birth control
[Implementing the birth policy to village as the grass-roots unit]

[Article in Chinese]

Yang K.

PIP: At the present time, the emphasis of the birth control program in China is in the rural areas where it is harder to implement a birth control policy. A new initiative taken in Liaoning Province to certify rural villages in family planning (FP) practice has proved to be successful. 6 criteria have to be met by a rural village to be qualified for certification: 1) an adequate FP organizational network, 2) comprehensive coverage of publicity and education program activities, 3) satisfactory FP program implementation, 4) extensive usage of contraceptive methods, 5) good quality service delivery, and 6) efficient program management. Specific regulations on organizational structure, educational activities, policy implementation, contraceptive supply, data collection and reporting, and management of finances have also been formulated to promote the certification process. Packages of incentives and disincentives have been established to integrate FP program implementation with the responsibilities, decision-making powers, and personal benefits of the leaders and the village community. The sense of birth control practice as a communal endeavor in villages has also been created under these regulations. Over 80% of villages in Liaoning province have now been certified. Various birth control model villages have been set up to promote the FP program elsewhere.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12159313&dopt=Abstract birth control



birth control
[Intensifying family planning policy, promoting population control]

[Article in Chinese]

China. Sui Zhou. Family Planning Commission.

PIP: Suizhou is a county located in China's western Hubei Province which has 1.3 million inhabitants including 90% living in rural areas. The Family planning (FP) program is not well accepted there. Since 1988, a few measured to promote FP were tried and proved to be effective. These measures include the following. 1) Setting-up a birth control contract system. Couples in child-bearing age sign contracts with their employers or village committees on the practice of birth control and fines in case of violation of birth control regulations. Under the contract, couples who may have a second child according to the FP policy are guaranteed such an opportunity so that they would not rush to have another child for fear of a policy change. Couples with a single child are ensured the special benefits stipulated in the birth control regulations. 2) FP is made a component of the terms of reference of local administrations. Those who fulfill their targets are rewarded, while those who did not are held accountable or penalized. 3) FP workers are evaluated every 6 months on different aspects of program achievements. Both qualitative and quantitative criteria were set for these aspects. Ranking by achievements will be used as the basis for reward or penalty. 4) The emphasis of FP programs became service- oriented. FP, health, and women's affairs workers acted as a team to deliver FP information and contraceptive supplies to people's door steps. At the same time, health check-ups and maternal and child care were also provided. These reforms in FP activities increased acceptability of the program among eligible couples in the country.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12159314&dopt=Abstract birth control



birth control
[Initially analyzing the characteristics and evaluated indexes in rural areas and making relative policies]

[Article in Chinese]

Jiang Z.

PIP: 20% of rural family planning (FP) programs in China have an unsatisfactory performance. A study was conducted in four townships with poor FP program performance in Pengxi County, Sichuan Province. Some common characteristics of these townships are as follows. Lack of concern about the FP program on the part of the local leadership. 2) Resistance of local people to FP communication and education; 96% of 426 families interviewed wanted to have 2 children, and only 3.7% wanted 1 child. 3) Lack of enforcement of the incentives and disincentives stipulated in the FP policy. 4) Lack of service delivery back-up in FP programs with a shortage of trained professional staff to provide clinical services and a shortage of the necessary medical facilities or equipment to meet the needs of FP service delivery. 5) The large number of early marriages, early child-births, extra-marital child-births without quota. At the present time, there is not specific quantitative standard to evaluate the FP program performance in a particular district. 3 indicators are appropriate for comparison of program performance. 1) Has the annual birth control target for the district been met? 2) The percentage of births with in the FP quota. Under 60% of births within the quota should be considered poor performance. 3) Over 20% of unplanned pregnancies reflect poor performance in the areas of birth control education, and contraceptive service delivery. The following are suggestions for solving the problems of poor program performance. 1) Community leaders should be evaluated on a per capita production output value rather than on total value. Their achievements should also be linked with their salary increases, promotions and bonuses. 2) One-child families should have a priority in receiving financial aids for development. 3) Governmental and non-government organizations should work together to promote the implementation of FP policies. 4) Service delivery systems should be strengthened by promoting population and FP education to families and in schools. Funding should be made available to increase the capability of birth control service delivery in terms of staff training, provision of equipment and housing and improvement in the quality of services. 5. Full use should be made of the potential of village leaders to take personal responsibility for every aspect of the FP.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12159353&dopt=Abstract birth control



birth control
[To grasp the family planning program early, carefully and surely according to the law of reproduction]

[Article in Chinese]

Fan Z.

