PUTTING COMMUNITY NEEDS FIRST

Item

Title
PUTTING COMMUNITY NEEDS FIRST
extracted text
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No. 223 January 1993

COMMUNITY HEALTH
326. V Main. I Dlook
Korambngala
Bangalore-560034

ISSN 0911-0755

JOICFP NEWS
Putting Community Needs First

African workshop calls for more effective project management to answer grassroots needs

iML I

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E
Participants of the African regional workshop on the IP in Addis Ababa.
“The concept of merging family
planning (FP) and other health service
components is a widely accepted strate­
gy for improving the effectiveness of
FP programs,” said Dr. Abdi Aden
Mohamed, vice minister of health,
Ethiopia. “Integrated projects provide a
system to maximize the use of resources
and to meet the needs of the community
flexibly through the horizontal integra­
tion of institutions, organizations and
groups involved in the same field.”
Officially opening the First African
Regional Workshop on Integrated FP,
Health Education and Parasite Control
Project Management and Evaluationfor
Strategy Development, Abdi commented
that promoting FP in an integrated
package with maternal and child health
(MCH) care and primary health care
(PHC) overcomes obstacles to FP.
Held in Ethiopia from November 23
- 27, the workshop provided participants
with a forum for reviewing project
management and monitoring/evaluation
mechanisms of the Integrated Project
(IP), discussing appropriate monitoring
and evaluation methodology for the IP
and developing strategies and guidelines

for future IP development. The first two
days of the workshop were taken up with
opening remarks and presentations by
officials of the Ethiopian government and
representatives of international organiza­
tions and non-governmental organizations
(NGOs) such as UNFPA, WHO, UNICEF,
IPPF and JOICFP as well as country
presentations by participants. Field trips to
three areas implementing the IP were also
included in the schedule.

effectiveness of integrating MCH/FP
efforts from the point of view of the
health sector as well as the convenience
of the user,” said Dr. Miriam K. Were,
representative, WHO. “I wish to pay
tribute to the promotion of the approach
of IP formulation and implementation
that JOICFP has undertaken across the
world in linking parasite control (PC) to
other practices that promote health and
well-being,” she said. “We are optimistic
of the results this can have on health
development in the countries where this
approach is supported.”

IP Guidelines for Africa

The workshop was organized by the
government of Ethiopia, IP National
Steering Committee, IPPF and JOICFP
and was sponsored by UNFPA. Repre­
sentatives of eight countries were among
the 30 participants of the workshop and
some 100 people were present for the
opening ceremony.
During the meeting, participants
compiled a set of resolutions concerning
project management and evaluation for
strategy development. It was recom­
mended that the objectives and deve­
lopment strategy of the IP be incorporated
into population policies and national FP
programs and that implementation of

Japanese Ambassador

In a show of support for the IP, Japanese
ambassador to Ethiopia, Hisakazu Takase
said that simplistic efforts to promote birth
control are doomed to failure, while the IP
arouses interest within communities and
encourages people to recognize the
importance of limiting childbirth. “The
government of Japan has been closely
involved with JOICFP’s efforts at
implementing the IP and has constantly
supported its associated activities,’’ he said.
“My government will continue with this
cooperation in order to ensure the continued
success and expansion of the project.”
“I believe most of us fully see the cost­

A Namibian participant (left) is
welcomed by members of a family
planning club in Addis Ababa.

I

the IP should take into account the needs
felt by the community people. To make
this a reality, participants urged that the
“The Brief Guidelines for Designing an
Integrated FP, Nutrition and PC Project”
be revised and used as a tool for
monitoring and evaluation. It was also
agreed that project evaluators should be
carefully selected based on their
knowledge of such projects and/or an
understanding of the country situation.
Participants also recommended that the
cost-effectiveness of the IP should not be
calculated merely in terms of FP
acceptance, but should take into account
other benefits for the community.

