[Some psychological problems in family planning work].

PubMed

Chen, J

1983-11-29

Psychology has significance in family planning work, because it may promote the scientific nature of family planning work and thus increase its effectiveness. Since people have some common aspects in their psychological process, family planning workers should master some common rules of the people's psychological process in order to understand psychological trends and possible behavior. Through this method, family planning workers may find how to adjust to problems they may encounter in their daily work, such as the worries about a single child being too lonely, spoiled, and hard to handle for the parents, the traditional belief that more children represent good fortune, and more male children may provide security for one's old age. Traditionally, the Chinese people believed that only male children can carry on the family line and that more children will provide a larger labor force, which is beneficial to a family's financial situation. In family planning work, all such incorrect ways of thinking should be corrected and revised. Studies of children's psychology should also be developed so that children may develop a healthy mentality. All these are crucial to the success of family planning work and the promotion of population quality.

Iranian women's perceptions of family-planning services quality: a client-satisfaction survey.

PubMed

Nakhaee, N; Mirahmadizadeh, A-R

2005-09-01

As Iran (IR) is included among the most successful developing countries in family planning, clarification and expression of the ideas and needs of women receiving the services not only have a great positive impact on national policies but also may be of interest to other nations. This research was conducted to clarify the client perceptions of the quality of family planning services in the capital cities of the two largest provinces of Iran. A representative sample of 909 women aged 15-50 referred to health centers were interviewed by skillful interviewers in a private area after obtaining informed consent. A questionnaire consisting of baseline data and 17 five-point Likert-scaled items measuring the satisfaction of clients and perceived importance of each item was developed by investigators. Half were aged 26-35 years, and most (84%) were housewives. The highest percentage of dissatisfaction was reported in relation to 'privacy protection' item. However, when the importance score was included, too, 'provision of sufficient information regarding other contraceptive methods' and 'unavailability of all methods' implicated the areas where priorities should be focused. The satisfaction levels obtained by the survey should be carefully heeded, and the supply chain and provision of information to the clients may be the first priorities in the process of improving the quality of care.

Comparison of family-planning service quality reported by adolescents and young adult women in Mexico.

PubMed

Darney, Blair G; Saavedra-Avendano, Biani; Sosa-Rubi, Sandra G; Lozano, Rafael; Rodriguez, Maria I

2016-07-01

Associations between age and patient-reported quality of family planning services were examined among young women in Mexico. A repeated cross-sectional analysis of survey data collected in 2006, 2009, and 2014 was performed. Data from women aged 15-29years who had not undergone sterilization and were currently using a modern contraceptive method were included. The primary outcome was high-quality care, defined as positive responses to all five quality items regarding contraceptive services included in the survey. Multivariable logistic regression and marginal probabilities were used to compare adolescents and women aged 20-29years. The responses of respondents using different contraceptive methods were compared. Data were included from 15 835 individuals. The multivariable analysis demonstrated lower odds of reporting high-quality care among women aged 15-19years (odds ratio 0.73; 95% confidence interval 0.60-0.88) and 20-24years (odds ratio 0.85; 95% confidence interval 0.75-0.96) compared with women aged 25-29years. Adolescents using hormonal and long-acting reversible contraception had significantly lower odds of reporting high-quality care compared with women aged 25-29. Adolescents in Mexico reported a lower quality of family planning services compared with young adult women. Continued research and policies are needed to improve the quality of contraceptive services. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

[On family planning and socialist cultural civilization].

PubMed

Yin, G; Cao, J; Yin, W

1984-03-29

Family planning is a very important part of the Socialist cultural civilization, and it has a great impact on the ideology, ethics, and change of moral concepts. The old concept of having a large family and favoring boys over girls has been changed because of the popularization of family planning, and the overall quality of China's population can thus be improved. In the practical work of family planning, construction of the Socialist cultural civilization should be handled well. Science should be developed and taught to the general public, and the traditional ideology concerning birth and population should be gradually changed and eliminated. In this way, people will become more conscious of the need for family planning. In the meantime, efforts should be made to promote social welfare, such as the establishment of more and better daycare centers and nursing homes so that the common worries about family planning can be removed. The people should gradually learn about their rights and responsibilities as citizens and understand that family planning is in the best interest of the whole country as well as for the good fortune of later generations. With close cooperation between the people and the government and with reasonable management of family planning, China will be built into a strong nation with an adavnced Socialist cultural civilization.

Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International

PubMed Central

Munroe, Erik; Hayes, Brendan; Taft, Julia

2015-01-01

Background: To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. Methods: We analyzed MSI’s social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008–2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011–2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI “Impact 2” model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Results: Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory

Family Planning & Literacy.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This publication is an International Planned Parenthood Federation (IPPF) annotated bibliography of books and articles concerned with family planning and literacy. The subject is divided into four major listings: (1) Literacy; (2) Education; (3) Literacy and Family Planning; and (4) Functional Literacy/Family Planning Projects and Programs.…

Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International.

PubMed

Munroe, Erik; Hayes, Brendan; Taft, Julia

2015-06-17

To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. We analyzed MSI's social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008-2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011-2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI "Impact 2" model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44.0), with 46.1% (95% CI = 40.9, 51.2) of

Village family planning volunteers in Indonesia: their role in the family planning programme.

PubMed

Utomo, Iwu Dwisetyani; Arsyad, Syahmida S; Hasmi, Eddy Nurul

2006-05-01

Family planning was once a sensitive issue in Indonesia, but today it is considered essential. This paper reports on a study in 1997-98 of the role of village family planning volunteers and the cadres who worked under them in West Java, Central Java and DI Yogyakarta, in implementing the national family planning programme in Indonesia. A total of 108 village family planning volunteers, 108 family planning cadres, 108 local leaders and 324 couples eligible for family planning from 36 villages in the three provinces were interviewed. The volunteers and cadres have made a significant contribution to the implementation of the family planning programme. They promote family planning, organise meetings, provide information, organise income-generation activities, give savings and credit assistance, collect and report data and deliver other family welfare services. Teachers, wives of government officials and others recognised by the community as better off in terms of education and living conditions were most often identified to become family planning volunteers. Because they are women and because they are the most distant arm of the programme, their work is taken for granted. As their activities are directed towards women, especially in women's traditional roles, the programme tends to entrench the existing gender gap in responsibility for family planning and family welfare.

Remediation plans in family medicine residency

PubMed Central

Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

2015-01-01

Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

Client Satisfaction And Decision Making Amongst Females Visiting Family Planning Clinics In Hyderabad, Pakistan.

PubMed

Memon, Arbia; Hamid, Saima; Kumar, Ramesh

2017-01-01

Family Planning is the basic right of the human being. It involves decision regarding the number of children and desired space between children by the couple themselves. Quality services involving multiple dimensions build the confidence of the clients and lack of quality is one of the constraints behind incomplete coverage of family planning. Objectives of the current study were to determine the client satisfaction, decision-making process and various influences on clients in adopting family planning methods. This cross-sectional study was conducted at Family Planning Centre of Liaquat University Hospital, Hyderabad in 2016. Quality of the family planning services and satisfaction with the services were assessed through responses obtained from women selected purposively and visiting family planning centre through exit interviews with structured pretested and reliable questionnaire after taking the written consent. Access to Family Planning Centre was not an issue in 92% cases but only 31% respondents were appropriately greeted, 77% faced blank expression and 13% received sufficient privacy. Health problems and socioeconomic conditions were inquired by 41% and18% providers respectively, while motivating force for service use was mother in law in most 35% cases. Health workers were successful in clarifying misinformation (86%) and explaining side effects (71%) but only 21% respondents were satisfied with services. Respondents are influenced by family and health care providers while making decision and type of influence was considered positive by 83% respondents. Training and monitoring system be strengthened at family planning centres to improve quality of services while important influencing relations be focused for family planning education to improve utilization of services.

Family planning education.

PubMed

Hamburg, M V

1983-02-01

17 days were spent devoted to the effort of learning about China's educational approach to family planning in the hope of discovering how they are achieving their remarkable success in reducing population growth. As a member of the 1981 New York University/SIECUS Colloquim in China, it was necessary to rely on the translation provided by the excellent guides. Discussions were focused on questions prepared in advance about the topics that concerned the group. These observations, based on a short and limited exposure, cover the following areas: marriage and family planning policies; the family planning program; school programs; adult education; family planning workers; and unique aspects of the program. China has an official position on marriage and family planning that continues to undergo revisions. The new marriage law sets the minimum ages of marriage at 22 for men and 20 for women. Almost everyone marries, and an unmarried person over age 28 is a rarity. The family planning program in China is carried out by an extensive organizational network at national, provincial, and local government levels. Officials termed it a "propaganda campaign." Hospitals, clinics, and factories invariably displayed posters; a popular set of four presents the advantages of the 1 child family as follows: late marriage is best, for it allows more time to work and study; 1 child is best for the health of the mother; one gets free medical care for his/her child if a family has only 1 child; and there is more time to teach 1 child. The state operated television regularly explains the 1 child policy utilizing special films. According to 1 family planning official, "before marriage there is little sex." There are few abortions for unmarried women. Education about sex is for adults, for those persons who are about to be married. There is little if any sex education in schools. Sexual teaching is not generally acceptable, especially in the rural areas. By contrast, in Shanghai the physiology

Quality Primary Care and Family Planning Services for LGBT Clients: A Comprehensive Review of Clinical Guidelines.

