JOICFP NEWS N0. 217 JULY 1992

Item

Title
JOICFP NEWS N0. 217 JULY 1992
extracted text
No. 217 July 1992

ISSN 0911-0755

JOICFP NEWS

Chinese Endorse Integrated Approach
China to expand Integrated Project into 10 new provinces in 1993
In a landmark decision, the National emphasis on project self-reliance, Peng community people to take an active part
Steering Committee (NSC) of the said. However, the NSC is seeking an in improving their living conditions and
IntegratedProject(lP) decided to expand increase in external funding to expand the health.
Meanwhile, a national
the project into 10 new provinces
workshop was held in Taicang
in Chinafrom 1993. The decision,
County, Suzhou City, Jiangsu
seen as an endorsement of the
Province, from April 16 - 20 to
project's
community-based
make preparations for baseline
approach to integrated family
surveys to be carried out prior to
planning (FP), maternal and child
initiating the IP in the new
health (MCH) and primary health
provinces. The meeting, attended
care, wasformally announced to a
by a total of 76 participants
JOICFP mission in April. The IP
including 41 representatives of the
has been implemented on a pilot
10 new provinces, included lectures
basis in China since 1984 and has
and presentations by Japanese and
gained considerable support from
Chinese experts and discussions.
people at the grassroots who play
Participants also observed IP
an active role in its promotion.
activities during a field trip in
Under the cunent plan, the IP
Taicang County which has been
will be expanded from the present
implementing the IP since 1984.
six provinces to cover a total of 16
Visits to a village, factory, town­
provinces out of mainland China’s
ship hospital, kindergarten, center
30 provinces. The 10 provinces
for the elderly and homes of farmers
selected for IP expansion are all
were included in the itinerary.
located along or to the south of the
To enable monitoring and
Yangtze River. In the southern part
evaluation of progress in the new
of China, progress in such activities
provinces in the future, participants
as FP promotion, MCH care and
spent much of the workshop
parasite control tends to lag behind
creating a draft format for a base­
the north.
line survey to determine
Dr. Peng Yu, vice minister, State
A mother of Taicang County displays the MCH knowledge, attitude and practice
FP Commission, and chairperson, Handbook she uses to record her child’s health.
(KAP) of FP and the status of other
NSC, told the JOICFP mission that
the people and local governments of the coverage of the IP nationwide in the future, aspects of health and living situations
covered by the IP. Once carried out in
planned project areas fully support the she said.
The innovative approach of the IP has each province, the surveys will yield
project and that the expansion will go
ahead next year regardless of whether won approval with people at the grassroots information on the situation of each
these governments receive an increase in as well as senior officials. One prominent pilot site to enable accurate assessment
external funding. In making its decision advocate of the project is Dr. Y an Renying, of the effectiveness of the project in
[7]
to expand the project, the NSC placed professor, Obstetrics and Gynecology, and the future.
honorary president, Beijing Medical
University; chairperson, Society of
Perinatology,

Dr. Van Renying

Chinese

Medical

Association; representative. National
People’s Congress; and member, NSC of
the IP. During a meeting with the JOICFP
mission, Yan said that she was very
interested in the innovative approach of the
IP which utilizes parasite control activities
to gain the participation of the community
in FP/MCH activities. She remarked that
the IP was effective for encouraging

Dr. Peng Yu

1

Bicycle Scheme

Bicycles
Traveling
New Roads
JOICFP’s bicycle donation
scheme sparks interest at
home and abroad
As people around the world weigh up
the environmental costs offuel-burning
automobiles, increasing attention is being
paid to the cost-effectiveness and
efficiency of non-motorized forms of
transport. One of the most prominent of
these, the bicycle, is the subject of a
JOICFP scheme bringing benefits to the
grassroots in developing countries. The
scheme has recently been highlighted in
a number of publications including the
December 1991 issue of UNFPA’s
POPULI magazine.
To serve the bicycle scheme, local
governments of Tokyo and surrounding
areas established the Municipal
Coordinating Committee for Overseas
Bicycle Assistance (MCCOB A) in 1989.
One of the main objectives of the
committee is to supply reconditioned
bicycles to personnel and volunteers
promoting family planning (FP), maternal
and child health (MCH) and primary

Wheels for TBAs

The donation of reconditioned bicycles
from Japan is mobilizing health agents
to bring FP/ MCH and primary health
care services to communities in the
Integrated Project area in Kapata
Peninsula, Luapula Province, Zambia.
For 20 newly graduated traditional
birth attendants (TBAs) and 22
community-based distributors, the
bicycles offer an efficient, low-cost
means of transport. Each new health
agent received a bicycle along with a
health kit and certificate at their
graduation ceremony held in Kapata
on January 31.

