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PubMed1999

Quality, accessibility, and contraceptive use in rural Tanzania.

We examine how informants' reports on community perceptions of the quality and accessibility of family planning facilities relate to the use of modern contraceptives by individuals in rural Tanzania. Using information on individual-level contraceptive use in conjunction with community-level information on the accessibility and quality of family planning facilities, we employ two distinct statistical procedures to illustrate the impacts of accessibility and quality on contraceptive use. Both procedures treat the community-level variables as imperfect indicators of characteristics of the facilities, and they yield nearly identical implications. We find that a community-level, subjective perception of a family planning facility's quality has a significant impact on community members' contraceptive use whereas other community measures such as time, distance, and subjective perception of accessibility have trivial and insignificant direct impacts, net of the control variables. Future research that uncovers the determinants of perceptions of both community-level and individual-level quality could provide key insights for developing effective and efficient family planning programs.

Adolescent↗
PubMedDate not supplied

[Evaluation of a health care program for women at a health center].

We show in this study the evaluation of the Women's Program in the San Antón Health Center during 1986. A separate analysis is made of each of the three subprograms (Pregnancy Control, Early Detection of Genital and Breast Cancer, and Family Planning), data on age, number of children, prior contraceptive methods, results, complications, remissions, etc... We have controlled a total of 102 women in the Family Planning program (10.88% of our female population of childbearing age), 134 (8.6%) in the Early Detection program, and/or 30 pregnancies (29.41%) have concluded. The coverage of the three subprograms has been low. Nevertheless, we must mention the detection of one carcinoma in place (0.75%). We point out the importance of carrying out this type of program in Health Centers, the elaboration of common indicators for further evaluations, as well as the importance of the nursing staff in the correct execution and increased coverage of the programs, which form the basis of teamwork in Primary Attention.

Adult↗
PubMed1975

Obstacles to family planning practice in urban Morocco.

Sixty in-depth interviews with mothers living in a urban slum of Morocco probed resistances to practicing modern methods of fertility control and began to shed light on some of the reasons family planning programs often fail to reach illiterate target populations. Economic insecurity and the disintegration of the support networks of the traditional extended family complicate the difficult lives of young mothers in the urban slum. While such factors tend to encourage smaller families, the uncertainties and complexities of the socioeconomic structure contribute to the problems blocking access to modern methods of fertility control.

Abortion, Induced↗
PubMedDate not supplied

Desired family size and son preference among Hispanic women of low socioeconomic status.

Among 432 Hispanic women aged 18-50 interviewed at a Los Angeles obstetrics and gynecology clinic, respondents reported wanting an average of 2.8 sons but only 0.1 daughters. Being older than 30, having no more than an eighth grade education, being separated, divorced or widowed, being Spanish-speaking or having been born outside the United States, and having a large family of origin were all positively associated with a desire for a greater number of sons. A multivariate analysis indicated that women who preferred to speak Spanish were 10.9 times as likely as those who preferred English to desire a greater number of sons, and those with more children were 2.5 times as likely as those with fewer children to have a strong desire for sons. Family planning programs for Hispanics may be more effective if they acknowledge this important motive for childbearing.

Adolescent↗
PubMed1984

Family planning in a healthy, married population: operationalizing the human rights approach in an Israeli health service setting.

A community health center in Israel, delivering services to a geographically defined population, attempted to formulate goals for its postpartum family planning service. Taking into account the pronatalist climate in Israel along with the good health status of the population served by this center, it was decided that the community-wide goal of the family planning program was to ensure the rights of couples to decide freely and responsibly on the number and spacing of their children. Specific process and outcome objectives were developed based on helping couples define and clarify their family planning goals, and assisting them to achieve these goals. Preliminary evaluation of the intervention based on the objectives showed that 84.0 per cent of the cohort of women who gave birth in 1980 (n = 212) had specific postpartum planning goals as opposed to 69.0 per cent of women who gave birth in 1977 (n = 242). The percentage of women experiencing unplanned pregnancies during the two years after birth was reduced by 46 per cent in the 1980 cohort (6.1 per cent of the women) as compared with the 1977 cohort (11.2 per cent).

Adult↗
PubMed1996

Farmers' paintings promote family planning.

