommendations of a training effort and seminar on Premarital Family Planning Counseling, on July 20, 1976, premarital information was institutionalized in the country by Presidential DEcree 965 which made family planning counseling obligatory to the marriage license applicants. Shortly after that, a multiagency effort gathered information on the status of the Premarital information program in the Philippines, which showed that there is no full-time specialist for the work. Medical officers; social workers; community welfare supervisors; and program and training officers do this work of information in addition to their usual duties. Distribution of the applicants varied greatly in age groups, educational levels, and professional category. The size of the group, length of session and topics of discussion varied greatly. Necessary efforts should be made to solve the major problems by selecting better sites for group sessions and training more personnel for the purpose. There is a great need fordeveloping more effective and research oriented information, education and communication materials, according to the needs and cultural traits of the target audience.     

ASEAN projects reviewed

The ASEAN Population Expert Group met in Manila and was followed by a meeting of the ASEAN heads of population programs, during the period November 5-10, 1979. Heads of population programs from Indonesia, Malaysia, Singapore, Thailand, and the Philippines attended. The meetings were held to review progress-to-date on phase 1 projects and to consider the development of an expanded population program. 5 projects funded by UNFPA are reviewed in tabular form with the project, the sponsoring country, date of implementation, data analysis, and date of completion. Suggestions were made for improving and extending these projects and it was also suggested that all projects being developed and proposed should include a section on use of research. 7 new projects were proposed as phase 2 projects. The 1st, sponsored by Malaysia, deals with women in development; project 2, lead by Thailand, will investigate population movement and its effect on development; project 3, led by the Philippines, will develop and strengthen national population information systems and networks in ASEAN countries; project 4, led by Indonesia, is directed towards institutional development and exchanges of personnel; project 5, led by the Philippines, will examine population and development dynamics and the man/resources balance; project 6, led by Thailand, will develop ASEAN social indicators; and project 7, led by Indonesia and Malaysia, will make a comprehensive analysis of existing medical/health care and family planning systems. It was recommended that an executive director of the proposed ASEAN population coordination unit should be appointed to expedite the recommendations of the meeting related to preparation and submission of phase 2 project proposals.     

The participation of non-governmental organizations in the Philippine population program

In 1957 the National Council of Churches in the Philippines (NCCP) established the Family Welfare Center, offering an educational program in family planning; it was subsequently expanded and reorganized into the Planned Parenthood Movement of the Philippines. Since its creation in 1970 the Philippine Population Program has brought together government, private, and religious activities. Under the 1987-92 development plan nongovernmental organizations (NGOs) will be taking a more active role in the implementation of the population program by contributing to the maternal and child health/family planning and the information, education, and communication (IEC) components. There are more than 50 private organizations engaged in such population activities. These include national women's organizations and development NGOs with a mass base. The Family Planning Organization of the Philippines is carrying out a 3-year comparative study of the effectiveness of community volunteers in the acceptance of natural family planning. The Reproductive Health Philippines has completed a follow-up of Depo Provera defaulters in a previous clinical study of Depo Provera acceptors conducted in 1985-87. IEC support from various medical and social organizations also helped advance family planning and population awareness of the program. The Mary Johnston Hospital and Iglesia ni Kristo have been front-runners in sterilization through their mobile teams and regular clinics. On the negative side, funding constraints are threatening the very existence of some NGOs. Even those that do not face such constraints face problems related to cost effectiveness, priority setting, capability building, and staff development. A survey of the Population Center Foundation identified some urgent concerns: sharing experience in self-reliance, enhancement of the managerial skills of staff, and funding problems. NGOs complement the family planning services of the government as well as focus on the smooth flow of IEC activities.     

Total maternal and child care: an approach to the population problem

This article describes the Bohol Province Maternal Child Health/Family Planning Project, a 5-year project financed by the United Nations Fund for Population Activities and the Philippines Department of Health. The objectives of the project are to improve general health services, introduce family planning services in the context of the MCH program, improve training of personnel and evaluated the results of the program. 88 barrio health centers have been established, offering a range of maternal, child health and family planning services. 34 boticas (drugstores) have been set up in local variety stores, dispensing drugs at low cost. A strong research unit collects data for program evaluation and has so far published 23 reports, which are listed at the end of this article. Community acceptance of the program has, in general, been good; midwives have been welcomed. The program has encountered problems of religious conservatism and insufficient contraceptive supplies and has learned the need for good relations with the barrio leaders and residents. The 5-year limit needs to be extended. Progress in health services has been excellent. The effect on family planning, while encouraging, cannot yet be evaluated.     