Chinese Study Teams

Promoting FPfor Health

Dr. Lu Jingxing, deputy director, Family
Planning Commission (FPC) of Fujian
Province, said, “Private organizations
played a major role in the promotion of
high-quality health services on a feecharged basis, successfully gained the
participation of the people and achieved
self-reliance.”
Meanwhile, the November team,
headed by Dr. Zhang Youming, deputy
director, FPC of Hunan Province, mainly
Sharing Experiences
comprised representatives of provinces
where the IP is being implemented.
K midwife in Niigata explains contra­
The field trips took in one urban ceptives and IEC materials to the team. Aimed at deepening understanding of
project area in Addis Ababa and two
the FP/MCH approach of the IP, the
rural project areas in West Shoa District.
The head ofa Chinese study team said study tour included lectures and discus­
In both rural project areas, the head of the that he was impressed with the promotion sions in Tokyo followed by a field trip
farmers’ association, a powerful decision­ offamily planning (FP) in Japan in the to Fukushima Prefecture.
making body, is also the head of the local postwar years as a means to improve
IP steering committee. In Denbella Keffa, maternal and child health (MCH), adding
Many Insights
West Shoa, participants noted that a new that this approach was more effective than
bridge had enhanced transport and using FP as a means to controlpopulation.
The main focus of the study tour was
communications, while construction of Dr. Guo Deming, director, FP Commission the field trip which included observations
safe water sources close to the village ofHubei Province, said that more emphasis of government and NGO activities.
had eased much of the work of local should be placed on the MCH benefits of During time spent in Hobara Town, the
women. The visitors also commented FP in China to make it more appealing to team observed activities of the Prefec­
that the establishment of revolving funds the people. The 10-member team headed tural Health Center in Hobara Town,
for the purchase of medicines had also by Guo was in Japan from October 12-25 preparation of primary school lunches,
enhanced the quality of services and to study FP and MCH activities. The study health checkups for infants conducted by
stimulated support for the project within tour wasfollowed by a visit from a second the Hobara Town Health Center, and the
communities. Not only were the com­ 10-member Chinese study team that was in activities of a private clinic and the
munity health agent and trained tradi­ Japan from November 5 -18.
Fukushima Health Service Association.
tional birth attendant in the village
“After observing health and IEC
health post working on a volunteer basis,
New Project Areas
activities in Japan, I can see that there is
but the people in the communities were
still much to be done to improve
The October team comprised repre­ promotion of the IP at the grassroots in
willing to pay nominal fees for services.
Based on the field observation, par­ sentatives of the State FPC, China FP my township,” said Bai Mingjun,
ticipants offered practical advice and Association and provincial FP commis­ honorary president, FPA, Donganshan,
recommendations to support the Ethi­ sions and associations. Most were drawn Township, Jiupu District, Anshan City,
opian IP, underscoring the success of the from provinces that have just initiated the Liaoning Province. Overall, the team
workshop as a forum for exchange of Integrated Project (IP) in January.
members were impressed with the
The first part of the tour was spent in efficiency of FP/MCH and preventive
experience and information. The work­
shop closed on November 27 with Tokyo where the visitors were given a health promotion in Japan and said that
remarks by Dr. Rogelio Fernandez, broad outline of the concept and strategies they had gained many insights into ways
country director, UNFPA.
[j] of the IP through lectures and discussions to smooth IP promotion in China.
and observed the activities of the Tokyo
Health Service Association and Japan
Family Planning Association (JFPA). The
team then moved on to Niigata Prefecture
where they observed the FP/MCH activi­
ties of local governments and non­
governmental organizations (NGOs). The
field trip took in visits to the Prefectural
Government Office, Niigata Health Service
Association, Niigata Midwives’/Nurses’
Association, Health Center of Shirone City,
a farmer’s house in Shirone, Yahiko Vil­
lage Primary School and the Public Health
The Chinese visitors observe infant
Participants observe a woman getting Center of Shibata.
Commenting on what he had learned, health checkups in Fukushima.
water from a spring in Denbella Keffa.
2

JO1CFP NEWS, January 1993

Aging in Asia

Financial
Security for
the Aged

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•

Seminar participants
compile lessons learned in
population aging
Under the theme of “Financial
Security for Old Age,” nine
representatives of nine countries
gathered in Japan to consider ways of
supporting the elderly, promoting their
self-reliance and enabling them to
contribute to society. Participants
focused on Japan s experiences and
observed activitiesfor the aged during a
field trip to Hiroshima Prefecture. The
seminar also served as an effective fo­
rum for the exchange of information,
experiences and strategies on aging
issues among participants to further
strengthen the collaborative network of
policy planners, program managers and
experts in the region.
The seminar, held from November
18 - December 2, was the first program
of JOICFP’s second regional population
aging project, “Promotion of Awareness
and Policy Formulation on Aging (R AS/