PIP: China's February 1982 Directive on Improving Family Planning Work stipulated that family planning should be incorporated into national economic and social planning by understanding it early, carefully, and surely according to the law of reproduction. Understanding family planning early means to implement the policy of birth control as a primary goal, to plan early for births, and to carry out birth control measures, i.e., formulating a plan is the basis of understanding early. For example, the following must be considered when mapping out a plan for 1983: the number of fertile women who wanted children but who remained childless for 3 years of marriage; those who conceived late in 1982 and will deliver in 1983; the number of newlyweds over 23 years of age who have not planned a pregnancy; those with 1 child over 4 years who due to unusual circumstances will have a 2nd child; the number of people planning marriages before March 1983. The next step is to make arrangements, which include submitting individual requests, getting permission from communes and approval from the general public, and delivering contraceptives to the homes of newlyweds and mothers. 9 months after arrangements are completed, adjustments must be made, e.g., those who were unsuccessful in their plan to conceive this year will try the next year. To understand carefully is to understand the concept, circumstances, and data of family planning and thus be able to administer it scientifically. This means primarily controlling fertile women who are newlyweds, mothers of 1 child, and mothers of multiple children. To understand surely is to conform to the organization, concept, policy, planning, and measures of family planning. This means training basic level birth control cadres in population theory and methods of family planning. In addition, it means persuading the masses to be enthusiastic, diligent, fearless, understanding, and to show initiative toward family planning.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12159368&dopt=Abstract birth control



birth control
[Women's behavior and knowledge concerning family planning in the region of the Park Health Center]

[Article in Turkish]

Ozyurda F, Durmusoglu M.

PIP: 1390 women aged 15-44 were surveyed between February-June 1988 in the vicinity of the Park Health Education Center by the Ankara University School of Medicine, Department of Public Health. Within this sample, the survey focused on the knowledge, attitude and behavior of the 1082 married women, regarding birth control. Birth control pills, IUDs, and condoms were classified as effective modern birth control methods. Other less effective traditional methods were classified as ineffective. Analysis of the data indicated 74.2% of the subjects resort to some form of birth control while 66.2% use an effective modern method. Age, education, work status, number of children and type and location of housing influence family planning decisions. In general, the women using birth control are primary school graduates aged between 25-39, living in urban areas for at least 5 years. Most have 2 to 3 children and have had an abortion. The most frequently used method of birth control is the IUD. It is notable that 29.5% use the ineffective withdrawal method. 58.62% of the women who do not use birth control, avoid family planning because of their husbands. These women have 2 or more children and are illiterate or primary school graduates between the ages of 25-35 when they are most likely to become pregnant. Family planning services should be geared towards educating these families, especially the husbands. Education services should also target families using the withdrawal method and the 35-44 age group of women who show a low percentage of contraceptive use.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12159442&dopt=Abstract birth control



birth control
Malthus and neo-Malthusianism in Sweden.

Kalvemark AS.

