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8th Postgraduate Course for Training in Reproductive Medicine and Reproductive Biology

Asia and Western Pacific Annual Technical Report 1997

Y.F. Wang and P.J. Rowe
HRP - UNDP/UNFPA/WHO/World Bank Special Programme

REGIONAL STRATEGY

One of the major goals of the Programme is to respond to the needs of developing countries. The two broad objectives of this goal are to ensure that the needs of developing countries are reflected in all activities of the Programme, and that the developing countries receive technical and financial support to strengthen their capacity to undertake research in reproductive health which is country-specific and, where appropriate, addresses global reproductive health problems.

To accomplish these objectives, the Regional Subcommittee for Asia and the Pacific of the Committee on Resources for Research (Subcommittee), during the past six years, recommended the following strategies: (i) encouraging countries to assess their needs in reproductive health and identify national priorities for research in reproductive health; (ii) strengthening the capacity of research institutions, including human resource development, to undertake research in reproductive health, with priority given to the least developed countries (LDCs); (iii) encouraging increased participation of women to ensure that their perspectives are incorporated in the research agenda; (iv) promoting intraregional cooperation and regional self-reliance in research training; and (v) assisting in the generation of additional support from other national and international agencies to strengthen research capacities.

The technical and financial support from the Programme has played a vital role in strengthening research capabilities and in improving, through research, reproductive health care and family planning policies and services in many of the countries in the region.

In spite of the significant progress that has been made, there is a need for periodic review and revision of the regional strategy in the light of changing circumstances such as:

  • dwindling resources available to the region;
  • the widening gap between advanced developing countries and the least developed countries;
  • the need to strengthen links between research and services.

At its meeting in 1997, the Regional Advisory Panel for Asia and the Pacific (the successor of the Subcommittee), while endorsing the above strategies, made the following recommendations for the future:

(1) Concentrate efforts on collaboration with selected institutions and countries and lay greater emphasis on impact

With over 60 per cent of the world's population residing in this region and given the diversity of reproductive health profiles and limited national resources, it is impossible for the Programme to support all the countries in the region with the limited resources available to it. The only feasible and cost-effective approach is to concentrate efforts on collaboration with selected institutes and countries and focus on limited targets and carefully chosen areas where the impact is likely to be greatest.

Generally speaking, there are two main types of countries to be selected for collaboration, i.e. so-called advanced developing countries and LDCs. There is a need to adopt different strategies for these two types of countries.

For advanced developing countries (type I) where institutional research capability has expanded, future collaboration between the Programme and the institutions in these countries requires adjustment. The Programme can now reduce the core support to individual institutions in these countries and help to establish an effective national coordination mechanism. Countries and institutions will be encouraged to formulate a national, comprehensive research programme composed of several interrelated research projects and to participate in regional and global collaborative research programmes. Scientists and institutions from these countries would also be called upon as a resource to promote as well as assist with research and research capacity building in the lesser developed countries in the region. Partnerships with other agencies to support the reproductive health research programmes in these countries will be encouraged.

For LDCs (type II), as their existing institutional research capacity and infrastructure to undertake research in reproductive health are inadequate, the Programme will assist them to identify their research needs, establish their own research priorities and formulate a long-term national strategy for reproductive health research, as well as a realistic workplan for research capacity building.

The following indicators are suggested to evaluate the impact of research capacity building on the institutes receiving support from the Programme:
  • number and quality of research projects in reproductive health in relation to total amount of financial support received;
  • number and quality of publications in peer-reviewed journals and other scientific/technical reports, and presentations of scientific results at national, regional and international meetings;
  • performance of scientific groups with an interdisciplinary approach;
  • number and quality of research training programmes and consultancy services the institution has provided within the country and in the region;
  • role in establishing national guidelines and standards for improving the scientific and ethical aspects of reproductive health research and the implementation of the national reproductive health programme;
  • role in dissemination of information on reproductive health and in promotion of reproductive health research collaboration within the country and the region;
  • role in the formulation and implementation of reproductive health policy of the country;
  • involvement and participation in the regional and global reproductive health research agenda.

(2) Draft a new research capacity building strategy and adjust the associated budget accordingly

Past investments of the Programme have played a significant role in strengthening research capacity of many institutions in Asia and the Pacific. However, the distribution of funds among the institutions that the Programme is collaborating with at present, tends to be more on the basis of sharing and equity between centres than in response to performance of the centres and actual impacts. Thus, it is necessary to draft a new research capacity building strategy and adjust the budget accordingly.

The key points of the new strategy are to:
  • increase the percentage of the budget for research projects of regional and national importance, including regional research initiatives;
  • establish a well-designed and outcome-oriented research training programme to assist in increasing knowledge and skills in specific areas considered to be of national importance or responding to urgent needs and to establish interdisciplinary research teams;
  • encourage intraregional research training activities through greater use of the resources available in the WHO Collaborating Centres in the region;
  • assist scientists who have completed their training to establish research careers at their home institutions; an increased emphasis on re-entry grants would be one possible approach;
  • strengthen intraregional communication and cooperation and promote regional networking activities;
  • encourage scientists in the region to participate more actively in the global research programme, especially multicentre studies sponsored by the Programme and other international agencies;
  • invite more scientists from the region to participate in various international scientific committees and to attend international scientific meetings;
  • individualize approaches to every institution or country.

(3) Devote major efforts to encourage intraregional cooperation, especially regional research initiatives and regional networking mechanisms

The initiation of several joint research programmes of regional importance in Asia and the Pacific is one of the high-priority tasks in the coming years. Special consideration will be given to:

  • the impact of these joint research programmes on national or regional policies on reproductive health;
  • the impact of these programmes on the support of national reproductive health programmes and the improvement of the quality of reproductive health care services;
  • the relevance of these programmes to the Programme's mandate and priorities;
  • how well global research and regional or national research complement each other.

Cost, time and feasibility also need to be considered.

Both multicentre and multicountry studies using the same design and methodology and joint research programmes with common objectives and targets involving several centres/countries are possible options. The scientists in advanced institutions could serve as coordinators, and the Programme would provide any necessary technical and financial support to these regional joint research programmes. The inclusion of scientists from LDCs in such programmes can provide valuable experience for them in conducting well-designed research studies while generating data of local value at the same time.

A regional research initiative is not only an activity aimed at generating new knowledge; it is also - and this is perhaps of even greater importance - a powerful tool to facilitate regional networking, as well as a cost-effective way of providing research training.