PubMed

Klein, David A; Malcolm, Nikita M; Berry-Bibee, Erin N; Paradise, Scott L; Coulter, Jessica S; Keglovitz Baker, Kristin; Schvey, Natasha A; Rollison, Julia M; Frederiksen, Brittni N

2018-04-01

LGBT clients have unique healthcare needs but experience a wide range of quality in the care that they receive. This study provides a summary of clinical guideline recommendations related to the provision of primary care and family planning services for LGBT clients. In addition, we identify gaps in current guidelines, and inform future recommendations and guidance for clinical practice and research. PubMed, Cochrane, and Agency for Healthcare Research and Quality electronic bibliographic databases, and relevant professional organizations' websites, were searched to identify clinical guidelines related to the provision of primary care and family planning services for LGBT clients. Information obtained from a technical expert panel was used to inform the review. Clinical guidelines meeting the inclusion criteria were assessed to determine their alignment with Institute of Medicine (IOM) standards for the development of clinical practice guidelines and content relevant to the identified themes. The search parameters identified 2,006 clinical practice guidelines. Seventeen clinical guidelines met the inclusion criteria. Two of the guidelines met all eight IOM criteria. However, many recommendations were consistent regarding provision of services to LGBT clients within the following themes: clinic environment, provider cultural sensitivity and awareness, communication, confidentiality, coordination of care, general clinical principles, mental health considerations, and reproductive health. Guidelines for the primary and family planning care of LGBT clients are evolving. The themes identified in this review may guide professional organizations during guideline development, clinicians when providing care, and researchers conducting LGBT-related studies.

A social marketing approach to quality improvement in family planning services: a case study from Rawalpindi, Pakistan.

PubMed

Gulzar, Jamshaid; Ali, Moazzam; Kuroiwa, Chushi

2008-02-01

In the 1990s, social marketing approach was introduced in Pakistan to improve the quality and accessibility of family planning methods involving private practitioners. This study measured six quality elements using a Bruce-Jain framework. Cross-sectional survey data were collected from 29 randomly selected Green Star clinics. The study's four components were 1) an inventory of each outlet (infrastructure, equipment, and supplies); 2) an observation guide for interaction between family planning clients and service providers; 3) exit interviews with clients attending the outlet; and 4) interviews with providers at the outlet. Of the 29 clients participating in the exit interviews, 72% were new users of family planning. The clients' mean age was 32 years; all clients were married; 93% had received formal education. Housework was the principal activity of 93% of clients. The mean number of children reported was three. Both hormonal and intrauterine contraceptives (IUCDs) were available in all facilities; 86% of the clients reported being able to obtain their contraceptive of choice. Most facilities had the equipment and supplies needed to deliver services; service personnel were trained and regularly supervised; the service outlets emphasized mechanisms to ensure continuity of use. Notable shortcomings included a shortage of information on alternative methods, contraindications, and side-effect management, as well as a dearth of registration records. In conclusion, this is a good example of public-private partnership involving private practitioners using a social marketing approach. The quality components of a Bruce-Jain framework were achieved, resulting in a satisfied clientele. Involvement of private service outlets increased the accessibility and enhanced the use of services. Social marketing may be expanded to improve quality and access by involving further components of health care.

Using COPE To Improve Quality of Care: The Experience of the Family Planning Association of Kenya.

ERIC Educational Resources Information Center

Bradley, Janet

1998-01-01

COPE (Client-Oriented, Provider-Efficient) methodology, a self-assessment tool that has been used in 35 countries around the world, was used to improve the quality of care in family planning clinics in Kenya. COPE involves a process that legitimately invests power with providers and clinic-level staff. It gives providers more control over their…

Combined Edition of Family Planning Library Manual and Family Planning Classification.

ERIC Educational Resources Information Center

Planned Parenthood--World Population, New York, NY. Katherine Dexter McCormick Library.

This edition combines two previous publications of the Katharine Dexter McCormick Library into one volume: the Family Planning Library Manual, a guide for starting a family planning and population library or information center, and the Family Planning Classification, a coding system for organizing book and non-book materials so that they can be…

The quality of family planning services and client satisfaction in the public and private sectors in Kenya.

PubMed

Agha, Sohail; Do, Mai

2009-04-01

To compare the quality of family planning services delivered at public and private facilities in Kenya. Data from the 2004 Kenya Service Provision Assessment were analysed. The Kenya Service Provision Assessment is a representative sample of health facilities in the public and private sectors, and comprises data obtained from a facility inventory, service provider interviews, observations of client-provider interactions and exit interviews. Quality-of-care indicators are compared between the public and private sectors along three dimensions: structure, process and outcome. Private facilities were superior to public sector facilities in terms of physical infrastructure and the availability of services. Public sector facilities were more likely to have management systems in place. There was no difference between public and private providers in the technical quality of care provided. Private providers were better at managing interpersonal aspects of care. The higher level of client satisfaction at private facilities could not be explained by differences between public and private facilities in structural and process aspects of care. Formal private sector facilities providing family planning services exhibit greater readiness to provide services and greater attention to client needs than public sector facilities in Kenya. Consistent with this, client satisfaction is much higher at private facilities. Technical quality of care provided is similar in public and private facilities.

Community-Based Financing of Family Planning in Developing Countries: A Systematic Review.

PubMed

Karra, Mahesh; Canning, David; Hu, Janice; Ali, Moazzam; Lissner, Craig

2016-12-01

In this systematic review, we gather evidence on community financing schemes and insurance programs for family planning in developing countries, and we assess the impact of these programs on primary outcomes related to contraceptive use. To identify and evaluate the research findings, we adopt a four-stage review process that employs a weight-of-evidence and risk-of-bias analytic approach. Out of 19,138 references that were identified, only four studies were included in our final analysis, and only one study was determined to be of high quality. In the four studies, the evidence on the impact of community-based financing on family planning and fertility outcomes is inconclusive. These limited and mixed findings suggest that either: 1) more high-quality evidence on community-based financing for family planning is needed before any conclusions can be made; or 2) community-based financing for family planning may, in fact, have little or no effect on family planning outcomes. © 2016 The Population Council, Inc.

Family planning Indonesia.

PubMed

Singarimbun, M

1968-06-01

The growth of family planning activities in Indonesia in the Postwar period is traced; and future prospects for family planning are assessed. Transmigration projects initiated by the Dutch and supported by President Sukarno after Indonesian independence as a means of decreasing population pressure on the island of Java, are identified as the only official response to the population problem until 1965. In the face of the government's opposition to the idea of birth control as a population control measure, the activities of the Indonesian Planned Parenthood Association (IPPA) after its founding in 1957 were limited to advising mothers on spacing of their children for health reasons. Statements made in support of a national family planning program by government officials at a 1967 IPPA Congress and on other occasions are noted. The major components of an approved national family planning program to start in 1969 are described. However, the government's policy as of late 1967 and early 1968 is characterized as one of mainly benevolent encouragement and help to voluntary organizations. The chief impediment to family planning in Indonesia is said to be a lack of motivation and the force of traditional values that favor large families. On the positive side are: 1) Studies showing considerable interest in birth control by the rural population; 2) A long history of traditional birth control practices; 3) The absence of outright opposition by religious groups to the principle of family planning. However, financial costs, the need for the training of personnel, and a general unawareness of the magnitude of the task lying ahead constitute other formidable obstacles.

Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.

PubMed

Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B

2016-10-01

This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess

Update: Providing Quality Family Planning Services - Recommendations from CDC and the U.S. Office of Population Affairs, 2017.

PubMed

Gavin, Loretta; Pazol, Karen; Ahrens, Katherine

2017-12-22

In April 2014, CDC published "Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs" (QFP), which describes the scope of services that should be offered in a family planning visit and how to provide those services (e.g., periodicity of screening, which persons are in need of services, etc.) (1). The sections in QFP include the following: Determining the Client's Need for Services; Contraceptive Services; Pregnancy Testing and Counseling; Clients Who Want to Become Pregnant; Basic Infertility Services; Preconception Health Services; Sexually Transmitted Disease Services; and Related Preventive Health Services. In addition, the QFP includes an appendix entitled Screening Services for Which Evidence Does Not Support Screening.

Paying for family planning.

PubMed

Lande, R E; Geller, J S

1991-11-01

This report discusses the challenges and costs involved in meeting the future needs for family planning in developing countries. Estimates of current expenditures for family planning go as high as $4.5 billion. According to a UNFPA report, developing country governments contribute 75% of the payments for family planning, with donor agencies contributing 15%, and users paying for 10%. Although current expenditures cover the needs of about 315 million couples of reproductive age in developing countries, this number of couples accounts for only 44% of all married women of reproductive age. Meeting all current contraceptive needs would require an additional $1 to $1.4 billion. By the year 2000, as many as 600 million couples could require family planning, costing as much as $11 billion a year. While the brunt of the responsibility for covering these costs will remain in the hand of governments and donor agencies (governments spend only 0.4% of their total budget on family planning and only 1% of all development assistance goes towards family planning), a wide array of approaches can be utilized to help meet costs. The report provides detailed discussions on the following approaches: 1) retail sales and fee-for-services providers, which involves an expanded role for the commercial sector and an increased emphasis on marketing; 2) 3rd-party coverage, which means paying for family planning service through social security institutions, insurance plans, etc.; 3) public-private collaboration (social marketing, employment-based services, etc.); 4) cost recovery, such as instituting fees in public and private nonprofit family planning clinics; and 5) improvements in efficiency.

Family planning and the controversial contraceptives.

