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Since its revival in 1989, the reproductive health and family planning program of Iran has made great strides in raising the contraceptive prevalence rate and reducing fertility. The majority of couples are using modern methods promoted and provided by the national program, although a sizable proportion of couples continue to depend on the traditional method of withdrawal. The longstanding urban-rural gap in contraceptive prevalence rates has been reduced to about 10 percent, which is mainly the result of better-educated urban couples' continued practice of withdrawal. Despite its enormous success in meeting the needs of married couples, in narrowing the urban-rural gap in access to and use of modern contraceptives, and in reducing fertility, the Iranian family planning program is open to criticism for confining its target audience to married couples and failing to address the issue of abortion. The restrictive aspects of the program are often justified on the grounds of religious values and fear of encouraging sexual promiscuity. Because of the theocratic nature of the political system and the immense power enjoyed by Shiite ulama (religious leaders), no step can be taken to address these restrictions without their implicit support and approval. This study describes some of the ethical issues facing the reproductive health program of Iran and indicates how pragmatic approaches adopted by the ruling Shiite ulama to solve some of the social and medical challenges of a rapidly modernizing society may be extended to overcome ethical hurdles faced by the reproductive health program.

Since its establishment in 1989, the family planning program of Iran has taken great strides in raising contraceptive prevalence rate and reducing fertility. The most recent national survey conducted in 2000 indicated a contraceptive prevalence rate of 74 and a TFR of 2.0 for the country as whole. This paper reviews the latest data on the extent of use of withdrawal by Iranian couples and identifies the social and demographic characteristics of women relying on this method. It is shown that women using this traditional method are more likely to be urban, come from the more developed provinces, and have higher levels of education. The experience of unintended pregnancy among withdrawal user is not more than the women who use modern contraceptives such as the pill.Key Words: Iran, Family Planning, Contraceptive Use, Withdrawal, RésuméDepuis sa création en 1989, le programme de planification familiale en Iran a réussi à mettre en hausse la prévalence des contraceptifs et à réduire le taux de fécondité. La dernière enquête nationale conduite en l'an 2000 indique un taux de prévalence des contraceptifs à 74 et un ISF (indice synthétique de fécondité) de 2.0 dans tout le pays. Cet article révise les dernières données sur l'étendue de la méthode du retrait chez les couples iraniens et identifie les caractéristiques sociales et démographiques des femmes qui se fient à cette méthode. Il est démontré que les femmes qui se servent de cette méthode traditionnelle ont tendance à être urbaines, issues de provinces plus développées et ont un niveau d'étude plutôt élevé. Les incidences de grossesses non désirées chez les femmes qui se servent de la méthode du retrait ne sont pas plus élevées que pour celles qui se servent de méthodes contraceptives plus modernes telles que la pilule.

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The demographic and health data col lected through the use of the vi tal horoscope in the villages cov ered by a ru ral health house pro vide an extremely rich source of data on a 10-year pe riod of ob servation.By Amir H. Mehryar, Mohsen Naghavi, Shirin Ahmad-Nia and Shahla Kazemipour* Despite their importance, longitudinal methods of data collection are complex, time-consuming and expensive. With longer periods of observation, the problems of population movement and loss to follow-up become important. This is particularly the case in developing countries with high rates of rural-to-urban migration and residential mobility within major urban centres. A more practical Asia-Pacific Population Journal, December 2008 55