In addition to initiating regional research initiatives, an attempt will be made to establish one or two intraregional cooperation networks, each of which would include one or two advanced developing countries and several lesser developed countries. Institutes from developed countries in the region could also be included in these networks. It needs to be appreciated that the creation of a regional cooperation network is a gradual process and hence that such networks will take some time to be established. Each network should make full use of already existing resources within the region, including South-to-South and North-to-South networks that already exist but require strengthening. It will be important for the Programme to devise mechanisms to harness and exploit the respective strengths of more mature countries and developing country institutions and involve them in creative ways to assist in strengthening reproductive health research in neighbouring developing countries that share similar demographic and cultural identities but are less advanced.

(4) Generate additional support for strengthening research capacities in addition to the resources available from the Programme

An imaginative and energetic approach to the mobilization of additional support for institutional development in Asia and Pacific region is required in order to respond adequately to the demands on the Programme. In the present funding climate, it is not possible for the Programme to entertain proposals for long-term support to many countries in the Asia and Pacific region. This is especially true for the LDCs where a sustained intensive effort is required over a long period. A possible solution to this problem is to generate additional support for strengthening research capacities in these countries.

(i) The Programme would like to continue collaborating with the countries in the region; however, future collaboration would be based upon mutual sharing of technical and financial resources to implement research programmes and other activities in these countries.

(ii) Within the Programme, as well as within WHO's Family and Reproductive Health (FRH) programme area, the research groups, units, and other programmes such as the Division on Reproductive Health Technical Support (RHT), contribute a wide spectrum of expertise by assisting in research project review, participation in field visits, organization of workshops, and so on. These activities often draw additional funding to centres, thus extending their research programmes and laying the foundation for future self-reliance in obtaining research funds.

(iii) Another important approach is to seek partnerships with, for example, UNFPA, Family Health International and bilateral agencies, which provide funds for projects within some of their country programmes. The Programme would take responsibility for the management of certain project activities funded by these other agencies and ensure that these activities are integrated with those supported directly by the Programme.

(iv) A twinning mechanism between less developed institutes and advanced research institutes in the region (Australia, Japan, Malaysia, New Zealand, Singapore, etc.) is another possibility that needs to be explored.

(v) The research institute directors need to be more entrepreneurial and develop clear strategies for fund-raising that do not compromise research quality and aim for a stable funding base.

REGIONAL ACTIVITIES

Workshop on Ethical Issues in Research in Reproductive Health, 31 March-4 April 1997, Bangkok, Thailand

The specific objectives of this Workshop were to: (i) enable participants to be aware of and address ethical concerns in deciding on research needs and priorities, in preparing research proposals, and in reviewing research proposals and monitoring the conduct of research; (ii) review and discuss ethical principles governing research involving human subjects; and (iii) identify sustainable mechanisms for ensuring that ethical requirements are adhered to at local and national levels, including the development of institutional ethical review committees, procedures to deal with failures to comply with ethical requirements, and follow-up workshops.

The Workshop brought together 51 people from six countries in the region (China, Indonesia, Mongolia, Myanmar, Thailand and Viet Nam), selected from centres currently collaborating in Programme-supported or Programme-related research. The participants included reproductive health researchers, programme managers or planners, representatives of consumers' groups and of women's groups. The faculty consisted of seven people: three from the region, two Programme staff and one each from the United Kingdom and USA.

The topics covered during the Workshop were: the need for ethical review; informed decision-making, including consent and dissent; risks and benefits; inducement; confidentiality; ethical considerations in social science and epidemiological research; research involving adolescents; questions concerning partner agreement; and the constitution and good conduct of ethical review committees. Participants were provided with copies of internationally- accepted guidelines relating to reproductive health research, as well as guidelines developed by the Programme that address specific topics or issues not covered by other guidelines.

There was general consensus among the participants and the faculty that this first Workshop had been a great success and nearly all participants found it very useful. A number of participants from China, Indonesia, Thailand and Viet Nam, expressed the intention to conduct similar workshops at the national or institutional level, using the material from this Workshop as a basis. All have requested some financial assistance and consultant inputs. A similar format can be followed for such workshops in other regions.

Regional self-reliance in research training

A dependence on developed country institutions in other regions for the training of developing country scientists is expensive and, for Asia and the Pacific Region, usually unnecessary. In recent years, centres in Australia, Singapore, Thailand, and increasingly in China and Malaysia, have hosted trainees in a variety of research areas. For research requiring a significant understanding of local public health issues and cultural values, for example, community-based studies using epidemiological or social science skills, there is a pressing need to provide training in a similar cultural setting. Table 1 summarizes the Research Training Grants funded in the past two years.

Scientific Meetings

(i) The Third International Conference on Reproductive Endocrinology

This Conference was organized by the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and the National Research Institute for Family Planning, Beijing, both of which are WHO Collaborating Centres. The Programme was also one of the sponsors. Some 350 Chinese participants and 20 overseas experts attended this Conference.

(ii) The Programme also supported several scientists from developing countries in this region to attend the VIth International Congress of Andrology held in Salzburg, Austria, 25-29 May 1997.

COUNTRY ACTIVITIES

CHINA

Collaboration between the Programme and China has been one of the most successful research capacity building activities in the last 18 years. Both the Chinese Government and the Programme unanimously agree that strengthening collaboration can significantly contribute towards the development of research capacity and the promotion of research in family planning and reproductive health in China, as well as enrich the Programme's experience and capacity to assist other developing countries to achieve the same goals. Since 1979, total funding from the Programme to these collaborative activities in China has amounted to some US$ 15 million. Total funding from UNFPA has been US$ 13 million. The Chinese Government has invested at least twice the combined WHO and UNFPA input of US$ 28 million, through covering all costs for capital construction, staff salaries and other running expenses. As China's institutional research capability has expanded, the strategy for collaboration in the future requires adjustment to remain appropriate. A review of the strategy for collaboration with China was initiated by the Programme in 1996. After several in-depth discussions between the Chinese Government and the Programme, a "Strategic Framework for Collaboration on Reproductive Health/Family Planning (RH/FP) Research between China and WHO (1998-2003)" and workplan for 1998-1999 were formulated in 1997.

The major components of this new strategy are:

  • to review and set priorities for RH/FP research at national and institutional levels;
  • to further strengthen the national and institutional capability to undertake research in RH/FP;
  • to conduct RH/FP research at national, provincial and community levels;
  • to promote dissemination, transmission and utilization of RH/FP research results to policy-makers, programme managers and service providers;
  • to improve the management and coordinating capacity in RH/FP research at national and institutional levels;
  • to participate in the global RH/FP research effort and share experiences with other countries.

