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PubMedDate not supplied

Pregnancies averted among U.S. teenagers by the use of contraceptives.

CONTEXT: The personal and social costs associated with teenage pregnancy in the United States concern many policymakers and researchers, yet the role of contraception in preventing these pregnancies has not been adequately quantified. METHODS: Published estimates of contraceptive effectiveness were applied to 1995 National Survey of Family Growth data on sexual and contraceptive practices in order to estimate the number of pregnancies averted through the use of contraceptives by U.S. teenagers. Four scenarios of contraceptives access--from current levels of access to highly restricted access--and teenagers' sexual and contraceptive practices in response to such restrictions are used to project the potential impact on pregnancies among teenagers. RESULTS: Current levels of contraceptive use averted an estimated 1.65 million pregnancies among 15-19-year-old women in the United States during 1995. If these young women had been denied access to both prescription and over-the-counter contraceptive methods, an estimated one million additional pregnancies (ranging from 750,000 to 1.25 million) would have occurred, assuming some decrease in sexual activity. These pregnancies would have led to 480,000 live births, 390,000 abortions, 120,000 miscarriages, 10,000 ectopic pregnancies and 37 maternal deaths. CONCLUSIONS: Contraceptive use by teenage women prevents pregnancies and negative pregnancy-related health consequences that can disrupt the lives of adolescent women and that have substantial societal costs. Continued and expanded access to contraceptives for adolescents is a critically important public health strategy.

Adolescent↗
PubMed1999

Unrecognized sexually transmitted infections in rural South African women: a hidden epidemic.

Sexually transmitted infections (STIs) are of major public health concern in developing countries, not least because they facilitate transmission of human immunodeficiency virus (HIV). The present article presents estimates of the prevalence, on any given day, of STIs among women in rural South Africa and the proportion who are asymptomatic, symptomatic but not seeking care, and symptomatic and seeking care. The following data sources from Hlabisa district were used: clinical surveillance for STI syndromes treated in health facilities, microbiological studies among women attending antenatal and family planning clinics, and a community survey. Population census provided denominator data. Adequacy of drug treatment was determined through quality of care surveys. Of 55,974 women aged 15-49 years, a total of 13,943 (24.9%) were infected on any given day with at least one of Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, or Treponema pallidum. Of the women investigated, 6697 (48%) were asymptomatic, 6994 (50%) were symptomatic but not seeking care, 238 (1.7%) were symptomatic and would seek care, and 14 (0.3%) were seeking care on that day. Only 9 of the 14 women (65%) were adequately treated. STIs remained untreated because either women were asymptomatic or the symptoms were not recognized and acted upon. Improved case management alone is therefore unlikely to have a major public health impact. Improving partner treatment and women's awareness of symptoms is essential, while the potential of mass STI treatment needs to be explored.

Adolescent↗
PubMedDate not supplied

Influence of recall period on estimates of diarrhoea morbidity in infants in rural Tamil Nadu.

Data collected on 689 infants, in a study to assess the incidence of diarrhoea during infancy, is used here to quantify the extent of under-reporting in diarrhoea morbidity surveys. The study area consisted of two contiguous primary health centres in Villupuram health unit district in Tamil Nadu, south India. Each day of infancy was assigned a recall period and proportion of diarrhoeal days for various recall period computed. The proportion of diarrhoea was 11.3%, 12.0% and 11.2% for zero, one and two days of recall period, respectively, (mean 11.5%) after which the proportion decreased. The under-reporting of diarrhoea was approximately 15%, 26% and 45% with three, six and 7-13 days of recall period, respectively compared to mean. As there is considerable under-reporting of diarrhoea morbidity when recall period exceeds three days, it would be better to collect information on diarrhoea twice a week in diarrhoeal morbidity surveys.