World Population Day '93 observed

President Abdur Rahman Biswas inaugurated the World Population Day '93 at the Osmani Memorial Hall in Dhaka, Bangladesh, on July 11. He stressed the importance of reducing the national population growth rate from 2.03% in 1923 to 1.82% by the 1995. The event was organized jointly by the Ministry of Health and Family Welfare, the Directorate of Family Planning, and the United Nations Population fund (UNFPA). The president expressed his deep concern over the population growth rates in developing countries, which are much higher than resources. He noted with satisfaction that 40% of the eligible couples in the country practice family planning (FP) and expressed hope that this could be raised to 50% by 1995. If the program becomes successful, ideal families would consist of two children by 2005. He later presented prizes and certificates to field workers, ulemas, traditional birth attendants, FP depot holders, and the workers of nongovernmental organizations for their commendable services in Fp and maternal-child health services. The Health and Family Welfare minister in his speech warned that if the current population growth is not checked, the consequences would be disastrous, which could be averted by adopting new strategies. The deputy minister for Health and Family Welfare illustrated the threat of population escalation and recounted some of the recent government control measures. The secretary, Ministry of Health Family Welfare, said that at the present rate of growth the Bangladeshi population would double in 34 years. The director general, Directorate of Family Planning, said that the FP program has become accountable with a system of incentives and disincentives. Earlier, the UNFPA country director in his speech remarked that it was crucial for the entire world to solve the population problem. In the morning, in the main cities, hundreds of people involved in national FP activities paraded to demonstrate the social legitimacy of the Bangladeshi Fp program.     

Serving the people stressed in family planning

There are 9 districts and 7 townships under the jurisdiction of Yuxi City in the Yunnan Province with a population of more than 280,000. The agricultrual population accounts for 85.3% and minority nationalities represent 11.6%. In the past few years, family planning has been carried out in an earnest way in Yuxi City. The natural population growth rate dropped from 17.5 per 1000 in the 1970s to 9 per 1000 in 1984 and the proportion of the 3rd or higher parity births dropped from 34% in 1979 to 2.14% in 1984. The workers of the Family Planning Committee of the Yuxi City program provide good service for family planning in 7 aspects; 1) publicity service; 2) economic aid for single-children households; 3) technical service for birth control; 4) welfare service; 5) health service; 6) service for infertile couples; and 7) nurseries, kindergartens and homes for the aged.     

大力普及人口知识教育,促进群众转变生育观念——新疆精河县普及人口与计划生育基础知识教育的实践与探索

计划生育工作单纯依靠行政命令、经济罚款是不能解决问题的。只有用人口与计划生育知识去引导、教育群众 ,帮助群众转变旧的生育观念 ,才是解决计划生育与群众生育意愿矛盾问题的根本出路     

A sensitive approach to family planning motivation in Malaysia

The goals of the Malaysian Family Planning Program are not only to reduce population growth from 3% to 2% by 1985 and to bring the crude birth rate to 28.2 from 30.3, but to generally improve the health of the family, and to enhance the government's efforts to raise the per capita income. The work program is divided into the Creative Unit, the Media Unit, the Production Unit, and the Field Diffusion Unit. The objectives are to build up strong support from political, community, and opinion leaders, and to run educational campaigns aimed at motivating potential acceptors. The program also runs centers training medical and paramedical personnel. The program is combined with development programs for women, especially useful among the rural population.     

Hong Kong: The Family Planning Association continues its pioneering role

Vital population statistics for Hong Kong are mentioned. The 1st efforts at providing birth control services in Hong Kong began in 1936 with the Eugenics League. The League was reorganized and formed into the Family Planning Association of Hong Kong (FPAHK) in 1950. The government began providing family planning services in 1974. Although there is no governmental incentive/disincentive policy, certain laws and practices do have the effect of encouraging population growth limitation. These are described. The FPAHK directs its efforts toward motivational activities. The Association is encouraging the concept of male responsibility for family planning. Personal visits to fisherfolk families have been instituted to combat their tendencies toward large families. Various separate activities of the government program and the FPAHK are discussed.     