Indonesia Prepares
Dr. Fahmi Saifuddin, assistant to the
coordinating ministerforpeople’s welfare,
Indonesia, was a participant of the aging
seminar. Below is an outline ofa Decem­
ber 1 interview with JOICFP NEWS.
In Indonesia, the family plays a central
role in the care of the elderly since the aged
are cared for primarily through noninstitutional means. In 1992, several laws
were enacted to give more attention to the
elderly. The government also gives
significant support to non-governmental
organizations which assist elderly people.
Japan has been thorough in anticipating
problems concerning the aged. It was
interesting to note that despite Japan’s
advancement as a developed nation with
sophisticated technology, the family still
plays a central role in care for the elderly.
I was also impressed that the central
government had created “Guidelines on
Policy for a Society of Longevity.” The
government of Indonesia is at present
finalizing its policy “Guidelines for the
Welfare of the Elderly.” What I have
learned during the seminar might provide
some input into this process.

Participants observe elderly women making miso in Takamiya Town.
92/P13).” The project was launched in
1992 and is being conducted in the Asian
region with UNFPA support through 1995.
Participants were introduced to policy
and programs for the aged in Japan by
officials of the Japanese government and
experts of population aging. Presentations
focused on the impact of population aging
on Japanese society and issues related to
economic security for the aged. The
highlight of the seminar was the field trip
to Hiroshima Prefecture which included
firsthand observation of some programs
for the elderly. The visitors were also
introduced to the prefecture’s policy and
programs for the aged during a visit to the
Hiroshima Prefectural Government Office.
The visitors showed keen interest in the
Caretaker Training Center and the Silver
Human Resources Center, which offers
work opportunities for the elderly.

Activities for the Aged
The field trip included a visit to
Takamiya Town where 31% of the
population is over the age of 65, which is
the same proportion of aged forecast for
the entire Japanese population in 30 years’
time. Participants visited a production
activity center, where the elderly are
engaged in various production activities
such as miso (soy bean paste), cookie and
dance mask production utilizing locally
available materials, and visited farm houses
in the area where the elderly are taken care
of within an extended family situation.
Through discussions with the families,
participants were made aware of the
important role that the family plays in
supporting the elderly and the impact that
urban drift of younger generations is having
on the rural extended family in Japan.
At the conclusion of the seminar,

JOICFP NEWS, January 1993

O6o

participants emphasized the importance
of providing work opportunities for the
elderly to enable them to remain
productive for as long as possible.
Another point highlighted was the need
for an institutional system to support the
elderly, particularly for rural populations
of developing countries not covered by
government programs. The need to look
into the impact of changing socioecon­
omic conditions on family structure and
how governments can provide support to
families was also emphasized.
[j]

China’s Challenge
Caiwei Xiao, program officer, Foreign
Affairs Office, China National Committee
on Aging (CNCA), took part in the aging
seminar. Below is an outline of a Decem­
ber 1 interview with JOICFP NEWS.
We estimate that by the year 2000, there
will be 130 million people over the age of
60 in China, about 10% of the population.
However, by 2020 the elderly will increase
to 280 million to make up about 19% of the
total population. The government has
established five principles or guidelines
concerning the elderly: they should be
properly supported; they should be cared
for medically; they should contribute to
society; they should be engaged in life­
long learning; and they should have a happy
life. We are now trying to establish and
improve social security systems for the
elderly. The government stresses the role
of the family in the support of the elderly,
but has realized that changes in extended
family will be important in the future.
The topic of financial security is
particularly relevant for China. I was
deeply impressed wit h the activities of the
Silver Human Resources Center and the
way that the elderly are viewed as a rich
resource rather than as a burden.