2

Jl
\ Ci
I

r'-

A community worker in West Shoa
District of Ethiopia tries out a bike.

health care at the community level under
the Integrated Project (IP).
The number of bicycles sent abroad
each year has continued to rise since
shipments began in 1988. Also, the scope
of the scheme has been broadened to
support a wider range of activities in
developing countries. Of the 2,850 bi­
cycles to be shipped abroad by MCCOBA
in fiscal 1992 (April 1, 1992 - March 31,
1993), the donation of some 2,000 will
be coordinated by JOICFP.
Support for FP/MCH

Already this year, 150 bicycles have
been sent to Vietnam and 150 have been
shipped to Ethiopia through JOICFP to
assist volunteers, field workers, health
educators, traditional birth attendants,
midwives and members of women’s clubs
in IP areas. A large number of this year’s
donation of bicycles will also be utilized to
support UNFPA’s FP/MCH projects in
countries such as Uganda and Namibia.
In Japan, the scheme has also gained
attention as an effective means of inter­
national cooperation. At MCCOBA’s
first meeting of the fiscal year on April 30,
representatives of the 11 member municipal
governments were joined by observers
from the five other governments. At the
last meeting, the governments of Arakawa
City, Tokyo, and Ageo City, Saitama
Prefecture, joined MCCOBA. The other
member governments are from Bunkyo,
Ota, Nerima, Setagaya, Tama and Toshima
cities of Tokyo, and Kawaguchi, Omiya
and Tokorozawa cities of Saitama.
One of the highlights of the meeting
was an address by Katsuhide Kitatani,
deputy executive director, UNFPA, who
emphasized the importance of local
government involvement in international
cooperation. During his stay in Japan,
Kitatani also visited the Mayor Saburo

IwanamiofNerimaCity. Iwanami heads
the Nationwide Association of Bike
Affairs, an organization that has been set
up to tackle problems concerning bicycles
in Japan. The association has a total
membership of 184 local governments,
including the member governments of
MCCOBA. During discussions with
Kitatani, the mayor expressed interest in
future collaboration with international
agencies and non-governmental
organizations such as JOICFP.
The bicycle scheme also recently
received a welcome boost from the Japan
Bicycle Promotion Institute, a body
supervised by the Ministry of
International Trade and Industry (MITI).
The institute pledged ¥20 million
(US$ 155,000 at an exchange rate of¥ 129
to US$1) to help cover the costs of
shipment of the bicycles in 1992. As
shipment costs pose the biggest hurdle
to the scheme, the donation will do much
to ensure that the bikes reach the people
in developing countries.
[J]

Kitatani’s Comments
Below are highlights of Kitatani’s
address to MCCOBA on April 30.
The nation ofJapan is both a collection
ofindividuals anda collection ofmunicipal
governments. When these individuals and
localgovernments express opinions toward
foreign assistance they will be reflected in
the nation’s
aid policies.
Therefore, it is
vitally
important that
individuals
and local
-J
governments
have a clear
idea of how
Japan should
provide aid.
Katsuhide Kitatani
The time
has come for Japan to create a more
substantial aid scheme with which to meet
the challenges of the 21st century. It is in
Japan’s own interests to extend support to
developing countries because their
prosperity will determine its survival.
Bicycles and sewing machines donated
by Japan have an enormous positive impact
on the lives of the people when they are
donated to developing countries. For
example, in some countries where access
to cars is limited, gasoline is expensive
and road conditions are very poor, people
are forced to rely on foot power. When
TBAs and public health nurses receive
bicycles, their productivity immediately
increases two- to three-fold. To me, this is
an example of assistance that genuinely
answers the needs of the recipients.

