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Women's position and family planning in Egypt.
In this report, data from the 1988 Egypt Demographic and Health Survey are used to address some of the most frequently raised questions about the relationship between gender inequality and reproductive behavior. The findings from binomial and multinomial logit models show that while the relationship between women's position and fertility control in Egypt is complex, some clear, broad patterns exist that have important theoretical and policy implications. First, although women's status in Egypt is clearly multidimensional, the reproductive aspect of women's position has a strong connection with the nonreproductive dimensions. Second, the case of the continued use of education and employment as proxies of women's position, especially in relationship to fertility control, is considerably discredited by the results. Finally, the findings indicate that Egyptian culture supports gender equality in the form of interaction and negotiation rather than women's autonomy.
Men's unmet need for family planning: implications for African fertility transitions.
This article introduces the concept of men's unmet need for family planning and explains its programmatic relevance. Using data from Demographic and Health Surveys (DHS) of Ghana (1988, 1993) and Kenya (1989, 1993), married men are found to have high levels of unmet need for family planning that are comparable to, although slightly lower than, those for women. The importance of men's unmet need is demonstrated when the analysis is restricted to marital pairs in the DHS samples; trends in the joint unmet need of husbands and wives are shown to be closely associated with the nature of the fertility transitions occurring in Ghana and Kenya. Because of wide discrepancies found between husbands' and wives' unmet need statuses, family planning programs that foster spousal communication are likely to facilitate the transition to lower fertility.
Family planning in the Jewish population of Israel: correlates of withdrawal use.
This report describes trends and differentials in contraceptive practices among Israeli Jews. Data from two fertility surveys show a heavy reliance on the IUD, little use of sterilization, and declining, but still significant use of withdrawal. The factors associated with the practice of withdrawal are explored. Evidence is found in support of Santow's hypotheses that the degree of sex-role differentiation within marriage and the belief that men hold the authority in reproductive decisionmaking are both positively related to the practice of withdrawal. Fear of oral contraceptives, a dislike of sterilization, and a reliance on the IUD only at greater parities imply a continuing role for withdrawal, especially among Israeli Jewish couples in which wives are less educated and have more traditional sex roles than the wives in other couples.
Gender differences in health care provider-patient communication: are they due to style, stereotypes, or accommodation?
This article examines gender differences in health care provider-patient communication within the framework of an ecological model of communication in the medical encounter. The ecological perspective posits that, although health care provider-patient interactions are situated within a number of contexts (e.g. organizational, political, cultural), the interpersonal domain is the primary context within which these interactions unfold. Hence, gender may influence provider-patient interaction to the extent that it can be linked to the interactants' goals, skills, perceptions, emotions, and the way the participants adapt to their partner's communication. The evidence reviewed in this essay indicates that gender differences in medical encounters may come from several sources including differences in men's and women's communicative styles, perceptions of their partners, and in the way they accommodate their partner's behavior during the interaction. However, because gender is but one of many personal and partner variables (e.g. age, ethnicity, personal experiences) that can influence these processes, gender differences are often quite modest (if apparent at all) when examined across a population of health care providers and patients. Implications for future research and communicative skill training are discussed.
Communicating with patients about intimate partner violence: screening and interviewing approaches.
Intimate partner violence is a major public health concern; it contributes to poor physical and mental health in affected individuals, primarily women. Due to documented poor detection rates of intimate partner violence by physicians, the medical community has focused increasing attention on the successful identification of victims in all medical contexts. Family medicine educators need to be aware of the current status of knowledge about intimate partner violence and convey this to students and residents. In this article, we review the literature on screening tools to identify victims of partner violence, discuss the pitfalls of relying on screening tools, review barriers to identification of partner violence from clinician and patient perspectives, and recommend a patient-centered methodfor conversing with patients about intimate partner violence.
Initiation of prenatal care by adolescents. Associations with social support, stress, and Hispanic ethnicity.
The purpose of this study was to determine the social factors associated with initiation of prenatal care by adolescents. Eighty-one postpartum adolescents aged 17 years and under were interviewed within 24 hours of delivery about background factors, living situation, experiences, and behaviors during pregnancy. Of the adolescents, 58 were of Hispanic (Mexican) origin; the remainder were non-Hispanic whites. The first prenatal visit occurred at a mean of 4.04 months' gestation for Hispanics and 4.39 months' gestation for the non-Hispanics, one month after the pregnancy test. Differences between the ethnic groups were not significant. Controlling for ethnicity, both age and social support from the partner and his family were associated with initiation of care (P less than .01). In a separate analysis, age and partner-family support were unaffected by the introduction of stress and parental support (P less than .01). These findings highlight the importance of the partner and his family as a source of support to pregnant adolescents. To whom and when the adolescent communicates about the pregnancy may be the key linking social support to initiation of prenatal care. Providers who work with sexually active adolescents should emphasize the importance of early communication with partners and with family members if a pregnancy is suspected.
Transitions to parenthood: his, hers, and theirs.
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Couple's literacy level and acceptance of family planning methods: Lorenz curve analysis.