Community Health Centers↗
PubMed2000

Factors in risk perception

Risk perception is a phenomenon in search of an explanation. Several approaches are discussed in this paper. Technical risk estimates are sometimes a potent factor in accounting for perceived risk, but in many important applications it is not. Heuristics and biases, mainly availability, account for only a minor portion of risk perception, and media contents have not been clearly implicated in risk perception. The psychometric model is probably the leading contender in the field, but its explanatory value is only around 20% of the variance of raw data. Adding a factor of "unnatural risk" considerably improves the psychometric model. Cultural Theory, on the other hand, has not been able to explain more than 5-10% of the variance of perceived risk, and other value scales have similarly failed. A model is proposed in which attitude, risk sensitivity, and specific fear are used as explanatory variables; this model seems to explain well over 30-40% of the variance and is thus more promising than previous approaches. The model offers a different type of psychological explanation of risk perception, and it has many implications, e.g., a different approach to the relationship between attitude and perceived risk, as compared with the usual cognitive analysis of attitude.

Journal Article↗
PubMed2000

A multivariate method for estimating mortality rates among children under 5 years from health and social indicators in Iraq.

BACKGROUND: Many reports on Iraq suggest that a rise in rates of death and disease have occurred since the Gulf War of January/February 1991 and the economic sanctions that followed it. METHODS: Four preliminary models, based on unadjusted projections, were developed. A logistic regression model was then developed on the basis of six social variables in Iraq and comparable information from countries in the State of the World's Children report. Missing data were estimated for this model by a multiple imputation procedure. The final model depends on three socio-medical indicators: adult literacy, nutritional stunting of children under 5 years, and access to piped water. RESULTS: The model successfully predicted both the mortality rate in 1990, under stable conditions, and in 1991, following the Gulf War. For 1996, after 5 years of sanctions and prior to receipt of humanitarian food via the oil for food programme, this model shows mortality among children under 5 to have reached an estimated 87 per 1000, a rate last experienced more than 30 years ago. CONCLUSIONS: Accurate and timely estimates of mortality levels in developing countries are costly and require considerable methodological expertise. A rapid estimation technique like the one developed here may be a useful tool for quick and efficient estimation of mortality rates among under 5 year olds in countries where good mortality data are not routinely available. This is especially true for countries with complex humanitarian emergencies where information on mortality changes can guide interventions and the social stability to use standard demographic methods does not exist.

Child Welfare↗
PubMed1975

Family planning services in the United States.

In recent years the United States has made considerable progress in providing family planning services for those in need. This does not mean, however, that the problems posed by unwanted pregnancies and unwanted births have been completely overcome. Estimates of the number of low-income women needing and receiving family planning services indicate that roughly 3.6 million women at risk of an unwanted pregnancy were receiving family planning services in 1973. This represented almost two-thirds of those in need at the time. Many programs are also seeking to meet the teenage need demonstrated by very high rates of out-of-wedlock births, premarital conceptions, obstetric problems, and legal abortion demands of women 15 to 19 years of age. As of 1973, it appeared that between 1.3 and 2.2 million never-married teenagers were in need of organized family planning services, and that of these, services were being received by between 25 and 42 per cent.

Abortion, Legal↗
PubMed1978

[Not Available].

Explore the source record for details and available documents.

Bulgaria↗
PubMed1987

Models of birth trajectories with certain patterns of variations in vital rates.

This article records experiments with a modified version of Lotka's stable population model. The traditional assumption of a set of unchanging net maternity rates as one of the preconditions has been replaced by allowing the rates to vary in certain ways while approaching or varying around a set of underlying constant rates. The integral equation assumes a different form but can be simplified and solved in the same old way. As a result, the birth trajectory does not necessarily attain a stable state. For certain patterns of mathematical functions the trajectory eventually becomes stable while for certain others it shows cyclical fluctuations. The variations in net maternity rates can also be postulated to follow the patterns of some measurable empirical functions which, like the mathematical functions, should be amenable to projections in the future. This information is needed for deriving the long-term solutions in additions to the information about the intrinsic rate of growth which is obtained from the traditional integral equation.

Birth Rate↗
PubMed1993

Estimates of net internal migration for Korea, 1985-90.

The authors "estimate the volume and rate of net internal migration in [South] Korea for each five-year age group for the period between 1985 and 1990, adopting the forward census survival ratio method.... Two sets of [estimates] are made: (1) net internal migration for administratively defined provinces and equivalent districts with urban-rural distinction and (2) net internal migration for each of 73 cities in 1990." Extensive tables contain the estimates.

Age Factors↗