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India

3

New Animated Film

A Message
for Rural
Women
New animated film in
‘‘Womens Health & Status'
series encourages women to
take initiative
The second film in JOICFP’s ani­ S2
mated “Women's Health & Status” series
was welcomed as a new, interactive edu­
cational material by audiences attending
preliminary showings in Beijing and
Shanghai, China, between December 7
and 10. Commenting on the impact of
“Twin Lotus,” Dr. Peng Yu, vice minister,
State Family Planning Commission, said
she was impressed that the film drew
responses from viewers rather than The main character, a newly married woman, experiences cramps in Twin Lotus.
pressured them to accept ideas. Thefilm
was also praised by the audience for Twin Lotus has no narration and is de­ birth of their first child and use modern
presenting complicated concepts in a signed to be used by instructors to support contraceptives to make this a reality.
simple and appealing manner.
women’s health and development activi­
The film was co-produced by the
Targeted at the East Asian region, ties in the region. A Chinese-language Shanghai studio and a team of technical
Twin Lotus is aimed at motivating wo­ manual is being produced for instructors. experts from Japan. It was co-directed
men to take initiative to protect their Twin Lotus follows the release of My by Hu Jinqing, who pioneered the paper­
own health and play an active role in Way, the first film in the series and a joint cutting animation technique in China,
family planning (FP) decisions. Sched­ Thai-Japanese production aimed at the and Tadahito Mochinaga from Japan. A
uled for release in January, Twin Lotus Southeast Asian region. The third film in former resident of Shanghai, Mochinaga
is a joint Chinese-Japanese production the series is under production in India and helped establish the Shanghai Animation
Film Studio after the Second World War
and is 13 minutes in length.
will target audiences in South Asia.
before returning to Japan where he later
As in previous JOICFP animations,
introduced puppet animation.
Visually Appealing
JOICf'P TVomen's Pteaftfi andStatus Series
Despite its Chinese setting and East
Asian
orientation, much of the content of
A
visually
appealing
film
created
with
_________ A New Animated Film__________
the innovative paper-cutting technique of Twin Lotus will be familiar to women
animation, Twin Lotus features beautiful living in rural communities in developing
images cut and painted by hand by artists countries around the world. Without the
13 min., Color/English, Chinese
working for the Shanghai Animation Film aid of narration, the film clearly expresses
Studio. To create the striking images and universal themes concerning women’s
settings, the artists used a combination of health. The film is being distributed by
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Indian ink and watercolor, a traditional Sakura Motion Picture Co., Ltd.
style of Chinese artwork.
Twin Lotus is set in a typical rural river
district in the southern part of China. For
the people of such areas, the river forms a
A newly-wed couple is just beginning Io live
focal point of life and is a source of water
together in o beautiful riverside district in southern
China. One day the wife collapses from illness
for drinking, cooking and bathing. The
while al work.
problems encountered by the main
Women today must learn about their bodies and
be intent upon maintaining their health so they can
character reflect problems relating to
lead more self-reliant lives.
environmental
sanitation, hygiene and
This film, from the Women's Health and Status
Series, is a Japan-China joint production that uses
health that face village women in daily
an animation technique based on a traditional
life. In Twin Lotus, a newly married wo­
paper-cutting method.
man
is confronted with the threat of serious
Distributed by
illness and seeks advice from a clinic on
Sakura Motion Picture Co., Ltd.
Yoyogi Center Btdg., 57-1 Yoyogi t chome
how to overcome her illness and avoid
Sbibuya-ku, Tokyo 151, Japan
Tel' 81 -3-3320-6311 /Fax. 81-3-3320-7666
future problems. The film also introduces (From left) Tadahito Mochinaga with
Telex: J34799 ITCINBTH
the
issue of FP as both members of the animation director Ge Guiyun and co­
16mm• VTR (Beta, VHS/NTSC, PALSECAM)
I
couple make a joint decision to delay the director Hu Jinqing.

Twin Lotus

4

JOICFPNEWS, January 1993

Viewpoint

Counseling: a Quality of Care Issue
Piotrow says mass media communication and counseling are two sides of same coin
Dr. Phyllis Piotrow, director, Center
for Communication Programs, The Johns
Hopkins University, and secretary,
Population Crisis Committee, was
interviewed by JOICFP NEWS on
November 18. During the interview, she
spoke about Johns Hopkins' EnterEducate Program, which aims to enter­
tain and educate target audiences main­
ly through the mass media, and the role
of counseling in improving quality of
care in family planning (FP) services.
Below is an outline of the interview.
Interpersonal communication and the
mass media are not competitive with one
another — they reinforce each other. In
fact, a lot of what is talked about in
interpersonal communication has to do
with what people have seen or heard
through the mass media. Through entereducate, we would like to see the mass
media working to legitimate a subject for
discussion, to create agendas for
discussion, to introduce new ideas into
the discussion, to reinforce ideas and to
create role models for behavior.
Counseling is really a quality of care
issue. Good interpersonal communica­
tion is where the provider helps the client
to make his/her own decision. In a lot of