I

JO1CFP NEWS, July 1992

New Documentary

Building a Bridge to a New Future
JOICFP film depicts struggle of women in Vietnam to improve community health and living conditions
Despite the many years that have
passed since the end ofthe Vietnam War,
the small rural Tan Buu Commune in
Long An Province still has no bridge to
replace the one that was destroyed by
bombs in the war. The river, which must
be crossed by community people by
boat, remains an obstacle to the
development of the commune. For the
women of Tan Buu who work as
community volunteers, however, the
hardship ofriver travel does little to dull
their enthusiasm. Driven by a shared
desire to improve the health and living
conditions oftheirfellow villagers, these
volunteers willingly navigate the currents
of the river in small boats to promote
family planning (FP), maternal and child
health (MCH), primary health care and
environmental sanitation among the
people in nearby areas.
The determination of the women of
Tan Buu is one of the main focuses of
JOICFP’s new documentary film The
Awaking Kowloon - Village Women in
Vietnam. Filmed on location in the
commune, the movie depicts the daily
struggle of the women volunteers to
promote community health and welfare
and documents the development of a
grassroots movement to construct a new
bridge and build a better future for the
whole community. Two of the main
characters of the film are women who
work as health volunteers in the village,
CaoThiXinhandLeThiBa. By featuring
the activities of these women, the film
highlights the role that women of
Vietnam have continued to play as a
driving force for change at the grassroots.
The 17th movie in a series of JOICFP
documentaries filmed on location in 10
countries, the latest film carries a new

I; M

Income generation in Tan Buu.
JOICFP NEWS, July 1992

The head of the women's union takes a boat with community people.

message and is aimed at slightly different
target groups than previous movies. The
film is targeted at audiences both in Japan
and Vietnam and is available in Vietnam­
ese- and Japanese-language versions.

Japanese Audiences
In Japan, the film will be used in
JOICFP’s domestic campaign to create
awareness of such issues as population and
development in developing countries. The
process of rebuilding a community through
communal efforts will be familiar to many
people in Japan where grassroots
movements did much to improve the health
and living conditions of the people in the
postwar years. Meanwhile, in Vietnam the
film will be used to promote community
participation in activities such as FP/MCH,
primary health care and environmental
sanitation. A standard 16mm film, The
Awaking Kowloon - Village Women in
Vietnam runs for 30 minutes and captures
the way of life in Vietnam with extremely
vivid footage of Tan Buu and its people.
Tan Buu in Long An Province is one of
nine pilot communes where JOICFP’s
Integrated Project (IP) has been
implemented at the grassroots since 1989.
Based on the achievements of these
communes, the project was expanded to
cover a total of 70 communes. According
to Dr. Pham Cong Dung, director, Long
An Community Health Center, the
commitment of the women volunteers has

been the key to the success of the project
in Tan Buu. Drawn from the wellestablished local women’s union, the
volunteers have worked as health agents
to disseminate health messages and
provide services throughout the com­
munity. The contribution of these women
to the project was also noted by Dr. Le
Dai Tri, head, Health Education Unit,
Long An Community Health Center, who
said that though Tan Buu is one of the
poorest communes in the province, its
volunteers are among the most active.
Perhaps the most important aspect of
the volunteers’ work captured by the film
is the deep sense of community spirit
shared by the women. When asked by
the JOICFP production team for her
reasons for being a volunteer, Xinh
replied: ‘Tn Tan Buu, we all share an
equal burden of poverty. That’s why we
work together and help each other.” [T]

A new bridge for the commune.

3

Japan

Population
Assistance High
on the Agenda
The Japanese government further
strengthened its support to international
population and family planning (FP)
activities by approving a contribution of
US$59.30 million to UNFPA in fiscal
1992 (April 1,1992 - March 31,1993).
The contribution, US$2.50 million or
4.4% higher than the previous year’s,
was approved by the Diet (parliament) in
its fiscal 1992 budget. With its
contribution, Japan will remain the
biggest donor to UNFPA, the world’s
largest multilateral agency providing
population assistance.
Japan has continued to increase its
contribution to UNFPA since it first began
providing assistance to the Fund in 1971
with adonationof US$1.5 million. Japan
began assisting population and FP
activities in 1969 with an initial
contribution to IPPF. The IPPF still
receives a portion of the funds contri­
buted each year by Japan to UNFPA.
The amount to be allocated to IPPF out of
this year’s contribution has not yet been
decided, but it will be higher than the
US$15.1 million it received in 1991.
Japan remains committed to assisting

Increasing Support
Contributions of the Japanese government to UNFPA
in millions of U.S. dollars.
x
59-30
56.80^^.