PIP: Focus in this discussion is on Malthus and neo-Malthusianism in Sweden. Neo-Malthusianism arrived in Sweden at the beginning of the 1880s when Knut Wicksell gave a public lecture at a youth meeting of a temperance society in Uppsala. The lecture resulted in public scandal and made neo-Malthusian ideas known overnight in Sweden. Wicksell maintained that poverty was the primary cause of most evils in society, and it was caused by the pressure from population increase on the means of subsistence. In his lecture he referred to Malthus explicitly and gave a summary of the Malthusian principle of population on which he based his reasoning. At the time he only knew of Malthus' ideas indirectly by reading George Drysdale's book, "The Elements of Social Science." The questions that arise are whether Malthus' ideas were only indirectly studied and whether neo-Malthusiansim was just seen as an equivalent of birth control and contraceptives, the very means of preventive checks for population growth that Malthus condemned for moral reasons. Wicksell focused on the causes and consequences of emigration in a lecture in 1881. He again saw rapid population growth as the cause of poverty, which in turn caused emigration. The rapid rise in Swedish emigration in the 1880s created considerable interest. Generally, the common view at the time was that Sweden suffered from a certain population pressure and corresponding underemployment. Johan Leffler, a young economist, had a different opinion. He saw the problem in an outspoken Malthusian way, suggesting that under the prevailing overpopulation in Sweden emigration could not be harmful. At the turn of the centruy Gustav Sundbarg was among those describing emigration as a deadly threat to Swedish society. Sundbarg not only turned against Malthus, but he also condemned neo-Malthusianism for moral reasons. Sundbarg maintained that demographic and economic development over the 19th century did not verify Malthus' assumption that population always grows faster than the means of subsistence. The neo-Malthusian message would lead to immortality and with the introduction of very small families finally to the extinction of the Swedish population. Wicksell held on to his view that continuing population growth would be dangerous. Fahlbeck, one of the critics of neo-Malthusianism, did not consider the differences between Malthus and the neo-Malthusians to be of any importance. He accepted birth control but thought that through the introduction of the 2-child system neo-Malthusians would only recognize private interests and neglect the public interest, which demanded population increase. At the turn of the century emigration was considered a threat to Swedish population development. In 1910, when emigration was relatively low, attention turned to the declining birth rates. Birth control and contraceptives were condemned for moral, religious, and demographic reasons by the Conservatives in particular. A law was passed against contraceptives and stayed in force until 1938. Neo-Malthusianism was thus publicly condemned, but its adherents continued their work to promote birth control.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12177840&dopt=Abstract birth control



birth control
Bishops on birth control: a chronicle of obstruction.

Shannon D.

PIP: The Catholic Church historically has obstructed birth control by various means, e.g., encyclicals, the posturing of the US Catholic Conference and state Catholic organizations, and by bishops and upper hierarchy in the church. The desire is to see the law reflect the Catholic teaching that sexual intercourse is permitted only within 1 marriage, and no sex act may include an attempt to prevent conception. The activities undertaken by the Catholic Church between 1920-86 to ban contraception are discussed. It is anticipated that the expected papal encyclical will only reiterate more harshly and loudly this ban, and the result will be a further rift between Catholic behavior and Catholic policy. In addition, if the bishop's would support a sensible and realistic policy approach to reproductive health, it is possible that unintended pregnancy, abortion, and sexually transmitted diseases would be reduced. Instead the bishops are part of the problem. For example, the following actions are noteworthy examples. 1) In 1921 the New York Archbishop and his secretary contacted the police in advance of Margaret Sanger's proposed speech to publicly discuss the morality of birth control, and the arrest was made. 2) In Massachusetts the church campaigned in the 1930s-40s to prevent repeal of state laws which barred dissemination of birth control information. 3) The Archdiocese of Hartford legal counsel led successful opposition to ease restrictions on birth control between 1941-654. 4) The church fought against soldiers' use of condoms in World War II. 5) The National Catholic Welfare Council in 1942 attached Planned Parenthood (PP) as packaging passion. 6) Catholic charities blocked funding for PP and dismissed Catholic doctors affiliated with PP. Nonetheless, by 1972 91% of Catholics used illicit contraceptive methods. Church policy turned to public opposition of publicly funded family planning. Title X of the Public Health Service Act passed despite opposition, but the 1991-92 bishop's legislative agenda includes opposition to reauthorization of Title X and school-based clinics and RU-486 or abortifacients. Contraceptive research funding has been opposed for many years, with the result that only 1 remaining drug company conducts new contraceptive research and Title X programs are underfunded objections pointed out were that natural family planning method improvements were excluded as well as reproductive biology.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12178852&dopt=Abstract birth control