countries we found that one reason why successful. We have also done about a
people were not accepting FP was because dozen radio soap operas and another 12
the providers were disagreeable. You or so are under way. As for television
always know whether
serial dramas, we
a doctor has treated
have probably done
Z
you nicely and cared
a total of six.
about you. That is
We have found
what you judge.
that different things
Therefore, the client
appeal in different
judges the quality of
countries. To be
care very much by
effective, you have
the quality of the
to tailor your pro­
communication.
gram to suit the local
According to a study
situation. It is im­
conducted world­
portant to remember
wide by the Popu­
is that no commu­
nication, sex edu­
lation Council, 20%
cation or any kind of
of the clinics provide
Phyllis Piotrow
80% of the services.
marketing is going
One of the big reasons they found why to get 100% of the people to do what you
people chose certain clinics over others want. It is like marketing a product.
was a choice of methods. Another reason Commercial marketers think they have
was word of mouth from satisfied clients succeeded if they get 2-3% more of the
who think they have been treated well.
market. Also, some people have the idea
As for our enter-educate programs, we that you do a communication activity
have carried out some sort of program in once then go on to something else. But
about 30 countries. Some of these are training, supervision, monitoring and
small activities such as the production of providing commodities are continuous
comic books. To date, we have done eight processes. So communication has to be
Q]
major songs of which six were very continuous.

U.S. Population Assistance Directions
Dr. Phyllis Piotrow made courtesy calls
to officials of government and non­
governmental organizations (NGOs)
involved in the population field and was
guest speaker at a number of events held
in Tokyo during her stay from November
13 - 19. On November 18, she gave a
presentation to members of the Council
on Population Education on the outlook
of U.S. population assistance. Below are
highlights of the presentation.
As an informed observer, I predict that
apart from foreign policy crises, foreign
assistance policy will not be the prime
concern on the president’s mind. But I would
not be surprised to see the first moves for
an increase in population assistance
coming from Congress. There are 27 more
members in the new Congress who support
FP and are pro-choice on abortion. These
people will probably also be supportive of
international FP programs. There are more
than 20 new women members and every
one of them is pro-choice and in favor of
FP. There are also six women senators now.
I also predict additional funding for

JOICFP NEWS, January 1993

population activities and see fewer arbitrary
restrictions placed on population assistance
by the executive branch of government. That
means the Mexico City Policy prohibiting
U.S. FP assistance to foreign NGOs which
provide abortion information or services will
probably be repealed soon and restrictions on
funding to UNFPA will be repealed. I predict
more support for programs of NGOs and
special emphasis on profit, social marketing
and commercial organ izations that can develop
sustainable programs. I see a greater emphasis
placed on communication, since people are
recognizing that communication leads the way
to FP and that the mass media bring new ideas
and role models into community norms.
We will also see more attention paid to
improving the quality of services and at the
same time there will be heated debates
among medical professionals about what
constitutes quality services and what
constitutes medical barriers to FP.
I also expect to see closer integration of FP
programs with activities related to women’s
health, child survival, AIDS and sexually
transmitted diseases.

Dr. Phyllis Piotrow (left) met with Deputy
Prime Minister and Foreign Minister Michio
Watanabe on November 18. Noting the
significant level of Japan s official develop­
ment assistance (ODA), Piotrow explained
to Watanabe that Japan still lags behind the
U.S. in its assistance to population activities.
She said that the new Democratic adminis­
tration of the U.S. will most likely show
increased concern for global population is­

sues and would probably welcome the
understanding and collaboration of the
Japanese government on these issues. In
reply, theforeign minister expressed a desire
to see further cooperation between Japan
and the U.S. in the field of population and
said he would also welcome closer ties
among parliamentarians concerned with
population and development.
fj]

OOMMUNiry health
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5

Nepal

Starting
at the
Grassroots
Technical assistance team
pinpoints problems, provides
answers to service provision
A Japanese technical assistance team
took to the mountains of Panchkhal in
Nepal for three days where they visited
six villages implementing the Integrated
Project (IP). A practical troubleshoot­
ing team, the team observed the family
planning (FP), maternal and child health
(MCH) and primary health care (PHC)
activities being conducted through
the community-based PHC units
(CBPHCUs) to determine strengths and
weaknesses of services. Funded by the
Voluntary Deposit for International Aid
(VDIA) scheme, the teamfollowed up its
observations with a two-day special
seminar, held at the IP Panchkhal Field
Office from November 6 -7.

