RESUMO
In a context with limited attention to mental health and prevalent sexual prejudice, valid measurements are a key first step to understanding the psychological suffering of sexual minority populations. We adapted the Patient Health Questionnaire as a depressive symptom severity measure for Vietnamese sexual minority women, ensuring its cultural relevance and suitability for internet-based research. Psychometric evaluation found that the scale is mostly unidimensional and has good convergent validity, good external construct validity, and excellent reliability. The sample's high endorsement of scale items emphasizes the need to study minority stress and mental health in this population.
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PIP: This article summarizes experiences of a Vietnamese delegation at a solidarity meeting of world women during April 13-16, 1998, in Cuba. The President of the Viet Nam Women's Union headed the delegation. The advisor was the vice-chairperson of the Vietnamese National Assembly. The delegation participated in 6 forums: women and sustainable economic development; women, health, education, and social security; women, communication and the mass media; women in politics and decision-making; women, violence and discrimination; and national independence, sovereignty, peace, and women. The delegation also participated in sessions on women's issues; implementation issues; women parliamentarians; and migrant and displaced women. The delegation met with delegates from other countries and participated in a world meeting and an Asian-Pacific meeting to support Cuban women. The entire delegation presented a stage show of songs, which was well received by the 3000 participants. The delegation met with Cuban delegates to discuss the formation of women's groups and to build better relations between the women of both countries. The delegation visited a training center of women cadres and the center for gender education. Participants adopted the Havana Declaration, which states the intention of world women to eradicate poverty and war and to promote peace, progress, and happiness in all countries. The Havana Declaration condemned the US embargo against Cuba. Fidel Castro spoke and expressed gratitude for the strong support from world women, especially Vietnamese women.^ieng
Assuntos
Congressos como Assunto , Relações Interpessoais , Pesquisa , Direitos da Mulher , Mulheres , América , Ásia , Sudeste Asiático , Região do Caribe , Cuba , Países em Desenvolvimento , Economia , América Latina , América do Norte , Política , Opinião Pública , Fatores Socioeconômicos , VietnãRESUMO
PIP: This article presents the speech of the President of the Viet Nam Women's Union, given on April 15, 1998, at a world women's solidarity meeting held in Cuba. The President gave the Cuban Women's Federation US$50,000 for women's and children's programs. The President indicated that the Vietnamese people wanted to help alleviate the hardships of the Cuban people and show solidarity with Cuba and Comrade Fidel Castro. The money was collected in a nationwide campaign in an effort to express Viet Nam's sympathy for Cubans who face difficult living conditions due to the US embargo. The President thanked the Cuban people for standing up to a superpower for all the world to see and for being confident and optimistic despite hardships. The Vietnamese are ready to defend revolutionary achievements, independence, and socialism. The Vietnamese will be celebrating the 35th year of the founding of the Cuban Committee for Solidarity with Viet Nam, Laos, and Cambodia. The Vietnamese delegation offered warm greetings to the Cuban Party and State and the Cuban women and children under the leadership of Comrade Fidel Castro.^ieng
Assuntos
Congressos como Assunto , Cooperação Internacional , Pesquisa , Mulheres , América , Ásia , Sudeste Asiático , Região do Caribe , Cuba , Países em Desenvolvimento , Economia , Administração Financeira , América Latina , América do Norte , Política , Opinião Pública , VietnãRESUMO
The introduction of new contraceptive technologies has great potential for expanding contraceptive choice, but in practice, benefits have not always materialized as new methods have been added to public-sector programs. In response to lessons from the past, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development, and Research Training in Human Reproduction (HRP) has taken major steps to develop a new approach and to support governments interested in its implementation. After reviewing previous experience with contraceptive introduction, the article outlines the strategic approach and discusses lessons from eight countries. This new approach shifts attention from promotion of a particular technology to an emphasis on the method mix, the capacity to provide services with quality of care, reproductive choice, and users' perspectives and needs. It also suggests that technology choice should be undertaken through a participatory process that begins with an assessment of the need for contraceptive introduction and is followed by research and policy and program development. Initial results from Bolivia, Brazil, Burkina Faso, Chile, Myanmar, South Africa, Vietnam, and Zambia confirm the value of the new approach.
