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PubMed1993

American families: policy issues.

"Increases in the number of children living in single-parent (usually female-headed) households and in the proportion of mothers who work outside their homes have raised concern in the United States about the effects of these trends on the well-being of children and the possible need for policy intervention. This paper discusses the arguments for and against policies that affect families. We review a number of such policies and what research suggests about their likely effects. The policies discussed...include those concerning child support, welfare, income taxes, child and dependent care, family leave, family planning, programs to improve parenting skills and family function, and economic growth."

Americas↗
PubMedDate not supplied

Supporting teenagers' use of contraceptives: a comparison of clinic services.

A program to provide teenage family planning clinic patients with special services designed to improve their ability to practice contraception effectively and avoid conception produced neither of these expected effects. Two types of special services were tested in nine clinics: one, to promote greater involvement of the teenager's family through special counseling sessions (family support); and the other, to provide more frequent contact between the teenager and clinic staff through telephone calls (periodic support). The services were provided in the six weeks following the first clinic visit. Only 36 percent of the girls who agreed to be in the family support group attended any counseling sessions, and only five percent of them came with a parent. Participation was greater in the periodic support group--84 percent of teenagers in the group received the follow-up phone calls. During the 15 months following the initial clinic visit, there were no significant differences in regularity of contraceptive use and pregnancy rates between the teenagers who received the special support services and those who received only the regular clinic services. About 40 percent of the special-service groups reported always using a contraceptive method during the study period, compared with 48 percent of controls; and about 40 percent of the former said they had rarely or never used a method, compared with 27 percent of the latter. The cumulative 15-month pregnancy rate was about 13 percent in both the special-service and the control groups.

Adolescent↗
PubMed1969

Patterns of contraceptive use among clients of the Barbados Family Planning Association.

This is a study of the behavior patterns of lower class Barbadian women during the fecund period of their lives with respect to the introduction of new types of contraceptives within a multiple method family planning program. The behavior patterns of these women are examined through their use of the facilities of The Barbados Family Planning Association (BFPA). In 1955, the BFPA was set up to disseminate information on family planning and to provide the material means for family limitation. From its inception, a variety of contraceptive methods have been made available to women utilizing the services. The study is developed within a diffusion theoretic framework that focuses on the trial and adoption stages of the diffusion process. Data are drawn for this thesis from 2 samples: 1) a systematic sample of records kept by the BFPA on its clients, and 2) a systematic stratified sample chosen from patients of the Population Council Research Project (PCRP). (The PCRP was an affiliate of the BFPA between 1965 and 1967.) Patients were interviewed at both the family planning clinics and in their homes. The BFPA has followed the policy of making available at nominal cost all existing contraceptive methods. This has led to very high dropout rates after admission and a considerable amount of method changing. However, changes take place generally in the direction of increasing the reliability of the method used. The lower the reliability of the method, the greater the rate of dropout as well as the rate of change from it. The longer the time spent in the program, the greater the number of methods used; but the longer the time a method is used, the less likely that it will be given up for another method. The transition probabilities for changing from user to nonuser in a year do not remain constant over the 12 years for which the program has been in operation. This is also true for changing from nonuser to user. In the case of the users these probabilities remain constant for time spans of 4 consecutive years; decreasing from one time span to another. The transition probabilities for going from nonuser to user remain constant for time spans of 4 consecutive years over the first 8 years of operation of the program and for the last 3 years. The year 1964 was found to be deviant. However, the probability of going from nonuser to user increases from one time span to the other. Therefore, 3 time subsystems are delimited, each characterized by constant probabilities. Each subsystem represents a unique period in the development of the program.

Barbados↗
PubMed1978

Declining world fertility: trends, causes, implications.

