Global Monitor

JOY COMES TO JOHNS HOPKINS UNIVERSITY!

Patricia Poppe, program officer of the Latin American Division of Johns Hopkins University Population Communications Services JHUIPCS, crowed with joy when, investigating opportunities for USAID-funded population control among Mexicans, she discovered that: “… suddenly we saw, on top of the XIVth century Spanish municipal building, a powerful satellite dish .… [and] three video rental stores .… At last we understood! Thus, the perfect setting — satellite and video rentals — has been created in which family planning communication campaigns may sprout in this and many similar hamlets.”1

USAID STAR ‘POPULATION PLAYER’ IN THAILAND

Mechai Viravaidya, formerly a prominent assistant to the Thai prime minister, is founder and secretary-general of the Population and Community Development Association of Thailand (PDA), a USAID-funded “social marketing” contraceptive/abortifacient program in Thailand. In the early 1970s he began a “desensitization” program to overcome taboos about population control methodologies among his people.

In 1991 PDA is beginning an AIDS prevention project for prostitutes and students in northern Thailand. The project is funded by the Public Welfare Foundation through the Johns Hopkins Center for Communications Programs. Mechai recently visited the Center and described the “condom-blowing contests” which he used to “help change people’s attitudes and behavior.”

An interviewer from Population Reports asked, “And did it work?” “Oh, yes.” said Mechai. “In our earlier campaigns we would ask for time at teacher training seminars to introduce the country’s population and family planning problems to young teachers. At these seminars we would hold condom-blowing contests, with both young single male and female teachers participating. Shyness would disappear amidst the humor of it all. These teachers then became family planning communicators, even providers.”

What about the use of the condom in family planning in Thailand today? “It’s only the spare tire. We have the four main wheels — sterilization, both female and male; the pill; injectables; and IUDs.”2

POPULATION COUNCIL — MADAGASCAR

The Population Council initiated an Operations Research (OR) Project in Madagascar in 1989. The project was planned with JIRAMA, the Water and Power Company of Madagascar, “one of the most innovative and dynamic organizations providing family planning services” in Madagascar. Dr. Monique Rakotomalala, Medical Director of JIRAMA, operates a mobile service program, with UNFPA support, in about twenty-seven rural Ministry of Health (MOH) clinics. As a result of clinic services, the contraceptive prevalence rate has increased almost four fold.

Nurses were added in “experimental clinics” to ensure that contraceptives and abortifacients were integrated into all Maternal and Child Health Care (MCH) services. At the same time community contraceptive education and supplies were increased.

FISA, the IPPF affiliate, participated in the project through the promotion of the Copper T 380A IUD. The university teaching hospital and FISA, are also collaborating in an “experimental” trial of NORPLANT levonorgestrel implants.3

“PROGRAM” OF SAO PAULO’S FEMINIST MAYOR

The election of Luiza Erundina mayor of Sao Paulo in 1988, “was a landmark in Brazilian political history.” Erundina is “the first mayor to establish a Women’s Clearinghouse linked directly to her office … she has made Sao Paulo the first Brazilian city to have a hospital fully equipped to perform abortions …” Additional plans were made for a “feminist public maternity ward specializing in alternative birthing techniques.”

Luiza Erundina hopes to leave office having “shared power with the organized sectors of society, initiating a process that will be irreversible.”4

IPPF SOAP OPERA IN MEXICO

“All is not well in the small Mexican community of Villa de Amor. The mayor spends most of his day defending himself against charges of philandering. A young woman faces an unplanned pregnancy as her boyfriend flees to avoid responsibility. And now, only days after refusing to allow their wives to attend local classes in family planning, virtually all the men in the village have become pregnant.”

Villa de Amor is the fictional home of the “Las Buenas Costumbres” (“Polite Society”). “Polite Society” is daytime television drama produced by the Mexican public television network, Imevision, with the help of MEXFAM, the Mexican branch of the International Planned Parenthood Federation. The program is intended “to spread the good news of family planning as widely as possible.”