4

55.78

50
42.91

population acti­
vities around the
30
world and viewsits
contributions as an
23.50
effective means by
which to help
10
developing coun­
tries overcome
health and social
7.Q!
J992
welfare problems.
1.5a
While providing
support through
multilateral chan­
1971
nels, Japan is also
Source: Ministry of Foreign Affairs
assisting countries
to tackle their popu­
lation problems through bilateral channels and Turkey. In addition, JICA is also
such as technical assistance. Japan’s sponsor for two international FP seminars
bilateral assistance provided through the held in Japan this year for which JOICFP
Japan International Cooperation Agency is serving as the implementing agency.
(JICA) to population and FP activities will
Awareness of the importance of
also increase to ¥1.164 billion (US$9.02 addressing international population
million at an exchange rate of ¥129 to problems continues to grow among the
public and government of Japan. The
US$1), up 5.7% from fiscal 1991.
In fiscal 1992, nine countries will be further increase in Japan’s multilateral
recipients of technical cooperation through and bilateral support underscores the
JICA: Egypt, Indonesia, Kenya, Mexico, commitment of the country to solving
|T]
Peru, the Philippines, Sri Lanka, Thailand these issues.

Russian Women
Take Action
The International Women’s Center
“Women’s Future” was established in
Russia last year as a non-governmental
organization (NGO) geared to promoting
the development and health of women and
children. With external assistance from
Planned Parenthood Federation ofAmerica
(PPFA), the center launched a five-year
project called the “Russia - 01 —Women’s
Health through Family Planning" in
January this year. The center’s president,
Dr. Alexandra Momdjian, spoke with
JOICFP officers on May 20 about issues
concerning women in Russia. Below is an
outline of her comments.
The present situation in Russia is
unbearable. The number of induced
abortions annually outnumbers live births
and our abortion rate is 10 times higher than
the European average. To change this
situation, we must overcome such obstacles
as the lack of quality contraceptives and the
absence of a service network.

60

Dr. Alexandra Momdjian
The main aim of our program is to ensure
freedom of choice in family planning (FP).
Every woman must know everything about the
method of contraception she uses. She must
have access to qualified FP consultation
services. She must also have constant access to
contraceptives. The children she has must be

the result of her choice and must be healthy.
When it is impossible for her to avoid having
an abortion, she should have the option of
safe abortion services.
Through our activities we aim to
contribute to the development of women
and improve the health of women and their
families by providing FP. The health and
social problems that presently confront
women in Russia are so serious that we must
approach women without waiting for them
to come to us for help.
The first obstacle to the promotion of
maternal and child health and FP in Russia
is the lack of a nationwide FP network and
the social services to put our strategy into
practice. Another major problem is that of
production facilities. Russia has no facilities
for producing high-quality contraceptives.
There is also no well-organized national
system for sex education, especially for
teenagers. Among the activities planned for
next year is an adolescent health program
that would entail counseling for school
children. We share similar problems in
adolescent sexuality with the U.S. and Japan.
Our purpose for visiting Japan, the U.S. and
Mexico is to talk with people directly
involved in FP.
JOICFP NEWS, July 1992

Japan

Concern for
a Graying
Nation
KAP survey finds women
concerned with low birthrate;
uncommitted on authorization
of low-dose pill
A greater proportion of women in
Japan are showing concern for the
continued decline in the nation s
birthrate, according to the results of a
knowledge, attitude and practice (KAP)
survey onfamily planning (FP) conducted
in March. The survey found 75.3% of
women are concerned about the falling
total fertility rate (TFR), which reached
an all-time low of 1.54 in 1990. The
previous such poll, conducted in June
1990 after Japan recorded a TFR ofl .57
in 1989, found 70.8% of women were
concerned about the rate. Despite the
continuing low TFR, the largest number
of respondents (45.7%) said that they
thought three was still the most ideal
number of children.
Conducted by the Mainichi Shimbun
Population Problems Research Council
in cooperation with JOICFP, the Japan
Family Planning Association and Family
Planning Federation of Japan, the 21st
National Survey on Family Planning was
carried out from March 27 - 29 and
includes the opinions of 2,389 married
couples between the ages of 16 and 50.
This year marks the first time that the
opinions of men were sought in the
survey. In principle, the survey is
conducted every two years.
Increasing Pessimism

The increase in pessimism among
respondents reflects the growing attention
being paid by the government, media and
public to the falling birthrate and
increasing elderly population. According
to the poll, most people cited a fear that
society would lose its vitality as the first
reason for concern, with higher costs of
supporting the elderly population cited
as the second concern. In general, men
were more optimistic about the issue
than women.
Despite the increase in concern,
56.8% of the male respondents and
60.9% of the female respondents replied
that government intervention to increase

JOICFP NEWS, July 1992

Japan's TFR was 1.54 in 1990, but most couples consider three children ideal.

births was undesirable. However, the
proportion of women in favor of some
form of government action increased
significantly from 17.7% (1990) to 34.0%.
The survey was carried out shortly
after the Yomiuri Shimbun newspaper
announced on March 11 that the
government was indefinitely delaying the
release of the low-dose contraceptive pill
on the market in Japan as an AIDS
prevention measure. In response to a
question on the issue, 18.8% of those who
opposed the pill agreed to its ban to halt
the spread of the disease.