PubMed

Dias Saxena, F

1995-01-01

India was one of the first countries in the world to launch a national family planning program in an apparent effort to help women gain access to birth control measures and reduce population growth. Family planning acquired a different meaning and emphasis in the 1960s, however, when a clause in the US PL480 wheat import policy demanded that India speed its implementation of birth control measures if the country wanted food aid. Women in India were therefore expected to consume contraceptives with dangerous and unknown side effects in order to quality the country for food aid. Women rejected this stipulation. By the 1980s, it was acknowledged that family planning programs in India had failed to produce a decline in the birth rate and that no sign of change was on the horizon despite the investment of substantial funds to that end, the input of expert assistance, and the establishment of appropriate infrastructure in the country. Experts and policy makers blamed women for having misused the pill and sought alternative methods which would not require user compliance. Norplant and norethisterone enanthate (Net-en) were subsequently developed. Policymakers, experts, and the press have now been clamoring for the right to conduct Norplant trials despite reported side effects. The drug's ability to prevent pregnancy is more important for family planning experts. The author notes that the emphasis has been upon contraceptive methods for women instead of men because men were not expected to take responsibility for family planning. She also notes that feminists are opposed to Norplant and Net-en, and hopes that the government withdraws them from the market.

Delivering high-quality family planning services in crisis-affected settings II: results.

PubMed

Curry, Dora Ward; Rattan, Jesse; Huang, Shuyuan; Noznesky, Elizabeth

2015-02-04

An estimated 43 million women of reproductive age experienced the effects of conflict in 2012. Already vulnerable from the insecurity of the emergency, women must also face the continuing risk of unwanted pregnancy but often are unable to obtain family planning services. The ongoing Supporting Access to Family Planning and Post-Abortion Care (SAFPAC) initiative, led by CARE, has provided contraceptives, including long-acting reversible contraceptives (LARCs), to refugees, internally displaced persons, and conflict-affected resident populations in Chad, the Democratic Republic of the Congo (DRC), Djibouti, Mali, and Pakistan. The project works through the Ministry of Health in 4 key areas: (1) competency-based training, (2) supply chain management, (3) systematic supervision, and (4) community mobilization to raise awareness and shift norms related to family planning. This article presents data on program results from July 2011 to December 2013 from the 5 countries. Project staff summarized monthly data from client registers using hard-copy forms and recorded the data electronically in Microsoft Excel for compilation and analysis. The initiative reached 52,616 new users of modern contraceptive methods across the 5 countries, ranging from 575 in Djibouti to 21,191 in Chad. LARCs have predominated overall, representing 61% of new modern method users. The percentage of new users choosing LARCs varied by country: 78% in the DRC, 72% in Chad, and 51% in Mali, but only 29% in Pakistan. In Djibouti, those methods were not offered in the country through SAFPAC during the period discussed here. In Chad, the DRC, and Mali, implants have been the most popular LARC method, while in Pakistan the IUD has been more popular. Use of IUDs, however, has comprised a larger share of the method mix over time in all 4 of these countries. These results to date suggest that it is feasible to work with the public sector in fragile, crisis-affected states to deliver a wide range of quality

The Situation Analysis Study of the family planning program in Kenya.

PubMed

Miller, R A; Ndhlovu, L; Gachara, M M; Fisher, A A

1991-01-01

A new, relatively "quick and clean" operations research approach called a "situation analysis" was developed for examining the strengths and weaknesses of the family planning program of Kenya. Field research teams visited a stratified random sample of 99 of the Ministry of Health's approximately 775 service delivery points. Observation techniques and interviewing were used to collect information on program components and on the quality of care provided to new family planning clients during the observation day. As late as 1986, the Kenya program was rated "weak" and "poor" in the international literature. The Kenya Situation Analysis Study found a functioning, integrated maternal and child health/family planning program serving large numbers of clients, with an emphasis on oral contraceptives and Depo-Provera (and an underemphasis on permanent methods). Although a number of program problems were revealed by the study, overall, in terms of performance, a rating of "moderate" is suggested as more appropriate for Kenya's national family planning program today. In terms of the quality of care, a "moderate to moderate-high" rating is suggested.

Family planning hotline.

PubMed

Dabbs, K

1970-01-01

Since last March, a family planning hotline has been putting the caller in touch with the Family Planning Information Service. This is possibly the 1st centralized referral and information service for family planning in any major city in the U.S. Each months this fall 1400 New Yorkers called the hotline number to obtain information about family planning, infertility, abortion, and voluntary sterilization. Several major parallel developments made the creation of the Family Planning Information Service possible and strengthened its changes of success. The service is headed by a registered nurse who is assisted by 2 specially trained nonprofessional staff members. The unit is housed in Planned Parenthood's Manhattan headquarters. The Service has a special telephone number which is listed in all telephone directories. A number of promotional devices have been used to build and maintain the volume of inquiries. The results of the intensive work to develop and maintain the service have been dramatic. From a monthly volume of 300 calls in March, the figure in May had reached 670. In July there were 962 inquiries and in October the figure rose to 1421. About 90% of these calls are from women. By far the largest number of requests for information have concerned contraception and where such services can be obtained. Over 200 calls have been inquires about infertility problems, and 361 calls have concerned abortion. More than 100 calls have been about sterilization, with men outnumbering women 2:1.

Attitudes toward family planning.

PubMed

Gille, H

1984-06-01

Many of the 135 countries participating in the 1974 UN World Population Conference were far from accepting the basic human right to decide freely and responsibly the number and spacing of their children and to have the information, education, and means to do so. Considerable progress has been made since then, and the number of developing countries that provide direct government support for family planning has increased to over 60%. Many have liberalized laws and regulations which restricted access to modern contraceptive methods, and a growing number provide family planning services within their health care programs. A few have recognized the practice of family planning as a constitutional right. In late 1983 at the Second African Population Conference, recognition of family as a human right was strongly contested by several governments, particularly those of West Africa. in developed countries most of the women at risk of unwanted pregnancy are using contraceptives. Of the major developing regions the highest use level is in Latin America, wherein most countries 1/3 to 1/2 of married women are users. Levels in Asian countries range from up to 10% in Afghanistan, Nepal, and Pakistan to up to 40% in the southeastern countries. China, a special case, now probably exceeds an overall use level of 2/3 of married women. Contraceptive use is lowest in Africa. There is room for improvement even among many of the successful family planning programs, as access to contraceptives usually is not sufficient to overcome limiting factors. To ensure the individual's free choice and strengthen the acceptability and practice of family planning, all available methods should be provided in service programs and inluded in information and education activities. Family planning programs should engage local community groups, including voluntary organizations, in all aspects of planning, management, and allocation of resources. At the government level a clear political commitment to family

[Diversification is the financial alternative for family planning].

PubMed

Castro Villamil, R

1991-12-01

During the 1960s, when family planning services were institutionalized in Colombia by PROFAMILIA, abundant foreign assistance was readily available. Few questions were asked about the longterm funding of family planning programs or the need for financial self-sufficiency. The emphasis was on program development without great attention to costs. Beginning around the early 1980s, international donors began to place a higher priority and greater investment in the incipient family planning programs of less developed countries. At present a greater number and higher quality of services are being demanded from PROFAMILIA at the lowest possible cost. Efficiency has replaced efficacy as the overriding goal. PROFAMILIA, due to its excellent results, has lost priority in the eyes of international donors. It has therefore reoriented its financing strategies toward a short, medium, and long term plan to reduce its financial dependence on international donor agencies. Self-sufficiency could be increased through various means, including total government subsidy, charging fees for services and materials sufficient to cover program costs, establishing services and marketing programs aside from family planning programs for the specific purpose of obtaining funds to cover program deficits, or establishing accounting and operational controls to reduce costs through greater efficiency. But large government subsidies are unlikely in a time of budgetary constraints, and raising fees for family planning users would exclude a large number of low-income clients from the family planning program. Cost reduction and implementation of diversified programs should therefore be emphasized for the present. The diversified program should be related to family planning so that use can be made of idle resources. PROFAMILIA has emphasized surgical procedures and medical consultations to utilize clinic facilities more fully and to increase income without increasing fixed costs. In 1990, foreign

Integration of family planning with poverty alleviation.

PubMed

Peng, P

1996-12-01

The Chinese Communist Central Committee and the State Council aim to solve food and clothing problems among impoverished rural people by the year 2000. This goal was a priority on the agenda of the recent October 1996 National Conference on Poverty Alleviation and Development and the 1996 National Conference of the State Family Planning Commission. Poverty is attributed to rapid population growth and underdevelopment. Poverty is concentrated in parts of 18 large provinces. These provinces are characterized by Family Planning Minister Peng as having high birth rates, early marriage and childbearing, unplanned births, and multiple births. Overpopulation is tied to overconsumption, depletion of resources, deforestation, soil erosion, pollution, shortages of water, decreases in shares of cultivated land, degraded grasslands, and general destruction of the environment. Illiteracy in poor areas is over 20%, compared to the national average of 15%. Mortality and morbidity are higher. Family planning is harder to enforce in poor areas. Pilot programs in Sichuan and Guizhou provinces are promoting integration of family planning with poverty alleviation. Several conferences have addressed the integrated program strategies. Experience has shown that poverty alleviation occurs by controlled population growth and improved quality of life. Departments should "consolidate" their development efforts under Communist Party leadership at all levels. Approaches should emphasize self-reliance and public mobilization. The emphasis should be on women's participation in development. Women's income should be increased. Family planning networks at the grassroots level need to be strengthened simultaneously with increased poverty alleviation and development. The government strategy is to strengthen leadership, mobilize the public, and implement integrated programs.