PIP: In response to difficulties associated with the introduction of new contraceptive technologies to public sector service systems, the UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction has formulated a new model. The strategic approach to contraceptive introduction shifts the emphasis from the promotion of a particular technology to quality of care issues, a reproductive health focus, and users' perspectives and needs. It further entails a participatory approach with collaboration among governments, women's health groups, community groups, nongovernmental providers, researchers, international donors, and technical assistance agencies. The underlying philosophy is that method introduction should proceed only when a system's ability to provide high-quality services exists or can be generated. Since 1993, WHO has provided support for the implementation of this perspective in public sector programs in Bolivia, Brazil, Burkina Faso, Chile, Myanmar, South Africa, Viet Nam, and Zambia. Preliminary assessments in these countries revealed major structural, managerial, and philosophical barriers to high-quality family planning services. In cases where assessments have indicated the feasibility of new method introduction, this has been implemented through a carefully phased, research-based process intended to encourage the development of appropriate managerial capacity and to promote a humanistic philosophy of care.
Assuntos
Anticoncepção , Atenção à Saúde/métodos , Países em Desenvolvimento , Serviços de Planejamento Familiar/métodos , Aceitação pelo Paciente de Cuidados de Saúde , Organização Mundial da Saúde , África , Sudeste Asiático , Participação da Comunidade , Anticoncepção/métodos , Anticoncepção/psicologia , Anticoncepção/normas , Atenção à Saúde/organização & administração , Serviços de Planejamento Familiar/organização & administração , Liberdade , Implementação de Plano de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Cooperação Internacional , Modelos Organizacionais , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Formulação de Políticas , Desenvolvimento de Programas , Qualidade da Assistência à Saúde , América do SulRESUMO
PIP: The Economic and Social Council for Asia and the Pacific (ESCAP) held a regional workshop in Thailand in 1992 to demonstrate how women's involvement at all levels of environmentally sound and sustainable water supply and sanitation programs and projects could be made more effective, easier, and productive. Using the same modules, with the support of other organizations such as the Department of Development Support and Management Services, ESCAP conducted four more workshops in the Philippines, Lao People's Democratic Republic (PDR), Vietnam, and Thailand in 1995. In the Philippines, the National Commission on the Role of Filipino Women expressed its intention to adapt the modules for the country. In the Lao PDR, three project ideas were proposed which would assist the Lao Women Union in gaining knowledge on the planning, implementation, operation, and management of water supply and sanitation projects at the national, regional and project levels. In Vietnam, three main directions for action were identified for the promotion of close and active cooperation between the Rural Water Supply and Environmental Sanitation Centres and the system of the Women Union of Vietnam. In Thailand, the National Committee on Health and Environment of the National Commission on Women's Affairs expressed its willingness to seek budgetary allocation for the promotion of women's role in water supply and sanitation.^ieng
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Educação , Desenvolvimento de Programas , Pesquisa , Saneamento , Nações Unidas , Abastecimento de Água , Direitos da Mulher , Mulheres , Ásia , Sudeste Asiático , Conservação dos Recursos Naturais , Países em Desenvolvimento , Economia , Meio Ambiente , Saúde , Agências Internacionais , Laos , Organização e Administração , Organizações , Filipinas , Saúde Pública , Fatores Socioeconômicos , Tailândia , VietnãRESUMO
PIP: 20% of the world's population is aged 10-19 years. Annually, almost 15 million young women under age 20 become mothers. However, surveys in developing countries show that 20-60% of the pregnancies and births to women under age 20 are mistimed or unwanted. While later marriage age in many places has provoked a decline in birth rates among young women, levels of sexual relations before marriage are increasing. Such sexual behavior opens sexually active young women to the risks of unwanted pregnancies, unsafe abortion, and sexually transmitted diseases (STDs). Millions of young people become infected with STDs annually. Among all age groups in the US, young women aged 15-19 have the highest incidence of gonorrhea among females and young men aged 15-19 have the second highest incidence among males. At least half of all people infected with HIV are under age 25. The UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction (HRP) completed 9 studies in 1996 on adolescent reproductive health. 14 studies were completed before 1996, and 18 are still underway.^ieng
