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“ Overpopulation is not simply population density but the numbers of people in an area relative to its resources and the capacity of the environment to sustain human activities”. Paul Ehrlich 1932-present
Women’s Reproductive Rights: pregnancy can be unwelcome
NORPLANT VASECTOMY INJECTABLE FSTERILIZN TCu380AIUD POPbreastfeeding LAM6mos OCP CONDOM DIAPH+SPERMCID FAB FCONDOMS SPERMCID NO METHOD 0-1: Always very effective 2-9: Effective as common- Ly used. Very effective when used correctly & consistently. 10-30: Only somewhat effective as commonly used. Effective when used correctly & consistently (0-1) (2-9) (10-30) Pregnancies per 100 Women in 1 st 12 mos Use Modern Contraceptives: Very Effective WHO, USAID, Bloomberfg, Family Planning A Global Handbook , 2007 COR CON USE TYP USE .1 .15 .3 .5 .8 1 2 6-8 14 20 20 21 26 85 .1 .1 .3 .5 .6 .5 .5 .1 3 6 1-9 5 6 85
Contraceptives: in WHO Core List of Essential Medicines Minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and cost-effective treatment. http://www.who.int/medicines/publications/essentialmedicines/en/
Women Population Church Medical ICPD POA 1994 The Reproductive Health Consensus
Compassionate counselling of women with unwanted pregnancies
Abortion policy change must be done according to national legislative processes
In circumstances where abortion is not against the law, such abortion should be safe. In all cases, women should have access to quality services for the management of complications arising from abortion.
Post-abortion counselling, education and family-planning services to avoid repeat abortions.
Abortion – according to ICPD POA 8.25
Goal: enable couples and individuals to decide freely and responsibly no.& spacing of their children Ensure informed free choice, is essential to long-term success of FP programs. Coercion, incentives and disincentives, targets & quotas have not worked Governmental goals for FP should be defined in terms of UNMET NEED for information and services. ICPD POA 7.12 FP Program principles
Bruce-Jain Framework of Quality FP Care (1990)
Choice of contraceptive methods
Full & accurate information
Continuity of care and follow up
Appropriate constellation of services
Creel et al, Overview of Quality of Care in Reproductive Health: Definitions and Measurements of Quality of Care , PRB & PopCouncil 2002
Guttmacher Institute and UNFPA, Adding it Up: The Costs and Benefits of Investing in Family Planning
and Maternal and Newborn Health , 2009; Population Reference Bureau, Family Planning Saves Lives , 2009
Comparative Cost-Effectiveness of FP Intervention Cost $ per DALY saved Insecticide-treated bednets 3-20 Malaria prevntn for pregnant women 29 TB treatment (epidemic sitns) 6-60 Modern contraceptive methods 62 ARV treatment India 150 ARV treatment Sub-Saharan Africa 252-547 BCG vaccination of children 48-203 Oral rehydration therapy 1,268 Cholera immunization 3,516 Guttmacher Institute and UNFPA, Adding it Up: The Costs and Benefits of Investing in Family Planning and Maternal and Newborn Health, 2009