Quality in Individualized Family Service Plans: Guidelines for Practitioners, Programs, and Families

ERIC Educational Resources Information Center

Gatmaitan, Michelle; Brown, Teresa

2016-01-01

The IFSP is both a document and process for developing, implementing, and evaluating the supports and services delivered to infants and toddlers with disabilities and their families eligible under Part C of the Individuals With Disabilities Education Improvement Act (IDEA; 2004). Recently, researchers have defined IFSP quality based on five…

Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

PubMed

Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

2017-05-01

Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

Effect of post-menstrual regulation family-planning service quality on subsequent contraceptive use in Bangladesh.

PubMed

Sultana, Farhana; Nahar, Quamrun; Marions, Lena; Oliveras, Elizabeth

2013-11-01

To determine whether the quality of post-menstrual regulation family-planning services (post-MRFP) affected contraceptive use at 3-month follow-up. 915 women who received post-MRFP in 2 public and 1 NGO clinics in a district in Bangladesh were interviewed to obtain information on service quality and other characteristics. Quality was scored based on 21 items and the score divided into 3 categories: low (0-6); medium (7-11); and high (12-21). Three months after menstrual regulation, 902 of the women were interviewed at their residence or a clinic and contraceptive status was recorded. Adjusted odd ratios (aORs) for using contraception were calculated via multivariate logistic regression. Contraceptive use was positively correlated with the level of service quality, with 78% use among women who received the lowest-quality care and 92% use among women who received the highest-quality care. The aOR for contraceptive use was 1.80 (95% confidence interval [CI], 1.11-2.93) among women who received moderate-quality services and 3.01 (95% CI, 1.43-6.37) among women receiving high-quality services compared with those who received poor-quality services. Good-quality post-MRFP increases contraceptive use, at least in the short term. © 2013.

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya

PubMed Central

Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

2017-01-01

Abstract The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client–provider consultation sessions. The cross-sectional study observed 366 client–provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63–0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07–14.21), adequate infrastructure (5.29; 95% CI: 2.89–7.69) and reagents (1.48; 95% CI: 1.02–1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92–4.36), job satisfaction (2.02; 95% CI: 1.21–2.83) and supervision (1.01; 95% CI: 0.35–1.68), while workload (−0.88; 95% CI: −1.75 to − 0.01) was negatively associated. Technical quality of the client–provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client–provider consultation sessions

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

PubMed

Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

2017-11-01

The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility

Financing family planning services: is categorical legislation still needed?

PubMed

Mcfarlane, D R; Meier, K J

1991-01-01

Federal and state funds have provided for family planning services in American since the 1960s. Since 1976, services have been funded principally through federal statutes Title X of the Public Health Service Act and Titles V, XIX, and XX of the Social Security Act as well as various state appropriations. While these statutes aim to ensure that women of lower socioeconomic status enjoy access to reproductive health care services, levels of public expenditure in this area vary widely among states. In 1987, public family planning expenditures/woman at risk ranged from $60.16 in Wisconsin to $9.41 in Florida. Within this range of expenditures, the relative importance of each funding source per state varies widely. States with the most robust Title XIX programs, Medicaid, however, have highest per woman family planning expenditures. Upon reviewing the complement of public funding sources and how they are spent at the state level, the authors argue that categorical legislation is still needed to protect access to contraceptive services in America. In particular, of funds from supporting statues, Medicaid is distributed most equitable across the country. These funds paid for 36% of all public outlays for family planning in 1987. Without categorical legislation, however, Medicaid is insufficient to maintain the national family planning effort; the 1987 contribution of $10.49/woman at risk of unwanted pregnancy was insufficient to provide minimum services. Title X requires grantees to follow regulations which ensure state uniformity of quality and service distribution; submission of annual 5-year plans to Congress on how family planning goals will be achieved; and also authorizes monies for training and research. Despite political attacks, family planning funding must remain separate from maternal and child health programs. Such independence will keep these services politically visible; allow use of the more extensive family planning delivery system; catalyze states to

India's misconceived family plan.

PubMed

Jacobson, J L

1991-01-01

India's goal of reducing the national birth rate by 50% by the year 2000 is destined to failure in the absence of attention to poverty, social inequality, and women's subordination--the factors that serve to perpetuate high fertility. There is a need to shift the emphasis of the population control effort from the obligation of individual women to curtail childbearing to the provision of the resources required for poor women to meet their basic needs. Female children are less likely to be educated or taken for medical care than their male counterparts and receive a lower proportion of the family's food supply. This discrimination stems, in large part, from parents' view that daughters will not be able to remunerate their families in later life for such investments. The myth of female nonproductivity that leads to the biased allocation of family resources overlooks the contribution of adult women's unpaid domestic labor and household production. Although government statistics state that women comprise 46% of India's agricultural labor force (and up to 90% of rural women participate in this sector on some basis), women have been excluded systematically from agricultural development schemes such as irrigation projects, credit, and mechanization. In the field of family planning, the Government's virtually exclusive focus on sterilization has excluded younger women who are not ready to terminate childbearing but would like methods such as condoms, diaphragms, IUDs, and oral contraceptives to space births. More general maternal-child health services are out of reach of the majority of poor rural women due to long distances that must be travelled to clinics India's birth rate could be reduced by 25% by 2000 just by filling the demand for quality voluntary family planning services. Without a sustained political commitment to improve the status of women in India, however, such gains will not be sustainable.

The organization and delivery of family planning services in community health centers.

PubMed

Goldberg, Debora Goetz; Wood, Susan F; Johnson, Kay; Mead, Katherine Holly; Beeson, Tishra; Lewis, Julie; Rosenbaum, Sara

2015-01-01

Family planning and related reproductive health services are essential primary care services for women. Access is limited for women with low incomes and those living in medically underserved areas. Little information is available on how federally funded health centers organize and provide family planning services. This was a mixed methods study of the organization and delivery of family planning services in federally funded health centers across the United States. A national survey was developed and administered (n = 423) and in-depth case studies were conducted of nine health centers to obtain detailed information on their approach to family planning. Study findings indicate that health centers utilize a variety of organizational models and staffing arrangements to deliver family planning services. Health centers' family planning offerings are organized in one of two ways, either a separate service with specific providers and clinic times or fully integrated with primary care. Health centers experience difficulties in providing a full range of family planning services. Major challenges include funding limitations; hiring obstetricians/gynecologists, counselors, and advanced practice clinicians; and connecting patients to specialized services not offered by the health center. Health centers play an integral role in delivering primary care and family planning services to women in medically underserved communities. Improving the accessibility and comprehensiveness of family planning services will require a combination of additional direct funding, technical assistance, and policies that emphasize how health centers can incorporate quality family planning as a fundamental element of primary care. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

An ounce of prevention. Is family planning disappearing from the healthcare picture?

PubMed

Hirshbein, N

1992-04-01

Despite family planning's enormous health and social benefits, US support for family planning is dwindling. Not only does family planning improve the health quality of life of children and their parents, it is also a cost-effective measure, saving an average of $4.40 in health and social services costs for each public dollar invested in the program. But over the past few years, political and financial neglect have brought the public family planning infrastructure near collapse. Combined federal and state spending on family planning amounts to less than 1% of public health care funds. In 1990, Medicaid represented the largest source of funds for family planning. But since Medicaid is tied to welfare eligibility, a woman must already have a child in order to qualify for Medicaid and its family planning benefits. Direct state funding for family planning services was the 2nd largest source. Several states, however, provided no funding whatsoever for family planning. The 3rd largest source was the Title X program, a federal program devoted exclusively to family planning. It provides services to some 4 million teens and low-income women nationwide. Over the past decade, Title X has received no significant increase in funding, and inflation has reduced its purchasing power by 2/3. As a result, Title X serves less women. Meanwhile, the number of unintended pregnancies continues to increase. The US already has the highest rate of unintended pregnancies in the developed world. This is partly a result of society's ambivalence towards sex, which makes it difficult to discuss -- much less promote -- family planning. Lack of support for family planning can also be traced to the vigorous efforts of the anti-birth control lobby, which has successfully defeated attempts to increase funding.

[Family planning in Benin: what future?].

PubMed

Danlodji, R

1993-01-01

In Benin, family planning began in the late 1960s, but its activities were not clear or specific. It made small strides in private clinics until a family planning association was formed, later named the Beninese Association to Promote the Family (ABPF). Family planning promoters maintain that reduction in births per couple is necessary for economic development in Africa. Family planning detractors think that a child is a fruit of God and that family planning impedes his or her coming to the world. ABPF has worked much to promote Beninese families, but it is still not well known. Despite the associations efforts and those of many other institutions, contraceptive prevalence is low and the abortion rate and its risks remain high, namely, death, infertility, and contraction of various diseases. Thus, it is important to rethink family planning strategies. All intervening parties should coordinate activities to better reach urban and rural populations. Many rural inhabitants go to cities to escape poverty and the misery evoked by their family size and meager earnings only to find unemployment in the cities. In order for family planning to have an effect in Benin, it is important to begin working with youth. Any family planning strategy must consider their aspirations. The youth are inclined to be more receptive to family planning than the adults who do not want to give up old habits. Yet, contraceptive use in 14-20 year olds is low even though sexual activity is high. Since the youth want a small family size, a small plot of land, a care, and a successful life, it is important to give priority to jobs. We need to educate the youth so they can freely decide their family size. Socioeconomic reasons are the primary factor pushing people to accept family planning, followed by health reasons. Research is needed to learn why contraceptive prevalence is still low.