There were 32 ongoing Programme-supported research projects (Table 2) in Chinese institutions during the 1996- 1997 biennium; 24 of these were under way in Collaborating Centres (National Research Institute for Family Planning, Beijing, 6; Shanghai Institute of Planned Parenthood Research, Shanghai, 7; Sichuan Family Planning Research Institute, Chengdu, 8; Tianjin Municipal Research Institute for Family Planning, Tianjin, 2; and Peking Union Medical College Hospital, Beijing, 1).

  Table 2. Distribution by topic of the ongoing research projects supported by the Programme in China

Discipline Number of research projects
Social science 2
Barrier methods 3
Postovulatory methods 2
Male methods 4
IUDs 12
Technology introduction 1
Surveillance and evaluation 5
Infertility 2
Basic research 1

Among these 32 research projects, there were two Re-entry Grant projects.

In the meantime, the progress of institutions which have been working with the Programme was reviewed by the Regional Advisory Panel for Asia and the Pacific in October 1997 and the following activities were noted.

Family Planning Research Institute of Zhejiang, Hangzhou

This Institute was established in 1978 and is one of six institutes of the Zhejiang Academy of Medicine under the Ministry of Public Health. This Institute is best known for its research on long-acting methods of fertility regulation, particularly for the development of injectable steroid preparations. The Institute has also been recognized for its pharmacological work on contraceptive steroids by the Drug Regulatory Bureau of China and for the promotion of Good Clinical Practice by the Ministry of Public Health and the Chinese Medical Society.

Research activities

Research activities in 1996-1997 included 19 research projects in the areas of emergency contraception, long-acting contraceptives, male methods, HIV and STDs, and basic research. After completing two large-scale introductory studies, the three-monthly DMPA injectable has been recommended by the Institute and accepted by the State Family Planning Commission (SFPC) as a good choice of contraception for lactating women from six weeks after delivery onwards.

Research capacity building

A formal Ethical Committee, including one lawyer, one representative of a women's group and one ethics professor from the Medical University, was established in the Zhejiang Academy of Medical Sciences in 1996. The Institute continued having responsibility for assisting the Government in planning and implementing the National Family Planning Research Programme and special responsibility in the administrative drug regulation process. As the research achievements of this Institute have been recognized favourably both nationally and internationally, the Director of this Institute was awarded the title of "National Meritorious Research Worker" by the SFPC in 1996. The Director of the Institute continued his activities in the Chinese National GCP/GLP Expertise Committee, and was appointed Deputy Chairman of the Task Force of Contraceptive Drugs and Devices by the SFPC. In addition, the Institute continued its collaboration with many international agencies and pharmaceutical companies.

Limited resource maintenance support from the Programme continued in 1997.

Dissemination of information

Fifteen scientific papers were reported to have been published.

The Regional Advisory Panel recommended that the Institute should be encouraged to participate more actively in research projects of national and global importance, including those supported by the Programme. The scientists of the Institute will also be called upon as a resource to promote, as well as assist with, research and research capacity building of other institutes in China and in the region.

Shanghai Institute of Planned Parenthood Research, Shanghai

The Shanghai Institute of Planned Parenthood Research (SIPPR), founded in 1979, together with the National Research Institute for Family Planning in Beijing, were established as national centres with special responsibility for assisting the Government in planning and implementing the national research programme. SIPPR pursues a very broad programme of reproductive health research, covering areas from social science, synthetic and analytical chemistry, pharmacology, preclinical studies and clinical trials to large-scale epidemiological projects and increasing activities in basic research.

Research activities

Research activities of the Institute in 1996-1997 included 47 research projects, among which 15 were supported by the Programme (some of them were funded in previous years and were to be completed in this period) covering the areas of social science, fertility regulation, induced abortion, reproductive tract infections and sexually transmitted diseases, and basic research.

Research capacity building

The Centre for Contraceptive Drug Development was jointly established by the Shanghai Academy of Sciences and Technology and SIPPR in 1996 with the mission goal of technology introduction and transfer. With the support of the State Commission on Science and Technology, RMB1 million was invested to subsidize the Laboratory of Reproductive Medicine at SIPPR. Under the approval of the Shanghai Municipal Commission on Science and Technology, the Reproductive Research Training Centre was set up on the campus of SIPPR.

During 1997, four staff members were undergoing training abroad and three others returned from training. Of these, five were supported by the Programme. In addition, four medical doctors from DPR Korea received research training for three months in the field of epidemiology at SIPPR.

In undertaking research, SIPPR collaborates with a number of institutions within China and several institutions overseas. Notable among the latter is Prince Henry's Institute of Medical Research, Melbourne, Australia. The twinning programme between these institutes, which is supported by the Programme, focuses on different aspects of fertility regulation research and has created a good opportunity for both institutes to establish close linkage in areas of mutual interest.

Dissemination of information

The Annual Report of SIPPR provided an impressive list of 76 professional publications in 1996.

The Science Information Centre at SIPPR is responsible for the collection and dissemination of scientific information, including translation of the Programme's Biennial Reports and other WHO publications relating to reproductive health, as well as the publication of the bilingual journal "Reproduction and Contraception". The Regional Advisory Panel noted that the Institute has made outstanding progress in its research, and has been actively collaborating with the Programme in participating in the global research agenda and providing research training in the region.

The Panel recommended that the Programme continue to encourage SIPPR to participate actively in research projects of national, regional and global importance, and further strengthen effective interaction with national authorities and international agencies. The scientists of the Institute will also be called upon as a resource to promote, as well as assist with, research and research capacity building of other institutes in China and in the region.

Division of Reproductive Endocrinology and Infertility, Peking Union Medical College Hospital, Beijing

The Peking Union Medical College Hospital (PUMCH) is a general hospital which is affiliated to the Peking Union Medical College and which has, for many years, enjoyed a reputation as the most prestigious medical university in China. In recognition of the contribution made in the field of reproductive health research, the Division of Reproductive Endocrinology and Infertility of PUMCH was designated a WHO Collaborating Centre for Research in Human Reproduction in 1993.

Research activities

During 1996-1997, the Division reported 12 ongoing research projects of which three were funded by the Programme (two IUD studies and one Re-entry Grant for STD research).

Research capacity building

Long-term Institutional Development (LID) Grant support to the Division began in 1990. In undertaking the research projects, the Division continued its good collaboration with many international agencies and pharmaceutical companies.

The 20 years of research on "Disorders of Sexual Differentiation" by the Division was among the eight First Prizes granted by the Ministry of Public Health for the year 1996. The Division organized the first "National Symposium on Male Reproductive Health" and joined in the organization of the "International Symposium on Emergency Contraception", held in Beijing in October 1996.