Oral Contraceptives
The majority of women respondents,
however, were noncommittal on the
question of the pill’s authorization, a result
that indicates a lack of availability of
information on the matter. Asked for
opinions on moves to approve the pill,
57.1% of the women were neither for nor
against, while 22.7% gave positive replies
and 20.2% were against authorization. In
the 1990 survey, 49.8% were uncommitted,
28.9% were for authorization and 21.3%
gave negative replies. Of those against
authorization in this year’s survey, Gl.’1%
cited side effects as the reason, down
slightly from the 70.3% of 1990. Only
6.9% of female respondents polled said
they would take the low-dose pill if it
were authorized, down from 10.5%.
The official number of induced
abortions carried out in Japan in 1990 was
457,000 compared to 1.24 million live
births. When asked for opinions on
abortion, the great majority of female
respondents were in favor with 26.2%
giving full approval and 56.6% giving
approval under certain conditions. As for
the practice of FP, 64.0% of the wives said
they practice some form of FP; 17.0% said

that they do not practice FP at present,
but have in the past; 15.1% replied that
they had never practiced FP and 4.0%
gave no reply.
For the first time since it was launched
in 1950, the survey included opinions on
Japan’s international responsibilities,
specifically in the field of international
cooperation in population activities. On
whether Japan’s experiences, as a nation
that achieved a demographic transition,
should be shared with developing
countries, the largest number of
respondents were in favor: 45.0% of
women and 47.6% of men. Respondents
who replied that population issues were
internal matters of each country and not
the concern of Japan amounted to 20.9%
for women and 25.2% for men.
[T]

Chinese MCH Handbook
A new Chinese-language version of the
Maternal and Child Health (MCH)
Handbook was published by JOICFP in
April. A personal health record for
pregnant women and mothers, the
handbook has been utilizedfor some years
in areas in China where JOICFP's
Integrated Project
(IP) is being
implemented. The
booklet is modeled
on the Japanese
MCH Handbook
which is credited
with having done
much io improve
MCH in the
postwar years.
Carried by the mother, the booklet serves
as a convenient and continuous record of
the health of the pregnant woman and
child for both the mother and medical
staff. For the new Chinese handbook,
several modifications were made to
improve effectiveness.
5

People

Changing Tack on Population
Singapore encourages births ahead of dramatic increases in elderly
Dr. Paul P. L. Cheung, chief
statistician, and director, Population
Planning Unit, Singapore, spoke with
JOICFP NEWS on May 26 about
population issues in Singapore and other
parts of Asia. JOICFP is conducting a
four-year regional project on aging in
Asia with the support of UNFPA. Below
is an outline of the interview.
According to the 1990 Census, the
total population of Singapore is about 3
million. The aged group—defined as 60
years and over — is about 9%, but is
increasing. The test will be in 10 to 15
years’ time when the baby boom cohorts
hit old age. The best thing for us to do is
maintain a proper age structural balance,
keeping the elderly population at 20%.
In caring for the elderly, we emphasize
individual and family responsibility.
Under the Central Provident Fund
scheme, we are all obliged to save for our
own financial security in the future. Part
of this fund is channeled into a special
account to pay for medical care. The
fund is quite well administered and is a
good model for a small country such as
Singapore. People are also encouraged
to maintain a healthy lifestyle and
generally to take responsibility for
themselves in their old age.
The age pyramid is shrinking at the

base because of the past population policies.
Singapore was very well-known in the
past for its antinatalist policy and its
disincentives to control population. But
the policy was too successful in the 1960s
and early 1970s. By 1975 we had already
dropped to below replacement fertility.
Since 1987, our policy has been pronatalist,
but we have found that it is not easy to
encourage people to have more babies.