[The press and family planning].

PubMed

Abraham De D'ornellas, R

1987-01-01

The treatment in the press of family planning hinges on two fundamental factors: the taboo of the leftist groups and the taboo of the Catholic Church, whose head is against abortion under any circumstances. Leftist views insinuate that family planning is the genocidal plan of North American imperialists against the Third World and, in particular, against Latin America. This genocidal plan is supposed to subject poor populations to international schemes. In the press family planning is often treated in a sanctimonious fashion, lumping it together with topics like pornography, sex, and violence. In 1983 the daily newspaper Expreso published a supplement running every week for almost three months about the issue of population, which dealt fairly extensively with such topics as population and housing, education, employment, and urban proliferation, as well as responsible parenthood and child survival. In addition, there was a detailed description of contraceptive methods. In October 1986 another surprising thing happened: the President of Peru talked about the topic of family planning, which at the time was an act of courage. Since then much has changed; the whole world is interested in family planning and certain aspects of population. Since October 1986 more has been published in this domain than during the preceding 20 years. In contrast, the Church reacted differently to this issue: after some initial caution, the conference of Peruvian bishops attacked all methods of modern contraceptives and private institutions of family planning. The information boom in family planning will certainly continue. At the moment this flood of articles and editorials about the issue is an expression of the anxiety of families related to uncontrolled reproduction and the fear of overpopulation in large cities devoid of minimal services.

Men and family planning in Portugal.

PubMed

Vicente, A

1993-10-01

Although family planning services in Portugal are open to everybody, male and female, and they are free of charge, it is mostly women who are using the services, since family planning services have integrated maternal health care. Between 1978 and 1981, the Commission for the Portuguese Commission for Equality and Women's Rights implemented a family planning information, education, and communication project under technical and financial aid by the United Nations Population Fund. During a training course for a group of 12 women, which took place in the small town Vialonga near Lisbon in 1992, all women said that their husbands did not play any role in family planning. The choice of the method was their sole responsibility. In 1988, data were gathered by the General Direction of Primary Health Care from the local health services. 17.6% of women used the pill, and 28% practiced coitus interruptus. Condom use amounted to 5.7%. Other methods were the IUD (7.3%), natural methods (3.6%), spermicides (2.6%), the diaphragm (0.3%), and sterilization (female 3.6%; male 0.3%). In 1992, the Commission published a study on family planning, involving 638 men and 882 women, which concluded that the responsibility for family planning was no longer exclusively with women and that young, single people were in favor of family planning information sessions. The Portuguese Constitution states that the state shall promote a wider knowledge of family planning methods and responsible parenthood. The Health Secretary of State ordered the integration of family planning into the National Health Service in 1976. A 1984 law, Sex Education and Family Planning, and a 1985 Government Order constitute the legal framework for the practice of family planning. The Commission for Equality and Women's Rights has been implementing information, education, and communication activities since 1976. One of the members of the Consultative Council is the Association for Family Planning, which has also been

Family Interaction Patterns, Career Planning Attitudes, and Vocational Identity of High School Adolescents

ERIC Educational Resources Information Center

Hargrove, Byron K.; Inman, Arpana G.; Crane, Randy L.

2005-01-01

The purpose of the current study was to examine how perceptions of family interaction patterns as defined along three dimensions of family environment (quality of family relationships, family goal-orientations, and degree of organization and control within the family system) predict vocational identity and career planning attitudes among male and…

Egypt boosts family planning.

PubMed

1977-10-27

A $4 million Agency for International Development (AID) agreement was signed in Cairo September 30 which will help the Egyptian government increase family planning services. The project is in response to a request for up to $17 million of AID funds for family planning programs during the next 3 years. The funds will pay for: contract advisors to provide short-term in-country training of physicians, architectural and engineering services to renovate a hospital for family planning and obstetrics/gynecology training, and a field training site for family planning service providers. Some Egyptians will receive training in specialized areas in the U.S. and other countries. More than $1.5 million of the $4 million will finance local costs of goods and services required. In addition, it is anticipated that U.S.-owned local currencies will be obligated for direct support of U.S. technical personnel. Over the 3-year life of the project the $17 million from AID plus $664,000 of U.S.-owned local currency will cover 44% of the total costs of selected Egyptian family planning activities. The Egyptian government will contribute at least $18.4 million and the U.N. Fund for Population Activities and the International Bank for Reconstruction and Development will contribute $4.3 million.

Family planning: the unfinished agenda.

PubMed

Cleland, John; Bernstein, Stan; Ezeh, Alex; Faundes, Anibal; Glasier, Anna; Innis, Jolene

2006-11-18

Promotion of family planning in countries with high birth rates has the potential to reduce poverty and hunger and avert 32% of all maternal deaths and nearly 10% of childhood deaths. It would also contribute substantially to women's empowerment, achievement of universal primary schooling, and long-term environmental sustainability. In the past 40 years, family-planning programmes have played a major part in raising the prevalence of contraceptive practice from less than 10% to 60% and reducing fertility in developing countries from six to about three births per woman. However, in half the 75 larger low-income and lower-middle income countries (mainly in Africa), contraceptive practice remains low and fertility, population growth, and unmet need for family planning are high. The cross-cutting contribution to the achievement of the Millennium Development Goals makes greater investment in family planning in these countries compelling. Despite the size of this unfinished agenda, international funding and promotion of family planning has waned in the past decade. A revitalisation of the agenda is urgently needed. Historically, the USA has taken the lead but other governments or agencies are now needed as champions. Based on the sizeable experience of past decades, the key features of effective programmes are clearly established. Most governments of poor countries already have appropriate population and family-planning policies but are receiving too little international encouragement and funding to implement them with vigour. What is currently missing is political willingness to incorporate family planning into the development arena.

Family planning gets a new boost.

PubMed

Ponle, B

1993-01-01

A workshop on family planning was held during 1993 in Ota, Ogun State Nigeria. An active participant was the Emir of Dass, Alhaji Bilyamini Othman, who helped to develop strategies for the implementation of the Family Health Services Project of the Federal Ministry of Health. His commitment to family planning surprised participants, since most pious Muslims are some of the least sympathetic groups. Alhaji Bilyamini is very enthusiastic about family planning and gives the advice that Allah would not like people to have children who could not be fed. Many men come to him for advice and he suggests that the men allow their wives to adopt family planning. Alhaji Bilyamini was educated at Ahmadu Bello University in business administration and currently is a chairman of the advisory committee for the Planned Parenthood Federation of Nigeria in Bauchi State. The involvement of traditional rulers such as Alhaji Bilyamini has been practiced since 1987, when the USAID approached rulers about family planning. Others who have received family planning messages were the Sultan of Sokoto, the Emirs of Kano and Suleija, and the Shehu of Borno, who also have involved their subordinates. The rulers and subordinates who receive training assist in broadcasting the messages to the people. Because of the authoritative position of the rule in the community, a family planning supporter among rulers means the whole community will be convinced. Future plans include involving the rulers through the first phase. Alhaji Bilyamini recommends continued involvement of traditional rulers, because of their success in changing public perceptions. For example, in Bauchi state, condom discussion was considered taboo, and now condoms are advertised on television. Not all emirs have so enthusiastically embraced the family planning idea. An emir in Ogun state turned away visiting family planning experts days before his daughter died while trying at school to abort a pregnancy. Conference participants

Paucity of family planning.

PubMed

Hawkins, C

1988-04-01

A wall chart compiled by the Population Crisis Committee of Washington D.C. called "World Access to Birth Control" is described. The chart compares developing countries and developed countries with respect to need of effective contraception, using data from the World Fertility Surveys. Up to 250 million women need contraception; a substantial percentage want no more children, over half in several large countries. The chart ranks the United Kingdom as 1st in providing family planning services, information, education and advertising. All of the developed countries were considered good except Russia and Romania, although some had deficiencies, such as Japan for lacking sterilization services. The U.S. ranked 7th, failing to provide women the full range of contraceptive methods, to provide adequate sex education and services to adolescents, and to publish information and adequate advertising about birth control. The USSR was placed 14th on the list of 15 because of poor quality and erratic supplies. Among the developing countries, Libya, Kampuchea and Laos were cited as having no services whatsoever. In contrast, several Asian national family planning programs, notably China, Taiwan, Singapore, South Korea and Hong Kong, had such excellent programs that fertility had declined over 30% in 15 years. In China, fertility has fallen 50% in that time.

Family Planning Handbook for Doctors.

ERIC Educational Resources Information Center

Kleinman, Ronald L., Ed.