The Third International Conference on Reproductive Endocrinology was organized by the Division of Reproductive Endocrinology and Infertility, PUMCH, the Chinese Academy of Medical Sciences and the National Research Institute for Family Planning, Beijing. The Programme was also one of the sponsors. Some 350 Chinese participants and 20 overseas experts attended the Conference.

Limited resource maintenance support and one Research Training Grant continued in 1997.

Dissemination of information

The Division published five original articles, two review papers, three book chapters and four congress abstracts in 1996. The WHO Technical Report on "Research on the Menopause in the 1990s" was translated and published. The Division continues to publish the "Journal of Reproductive Medicine", which is partly supported by the Programme, and welcomed by both Chinese and international readers.

As the research capability of this Division has increased, the Regional Advisory Panel recommended that the financial and technical support to the Division should go towards the support of some research projects of national, regional and global importance.

Institute of Population Research, Peking University, Beijing

The Institute of Population Research, Peking University (IPRPU) is an interdisciplinary centre with expertise in population economics, economic demography, social demography and population demography. It has a broad research programme, including studies on behavioural and social determinants of fertility regulation, fertility preferences and analysis of national population census data.

Research activities

During 1996-1997, the Institute initiated or continued four social science research projects on reproductive health.

Research capacity building

The Institute has received an LID Grant from the Programme since 1990. Central to the LID Grant proposal was support for a postgraduate course leading to a Master's Degree (M.A.). Since 1996, the financial and technical support to this Institute has been decided on a yearly basis.

During 1996, six Chinese students and one foreign student were enrolled in the International M.A. Degree Programme in Population Science. In addition, a forum on "Population growth and food in future China" was held by the Institute. More than 50 experts and Government officials participated in this forum. The Institute is in an excellent position to play a significant part in advising the Government on population policy and to help other institutions through teaching and collaborative research.

Dissemination of information

During the reporting period, 28 original papers and two books were published.

The Regional Advisory Panel recommended that the Programme should economize on core support to the Institute. However, the Institute should be encouraged to participate actively in research projects of national, regional and global importance, as well as communicate frequently with national authorities to discuss relevant policy issues based on research findings.

National Evaluation Centre for the Toxicology of Fertility Regulating Drugs, Shanghai

The National Evaluation Centre for the Toxicology of Fertility Regulating Drugs evaluates the toxicity of new drugs. It was built to very high standards following advice from WHO consultants specializing in toxicology, animal husbandry, and the design of research laboratories and breeding facilities. It also provides specific pathogen- free animals.

Research activities

During 1996-1997, seven research projects were on-going. The Centre's research programme focused mainly on studies of the environment and human reproduction, male methods, and immunocontraception. There were no ongoing research projects directly supported by the Programme.

Research capacity building

The Centre was provided with a Resource Maintenance Grant during 1997, with emphasis on the implementation of the toxicological assessment of fertility regulating agents and for the preparatory work for Good Laboratory Practice (GLP).

With the support of the Programme, the Director of the Centre paid a one-month visit to four institutions in Japan and a joint research project on the study of reproductive toxicity was established between the Centre and Nagoya University, Nagoya, Japan.

The Centre has submitted a new proposal to be implemented over the next five-year period (1997-2001). The broad objectives are to: (i) develop the Centre to be an authorized centre for the evaluation of contraceptive drugs and devices; and (ii) introduce the GLP standard and put it into practice for the evaluation of fertility regulating drugs and devices.

Dissemination of information

Six original papers, two congress abstracts and seven official reports were released during this period. Since the Centre has well equipped research laboratories and trained staff, the Regional Advisory Panel recommended that further assistance should be through supporting research projects which are relevant and of high priority for both China and the Programme.

INDIA

The potential of Indian scientists and institutions to undertake research in human reproduction and fertility regulation was recognized from the inception of the Programme. Since then, the Programme has contributed to the strengthening of research capability in India by providing support to institutional research resources in the form of various Research Capability Strengthening Grants (of which some 70 were awarded) and to the development of human resources through the award of some 135 Research Training, Visiting Scientist and Re-entry Grants to various Indian institutions. Four Indian institutes have been officially designated as WHO Collaborating Centres for Research in Human Reproduction; these are:

  • All India Institute of Medical Sciences, New Delhi;
  • Institute for Research in Reproduction, Indian Council of Medical Research, Mumbai;
  • Centre for Reproductive Biology and Molecular Endocrinology, Indian Institute of Science, Bangalore;
  • Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh.

By the end of 1996, the cumulative financial support to India from the Programme amounted to over US$ 11 million.

The collaborative activities between India and the Programme peaked in the late 1970s. However, since 1985, there has been a gradual decrease in these activities, which has been of great concern to the Programme. Efforts were made, therefore, to revitalize the collaboration. In June 1992, a Memorandum of Understanding was signed with the Government of India with the aim of strengthening reproductive health research through mutual collaboration. It was realized that the strengthening of mutual collaboration could contribute significantly to the development of research capacity and the promotion of research in reproductive health in India, as well as enrich the Programme's capacity to assist other countries to achieve the same goals, especially in Asia and the Pacific.

In 1997, a comprehensive document on "Reproductive Health Research Needs Assessment" was finalized by the National Committee on Research in Human Reproduction, which was established in 1992 by the Government of India with the mandate of promoting coordination and collaboration amongst different ministries, departments, agencies and organizations supporting research in the field of human reproduction and related health issues. This assessment categorized the various recommendations under eight broad areas, each of which included several research activities of different priorities: management and operational issues; maternal health and women's health and development; child survival and child health and development; fertility regulation (family planning and infertility); safe abortion; reproductive tract infections and sexually transmitted diseases; adolescent reproductive health; and old age problems. The Government of India decided to launch a Reproductive and Child Health Initiative from April 1997. The major emphasis of this national programme is the integrated delivery of services for fertility regulation, maternal and child health, safe abortion and RTI/STDs, and undergoes a "paradigm shift", with the focus on quality rather than quantity of services and decentralized participatory planning. The Programme hopes that the efforts that have been made will help re-establish a more fruitful partnership with the Government of India for the benefit of reproductive health of the people of India and of the region.

All India Institute of Medical Sciences, New Delhi

The All India Institute of Medical Sciences (AIIMS) has been collaborating with the Programme since 1972 and has had the official designation as a WHO Collaborating Centre since then. It is a well-established national research and training institute set within a large teaching hospital. The following Departments at AIIMS have collaborated with the Programme: Physiology, Reproductive Biology, Obstetrics and Gynaecology, Central Radio-immunoassay Facility, Biostatistics and the Non-human Primate Research Facility. The main areas of research in reproductive health at AIIMS are: (i) the development of postovulatory methods for fertility regulation; (ii) the development of methods for male fertility regulation; and (iii) the study of male and female reproductive physiology.