Rising Singles Population
The cause of Singapore’s population
problems is really that people are marrying
late or not getting married at all — and the
proportion is getting higher. We now
expect 15 to 20% of all women to remain
single. For university graduates, the
proportion is as high as one-third.
In some newly industrializing countries
of Asia, women’s status has gone up
tremendously. However, traditional
attitudes toward marriage have not
changed, or have not changed fast enough.
Men still prefer to marry someone more
submissive and less educated. On the
other hand, well-educated women prefer
to marry someone of their equal, if not
more qualified.
In general, it is far easier to control
births than it is to increase them. Once

FP Goals
for Mexico
Dr. Arturo Zarate Trevino, director
general, Family Planning Bureau, Ministry
ofHealth, Mexico, spoke to JOICFP officers
on May 26 and 27 about the Mexican
government's family planning (FP) goals.
Below is an outline of his comments.
Maternal and child health (MCH) care
is promoted in Mexico as part of family
planning (FP). It is our belief that if pro­
grams focus on MCH rather than FP, the
FP program tends to be neglected as the
bulk of government and private resources
get channeled into MCH care.
One of the main goals of our FP program
is to reach people in rural areas. We are
trying to do this in each community through
a nurse and a volunteer. The volunteer is
selected from among the women of the
community and taught to promote FP and
provide child care, prenatal care, postnatal
care, vaccinations and treatment of diarrhea

6

Dr. Arturo Zarate Trevino

as a whole program. We integrate MCH with
FP at the primary level in the promotion of
health. For this program, person-to-person
communication is very important.
Reaching adolescents is another goal
because this group represents in 20% of the
Mexican population. We are very much
concerned with unplanned pregnancies and
sexually transmitted diseases (STDs). So we
have to approach this huge population with sex
education — counseling on contraceptive
methods.
Another goal is to reach women through

Dr. Paul P. L. Cheung

people have the means to control fertility
at their disposal, it is really a matter of
their own preference to have another
baby or not.
Despite the country’s pronatalist
policy, there is a need not to ignore the
concept and the methods of family
planning (FP). We still want people to
plan their families and the government
still subsidizes FP, but the contraceptive
prevalence rate is dropping a little. At
present, the two most popular methods
are the condom and sterilization.
Singapore is nothing more than a
demographic forerunner of other deve­
lopingcountries in Asia. We are small so
the effects are felt quicker. If countries
have a prolonged period of fertility be­
low replacement level then they should
start thinking about action.
[j]

our post-partum program. We are
establishing post-partum programs at all
clinics dealing with deliveries so that at least
60% of the women that have just given birth
or had a natural abortion leave hospital as
an acceptor of FP. The main contraceptives
are tubal ligation, IUDs and the pill.
The success of FP will depend to a great
degree on the participation of men in the
programs. We recognize that it is very
important to change traditional male atti­
tudes (machismo) in Mexico and promote
the norm of a small family to men. For this
reason, we have placed importance on
strengthening our education and motivation
activities aimed at men.
Japan’s MCH program is one of the best
in the world. It is excellent because it is
incorporated into services at the municipal
level. Around 98.5% of deliveries in Japan
are attended by physicians and pregnant
women get very good information and
follow-up services. There is also a very
large service network for pre-term deliveries
and low-birth-weight babies. We would like
to imitate some aspects of Japan’s system of
organization.
JOICFP NEWS, July 1992

FP/MCH

Flowers
for Mothers

Taking an Active Part
FP seminar participants learn through energetic involvement

IPPFIWHR dramatizes 500,000
annual maternal deaths with
ceremony at UN

I

J

Health volunteers of Suzaka in the aprons that have become their trademark.
Participants of this year’s Seminar
on Community-based Family Planning
Strategy were expected to do more than
listen to presentations by experts. Rather,
all 11 representatives were required to
take an active part by participating in
four panel discussions, exchanging
information and experiences and creating
their own IEC materials on the
community-based healthcare activities
ofSuzaka City, Nagano Prefecture. Held
in Japan from May 18 - June 12, the
seminar was sponsored by the Japan
International Cooperation Agency
(J1CA) and organized by JOICFP. It was
attended by representatives of
Bangladesh, Brazil, Egypt, Indonesia,
Kenya, Malaysia, Mexico, Nepal, Peru,
Sri Lanka and Vietnam.
For participants, one of the most
valuable aspects of the seminar was the
time spent in Suzaka City learning about
the extremely successful community­
based healthcare system set in place in
the postwar years. Inspired by a

Ohba speaks to a local woman.