Grassroots Needs

The time spent in the villages provid­
ed the team with insights into service
delivery problems and gave them a
broader understanding of needs at the
grassroots which was reflected in the
contents of the special training. Attend­
ed by health workers from 12 CBPHCUs
in the IP area of Panchkhal, the course
included training on use of equipment,
provision of first aid and how to recognize

I
17:^

Community health workers enjoy a first aid lesson from Fumiko Mukaigawara.
serious health problems and avoid incorrect
practices. The training involved innovative
teaching techniques and required the active
participation of all in attendance.
Accompanied by a JOICFP officer, the
technical assistance team comprised
Takaaki Hara, director, Research and
Study Department, JAPC, and Fumiko
Mukaigawara, a Japanese nurse who spent
over five years in Nepal involved in health
promotion. The team was assisted by
Sabitri Basnet, chief matron, Teaching
Hospital, Tribhuvan University of Kat­
mandu, whose vast experience as a
community health nurse and knowledge of
community healthcare and FP/MCH
provided valuable input into the training.
The funds extended for the technical
assistance team mark the second year for
the Nepal IP to receive VDIA funding.
The first allocation of funds was used to

construct three new CBPHCUs to
effectively establish one such unit in
each of the 15 IP villages. The funds
were also used to purchase basic medical
equipment which is currently being
utilized in the 15 units. The equipment,
mainly provided for MCH care, also
included education material such as the
Magnel Kit for teaching reproductive
health and FP. One of the reasons for the
dispatch of the technical assistance team
was to train community health workers
to utilize medical equipment effectively.
The initial allocation of VDIA funds has
also been utilized to develop an MCH
Handbook and health record cards for
mothers and children to support MCH
care activities. The handbook, a colorful,
visually appealingpublication with many
photos, has been particularly wellreceived by the community people, [j]

Women Focus of New Project

Or
1^. ■

Community health workers observe
a stethoscope demonstration.
6

Much of the groundwork was laid for the
implementation of the newfour-year plan for
the IP during the recent JOICFP mission to
Nepal. Titled “Sustainable Community-based
FP/MCH Project with Special Focus on
Women,” the project is one offour with the
same theme being implemented in Bangla­
desh, Nepal, Laos and the Philippines on a
regional basis by JOICFP. The project is
being executedbyIPPF with UNFPA support.
In preparation for the new project, the
JOICFP mission held discussions on the
selection of the new project areas, objectives
of the project and utilization of locally
available resources with government officials
and representatives of related organizations
such as UNFPA, UNICEF, WHO and local
FP associations. Among those consulted on

the project were senior officials of the
Ministry of Local Development governing
women’s development programs in Nepal
and the chief of the FP/MCH Division. A
meeting was also held with members of
the National IP Steering Committee of
Nepal on the new project and the JOICFP
mission consulted local experts on the
FP/MCH aspects of the project.
Coinciding with the JOICFP mission, a
two-member team made an evaluation of
the achievements of the IP in Nepal from
November 1 - 15. The evaluation team
comprised Jeev Krishna Shrestha, former
senior official, FP/MCH Division, Nepal,
and Dr. Ramesh Adhikari, associate
professor, Child Health, and deputy director,
HLM Center, Institute of Medicine, Nepal.
JOICFP NEWS, January 1993

In the News

Taking It to the Street
AIDS prevention campaigners mark World AIDS Day
Supporters of AIDS-prevention
activities literally took their message to
the streets in Japan in events held
nationwide to mark World AIDS Day on
December 1. Joined by celebrities,
government officials, members ofAIDSprevention groups and the public, the
activities mainly focused on creating
awareness and gaining new supporters
for HIV!AIDS-prevention activities.

Awareness Creation
In Tokyo, the day was marked by a
number of awareness-creation activities
including a symposium organized by the
Education Ministry foreducation officials
and a street campaign organized by the
Health and Welfare Ministry (MOHW).
The rousing show of support marked
a dramatic change from previous years
and demonstrated the recent increase of
awareness ofthe AIDS issue in Japan. In
particular, the latter half of 1992 saw the
launch of massive AIDS awareness
campaigns by the central and local
governments. The campaigns have done
much to reinforce the on-going AIDS-

ii iiifiiii'