Research activities

The ongoing research programme of AIIMS included 16 research projects, among which two were supported by the Programme: (i) A prospective, randomized, multicentre study comparing the Yuzpe regimen with levonorgestrel in emergency contraception; (ii) The effect of a long-acting androgen in inducing and maintaining azoospermia in combination with a long-acting levonorgestrel ester (both preparations have been developed by the Programme in collaboration with the National Institute of Child Health and Human Development, Bethesda, MD, USA).

Research capacity building

During 1996-1997, the Programme continued resource maintenance support to the Central Radioimmunoassay Facility and the Primate Research Facility at AIIMS. A workshop on "Molecular biology techniques in the study of sperm functions" was conducted in March 1997 with support from the Programme.

Dissemination of information

Thirty-seven scientific papers resulted from the work carried out by the above mentioned departments in AIIMS during 1996.

In view of the comparative advantage of AIIMS in studies on male fertility regulation, the Regional Advisory Panel recommended that the Programme invite AIIMS to be one of the participating centres in the Programme's proposed studies in this area. This collaboration would have the advantages of: (i) obtaining data on Indian men for comparison with those obtained on other population groups; (ii) involving an Indian centre in the Programme's international research initiatives in male fertility regulation; and (iii) establishing a framework for other collaborative activities in the future.

Institute for Research in Reproduction, Indian Council of Medical Research, Mumbai

The Institute for Research in Reproduction (IRR), Indian Council for Medical Research (ICMR), is located in Mumbai. It was designated a WHO Collaborating Centre in 1972 and has, in the past, actively participated in collaborative research with the Programme, mainly in the area of postovulatory methods for fertility regulation. The Institute has a broad range of scientific programmes in basic and clinical research such as: immunocontraception, gonadal peptides as contraceptives, contraceptive potential of antiprogestogens, development of diagnostic kits for infertility, reproductive tract infections, breast-feeding and lactational amenorrhoea, acceptability studies of contraceptive methods, etc.

Research activities

During 1996-1997, 47 research projects were under way at IRR; one of these, "Molecular mechanisms regulating steroidogenic enzymes in ovarian androgen-producing cells", was supported by a Re-entry Grant.

Research capacity building

In 1996, the Programme received neither the 1995 Annual Report nor the Grant Proposal for 1997 from the Institute. Three of the staff were trained in the USA and four returned from training, among whom two were supported by the Programme.

Dissemination of information

Fifty-two scientific papers were published in 1996, including 12 in international journals.

The Regional Advisory Panel recommended that the Programme should encourage IRR's participation in specific research projects of both national and global importance, including Programme-supported research projects.

INDONESIA

The National Family Planning Coordinating Board (BKKBN) is responsible for organizing and implementing the national family planning programme in Indonesia. Its research programmes are implemented through a nationwide network of multidisciplinary Human Reproduction Study Groups (HRSG) established in medical schools. In late 1994, BKKBN restructured the network of HRSGs and its research programme is now restricted to only three centres - Faculty of Medicine, University of Indonesia, Jakarta; the West Indonesian Reproductive Health Development Centre, Faculty of Medicine, University of North Sumatra, Medan; and the Medical Faculty, Airlangga University, Surabaya. The Programme has been informed that all the collaborative activities, including those supported by the United Nations Population Fund (UNFPA), should focus only on these three HRSGs.

The Human Reproduction Study Group, Faculty of Medicine, University of Indonesia, Jakarta

The HRSG in Jakarta has well qualified staff involved in teaching and clinical services, both in the University Hospital and in private practice. Despite these commitments, the majority of staff appear to find some time for research. Research interests are varied, but the Group is well known for its studies on long-acting hormonal methods of fertility regulation and, as such, has active collaboration with the research component of the Programme that deals with these methods.

Research activities

The immediate objectives stated for the second LID Grant (1997-2001) include:
  • support to the Master's Degree of Reproductive Science programme;
  • continued research on mechanisms of endometrial bleeding using tissue culture, immunohistochemistry and radioimmunoassay;
  • research on pre-eclampsia and hydatiform mole;
  • research on AIDS.

Five new projects were submitted in 1997, involving members of the Study Group and students undergoing the Master's Degree of Reproductive Science programme. The studies include collagen fibre expression in endometrial stroma and the basement membrane of the endometrial epithelium during the normal menstrual cycle and under the influence of progestogens; desmosomes, hemi-desmosomes, and expression of cytokeratin 7, 8, 18 and 19 in the endometrial epithelium under the influence of progestogens; and protein analysis to confirm these results. The studies are being conducted sequentially and are expected to be completed by 1999.

Research capacity building

In 1997, support was provided for staff salary and communication costs.

Dissemination of information

In 1996, there were seven publications from the Study Group and two presentations were made at international meetings.

Human Reproduction Study Group, Medical Faculty, Airlangga University, Surabaya

This Group at the Medical Faculty of Airlangga University is engaged in teaching, the provision of services and the conduct of medical research. The current LID Grant proposal was submitted in 1991 and was approved, in principle, for the period 1992-1996. Though the HRSG has at least 30 members with an M.D. or Ph.D. degree, the amount of time available for research is severely limited owing to the need to give priority to teaching, service provision (including private practice) and administration. As in 1996, the Group failed to submit a LID Grant application for 1997 and was only awarded funds to cover journal subscriptions.

West Indonesian Reproductive Health Development Centre (WIRHDC), Faculty of Medicine, University of North Sumatra, Medan

The WIRHDC was nominated as one of three "centres of excellence" by the State Minister for Population and Family Welfare in December 1995. In 1996, the staff and Director of the Centre developed a research strategy plan with short-, medium- and long-term objectives which was formulated into a LID Grant application. This was approved by the Regional Advisory Panel in 1996.

The immediate objectives for the first cycle of the LID Grant include institution strengthening by the training of staff, upgrading research facilities, and establishing a local network of clinics to undertake clinical research. Research will focus on improving the family planning programme in Sumatra, the adoption of safe motherhood practices, and the clinical investigation and management of infertility and genital tract infections.

Research activities

Of the two research projects that were planned to start in 1997, one on the effects of chlamydial infection on male fertility, has been postponed pending the return of a research trainee and installation of the microbiology laboratory. The other study is a randomized comparative trial of two IUDs - the Multiload 375 and the TCu380A.