Longyan Prefecture in West Fujian has a long and noble tradition of folk painting. The local authorities have made use of all forms of art, including folk painting, to promote the implementation of the family planning program. Folk painters in Longyan Prefecture have fully displayed their talent in producing numerous paintings to increase the population awareness of the public, depict people's keenness to respond to calls by the government for practicing family planning, and show the progress they have made in integrating family planning with economic development in rural areas. Most painters are farmers, while some are grassroots government officials working in towns and townships. They applied this ancient form of art to serving the great cause of controlling population growth and improving the quality of life in the country. Selected paintings were exhibited first in Fujian Province and then in Beijing, and have won several awards. Some of them were shown in Britain, America, Denmark, and the Philippines.

Advertising↗
PubMed1997

Migration, fertility, and state policy in Hubei Province, China.

Despite China's one-child family planning policy, the nation experienced a slight rise in the birth rate in the mid-1980s. Many observers attributed this rise to the heightened fertility of those rural-to-urban migrants who moved without a change in registration (temporary migrants), presumably to avoid the surveillance of family planning programs at origin and destination. Using a sequential logit analysis with life-history data from a 1988 survey of Hubei Province, we test this possibility by comparing nonmigrants, permanent migrants, and temporary migrants. While changing family planning policies have a strong impact on timing of first birth and on the likelihood of higher-order births, migrants generally do not have more children than nonmigrants. In fact, migration tends to lower the propensity to have a child. More specifically, the fertility of temporary migrants does not differ significantly from that of other women.

Adolescent↗
PubMed1985

Postpartum IUDs in Mexico.

Dr. Ramon Aznar, head of the medical subdivision of the Mexican health insurance program (IMSS), reports that postpartum insertion of IUDs has met great success in Mexico. In 1983, the number of postpartum IUD acceptors in the family planning program of the IMSS reached 83,763, making it the most popular method of postpartum contraception there. The program emphasizes the need for adequate training of delivery room staff and for alerting women to possible contraceptives postpartum. FHI has conducted studies of postpartum IUD use worldwide, including Mexico before the programmatic use of the method. Mexico now has the largest experience of any country in postpartum insertion. The Mexican experience serves to validate the contention that postpartum IUD insertion, accomplished during 1 of the few times in many women's lives that they have contact with the health care system, can make a significant contribution to family planning in the developing world.

Americas↗
PubMed2000

Social networks, ideation, and contraceptive behavior in Bangladesh: a longitudinal analysis.

Longitudinal survey data from a panel of married women in Bangladesh is used to estimate the impact of a social network approach to family planning field worker communication and to test a theoretical model of behavior change that explains why women adopt modern contraceptives. Government field workers were trained to organize group discussions with women in the homes of opinion leaders located at central points in each village's social network. A set of intervening variables, referred to collectively as 'ideation', are derived from diffusion of innovation and social network theory to explain how the social network approach affects contraceptive behavior. The rate of increase in modern contraceptive use was found to be five times greater among women in the social network approach than among women who were visited by field workers at home. The impact of the social network approach on modern contraceptive use was almost double that of conventional field worker visits after controlling for the effects of prior contraceptive use and intention, prior home visits, and selected socio-demographic characteristics. Both approaches had the same degree of impact on ideation. The results confirm the influence of ideation on fertility change and suggest that family planning programs would benefit from training field workers to use a social network approach.

Adolescent↗
PubMed1996

Transition from high to replacement-level fertility in a Kerala village.

This paper uses a micro-approach to examine the motivation and processes of rapid fertility decline in a Kerala village. Fertility declined in the village substantially during the 1970s and continued to decline to reach replacement level at the time of study. The proximate determinants are postponement of marriage and extensive use of contraceptives. However, the changes in these factors were the result of changing socio-economic conditions. At the time of study the singulate age at marriage was 29 years for males and 23 years for females, higher than elsewhere in India. Delayed age at marriage was a combined effect of favourable attitudes to education and economic changes. Smaller families became advantageous because of decreasing agricultural opportunities, expanded education and mortality decline. Contraceptives were available with the implementation of the family planning program. Higher use of contraceptives can be attributed to favourable conditions resulting from socio-economic changes.

Adolescent↗
PubMed1981

Japan, Indonesia to investigate condom plant feasibility.

