• 제목/요약/키워드: Live birth

검색결과 210건 처리시간 0.03초

Comparison of mild ovarian stimulation with conventional ovarian stimulation in poor responders

  • Yoo, Ji-Hee;Cha, Sun-Hwa;Park, Chan-Woo;Kim, Jin-Young;Yang, Kwang-Moon;Song, In-Ok;Koong, Mi-Kyoung;Kang, Inn-Soo;Kim, Hye-Ok
    • Clinical and Experimental Reproductive Medicine
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    • 제38권3호
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    • pp.159-163
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    • 2011
  • Objective: To compare the IVF outcomes of mild ovarian stimulation with conventional ovarian stimulation in poor responders. Methods: From 2004 to 2009, 389 IVF cycles in 285 women showed poor responses (defined as either a basal FSH level ${\geq}$12 mIU/mL, or the number of retrieved oocytes ${\leq}$3, or serum $E_2$ level on hCG day <500 pg/mL) were analyzed, retrospectively. In total, 119 cycles with mild ovarian stimulation (m-IVF) and 270 cycles with conventional ovarian stimulation (c-IVF) were included. Both groups were divided based on their age, into groups over and under 37 years old. Results: The m-IVF group was lower than the c-IVF group in the duration of stimulation, total doses of gonadotropins used, serum $E_2$ level on hCG day, the number of retrieved oocytes, and the number of mature oocytes. However, there was no significant difference in the number of good embryos, the number of transferred embryos, the cancellation rate, or the clinical pregnancy rate. In the m-IVF group over 37 years old, the clinical pregnancy rate and live birth rate were higher when compared with the c-IVF group, but this result was not statistically significant. Conclusion: In poor responder groups, mild ovarian stimulation is more cost effective and patient friendly than conventional IVF. Therefore, we suggest that mild ovarian stimulation could be considered for poor responders over 37 years old.

Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study

  • Han, Ae-Ra;Kim, Hye-Ok;Cha, Sun-Wha;Park, Chan-Woo;Kim, Jin-Yeong;Yang, Kwang-Moon;Song, In-Ok;Koong, Mi-Kyoung;Kan, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • 제38권2호
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    • pp.103-108
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    • 2011
  • Objective: To investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups. Methods: Women with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese PCOS group, obese-PCOS group, non-obese tubal factor group, and obese tubal factor group, with obesity defined by a body mass index over 25 kg/$m^2$, and reviewed focusing on the basal characteristics, ART outcomes, and adverse pregnancy outcomes. Results: There was no difference among the groups' the clinical pregnancy rate or live birth rate. Regarding adverse pregnancy outcomes, the miscarriage rate, multiple pregnancy rate, and prevalence of preterm delivery and pregnancy induced hypertension were not different among the four groups. The incidence of small for gestational age infant was higher in the PCOS groups than the tubal factor groups ($p$ <0.02). On the other hand, the morbidity of gestational diabetes mellitus (GDM) was not high in the non-obese PCOS group but was in the obese groups. And in the obese PCOS group, the newborns were heavier than in the other groups ($p$ <0.02). Conclusion: Non-obese PCOS presents many differences compared with obese PCOS, not only in the IVF-parameters but also in the morbidity of adverse pregnancy outcomes, especially in GDM and fetal macrosomia.

Effect of luteal phase support with vaginal progesterone on pregnancy outcomes in natural frozen embryo transfer cycles: A meta-analysis