Assuntos
Adolescente , Pesquisa sobre Serviços de Saúde , Gravidez na Adolescência , Gravidez não Desejada , Medicina Reprodutiva , Assunção de Riscos , Comportamento Sexual , Infecções Sexualmente Transmissíveis , Nações Unidas , África , África Subsaariana , África Ocidental , Fatores Etários , América , Ásia , Sudeste Asiático , Comportamento , América Central , Demografia , Países em Desenvolvimento , Doença , Ásia Oriental , Fertilidade , Guatemala , Saúde , Infecções , Agências Internacionais , Coreia (Geográfico) , América Latina , Nigéria , América do Norte , Organizações , Filipinas , População , Características da População , Dinâmica Populacional , Pesquisa , Tailândia , VietnãRESUMO
PIP: The many young people worldwide who are sexually active need correct knowledge on pregnancy and sexually transmitted diseases (STDs) so that they may take appropriate and effective measures to prevent them. However, recent studies of young people's sexual behavior conducted in Korea, Guatemala, Nigeria, the Philippines, Thailand, and Vietnam found that knowledge about sexuality, reproduction, and contraception does not always lead young people to practice safe sex. A study in Korea of male students and industrial workers found that while 96-99% knew that AIDS can be transmitted through sexual intercourse with an infected person and over 90% knew that condoms can prevent pregnancy and the transmission of STDs, only 39-48% of those sexually experienced reported using a condom during their most recent episode of sexual intercourse. Of those who were sexually experienced, 80% of industrial workers and 73% of students reported having had sex with a prostitute. Almost all sampled adolescents in Guatemala had heard of AIDS, but the young men reported only sporadic condom use. This discrepancy between knowledge and condom use observed in the other country studies is reported.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida , Adolescente , Preservativos , Infecções por HIV , Comportamentos Relacionados com a Saúde , Conhecimento , Comportamento Sexual , África , África Subsaariana , África Ocidental , Fatores Etários , América , Ásia , Sudeste Asiático , Comportamento , América Central , Anticoncepção , Demografia , Países em Desenvolvimento , Doença , Serviços de Planejamento Familiar , Ásia Oriental , Guatemala , Coreia (Geográfico) , América Latina , Nigéria , América do Norte , Filipinas , População , Características da População , Tailândia , Vietnã , VirosesRESUMO
PIP: UNAIDS has launched an 'HIV Drug Access Initiative' in the Ivory Coast, Uganda, Chile, and Vietnam; the pilot project will attempt to improve access to HIV drugs. Public and private sector efforts will be coordinated. The Glaxo Wellcome, Hoffman-La Roche, and Virco pharmaceutical companies will participate. Each country will 1) adapt its present system with regard to HIV and 2) establish both an HIV drug advisory board and a non-profit company which will import the drugs. Health ministries within each country will be required to find sources of funding for the programs. Uganda will probably use funds from its sexually transmitted disease (STD) program, which is supported by the World Bank; the Ivory Coast will combine corporate contributions, new tariffs, and non-profit insurance system monies into a 'solidarity fund.' UNAIDS funds will be used for oversight and evaluation. UNAIDS also released a review of 68 studies which examined the impact of sex education on the sex behavior of young people; it indicated that, in 65 of the studies, sex education did not increase the sexual activity of youth. UNAIDS concluded that quality programs helped delay first intercourse and often reduced the number of sexual partners, resulting in reduced rates of STDs and unplanned pregnancy. UNAIDS further concluded that effective sex education should begin before the onset of sexual activity, and curriculums should be focused. Openness in communicating about sex should be encouraged, and social and media influences on behavior should be addressed. Young people should be taught negotiating skills (how to say 'no' to sex and how to insist on safer sex).^ieng
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Adolescente , Países em Desenvolvimento , Administração Financeira , Órgãos Governamentais , Infecções por HIV , Cooperação Internacional , Preparações Farmacêuticas , Setor Privado , Educação Sexual , Infecções Sexualmente Transmissíveis , Nações Unidas , África , África Subsaariana , África Oriental , África do Norte , África Ocidental , Fatores Etários , América , Ásia , Sudeste Asiático , Chile , Côte d'Ivoire , Demografia , Doença , Economia , Educação , Infecções , Agências Internacionais , América Latina , Organizações , População , Características da População , América do Sul , Terapêutica , Uganda , Vietnã , VirosesRESUMO