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awareness activities of non­
governmental organizations and
community groups.
According to Teishiro
Minami, executive director,
AIDS Action, the change in the
government’s attitude toward
HIV/AIDS has coincided with
the release of official figures at The AIDS Action street march in Tokyo.
the end of 1991 indicating
heterosexual HIV infection exceeding the stimulate action on HIV/AIDS.
HIV-infection rate among homosexuals.
In its September-October survey, the
“The magnitude of the problem was not MOHW identified 98 new HIV/AIDS
recognized prior to the release of the statis­ cases to raise the 1992 total of new cases
tics because it affected the homosexual to 424. Fifty-six of the 98 new cases
community which does not officially exist contracted the disease through hetero­
sexual intercourse. The new figures bring
for the government,” said Minami.
Established in 1989, AIDS Action is the total number of people in Japan
the biggest and most active voluntary suffering from AIDS to 977.
AIDS-prevention group in Japan. To mark
According to estimates of WHO/
World AIDS Day, AIDS Action organized Global Program on AIDS, 10-12 million
a number of activities including a colorful people are infected with HIV worldwide,
march through Tokyo on November 29 a number that will more than triple by
and performances with African dancing. 2000. Responding to this issue, UNFPA
The group has been instrumental in gaining has been strengthening HIV/AIDSsupport for the Red Ribbon International prevention activities, particularly through
movement in Japan, which aims to break education and communication programs,
g]
down prejudice, create awareness and counseling, training and research.

Adolescents & Abortion in the U.S.
Jeannie Rosoff, president, Alan
Guttmacher Institute, spoke with JOICFP
NEWS on November 16 about the issue of
abortion in the U.S.,particularly concerning
the legal situation ofteenagers. Below is an
outline of her interview.
Contraception and abortion for minors
has been a very controversial issue for 20
years. The first reason is basically a religious
or moral one — even though most married
women in the U.S. have had intercourse
before they got married and usually long
before they got married — there is still an
underlying perception among people that
sexual activity before marriage, particularly
for girls, is wrong and should not happen.
This has become more important in recent
years because of the general move toward
more conservative attitudes. The other
reason is more neutral. It is simply the
concern ofparents, either about their daughter
not getting into trouble or about the question
of parental control.
The debate about teenagers and abortion
is really part of the bigger debate about
abortion in general in the U.S. This is a very
violent debate to the point of physical
violence. When abortion was legalized in

JOICFP NEWS, January 1993

1973, the Supreme Court ruling essentially
overturned state laws. At that point, some
states had already liberalized their abortion
laws. But those states that had not liberalized
their laws rebelled and began to pass all sorts of
impossible laws to try to resist the Supreme
Court deci sion. The S upreme Court overturned
these laws one by one — but it took 20 years.

Hot Political Issue
The issue of minors having abortions is
obviously wonderfully emotional and if you
talk about 12-year-old girls having abortions,
you can get the public very excited. In particular,
the debate on the issue of girls having abortions
without their parents’ knowledge has been a
very hot political one because it has everything
— sex outside of marriage, sex by young girls
and abortion as a crime or murder.
At present, the Supreme Court rules that a
state may not give parents an absolute veto over
their minor daughter’s decision to terminate
her pregnancy. It has also held, however, that
a state may require a teenager to obtain the
consent of one or both parents if it provides her
with an alternative of obtaining authorization
from a judge, or in some states, a teacher,

Jeannie Rosoff
minister, or a doctor.
The current rules regarding minors’
decision-making powers are very unusual.
For example, if a pregnant 14-year-old girl
decides to have the baby, her parents do not
have to agree. If she decides to give the baby
away, she does not even have to tell her
parents. Her parents can keep her from having
an abortion, but they cannot keep her from
giving the baby away. The same 14-yearold girl cannot OK the doctor to take her
appendix out, but if she is a mother, she can
give permission for her baby to undergo
brain surgery. It is a very peculiar arrange­
ment that once you become a mother you
have some of the decision-making powers
of an adult — even if you are 12 years old.

7

Voice of Voices

ANNOUNCEMENT

By Chojiro Kunii

IEC Workshop for the Production of Printed Educational Materials for
Preadolescent Women’s Health
Date:
February 6-11, 1993
Venue:
Kuala Lumpur, Malaysia
Organizers: JOICFP and Federation of Family Planning Associations of
Malaysia (FFPAM), supported by UNFPA and IPPF
Objectives: 1) To produce regional prototype printed educational materials for
the promotion of reproductive health among preadolescent
women
2) To share the rich experiences of FFPAM in its promotion of
family life education activities
3) To provide an opportunity for the exchange of experiences with
other Asian experts and organizations
Participating Countries: Bangladesh, Bhutan, China, India, Indonesia, Laos,
Malaysia, Nepal, the Philippines, Sri Lanka, Thailand, Vietnam
Note: Self-funded participants are welcome to attend the seminar. For more
information, please contact JOICFP.