This Bulletin examines the evidence that the world's fertility has declined in recent years, the factors that appear to have accounted for the decline, and the implications for fertility and population growth rates to the end of the century. On the basis of a compilation of estimates available for all nations of the world, the authors derive estimates which indicate that the world's total fertility rate dropped from 4.6 to 4.1 births per woman between 1968 and 1975, thanks largely to an earlier and more rapid and universal decline in the fertility of less developed countries (LDCs) than had been anticipated. Statistical analysis of available data suggests that the socioeconomic progress made by LDCs in this period was not great enough to account for more than a proportion of the fertility decline and that organized family planning programs were a major contributing factor. The authors' projections, which are compared to similar projections from the World Bank, the United Nations, and the U.S. Bureau of the Census, indicate that, by the year 2000, less than 1/5 of the world's population will be in the "red danger" circle of explosive population growth (2.1% or more annually); most LDCs will be in a phase of fertility decline; and many of them -- along with most now developed countries -- will be at or near replacement level of fertility. The authors warn that "our optimistic prediction is premised upon a big IF -- if (organized) family planning (in LDCs) continues. It remains imperative that all of the developed nations of the world continue their contribution to this program undiminished."

Africa↗
PubMed2002

Spousal communication and family planning behavior in Navrongo: a longitudinal assessment.

The poor performance of most family planning programs in the 1980s, especially in sub-Saharan Africa, generated concern among researchers and led to a quest for explanations. In most countries, the alienation of men from participation in these programs was subsequently identified as one of the major causes, a finding that led researchers to redirect their attention to couples instead of individuals as the focus of such programs. Lack of spousal communication about family planning was identified as one reason for the low level of contraceptive use among women. Subsequent research has persistently demonstrated a positive relationship between spousal communication and contraceptive use. Most prior studies on this topic have been based on cross-sectional data, so that whether the identified relationships are causal remains unclear. Does communication, in fact, predict contraceptive use, or does the use of contraceptives generate communication among couples? This study addresses the question of causality by using longitudinal data from the Navrongo Health Research Centre panel survey. Results from both cross-sectional and longitudinal analysis demonstrate that spousal communication does, indeed, predict contraceptive behavior, even when other factors are controlled.

Adolescent↗
PubMed1998

Contraceptive choices among Nigerian women attending an antenatal clinic.

The factors determining the choice of contraception were studied among 230 pregnant women attending the antenatal clinic at Nnewi, Nigeria. There were 174 (52.1%) choices for the natural methods of contraception, 86 (25.7%) for the traditional methods, and 74 (22.2%) for the artificial methods. The most commonly chosen contraceptive methods were rhythm, 95 (28.4%) and Billings, 79 (23.5%), while the least was surgical contraception, 4 (1.2%). The barrier method was not chosen at all. The most common reason given for choice of contraception was safety, 28.7%, followed by dislike of artificial methods, 25.2%; the no-response rate was 29.1%. Other reasons given were ease of use, 10%; husband's decision, 1.3%; fear of the complications of the artificial methods, 13%; dislike of foreign body, 2.6%; the method most understood, 24.8%; need for further counselling, 7%; and long-lasting, 2.6%. The most common reason given against the use of the artificial methods of contraception was fear of its complications, 31.9%, followed by preference for the natural methods, 22.3%. Condom use decreased with increasing age, being highest at 16-20 years, 37.5%, and lowest at 31-35 years, 5.9%. When compared with other parity groups, the grandmultipara group (> or = 5) used the IUD, 14.3%; injectable contraception, 4.8%; and other traditional methods (breastfeeding and abstinence), 28.5%, and did not use the rhythm method. Women of the lowest social class most commonly chose other traditional methods, 57.1%, and never chose the Billings method. Women who desired 1 to 3 children most commonly chose the pill, 23.5%, or withdrawal method, 23.5%, while women who desired 4 to 10 children most commonly chose the rhythm and Billings methods. There was no difference in choice of method of contraception for the various religious denominations, although the artificial methods were less commonly chosen by Catholics, 14.1%, compared with Anglicans, 33%, and other Christian denominations, 33.3%. The physician was the most common source of information for the choosers of the condom, 18.9%; surgical contraception, 2.7%; and the pill, 8.1%; the nurse for injectable contraception, 4.9%, while the commonest source of information among choosers of the rhythm method was the electronic media, 40.5%; print media, 34.9%; and peer group, 34.4%. Lecture/sex instruction was the commonest source of information among choosers of the Billings, 35.5%, and withdrawal, 22.6%, methods, while the no-response rate on source of information on contraception was highest among choosers of the Billings method. There is a need to bridge the gap in contraceptive information by redirecting counselling strategies and restructuring family planning programs to dispel negative perceptions and encourage informed choice of effective family planning methods.

Adolescent↗
PubMed2003

[Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods].