PIP: This article briefly describes JOICFP projects in Bangladesh, China, Ghana, Tanzania, Guatemala, and Vietnam that received funding from the Japanese Postal Savings for International Voluntary Aid program (POSIVA). POSIVA gather donations from the public to support the work of Japanese nongovernmental groups in developing countries. In Bangladesh, support was given to the Integrated Family Development Project in 1995. This project empowered women by establishing women's centers in 48 villages and promoting health, education, and economic activities. In China, POSIVA funds supported the Integrated Program at Taicang Family Planning Center. The Taicang center provides reproductive health and family planning services, parasite control services, and adolescent health education promotion. Funds are used to support the center's general services, to supply medical equipment, and to support IEC and nutrition activities. In Ghana, funds were used to construct a clinic for four villages, build toilets, and support women's income generation and health education activities. In Tanzania, funds supported integrated programs that aimed to develop human resources at the local level and to raise quality of care. In Guatemala, POSIVA supported programs for improving the health of indigenous people. Funds were used to provide health education in the junior high schools and skill training and income generation activities. In Vietnam, funding went to promoting community-based reproductive health services and to raising quality of care.^ieng
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Planejamento em Saúde , Serviços de Saúde , Cooperação Internacional , Organizações , Medicina Reprodutiva , África , África Subsaariana , África Oriental , África Ocidental , América , Ásia , Sudeste Asiático , Bangladesh , América Central , China , Atenção à Saúde , Países Desenvolvidos , Países em Desenvolvimento , Economia , Serviços de Planejamento Familiar , Ásia Oriental , Administração Financeira , Gana , Guatemala , Saúde , Japão , América Latina , América do Norte , Organização e Administração , Tanzânia , VietnãRESUMO
PIP: Scarcity of long-term funding has influenced Family Health International (FHI) to stop new animal studies on the safety of quinacrine pellets that are used in nonsurgical female sterilizations. These studies would have lasted 8 years and cost $8 million. FHI planned to examine quinacrine's potential toxicity, including life-time carcinogenicity in rodents. In the early 1980s, it sponsored toxicology studies but the US requirements for evaluating toxicity were different then. In 1994, a meeting of experts evaluated quinacrine research and FHI then decided to conduct short-term genetic toxicity tests on quinacrine. These tests proved that quinacrine causes genetic damage in vitro. FHI sent both the World Health Organization (WHO) and the US Agency for International Development (USAID) these results. FHI is presently conducting follow-up of two clinical studies in Chile (USAID-funded) and in Vietnam (Mellon Foundation-funded). A small cancer cluster promoted the follow-up study of 1492 women in Chile. One woman had developed the rare form of uterine cancer called uterine leiomyosarcoma. Data up to 1991 reveal that quinacrine did not increase the risk of cancer, but the sample size was too small to confirm quinacrine's safety relative to cancer. The Vietnamese government asked FHI to conduct a follow-up study that includes more than 2000 quinacrine acceptors and about 1500 controls. Ministry of Health providers had inserted the quinacrine pellets in the cases. Based on the findings of the original study, WHO recommended that Vietnamese officials suspend quinacrine sterilizations until more toxicologic evaluation of quinacrine could be performed.^ieng
Assuntos
Animais de Laboratório , Ensaios Clínicos como Assunto , Anticoncepção , Administração Financeira , Neoplasias , Organizações , Esterilização Reprodutiva , América , Ásia , Sudeste Asiático , Chile , Países Desenvolvidos , Países em Desenvolvimento , Doença , Economia , Serviços de Planejamento Familiar , América Latina , América do Norte , Pesquisa , América do Sul , Estados Unidos , VietnãRESUMO