The International Planned Parenthood Federation (IPPF) believes that all people have the right to family planning information, including premarital and marital counseling, contraception information, and sex education. This physician's handbook is designed to provide all doctors with the necessary instructions on the latest family planning methods…

Motivations and Constraints to Family Planning: A Qualitative Study in Rwanda’s Southern Kayonza District

PubMed Central

Farmer, Didi Bertrand; Berman, Leslie; Ryan, Grace; Habumugisha, Lameck; Basinga, Paulin; Nutt, Cameron; Kamali, Francois; Ngizwenayo, Elias; Fleur, Jacklin St; Niyigena, Peter; Ngabo, Fidele; Farmer, Paul E; Rich, Michael L

2015-01-01

Background: While Rwanda has achieved impressive gains in contraceptive coverage, unmet need for family planning is high, and barriers to accessing quality reproductive health services remain. Few studies in Rwanda have qualitatively investigated factors that contribute to family planning use, barriers to care, and quality of services from the community perspective. Methods: We undertook a qualitative study of community perceptions of reproductive health and family planning in Rwanda’s southern Kayonza district, which has the country’s highest total fertility rate. From October 2011 to December 2012, we conducted interviews with randomly selected male and female community members (n = 96), community health workers (n = 48), and health facility nurses (n = 15), representing all 8 health centers’ catchment areas in the overall catchment area of the district’s Rwinkwavu Hospital. We then carried out a directed content analysis to identify key themes and triangulate findings across methods and informant groups. Results: Key themes emerged across interviews surrounding: (1) fertility beliefs: participants recognized the benefits of family planning but often desired larger families for cultural and historical reasons; (2) social pressures and gender roles: young and unmarried women faced significant stigma and husbands exerted decision-making power, but many husbands did not have a good understanding of family planning because they perceived it as a woman’s matter; (3) barriers to accessing high-quality services: out-of-pocket costs, stock-outs, limited method choice, and long waiting times but short consultations at facilities were common complaints; (4) side effects: poor management and rumors and fears of side effects affected contraceptive use. These themes recurred throughout many participant narratives and influenced reproductive health decision making, including enrollment and retention in family planning programs. Conclusions: As Rwanda

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...

Family Health and Family Planning.

ERIC Educational Resources Information Center

World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

This document is made up of a selection of some of the papers distributed to participants in courses on "Family Health and Family Planning" which have been organized each year since 1973 by the International Children's Center and the World Health Organization Regional Office for Europe. Six courses, held between 1973 and 1978, brought together a…

Association of the quality of interpersonal care during family planning counseling with contraceptive use.

PubMed

Dehlendorf, Christine; Henderson, Jillian T; Vittinghoff, Eric; Grumbach, Kevin; Levy, Kira; Schmittdiel, Julie; Lee, Jennifer; Schillinger, Dean; Steinauer, Jody

2016-07-01

Health communication and interpersonal skills are increasingly emphasized in the measurement of health care quality, yet there is limited research on the association of interpersonal care with health outcomes. As approximately 50% of pregnancies in the United States are unintended, whether interpersonal communication influences contraceptive use is of public health importance. The aim of this study was to determine whether the quality of interpersonal care during contraceptive counseling is associated with contraceptive use over time. The Patient-Provider Communication about Contraception study is a prospective cohort study of 348 English-speaking women seen for contraceptive care, conducted between 2009 and 2012 in the San Francisco Bay Area. Quality of communication was assessed using a patient-reported interpersonal quality in family planning care measure based on the dimensions of patient-centered care. In addition, the clinical visit was audio recorded and its content coded according to the validated Four Habits Coding Scheme to assess interpersonal communication behaviors of clinicians. The outcome measures were 6-month continuation of the selected contraceptive method and use of a highly or moderately effective method at 6 months. Results were analyzed using mixed effect logistic regression models controlling for patient demographics, the clinic and the provider at which the visit occurred, and the method selected. Patient participants had a mean age of 26.8 years (SD 6.9 years); 46% were white, 26% Latina, and 28% black. Almost two-thirds of participants had an income of <200% of the Federal Poverty Level. Most of the women (73%) were making visits to a provider whom they had not seen before. Of the patient participants, 41% were still using their chosen contraceptive method at 6-month follow-up. Patients who reported high interpersonal quality of family planning care were more likely to maintain use of their chosen contraceptive method (adjusted odds

"Safe motherhood", family planning and maternal mortality: an Indonesian case study.

PubMed

Smyth, I

1994-06-01

This case study in Indonesia examined some assumptions about the outcome of family planning services. Safe Motherhood programs were flawed, because of the misplaced emphasis on family planning as a strategy to reduce maternal mortality. Family planning programs reduce the exposure to the risks of child-bearing, but they do not reduce the actual risks. Reproductive health should not be linked so tightly to demographic concerns and family planning. That cost saving occurs from family planning is insufficient to justify inattention to the needs of high quality obstetric care. Family planning should be viewed as just one component of a larger, comprehensive set of measures designed to assure the health of women at all stages in the life cycle: as citizens and workers, as mothers, and as adolescents. Interventions must begin before childbearing and include growth in economic, educational, and health opportunities. The aim of reducing maternal mortality by 50% by the year 2000 was included in Indonesia's five-year development plan: Repelita V. The example of Indonesia was important, because of its achievements in reducing poverty and increasing the standard of living of the population, and because of its large population size. Estimated maternal mortality in Indonesia was 450/100,000 live births in 1989, up from 390/100,000 in 1982. There was evidence from other studies that maternal mortality has increased. Criticism has been directed to the misplaced emphasis on family planning and the top-down delivery of professional services for ignoring local health-enhancing practices and the role of families, fathers, and communities as health providers. The realized cost effectiveness of family planning is an abstraction. Fertility has declined with an increase in family planning from 5.6 children to 3.0 children in 1990, but, for example, Bali has both high levels of contraception use and high maternal mortality. Integrated programs and the high risk approach have not been

A cost-benefit analysis of the Mexican Social Security Administration's family planning program.

PubMed

Nortman, D L; Halvas, J; Rabago, A

1986-01-01

A cost-benefit analysis of the family planning program of the Mexican Social Security System (IMSS) was undertaken to test the hypothesis that IMSS's family planning services yield a net savings to IMSS by reducing the load on its maternal and infant care service. The cost data are believed to be of exceptionally high quality because they were empirically ascertained by a retrospective and prospective survey of unit time and personnel costs per specified detailed type of service in 37 IMSS hospitals and 16 clinics in 13 of Mexico's 32 states. Based on the average cost per case, the analysis disclosed that for every peso (constant 1983 currency) that IMSS spent on family planning services to its urban population during 1972-1984 inclusive, the agency saved nine pesos. The article concludes by raising the speculative question as to the proportion of the births averted by the IMSS family planning program that would have been averted in the absence of IMSS's family planning services.

Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

PubMed

Zakiyah, Neily; van Asselt, Antoinette D I; Roijmans, Frank; Postma, Maarten J

2016-01-01

A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate

Search is on for most outstanding family planning workers and clinics.

PubMed

1994-01-01

The JSI Research and Training Institute, Inc, sponsored a national wide search in the Philippines commencing March 15, 1994, and ending July 7, 1994, for commendable family planning workers. The winners of the competition were selected from five categories: the best family planning volunteer worker, government family planning service worker, nongovernment family planning service worker, a government family planning clinic or center, and a nongovernment family planning clinic or center. Winners in each category were selected at the provincial or chartered city level, regional level, and national level. Nomination forms were made available in Provincial Health Offices or City Health Offices. Nomination criteria involved a worker who must have worked for at least 18 months for a family planning service agency and a volunteer who must have worked at least a year a family planning service agency in referring cases. Clinics or centers must have been in operation for at least 18 months and preferably accredited by the government. Winner selection criteria was based on the number of clients served, the commitment to family planning, and the quality of their work. Nominations were disqualified if workers were involved with performing abortions, coercing clients to practice family planning, or discriminating against any legally acceptable methods of contraception. Provincial selection of the winner occurred on July 15, 1994, and these winners were entered in the regional competition, which was set for August 1 and September 15, 1994. Regional winners competed in the national competition in November 1994. The award for each provincial winner will be a certificate, an aneroid sphygmomanometer, and a stethoscope. Provincial clinics will receive a certificate and a wall clock. Regional winners will receive a certificate and wrist watches. Regional clinics will receive a certificate and an examining table or karaoke sound system. The five national winners will receive a plaque of

Study findings on evaluation of integrated family planning programme performance.

PubMed

1980-01-01

In 1976 the United Nations's Economic and Social Commission for Asia and the Pacific launched a comparative study on integrated family planning programs in a number of countries in the region. In November 1979 the study directors from the participating countries meet in Bangkok to discuss the current status of the studies in their countries. The Korean and Malaysian studies were completed, the Bangladesh study was in the data collecting phase, and the Pakistani research design phase was completed. The meeting participants focused their attention on the findings and policy implications of the 2 completed studies and also discussed a number of theorectical and methodological issues which grew out of their research experience. The Malaysian study indicated that group structure, financial resources, and the frequency and quality of worker-client contact were the most significant variables determining program effectiveness. In the Korean Study, leadership, financial resources, and the frequency and quality of contact between agencies were the key variables in determining program effectiveness. In the Malaysian study there was a positive correlation between maternal and child health service performance measures and family planning service performance measures. This finding supported the contention that these 2 types of service provision are not in conflict with each other but instead serve to reinforce each other. Policy implications of the Korean study were 1) family planning should be an integral part of all community activities; 2) family planning workers should be adequately supported by financial and supply allocations; and 3) adequate record keeping and information exchange procedures should be incorporated in the programs.

Attitudes of physicians providing family planning services in Egypt about recommending intrauterine device for family planning clients.

