This article reviews the grim statistics of the worldwide AIDS epidemic and the worldwide tragedy of maternal mortality. It stresses that as much effort should be put into eliminating maternal mortality as has been put into eliminating AIDS. The perception that maternal mortality is natural and inevitable is hindering the introduction of modern contraceptives into some countries. AIDS makes men risk their lives for sex in the way that women have done throughout history and prehistory: AIDS is turning men into women when it comes to mortality statistics. Hopefully, this new situation will bring a new maturity to the public understanding of important public health issues, especially maternal mortality. The world as a whole must give more thought than it has in the past to the largely invisible plague of maternal mortality. In responding to AIDS and to maternal mortality, people must be helped to change their age-old patterns of sexual behavior and use contraceptives. By making men risk their lives for sex in the way that women always have, AIDS has the potential to make everyone more rational, more humane, and more concerned about fellow human beings.
The promotion of family planning and birth control in Pacific countries is often frustrated by traditional and religious beliefs, if not deterred by tremendous funding and logistics problems. In the central Pacific republic of the Marshall Islands, however, youthful health workers are taking a unique approach to health promotion that has spurred acceptance of the once controversial subjects of family planning and birth control. A group known as Youth to Youth in Health is spearheading a family planning outreach drive in the schools and community in the Marshall Islands. Coupling health presentations with traditional island music and dance to produce lively health shows, the group's programs on family planning, birth control, nutrition, and cancer have struck a responsive chord in a culture known for its religious and traditional conservatism. The group makes creative use of puppet shows, skits, health songs, and pantomimes, interspersed with contemporary renditions of Marshall Islands music and traditional dances. These have rekindled pride in their culture among the group and sparked a sense of urgency about the need to improve health conditions in the islands. As evidence of the group's impact, family planning staff point to a nearly 4-fold rise in the number of youth clients under 19 years since the Youth to Youth started in mid-1986. Their combination of traditional custom with family planning and other health information has proved to be an innovative and needed program for the islands.
Improvements in health care, particularly among families, enhance the quality of life. Evidence is presented comparing economic and social indicators of development for selected countries. The paper begins by tracing how the concept of basic needs for reasonable living standards has gradually expanded. Next, the history of family planning throughout the world is explained as is its importance to family health. This is followed by an examination of the interactions between fertility and quality of life, and how sustaining high fertility in developing countries adversely affects the quality of life in 2 ways: maternal/child health and socioeconomic development. Finally, it is stressed that for quality of life to improve through these programs, efficient management of the programs is a necessity.
Mexico,s family planning programs have been directed towards women of childbearing age. However, Mexico's family planning movement is now mature enough to set more ambitious goals. This paper deals exclusively with the programs for young people. MEXFAM's basic strategy has been to create, not a separate structure, but rather a movement that infiltrates all the other youth organizations. In general terms, the objectives of MEXFAM's young people's movement are to promote knowledgeable participants among those who do not have sexual relations yet, obtain active users of birth control among those who already have sexual relations, and retard the 1st pregnancy until after the woman is 20 years old. For a better chance to reach these goals, the young people's movement is using a series of untraditional methods so as to avoid the authoritarian options dictated by adult criteria. One of these educational mediums that awaken the consciousness and sense of responsibility in the youth is the video. MEXFAM's youth films are directed to different aspects of sexuality. "Dream of Reality" and "With Hands in the Pockets," deal with adolescent pregnancy; "Like Buddies" with parent-child relationships; "Escape," with drug addiction and sexual responsibility, and "The Last Train" with myths and taboos that go with 1st sexual relations. 4 of these films were produced with the help of JOICFP. 5 films planned for this year are on: the adolescent mother and communication with her own mother, communication in the adolescent couple, prostitution, the media and sexuality, and contagious sexual illness.
Social development communication activities are competing with all of the other communication activities for the attention of the audience. The Johns Hopkins University/Population Communication Services (JHU/PCS) strongly believes that one of the best ways to get the attention of a designated audience, and to keep it, is to entertain the audience and educate it at the same time. They call this concept enter-educate. The basic precepts of this approach include: 1) Choose the most appropriate medium to reach the intended audience; 2) Enlist professionals experienced in the chosen medium in order to have access to the best available resources; 3) Develop a high-quality product that will attract the commercial sector; 4) Use a medium which has a big regional or national audience; and 5) Make the program appealing by including entertainment elements appropriate for the intended audience and not obviously preachy. The most successful project that JHU/PCS has supported that incorporated the concept of enter-educate is the Communication for Young People project in Latin America, better known as the Tatiana and Johnny project. This project used popular music, and its spin offs, to reach young people in 11 Spanish-speaking countries with a sexual responsibility message. Other successful projects in Nigeria and Mali are also described. Nigeria used television shows with family planning skits; in Mali the traditional Koteba theatrical format was made into films for short cinema showings before the main feature.
