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PubMed1992

Popularizing spacing methods of family planning in rural areas: the perception of programme personnel and the community in Karnataka.

"In this study an attempt has been made to identify the possible factors inhibiting the use of spacing methods through a field investigation in the rural areas of northern Karnataka [India] by interviewing both programme personnel and the community (leaders and couples). This paper presents the salient findings and policy implications of the study.... The specific objectives of the study were: (i) to assess the perception and experiences of the programme personnel, from district level to grassroots level, about popularizing spacing methods of family planning in the rural areas; (ii) to understand the community leaders' knowledge about spacing methods and their perception regarding couples accepting them; and (iii) to study the knowledge, attitude and practice of different family planning methods by couples...in the villages."

Asia↗
PubMed2002

Adjusting period tempo changes with an extension of Ryder's basic translation equation.

We show that the observed changes in the period tempo of fertility are biased and derive a new formula for adjusting such bias. We present illustrative applications of our proposed method to the cases of the United States and Taiwan. We then describe the relevance of adjustments of observed period fertility tempo for evaluating family planning programs aiming at delaying and reducing births to slow down population growth in developing countries. The work reported in this article also can be regarded as an extension of Ryder's basic translation equation. The extension provides a set of formulas expressing relationships of quantum-tempo between cohorts and periods under specified assumptions.

Bias↗
PubMed2004

Family planning in the balance.

Family planning has long been acknowledged as an effective public health intervention. In recent years, however, family planning has come under increased scrutiny from conservative politicians and constituents. National US policies instituted since 2001 are resulting in cutbacks in family planning programs worldwide. In the long run, these conservative initiatives may set back several decades of progress in reproductive health and reproductive rights. In promoting an ideologically driven approach to sexual and reproductive health, the recent policy developments threaten to subvert ethical standards of medical care and the principle of evidence-based policy.

Abortion, Induced↗
PubMed1990

Relevance of socio-economic data for the establishment of solution models based on international statistical material.

Using the official data of WHO statistics, the impact of some social, biological and medical factors on infant mortality rates (IMR) was compared for countries with very high, high, moderate and low IMR: Factors reflecting a low quality of life (illiteracy, low level of women's education, low urbanization, malnutrition etc.) showed a highly significant statistic correlation with increased IMR. The lack of a nationwide family planning program and a low level of medical care (prenatal care, presence of medical personnel during delivery, availability of contraceptives etc.) act in the same direction. In developing countries the GNP per capita did not markedly influence the IMR nor the rate of infants of low birth weight (UGR). One of the main reasons of this phenomenon is probably the wide gap of the income between different social groups in these countries. In contrast to this the GNP in economically developed countries (Europe, Australia, North America) correlates very closely with IMR and UGR. The impact of family planning differs between countries with legally artificial abortion and those with a more restrictive legislation. The nutritional status (i. e. in these countries hyperalimentation) shows a positive correlation with UGR but no impact on IMR. Some countries (in Europe Greece, Spain, Ireland/Yugoslavia, Romania) show a significant deviation (positive/negative) from the mean calculated according to the WHO data. These deviations can be (and should be) analysed for detecting and evaluating factors which could be influenced by strategies of social or/and medical interventions in order of further improvement of IMR.

Data Interpretation, Statistical↗
PubMed1993

Midwives in the Mexican health system.

The health care system in Mexico was built upon a western model in which curative rather than preventive medicine is emphasized. However, the incorporation of indigenous midwives into maternal and child care and family planning programs by several public health agencies is an exception to the governmental health policies. An analysis of midwife preferences among rural women indicates that primarily poor illiterate women with children, living in remote areas with difficult access, rely on midwives. The continued reliance on midwives by this sector of the population makes the government programs most important. These programs are a unique case in which the incorporation of traditional practitioners in the modern health system has occurred. However, in order to implement programs that have the capability to offer rural women the benefits of both health systems, the incorporation of the traditional midwives requires not only the upgrading of their skills in modern antiseptic techniques, but the recognition of the contributions of traditional health practices, and the research of elements and practices to foster its understanding.

Adolescent↗
PubMed1975

Fertility and family planning in Thailand: results from two rounds of a national study.