  • Seol, Aeran;Shim, Yoo Jin;Kim, Sung Woo;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • 제47권2호
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    • pp.147-152
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    • 2020
  • Objective: The purpose of this study was to determine the effect of vaginal progesterone for luteal phase support (LPS) on the clinical pregnancy rate (CPR) in natural frozen embryo transfer (FET) cycles via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) and retrospective studies that met our selection criteria. Four online databases (PubMed, Embase, Medline, and the Cochrane Library) were searched between January 2017 and May 2017. Studies were selected according to predefined inclusion criteria and meta-analyzed using R software version 2.14.2. The main outcome measure was CPR. Results: A total of 18 studies were reviewed and assessed for eligibility. One RCT (n = 435) and three retrospective studies (n = 3,033) met the selection criteria. In a meta-analysis of the selected studies, we found no significant difference in the CPR (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.60-1.55) between the vaginal progesterone and control groups. An analysis of the two retrospective cohort studies that reported the live birth rate (LBR) following FET showed a significantly higher LBR in the vaginal progesterone group (OR, 1.72; 95% CI, 1.21-2.46). A subgroup meta-analysis of FET conducted 5 days after injection of human chorionic gonadotropin showed no significant differences between the two groups with regard to the CPR (OR, 1.18; 95% CI, 0.90-1.55) or miscarriage rate (OR, 0.73; 95% CI, 0.36-1.47). Conclusion: The results of this meta-analysis of the currently available literature suggest that LPS with vaginal progesterone in natural FET cycles does not improve the CPR.

인구자질과 태생기.주산기.영아기 사망에 관한 연구: 제1보-태생기 생명현상의 수량적 분석 (A Study on Fetal and Infant Mortality in Association with Population Quality: Report 1-Quantitative Analysis on Fetal Life)

  • 김정근;이승욱;이주열;김무채
    • 한국인구학
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    • 제19권2호
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    • pp.47-76
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    • 1996
  • 이 논문은 인구자질정책을 전개하는 데 필요한 기초적인 정보를 제공하기 위하여 실시된 임신추적조사의 결과이다. 경기도 가평군 전지역을 대상으로 1993년 11월 3일부터 1995년 12월 31일까지 유배우 여성이 경험한 모든 임신을 추적조사하여 임신경과와 그 결과를 관찰하였다. 조사기간중 782건의 임신이 관찰되었는데, 이중 642건은 최종 임신종결 형태가 확인되었으며 140건은 전출 및 조사종료에 따라 관찰이 중단되었다. 본 연구에서는 임신추적조사 자료로 태생기 생명표를 작성하여 그 생명현상을 분석하였다. 태생기 생명표에 따른 임신종결확률은 출생률 53.5%, 태아사망률 14.5%, 인공유산율 32.0%로 전임신기간을 통해서 46.5%의 임신손모가 있었으며, 태아주령에 따른 임신종결확률의 곡선모양은 인공유산율과 태아사망률 모두 L형을 나타내었다. 한편 인위적으로 임신을 중단시키는 인공유산을 제외했을 경우의 태아사망확률은 21.9%였다. 본 연구의 결과에 따르면 임신 초기에 태아사망이나 인공유산과 같은 임신손모에 의해 태생기의 생명이 상당히 손실되고 있는 것으로 나타났다. 따라서 임신손모를 방지하기 위한 대책이 이루어져야 할 것이다.

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Comparison and analysis on sheep meat quality and flavor under pasture-based fattening contrast to intensive pasture-based feeding system

  • Zhang, Zhichao;Wang, Xiaoqi;Jin, Yan;Zhao, Kai;Duan, Ziyuan
    • Animal Bioscience
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    • 제35권7호
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    • pp.1069-1079
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    • 2022
  • Objective: The objective of this study was to investigate the effect of 4-month intensive feeding on the meat quality, fatty acid profile, flavor, and growth performance of grazing Hulunbuir sheep (HBS). Methods: The HBS were selected 4-months after birth in a pasture rearing system as the experimental animals (n = 44, female, average body weight 23.8±2.2 kg) then divided equally into pasture-based grazing fattening (PAS) and concentrate-included intensive fattening (CON) groups for another 4-month finishing. When finished fattening, all animals were slaughtered to collect musculus longissimus dorsi subcutaneous adipose tissue and to investigate the influences on meat quality, fatty acid profile, flavor and growth performance. Results: The results showed lambs in CON group got significantly higher live weight, hot carcass weight, and dressing percentage. The CON group had significantly higher value of redness (a*), lightness (L*) and water holding capacity (p<0.05), significantly lower value of Warner-Bratzler shear force than the PAS group (p<0.05). The subcutaneous fat from CON group lambs demonstrated a significantly higher content of C18:1 and C18:2 (p<0.05), but lower C14:0 and C16:0, indicating an increased degree of unsaturated fatty acid. The content of 4-methyloctanoic acid, 4-ethyloctanoic acid and 4-methylnonanoic acid had increased 2 to 4 times, representing a more intense odor in the CON group. However, the values were still lower than most sheep breeds reported, indicating the indoor feeding system could not fundamentally deteriorate the excellent meat characteristic of HBS. Conclusion: It was evident that lambs in CON group exhibited a better meat production performance, improved in meat color, texture and healthier fatty acid profile through pasture-weaned concentrate included intensive fattening system, which offers a good alternative regimen for lamb finishing and has a wide prospection in the HBS meat industry.