JOICFP NEWS, July 1992

pioneering public health nurse Miyoshi
Ohba, the system of health volunteers was
established to supplement the activities of
the public health nurses engaged in such
areas as maternal and child health (MCH)
care and FP.
Still in place today, SHPA (Suzaka
Health Promoters Association) comprises
volunteers drawn from the community who
promote preventive healthcare under the
concept of “Protecting one’s health by
one’s own hands”. One of the most
important roles of these volunteers is to
explain to the community about govern­
ment health checkups and cooperate with
public health nurses. By being in close
contact with the community and public
health personnel and officials of the local
government, these volunteers also function
as an effective information and
communication pipeline between the
community and the local authority.
During the field trip, participants
learned much about the effectiveness of
involving the community in healthcare
through discussions with officials, public
health personnel, volunteers and FP/MCH
pioneers including Ohba, who currently
serves as the standing director of the Japan
Nursing Association. Based on the
knowledge gained through these dis­
cussions and observations of such activities
as mass children’s checkups, home visits
and school health activities, the partici­
pants collaborated on an IEC material to
be used in their home countries. The result
of their efforts was an informative text on
community-based preventive healthcare
in Suzaka to accompany a series of color­
ful slides.
[J]

Ina unique ceremony, the IPPF/Western
Hemisphere Region (IPPFIWHR) displayed
500,000 carnations on the North Lawn of the
UN Headquarters in New York on May 8 in
memory of the 500,000 women who die each
yearfrom pregnancy and childbirth. Endorsed
by leading health and development agencies
and attended by prominent individuals
including legislators and diplomats, the event
dramatized the sheer magnitude of maternal
mortality — equivalent to a jumbo jet full of
women crashing every four hours every day
— and the need to prevent these deaths
through such means asfamily planning (FP).
The ceremony, held two days before
Mother’s Day, was organized by IPPF/WHR
to increase public awareness of maternal
mortality and morbidity and women’s
reproductive health and FP needs. One of the
activities launched by IPPF/WHR under the
Safe Motherhood Initiative, the event drew
attention to the effective role that FP can play
in preventing maternal deaths.

Maternal Deaths
Some 99% of maternal deaths occur in
developing countries. Family planning is the
simplest, most cost-effective way to prevent
such deaths, since most cases occur as a result
of unwanted, unplanned pregnancies.
Currently, over 300 million couples want, but
have no access to FP services. Obstetric first
aid, prenatal care and training for birth
attendants and health personnel are also
critical to reducing to maternal deaths.
The Safe Motherhood Initiative was
launched in 1987. Under this initiative, IPPF/
WHR is committed to promoting the
expansion of FP services; developing FP and
reproductive health education programs;
calling for increased financial support for FP
programs; promoting the participation of
institutions in FP programs; and mobilizing
communities and women themselves in the
planning and implementation of policies,
programs and projects.
5

I

I

Celebrities lay flowers at the UN.
7

Voice of Voices
By Chojiro Kunii

Community Participation
Without positive community
participation, all project approaches and
plans will result in nothing. How do we
solicit such participation?
Human beings are essentially selfish
creatures. Before accepting the concept
of a project, they will first consider
whether they will benefit or lose from it.
Prior to the start of any project,
consideration should be first given to
this basic human characteristic.
By sheer chance, I got involved in
parasite control (PC) activities just after
the end of the war. My experiences
taught me many things. One is that
people suffering from parasite infection
accept parasite control willingly and
with much enthusiasm. This is simply
because deworming relieves their pain
and makes them feel better. Moreover,
this kind of good news travels quickly
among the people. I therefore built on
this experience and began to use PC as an
entry point for the introduction of other
health-related activities for the deve­
lopment of communities.
What steps should follow de­
worming? After gaining the confidence
of the community, simple steps should
be taken to improve water and sanitation,
to relieve children’s abdominal pains,
and to promote immunization and family
planning (FP). The methods and
technologies are simple and, naturally,
our work should always begin by gaining
the full and voluntary support of the
people.
The preventive health activities of
Japan started from humble beginnings.
They were not initiated in expensive
facilities and based on complicated
technology. The key to their success was
to first gain the determined voluntary
support of the people. The commitment
of the people was won by sparking
concern for the health of the masses with
parasite control.
In much the same way, FP was
launched in Japan out of a common desire
among people to reduce the number of
induced abortions. It was the concern of
people that began this movement, not a
government decree.
This concern for women’s health took
the concept of a mass health movement
to Taiwan and Korea in the form of the
Integrated Project (IP). The IP has
continued to spread around the world and
is currently being implemented in 24
countries.
[J]

