Using data from India\'s first National Family Health Survey (NFHS-1), this study examines breast-feeding practices and their effect on infant mortality in India. Conducted in 1992-93, NFHS-1 collected complete birth histories from a probability sample of 89,777 ever-married women aged 13-49 years. In the study, the breast-feeding status of infants at ages 2,7, and 11 months and the effects of exclusive and nonexclusive breast-feeding on mortality at ages 1-14 months were estimated using logistic regression models to NFHS-1 data. Separate analyses focus on three groups of states, distinguished according to levels of infant mortality, namely, high-mortality states, medium mortality states, and low-mortality states. Results show that breast-feeding reduces mortality in the first few months of life. The beneficial effects extend to older infants when combined with supplemental foods. At the same time, the results indicate that the effect of breast-feeding in lowering infant mortality is smaller the higher the level of mortality. The beneficial effects of both exclusive and nonexclusive breast-feeding are weakest in states where infant mortality is high and strongest in the medium-mortality states. Findings suggest that educational programs that promote breast-feeding with supplementation could help lower infant mortality in India.

According to the UN High Commissioner for Refugees, there are approximately 40 million refugees and other internally displaced people worldwide, with the overwhelming majority coming from and still living in developed countries. 80% of all refugees are estimated to be women and children. Many refugees spend months and even years in what are designed to be temporary settings where efforts are made to accommodate their basic needs such as food, clean water, shelter, security, and primary health care during emergency situations. Women refugees, however, have certain unique needs beyond what traditionally have been considered basic in relief programs. Many women in developing countries suffer considerable health risks during the best of times due to their poverty or low social status. When fleeing conflict or natural disaster, their health status is at even higher risk of being compromised by severe living conditions and the complete absence of reproductive health services. The recognition that women refugees often face serious and sometimes life-threatening reproductive health-related situations led to the development of a field manual on reproductive health for use at the local level. Planned for publication in late 1998 or early 1999, the guide will describe the goals of a minimum array of reproductive health services in the early phase of an emergency and provide direct guidance on care relating to sexual violence, STDs, family planning, adolescents\' needs, and other reproductive health concerns such as female genital mutilation and treatment for septic and incomplete abortion. The manual has garnered worldwide attention and support, as well as scrutiny by abortion opponents in the US, in particular New Jersey Republican Representative Chris Smith.

The 1996 publication of \"The Guidelines for Comprehensive Sexuality Education in Nigeria,\" a result of collaboration between SIECUS and Nigerian organizations, is a major step toward incorporating sex education into current reproductive health and population initiatives. A National Task Force of 20 key Nigerian agencies and institutions working in the area of adolescent health, education, and development prepared the document with technical assistance from SIECUS. Days before the document\'s public release, a workshop was held for members of the mass media to increase their understanding of adolescent reproductive and sexual health in Nigeria. 70% of males and 50% of females attending secondary school are sexually active before the age of 20 years; by the time they leave school, one out of every five Nigerian girls has terminated an unwanted pregnancy. The Guidelines seek to help Nigerian youth to acquire knowledge and develop responsible behavior to reduce high rates of unwanted pregnancy, complications from unsafe abortion, sexually transmitted diseases, and acquired immunodeficiency syndrome.

This article, written by the Head of the department responsible for preparing the 1999 Russian census, first summarizes current demographic trends in the country. The main emphasis is on initiating a debate on methodological issues concerning the upcoming census, particularly on topics such as migration, households and families, ethnic and national groups, age and sex composition, and labor force activities. The paper is followed by a discussion of these topics (pp. 24-30). (SUMMARY IN ENG)

India\'s guidelines for voluntary sterilization from the Ministry of Health and Family Welfare, March 18, 1986 to all Health Secretaries of States contains the following for vasectomy and tubal ligation: the following important guidelines should determine the eligibility of persons undergoing sterilization: 1) the age of the husband should not ordinarily be less than 25 years; 2) the age of the wife should not be less than 20 years nor more than 45 years; 3) if the couple has 2 or more living children, the lower limit of age for the husband and wife may be relaxed at the discretion of the operating surgeon; 4) sterilization services may be provided to couples with at least 2 living children irrespective of the age of the second child; 5) as a general rule, very old and very young persons should not be sterilized unless there are other reasons justifying such an operation, in case of old people the age of the wife should be one of the considerations for performing the operation; and 6) before selecting a person for a sterilization operation, the operating surgeon must interview the person to assess if the person concerned is suffering from psychiatric instability and is fully convinced and motivated about getting the operation performed. The application form is to be signed by the Medical Officer who will state the age of the applicant by their appearance. These instructions may be given wide publicity.