PubMed

Aziz, Mirette; Ahmed, Sabra; Ahmed, Boshra

2017-12-01

To assess the attitudes of physicians providing family planning services at the public sector in Egypt about recommending intrauterine device (IUD) for family planning clients, and to identify the factors that could affect their attitudes. A descriptive cross sectional study, in which all the physicians providing family planning services in Assiut Governorate were invited to complete self-administered questionnaires. The study participants were recruited at the family planning sector monthly meetings of the 13 health directorates of Assiut Governorate, Upper Egypt. 250 physicians accepted to participate in the study. Bivariate and Multivariate regression analyses were performed to identify the most important predictors of recommending IUD to family planning clients when appropriate. Less than 50% of physicians would recommend IUD for clients with proper eligibility criteria; women younger than 20 years old (49.2%), women with history of ectopic pregnancy (34%), history of pelvic inflammatory diseases (40%) or sexually transmitted diseases (18.4%) and nulliparous women (22.8%). Receiving family planning formal training within the year preceding data collection and working in urban areas were the significant predictors of recommending IUD insertion for appropriate clients. Physicians providing family planning services in Upper Egypt have negative attitudes about recommending IUD for family planning clients. Continuous education and in-service training about the updated medical eligibility criteria, especially for physicians working in rural areas may reduce the unfounded medical restrictions for IUD use. Copyright © 2017 Elsevier B.V. All rights reserved.

Improving the urban family planning programme.

PubMed

1997-10-01

This report presents the directives on improving urban family planning (FP) programs issued by various Chinese departments in March 1997. The departments included the State Family Planning Commission, State Economic and Trade Commission, Ministry of Public Security, Ministry of Personnel, Ministry of Labor, Ministry of Public Health, and the National Industrial and Commercial Administration. The directives related to time frame, objectives, management, local level operations, IEC, the floating population's needs, the responsibility system, and a well-trained staff. It was stated that urban FP improvements will take some time, due to expansion of urban population, the increase in floating population, and the demand for quality services. The guiding principles support Deng Xiaoping's theory of building socialism with Chinese characteristics and balancing population with socioeconomic and sustainable development. The aim is to improve IEC and services and achieve low fertility as a way of creating favorable demographics for modernization. Leaders must be held responsible for the practice of FP in their unit. Subdistrict offices are a key link for managing FP in all units and neighborhood committees in their territory. Efforts need to be increased to spread IEC on population and FP and to reduce abortion. Every department registry should make an effort to provide comprehensive FP to floating populations. Urban centers should concentrate on improving the quality of FP services. Staff should be carefully chosen.

The Role of Federally Qualified Health Centers in Delivering Family Planning Services to Adolescents.

PubMed

Mead, Katherine H; Beeson, Tishra; Wood, Susan F; Goldberg, Debora Goetz; Shin, Peter; Rosenbaum, Sara

2015-07-01

The purpose of this article was to examine the role of community health centers (CHCs) in providing comprehensive family planning services to adolescents, looking at the range of services offered and factors associated with provision of these services. This study employed a mixed methods approach comprising a national survey of CHCs and six in-depth case studies of health centers to examine the organization and delivery of family planning services. We developed an adolescent family planning index comprising nine family planning services specifically tailored to adolescents. We analyzed the influence of state-level family planning policies, funding for adolescents, and organizational characteristics on the provision of these services in CHCs. The case studies identified barriers to the provision of family planning to adolescent patients. The survey found substantial variation in the provision of family planning services at CHCs, with a mean of 6.33 out of a maximum score of 13 on the family planning adolescent services index. Title X funding and location within a favorable state policy environment were significantly associated with higher scores on the family planning adolescent services index (p value < .001 and .002, respectively). Case studies revealed barriers to adolescent family planning, including lack of funding, lack of knowledge, and limitations on school-based clinical services. CHCs have the opportunity to play a significant role in providing high-quality family planning to low-income, medically underserved adolescents. Additional funding, resources, and a favorable policy climate would further improve CHCs' ability to serve the family planning needs of this special patient population. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Family Planning in the Balance

PubMed Central

Hwang, Ann C.; Stewart, Felicia H.

2004-01-01

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. PMID:14713687

Family planning advice and postpartum contraceptive use among low-income women in Mexico.

PubMed

Barber, Sarah L

2007-03-01

In Mexico, family planning advice has been incorporated into the clinical guidelines for prenatal care. However, the relationship between women's receipt of family planning advice during prenatal care and subsequent contraceptive use has not been evaluated. Data were collected in 2003 and 2004 in 17 Mexican states from 2,238 urban low-income women postpartum. Participating women reported on prenatal services received and contraceptive use. Logistic and multinomial logistic regression models evaluated whether receiving family planning advice during prenatal care predicted current contraceptive use, after quality of care in the community, service utilization, delivery characteristics, household socioeconomic characteristics, and maternal and infant characteristics were controlled for. Overall, 47% of women used a modern contraceptive method. Women who received family planning advice during prenatal care were more likely to use a contraceptive than were those who did not receive such advice (odds ratio, 2.2). Women who received family planning advice had a higher probability of using condoms (relative risk ratio, 2.3) and IUDs (5.2), and of undergoing sterilization (1.4), than of using no method. Integrating family planning advice into prenatal care may be an important strategy for reaching women when their demand for contraception is high.

Family planning and health: the Narangwal experiment.

PubMed

Faruqee, R

1983-06-01

The findings of a 7-year field experiment conducted in the Indian Punjab show that integrating family planning with health services is more effective and efficient than providing family planning separately. The field experiment was conducted between 1968 and 1974 at Narangwal in the Indian State of Punjab. It involved 26 villages, with a total population of 35,000 in 1971-72. The demographic characteristics of the villages were found to be typical of the area. 5 groups of villages were provided with different combinations of services for health, nutrition and family planning. A control group received no project services. A population study was made of the effects of integrating family planning with maternal and child health services. A nutritional study looked at the results of integrating nutritional care and health services. The effectiveness of integration was evaluated by identifying it both with increased use of family planning and improved health. Efficiency was judged by relating effectiveness to input costs. Distribution of the benefits was also examined. The effectiveness of these different combinations of services on the use of family planning was measured: 1) by all changes in the use of modern methods of family planning, 2) by the number of new acceptors, 3) by the changes in the proportion of eligible women using contraceptives, and 4) by how many people started to use the more effective methods. Results showed the use of family planning increased substantially in the experimental groups, whereas the control group remained constant. It was also found that, though the services combining family planning with maternal health care stimulated more use of family planning, they were more costly than the more integrated srevices. The Narangwal experiment provides significant evidence in favor of combining the provision of family planning and health services, but its potential for replication on a large scale needs to be studied.

Guns or butter, family planning or widgets?

PubMed

Hirshbein, N

1992-02-01

In January 1992 Congress returned from its Christmas recess to begin wrestling with the upcoming year's federal budget. The Budget Enforcement Act places absolute limits on the amounts Congress can appropriate for domestic programs, international assistance, and defense spending. Unless the president declares an emergency, Congress has no flexibility to adjust the $293 billion defense allocation in favor of domestic or international assistance. For the next few years, spending for the military would account for about 55% of all discretionary spending. The Labor, Health and Human Services, and Education Appropriations subcommittee has a predetermined slice of the $222 billion domestic allocation. The subcommittee must then decide how to subdivide its slice among employment programs, education assistance, and health care, which includes domestic family planning programs. Similarly, the foreign operations subcommittee slices up a small $20 billion for international assistance. Some will go for economic aid, some for development assistance, including international family planning programs. And, about 30% of the international aid budget will go to military assistance to foreign governments. The massive shifts on the international scene and an uncertain domestic economy are forcing a reconsideration of this iron-clad budget agreement. Consequently, efforts to nullify the budget agreement are underway. Over 100 organizations and church groups have formed a coalition calling on Congress and the administration to reorder fiscal priorities so that resources can be redirected toward worthwhile domestic and international programs. Worldwide, the demand for contraceptive services is increasing, yet the US spends only about $300 million for population assistance per year, about the same as it was 20 years ago. But policy makers are finally beginning to understand that the costs of Title X, international family planning, and providing quality family planning services are far less

Putting 'family' back in family planning.

PubMed

Seifer, David B; Minkoff, Howard; Merhi, Zaher

2015-01-01

Family planning visits are designed to help women build families in a manner most compatible with their life goals. Women's knowledge regarding age-related fertility is suboptimal, and first wanted pregnancies are now occurring at older ages. Here we review the issue of diminishing chances of a pregnancy occurring in women over 30 years of age. A debate arises over whether to perform a standard fertility assessment at an age when, for example, oocyte freezing is still practical and feasible, knowing that the proven predictors in subfertile couples may be less informative, or even inappropriate, in women without complaints about fertility. Studies have demonstrated that if women knew that their fertility was diminishing, they might alter life plans, including having children sooner or considering oocyte preservation. Therefore, we argue that physicians need to make an effort to evaluate a woman's childbearing priorities, though not necessarily their fertility, during the initial family planning visit. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Barriers and facilitators to family planning access in Canada.

PubMed

Hulme, Jennifer; Dunn, Sheila; Guilbert, Edith; Soon, Judith; Norman, Wendy

2015-02-01

Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada. Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes. Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system. Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada. Copyright © 2015 Longwoods Publishing.

Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review

PubMed Central

Zakiyah, Neily; van Asselt, Antoinette D. I.; Roijmans, Frank; Postma, Maarten J.

2016-01-01

Background A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. Study design A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Conclusion Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved

Population Growth: Family Planning Programs.

ERIC Educational Resources Information Center

Doberenz, Alexander R., Ed.; Taylor, N. Burwell G., Ed.

These proceedings of the second annual symposium on population growth bring together speeches and panel discussions on family planning programs. Titles of speeches delivered are: Communicating Family Planning (Mrs. Jean Hutchinson); Effects of New York's Abortion Law Change (Dr. Walter Rogers); The Law and Birth Control, Sterilization and Abortion…

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

PubMed Central

Kwete, Dieudonné; Binanga, Arsene; Mukaba, Thibaut; Nemuandjare, Théophile; Mbadu, Muanda Fidele; Kyungu, Marie-Thérèse; Sutton, Perri; Bertrand, Jane T

2018-01-01

Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013–14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014–2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges.

