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PubMed2002

Africa: the new family planning frontier.

Sub-Saharan Africa will be the family planning frontier of the twenty-first century. Fertility levels and population growth rates are still high, and family planning programs suited to the region are still being developed. Nevertheless, by the end of the twentieth century, fertility transition was under way in Southern Africa and a few countries elsewhere. Successful regional family planning in the twenty-first century will depend upon stronger political leadership, the development of family planning programs that meet the needs of all segments of society and not only currently married women, assistance to the market, and a recognition of the central importance of hormonal methods, especially injectables. Problems include stagnation in economic growth and in child mortality decline, as well as the persistence of the AIDS epidemic.

Africa South of the Sahara↗
PubMed1993

Changes in the determinants of fertility in Korea: analyses of pregnancy intervals and outcomes.

Korea completed the whole process of what is called the demographic transition to a low fertility and mortality level with the successful implementation of the national family planning program in 1962, and this has been accompanied by rapid socioeconomic development. Most of the fertility decline was due to a rising age at marriage and to lower marital fertility. The national family planning program, combined with the widespread practice of induced abortion, has placed an important role in reducing marital fertility, particularly among older women. This paper aims, therefore, to examine the determinants of fertility and their changes over time in an effort to suggest future population policy directions for Korea. The analysis is divided into 2 parts-estimation of pregnancy intervals by applying the proportional hazards model, and estimation of the determinants of fertility by adopting the logistic regression model to find out whether a pregnancy terminates in a live birth or in an abortion. In both analyses, the sex was included as the main explanatory variable. A woman's education has been shown to have a significant effect on delaying the timing or on the wife's age at first pregnancy, but its effect on the pace of subsequent pregnancies is much smaller and often positive. On the other hand, the woman's education has a consistently positive effect on the probability of a pregnancy ending in an abortion although the effect shows a steady decline over time. Form first parity, the sex composition of previous children stands out consistently as the most important factor in deciding both the pace of pregnancy and its outcome. The pregnancy risks of the women with sons are reduced by almost 50% at the second and third parities. The probability of a pregnancy ending in an abortion also increases substantially when parents already have a son. The decline of the desired family size but the sustained strong son preference has made the sex of children a more important factor in the determination of Korean fertility. The woman's education, on the other hand, has become a less important factor.

Abortion, Induced↗
PubMed1987

Family planning for inner-city adolescent males: pilot study.

The results of a pilot family planning program (FPP) in a pediatric practice are reported for 66 inner-city male adolescents. The FPP was designed to eliminate registration barriers to the procurement of contraceptives by adolescent males, and to prompt the community neighborhood health center (CNHC) providers to initiate discussion of birth control with their male adolescent patients. Utilization data show that males were more likely to receive contraceptives if the provider first raised the topic of birth control to them. Unstructured follow-up interviews with 27 adolescent male FPP users identified a desire for anonymity/confidentiality and embarrassment or discomfort as the key reasons for not seeking contraceptives from the CNHC. If health care providers are sensitive to male adolescents' feelings about birth control, community health centers potentially could serve as a cost-effective source of contraceptives for sexually active male adolescents.

Adolescent↗
PubMedDate not supplied

Fertility policy and family planning in the Arab countries.

An increasing number of Arab countries are instituting family planning programs to lower their populations' high fertility rates. This article examines Arab governments' perceptions of their countries' fertility situation, their desire to intervene in order to reduce or increase the rate of population growth, and the measures they have taken to influence the level of fertility. Special attention is given to family planning programs and access to methods of fertility regulation. A combination of stronger program effort and improved socioeconomic conditions account for much of the variation in contraceptive prevalence rates in 11 countries. Socioeconomic setting and political factors are found to be of primary importance in determining Arab fertility policies.

Family Planning Services↗
PubMed2004

Changes in American opinion about family planning.

A 1998 public opinion survey conducted in the United States indicated high levels of support for many family planning policies, including US health insurance coverage of family planning services and US sponsorship of family planning programs in developing countries. To gauge changes in opinion on these issues since then, some of the 1998 questions were asked in an omnibus 2003 survey. The results indicate continuing high support for requiring US health insurers to cover family planning services (87 percent in 1998 and 84 percent in 2003), but some loss of support (from 80 to 69 percent) for US sponsorship of family planning programs in developing countries. Opinion remains divided on the policy of prohibiting nongovernmental organizations from receiving federal funding for performing or actively promoting abortion services. The authors explore several possible explanations for these findings, including the role changing presidential policy may have had in shaping opinion regarding family planning aid for developing countries.