OBJECTIVE: To describe the proportion of unwanted pregnancies among all pregnant adolescents, its association with sociodemographic characteristics, and the use of post-partum contraceptive methods. MATERIAL AND METHODS: A cross-sectional study was conducted among 220 women between 13 and 19 years of age, in two semi-urban municipalities of the State of Morelos, Mexico, interviewed between 1992 and 1994. Women were interviewed at home, six to twelve weeks after their delivery date. Women were asked whether they had wanted their last pregnancy, and about knowledge and use of contraceptive methods after delivery. RESULTS: Adolescent pregnancies accounted for 17% of all births registered in these two municipalities. Among all adolescent mother 22.73% reported that their pregnancy had not been wanted. A positive association was found between the lack of access to health services provided by public medical insurance systems (Instituto Mexicano del Seguro Social IMSS and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado ISSSTE) and unwanted pregnancy (adjusted OR = 3.03, 95% CI (1.31, 7.) An association was also found between living in an urban community (adjusted OR = 2.16, 95% CI (1.08, 4.33) and an unwanted pregnancy. Among all adolescent mothers, 91.3% were familiar with "the pill" as a contraceptive method; 84.72% knew about the IUD, and 63.68% knew about the condom. However, only 35% of them were actually using an effective contraceptive method six weeks after delivery. No difference in frequency of contraceptive use was found among the adolescent mothers, according to whether they wanted their last pregnancy. Only 43.39% of mothers who delivered at hospitals or health centers were using an effective contraceptive method. CONCLUSIONS: These findings suggest that there is a great potential for family planning programs to target adolescents, and that the use of contraceptive methods after delivery should be promoted among adolescent mothers, especially those lacking access to public medical insurance and those living in semi-urban settings. It is also recommended to conduct studies on family planning education programs that can be introduced earlier in the school system in Mexico.

Adolescent↗
PubMed1975

The containment of world population growth.

The world has reached the present position of unprecedentedly rapid population growth not by achieving uniquely high fertility but by bringing about extraordinarily low mortality. The high growth rate and the built-in momentum of the age structure are obstacles to achievement of an acceptable standard of living for most of the world's population. Although government population programs have the potential to curb this growth rate, this potential has not been realized, and such programs are too often perceived both by their administrators and the population concerned as an end in themselves rather than a means toward a better standard of living. It is in this latter perspective, and in the context of the total development process, that population programs should be implemented.

Adult↗
PubMed1989

Fertility decline in Mauritius: the role of Malthusian population pressure.

Mauritius provides 1 of the outstanding cases of modern fertility reduction in the Third World, yet there has been little analysis and virtually no comparative assessment of this important demographic progression. It is argued that fertility decline in Mauritius has been hindered by cultural composition, assisted only modestly by ongoing development, but aided significantly by family planning program intervention and by a remarkable wide recognition at government and individual levels of the diseconomies associated with population growth in a congested society; comparisons are made with other densely peopled, small islands. Spatial variations in fertility and in family planning activity are slight, but Western economic theories of fertility are found to be helpful in interpreting significant temporal fluctuations.

Africa↗
PubMed1991

A strategy for reducing numbers? Response.

I am not particularly knowledgeable on the subject-matter of this article; but would like to make brief comments from the broad economic point of view. The concept of a demographic 'trap' is not sound. For one thing, this concept completely ignores the possibility of 'trade' in food by implicitly assuming that the capacity of a community to support its population depends on its own output of food through appropriate economic policies. There were many predictions of disastrous famines in India in the early 70s on the basis of considerations such as those advanced by Dr Ding. Amartya Sen has argued, quite plausibly, that famines occur because of maldistribution of food and lack of adequate 'safety nets' rather than a decline in total food output. Sen is referred to at 1 place in the article; but somewhat out of context. The conclusion that if the birth rate does not fall, the death rate should also not be allowed to fall is repugnant. Look at the countries of Latin America; population growth is high, but there is no 'entrapment'. The so called 'trap' can, of course, occur because of failure of economic and social policies and international economic policies. However, there is nothing inevitable about it (at any given rate of population growth). The author's plea for greater information and public education in respect of demographic trends and consequences is valid. There is also an urgent need for a new thrust in family planning programs on wider economic and social grounds. However, this case is quite independent of the 'entrapment' theory.

Asia↗