The Longitudinal Study of Social, Economic, and Demographic Change was undertaken during the late 1960s to provide detailed national information on behavior and attitudes related to fertility and family planning in Thailand. Results from the second round of the study indicate that the practice of family planning increased substantially in both rural and urban areas during the three-year interval between the two rounds. During this period, marital fertility registered a decline in the urban areas. This was a result of a small rise in fertility among Bangkok-Thonburi women combined with a sharp decline in fertility among provincial urban women. Because the National Family Planning Program was officially begun at the time of the first round, its role in the increase in contraceptive use is examined. Although the study shows that the desired number of children is substantially below the actual number of children Thai womenhave by the end of their reproductive years, the desired number of children is still well above the number usually considered ideal in developed countries. Nonetheless, changes in reproductive behavior appear to reflect the impact of modernization on Thai society. In urban areas, marital fertility is only moderately high and a substantial proportion of couples practice family planning. Of particular importance over the remainder of the decade will be the reproductive behavior of rural women, who constitute an extremely high proportion of the Thai female population.

Adolescent↗
PubMedDate not supplied

The clandestine epidemic: the practice of unsafe abortion in Latin America.

In Latin America, induced abortion is the fourth most commonly used method of fertility regulation. Estimates of the number of induced abortions performed each year in Latin America range from 2.7 to 7.4 million, or from 10 to 27 percent of all abortions performed in the developing world. Because of restrictive laws, nearly all of these abortions, except for those performed in Barbados, Belize, and Cuba, are clandestine and unsafe, and their sequelae are the principal cause of death among women of reproductive age. One of every three to five unsafe abortions leads to hospitalization, resulting in inordinate consumption of scarce and costly health-system resources. Increased contraceptive prevalence and restrictive abortion laws have not decreased clandestine practices. This article addresses how the epidemic of unsafe abortion might be challenged. Recommendations include providing safer outpatient treatment and strengthening family planning programs to improve women's contraceptive use and their access to information and to safe pregnancy termination procedures. In addition, existing laws and policies governing legal abortion can be applied to their fullest extent, indications for legal abortion can be more broadly interpreted, and legal constraints on abortion practices can be officially relaxed.

Abortion, Illegal↗
PubMed1978

Study confirms values of ovulation method.

In order to determine the effectiveness of the ovulation method in spacing or achieving pregnancy as well as couple satisfaction with the method, the Natural Family Planning Program of St. Vincent Hospital, Green Bay, WI, studied 453 couples who had participated in the program. The program's director reports that the study results suggest the method provides a safe, effective approach to birth control and assists some women to become pregnant who have not succeeded prior to using this method.

Adult↗
PubMed2004

Reproductive and sexual health among young adults in Uzbekistan.

Since 1991, contraceptive use has risen significantly in Uzbekistan while reliance on abortion has declined; yet reproductive health improvements have not translated into better conditions for sexual health. The prevalence of sexually transmitted diseases increased significantly in the 1990s, and UNAIDS currently identifies the Central Asian region as a high HIV-growth zone. Structural, institutional, and attitudinal factors have contributed to the disconnection between reproductive and sexual health in Uzbekistan, even though family planning programs have been well established during the HIV pandemic. Integrating state statistics, Demographic and Health Survey data, and focus-group-discussion results, we highlight the ways in which a heavily centralized program focusing on reproductive health did little to better sexual health, especially among young adults. The example of Uzbekistan reveals pathways by which reproductive health efforts may continue to be compartmentalized, decreasing their potential contributions to sexual health, especially among young adults.

Adolescent↗
PubMed1996

Norplant subdermal contraceptive system: experience in Taiwan.

From November 1988 to December 1994, a total of 567 female volunteers were enrolled in Norplant implant studies at the National Taiwan University Hospital. After a median follow-up of 29 months, only 3 of the 529 available cases became pregnant (a cumulative rate of 1.2 pregnancies per 100 users over 5 years). Chromosome analysis of 2 of the 3 abortuses revealed 46,XX/46,XX,inv(3) and 46,XX. Menstrual problems were the most common adverse effects and were also the main reason for discontinuation (65%, 108/166). The continuation rate was 90%, 78%, 70%, 61%, and 42% at the end of 1, 2, 3, 4, and 5 years after insertion, respectively. In the 21 patients who wished to become pregnant, fertility recurred soon after removal of the Norplant implants. The data suggested that the Norplant implants system is a highly effective, safe, and long-acting method of reversible contraception. It would be worthwhile to introduce this contraceptive system to Taiwan's family planning program.

