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PubMed1992

The check-up of reproductive health and genetic counseling.

The Hungarian Family Planning Program was a feasibility study on combining methods of periconceptional care. The first step was the check-up of reproductive health, including family history of the couples, case history of females, pre-pregnancy examination (vaginal and cervical smears), and the measurement of basal body temperature, sperm examination, psycho-sexual exploration and exclusion of some risk factors. This preconception screening program was carried out by graduate trainee nurses to identify those participants secondary health services. The data of 4,240 couples attending in the Budapest Center indicated a useful relationship between the check-up of reproductive health and genetic counseling clinics, by selecting couples requiring genetic counseling and preventing other couples making unnecessary visits.

Adolescent↗
PubMed1993

Quality of care in family planning in Latin America.

The majority of family planning programs in Latin America have been implemented in response to the region's population growth and aimed mainly at obtaining quantitative results, leaving quality, from the user's point of view, in second place. Recent decades have witnessed an increasing concern for quality of care in family planning because most researchers and service providers began to realize that when contraceptive methods are delivered without maintaining high quality levels, continuation rates are usually low and the image of methods and services is impaired. This paper reviews the level of quality of services in family planning in Latin America following Judith Bruce's framework and proposes, some activities that may improve it. The analysis found severe deficiencies in almost all the elements mentioned by Bruce, mainly in choice, technical competence, and mechanisms for improving continuity. The authors propose that to improve quality, services should (a) generate top management commitment to quality, (b) stay close to the client/user, (c) improve work conditions of providers/health workers, (d) measure quality, and (e) reward quality. The authors' conclusions are that (a) better quality services lead to better program results, (b) high quality is cost-effective, (c) managerial commitment is critical to improvement of quality, and (d) quality of care is not a luxury; it is necessary and possible in all settings.

Clinical Competence↗
PubMed2005

Client participation and provider communication in family planning counselling and the sample study from Turkey.

BACKGROUND: The family planning program in Turkey was established in 1965 to curb the rapid increase in population growth. The last Demographic and Health Survey showed that about 64 % of married women in Turkey used contraception. OBJECTIVES: This study examines of behaviour of family planning clients and provider in Eskisehir/Turkey, to see whether they can achieve this ideal parnership. METHODS: Consultation between 83 physicians, 222 nurses and 324 clients requesting family planning methods were audiotaped and analysed for physicians and nurses communication style. Data were collected from 3 hospital and 14 small health units that give services in Eskisehir. The audiotaped consultations were coded using an adaptation of the RIAS which has been used extensively in both developed and developing countries and in statistical analysing chi(2) and t test were utilized. RESULTS AND CONCLUSION: The single strongest factor was providers giving biomedical and technical information. The qualitative analysis of audiotapes found that most of clients' questions concern contraceptive side effects and symptoms. The next category social talk, consisted largely of greetings. Most of the providers (87.6 %) are women. The results show that providers dominate most counselling session and clients rarely take on active role.

Adolescent↗
PubMed1997

Male involvement in family planning: a case study spanning five generations of a south Indian family.

Family planning program planners often view men as gatekeepers who, if involved in reproductive decisionmaking, will thwart women's efforts to regulate fertility. This study examines fertility decisions made by five generations of one South Indian family and the factors affecting its sudden observed fertility decline. Male involvement in family planning and use of male methods are associated with the fertility decline and resulted in long-term benefits for women. Traditional notions about gender roles and family, in addition to economic concerns, shaped fertility decisionmaking. Individual motivation rather than choice of methods was more important for positive male participation in family planning.

Decision Making↗
PubMed1989

Effect of public programs on family size, child education and health.

"A bulk of public resources in developing countries is devoted to the subvention of population control and health investments. The effects of these programs have been evaluated in this study with household and community data from Bangladesh. The results suggest that subsidy on family planning and secondary school would be most effective in the achievement of harmonious goals of reducing fertility and mortality and fostering investments in child education."

Asia↗
PubMedDate not supplied

From one generation to the next: changes in fertility, family size preferences, and family planning in an Indian state between 1951 and 1975.

Over the last 25 years modernization in Karnataka, India, resulted in a large reduction in infant and child mortality, substantial increases in literacy, and initiation of an intensive family planning program. The drop in the birth rate during this period, however, was much less than would be anticipated under such circumstances. Two surveys carried out in 1951--52 and 1975 provide data on current and cumulative fertility, family size preferences, and knowledge and use of family planning. A comparison of these data leads to the conclusion that the level of family planning activities was not high enough to counteract the increase in the fertility of married women that was a consequence of modernization.