PIP: A workshop was held December 9 in Kathmandu to introduce participants to three innovative information, education and communication materials developed for China with funds from UNFPA/JOICFP. This workshop was a follow-up to two others held early in 1993 in Kuala Lumpur and Tokyo. The first workshop focused upon printed educational materials for preadolescent girls, while the second was aimed at producing video scripts for women's health. The deputy director and secretary general of the Shanghai International Center for Population Communication, China, introduced the participants to the eight types of menstrual record cards produced for pre-adolescent girls and two videos, one for STD prevention and one for AIDS prevention. Aimed at encouraging girls to accept and better understand their reproductive cycles, the menstrual record cards have been distributed to young girls in Shanghai. They were produced from several prototypes created at the Kuala Lumpur workshop and with information from a knowledge, attitude, and practice survey conducted among school girls in Shanghai. The STD video was broadcast nationwide on China Central TV before the workshop, while the AIDS video was broadcast on World AIDS Day on December 1 in Shanghai and Yunnan. The second part of the workshop focused upon the experiences of the Mexican Foundation for Family Planning (MEXFAM) which has been promoting an adolescent health program. The third part of the workshop offered a video developed by a Vietnamese nongovernmental organization designed to raise women's self-esteem. Another recently produced JOICFP video on Asia was presented, while participants were given a demonstration of a prototype for a new easier to carry, simpler, and cheaper version of the educational Magnel Kit.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida , Educação , Infecções por HIV , Educação em Saúde , Serviços de Informação , Pesquisa , Educação Sexual , Infecções Sexualmente Transmissíveis , Gravação de Videoteipe , Adolescente , Fatores Etários , América , Ásia , Sudeste Asiático , Criança , China , Comunicação , Demografia , Países em Desenvolvimento , Doença , Ásia Oriental , Planejamento em Saúde , Infecções , América Latina , Meios de Comunicação de Massa , México , América do Norte , População , Características da População , Gravação em Fita , Vietnã , VirosesRESUMO
PIP: Nonsurgical female sterilization, through use of quinacrine hydrochloride pellets inserted into the uterus, has the potential to make low cost permanent contraception accessible to the millions of women in developing countries who desire no more children but do not live close to surgical facilities or cannot spend time away from their families. Family Health International (FHI) has been studying this agent in clinical trials in Chile since 1976. The efficacy rate for 2 100-minute pellets is 95-98% at 12 months. The predominant side effects, temporary and minor, are amenorrhea of 1-3 months' duration, lower back pain, heavier menstrual bleeding, and headache. In 1990, however, FHI withdrew its Investigational New Drug application to explore the agent's toxicity, teratogenicity, and carcinogenicity. In 1989, 8 cases of cancer in 6 different anatomical sites were identified among the 572 Chilean women who had received quinacrine in clinical trials in the preceding decade. A retrospective study of 1492 Chilean women who were sterilized with quinacrine in 1977-89 revealed 17 cancer cases. Small sample sizes and the lack of cancer incidence data in Chile make it impossible to draw conclusions on the drug's carcinogenicity, but FHI will monitor this group for another 5 years. Early preclinical studies in pregnant rats and monkeys have indicated high rates of fetal death but no evidence of chromosomal damage; however, these studies must be repeated to meet new requirements, including the evaluation of bacterial gene mutation, mammalian cell gene maturation, and in vitro cytogenetics. Another research site has been Vietnam, where 31,781 quinacrine pellet sterilizations were performed in 1989-92 at the request of the government. FHI researchers are collecting data on health related outcomes as well as acceptor satisfaction, provider counseling, and service delivery among 1800 of these women and will complete its study in 1994. If the toxicology study yields favorable results, clinical trials will be repeated in the US.^ieng
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Anticoncepção , Países em Desenvolvimento , Esterilização Reprodutiva , América , Ásia , Sudeste Asiático , Chile , Serviços de Planejamento Familiar , América Latina , América do Sul , VietnãRESUMO
PIP: The author describes a set of principles concerning census procedures agreed to by the countries of the Council for Mutual Economic Assistance. These include an agreement to conduct a decennial census at the end of each decade and close to the beginning of a year, and an agreed number of minimum and optimum components. Dates of future censuses include: Poland, 1988; USSR, 1989; Mongolia, 1989; Viet Nam, 1989; Romania, 1990; Hungary, 1990; Cuba, 1990; Czechoslovakia, 1990; German Democratic Republic, 1991; Yugoslavia, 1991; and Bulgaria, 2000.^ieng
