Family planning in Pakistan

The Pakistan Family Planning Program functions as an autonomous body through the Ministry of Health. The Minister of Health is chairman of the Family Planning Council which is the main policy and planning unit. Each province has a Provincial Family Planning Board responsible for implementation. The District Family Planning Board functioning within the province is in charge of publicity and education, distribution and sale of supplies, and provision of clinical services and facilities. The District Board has about 1000 workers--medical and paramedical in the clinics, family planning officers for education and motivation, lady organizers (local motivator and agent of sale of conventional contraceptives), and agents (outlets for conventional contraceptives). There are full-time clinics for IUD insertions, follow-up, and medical and paramedical training; part-time clinics; and mobile clinics for IUD service in remote areas. In 1967-1968 there were 938 clinics: 361 urban and 577 rural. There were 46 full-time and 315 part-time urban clinics and 158 full-time and 419 part-time rural clinics. 65,000 IUD insertions are done a month.     

云南省基层计划生育服务机构宫内节育器放置类型的差异及其成因探讨

目的:比较云南省县、乡计划生育服务机构宫内节育器(IUD)放置类型的差异及其成因。方法:根据计划生育优质服务县的标准将云南所有县分为"好"、"中等"、"差"3层,每层抽取1个县,进行3个县、区的横断面调查。收集与IUD放置类型相关数据及资料,并进行小组及个人访谈以确定县、乡差异原因。结果:云南省县、乡两级机构所放置的IUD类型存在差异、造成差异的原因较多;乡级服务机构采用政府采购IUD的比例高于县级服务机构。结论:应促进各级IUD放置服务机构科学地优选失败率低的IUD类型,进一步提高政府采购IUD的接受性和使用,减少IUD类型选择不当而导致的避孕失败。     

Family planning in Uganda

Characteristics of child welfare clinics with family planning services, postnatal clinics with family planning services, and separate family planning clinics, all in Uganda, are discussed. During the years 1964-1967, growth was most rapid in and attendance was larger at separate family planning clinics. It is thought that this is the only way women in small villages will ever be reached. Whether a family planning clinic is a separate unit or is integrated with other clinics depends on the local situation. When women begin to learn that there are safe ways of controlling fertility, the government will probably begin offering these services along with other maternal and child health services. Until that time, the Family Planning Association has an important role to fill in offering these services in whatever manner the situation permits.     

Clinical performance of the Nova-T380 IUD in routine use by the UK Family Planning and Reproductive Health Research Network: 12-month report

Doctors working in general practice and at family planning clinics throughout the UK who collaborate in the UK Family Planning and Reproductive Health Research Network were responsible for the fitting of 572 Nova-T380 intra-uterine contraceptive devices (IUDs). The Nova-T (and formerly the identical Novagard) IUDs have copper with a surface area of 200 mm(2). The device used in this study, the Nova-T380, has copper with a surface area of 380 mm(2). The purpose of the study was to evaluate the pregnancy and complication rates of this new device, with its increased area of copper, in comparison with other published results, in the clinical setting of British general practice and family planning clinics. The 12-month cumulative life-table event rates were: pregnancy 0.8, expulsion 5.6, removal for bleeding or bleeding and pain 11.0. The continuation rate was 73.4. The pregnancy rate at 12 months showed good contraceptive performance. The increased surface area of copper was not associated with a reduced pregnancy rate, but as this was not a direct comparative study with the Nova-T, the influence of the increased area of copper must remain somewhat uncertain. This study found the discontinuation rate for bleeding problems and pain with bleeding to be higher than in other published studies. Other event rates were consistent with other published studies.     

Country watch: Hong Kong

Two decades of Family Planning Association of Hong Kong (FPAHK) advocacy of husband-wife communication and cooperation in family planning led Hong Kong's population to finally accept the notion of male responsibility in family planning. Recent surveys have documented high rates of male contraceptive use. The FPAHK established its first clinic to provide men with birth control advice and services in 1960, then set up a vasectomy clinic and installed condom vending machines. Working against prevailing traditional beliefs that childbearing is the exclusive domain of women and that vasectomy harms one's health, the FPAHK began campaigns to motivate men to take a positive and active role in family planning and to correct misinformation on vasectomy. Successful FPAHK efforts to stimulate male support for family planning include the 1977 "Mr. Family Planning" campaign, the 1982 "Family Planning - Male Responsibilities" campaign, and the 1986-87 "Mr. Able" campaign. Although these campaigns ended in the 1980s, men may now be counseled on contraception at 3 of the 8 FPAHK-run birth control clinics.     

