Comics: a medium for today's development messages

Filipino illustrated magazines, or the comics, may yet prove to be the most effective media, if not the most effective, for spreading the country's development messages. Long criticized by intellectuals and the social elite, the comics have been grossly underrated in their potential to inform, persuade, and even influence the life-style of the people. The government's Commission on Population (Popcom) has developed an information-education-communication program using the comics, among other media, to disseminate stories on family planning, responsible parenthood, and related topics. Its best quality is popular appeal, and for publishers and distribution outlets, the comics provide good business. A review of these materials shows that their themes reflect the following topics or issues: 1) population trends and consequences; 2) socioeconomic benefits of family planning; 3) customs which influence family planning; 4) family planning concepts; 5) family planning methods; 6) human sexuality and reproduction; 7) the husband-wife relationship; 8) guides for family planning motivation or communication; and 9) guides for teaching family planning. The materials were developed with 4 qualities in mind so as to attract audience or reader interest: simplicity, familiarity, realism, and attractiveness of materials. The consensus is that in the comics, population and development agencies may have found a "secret weapon" in getting these messages across, and that this new-found use for the illustrated magazines may be giving them a new respectability without in any way diminishing their popular appeal.     

计划生育家庭福利政策改革思路研究

随着经济体制变革、社会结构变动、利益格局调整等不断深化,传统家庭功能面临严峻挑战,计划生育家庭问题尤为突出。家庭是国外为数不多的福利扩张领域,也应是我国福利"增长"的优先领域。计划生育家庭福利改革框架包括三个层面:一是针对因执行计划生育国策而产生的确定性风险或不足,在养老保障个人账户下建立计生子账户,实现国家补贴直接送达家庭;二是针对因特有概率事件而形成的不确定性风险建立政策性生育保险,并覆盖农村育龄群体;三是明确计划生育/生殖健康服务作为国家基本公共服务的属性。     

A fresh look at family planning communication

As a step toward development of a national information, education, and communication (IEC) plan, a reassessment of such efforts practiced by the agencies involved was undertaken. A paper published in 1978 by the Research Utilization Unit of the Population Information Division, Population Center Foundation, reviewed materials used and accounts of experience in conceptualizing and communicating family planning messages by 12 private and public sector agencies. The most common concepts employed by the agencies were small family size, responsible parenthood, family welfare, community and national development, birth spacing, delayed marriage, contraceptive use-effectiveness, "manliness," delayed 1st pregnancy, value and rights of children, human behavior and social environment, and population dynamics. Most of the messages were conceptualized and developed through formal and informal consultation with field staff. The need to consider the specific needs of target audiences was considered crucial, and thus decentralization of IEC production was recommended. Such decentralization has been a goal of the Philippine program since 1976, but the effort has been hampered by lack of local training and resources, and of studies to support successful implementation. Mass and mixed media approaches were found to be used by most of the agencies, although a reliance on interpersonal approaches was found to be most prevalent in rural areas. Among recommendations for policy makers were development of a systematized data base for IEC materials, regional capabilities in research and development, and studies of funding and existing resources.     