Adolescent↗
PubMed1998

On-the-job training through follow-up visits to improve the quality of family planning services.

As part of a broader set of activities to strengthen family planning training and improve the quality of family planning services in Turkey, follow-up visits were performed at different family planning sites across the country in order to conduct on-the-job training. The objective of on-the-job training was to refresh and improve family planning counselling skills for all methods as well as to refresh and improve intrauterine device insertion/removal skills and also some determinants of quality care. It was also aimed at transferring up-to-date information to family planning practitioners, identifying frequently encountered problems and helping with solution approaches for problems both at the individual and programmatic levels. The results of the follow-up visits reflect issues about both the staff and the clinical facility itself in terms of conforming with the standards of the 'National Family Planning Guidelines' set forth by the Ministry of Health. The follow-up team consisted of nine members who were specially trained. They represented different sectors such as a non-governmental organization, a medical school and the Ministry of Health. The follow-up team performed 90 visits to 16 clinics in 11 provinces between 1995 and 1998. Methods used were structured observations via standard checklists, meetings with the clinic staff, self-assessment, role plays, demonstration, coaching and the provision of feedback. During this period, a total of 130 health professionals working in 16 clinics were trained on-the-job. A significant improvement was observed in the performance of the family planning practitioners and the quality of care provided in clinics. While none of the service providers were found to have a standard skill level in general counselling during the first visit, at the end of the fifth visit all were capable of providing counselling services according to the national standards. Intrauterine device insertion skills were high at the beginning of the visits, and 16 of the 17 observed service providers (94%) were assessed as conforming to the standards. At the fifth visit, all of the 42 service providers (100%) were found to be adequate. At the facility level, all 16 clinics established separate counselling rooms in the follow-up period. Additionally, the number of clinics conforming to infection prevention standards increased from two clinics in 15 at the first visit to all 16 clinics at the fifth visit. This study showed that the ultimate success of family planning programs depend on structured and well-supervised on-the-job training through follow-up visits to the sites.

Clinical Competence↗
PubMedDate not supplied

Contraceptive use in Matlab, Bangladesh in 1990: levels, trends, and explanations.

The results of a 1990 knowledge, attitudes, and practice survey in Matlab, Bangladesh, indicate that contraceptive prevalence has risen to 57 percent in the maternal and child health/family planning project area. Between 1984 and 1990 significant increases were registered in the proportions of women using contraceptives for the purposes of spacing and limiting births. By 1990 fertility control in the intervention area had become so widely diffused that educational differentials in contraceptive practice were no longer evident. Although significant gains in contraceptive use were also evident in the neighboring comparison area during this period, at 27 percent, prevalence there still remained substantially below the levels in the intervention area. The disparity in contraceptive use between the two areas is adequately explained neither by differences in socioeconomic conditions nor in the demand for family planning, but rather by differences in the intensity, coverage, and overall quality of their family planning programs.

Adolescent↗
PubMed1994

Household registration type and compliance with the "one child" policy in China, 1979-1988.

This research analyzes how type of household registration, which reflects the degree of government control, affects compliance with China's "one child" policy for women at risk during the first decade of implementation. Although socioeconomic and cultural factors have significant effects on four fertility events after first live birth, household registration type is the most important. Furthermore, household registration type interacts with urbanization in such a way that the modernization influence associated with urbanization is more evident for women under less government control. The notable success of China's family planning program is linked to its unique system of government control.

Abortion, Legal↗
PubMed1991

[Trends and correlates of fertility decline in the NIES].

"Trends and correlates of dramatic fertility declines in the NIES [newly industrialized economies of Asia] from the 1960s to the 1980s are examined in this paper. Specifically, we first look at changes in the fertility effects of such demographic factors as age structure of fertility, age pattern of marriage, and marital fertility. Next, as major proximate determinants of fertility, we examine changes in contraception and induced abortion. We then examine the fertility effects of changes in infant mortality and family planning programs. Finally, by examining changes in such socioeconomic factors as educational attainment and female labor force participation as well as attitudinal changes toward marriage and the family, we seek to infer their effects on fertility declines in the NIES." The data primarily concern Hong Kong, the Republic of Korea, Singapore, and Taiwan. (SUMMARY IN ENG)

Abortion, Induced↗