This article examines the rationales for commonly advocated postpartum family planning services and challenges the behavioral and biological assumptions on which they are based. An alternative approach to service delivery is suggested. Services should be designed to incorporate breastfeeding and to increase their acceptability to postpartum women.

Attitude to Health↗

PubMedDate not supplied

[Echographic determination of the inferior segment in at-risk premature labor. Preliminary study].

Explore the source record for details and available documents.

Female↗

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Indicators for measuring the quality of family planning services in Nigeria.

This article presents the Situation Analysis approach as a means of collecting data that can be used to assess the quality of care provided by family planning service-delivery points (SDPs), and describes the quality of services offered in Nigeria. Elements of the quality of services provided at 181 clinical service-delivery points in six states of Nigeria are described. The substantive results from the study suggest that although most of the 181 service points sampled are functional, the quality of care being provided could be improved. Illustrative scores for these indicators and elements of the Bruce-Jain framework are given. By comparison with contraceptive prevalence surveys, the Situation Analysis approach is still in its early stages. Some methodological issues are raised here and future directions for strengthening the validity and applicability of the approach are discussed.

Bias↗

PubMedDate not supplied

Using situation analysis data to assess the functioning of family planning clinics in Nigeria, Tanzania, and Zimbabwe.

Situation analyses conducted in Nigeria. Tanzania, and Zimbabwe have revealed problems in the functioning of many of the subsystems of family planning service delivery, namely in supplies of commodities; in facilities and equipment; in staffing and training; in information, education, and communication; and in record keeping. Although a clear pattern of clinic use exists, in that only a few service-delivery points provide contraceptive services to the majority of new family planning acceptors in the three countries, an attempt to explain how clinics with more clients differ from those that are visited less frequently revealed only a weak association between subsystem functioning and use.

Bias↗

PubMedDate not supplied

A new approach to eliciting information about induced abortion.

Reliable quantitative data on abortion are sorely needed, particularly in developing countries. Past experience in large-scale survey research has demonstrated that direct questioning on this subject results in significant underreporting. This article presents results of an experiment to collect data on induced abortion in Côte d'Ivoire within the context of a family planning operations research study. First, questions were employed to broach the topic of unwanted pregnancy in a value-free manner, and then the potential for a variety of actions, including abortion, was acknowledged. The results indicate that approximately 25 percent of all women attending a family planning clinic on the day of the survey had had an induced abortion. The use of improved abortion-related questions shows promise for providing more complete measurement of a neglected dimension of women's reproductive health.

Abortion, Induced↗

PubMedDate not supplied

Comparing the Peru service availability module and situation analysis.

This report reviews the experience of the World Fertility Surveys and the Demographic and Health Surveys (DHS) in collecting community-level data on family planning. It assesses the validity of the community data for Peru that were collected via a service availability module, much like that which is used for the DHS, through a comparison with data from the Situation Analysis. The analysis indicates that the knowledgeable informant, the main source of information about family planning in each community for the service availability module, may not be an accurate source of data. Information about the availability of family planning services is more reliable when it is obtained by means of visits to service sites. However, given cost considerations, sampling problems, and analysis issues, routine linkage of Situation Analyses to household surveys such as the DHS is not recommended at this time.

Contraception Behavior↗

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The impact of the quality of family planning services on contraceptive use in Peru.

Through linkage of a Demographic and Health Survey to a situation analysis, this article explores whether current contraceptive use in Peru is affected by the service environment in which a woman resides. The investigation focuses explicitly on the impact of the quality of family planning services and finds that, net of personal and household characteristics, a significant, albeit small, effect exists for one specification of quality in the total sample and for the other specification a nearly significant (p = .053) effect exists. The analysis reveals that contraceptive prevalence would be 16 to 23 percent greater if all women lived in a cluster with the highest quality of care compared with the lowest. Methodological problems that arise in measuring quality of care at the cluster level and in linking quality to individual contraceptive use are also addressed.

Adolescent↗

PubMedDate not supplied

Survey questions for the measurement of induced abortion.

Underreporting of induced abortion in survey research is a ubiquitous problem. The use of an indirect interview technique in which questions were asked about abortion in the context of unwanted pregnancy was described earlier as holding promise for increasing the response rate. This report reviews the mixed results from multicountry studies that used indirect technique. Exploratory qualitative studies are needed to identify a setting-specific context for discussing abortion. Because the subject of induced abortion is inherently sensitive, survey measurement of this practice is less precise than that of other, less controversial maternal health-care practices. This lack of precision should not deter the pursuit of the study of this critically important public-health-care concern.

Abortion, Induced↗

PubMedDate not supplied

The reliability of the situation analysis observation guide.

The use of direct observation to assess the quality of family planning services is a central element of situation analysis studies. The interrater reliability of observational data from a study in Turkey was assessed using teams of multiple observers. Overall, the findings suggest a strong degree of reliability. Observers were more likely to agree when rating physical actions than verbal cues and when both observers were of similar backgrounds. The high degree of reliability in the situation analysis observation guide is considered to be due to a relatively low level of measurement and the use of crude indicators for several dimensions of quality. The guide's reliability makes this sort of study particularly valuable to family planning clinicians, program managers, and policymakers.

Family Planning Services↗