Ilocos region: BSPO paramedics: training in Abra pays off

The study entitled "the comprehensive Baragay Medical System in Arba: An Evaluation" analyzed the performance of trained paramedics and found that the effectiveness of barangay service point officers (BSPOs) as outreach workers depeded on: the knowledge and skills they acquired after traning, which helped them meet the medical needs of community residents; their acceptability to the community; and their positive attitude toward their job. The study indicated that adquate training for the job was crucial to the effective performance of outreach workers. The study compared the performance fo BSPO paramedics and BSPO nonparamedics in metting the health care and family planning needs of residents of the communities the served. BSPO paramedics fared much better as outreach workers in the tasks they were trained for -- rendering services in family planning and health care -- than BSPO nonparamedics wo were not given that kind of training. The study was conducted in the towns of Sallapadan, Pilar, and Danglas for BSPO paramedics and in Manabo, Villaviciosa, and La Paz for BSPO nonparamedics. Interviewed were a sample group of married adults in the areas, 15 BSPO paramedics, and 15 BSPO nonparamedics. The BSPO paramedics had undergone training in preventive medicine, environmental sanitation, and treatment of minor illnesses. The were taught advanced first aid techniques, over the cunter dispensing of medicines, and basic laboratory analysis. The nonparamedics were not trained in these functins. The residents preferred to approach BSPO paramedics for both family planning and medical servies, and more community members also derived the "highest degreee of satisfaction" from the paramedics' services. The BSPO paramedics also served more family planning clients and provided community residents more kinds of medical services. These included medical checkup, the distribution and sale of medicines, curing illnesses, and assisting in child delivery. In terms of job satisfaction, 13 out of every 15 BSPO paramedics interviewed indicated that they were "very satisfied" with their jobs, while only 6 of 15 nonparamedics gave the same rating. The survey findings suggest that the Arba Comprehensive Barangay Medical System can be a viable model for outreach workers in remote communities.     

黑龙江省穆棱市计划生育村民自治调查报告

计划生育村民自治是我国农村社区计划生育的管理方式。穆棱市早在1999年就进行了计划生育村民自治试点工作。穆棱市在具体推行中以人为本,将维护群众的合法权益作为第一要义,尊重和保护群众的生育权、知情权、计划生育技术服务的获得权以及民主参与权。同时,对于低生育水平下的人口与计划生育工作,穆棱市勇于实践,适时改革,取得显著成效。     

4th International Population Conference: drawing the community into population programs

Summarizes the deliberations and recommendations of the (1978) 4th International Population Conference: "Expanding Rural and Urban Community Participation in Population Programs," sponsored by the World Population Society and the Population Center Foundation, and held in the Philippines. The 2 main concerns were finding ways of involving people in rural villages and urban communities in population programs, and fostering the sharing of ideas and experiences for the benefit of program administrators. Topics covered by the conference and reviewed here were organization and action for community participation; relating population and family planning to other services and the relevant personnel; role of women and women's organizations; involvement of youth; distribution of family planning information, techniques, and supplies; and new ideas and approaches. The resolutions of the delegates and other recommendations are also reviewed.     

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.     

Grasping economic reform and family planning simultaneously]

This report aims at proposing ways the Chinese government can raise productivity levels and living standards while promoting the objectives of family planning. During the 1970's, family planning was heavily emphasized. Every factory, commune, and government agency had a specialized group of personnel responsible for family planning. Since the time of economic reform, this group has been vastly minimized because of the central government's demands for reduction of "unproductive" personnel. Thus, with economic reform came a sizeable obstacle to the family planning campaign. The report takes Hong Lai County as an example of recent undertakings to balance the new reforms and the family planning objectives. Hong Lai County, one of the poorest counties in the Sichuan Province, located in western central Chna, has seen a growth in GNP of 100% since the economic reform of 1979. At the same time, the government of the county has had to work extremely hard to promote family planning, especially in rural areas where these objectives are more difficult to reinforce. The county government, in an effort to encourage these objectives, has set up programs of compensation in the form of special allowances and bonuses. Moreover, eucational programs have proven effective in this area. The report indicates that much success has been achieved in the areas of education through promotional campaigns and vocational training which have, in turn, increased productivity levels and living standards.     

Measurement of the quality of family planning services

The quality of health services is a subject of increasing interest to health care providers and organizations responsible for financing and promoting health services. The importance of the client's perspective (and by inference, the perspective of potential clients, as well) is now well established, but efforts to define and measure quality have thus far been limited to the perspective of experts even when the experts claim to speak for the clients. In this paper we utilize family planning programs to explore issues of the quality of health services. We propose that a better understanding of the view of quality actually held by family planning program clients will clarify the influence of quality on the use of services, a clarity that has not been possible by looking at quality only as defined by providers, managers or experts. We review the literature on quality of services and identify the gaps in research that must be filled if a better understanding of what quality is and how it relates to service outcomes is to be obtained. A first step must be the research required to develop a set of measures of quality that reflects the multi-dimensional nature of quality, includes the clients' view of services in the definition of quality, and incorporates methodologies required to ascertain the true view of clients. Finally, we suggest that dimensions of quality identified as important for clients as a group will be more predictive of use of services than dimensions identified as important to providers.     