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The most neglected intimacy -- birth control. How to shorten the responsibility gap between men and women.
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[Similarities and differences in reproductive wishes of spouses in families with few children].
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Safer sex communication and unsafe sexual behavior among young men who have sex with men in California.
Our objective was to investigate sexual communication and risk-taking behaviors among young men who have sex with men (MSM). MSM aged 17 to 25 years were recruited from four areas throughout California. The construct Safer Sex Communication, assessed through principal-components analysis, was defined as perceived efficacy or experience in minimizing the risk of sexual HIV infection through communication with partners. In the 6 months prior to the survey, 35.6% of the MSM had participated in unprotected anal intercourse (UAI). Adjusted logistic regression analyses found low Safer Sex Communication to be predictive of UAI. In addition, negative attitudes toward safe sex, high perceived risk of HIV infection, 10 or more male sex partners during the previous 6 months, and use of cocaine in the past 6 months were also independently related to UAI. Safer Sex Communication skills should be an outcome of interventions designed to prevent HIV transmission among young MSM.
Family planning in Maghreb: redefining responsibility.
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Content of educational programmes for men.
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The impact of a family planning multimedia campaign in Bamako, Mali.
An integrated multimedia campaign featuring family planning messages saturated the 900,000-person city of Bamako, Mali, for three months during the spring of 1993. With traditional theater and music, family planning messages were repeatedly broadcast on radio and television that conveyed information about modern contraceptive methods, the need for male sexual responsibility, the health and economic advantages of family planning, the need for communication between spouses, and that Islam, the predominant faith of Mali, does not oppose family planning. A separate sample pretest-post-test quasi-experimental research design was used to evaluate the effects of the campaign and exposure to specific messages on changes in contraceptive knowledge, attitudes, and practice. Results indicate a high level of exposure to and agreement with the messages. A dramatic drop was found in the proportion of men and women who believe that Islam opposes family planning. Logistic regression results indicate that contraceptive knowledge and use and more favorable attitudes toward family planning are positively associated with intensity of exposure to the project interventions, after controlling for relevant variables.
Social and linguistic factors influencing adaptation in children's speech.
The ability to appropriately reciprocate or compensate a partner's communicative response represents an essential element of communicative competence. Previous research indicates that as children grow older, their speech levels reflect greater adaptation relative to their partner's speech. In this study, we argue that patterns of adaptation are related to specific linguistic and pragmatic abilities, such as verbal responsiveness, involvement in the interaction, and the production of relatively complex syntactic structures. Thirty-seven children (3-6 years of age) individually interacted with an adult for 20 to 30 minutes. Adaptation between child and adult was examined among conversational floortime, response latency, and speech rate. Three conclusions were drawn from the results of this investigation. First, by applying time-series analysis to the interactants' speech behaviors within each dyad, individual measures of the child's adaptations to the adult's speech can be generated. Second, consistent with findings in the adult domain, these children generally reciprocated changes in the adult's speech rate and response latency. Third, there were differences in degree and type of adaptation within specific dyads. Chronological age was not useful in accounting for this individual variation, but specific linguistic and social abilities were. Implications of these findings for the development of communicative competence and for the study of normal versus language-delayed speech were discussed.
Gendered communication among young people in Mexico: implications for sexual health interventions.
Effective communication between partners is crucial for good sexual health, but is often difficult to achieve. This qualitative study shows how gendered communication can act as an important barrier to successful dialogue between men and women. Both content and manner of speaking are often gendered: not only can topics of conversation be socially defined as more or less appropriate for a speaker according to his or her sex, but men and women can also differ systematically in terms of the phrases and words they use. This may lead to a lack of the common forms of expression that are needed for effective communication. The study examines communication about sexuality among young men and women in low-income areas of Mexico City. The relationship between gender stereotypes of sexual behaviour and the gendered nature of communication strategies is explored. The negative consequences of gendered communication for effective dialogue between men and women are illustrated. Interventions that can enhance communication between men and women would be expected to have a positive impact on sexual health. This paper argues that research and interventions intended to improve sexual health may instead inadvertently reinforce communication barriers not only by failing to address the social pressures that exacerbate gendered communication, but also more insidiously, by using language that actively contributes to these pressures. An example of an intervention that avoids this problem is the Mexican programme "Gente Joven" ("Young People").
The pre- and poststerilization predictors of poststerilization regret in husbands and wives.
Husbands and wives from 141 tubal sterilization couples and 162 vasectomy couples were interviewed just prior to sterilization and then again 1 and 2 years later. We conducted linear regression analyses to determine the pre- and poststerilization predictors of poststerilization regret in each of the four gender x method groups (tubal husbands, tubal wives, vasectomy husbands, vasectomy wives). We confirmed a number of hypotheses based on the research literature and our own earlier work. Both individual and couple factors contributed to the development of regret, as did both pre- and poststerilization factors. An important finding was the degree to which regret among the nonsterilized respondents (tubal husbands, vasectomy wives) was affected by pre- and poststerilization interaction with their spouses.