[Reproductive health: definitions, data and challenges]. / Salud reproductiva: definiciones, datos y desafios.

PIP: Emergence of the concept of reproductive health over the past decade was stimulated by distinct currents in the fields of health and of feminist theory. The broadened concept represents a reaction to the essentially demographic justification offered for population policies and their principal instrument of action, family planning, since the 1970s. The new focus is more affirmative, and its discourse promotes the right to health, to improved access to services, and to health services offering quality and respect for women. Social justice aspects, especially nondiscrimination against the poor and other specific groups, and free selection of contraceptive options and services have assumed greater importance. Reproductive health is viewed as encompassing psychological aspects and power relations within marital unions. Very general provisional definitions of the concept of reproductive health are acceptable for the moment. But it is important to arrive at a definition that will be clear and specific and will combine the preoccupations of the health field with feminist concerns. The problem of measurement is related to the problem of definition. Satisfactory indicators of reproductive health are lacking. Existing indicators such as maternal mortality, fertility measures, or contraceptive prevalence continue to be used despite their narrow focus. Several priority areas of research in reproductive health have been identified, including aspects and determinants of sexual behavior, roles of men and women in reproductive health, the dynamics of contraceptive usage, undesired pregnancy, determinants and consequences of induced abortion, lactation and spacing and their relationship to sterilization, and maternal morbidity and mortality.^ieng

[Toward constructing a research agenda: the threat posed by induced abortion in Latin America]. / Hacia la construccion de una agenda de investigacion: el reto del aborto inducido en America Latina.

PIP: This work calls attention to the need for constructing a research agenda on induced abortion, which constitutes a serious pubic health problem in Latin America because of its illegality, clandestine practice, and ramifications for women's health, their families, and the health services. The incidence of abortion in Latin America is estimated, in the absence of reliable statistics, at 4-6 million annually. Over half the women in some countries are believed to resort to abortion during their reproductive lives. The concept of reproductive health emerged in the past decade from two distinct sources, the field of health and the feminist movement, as contraception became an increasingly accepted component of primary care. Reproductive aspects acquired a central role in the expanded concept of women's health, and reproductive health was converted into a new objective of service programs. The World Health Organization in 1988 for the first time unofficially defined reproductive health, and in 1994 an official definition was proposed. The definition did not mention abortion directly. Abortion is increasingly a topic of political debate in Latin America, where it is legal only in Cuba. The resolute opposition of the Catholic Church undoubtedly affects health policies. The feminist movement is perhaps alone in raising the issue and seeking means of legalizing abortion, based on human rights and public health considerations. The new definition of reproductive health challenges researchers from many disciplines to provide reliable information on poorly known aspects of abortion. The ultimate goal of the research is to reduce the frequency of abortion and eliminate morbidity and mortality caused by illegal abortions. Recommended topics for research include the incidence of abortion, undesired adolescent pregnancy and abortion, abortion and working women, the influence of cultural and social patterns on abortion, the role of men in reproductive decisions and abortion, the relation of abortion and contraception, costs of abortion, attitude of abortion practitioners and illegal abortionists, evaluations of the legal status of abortion, and models of risk detection and prevention.^ieng

[The role of family planning programs in the fertility transition in Latin America]. / Los programas de planificacion familiar y su funcion en la transicion de la fecundidad en America Latina.

"This article traces the origins of fertility changes, of attitudes towards contraception and of lower family size values in Latin America, on the basis of information collected during the 1960s and 1970s on abortion, fertility and contraceptive prevalence. It explores the origins and the role of family planning programmes and suggests that they acted as facilitators of the 'mass' transition rather than as the agents that unleashed this process." (SUMMARY IN ENG)

[The cases of China and Brazil]. / Os casos de China e Brasil.

PIP: Demographic developments and family planning in China and Brazil are described and compared. Postrevolutionary China was characterized by initial rapid economic expansion, followed later by recurrent agricultural crises. Abortion and sterilization were strictly forbidden. The mid-twenties was legal minimum age for marrying, thus increasing the work force. In the early 1960s, population control measures were introduced, legalizing sterilization and abortion, a trend reversed, in 1966, by the cultural revolution, which resulted in a baby boom and an enormous proportion of young women, today, in their reproductive ages. Various stages of increased government involvement finally resulted in a 1 family, 1 child policy adopted in 1978, coercing families and individuals to sign a certificate, severely limiting earning potentials and privileges, if having more than 1 child. By the year 2050, if current policies are being enforced, the population is projected to be 917 million. Brazil traditionally has had an intellectual pro-natality movement, due to its vast internal space, low population density and high economic productive capacity. By 1970, however, the economic miracle had passed. Child mortality and health problems became rampant. Democratizing access to contraceptive means and services, and the economic for migration to large empty spaces of the country were emphasized. The state assumed responsibility for providing contraceptive means instead of leaving it in the hands of private agencies. Brazil refuses to recognize simplistic rhetoric blaming population increases for all ills in the developing countries and espouses the position that planning for children, the more positive term for family planning, is a fundamental right of all human beings and should stem from free and informed choice by couples and individuals.^ieng

Seminar on the use of demographic knowledge for population policy formulation in Latin America. Lima, Peru, 14-17 January 1986. An overview.

The author reports on a seminar on the application of demographic knowledge to population policy in Latin America. "In the absence of reliable empirical evidence, the actual objective of the seminar became an exploration, with Brazil, Mexico, Peru and Bolivia as case studies, of questions such as: what applications, what knowledge, what relationships, what emphases, what transmission mechanisms, what communication channels, what investment by public and private agencies are needed to respond to the demand--actual and potential--for demographic knowledge for policy purposes." The seminar brought together not only academics, but parliamentarians, members of international agencies, and other professionals concerned with population issues. The focus of the discussion was on ways and means of improving existing flows of information and of expanding knowledge available for policy purposes.

REALPOP: a mathematical model for resource allocation in population programs-results from a test in the Dominican Republic.

The structure of a computerized mathematical model for resource allocation in population programs (REALPOP) and its application to the Dominican Republic's national family planning program are described. The model integrates demographic and management science approaches in the analysis of resource allocation, program planning, goal evaluation, and growth strategies of a family planning program. It is designed primarily to aid administrative decision-makers. The Dominican National Population and Family Council (NPFC) established a goal of reducing the crude birth rate from its 1968 level of 48 per thousand population to 28 per thousand in 15 years. Further, the program has established a clear set of program plans and alternatives. This study investigates the implication of these plans for the program's stated goals.

Latin American attitudes on birth control: a typology.

PIP: A survey of Honduran elites consisting of 300 government, business, industrial and professional leaders and 400 university students, was undertaken to determine the sources of negative and positive influences on birth control in order to outline a typology of opinions covering the entire range of attidues toward this issue. Major sources of negative influence are the Roman Catholic Church, political parties, and the universities. The support of this issue is also encountered along the entire political spectrum, mainly the centralist and rightist positions, with the most vocal support coming from the Family Planning Association. The paper describes the view of the various groups and then arranges the elite's opinions on birth control into a typology.^ieng