Research capacity building

In 1997, funds were made available to establish a semen analysis laboratory and to provide training in semen analysis as well as to buy equipment and supplies for the ELISA detection of chlamydial lower genital tract infection. Funds were also made available for journal subscriptions and the purchase of books for the library. A Workshop on Computing Applications for Reproductive Health Research attended by 36 participants was held in 1997 and the following topics were covered: epidemiological design for clinical research; proposal development; steps in data management; use of several statistical programs.

Although five Research Training Grants were approved by the Regional Advisory Panel, only one candidate has been identified for training in the clinical management of infertility. There were four consultant visits to the Centre during 1997. It is recognized that this Centre will require considerable consultant input to enable it to undertake research.

Dissemination of information

A meeting of potential investigators was held in 1997 to develop the scope and goals of the LID Grant and to canvass their interest and commitment to the proposed research plan developed by the Centre.

LAO PEOPLE'S DEMOCRATIC REPUBLIC

Institute of Maternal and Child Health, Ministry of Health, Vientiane

The Institute of Maternal and Child Health (IMCH) belongs to the Ministry of Health and was established in November 1989. Initially there were 11 staff members, today there are 40 (two specialists in paediatrics, two Masters of Tropical Health, 30 Bachelors of Science and six technical staff).

IMCH plays an important role in research. It guides studies and research on knowledge, attitudes and practice (KAP), MCH problems, fertility, and diseases which are the main causes of morbidity and mortality in mothers and children. It also uses the findings of the research for improving mother and child health.

The Institute had been supported in 1995 and 1996 by the Technical Cooperation between Developing Countries initiative with the Institute for Health Research, Chulalongkorn University, Bangkok, Thailand as the technical counterpart. In 1997, this support was converted into a LID Grant at the request of the Lao Ministry of Health and a five-year LID Grant for the period 1997- 2001 was approved by the Regional Advisory Panel in October 1996.

The short-term objectives for 1997 included training in epidemiology and cervical cytology and colposcopy. The intermediate objectives of the LID Grant are:

(i) to determine the magnitude and roles of important infections related to reproductive health;

(ii) to describe the magnitude and extent of maternal and neonatal morbidity and mortality among patients attending the Institute for Maternal and Child Health;

(iii) to describe contraceptive preferences, prevalence, and continuation rates among users; and

(iv) to determine the prevalence of cervical cancers among women attending the Institute.

It will be necessary to continue training scientists from the Institute throughout 1998 and provide equipment and supplies before any research projects can be initiated.

Research activities

No research projects were planned for or initiated in 1997.

Research capacity building

In 1997, a clinician received training in clinical research methodology, cervical cytology and colposcopy at the Chulalongkorn WHO Collaborating Centre, Bangkok, Thailand, and another entered the two-year M.Sc. Course in Epidemiology at the Prince of Songkla University, Hat Yai, Thailand.

A two-day Workshop on Infection and Reproductive Health was held in December 1997 for 15 participants from Vientiane and provincial hospitals.

MONGOLIA

State Research Centre on Mother and Child Health and Human Reproduction, Ulaanbaatar

The State Research Centre on Mother and Child Health (MCH) and Human Reproduction was established by the Ministry of Health in 1988. The Centre, apart from being the most advanced MCH hospital in the country, is charged with studying problems relating to MCH and family planning in support of Government policies.

In 1992, a LID Grant was approved for 1993-1997, the long-term objectives of which are to undertake research on: (i) the assessment of contraceptive efficacy, safety and acceptability; (ii) the prevention and treatment of infertility; (iii) maternal and child health; and (iv) the quality of care provided by family planning services. The short-term objectives relate to the recruitment and training of staff, equipping of laboratory facilities, development of research projects, and establishment of a unit for the collection and dissemination of technical information on reproductive health.

Research activities

The Centre conducted five research projects in 1997. These included a trial of the TCu380A IUD, the clinical management of infertility, menstrual blood loss quantification in healthy Mongolian women, an epidemiological study of infertility, and a clinical trial of the injectable contraceptive, DMPA. In addition, the Centre participated in a multicentre study on emergency contraception coordinated by the Programme.

Three new research projects were initiated in 1997 on IUDs, STD prevalence, and contraceptive prevalence.

Research capacity building

In 1997, funds were provided for equipment and supplies for the microbiology department and for the semen analysis laboratory. Two staff members continued with the M.Sc. Course in Epidemiology at the Prince of Songkla University, Hat Yai, Thailand and one started 12 months' training in reproductive physiology in Bangkok, Thailand.

A workshop on data management was held in July 1997, with data from ongoing research used as practical examples; ten of the Institute's staff participated. Five consultants, expert in data management, epidemiology, STDs, microbiology and clinical research, visited the Centre in 1997.

Dissemination of information

A workshop was convened in 1997 on the establishment of a network of centres for the collection of information on maternal morbidity and mortality. This involved 16 clinicians and paramedical personnel. In 1996, staff from the Institute published one book and seven journal articles.

MYANMAR

Department of Medical Research, Ministry of Health, Yangon

Five institutes collaborate with the Programme: (i) the Department of Medical Research (DMR), Ministry of Health; (ii) the Institute of Medicine 1, Yangon; (iii) the Institute of Medicine 2, Yangon; (iv) the Central Women's Hospital, Yangon; and (v) the Institute of Medicine, Mandalay. The focal point for collaboration with the Programme is the DMR.

The long-term objective of collaboration is the development of the capability of participating institutions to address areas of reproductive health research identified as being of national priority. Specific objectives to be achieved with the LID Grant, which started in 1993, are to: (i) upgrade research skills and facilities; (ii) promote networking among participating centres under the leadership of the DMR; (iii) establish mechanisms that facilitate the utilization of research results; and (iv) establish a management information database in reproductive health.

Research activities

The DMR completed three studies in 1997. These studies included a follow-up study on contraceptive practices after induced abortion, the clinico-epidemiological profiles of infertile couples and a study, funded by UNFPA, of contraceptive acceptability and efficacy. Two new studies were initiated on the socioeconomic characteristics and behaviour of adolescent mothers and the quality of antenatal care at outpatient clinics.

Research capacity building

In 1997, two staff members received research training for six months at the University of Malaya, Kuala Lumpur, Malaysia, one in STD epidemiology and the other in STD microbiology. Funds were provided for the purchase of journal subscriptions. There were three consultant visits in 1997 for data management and social science. A six-day course was held for 20 participants in data management techniques and statistics.

Dissemination of information

A national seminar with more than 40 participants was convened to disseminate the findings of the research projects completed in the previous five years. In 1996, there were three publications and six presentations at national scientific meetings.