The OSHA (Occupational Safety and Health Administration) issued new lead exposure standards which were effective February 1979. The policy provides that workers in childbearing years should receive protected earnings and benefits for 18 months while temporarily removed from their regular job to one with less lead exposure. Excessive lead exposure can reduce sex drive, cause impotence and sterility in men, and cause reduced fertility and menstrual disorders in women. Children of exposed parents may have birth defects, mental retardation, or die in their first year.

This document, developed by the Panel on Clinical Practices for Treatment of HIV Infection, contains recommendations for the clinical use of antiretroviral agents in the treatment of HIV-infected adults and adolescents. The recommendations are presented in the context of and with references to the Principles of Therapy. However, these recommendations are not intended to substitute for the judgement of a physician who is expert in the care of HIV-infected individuals. For every recommendation, there is an accompanying letter, which signifies the strength of the recommendation, based on the opinion of the panel. There is also a roman numeral rating which reflects the nature of the evidence from this recommendation. This document addresses: 1) the use of testing for plasma HIV ribonucleic acid levels (viral load) and CD4+ T cell count; 2) considerations for initiating therapy in asymptomatic HIV patient; 3) special considerations for therapy in patient with advanced stage disease; 4) interruption of therapy and considerations for changing therapy and available therapeutic options; 5) the treatment of acute HIV infection; and 6) considerations for antiretroviral therapy in pregnant women.

Population organizations have a particular interest in adolescents\' reproductive health, with emphasis on the prevention of early pregnancy. It is essential that information, education, and communication (IEC) and service personnel have a clear picture of the persons most affected by them. 1) The group that is easiest to identify is made up of adolescents who are in school. One obvious way to reach them is through the school system. This particular group may be subdivided again, into those who are at risk of early pregnancy and those who are not. Adolescents who are in school and at risk of pregnancy will need special attention. In addition to class work, individual counseling may have an impact. Appropriate school personnel and peer counsellors will be needed in order to enhance communication with adolescents who need guidance. Also, health services should provide contraceptives, sexually transmitted diseases/HIV and other reproductive-related screening and treatment as well as prenatal care for those adolescents who are pregnant. 2) A second major subgrouping is made up of married adolescents. The health risks associated with young maternal age are present whether or not the young mother is married. 3) Those couples who are living together without a marriage license pose a more formidable challenge than the other two groups because they are less easy to identify. Outreach workers can also work with couples in union, especially difficult-to-reach unmarried, out-of-school adolescents. 4) Others sexually active may be students and street children. Each of these four main categories of adolescents offers an entry point for IEC. Two types of data are needed: one to give an overview of the number of births to adolescents and/or ages-specific fertility rate; the second, to physically locate the individuals/couples in need of attention through clinic records, community surveys, or censuses.

In April, 1994, at UN headquarters in New York, delegates from almost 200 countries and nongovernmental organizations (NGOs) negotiated a Programme of Action to be ratified following more debate at the International Conference on Population and Development in Cairo in September. A sizable consensus emerged for this Preparatory Committee III (PrepCom) meeting. It has an expanded view of population policy that centers more on meeting individual needs and less on achieving strict demographic goals. Thus, it focuses on the unmet need for reproductive health services (family planning, basic women\'s health care, and services linked to sexually transmitted diseases). It considers women\'s status and female education as being important themselves as well as key determinants of fertility rates. Disagreement over access to abortion services and reproductive health services for adolescents remain. Unlike earlier world conferences, most of the world is working towards a consensus, while the Vatican and just a few small countries (Benin, Malta, Honduras, and Nicaragua) object to these services. Some topics that US National Conference of Catholic Bishops did not want in the Programme of Action were references to reducing the incidence of unsafe abortion, promoting condom use to prevent HIV/AIDS, and even safe motherhood. The US and Japan have committed sizable increases in population assistance. Some European countries are concerned about how their contributions would be allocated. US Undersecretary for Global Affairs and a mostly female 23-member US delegation attended PrepCom III. Most of the US delegates were from NGOs. Many country delegates were women. Many countries accepted recommendations of the women\'s caucus. The US\'s priorities are promotion of universal access to the full range of high quality family planning and reproductive health services; increasing women\'s status; child survival promotion; serving adolescent needs; augmenting the role and responsibility of men in reproductive health; strengthening the family; and sustainable development.

This paper presents elements of the growing governmental and organizational consensus that population issues are at the heard of sustainable development. An integrated approach to population and resources is urgently needed. This approach would comprehensively consider population dynamics and not simply fertility. Radical change in approach, policy, and decision making processes are needed to effect such an approach, as are a better understanding of relevant science, strengthened political commitment, and additional financial support. Governments and organizations also agree that population targets should be consistent with national development goals and that the role and status of women are at the center of population and environment strategies. Overall, a participatory approach and national capacity building are the two major ingredients of efficient population/environment activities.