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Refresher course on family planning.

Dr. Jean Infield, a family planning expert from England, was invited to conduct a series of refresher lectures to the medical personnel of the Association. The 4-session refresher course was held in the mornings of February 26 to March 1 for 47 doctors, advisers and nurses. The topics were on the choice of contraceptive, postcoital contraception, overview of hormonal contraception, myths and fallacies of oral contraceptives, intrauterine contraception, contraception for the older women and barrier methods. Participants agreed that the lectures were informative and useful to their work in family planning.

Asia↗

Field experiences integrating family planning into programs to prevent mother-to-child transmission of HIV.

This article reviews field experiences with provision of family planning services in prevention of mother-to-child transmission (PMTCT) programs in ten countries in Africa, Asia, and Latin America. Family planning is a standard component of most antenatal care and maternal-child health programs within which PMTCT programs are offered. Yet PMTCT sites often miss opportunities to provide HIV-positive clients with family planning counseling. Demand for family planning among HIV-positive women varies depending on the extent of communities' openness about HIV/AIDS, fertility norms, and knowledge of PMTCT programs. In Kenya and Zambia, no differences were observed in use of contraceptives between HIV-positive and HIV-negative women in the study communities, but HIV-positive women have more affirmative attitudes about condoms and use them significantly more frequently than do their HIV-negative counterparts. In the Dominican Republic, India, and Thailand, where HIV prevalence is low and sterilization rates are high, HIV-positive women are offered sterilization, which most women accept. This article draws out the policy implications of these findings and recommends that policies be based on respect for women's right to informed reproductive choice in the context of HIV/AIDS.

Contraception↗

What does the Matlab fertility experience really show?

The family planning program in the Matlab District of Bangladesh has been described in unique detail for more than 25 years and is regarded as a model for equally poor parts of the world. Its experience has been reported as showing the ineffectiveness of contraceptive saturation approaches and the prime importance of program management and especially of the selection of a special type of family planning household visitor, criteria that render family planning programs relatively expensive. This reanalysis of the Matlab experience suggests that there is inadequate evidence from which to judge the record of the saturation experiment and of family planning workers from less highly selected backgrounds. It is also argued here that the role of contraceptive choice and of access to different types of contraceptives, especially injectables, delivered to the door in this society of secluded women has been underestimated, and that too little importance has been attributed to demand in contrast to supply. While it is agreed that the Matlab demonstration has been of central importance in showing that fertility can be reduced in Bangladesh, it is argued that many developing countries can draw on this experience to provide less costly family planning programs with less emphasis on the managerial, top-down approach.

Bangladesh↗

Women's lives in transition: a qualitative analysis of the fertility decline in Bangladesh.

The fertility decline that began in Bangladesh in the late 1980s and continues has prompted diverse theories to explain it. In this qualitative analysis of 21 focus-group sessions with rural women ranging in age from the teens to late 40s and living in the villages of the Matlab area, the women's perceptions of their changing society and of the influence of the family planning program are examined. The women's statements reveal their awareness of the social and economic transition they are undergoing and their interest in family-size limitation, which is bolstered by a strong family planning program. Although the shifts in economic and social circumstances are not large, in conjunction with the strong family planning program they constitute a powerful force for change in attitudes, ideas, and behavior among these women.

Adolescent↗

Traditional midwives and family planning in Asia.

The objectives of this article are (1) review the contribution of traditional midwives to family planning communication in several Asian countries; (2) organize knowledge gathered from various studies into general guidelines for the most effective use of traditional midwives in family planning programs; and (3) present hypotheses for future research. In certain countries where pilot projects have tested the potential performance of traditional midwives in family planning programs, results have been encouraging. In other nations, more research is needed to determine the contribution traditional midwives can make to the family planning program.

Asia↗