Effect of Saccharomyces cerevisiae boulardii on sows' farrowing duration and reproductive performance, and weanling piglets' performance and IgG concentration

  • Sun, Haiqing;de Laguna, Fernando Bravo;Wang, Shuai;Liu, Fengju;Shi, Liang;Jian, Haidi;Hu, Xiaoxia;Qin, Peng;Tan, Jiajian
    • Journal of Animal Science and Technology
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    • 제64권1호
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    • pp.10-22
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    • 2022
  • We studied the effects of Saccharomyces cerevisiae boulardii CNCM I-1079 (LSB) supplemented to lactating sows on reproductive traits and farrowing duration and to piglets from day 7 of life on post-weaning performance and IgG concentration. Ninety-six Landrace × Yorkshire sows started the trial 5 days before the expected farrowing date. Sows were distributed into 2 groups according to parity number and backfat thickness: control (CON: regular lactation diet) and LSB (CON + LSB at 2 × 109 colony forming units [CFU]/kg of feed). Seven days after birth, litters were randomly selected from each group and supplemented creep feed with or without LSB at 2 × 109 CFU/kg. At weaning, piglets from CON sows were shifted to a commercial farm and allocated to 14 pens in groups of 25 piglets/pen according to the creep feed supplemented during lactation. Piglets followed a 3-phase feeding program: creep, pre-starter and starter, with or without LSB at 2 × 109 CFU/kg LSB in creep and pre-starter, and 1 × 109 CFU/kg LSB in starter. The piglets were vaccinated against classical swine fever on days 41 and 72 of life. One day before each vaccination and at the end of the trial, blood samples were collected from 15 randomly selected piglets per treatment and assessed for total IgG. Supplemented sows with non-supplemented litters displayed the lowest backfat thickness loss during lactation (p < 0.05). The LSB supplementation shortened farrowing duration (p < 0.05) and increased feed intake (p < 0.05) during the first week of lactation. The LSB-fed piglets were heavier at the end of creep (p < 0.05), pre-starter (p < 0.05), and the trial (p < 0.05); grew faster during creep (p < 0.05), starter (p < 0.05), and overall (p < 0.05); and displayed an improved feed conversion ratio during creep (p < 0.05). Total IgG content was higher at days 40 (p < 0.05) and 71 (p < 0.05) in LSB-fed piglets. We conclude that supplementing sows with Saccharomyces cerevisiae boulardii CNCM I-1079 from late gestation until weaning shortens farrowing duration, increases feed intake, and minimizes backfat losses during lactation. When supplemented to piglet diet, post-weaning performance is improved. This improvement observed could be linked to a better immune status, as suggested by the higher IgG.

