Reproductive Health Interventions

Report of a Meeting

John G. Haaga, Amy O. Tsui, and Judith Wasserheit, editors

Panel on Reproductive Health

Committee on Population

Commission on Behavioral and Social Sciences and Education

National Research Council

NATIONAL ACADEMY PRESS
Washington, D.C.
1996



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Reproductive Health Interventions: Report of a Meeting Reproductive Health Interventions Report of a Meeting John G. Haaga, Amy O. Tsui, and Judith Wasserheit, editors Panel on Reproductive Health Committee on Population Commission on Behavioral and Social Sciences and Education National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1996

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Reproductive Health Interventions: Report of a Meeting NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Harold Liebowitz is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Harold Liebowitz are chairman and vice chairman, respectively, of the National Research Council. This activity was funded by a cooperative agreement with the Office of Population of the U.S. Agency for International Development, and by grants from the Andrew F. Mellon Foundation and the William and Flora Hewlett Foundation. Additional copies of this report are available from: Committee on Population National Research Council 2101 Constitution Avenue N.W. Washington, D.C. 20418 Printed in the United States of America Copyright 1996 by the National Academy of Sciences. All rights reserved.

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Reproductive Health Interventions: Report of a Meeting PANEL ON REPRODUCTIVE HEALTH AMY O. TSUI (Cochair), Carolina Population Center, University of North Carolina, Chapel Hill JUDITH WASSERHEIT (Cochair), Centers for Disease Control and Prevention, Atlanta ALAKA M. BASU, Division of Nutritional Sciences, Cornell University JOSÉ-LUIS BOBADILLA, The World Bank, Washington, D.C. WILLARD CATES, JR., Family Health International, Research Triangle Park, North Carolina CHRISTOPHER J. ELIAS, The Population Council, Bangkok, Thailand MARGE KOBLINSKY, John Snow, Inc., Arlington, Virginia PIERRE MERCENIER, Institute of Tropical Medicine, Antwerp, Belgium MARK MONTGOMERY, The Population Council, New York SUSAN E. PICK, Instituto Mexicano de Investigacion de Familia y Poblacion (IMIFP), Mexico City ALLAN ROSENFIELD, School of Public Health, Columbia University HELEN SAXENIAN, The World Bank, Washington, D.C. JAMES TRUSSELL, Office of Population Research, Princeton University HUDA ZURAYK, The Population Council, Cairo, Egypt JOHN G. HAAGA, Study Director CAROLE JOLLY, Study Director (until November 1994) JOEL A. ROSENQUIST, Project Assistant JOYCE WALZ, Administrative Associate

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Reproductive Health Interventions: Report of a Meeting COMMITTEE ON POPULATION RONALD D. LEE (Chair), Department of Demography, University of California, Berkeley CAROLINE H. BLEDSOE, Department of Anthropology, Northwestern University JOSÉ-LUIS BOBADILLA, The World Bank, Washington, D.C. JOHN BONGAARTS, The Population Council, New York JOHN B. CASTERLINE, The Population Council, New York LINDA G. MARTIN, RAND, Santa Monica, California ROBERT A. MOFFITT, Department of Economics, Brown University MARK R. MONTGOMERY, Department of Economics, State University of New York, Stony Brook ANNE R. PEBLEY, RAND, Santa Monica, California RONALD R. RINDFUSS, Department of Sociology, University of North Carolina, Chapel Hill JAMES P. SMITH, RAND, Santa Monica, California BETH SOLDO, Department of Demography, Georgetown University MARTA TIENDA, Population Research Center, University of Chicago AMY O. TSUI, Carolina Population Center, University of North Carolina, Chapel Hill JOHN G. HAAGA, Director BARNEY COHEN, Program Officer TRISH DeFRISCO, Senior Project Assistant BARRY EDMONSTON, Senior Program Officer KAREN A. FOOTE, Program Officer JOEL A. ROSENQUIST, Project Assistant JOYCE WALZ, Administrative Associate

