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- Volume 15, Issue 4, 2000
Asia-Pacific Population Journal - Volume 15, Issue 4, 2000
Volume 15, Issue 4, 2000
Issued quarterly, this journal is an invaluable resource containing opinions and analysis by experts on critical issues related to population. It provides a medium for the international exchange of knowledge, experience, ideas, technical information and data on all aspects of population.
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A strategic approach to reproductive health programme development
Authors: Jay Satia, Peter Fajans, Christopher Elias and Maxine Whittaker Peter FajansMany countries are transforming their efforts to meet their population’s reproductive health needs by refocusing maternal and child health and family planning activities into more comprehensive reproductive health programmes. Clearly, the specific directions and magnitude of the changes involved should depend on the socio-economic context and local epidemiology of reproductive health problems, as well as on the current programmatic situation. In seeking to innovate and expand reproductive health services, programme managers and policy makers are generally advised to follow an approach that is (a) public health based - addressing key reproductive health problems, (b) pragmatic - adding interventions and services in an incremental manner and building on what already exists, and (c) participatory - recognizing what different actors can feasibly do (Fathalla, 1996). The need to identify appropriate service delivery models and subsequently scale-up successful efforts is acute.
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Strategic assessment of reproductive health in the Lao People’s Democratic Republic
Authors: Pany Sananikhom, letje Reerink, Peter Fajans, Christopher Elias and Jay SatiaThe status of women’s reproductive health remains a serious problem in the Lao People’s Democratic Republic. Although data on reproductive health are generally scarce, the maternal mortality ratio has been estimated to be 656 per 100,000 live births (Ministry of Public Health and United Nations Children’s Fund (MOPH and UNICEF), 1998). Estimates of total fertility rates vary from 4.7 children per woman for urban women to 7.8 for rural women (National Statistical Centre (NSC) and the Lao Women’s Training Centre (LWTC), 1995). Only limited data exist on the incidence of reproductive tract infections (RTIs and sexually transmitted infections (STIs), but anecdotal evidence suggests that the magnitude of these problems is likely to be great. The data from the sentinel surveillance system show generally low prevalence rates for HIV, but only limited testing has been carried out and a more comprehensive sentinel surveillance system has only recently been put into place. Abortion and adolescent reproductive health remain politically sensitive issues. A report from a small-scale survey conducted by the Japanese Organization for International Cooperation in Family Planning (JOICFP) in three districts showed that the abortion rate was 101.1 per thousand pregnancies (Podhisita and others, 1997). Early marriage and pregnancy in adolescence are the norm in the Lao People’s Democratic Republic, The Fertility and Birth Spacing Survey (NSC and LWTC, 1995) estimated that the median age at first birth for all married women was 20.5 years.
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A strategy for advancing reproductive health in Myanmar
Authors: Thein Thein Htay, Katherine Ba-Thike, Michelle Gardner, Christopher Elias and Peter FajansThe implementation of a strategic approach to the introduction of contraceptive services has had a significant impact on the development of the reproductive health programme in Myanmar. At the time of the initial Stage I activity, entitled “An assessment of the contraceptive method mix in Myamnar” (Ministry of Health (MOH) and WHO, 1997), public sector contraceptive service provision was very limited in geographic coverage, and there was no framework for the integration of contraceptive services with other areas of reproductive health. That assessment provided vital information for informing the development of many components of the reproductive health programme in a context where such a programme was in its infancy. Subsequent follow-up activities comprising behavioural and operations research have provided useful tools for improving the quality of care and for moving towards a more comprehensive reproductive health programme.
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The strategic approach to the introduction of DMPA as an opportunity to improve quality of care for all contraceptive methods in Viet Nam
The Government of Viet Nam has an explicit policy to regulate population growth and, in 1993, established replacement level fertility as a target. It has implemented a strong family planning programme and contraceptive prevalence is high. The contraceptive method mix, however, remained very skewed. In 1996, the contraceptive prevalence of modern methods was 52 per cent, of which the IUD accounted for 72 per cent, female sterilization 10.4 per cent, condom 9 per cent and oral pills 6.9 per cent. The use of injectables was negligible. In addition, 16.3 per cent reported using natural methods (NCPFP, 1998). One of the concerns of the national population policy is to diversify the mix through adding more methods such as the DMPA (depot medroxyprogesterone acetate) injectable and the Norplant implant. There continues to be a concern about the high rate of induced abortion in the country and the need to address unmet need for family planning has been highlighted as a means to address this issue (Be’ langer and Khuat Thu Hong, 1998; Do Trong Hieu and others, 1993).
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Volumes & issues
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Volume 32
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Volume 31
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Volume 30
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