Abortion, Induced↗
PubMedDate not supplied

[Population policy in Thailand].

Population policy may be defined differently by students of demography but it is generally defined as measures aiming at influencing demographic processes--fertility, mortality, and migration--through public and private programs. Population policy may also be classified into different types: direct and indirect policies; population influencing and population responsive policies; explicit and implicit policies; and domestic and international policies. For Thailand, earlier population policies tended to be policies aimed at increasing the size of population through pronatalist and public health measures. However, findings of various studies in the early 1960s indicated that the rate of population growth in Thailand since the end of World War II had been as high as 3% per annum. These had led the government to eventually issue the first national population policy statement "supporting family planning through a voluntary system..." in March 1970. The first 5-year family planning program was included in the health plan of the Third National Economic and Social Development Plan (1972-1976). From the Fourth National Economic and Social Development Plan (1977-1981) onwards, population policies were made more comprehensive to cover all dimensions of population: population growth; quality of population; and population distribution and human settlements. Since population policy is an integral component of overall economic and social policies, conflicts between objectives of sectoral policies have to be minimized as much as possible. Future options of the population policies were briefly discussed.

Asia↗
PubMed1993

Norplant-2 subdermal contraceptive system: experience in Taiwan.

Subdermal Norplant-2 implantation, developed for contraception based on sustained release of levonorgestrel, has already been conducted in many countries around the world. From October 1986 to November 1988, a total of 267 female volunteers were enrolled in Norplant studies at the National Taiwan University Hospital. After a follow-up of 36 months, only one of the 231 evaluable cases (0.4%) became pregnant. The continuation rate was 84.5%, 61.3%, and 52.0% at the end of 12, 24 and 36 months after insertion, respectively. Menstrual problems were the most common adverse effects and were also the main reason for discontinuation. In the 23 patients who wished to become pregnant, fertility occurred soon after removal of the Norplant implant. After insertion, serum total cholesterol and triglyceride levels significantly decreased and the hemoglobin concentrations were increased. No liver or renal toxicities were detected. The data suggest that Norplant-2 is a highly effective, safe and long-acting method of reversible contraception. It would be worthwhile to introduce this contraceptive system into Taiwan's family planning program.

Adult↗
PubMed1977

Toward stationary populations and beyond.

The world's rate of population growth is declining. Most industrialized societies have achieved or are moving rapidly toward stationary populations, but while birth rates are also declining in many developing countries, continued growth must be expected because of the large proportions of young people in these populations. New evidence of exceptions to the classical demographic transition theory indicate that declining fertility is compatible with high mortality or low socioeconomic development if acceptable means of fertility control are readily available. "Fertility silhouettes" showing differing age-specific fertility rates indicate that present family planning programs have had a demographic impact. A review of the economic and ecologic consequences of rapid population growth justifies the conclusion that considerable effort will be required to again bring the world's population into balance with these systems. The author outlines priorities for this effort, with emphasis on the need to devise acceptable means of fertility control that will not tax the frail health care infrastructures of developing countries.

Adolescent↗
PubMed2003

[Neighborhood effects influencing reproductive health of Chilean women].

BACKGROUND: Fecundity rates have decreased considerably in Latin America, due to a higher contraceptive use and better family planning programs. AIM: To determine whether neighborhood level socioeconomic variables have an independent effect on reported modern contraceptive use, over and above the effect of individual level measures of socioeconomic status and reproductive health behavior. SUBJECTS AND METHODS: Multilevel logistic models determined the effects of individual and neighborhood dimensions (socioeconomic status, urbanization, quality of public health facilities) on contraceptive use among 509 women aged 15 to 49 years living in 85 neighborhoods within the Region of Bio Bio, Chile. RESULTS: After adjustment for women's individual socioeconomic characteristics and other risk factors, less favorable neighborhood socioeconomic characteristics were significantly associated with lower rates of modern contraceptive use. CONCLUSIONS: Changes in the quality of facilities for family planning at the neighborhood level may enhance modern contraceptive use.

Adolescent↗