论“三关爱”理念与构建和谐社会的关系

长春市人口和计划生育委员会提出并落实了“三关爱”的工作理念。“三关爱”既是人口和计划生育系统为构建社会主义和谐社会所做的努力,又是和谐社会应有之义和重要内容。     

NFP update: researcher cites need to improve instruction

In the Philippines more and more couples are practicing natural family planning (NFP), but there is a need to improve instruction on this method to increase its effectiveness. Calendar rhythm has been the most popular technique of NFP, but failure rates have been high. This could be changed by improved calendar rythm instruction and the introduction of newer, more effective natural techniques like the basal body temperature, cervical mucus, and symptothermal methods. Dr. John E. Laing, in a paper entitled "research on Natural Family Planning in the Philippines," examines the trends in NFP and summarizes major findings of past research related to NFP and the status of current research. It also discusses the implications of such findings for the National Population Program and the needs for current research. Cting World Fertility Survey (WFS) data on 19 developing countries, Laing states that the Philippines is second only to Peru in current and past use of the rhythm method. He also indicates that since the start of the National Population Program in 1971, rhythm has been offered as an official program method. Yet, in the early years of the program rhythm was not promoted as actively as the other family planning methods. In the last few years, program, officials have become more interested in NFP. 1976 National Acceptor Survey (NAS) data showed that rhythm reduced fertility by 78% compared to the condom's 79%, oral contraceptive's 94%, and the IUD's 98%. A comparison of data from the 1972, 1974, and 1976 NAS indicated a decline in continuation rates and an increase in overall pregnancy rates for all methods except rhythm. The overall pregnancy rate of rhythm declined, but there was no significant change in continuation rate. Laing suggests that probably, while the national population program was increasingly recruiting less motivated couples to try other methods, the rhythm acceptors, who were largely self initiated, mantained earlier levels of motivaton. Evidence points to the widespread use of crude formulas that do not take into account individual variations in cycle length. Many users do not even fully understand the mechanism by which rhythm affects fertility. There is also little knowledge among acceptors of the new and more reliable techniques of NFP for identifying the safe and unsafe periods. Despite problems, a considerable number of acceptors still prefer rhythm to other methods. The commission on population has embarked on a solution to some of the problems by committing itself to the training of volunteers of community-based organizations, particlarly lay leaders. 3 large scale projects are planned for this purpose.     

The National Conference of Propaganda Work on Family Planning held Beijing]

The National Conference on Propaganda Work in Family Planning, held in Beijing from November 1-6, 1982, was sponsored by the the Propaganda Department of the Chinese Communist Party Central Committee and the National Family Planning Committee. Among the 136 participants were representatives from various provincial, city, and autonomous region propaganda and family planning units, the General Political Department of the People's Liberation Army, general trade unions, All China Women's Federation, Communist Youth League, and propaganda reporters. The purpose of the conference was to discuss how to organize family planning propaganda in meeting China's goal of limiting the population to 1,200,000,000 by 2000, and how to arrange a Family Planning Propaganda Month for early 1983. The Chairman of the National Family Planning Committee made 3 points: family planning is a basic national policy, greater propaganda efforts must be made towards peasant family planning, and everyone must work hard to create a new situation in family planning work. The Vice Minister of the Propaganda Department remarked that family planning propaganda was foremost among the 12 national propaganda topics; these sentiments were supported totally by the representatives of the women and youth groups. The Vice Chairman of the Advisory Committee of the Central Committee said that family planning work was longterm, and that its success lay in the countryside. Finally, the Vice Chairman of the National Family Planning Committee encouraged all delegates to take the spirit of the conference back to their home. During the conference delegates also met to discuss important points in planning the Family Planning Propaganda Month.     

Adolescent fertility programs: taking the first few steps

Adolescent fertility programs in Asia and the Pacific have a long way to go to check the problems associated with adolescent fertility, but a start has been made. Delegates from 8 countries met in 1982 to share their problems and experiences in their own countries. The conference participants drew up plans to deal with a high rate of adolescent fertility, sexually active adolescents, out-of-wedlock births, unwanted pregnancies, sexually transmitted diseases, prostitution, rape, abortion, and drug addiction. The delegates felt that for adolescent fertility programs to be effective the program workers must first be equipped with the needed skills through proper training. Inadequate knowledge of the subject matter, inability to communicate with adolescents, personal bias, and lack of counseling skills were among the worker-related problems that conference participants identified. A few months after the conference, participant countries conducted a training program on the effective delivery of adolescent fertility-related information and counseling services. The training program, held in Manila from January 23 to February 2, 1984, was conducted by the Population Center Foundation and sponsored by the Family Planning International Assistance. Training program objectives included: in crease the participants' knowledge of sexuality-related matters; help them to communicate better with adolescents on matters related to sexuality and fertility; make them aware of other ways of responding to fertility-related information needs of adolescents; and improve their skills in counseling adolescents. Lectures, structured learning activities, discussions, role playing, and other methods were used to maximize learning. The training program was divided into 6 modules: group dynamics; human sexuality; information dissemination; counseling techniques; management; and action planning. The plans of Fiji, India, Indonesia, Nepal, Sri Lanka, Thailand, and the Philippines are reviewed. Organizers of the training program are confident that the action plans of the individual countries will take shape soon and clear the path toward more effective adolescent fertility programs.     