NEPAL

Institute of Medicine, Tribhuvan University, Kathmandu

The Department of Community Medicine and the Centre for Family Health, Tribhuvan University, are the focal points for research in reproductive health. A work-shop on Assessment of Needs for Research in Reproductive Health was organized by the Institute in 1991 with Programme support.

Research activities

During 1996-1997, the Institute has submitted several research projects to the Programme, which are still undergoing review and improvement prior to implementation. One research project supported by the Programme is still ongoing: "Hospital-based case-control study of prostate cancer and vasectomy".

Research capacity building

1995 was the first year of LID Grant support. In view of the great need for research capacity building, the Institute will initially collaborate in the formulation of a programme for research and strengthening of research capacity.

During 1996, one expert spent two weeks at the Institute, helping the staff to generate research proposals as well as conducting a workshop on epidemiology. One staff member completed her training in reproductive endocrinology at the National University of Singapore, and four other staff members completed their training in Thailand and returned to the Institute during 1997: one was trained in reproductive health research, one in social science, and two in research management.

Regular meetings were held with the Ministry of Health and other concerned bodies such as the Nepal Health Research Council and the Family Planning Association of Nepal for the development of long-term plans for human reproduction research in Nepal.

Dissemination of information

Two original articles, one congress abstract and one official report were released during 1996.

The Regional Advisory Panel noted that the existing institutional research capacity and infrastructure to undertake research in reproductive health are still inadequate in Nepal, and the potential research projects identified at the workshops during the last several years are yet to be further developed. The Panel thus recommended that the strengthening of research capacity will require a comprehensive strategy including guidance for the formulation of a research programme composed of several interrelated research projects of national importance, strengthening of research capacity including human and non-human resources, and frequent monitoring of the research programme.

SRI LANKA

Coordinating Committee for Research on Reproductive Health, Colombo

Research in reproductive health in Sri Lanka is carried out by four multidisciplinary Task Forces located in Colombo, Galle, Jaffna and Peradeniya. The activities of these four Task Forces are coordinated by a National Coordinating Committee with its office in Colombo.

Research activities

During 1996-1997, a total of 42 research projects were started or in progress, of which three were funded by a LID Grant.

Research capacity building

In 1989, the Programme had supported a workshop in Sri Lanka to assess its research needs in reproductive health. Subsequently, the four Task Forces got together and, in 1992, jointly developed a LID Grant proposal to address some of the research needs identified at the workshop.

During 1996, three Thai experts supported by the Programme, visited the Colombo Institute and conducted a 10-day workshop on social science research, with 17 participants; two research projects on induced abortion were developed. A part-time senior research officer was appointed with responsibility for the coordination of research activities in the four Task Forces and compiling research results and publications from Sri Lanka since 1991. In addition, the National Coordinating Committee convened a special meeting with policy-makers and programme planners from the Ministry of Health and Family Planning Association to identify current priority areas in reproductive health research in Sri Lanka. Subsequent to this meeting, the National Coordinating Committee formulated a focused programme of research for the next five years.

Dissemination of information

Eight original articles, three book chapters, 34 congress abstracts and 14 official reports were released during the reporting period.

Since the institutions in Sri Lanka now have well developed research facilities, support for research projects will be the focus in future. The Regional Advisory Panel suggested that the National Coordinating Committee should consider setting up Task Forces around specific research programmes rather than the present, geographically- based system of having a Task Force in each medical school.

THAILAND

Family Health Division, Department of Health, Ministry of Public Health, Bangkok

The Ministry of Public Health is responsible for the promotion of reproductive health research in Thailand. Its research activities are carried out by nine institutions, the activities of which are coordinated by the Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen. The research group has approximately 100 scientists and 20 supporting staff. The objective of the Programme's support has been to strengthen research capabilities of the institutions to undertake research on the development of contraceptives through field trials, including evaluation of the safety and efficacy of currentlyused methods. The first cycle of five-year LID Grant support expired in 1992 and a new five-year Grant started in 1993. In addition to funding received from the Programme, the institutes obtained financial support from UNAIDS, the Faculty of Medicine of Khon Kaen University, and the Thai Research Council.

Research activities

In 1997, the LID Grant indirectly supported research being conducted by the centres in the network by providing funds for the annual investigators' meeting at which issues relating to monitoring of the studies and new research topics were discussed. The research projects that were undertaken in 1997 concerned risk factors for osteoporosis, prevention of vertical transmission of HIV infection, control of thalassaemia by health education and prenatal diagnosis, a randomized trial of a new antenatal care model, and psychosocial aspects of HIV transmission.

Research capacity building

Each of the three regional centres in Chiang Mai, Hat Yai, and Khon Kaen received funds for MEDLINE and journal subscriptions.

Dissemination of information

In 1996, the network of centres published five papers in national and international journals.

VIETNAM

Institute for the Protection of the Mother and Newborn, Hanoi

The Institute for the Protection of the Mother and Newborn (IPMN) is a tertiary-level women's hospital in Hanoi which provides a variety of services, including family planning and infertility care, and acts as a resource of technical advice to the Ministry of Health and the National Committee on Population and Family Planning. Collaboration between Viet Nam and the Programme began in 1979 with the objective of developing capabilities for research on the safety and efficacy of currently-used family planning methods and on the evaluation of new methods. UNFPA also has provided support through the Programme to extend the research capacity building to include up to nine institutes throughout the country. This national research network is coordinated by IPMN and has collaborated on a number of research projects. Over 70 scientific staff are available for research, but most can devote only a relatively small fraction of their time.

The long-term goal, as set out in the LID Grant application for 1993-1997, was to establish the IPMN as a centre for research and information in maternal and child health care and in reproductive health in the South-east Asia Region. Short-term objectives are the training of IPMN staff and further equipping of research facilities.

Research activities

In 1997, two studies were started. One involved the long-term follow-up of subjects admitted to an IUD trial that had started six years previously. Initially, this study will be conducted in Hanoi and, if the loss to follow-up is not excessive, it will be extended to subjects in two other cities. The other study concerns the prevalence of lower genital tract infection including chlamydial and gonococcal infection, trichomoniasis, moniliasis and bacterial vaginosis in two family planning clinics in Hanoi.

Research capacity building

A three-day symposium on infection and its impact on reproductive health was held at the Institute in 1997. It was attended by more than 100 medical and paramedical staff members from most Vietnamese provinces and cities. One staff member who enrolled in the M.Sc. Epidemiology Course at the Prince of Songkla University, Hat Yai, Thailand obtained the Programme's approval to extend her study to a Ph.D. with the support of the Programme.

