PIP: Family planning in Malaysia is discussed. Family planning began in Malaysia about 15 years ago through the efforts of voluntary family Planning Associations in the various Malay states. In 1966 the Malaysian Parliament passed the National Family Planning Act setting up the National FAmily Planning Board to formulate policies and methods for the promotion and spread of family planning knowledge and practice on the grounds of health of mothers and children and welfare of the family. In 1967, the board set a target of 40,000 new acceptors of family planning and 90% of the target was reached. This represents 3% of the child-bearing married women aged 15-49. The target for 1968 of 65,000 new acceptors is being achieved. A survey of acceptors is to be carried out from December 1968 to April 1969 to ascertain how many women who accepted family planning continue to practice it. Malaysia's crude birth rate declined from 46.2 in 1957 to 37.3 in 1966 before the government program was instituted. Abortion attempts have been frequent. The main method of contraception used is oral contraceptives. According to a 1957 survey, 31% of the married women in the metropolitan areas and 2% of rural women were using contraception. Presently, in Malaysia there is a need to: 1) train personnel to provide services, 2) inform and motivate families to accept family planning, 3) continue a broad educational program, 4) reform Malaysia's antiquated abortion law, and 5) integrate family planning services more fully into the general health services of the country.
PIP: The initial results of a study conducted to develop guidelines for the clinical management of family planning acceptors with regard to return of fertility following contraceptive use, are presented. 193 parous women attending an urban family planning clinic were interviewed regarding their last pregnancy conceived after stopping a method of contraception. The average interval to pregnancy was 3.9, 2.8 and 1.8 months for ex-users of oral pills, intrauterine devices and conventional methods of contraception, respectively, with median delays to conception of 1.9, 1 and within the 1st month for the 3 categories. In comparison, 149 women who had not used any method at all took 7.3 months before becoming pregnant. Selected variables including age and parity, duration of use and problems encountered, and outcome of pregnancy are further analysed. Follow-up investigations and treatment are recommended 12 months after stopping oral pills and 6 months after removal of intrauterine device for those who have not yet conceived.
An excess of male over female deaths is characteristic of modern national populations, whereas in some high-mortality societies female mortality exceeds that of males. Among the Semai Senoi, a Malaysian Orang Asli ("aboriginal") population, women experienced higher mortality than males in the decades before 1969. This differential occurred in all age classes older than 15 years so that the sex ratio progressively increased with age. A recent (1987) restudy of the Semai population found that sex-specific differential mortality is much reduced. A comparison of the 1969 and 1987 life tables shows a sharp shift in the sex ratios of mortality for the post-15-year-old age classes (the geometric means of age classes 15-44 were 0.768 in 1969 and 0.997 in 1987) so that male and female expectations of further life at age 15 are now nearly identical. In contrast to the best-known cases of high female mortality (mostly in South Asia), Semai sex differential mortality does not include the childhood ages. The Semai have traditionally been relatively sexually egalitarian, and sex bias in care has not occurred. Analysis of sex-specific causes of death for the pre-1969 population suggests that maternal mortality is the major cause of the excess female deaths. The reduced number of maternal deaths seems largely due to better health care, particularly the availability of hospital services. Interestingly, the reduction in female mortality has occurred simultaneously with increased fertility, and overall mortality has continued at relatively high levels (eO less than 36). Thus, rather than forming a component of a unitary demographic transition, declining sex differences in mortality can be accounted for by a specific factor, better maternal care.
"The past 20 years have seen extensive elaboration, refinement, and application of the original Brass method for estimating infant and child mortality from child survivorship data. This experience has confirmed the overall usefulness of the methods beyond question, but it has also shown that...estimates must be analyzed in relation to other relevant information before useful conclusions about the level and trend of mortality can be drawn.... This article aims to illustrate the importance of data analysis through a series of examples, including data for the Eastern Malaysian state of Sarawak, Mexico, Thailand, and Indonesia. Specific maneuvers include plotting completed parity distributions and 'time-plotting' mean numbers of children ever born from successive censuses. A substantive conclusion of general interest is that data for older women are not so widely defective as generally supposed."
PIP: The influence of socioeconomic status (ethnicity, income and parity) on electrolyte composition (sodium and potassium) in human milk is little known. We have thus quantitatively analyzed approximately 700 samples of milk (1-90 days postpartum) obtained from healthy Malaysian mothers' (Malay, Chinese and Indians) of full term infants. Results show that the mean concentration (mmol/l) of sodium is highest (48.2+or-1.7, Mean+or-SEM) in the Malaysian mothers' colostrum and this value decreased by 30% in their transitional milk and remained constant throughout subsequent days of lactation (mature milk). Ethnically, it is found that the level of sodium in colostrum of Malay and Chinese mothers were similar while the Indian mothers' colostrum showed apparently higher value (52.7+or-3.4 mmol/l) that is statistically insignificant. The transitional milk of all 3 ethnic groups studied exhibited similar levels of sodium. On subsequent days of lactation (mature milk) the Malay mothers exhibited lowest concentration (25.9+or-2.6 mmol/l) of sodium that is significantly (P0.05) different from that of Chinese and Indian mothers. Income and parity do not significantly affect the sodium level in Malaysian mothers' milk during all stages of lactation studied. The level of potassium, however did not change significantly with days of lactation. Like sodium, potassium too was not influenced by income and parity. (Author's).