Family planning--the role of the nurse/midwife in Britain in 1984

This article details the role of family planning nurses and midwives in the British health services today. They receive their training from Family Planning Association nurses in English National Board Course 900, Family Planning Nursing. This course, extending over a 3-month period, is now conducted in 37 centers. 7363 family planning nurses and midwives have received the Statement of Competence since 1976, when the former Joint Board of Clinical Nursing Studies 1st approved the course. The course provides personnel with a thorough background in birth control methods, counseling skills, and recognition of medical conditions. Ongoing education is provided through 1-day courses organized by the employing authority. Extended training also enables nurses and midwives to check and remove IUDs, fit occlusive caps, conduct routine pelvic examinations, and refer abnormal findings to physicians. At present, it is not within the scope of the role of nurses and midwives to prescribe hormonal contraception. Family planning is an area of medicine where well trained nurses and midwives can play an especially important role, freeing up physicians to concentrate on the more complicated cases. International exchange visits could provide family planning nurses and midwives with a better understanding of population planning issues in other areas of the world.     

Nurse specialists in family planning: The results of a 3-year study

In the first three years of a Nurse Specialist Clinic in Family Planning, 1422 new patients were seen. Oral contraception (OCs) was dispensed for 638 patients, 548 intrauterine devices (IUDs) were fitted and 126 patients received an injectable contraceptive. The continuation rate at thirty months was, 73.2 for OCs, and 68.6 for IUDs. The additional training received by the nurse specialists allowed them to practice comprehensive family planning safely and effectively as shown by the low “problem” rate, 9.1% for OCs and 7.2% for IUDs. Continued use effectiveness, as shown by the second choice of contraception initiated in the clinic for those who stopped using their first method, was also high, 81.5% for OCs and 90.5% for IUD closures.     

Family planning in the reorganized N.H.S. (b) Future of the clinic service

The National Health Service (N.H.S.) of the United Kingdom will be resturctured in April 1974 and that will be the start of a new era, the author asserts. Family planning services are ready for an integration and that is what the reorganization will aim for. Access to family planning services at present is achieved through the general practitioner, free access clinics and hospitals, and there is no coordination of these 3 contraceptive services. The family planning Association (FPA) has been responsible for the establishment of clinic services and for the rise in contraceptive services. The reorganization of N.H.S. will also aim for decentralization so that the main reponsibility for the integration of family planning services will be done at the district level. A Co-ordinator of Family Planning Services should be appointed for each district. In the integrated Health Service, each clinic is to have a local backup of health visitor and social workers, and consultant obstetricians and gynecologists.     

A broadly based project

The family planning work in and around the North Thai town of Chieng Mai, under the leadership of Thai doctors and their colleague Dr. Edwin B. McDaniel, is well known in family planning circles. It is estimated that in 1969 about 13,000 women-years of protection against pregnancy were provided. The services are interesting for the variety of methods used and the range of clinical activities undertaken. Family planning is integrated with the local McCormick Hospital. Injectable methods accounted for 1700 new patients last year at this hospital, and in some cases the method was used postpartum. Oral contraceptives and IUDs are also distributed, and 270 women had sterilization operations. Family planning is available too at municipal clinics; here a patient load of 30,000 was served during 1969. There are also mobile clinics, some of which serve villages many miles from the rural capital of Chieng Mai. The mobile clinics work in each area for four days, and served 1350 new patients in 1969, of whom 60% accepted oral contraceptives. Finally, the clinical and administrative experience of the teams working in Chieng Mai has inspired a series of cooperative clinics outside the province. Nearly 4000 new patients attended at these clinics in 1969, and most of them received oral contraceptives. It appears that in order to serve a large community, family planning needs to be offered at a number of different sites and that a variety of methods appears to be necessary in order to get widespread acceptance. It is possible that as schemes develop in a community the fixed and mobile clinics, and clinics which are conducted in buses which are also used for other aspects of community care, may be mutually supportive. It is interesting that injectable contraceptives have proved most popular, but in addition to solving the family planning needs of many women they appear to carry in their wake interest in other forms of family planning, so that when they are used there is an increase in the acceptance of alternative methods, such as oral contraceptives, within the same community.     