Adult↗
PubMed1992

We must tackle population problems.

Thank you Mr. Chairman, for the opportunity to speak out not only as a Japanese parliamentarian, but also as a member of GLOBE International, Global Legislators Organization for a Balanced Environment, consisting of legislators from the US Congress, EC Parliament, USSR Assembly and Japanese Diet who have joined together to compare, improve and coordinate our respective legislative activities in an effort to effectively address the complex issues surrounding environment and development. Mr. Chairman, world population--which reached 5.4 billion in mid-1991--is growing exponentially. According to 1 UNFPA report 3 people are born every second, a total of 250,000 people every day or 95-100 million people every year. At this rate, world population will reach 6.4 billion by year 2001, and if this rate continues to go unchecked, world population will reach 14-15 billion by the end of the 21st century. GLOBE is highly aware of the relationship between rapidly growing human populations, environmental degradation and sustainable development. We urge UNCED negotiators to address population growth rates and the integrally linked concerns of resource consumption levels, particularly in the industrialized world, in their search for solutions to the conflict between environment and development. Negotiators should also seriously consider ways in which to broaden educational and economic opportunities for women to ease population growth rates, and to alleviate poverty and stresses on the environment that result from population pressures. Social and economic factors must be integrated into population planning. It is saddening to note that almost 40,000 children die every day due to malnutrition, lack of fresh water and access to resources. Over 100 million children do not receive a primary education. Mr. Chairman, worldwide demand for a range of family planning services is increasing faster than supply. Recent studies indicate that if quality family planning information, training and services were made readily available by government and other groups, population rates would drop to manageable levels. Widespread access to family planning services is essential to population stabilization. The health of mothers, children and general quality of life is also improved through the implementation of family planning programs. At the present time many women cannot make use of the limited available services because of cultural constraints, lack of status and self-confidence. Unless complementary efforts are made to expand economic and educational opportunities for women, family planning and other reproductive health services will not reach their full potential for stabilizing population. Although family planning is an individual decision, and implementation of population programs is a sovereign matter in each country, I would urge developed countries to help their neighbors in developing countries who are in need of support for family planning and health services. Investment in family planning programs is 1 of the best ways to contribute to environmental protection and improvement. A greater portion of our foreign aid monies should be allocated for direct population assistance programs that will reach people at the grassroots level. To achieve this, a cooperative working relationship with local nongovernmental organization (NGOs) is essential. The members of GLOBE hope to facilitate cooperation between NGOs and governments so that we might stabilize human population.

Conservation of Natural Resources↗
PubMed1999

Ethical foundations of client-centered care in family planning.

Biomedical ethics provides the foundation for a model of client-centered care that can assure the good quality of family planning and other reproductive health services in developed and developing countries. Client concerns mirror the four ethical principles of autonomy, justice, beneficence, and nonmaleficence. Autonomy reflects clients' desire for full information and respect from providers so that they can exercise their right to make their own informed decisions. Justice, for clients, means fair treatment and ready access to services, regardless of one's socioeconomic status, education, ethnic group, or residence. Beneficence means that providers possess the technical competence and understanding needed to act in the best interest of their clients, as clients expect. Nonmaleficence translates into client concerns about safety--that no harm will come to them as a result of seeking services. Putting these ethical principles into practice requires changing providers' attitudes from paternalistic to client centered. Assessments of client satisfaction can help family planning programs identify and respond to client values and even raise client expectations about the care they should receive. Managers also can contribute to good quality care by meeting providers' professional needs for training, supervision, supplies, record keeping, and so on. Family planning programs around the world are focusing on these ethical concerns to emphasize respect for client values, appropriate decision making, broader access to services, and basic safety issues. Although they use a variety of techniques, all these quality assurance and improvement initiatives share an ethically based, client-centered philosophy.

Adult↗
PubMed1990

Is development really the best contraceptive? A 20-year trial in Comilla district, Bangladesh.