Dissemination of information

The Symposium on the Impact of Infection on Reproductive Health held in January 1997 attracted more than 100 participants, mainly from provincial hospitals.

Hung Vuong Hospital, Ho Chi Minh City

The Hung Vuong Hospital is a tertiary-level referral hospital in obstetrics and gynaecology and family planning. The Hospital is responsible for routine health care and teaching of medical students and midwives, and undertakes research. Although clinical care responsibilities are close to exceeding the availability of staff resources, the Hung Vuong Hospital has established a group interested in conducting research related to reproductive health and has acted as a coordinating centre for several national-level studies.

The long-term objective of Hung Vuong Hospital is to develop the capacity to conduct research that will support policy-making and planning for the national family planning programme and contribute to an understanding of a variety of reproductive health problems, their causes, prevalence and treatment and prevention. Short-term objectives relate to the upgrading of staff skills and facilities for research. Four research programmes of relevance to southern Viet Nam were planned: (i) Health indicators: surveys of genital tract infections and maternal and perinatal mortality in Ho Chi Minh City; (ii) Fertility regulation: methods for men and women; (iii) STDs: prevalence and impact of contraceptive use; and (iv) Infertility: causes and risk factors.

Research activities

The LID Grant supported two research projects in 1997. The first concerned the acceptability of the Falope ring method of female sterilization, and the second, the use of pelvic ultrasound for the monitoring of follicular growth and detection of ovulation in cases of female infertility.

Research capacity building

In 1997, a Qualitative Research Methodology Workshop was supported by the LID Grant and was attended by 22 participants. It is expected that a number of research proposals resulting from this Workshop will be submitted for funding by the Programme. Funds were provided for the purchase of a low temperature freezer and a laptop computer as well as library resources. Two Research Training Grants in biostatistics and social science research, respectively, were approved in principle by the Regional Advisory Panel in 1997.

Dissemination of information

In 1996, scientists associated with the centre published two articles.

Table 1. Research training grants funded in the past two years.

Home Country Gender Subject Training in region Training out of region
China Male Infertility Australia
China Male Contraception USA
DPR Korea Female Contraception China
DPR Korea Female Contraception China
DPR Korea Female Contraception China
DPR Korea Female Contraception China
India Male Social science Thailand
Laos Male Epidemiology Thailand
Laos Male Clinical research Thailand
Mongolia Female Semen analysis Thailand
Myanmar Male Public health Australia
Myanmar Female Data management Indonesia
Myanmar Male STDs Malaysia
Myanmar Female STDs Malaysia
Nepal Female Reproductive health Thailand
Nepal Female Social science Thailand
Nepal Female Research management Thailand
Nepal Female Research management Thailand
Nepal Male Data analysis India
Nepal Male Reproductive endocrinology Singapore
Sri Lanka Male Social science Thailand
Sri Lanka Male Research methodology Thailand
Viet Nam Male Reproductive endocrinology Thailand
Viet Nam Female Epidemiology Thailand
Viet Nam Female Semen analysis Thailand
Viet Nam Male Epidemiology Thailand
Viet Nam Male STDs Thailand
Viet Nam Male Biostatistics Thailand

 

Annex 1

REGIONAL ADVISORY PANEL FOR ASIA AND THE PACIFIC IN 1997

Members
  • J.K Findlay (Chairman), Prince Henry's Institute of Medical Research, Melbourne, Australia
  • V. Goh, Department of Obstetrics and Gynaecology, National University of Singapore, Singapore
  • *S. Hatmadji, University of Indonesia, Jakarta, Indonesia
  • *N. Huq, Naripokkho, Dhaka, Bangladesh
  • R. Mra, Ministry of Health, Yangon, Myanmar
  • *M. Passey, Papua New Guinea Institute of Medical Research, Papua New Guinea
  • *D. Zhang, State Family Planning Commission, Beijing, China
Temporary Advisors
  • *S. Jejeebhoy, Mumbai, India
  • R. Karim, National Population and Family Development Board, Kuala Lumpur, Malaysia
Regional Office staff
  • *S. Acharya, Regional Office for South-east Asia
  • J. Annus, Regional Office for the Western Pacific

*Denotes woman

 

Annex 2

REGIONAL SCIENTISTS

Heads of centres 1997
  • B. Affandi, University of Indonesia, Jakarta, Indonesia
  • *H.H. Akhter, Bangladesh Institute of Research for Promotion of Essential and Reproductive Health Technologies,
  • Dhaka, Bangladesh
  • *Duong Thi Cuong, Institute for the Protection of Mother and Newborn, Hanoi, Viet Nam
  • Ding Xuncheng, National Evaluation Centre for the Toxicology of Fertility Regulating Drugs, Shanghai, China
  • Gao Ershang, Shanghai Institute of Planned Parenthood Research, Shanghai, China
  • *Ge Qin-sheng, Peking Union Medical College, Beijing, China
  • H.S. Juneja, Institute of Research in Reproduction, Mumbai, India
  • D. Lutan, University of North Sumatra, Medan, Indonesia
  • Phonethep Pholsence, Maternal and Child Health Institute, Ministry of Public Health, Vientiane, Lao People's Democratic Republic
  • R.P. Prabowo, Airlangga University, Surabaya, Indonesia
  • J. Radnaabazar, State Research Centre on Mother and Child Health and Human Reproduction, Ulaanbaatar, Mongolia
  • *M. Rajalakshmi, All India Institute of Medical Sciences, New Delhi, India
  • Jagannath Rao, Centre for Reproductive Biology and Molecular Endocrinology, Indian Institute of Science, Bangalore, India
  • *Sungwal Rongpao, Chiang Mai University, Chiang Mai, Thailand
  • Sang Guo-wei, Family Planning Research Institute of Zhejiang, Hangzhou, China
  • B. Saxena, Indian Council of Medical Research, New Delhi, India
  • M.P. Shrestha, Tribhuvan University, Kathmandu, Nepal
  • *Gi Sok Ha, Pyongyang Maternity Hospital, Pyongyang, Democratic People's Republic of Korea
  • Thein Hlaing, Department of Medical Research, Ministry of Health, Yangon, Myanmar
  • *Nguyen Thi Thuy, Hung Vuong Hospital, Ho Chi Minh City, Viet Nam
  • Virasakdi Chongsuvivatwong, Prince of Songkla University, Hat Yai, Thailand
  • *C.N. Wijeyaratne, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
  • Zeng Yi, Institute of Population Research, Peking University, Beijing, China

*Denotes woman