举办宫内节育器换代培训班的体会

<正> 宫内节育器(IUD)在当今我国的计划生育工作中占据了重要的地位,并已取得了明显的成绩。1988年我国育龄妇女应用IUD避孕的人数占应用可逆性避孕措施的80％。在国家计划生育委员会的重视下,随着放置IUD的育龄妇女数的逐年增加,IUD的系统管理也在逐渐建立和完善。自1993年已开始推广由活性带铜IUD替代隋性不锈钢IUD。由于我国广大使用IUD的育龄妇女在基层农村,根据这一特性,天津市计划生育研究所宫内节育器研究室与天津市计划生育委员会科技处自1993年开始共同主办了面对基层(市郊、县和乡计划生育技术服务站)的技术人员的IUD换代培训班8期,每期3天,共培训人员175人。     

East Asia Review, 1973. 1. Hong Kong

Developments in the field of population and family planning during 1973 in Hong Kong are reviewed. The most significant event of the year was the start of the government family planning program. Hong Kong $2.4 million has been allocated to cover the cost of the government's participation in a phased program to integrate family planning services into its maternal and child health program. 4 part-time clinics run by the Family Planning Association of Hong Kong became the responsibility of the Medical and Health Department in October 1973. In January 1974, 4 full-time clinics will be taken over, and the remaining clinics in maternal and child health centers will be turned over beginning April 1974. This should 3e completed by the end of 1974. The crude annual birth rate for 1973 was 19.8 per thousand. In 1972 it was 19.7. The death rate remained at around 5. The population growth rate increased to around 3%, of which about half was due to immigration from China. There was a 5.8% increase in new acceptors from January 1973 to November 1973. The Association increased its use of the mass media, particularly radio and television. In 1972, the Association conducted a "Study of the Impact of Industrialization on Fertility in Hong Kong" in conjunction with the Social Research Center of the Chinese University. It was determined that industrialization has affected fertility in a number of interrelated ways. Higher education levels, better employment opportunities (particularly for women), urbanization, desire for improved living standards, and postponement of marriage, which are the primary effects of industrialization, have resulted in changing attitudes toward children and childbearing as reflected in the finding that the percentage of people using contraceptives rose from 44% in 1967 to 48% in 1972. In the future, the Association will establish new clinics in those parts of the colony not presently being reached, and it will develop services to reach such groups as working women, men, and "middle-class" clients. The Association will develop large-scale information, education, and publicity programs.     

加强部门协调 发挥两个积极性 做好计划生育和妇幼保健工作

云南省党委、省政府十分重视妇幼保健和计划生育工作，在统一思想、提高认识的基础上，正确地认识两项事业的关系，把两项事业都摆在优先发展的位置上。省委、省政府加强了对计生和卫生两个部门的领导，使两个部门相互尊重、相互支持、相互配合，在行政管理中加强部门的协调和法规衔接，在业务上互相支持，互相配合，有效地促进了计划生育与妇幼卫生两项事业的共同发展。     

Barriers to effective family planning in Nepal

To investigate why family planning (FP) services in the Kathmandu Valley of Nepal are underused, a study was initiated under the auspices of the Nepal Family Planning/Maternal--Child Health Project. The study was intended to provide a user perspective, by examining interactions between FP clinic staff and their clientele. "Simulated" clients were sent to 16 FP clinics in Kathmandu to request information and advice. The study revealed that in the impersonal setting of a family planning clinic, clients and staff fall into traditional, hierarchical modes of interaction. In the process, the client's "modern" goal of limiting her family size is subverted by the service system that was created to support this goal. Particularly when status differences are greatest, that is, with lower-class and low caste clients, transmission of information is inhibited.     

3种宫内节育器临床使用12个月避孕效果比较分析

目的:比较育龄妇女月经间期放置3种宫内节育器(IUD)的使用效果.方法:对2008年1月～2010年5月在本中心、青海红十字医院和乐都县计划生育服务站放置GyneFix330、TCu380A和MLCu375IUD共799例妇女进行1年随访,比较使用1年的临床效果和副反应.结果:GyneFix330、TCu380A和ML...     