8

DIARY

New Publication

JOICFP Program Officer Hiroshi Taniguchi
was in Indonesia from Apr. 22 - May 8 to gather
information for Integration magazine.
*
*
*
Finlay Craig, director, Asia Training Center
on Aging, Help Age International, visited
JOICFP on May 8 to exchange information.
*
*
*
Zhou Ke Qin, director/general manager/film
director, Shanghai Yilmei Animation Co., Ltd.,
and Tadahito Mochinaga, freelance animator,
visited JOICFP on May 11 to exchange
information on the production of an animated
film.
*
*
*
Two representatives of the International
Women’s Center—“Women’s Future”, Russia,
Dr. Alexandra Momdjian, president, and Dr.
Natalya Grigorieva, director, Training and
Education Program, visited JOICFP on May 20
to exchange information.
*
*
*
From May 9 - 20, JOICFP Program Officer
Sumie Ishii was in Bhutan to attend the final
tripartite meeting of the IP, in Nepal to monitor
IP and VDIA activities and in Thailand to
coordinate the development of EC materials.
*
*
*
Dr. Paul P. L. Cheung, chief statistician,
Department of Statistics, Singapore, visited
JOICFP on May 26 to exchange information.
*
*
*
Dr. Arturo Zarate Trevino, director general,
Family Planning Bureau, Ministry of Health,
Mexico, visited JOICFP on May 26 to ex­
change information.

As part ofthe UNFPA -supported
project, “Creation ofAwareness on
Aging for Policy Making Purposes
in the Asian Region”, a report was
recently
published on
the workshop
. . .. .
held in Bang­
kok from July
15 - 22, 1991
_____ under thejoint
auspices of
JOICFP and
ESCAP.
Titled “Population Aging in Asia”,
the report covers the meeting, aimed
at creating greater awareness among
planners and policy makers ofmajor
issues ofpopulation aging.

Japan to Probe
Surge in Singles

Despite the many years that have passed
since the end of the Vietnam War, the people of
Tan Buu Commune still have no bridge to
replace the one that was destroyed in a bombing
raid. Each day, children cross the river by boat
to go to school along with women volunteers
who promote family planning and maternal and
child health among the community people.
The Awaking Kowloon — Village Women in
Vietnam documents the struggle of the Tan
Buu people to rebuild their bridge and the vital
role that women play as agents of change.

The Institute of Population Problems,
Ministry of Health and Welfare, will
conduct a national survey in July to
determine the reasons for the dramatic
increase in the number of unmarried
people in Japan.
According to the 1990 National
Census, the percentage of Japanese
that have never married has increased
significantly over the last 15 years. The
survey found that 40.2% of women and
64.4% of men in their late 20s (25 - 29)
were single in 1990, up from the 20.9%
of women and 48.3% of men of the same
age group that were not married in 1975.
The Census, carried out by the
Statistics Bureau of the Management
and Coordination Agency, found
increases in the proportion of single
men in the over-30s age groups
particularly remarkable. In the 30 - 34
age group, the percentage of single men
more than doubled from 14.3% in 1975
to 32.6% in 1990. Meanwhile, in the 35
- 39 age group, the proportion of single
men more than tripled from 6.1% in 1975
to 19.0% in 1990.

fORULATlON MEINS IN ASIA

I

JOICFP DOCUMENTARY SERIES
NEW DOCUMENTARY FILM

The Awaking Kowloon
Village Women in Vietnam
30 min., color/Vietnamese, Japanese

Distributed by

Sakura Motion Picture Co., Ltd
STANDARD BLDG., 22-1, NISHI-SHINJUKU 1-CHOME
SHINJUKU-KU. TOKYO 160, JAPAN TEL: 03-3342-5768
Cable:'SAKURA MOVIES TOKYO"/Telex:J34799 ITCINBTH

16min/VrR (Beta, VHS/NTSC, PAI., SF.CAM)

|

JOICFP NEWS is a monthly newsletter
published by the Japanese Organization for
International Cooperation in Family Planning,
Inc. (JOICFP).
JOICFP NEWS welcomes your comments,
suggestions and contributions. Please mail to:
JOICFP NEWS
Hoken Kaikan Bckkan
1 -1, Sadohara-cho, Ichigaya
Shinjuku-ku, Tokyo 162 Japan

Phone: Tokyo 3268-5875
Telex: 2324584 JOICFP J
Cable Address: JOICFP Tokyo
Facsimile: Tokyo 3235-7090
JOICFPNEWS, July 1992
Media
NO. 217 JULY 1992.pdf

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