ABSTRACT
PIP: Condom social marketing (CSM) programs have been successful in Rwanda and Haiti because they make it possible to sell condoms at prices even low-income people can afford. In Haiti, a packet of 3 Pante condoms costs US$0.06, about the same amount as a packet of 4 Prudence condoms in Rwanda. Less expensive condoms translate into higher condom sales, greater condom use, and a lower degree of HIV transmission. Fewer infections mean funding for AIDS prevention and care can be diverted to other health needs, fewer workers become sick and drop out of the economy, and fewer orphaned children become wards of the state. A major factor which allows such low prices in Haiti and Rwanda is the absence of taxes and tariffs on imported condoms, which comprise the bulk of socially marketed condoms. Botswana, Tanzania, and Bangladesh also do not collect duties on foreign condoms. Some countries, however, impose considerable taxes upon imported condoms. Malaysia, a major condom manufacturer and exporter, imposes a 25% tax upon imported condoms, while Brazil charges condom importers a 10% import duty and all condom marketers an 18% circulation tax. Condom prices in Brazil are among the highest in the world. Even subsidized socially marketed condoms are too expensive for many to buy consistently. Brazil's tariffs together with condom testing regulations and legal expenses impede the sale of subsidized condoms in the country. Efforts are underway to get the Brazilian government to eliminate taxes on imported condoms.^ieng
Subject(s)
Acquired Immunodeficiency Syndrome , Commerce , Condoms , HIV Infections , Health Services Needs and Demand , Marketing of Health Services , Taxes , Americas , Brazil , Contraception , Developing Countries , Disease , Economics , Family Planning Services , Financial Management , Latin America , South America , Virus DiseasesABSTRACT
In a country of 6 million that is the hemisphere's poorest, an American-supported Haitian campaign against AIDS has moved beyond getting people to ask questions about the risk of disease and helped make condom use commonplace. Within a year, the program has gone from selling about 40,000 condoms a month to nearly half a million. The story of condom use in Haiti, experts say, is one of careful attention to local psychology and culture. Equally important, they say, has been the subsidized price, currently about 3 cents each. In Haiti, despite infection rates that are thought to approach 10% in urban areas, there has been strong resistance to belief in the threat posed by AIDS.
Subject(s)
Acquired Immunodeficiency Syndrome , Condoms , HIV Infections , Health Behavior , Health Education , Sex Education , Americas , Behavior , Caribbean Region , Contraception , Developing Countries , Disease , Education , Family Planning Services , Haiti , Latin America , North America , Virus DiseasesABSTRACT
PIP: Refuting research findings on IUDs from the early 1980s, and controversy over the safety of the Dalkon Shield, research published over the past 10 years indicates that modern IUDs are safe and effective for most women. Better understanding of pelvic inflammatory disease (PID) reveals PID to present no more frequently among IUD user selection, insertion, and monitoring techniques are followed. Following such guidelines, and avoiding use in women at high risk for infection from sexually transmitted diseases (STD) will generally provide effective, acceptable, and inexpensive protection against pregnancy. The TCu 380 A IUD has in fact proved to be as effective as injectables or newly- developed hormonal implants. Accordingly, expanded use around the world is encouraged. The IUD has already become the most widely used from of reversible contraceptive with 85 million users in China, developed nations, Indonesia, Mexico, Egypt, and India. China claims 60/85 million users. Family Health International clinical trials involving 10,000 women in 23 developing countries during the period 1985-89, found declining removals due to complications, with increasing rates of method continuation. Women having a baby are ideal candidates for IUD acceptance and insertion. Such women may receive IUD insertion 10 minutes following expulsion of the placenta, while not posing risks to safe breastfeeding. Method drawbacks include the need for trained health professionals in insertion, removal, and follow-up exams over the 1st 3 months following insertion. IUDs also do not protect against STDs.^ieng
Subject(s)
Acquired Immunodeficiency Syndrome , Breast Feeding , Contraception , Developed Countries , Developing Countries , HIV Infections , Intrauterine Devices, Copper , Patient Acceptance of Health Care , Postpartum Period , Pregnancy, Unwanted , Sexually Transmitted Diseases , Time Factors , Africa , Africa, Northern , Americas , Asia , Asia, Southeastern , China , Contraception Behavior , Demography , Disease , Egypt , Europe , Family Planning Services , Asia, Eastern , Fertility , Health , India , Indonesia , Infant Nutritional Physiological Phenomena , Infections , Intrauterine Devices , Latin America , Mexico , Middle East , North America , Nutritional Physiological Phenomena , Population , Population Dynamics , Reproduction , Sexual Behavior , Therapeutics , United States , Virus DiseasesABSTRACT
PIP: Prices for socially marketed condoms and oral contraceptives (OCs) in selected countries--Bangladesh, Costa Rica, El Salvador, Ghana, Honduras, India, Indonesia, Jamaica, Nepal, Zimbabwe, and Mexico--are set forth and compared with cost of living data such as per capita income and food prices. Also presented for each country is a couple-years of protection cost factor, representing the hypothetical number of days of income per capita needed to purchase a 1 year supply of condoms. The lowest such cost factor exists in India (0.9 day), followed by Jamaica (1.4 days) and Ghana (1.6 days). Countries with particularly high couple-years of protection cost factors include Honduras (10.3 days) and Zimbabwe (11.6 days). Contraceptive prices relative to a kilogram of rice are highest in Mexico, Zimbabwe, and Honduras and lowest in Bangladesh and India. Condom prices are more than twice the comparable couple-years of protection rate for OCs in Honduras and El Salvador, while there is a price equivalency in the contraceptive costs of these 2 methods in social marketing programs in Bangladesh, Jamaica, and Nepal.^ieng
Subject(s)
Commerce , Condoms , Contraception Behavior , Contraception , Contraceptive Agents, Female , Contraceptives, Oral , Costs and Cost Analysis , Economics , Evaluation Studies as Topic , Family Planning Services , Marketing of Health Services , Socioeconomic Factors , Africa , Africa South of the Sahara , Africa, Eastern , Africa, Western , Americas , Asia , Asia, Southeastern , Bangladesh , Caribbean Region , Central America , Contraceptive Agents , Costa Rica , Developed Countries , Developing Countries , El Salvador , Ghana , Health Planning , Honduras , India , Indonesia , Jamaica , Latin America , Mexico , Nepal , North America , Program Evaluation , ZimbabweABSTRACT
This paper presents data on contraceptive use and fertility in Honduras obtained from a household survey conducted in 1984, and compares these data with similar information obtained from surveys carried out in 1981 and 1983. About half of the increase that has taken place in contraceptive use in Honduras is accounted for by sterilization. In 1981, 27 percent of women in union aged 15-49 years were practicing contraception; in 1984, the percentage of those 15-44 was 35 percent. The increase in urban areas was smaller (from 47 percent to 51 percent) than in rural areas (from 16 percent to 24 percent). Also, fertility remained almost unchanged in urban areas while declining in rural areas. Information from questions on place of purchase, price, and brand of contraceptive (for orals) was used to determine source of supply. The use of multiple questions to determine source results in a higher percentage of contraceptive use attributed to the Honduran Family Planning Association as compared with answers to a single question. The duration of breastfeeding in Honduras has increased, with the greatest changes occurring among women in urban areas and women with the highest levels of education. Efforts have been made to promote breastfeeding in urban areas and these results suggest that the efforts have been successful.