The Role of Innovative Activities in Training Students Using Computer Technologies

  • Minenok, Antonina;Donets, Ihor;Telychko, Tetiana;Hud, Hanna;Smoliak, Pavlo;Kurchatova, Angelika;Kuchai, Tetiana
    • International Journal of Computer Science & Network Security
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    • 제22권8호
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    • pp.105-112
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    • 2022
  • Innovation is considered as an implemented innovation in education - in the content, methods, techniques and forms of educational activity and personality education (methods, technologies), in the content and forms of organizing the management of the educational system, as well as in the organizational structure of educational institutions, in the means of training and education and in approaches to social services in education, distance and multimedia learning, which significantly increases the quality, efficiency and effectiveness of the educational process. The classification of currently known pedagogical technologies that are most often used in practice is shown. The basis of the innovative activity of a modern teacher is the formation of an innovative program-methodical complex in the discipline. Along with programmatic and content provision of disciplines, the use of informational tools and their didactic properties comes first. It combines technical capabilities - computer and video technology with live communication between the lecturer and the audience. In pedagogical innovation, the principles reflecting specific laws and regularities of the implementation of innovative processes are singled out. All principles are elements of a complex system of organization and management of innovative activities in the field of education and training. They closely interact with each other, which enhances the effect of each of them due to the synergistic effect. To improve innovative activities in the training of students, today computer technologies are widely used in pedagogy as a science, as well as directly in the practice of the pedagogical process. They have gained the most popularity in such activities as distance learning, online learning, assistance in the education management system, development of programs and virtual textbooks in various subjects, searching for information on the network for the educational process, computer testing of students' knowledge, creation of electronic libraries, formation of a unified scientific electronic environment, publication of virtual magazines and newspapers on pedagogical topics, teleconferences, expansion of international cooperation in the field of Internet education. The article considers computer technologies as the main building material for the entire society. In the modern world, there is a need to prepare a person for life in a multimedia environment. This process should be started as early as possible, because the child's contact with the media is present almost from the moment of his birth.

지역사회거주 비혼모의 기업가정신 (Entrepreneurship) 경험에 관한 연구 : 모성권과 노동권을 중심으로 (A Study on the Entrepreneurship Experience of Unmarried Mothers Living in Community : Focusing on Maternity Rights and Labor Rights)

  • 강라현
    • 가족자원경영과 정책
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    • 제27권4호
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    • pp.1-17
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    • 2023
  • 본 연구는 창업에 성공한 지역사회거주 비혼모들의 기업가정신 경험에 관한 연구이다. 연구자는 지역사회에 거주하며 자녀 출산, 양육과 직업 활동을 병행하고 있는 비혼모 5인의 모성권과 노동권을 중심으로 살펴보았다. 연구 참여자들과의 일대일 심층면담을 바탕으로 수집된 자료를 Colaizzi(1978)가 제안한 기술적 현상학적 방법으로 분석하였다. 자료 분석 결과 53개의 주제와, 10개의 주제결집이 드러났다. 자료 분석 결과를 바탕으로 임신갈등 극복, 창업의 계기, 창업 성공 경험의 범주에 재배열하여 기술하였다. 본 연구의 주제결집은 '생명단절의 압력', '축복받지 못한 생명을 떠맡음', '낙인과 기회의 박탈', '기본 생활 유지 불안과의 동고동락(同苦同樂)', '인생 제로(Zero)그라운드에서의 시작', '일과 양육, 줄다리기', '지원보다는 나의 능력에 의지', '신용 자본의 획득', '동반 성장 철학', '벼랑 끝에서 만난 무한 가능성'으로 나타났다. 본 연구의 연구 참여자들은 자신과 자녀의 생존을 위해 긍정심리자본을 기반으로 창업을 시도한 결과 사회적 자본이 드러났으며 동반성장을 도모하고 있었다. 연구 결과를 바탕으로 동반 성장의 윤리와 레질리언스에 대한 논의를 하였다.

"삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석 (Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$)

  • 신순식;최환수
    • 제3의학
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    • 제2권1호
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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가족계획(家族計劃) 및 모자보건사업(母子保健事業)의 효율적 통합방안(統合方案)에 관한 연구(硏究)(서산군(瑞山郡)) -기초조사보고(基礎調査報告)- (The Seosan County Family Planning/Maternal & Child Health Service Research Project, Korea -Project Design and Findings of the Baseline Survey-)

  • 방숙;조태호;이상주;한성현;임경주;안문영
    • Journal of Preventive Medicine and Public Health
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    • 제16권1호
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    • pp.163-192
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    • 1983
  • In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

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