Satellite outreach in Asia and the Pacific

Communication by satellite is rapidly changing information exchange in Asia, especially for rural areas. The integrated education planned for satellite networks includes family planning as part of general development. A series of conferences has already been held successfully via satellite for family planning associations who are members of the East and Southeast Asia and Oceania Region of the International Planned Parenthood Federation. These included a conference on nursing training. In India the Satellite Instructional Television Experiment (SITE) made history during its 1-year trial. By 1981 the entire nation is to be linked by satellite. The question is whether the television education will truly change rural life or whether it will become merely a diversion. In Indonesia, satellites were chosen as the fastest way to obtain interisland communication. The Domsat system links the entire 13,000-island archipelago and is already being used for emergency communications. The system, which was developed in 1 1/2 years by the Hughes Aircraft Corporation will be used for teaching basic health, hygiene, and family planning. It will be several years before Domsat is fully operational, but it bears watching.     

PPAT works with private clinics and industrial enterprises

Doctors from private clinics have responded to an effort by the Planned Parenthood Federation of Thailand (PPAT) to enlist their voluntary services in support of family planning goals. The private doctors will provide contraceptive services at a nominal cost to the public or free to those who cannot pay. Representatives of PPAT, the Labor Department, the Health Department, and 31 industrial factories in Parthum Thani province met last year to work to find ways of including family planning services as part of workers' welfare in every factory. The participants recommended that family planning services should be officially included as part of workers' welfare. The National Population Clearinghouse/Documentation Center has established its home office at Bangkok. Documentary collection activity is focusing on 5 subject areas: family planning, population/demogrpahy, maternal/child health, nutrition, and primary health care. The Center has already begun to translate selected materials from English into Thai.     

Integrating reproductive health services into family planning programs

A recent Population Council publication, Reproductive Health Approach to Family Planning, discusses integration of reproductive health into family planning programs in a series of edited presentations that Council staff and colleagues gave at a 1994 meeting of the US Agency for International Development (USAID) cooperating agencies. The presentations reflect the Council's view that family planning programs ought to help individuals achieve their own reproductive goals in a healthful manner. The report discusses four areas of reproductive health: reproductive tract infections (RTIs), including sexually transmitted diseases; prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. Christopher Elias (Senior Associate, Programs Division) argued that family planning programs ought to provide services that target RTIs, given that these illnesses afflict a significant proportion of reproductive-age women. The family planning community has an ethical responsibility to provide services to women who experience an unwanted pregnancy. They must have access to high-quality postabortion care, including family planning services. Professional midwives are ideally suited to serve as integrated reproductive health workers trained to combat the five major maternal killers: hemorrhage, sepsis, pregnancy-induced hypertension, obstructed labor, and unsafe abortion. This was demonstrated in a highly successful Life-Saving Skills for Midwives program undertaken in Ghana, Nigeria, and Uganda, and soon to start in Vietnam in conjunction with the Council's Safe Motherhood research program. Family planning services should be viewed as part of a comprehensive set of health services needed by postpartum women, which include appropriate contraception, maternal health checks, well-baby care, and information about breastfeeding, infant care, and nutrition. Family planning programs should incorporate breastfeeding counseling into their services. When programs aim to help individuals meet their own reproductive goals in a healthful manner, this implies that services will not increase clients' risk of morbidity.     

Health on wheels: public service of a private hospital

This article describes the history and activities of the mobile clinic field by the Lorma Medical Center in Carlatan, San Fernando, in the province of La Union. The clinic is free and offers integrated medical services to 4-5 baranguays (villages) per day, averaging 861 cases including an average of 86 family planning cases. The clinic is part of Lorma's Outreach Program which includes a daily radio program answering questions on "Better Health for You and Your Family," a seminar program for local, voluntary health assistants and an "Adopt a Family" program in which nursing students visit and care for an indigent family throughout their training. In September 1977, a mobile vasectomy clinic will begin daily rounds. The mobile clinic program has little access to remote areas because the van cannot navigate the narrow, bumpy roads. However, funding is the program's only real limitation and its possibilities for improved health and family planning services are very great.     