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Censos , Cooperação Internacional , América , Ásia , Sudeste Asiático , Bulgária , Região do Caribe , Cuba , Tchecoslováquia , Países Desenvolvidos , Países em Desenvolvimento , Europa (Continente) , Europa Oriental , Ásia Oriental , Alemanha Oriental , Hungria , América Latina , Mongólia , América do Norte , Polônia , Características da População , Pesquisa , Romênia , U.R.S.S. , Vietnã , IugosláviaRESUMO
PIP: This article presents current estimates of the number, rate, and proportion of abortions for all countries which make such data available. 76% of the world's population lives in countries where induced abortion is legal at least for health reasons. Abortion is legal in almost all developed countries. Most developing countries have some laws against abortion, but it is permitted at least for health reasons in the countries of 67% of the developing world's population. The other 33%--over 1 billion persons--reside mainly in subSaharan Africa, Latin America, and the most orthodox Muslim countries. By the beginning of the 20th century, abortion had been made illegal in most of the world, with rules in Africa, Asia, and Latin America similar to those in Europe and North America. Abortion legislation began to change first in a few industrialized countries prior to World War II and in Japan in 1948. Socialist European countries made abortion legal in the first trimester in the 1950s, and most of the industrialized world followed suit in the 1960s and 1970s. The worldwide trend toward relaxed abortion restrictions continues today, with governments giving varying reasons for the changes. Nearly 33 million legal abortions are estimated to be performed annually in the world, with 14 million of them in China and 11 million in the USSR. The estimated total rises to 40-60 million when illegal abortions added. On a worldwide basis some 37-55 abortions are estimated to occur for each 1000 women aged 15-44 years. There are probably 24-32 abortions per 100 pregnancies. The USSR has the highest abortion rate among developed countries, 181/1000 women aged 15-44, followed by Rumania with 91/1000, many of them illegal. The large number of abortions in some countries is due to scarcity of modern contraception. Among developing countries, China apparently has the highest rate, 62/1000 women aged 15-44. Cuba's rate is 59/1000. It is very difficult to calculate abortion rates in countries where the procedure is illegal. On the basis of hospital reports and other fragmentary information, the true rate appears to be relatively high in Latin America and the Far East. The abortion rate for Latin America in the mid-1970s was estimated at 65/1000 fertile aged women, and rates were believed to be higher in urban areas. Sub-Saharan Africa, where women desire very large families, apparently had the lowest rates. Up to 68% of pregnancies in the USSR, 57% in Rumania, and 55% in Japan may end in abortion. The proportion in developing countries ranged from 8% in Vietnam to 43% in China. Women undergoing abortion in developed countries tend to be young, childless, and single, while those in developing countries tend to be older, high parity, and married. Abortion mortality is still high in countries where large numbers of illegal abortions are performed by unqualified personnel, as in many parts of Latin America.^ieng
Assuntos
Aspirantes a Aborto , Aborto Criminoso , Aborto Induzido , Aborto Legal , Países Desenvolvidos , Países em Desenvolvimento , Estudos de Avaliação como Assunto , Serviços de Planejamento Familiar , Legislação como Assunto , Política , Projetos de Pesquisa , Pesquisa , África , África Subsaariana , América , Ásia , Sudeste Asiático , Região do Caribe , América Central , Anticoncepção , Cuba , Europa (Continente) , Europa Oriental , Ásia Oriental , Japão , América Latina , América do Norte , Romênia , América do Sul , U.R.S.S. , VietnãRESUMO
PIP: Responses to the second worldwide survey of 80 nations on their population policy can be divided into 3 categories. First are countries with large official programs of family planning in existence: Egypt, Kenya, Tunisia, Barbados, Colombia, Panama, Trinidad and Tobago, China, India, Iran, Japan, Nepal, Pakistan, Philippines, Republic of Viet-nam, Singapore, Sri Lanka, Thailand, Turkey, Denmark, Netherlands, United Kingdom, Yugoslavia, Canada, and Fiji. Madagascar and New Zealand are starting programs. The second category is countries that encourage private family planning programs: Tanzania, Mexico, Israel, Cambodia, Bahrain, Jordan, Laos, Syria, Austria, France, West Germany, Finland, and Norway. Third are listed countries that do not officially support, or that forbid contraception: Gabon, Malawi, Zambia, Greece, Italy, and Spain. Thus Asia and North Africa have the most ambitious programs, but Europe and North America practice contraception universally.^ieng