The Japanese government has begun investigations on the possibility of constructing a condom manufacturing plant in Indonesia in response to a request by the Indonesian government. Indonesia, which hopes to reduce its birthrate as of 1971 by 1/2 by 1990, asked for Japanese assistance in building a condom plant based on the expectation that demand for this contraceptive method, although quite low at present, will increase rapidly in the near future with stepped-up motivation campaigns. As a 1st step in the investigation, the Japan International Cooperation Agency (JICA) sent a study team of family planning experts headed by Family Planning Federation of Japan Chairman Dr. Hidebumi Kubo and including JOICFP International Division Director MR. Tameyoshi Katagiri to Indonesia from March 15-24. During its visit, the JICA team held discussions with representatives of BKKBN (the National Family Planning Coordinating Board) including its Chairman and Minister of Health Dr. Suwardjono and reached agreement on the scope and schedule of work toward determining the feasibility of building and operating a condom plant in Indonesia. In defining the scope of work and the schedule, the JICA team and the BKKBN representatives decided on specific issues to be investigated in the feasibility study to be carried out by JICA and scheduled to be completed by the end of October of this year. To be included in the feasibility study are: estimation of future domestic demand for condoms, examination of the domestic supply of latex capacity, chemicals and packaging materials, and collection of information on infrastructure relating to water, energy, transportation, etc. Actual data collection for the study is expected to begin in late May or early June. Dr. Kubo and Mr. Katagiri, upon returning to Japan, reported great enthusiasm for the project in Indonesia and expressed the hope that the plant construction will be feasible so that the country's family planning program can be given a boost and the cooperative relationship between Indonesia and Japan deepened.

Asia↗
PubMed1998

Covert contraceptive use: prevalence, motivations, and consequences.

This article examines women's covert use of contraceptives, that is, their use of a method without their husbands' knowledge. Three questions are addressed: (1) How is covert use measured? (2) How prevalent is it? and (3) What are the factors underlying covert use? Existing studies are used together with survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and their husbands. Women's covert use of contraceptives is estimated to account for 6 to 20 percent of all current contraceptive use, and it is more widespread when contraceptive prevalence is low. The multivariate analysis indicates that difficult spousal communication about contraception is the strongest determinant of covert use. Husbands' disapproval of contraception works through spousal communication rather than as a direct influence on covert use. Husbands' pronatalism had no significant effect. The article concludes with implications of covert use for reproductive health and family planning programs, especially women's (and men's) needs for confidential services.

Adolescent↗
PubMed1995

Building a community-based maternity program.

The MotherCare Project has as its goal the reduction of maternal and neonatal mortality and related morbidities, and the promotion of the health of women and newborns. To achieve these goals, maternal and family planning programs were strengthened in both rural and urban settings through three intervention strategies--policy reform, affecting behaviors and improving services. The fundamental premise in each project was to strengthen the weakest part of the maternity care pyramid, ensuring linkages among all levels of service--from community through to the referral hospital level. In rural Andean populations of Bolivia, knowledge of danger signs and women's response to them improved, increasing in use of prenatal and family planning services through a participatory problem-solving and community-based strategy. In West Java, Indonesia, bringing professional midwifery services and facilities closer to women together has resulted in a positive response to their use. Augmenting this intervention with a transport and intercommunication system together with improved hospital practice through perinatal mortality meetings and in-service training for doctors and midwives has reduced the maternal and perinatal mortality over a four year period. Hospital practice has improved in Uganda and in two states of Nigeria, maternal mortality and morbidity have been reduced in the training facility where seminars for physicians, training of midwives in life saving midwifery and interpersonal communication skills have taken place, and equipment and supplies have been improved. Furthermore, in rural Guatemala, implementation of norms and protocols, expert supervision and sensitization of hospital staff to the needs of the community has increased referral by traditional birth attendants (TBAs) to the hospital and reduced perinatal mortality.

Community Health Services↗
PubMedDate not supplied

Preference for male children and contraceptive use in Taiwan.

Taiwan has an active family-planning program. Yet the preference for sons is deeply ingrained in the Chinese culture and may discourage women from limiting their family size if they feel they have too few sons. In this study, research problems concerned the relationships between women's stated preferences for the sex of their children, their perceptions of their in-laws' preferences for the number and sex of their children, and their use of birth control and choice of birth control methods. It was found that few women verbalized a preference for the sex of children, but the number of boys already in the family was related to the reliability of contraceptive method used later and to the willingness to consider abortion if pregnancy occurred. The desired number and occurrence of additional children related to women's perceptions of their in-laws' preferences for boys. The perception of in-laws' preferences for girls either related negatively or was not significant.

Adult↗