Establishing evaluation indicators on the population knowledge,attitudes, practices and skills (KAPS) of secondary school teachers and students in the Philippines

This study was conducted to establish evaluation indicators to be used as a basis in evaluating the integration of the population education program (POPED) of the Ministry of Education, Culture, and Sports within the Philippine 2ndary school curriculum. Questionnaires were used to determine existing knowledge, attitude, practice and skills (KAPS) of 3,136 high school students and 490 teachers, and data was analyzed for significant relationships between KAPS concerning POPED and demographic characteristics, exposure to population information sources, type of school attended, and exposure to POPED. KAPS and teaching method determine KAPS of the student. Data indicate that 81% of teachers had integrated POPED into the curriculum; only 19% of these had attended training on POPED. 93% utilized a lecture-discussion method in teaching POPED. Knowledge tests given to students and teachers were the same, covering demography, family size, age at marriage, responsible parenthood, use-effectiveness of methods, and population and development. Teachers performed better than students in questions on knowledge; on attitude statements teachers showed a slightly more favorable attitude towards POPED issues, most favorable to responsible parenthood, and least favorable to age at marriage. Mean preferred age at marriage (25) and mean desired number of children (3) was the same for teachers and students; teachers desired wider child spacing than students (3.3 years vs. 2.7 years). 84% of teachers used or wanted to use a family planning method, 76% of students felt they would use a method after marriage. Factors useful in predicting KAPS of teachers and students on POPED are: region of residence, age, sex, educational level, marital status, grade average, type of school, and exposure to various sources of POPED information.     

Microcredit,Family Planning Programs,and Contraceptive Behavior: Evidence From a Field Experiment in Ethiopia

The impact of community-based family planning programs and access to credit on contraceptive use, fertility, and family size preferences has not been established conclusively in the literature. We provide additional evidence on the possible effect of such programs by describing the results of a randomized field experiment whose main purpose was to increase the use of contraceptive methods in rural areas of Ethiopia. In the experiment, administrative areas were randomly allocated to one of three intervention groups or to a fourth control group. In the first intervention group, both credit and family planning services were provided and the credit officers also provided information on family planning. Only credit or family planning services, but not both, were provided in the other two intervention groups, while areas in the control group received neither type of service. Using pre- and post-intervention surveys, we find that neither type of program, combined or in isolation, led to an increase in contraceptive use that is significantly greater than that observed in the control group. We conjecture that the lack of impact has much to do with the mismatch between women’s preferred contraceptive method (injectibles) and the contraceptives provided by community-based agents (pills and condoms).     

Integrating family planning with nutrition and parasite control

At the Inter-Governmental Coordinating Committee Workshop on an Integrated Approach towards Family Planning and Health Programs held at Kuala Lumpur from March 23 to 25, 1977, the feasibility of integrating family planning with nutrition and parasite control through the proper planning of motivational considerations, resource allocation and coordination was studied in detail. Discussion focused on the experience of participating countries in generating community participation in total health programs. Malaysia reported that in the expansion of the national program into the rural areas functional integration has been the approach. In Indonesia nutrition has been an important objective of maternal and child health services. A total integrated development approach has been the objective in the Philippines where family planning information-education-communication has been integrated with nutrition programs and a pilot project on integration of family planning and parasite control has been conducted. Thailand reported on the introduction of an integrated family planning and parasite control program, while Sri Lanka reported on an integrated approach that included family planning with maternity and child health services. A recommendation of the meeting was that experimental pilot projects be established which include nutrition and parasite control elements within the framework of family planning services.     