"This article examines which public programmes and which socio-economic development indicators have had an impact on contraceptive practices and fertility in a selected group of villages in Comilla district of Bangladesh. It finds that equitable, even-handed development may be a good 'contraceptive', but is not a realistic alternative to family planning effort.... This research, undertaken in 1985, replicates a similar knowledge, attitudes and practice (KAP) type study undertaken in these same villages some 20 years earlier, in 1967/68....Thus, the two studies provide a unique look at demographic behavioural characteristics when these agricultural development programmes were in an early stage and then 20 years later."

Asia↗
PubMed1995

Effectiveness of computer-generated telephone messages in increasing clinic visits.

OBJECTIVE: To evaluate the effectiveness of computer-generated telephone reminder calls in increasing kept appointment rates in a public health setting. DESIGN: Randomized controlled trial. SETTING: Public health clinic, Georgia. PATIENTS: Five hundred seventeen clients with scheduled appointments during a 4-week period at immunization, women, infant, and children; well-child; or family-planning programs. INTERVENTION: A single computer-generated telephone reminder 1 day before each client's scheduled appointment. MAIN OUTCOME MEASURE: Rates of kept appointments. RESULTS: Of the 277 clients assigned to receive the intervention, 144 (52%) kept their appointments, compared with only 78 (32.5%) of 240 who were not assigned to receive a message (P < .05). Improvement in kept appointment rates associated with receiving the message was highest for the immunization-program (183% increase, P < .05), with increases of 64%, 53%, and 44% for the well-child; women, infant, and children; and family-planning programs, respectively. CONCLUSIONS: These results suggest a simple and effective method to increase kept appointment rates in a variety of public health programs.

Ambulatory Care↗
PubMed1976

Family planning during psychiatric hospitalization.

Ongoing experience with development of family planning programs in psychiatric hospitals suggests that models must be flexible to allow for varying structures and traditions of institutions and for special needs of specific patient populations. However some issues, particularly those related to patients' rights and to usefulness of particular contraceptives, are broadly applicable. Introduction of a family planning program for psychiatric patients is described.

Adolescent↗
PubMedDate not supplied

Management issues in the organization and delivery of family planning services.

Statewide family planning programs have been developed primarily in the Southeast and in a few other States of the nation. They are managed by State public health agencies with a few exceptions. This paper presents issues which are of importance to persons and agencies interested in developing a statewide family planning program; namely State support, allocation of funds, setting goals based on impact rather than efficiency of services, secondary sources of funding, and patient data systems. Arguments for a statewide program include the maximum use of available resources (for example, title V maternal and child health funds), the opportunity to distribute resources equitably throughout the State, the development of a statewide third-party reimbursement system, the opportunity to develop evaluation mechanisms, support for starting a system of fee collection, and the use of a statewide patient data system. Arguments against a State program include some loss of local control of a project, possible organizational battles within State agencies, State political domination of program policy, and a possible shift of funding away from existing strong projects. In the early 1970s, development of statewide systems was coupled with a rapid increase of funding when broad coverage of services and accessibility were key factors. At the present, categorical funding is no longer increasing, and efficiency and maximization of resources are becoming more important.

Adolescent↗
PubMedDate not supplied

Is lactation nature's contraceptive? Data from Samoa.

Data from a Samoan menstruation study suggest that lactation, even intensive on-demand lactation, does not inhibit menstruation or conception. This paper explores the applied and theoretical implications of continuing to accept lactation as a universally effective fertility control mechanism. Such thinking can have disastrous implications for family planning programs, and it keeps us from challenging long-held assumptions about lactation's role in population growth in early populations.

Body Weight↗
PubMed1987

The right to have a second birth given up.

The Government of the Wendeng County, Shandong Province has taken measures to carry out the family planning program in a down-to-earth way. For the past few years, there are 2141 couples who have given up, of their own accord, the right to have a 2nd birth, though they are entitled to have. During the practice of family planning, the Wendeng Government started with the publicity of family planning policies. More than 30,000 copies of publicity pamphlets were distributed and about 220 shows of videotapes, films and slides were played in the countryside. The county's Family Planning Committee and the Maternal and Child Health Care Station, together with other departments concerned gave 120 lectures on birth control in the rural areas and sent contraceptives to every village with guidance to households. For the past 3 years, the proportion of women at childbearing age using contraceptives has increased by 62%.

Asia↗