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Reproductive Health Interventions: Report of a Meeting PARTICIPANTS MEETING ON REPRODUCTIVE HEALTH INTERVENTIONS SIGRID ANDERSON, U.S. Agency for International Development SUE ANTHONY, U.S. Agency for International Development ALAKA M. BASU, Cornell University RHONA BIRRELL WEISEN, World Health Organization (Geneva) JOSÉ-LUIS BOBADILLA, The World Bank JEANINE BUZY, U.S. Agency for International Development WILLARD CATES, JR., Family Health International ROBERT CLAY, U.S. Agency for International Development PETER COWLEY, The World Bank BARBARA CRANE, U.S. Agency for International Development CAROL DABBS, U.S. Agency for International Development NILS DAULAIRE, U.S. Agency for International Development PAUL DELAY, U.S. Agency for International Development CHRISTOPHER J. ELIAS, The Population Council (Thailand) BARBARA FERINGA, U.S. Agency for International Development PHYLLIS GESTRIN, U.S. Agency for International Development CATHERINE GORDON, U.S. Agency for International Development JOHN HAAGA, National Research Council DEBRA HAFFNER, Sexuality Information and Education Council of the United States (SIECUS) LORI HEISE, Pacific Institute for Women's Health MARGARET HEMPEL, The Ford Foundation JOYCE HOLFELD, U.S. Agency for International Development JANE HUGHES, The Rockefeller Foundation JODI JACOBSON, Pacific Institute for Women's Health BARBARA JANOWITZ, Family Health International CATE JOHNSON, U.S. Agency for International Development SANDRA MOSTAFA KABIR, Bangladesh Women's Health Coalition LAWRENCE KINCAID, Population Communication Services, Johns Hopkins University DOUGLAS KIRBY, ETR Associates MARGE KOBLINSKY, John Snow, Inc. DAWN LIBERI, U.S. Agency for International Development ASHLEY MADDOX, U.S. Agency for International Development ELIZABETH MAGUIRE, U.S. Agency for International Development CAROLYN MAKINSON, The Andrew W. Mellon Foundation PIERRE MERCENIER, Institute of Tropical Medicine (Antwerp, Belgium) LISA MESSERSMITH, U.S. Agency for International Development FAITH MITCHELL, National Research Council

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Reproductive Health Interventions: Report of a Meeting MICHELE MOLONEY, U.S. Agency for International Development MARK MONTGOMERY, The Population Council (New York) MARJORIE MUECKE, The Ford Foundation MARGARET NEUSE, U.S. Agency for International Development DAVID OOT, U.S. Agency for International Development BONNIE PEDERSEN, U.S. Agency for International Development SUSAN E. PICK, Instituto Mexicano de Investigacion de Familia y Poblacion (IMIFP) (Mexico City) WILLA PRESSMAN, U.S. Agency for International Development ESTELLE QUAIN, U.S. Agency for International Development ELIZABETH RALSTON, U.S. Agency for International Development CAROL RICE, U.S. Agency for International Development ALLAN ROSENFIELD, Columbia University School of Public Health JOEL ROSENQUIST, National Research Council MARTHA SACCOCIO, International Women's Health Coalition HELEN SAXENIAN, The World Bank WILLIAM SCHELLSTEDE, Family Health International JAMES SHELTON, U.S. Agency for International Development RUTH SIMMONS, University of Michigan WILLIAM SMITH, Academy for Educational Development MARY ELLEN STANTON, U.S. Agency for International Development KRISTA STEWART, U.S. Agency for International Development WAYNE STINSON, University Research Corporation BARBARA TORREY, National Research Council JAMES TRUSSELL, Princeton University AMY TSUI, University of North Carolina at Chapel Hill JOYCE WALZ, National Research Council JUDITH WASSERHEIT, Centers for Disease Control and Prevention ANNE WILSON, U.S. Agency for International Development BEVERLY WINIKOFF, Population Council (New York) BARBARA DE ZALDUONDO, U.S. Agency for International Development HUDA ZURAYK, The Population Council (Egypt)