Men and family planning: toward a policy of male involvement

The stated aim of this discussion is to examine the extent of male use of family planning and the nature of men's role in family planning in developing countries. Case studies are presented which are successful examples of strategies for involving men in family planning. Policies that aim to increase male involvement must be sensitive to cultural values, apply to a decentralized government approach toward information and supplies, include adequate political will, and consider the costs and benefits of changing values. A male family planning policy would not always be compatible with all fertility values in developing countries or traditional values of the older population. A policy should stress the value of male individuals contributing as much as possible for their own and others' welfare. Community participation is considered important in order to create a feeling of mutual support. A sizeable investment will be required for mass distribution of contraceptive information. Schools are viewed as an ideal place for educating youth about the problems of high fertility and about use of family planning methods, such as the condom. Religious organizations should be used to educate people about responsible parenthood and to minimize barriers to use of modern contraception. Comic books on how to use condoms are suggested as a good source. Local authorities who are trusted are useful in influencing acceptance among local populations. Local personnel may be trained as information disseminators. Adequate contraceptive information needs to be supplied to a wide audience. Lack of supply and inadequate information are given as two key reasons for insufficient use of male contraception. Condoms should be priced to be affordable to the average person and free to those with no income. Program strategies that proved successful are cited for Thailand's Mechai Viravaidya program and Bali's grass-roots program. The vasectomy program in Bangladesh is also noted for its success. Low levels of condom use are attributed to factors such as price, education, availability, accessibility, culture, religion, and economic conditions. Male sterilization levels can be enhanced with wider availability of clinics and provision of correct information for challenging beliefs that vasectomy is a form of castration.     

On Mao Zedong's thoughts about population]

The historical position for Comrade Mao Zedong's thoughts about population cannot be ignored. History has told us that the Party and Government of China have always treated the problem of birth control and family planning seriously. In 1957, Chairman Mao lectured both inside and outside the Party on the importance of family planning. Regulations were drafted to govern the excercise of family planning. According to these regulations, people who live in the populated areas should be educated concerning the need for and practice of birth control, and they should have children according to family planning regulations. In this way, the overburden for families may be reduced, the younger generation may receive a better education, and they will have sufficient employment opportunities when they grow up. In the areas inhabited by ethnic minorities, and exception should be made as far as family planning is concerned. In general, family planning should be integrated as a part of the overall plan for the development of the national economy. On the need for emphasizing both quantity and quality in population policy, Mao Zedong pointed out that people should learn how to manage material production and how to "manage themselves." Such thoughts of Mao Zedong provide an essential guideline in China's revolution and social construction.     

The family planning work as suggested by analysis of the age at first marriage in Jiaxing Prefecture, Zhejiang Province]

Since 1970 when the big push for family planning began, China advocated late marriages. In general, the age for late marriage for female peasants is 23 years and 25 for males; for urban females and males, it is 25 and 27 years, respectively. In 1981 the New Marriage Law stipulated the age at marriage to be 20 years for females and 22 for males (these ages are lower than the ages advocated for marriage in actual practice). Despite the New Marriage Law, however, there was in 1981 an increase in the number of people who married before attaining the "late marriage age," thereby creating problems in family planning work. Since 1981, early marriages have been an increasing phenomenon (for the purposes of this essay, age at early marriage is 23 years for females and 25 for males). Jiaxing Prefecture had a 460.53% increase from 1979 to 1981 in the number of women who married early. The following findings were based on studies of Tungxiang and Pinghu Countries. Early marriages as well as "regular" marriages have increased greatly, with early marriage exceeding the number of other marriages. Urban marriages are far more moderate in number than rural marriages, partly because family planning work in urban areas is more effective. Early marriage in areas where family planning work was effective is less extreme than in areas where family planning work was ineffective. Findings from Kayuan Commune of Tungxiang County shows that 47.8% of all male marriages in 1981 were early marriages, as opposed to 6.3% in 1980. The average age for men at marriage in 1981 was 1.6 years younger than in 1980, and .75 years younger for females. Undoubtedly the New Marriage Law influenced the trend in early marriages, but the main reason is that the agarian economy is backwards. Further, traditional attitudes (e.g., "the sooner the children come the sooner the riches come") prevail.