Experiences to Share
Guided by the UN, preparations are
now under way for the International
Conference on Population and Develop­
ment to be held in Egypt in 1994. What
can Japan contribute to this conference?
20-year Struggle

Following its defeat in the Second
World War, Japan struggled for 20 years
to slow its rapid population growth and
overcome related problems such as
poverty, unemployment and lack of
resources. Despite the hardships, the
Japanese people persevered and built
solid foundations for development. As a
result of their efforts, the birthrate was
cut in half and the economic growth rate
doubled, while the quality of life of the
citizens was significantly enhanced. It is
these achievements that have earned
Japan a reputation as a miracle nation.
When I consider the international
situation, I can see that the biggest
problem facing the human race today is
population. It is an issue that confounds
many ofthe world’s greatest minds. Many
of these people feel at a loss when faced
with the magnitude of this problem.
Population Solutions

But Japan managed to solve its
population problems. The solution was
not found by the government enforcing
top-down measures, but rather it was the
result of initiatives taken by the people
themselves who wished to develop and
expand their lives. It was a movement of
the people at the grassroots and was
based on the desires of the communities
in the villages, towns and cities. Within
this movement were initiatives to promote
maternal and child healthcare (including
family planning) and expand preventive
health with health education. Upon such
foundations and in the spirit of selfreliance, the Japanese people established
innovative systems of work and made
great strides in development under the
leadership of the heads of municipalities
and agricultural cooperatives.
Businesses, meanwhile, incorporated
the large population into their work forces
by absorbing inhabitants into their
industrial zones. The Japanese industries
were hence able to develop and expand
in a short period of time and the rural
lifestyle of Japan was dramatically
transformed into one of an industrialized

8

nation. The impact of the Western
education system introduced in the Meiji
period also contributed to Japan’s
industrialization by creating a pool of
people with scientific knowledge.
The experiences of Japan have not
only attracted attention in Asia, but Latin
American and African countries are also
taking a closer look at Japan’s past. [J]

DIARY
Perdita Huston, director, The Global Family
Project, visited JOICFP on Oct. 26 to exchange
information.
*
*
*
JOICFP Program Officer Hiroshi Taniguchi
was in the Philippines and Thailand from Oct.

New Publication
The 45-year history of the Hoken Kaikan
Group is reviewed by JOICFP Chairman
Chojiro Kunii in the English-language
version of “It All Startedfrom Worms—the
45 - Year Record ofJapan ’ s Post- World War
Il National Health and Family Planning
Movement, ” published by the Hoken Kaikan
in December 1992. Featuring essays,
articles, poems and
photos, this volume spans
the years since World
War II and takes in the
cooperative movement
as well as the parasite
control, preventive
health and family
planning activities that
shaped the organizations
of the Hoken Kaikan
since the group's establishment. The book
concludes with a section on new challenges
in the field of population, world peace and
international cooperation. A total of 2,000
copies have been published and are avail­
able from JOICFP.

14 - 28 to gather information for JOICFP’s
quarterly magazine Integration.
*
*
*
JOICFP Program Officer Atsushi Yoshino
was in Guatemala in preparation for the
production of a documentary film on
community development from Oct. 16-28.
*
*
*
Dr. Hirofumi Ando, director, Information
and External Relations Division, UNFPA,
visited JOICFPon Oct. 27 and 28 toexchange
information.

*

*

*

JOICFP Program Officer Sumie Ishii joined
the study mission of the Japan Parliamen­
tarians Federation for Population (JPFP) on
population and development in India from
Oct. 18-25.

*

*

*

JOICFP Deputy Executive Director Yasuo
Ron and Program Officer Ishii were in India
to attend the Expert Group Meeting of Family
Planning, Heath and Family Well-being, held
in Bangalore, India, from Oct. 26 - 30.
*
*
*
Shunichi Inoue, director, Population
Division, Department of International
Economic and Social Affairs, UN, visited
JOICFP on Nov. 4 to exchange infonnation.
*
*
*
Program officers Ishii and Yoshino were in
India from Nov. 1 - 11 in preparation for the
production of the third animated film in the
Women’s Health & Status series. The film
is targeted at countries of South Asia.
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
Hokcn Kaikan Bckkan
1 -1, Sadohara-cho, Ichigaya
Shinjuku-ku, Tokyo 162 Japan
Phone: 81-3-3268-5875
Telex: 2324584 JOICFP J
Cable Address: JOICFP Tokyo
Facsimile: 81-3-3235-7090

JO1CFP NEWS, January 1993
Media
No. 223 JANUARY 1993.pdf

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