关于长春市以“三关爱”理念推进人口计生工作的调查报告

长春市人口和计划生育委员会在全面深化人口和计划生育工作综合改革过程中,提出了“人性关爱,人情关爱,人文关爱”的服务理念,取得了人口和计划生育工作的崭新成果,得到了广大群众的好评,得到了国家和省有关部门的充分肯定。     

Implementation of China's population policy

On July 1, 1982 China's 3rd national population census reported the population of the 29 provinces, municipalities, and autonomous regions on the mainland at 1,008,175,288, showing a net increase of 460,000,000 or 84% over the 548,000,000 recorded at the end of 1949. At this time China's population is about 1/4 of the world. Its population policy must conform to her national conditions and will be successful only to the extent that it does so. Discussion focuses on the main features of China's population policy. In 1953 the State Council instructed the Ministry of Health to support birth control by providing contraceptives. It also ratified provisions concerning contraception and induced abortions. In 1962 the State Council issued "Instructions on Conscientious Advocacy of Family Planning." China not only advocates and publicized family planning but also takes specific measures. Special administrative organizations were established in 1964 to oversee scientific research, production, and supply of contraceptives and to provide couples of childbearing age with free contraceptives. An all round attack on family planning work in 1966 led to unchecked childbirth resulting in rapid population growth. In 1971 Premier Zhou Enlai reiterated the importance of population control in 1971 and asked that it be incorporated into the 4th Five Year Plan for the development of the national economy. Family planning was incorporated into the Constitution in 1978. China's 20 years of experiences with family planning suggest that a country's population policy becomes effective only with repeated efforts. The 10-year period of turmoil undermined the enforcement of the population policy. Recently the State Family Planning Commission organized a nationwide fertility survey which indicated tremendous successes for China's population control drive. The total fertility rate dropped from 5.29 in the 1950s to 2.63 in the 1980s. The population census shows that the momentum of China's population growth cannot be checked without strict measures because the population is characterized by a huge base figure, a young age composition, and a fertility rate much higher than a population replacement level. China's population policy is formulated in line with her national conditions. Specific provisions for family planning reflect different ways to deal with different people.     

Integrated family planning/parasite control project: a different approach to community health problems

An obstacle to the acceptance of family planning is the fact that its advantages are not immediately apparent or tangible. A way to get around this obstacle is through the use of "entry points"--projects which yield tangible results in a relatively short time. Through these entry points, the fieldworker builds credibility and wins the confidence of the people in the community he or she is serving. Thus, when the time comes, the people will be receptive to the family planning message. This strategy of the use of entry points is common to integrated projects with a community development program becoming a sort of entry point for family planning fieldworkers. 1 such project, begun quite recently by the Family Planning Organization of the Philippines (FPOP) in 4 pilot sites, uses deworming as an entry point. It is officially known as the Integrated Family Planning/Parasite Control/Nutrition Project. It is 1 of several projects cosponsored and financed by the Japanese Organization for International Cooperation in Family Planning (JOICFP) and the Asian Parasite Control Organization (APCO) in almost a dozen other Asian and Latin American countries. The immediate objective of the project is to establish or increase the credibility of family planning fieldworkers among the people in a target area. Fieldwork connected with family planning is conducted alongside a related community health effort that can produce immediate and visible results. The ultimate goal is to encourage community participation to such an extent that there will no longer be a need for the fieldworker. Strategic planning involves thinking up the "backbone" and molding the "skeleton" of the project, i.e., its concept and basic policies. As the project goes into the design and development stage, additional people are drawn into it. Project experience in Thailand underscores the need to consult with local leaders. The earliest projects were initiated in 1976, but some are already showing successful results. The overall Philippine experience provided support to JOICFP Director Kunii's reiteration of his belief in the effectivity of parasite control as an entry point for population planners. Integration of the nutrition element in the project is regarded as essential.