Family planning in Britain-the doctor's role

Ann Cartwright's recent book, "Parents and Family Planning Services" provide insight into the medical methods of distributing contraceptive advice in Britain where friends and relatives are the most important sources of birth control advice. The percentage of people who consider the family doctor the most important source of birth control has risen from 20% in 1968 to 28% in 1970, while family planning clinics as the stated source have dropped from 12% to 9% during the same period. Cartwright's book also examines some of the attitudes among doctors which make the spread of birth control advice difficult.     

乡级计划生育服务效果案例分析

云南省双柏县2个乡11年间计划生育服务的案例分析结果显示,2乡的计生服务对人口数量的控制均起了重要作用。2乡比较,鄂嘉乡由于有乡计生所常年不懈地提供孕前型服务,其计划生育的质量优于大庄乡。     

Studies in family planning. 6. Singapore

Family planning progress in Singapore during 1972 is reviewed. The Singapore Family Planning and Population Board launched its most intensive family planning campaign in July 1972. A primary objective of the campaign was to promote both male and female sterilizations. Stronger social disincentives to discourage large family size (higher delivery fees, reduction of income tax deductions, reduction of allowable maternity leaves, and housing priority for small families) have been read in Parliament and will take effect August 1, 1973. The 1972 crude birth rate was estimated at 22.6 per 1000, compared with 22.3 in 1971. The crude death rate remains constant at an estimated 5.4 per 1000. The rate of natural increase has risen to an estimated 17.2 per 1000, compared with 16.9 in 1971. The Second Five-Year Plan (1971-1975) sets a target of 80,000 new acceptors to be recruited evenly throughout the period. In 1972, the Board recruited 17,666 new acceptors. The main method used continued to be the pill, but the number of new pill users dropped from 19,000 in 1968 to 10,000 in 1971 and 1972. The number of condom acceptors dropped from 10,076 in 1968 to 7343 in 1972. IUD insertions were 3703 in 1968, and in 1972 there were only 177 IUDs inserted. Female sterilizations rose from 477 in 1966 to 3848 in 1971 to over 5700 in 1972. Abortions rose from 2929 in 1969 to 5943 in 1972. The Board approved the establishment of a Research and Evaluation Committee at the close of 1972. An Information, Education, and Communication Unit and a Training Center financed by the United Nations Fund for Population Activities (UNFPA) were established in 1972. The Family Planning Campaign is being evaluated by pre- and postcampaign KAP-type surveys. During 1972, clinical trials were initiated on the Dalkon Shield and the Copper 7 with encouraging preliminary results. The average desired family size among Singapore families is 3.6, and there are problems in trying to reduce this figure. The informational aspects of the communications program have reached a "saturation" stage. Future emphasis must be on persuasion and motivation.     

Non-availability of the IUD and contraceptive choice

The Copper 7 and Lippes Loop IUD are no longer distributed in the United States, and the cost of the Progestasert precludes usage in many family planning clinics. The impact of the loss of this widely used contraceptive method was assessed in a pilot study at the UCLA Family Planning Clinic. The clients who would have selected an IUD at the time of their clinic visit between March and December of 1986 instead chose oral contraceptive pills (55%) or barrier methods (45%) but their level of dissatisfaction with the methods they received was significantly greater than that of all other contraceptors, and this led to their subsequent selection of another method which, in the majority (66%), was of lower efficacy than the IUD. There were two unplanned conceptions amongst twenty women who would have chosen an IUD, both due to non-compliance with oral contraceptive pills; and at the time of survey in March 1987, no clients had opted for sterilization. Women who no longer have their choice of the IUD represent a high risk for contraceptive dissatisfaction and failure, but have not made precipitous decisions to undergo permanent sterilization.     

Family planning in the United Arab Republic

Discussion of the family planning program in the United Arab Republic (UAR) is presented. The Supreme Council for Family Planning was set up in 1965 with the aim of organizing programs of family planning in the UAR as well as setting up time schedules for execution, supervision, follow-up, and evaluation. In 1966, The National Planning Program started to operate 1,991 centers in urban and rural areas for women requesting oral contraceptives. By July of 1969, the number of centers reached 2700. However only villages with government health units have family planning centers. Each center is fully equipped and has a doctor, nurse or midwife, 1 or 2 assistant midwives, a social worker a clerk, and a worker. Centers now also offer IUD services. Propaganda and motivation in connection with family planning is discussed, as is training of personnel involved in the program.