“Although the success of these programs is impressive, getting people to watch is, for the shows’ creators, only part of the mission. The real aim is to change the way people think about and act on family planning.”

“Many soap opera creators have been able to lighten this financial burden by drawing upon support from outside sources, including the United Nations Population Fund, the International Planned Parenthood Federation, and the United States Agency for International Development.”5

SEX EDUCATION — LATIN AMERICA AND THE CARIBBEAN

An evaluation of Planeando tu Vida, an educational program for adolescents in Mexico, was carried out in MEXFAM family planning clinics and in high schools. “Planeando tu Vida” (Planning Your Life) includes the following topics: the beginning states of a relationship; sexuality, reproductive anatomy and physiology; pregnancy and its consequences; sexually transmitted diseases; contraception; mechanisms for decision making; self-esteem and prioritizing values; communication and assertiveness.

Adolescents, teachers and school authorities were asked to give their comments regarding the course. The major findings of the evaluation were that there were no significant changes in the initiation of sexual activity but there was a significant increase in knowledge of where to obtain and how to use contraceptives.

Planeando tu Vida has been implemented in nearly 100 public and private schools. Over 13,000 adolescents have “benefited” from the course. More than 1,500 teachers, health personnel and counselors are being trained to implement the course in their communities. In addition, course materials are being developed and evaluated for children and their parents from pre-school through high school. Over 20 booklets of the Planeando tu Vida series are currently available and in use and another 30 are in press.6

GRAYING OF JAPAN

During the first quarter of the 20th century, Japan experienced the high mortality and fertility levels characteristic of many present-day developing countries. In 1925, life expectancy at birth was about 45 years on average and women gave birth to a total of 5.1 children, during their child-bearing years. But both mortality and fertility rates fell rapidly in the ensuing decades. By 1950, life expectancy had increased to 60 years and the total fertility rate (TFR), or average number of lifetime births per woman under current birth rates, had fallen to 3.7 children. The demographic change after World War II was even more dramatic. By 1960, the TFR had fallen below the replacement level of 2.1 children per woman (the number of children needed to just replace each couple in the population). Between 1977 and 1987, the TFR was stable at about 1.8 children. Japanese life expectancy is the highest on earth — in 1987, 76 years for males and 82 years for females. With no significant international migration, the low fertility and mortality yield an annual population growth rate of only 0.5 percent.

Japan began its demographic transition from high to low fertility and mortality much later than the United States and other developed countries, but finished it with record speed. The transition occurred in less than 50 years, resulting in the extremely rapid aging of Japan’s population. Although the proportion of the population 65 and over — 10 percent in 1985 — is less than in many other developed countries such as the United States (12 percent) and Sweden (17 percent), by the year 2025, Japan is projected to have one of the most elderly populations on earth — 23 percent over age 65. In absolute numbers, the elderly population of Japan is expected to increase from 12.5 to 31.5 million between 1985 and 2025 which will escalate the demand for age related services, such as medical care.7

“COMMISSION OF WISE PERSONS”

The North South Roundtable and the United Nations Development Program presented a roundtable on “Development for People: Goals and Strategies for the Year 200D” at a conference in Islamabad, Pakistan. The report of that conference reveals a cradle-to-grave manipulation of man who is described as the “engine of growth.” Utilizing a “capabilities approach,” the objective of investment in “human development” is portrayed as a means “to bring into play unused resources in order to increase the level of productive activity.”

Development strategy should stress health, education and nutrition, with specific targets for the status of women and population policy. Women must be “categorically, unequivocally and irreversibly” integrated into development programs as “both means and ends.”

At the national level, all countries, “should be encouraged to review and restructure their national development plans to include human balance sheets and human goals.” At the international level, “in order to stimulate rethinking and practical action,” a Commission of Wise Persons should be constituted to interact with national and international policy makers on concrete strategies and measures. Such commissions should preferably be small — perhaps no more than six members each, with equal numbers of men and women — and should consist of outstanding personalities who could “encourage structural changes nationally, regionally or globally.”8