PubMed

Kwete, Dieudonné; Binanga, Arsene; Mukaba, Thibaut; Nemuandjare, Théophile; Mbadu, Muanda Fidele; Kyungu, Marie-Thérèse; Sutton, Perri; Bertrand, Jane T

2018-03-21

Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013-14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014-2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in

Incentives to promote family planning

PubMed Central

Heil, Sarah H.; Gaalema, Diann E.; Herrmann, Evan S.

2012-01-01

Objective Over the past 60 years, population control has become an increasingly urgent issue worldwide as a growing population strains already limited resources. The use of financial incentives to promote family planning is an innovative approach that has potential to make a contribution to efforts to better manage population growth. This report reviews eight studies that examined the effect of incentives on family planning. Method Published studies that tested the impact of incentives to promote some aspect of family planning and included an appropriate control or comparison condition were reviewed. Results Incentives have been used to promote attendance at contraceptive education sessions, adoption and continuation of contraceptive methods, sterilization, and to limit family size. All but one of the eight studies reviewed reported positive outcomes, but weaknesses in study design and execution limit the strength of the conclusions that can be drawn. Conclusion Review of this literature suggests that family planning behaviors, like other behaviors, are sensitive to incentives. Given the tremendous need for efficacious interventions in global efforts to manage population growth, further research on this topic using more rigorous experimental methods is warranted. PMID:22743293

[Implementation and expansion of family planning services: questions and controversies].

PubMed

Canesqui, A M

1985-01-01

Even though the Brazilian government's position on birth control in the last few years has been ambiguous, it is moving away from the pro-life attitude that was prevalent in the 1960s and through the mid-1970s. The economic conditions during this period created a sense of urgency in establishing family planning programs to divert possible economic and social repercussions. The creation and expansion of family planning services in the last 2 decades have improved the distribution of contraceptives, related health care, and research. The problems of birth control and family planning are the same in Brazil as in the rest of the world. There is and always will be a moral, ethical, religious, or political question from the groups that traditionally oppose these concepts. The theme of responsible birth control is 1 of the tools used in the attempt to get the message across. Some results of irresponsible birth control are abortions, poverty, and misery. Proposals for integrating the various family planning services have not been implemented due to a lack of priorities in spending the available funds. Most of these health groups place responsibility for providing these methods of family planning upon the State. The groups say the State needs to consider women's freedom, sexuality and personal preferences in providing the family planning programs. A few groups prefer private sector sponsorship in order to preserve the woman's options concerning health care. The need for health care and the question of democracy both need to be taken into consideration when dealing with human reproduction. Attention should also be paid to the quality of health service, in order to guarantee less distortion of the issue and provide better medical care for all.

Family planning and maternal and child health services.

PubMed

Singh, A

1975-12-01

Considerable effort has been made in the area of family planning in the State of Punjab. Family planning personnel has been recruited and trained at the State Family Planning Training and Research Center in Kharar; supplies of Nirodh, IUDs, oral contraceptives, and hospital equipment along with transportation facilities have been made available; and there has been some building construction. The State Health Education Bureau has worked to produce publicity material and has also used the mass media to create awareness of family planning among the people. As many as 120 rural and 49 urban Family Welfare Planning Centers are providing family planning services along with 856 subcenters in rural areas. 1123 other institutions are also doing family planning work in addition to the efforts of 34 mobile sterilization and IUD units attached to the District Family Planning Bureau and the contributions of some voluntary organizations. Although the state has adopted the cafeteria approach to family planning and the focus is on provision of family planning services on routine days in the various institutions to well-motivated couples, mass family planning camps for vasectomy, tubal ligations, and IUD insertions have been held with considerable success. Additionally, the State has integrated family planning programs with maternal and child health care in order to provide a totality of service. This precedes the total integration of this national program w ith general health services. Punjab has done well in achieving its targets for 1974-1975. Sterilization targets were set at 38,300 and 36,460 sterilizations, 95.2% of the target, were performed. IUD targets were 27,000, and the number achieved was 39,637 or 109.4%. The conventional contraceptive user target was 99,800, and 151,976 or 152.3% of the target figure became conventional contraceptive users.

Kenya's Maternal Child Health Family Planning Program (Family Health).

PubMed

Kiereini, E M

1982-01-01

In an attempt to improve accessibility to health care for the majority of its population, the government of Kenya has, since 1970, undertaken an integration of its dispersed health care system. In 1972 the Ministry of Health carried out a study to identify the problems associated with health care in rural areas. A task force consisting of government and other officials carried out a situation analysis with a view to making specific recommendations for improving community health status. The 4 main health problems identified had to do with family health problems, communicable diseases, diseases related to poor environmental sanitation, and health problems related to poor nutrition. The analysis also revealed the importance of maternal and child health for overall health of the community. A Maternal Child Health Family Planning (MCH/FP) program was then designed to improve services to women aged 15-49 years and children below 5 years, the groups proven to be at greatest risk for ill health. Also integrated into this approach were family planning services. Health workers ranging from enrolled community nurses (equipped with knowledge and skills for diagnosing and treating common conditions) to traditional birth attendants, serve both rural and urban areas. In addition, registered public health nurses, supervising MCH/FP services in district facilities, also operate in urban areas. Rural populations also have the services of a clinical officer who is answerable to the district medical officer, and who has charge of the health center. The Family Health Field Educators Training Program, which was started in 1975 has not yet been evaluated, but it is evident that the efforts of the government to train and equip health workers has greatly improved the quality and availability of health care service to Kenyans.

Men and Family Planning. Worldwatch Paper 41.

ERIC Educational Resources Information Center

Stokes, Bruce

This monograph focuses on men's potentially positive role in family planning. In addition, it identifies reasons why so few organized family planning programs have targeted men as clients and why men have so often played a peripheral or negative role in family planning. The document is presented in seven chapters. Chapter I introduces the topic…

Practical Suggestions for Family Planning Education.

ERIC Educational Resources Information Center

Health Services Administration (DHEW/PHS), Rockville, MD. Bureau of Community Health Services.

This manual is designed to address some of the basic problems of those who work in family planning education, and is based on the recurring questions and concerns of participants in a nationwide series of DHEW-sponsored family planning education and communication workshops. The manual proceeds chronologically, dealing first with the planning of a…

An integration programme of poverty alleviation and development with family planning.

PubMed

1997-04-01

The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties identified by the central government and provincial governments must be fulfilled. This should contribute to breaking the vicious circle of poverty leading to more children, in turn generating more poverty. The circular demands that more efforts should focus on the training of cadres for the Integrated Programme and on services for poor family planning acceptors. full text

A dynamic family planning and health campaign.

PubMed

1986-11-01

Any successful development program that combines family planning, nutrition, and parasite control such as the integrated project, must include effective information, education, and communication (IEC) components. The Population an Community Development Association (PDA), the largest nonprofit organization in Thailand provides a network of family planning service delivery composed of volunteer distributors including midwives, school techers and shopkeepers. Reliability and accessibility are the 2 important elements. A concerted media campaign which exposes people to condoms and other contraceptives helps desensitize an otherwise "too personal" issue. The problem which confronts family planning communication is how to counteract the sensuous messages form advetisers while focusing on mundane topics such as maternal and child health, responsible parenthood, and family budgets. The PDA has tried to use the same attractions to promote family planning. It distributes promotional items such as T-shirts, pens towels and cigarette lighters bearing family planning messages. In addition to the use of television and radio, PDA also utilizes every possible channel of communication. Approaches include: the Youth-to-Youth Program; informational exhibits; video-mobile vans which visit schools and factories; and the holding of PDA's vasectomy festivals. Informational exhibits on family planning and health care use a variety of audio-visual methods. Video is an effective communication medium. The PDA video material ordinarily consists of family dramas illustrating good and bad family planning practices. By holding vasectomy festivals, PDA provides a media-attracting forum to educate the public and promote vasectomey as the most effective birth control method. Mass media campaigns must be linked with fieldwork outreach.

Agency leads in family planning assistance.

PubMed

1989-01-01

The US Agency for International Development (USAID) is the main source of family planning assistance for the developing countries of the world. It accounts for 45% of the funding for population programs worldwide. USAID's policy promotes expanded family planning services, providing a broad range of birth control methods, promotes consumer delivery systems, and urges private sector assistance. Since the program began in the 1960's the number of people in the developing world using family planning increased from 15 million to 200 million. In 1959 there was only 1 country with a population policy, India, now there are 63 developing countries with policies. USAID has brought $567.7 million worth of contraceptives for distribution in 75 countries including 6.9 billion condoms, 1.6 billion cycles of pills, 49.7 million IUD's, and 16.5 vaginal foam tablets. USAID has funded research in contraceptives including the Hulka clip, laparoscopic sterilization, low-estrogen pills, progestin pills, Copper-T IUD, NORPLANT and NORPLANT 2. In addition, funding for a 3-month injectable and a 12 month pellet is being provided. The agency has also worked with the entertainment industry to produce songs to warn of the dangers of early pregnancy. They have also conducted the largest survey research program, using data from 149 surveys in 65 countries to assess the demand for family planning and analyze population dynamics. The number of women of reproductive age will increase 45% by the year 2000 increasing the demand for family planning dramatically. The resources needed by 2000 are estimated to be $5 billion and $7 billion by the year 2010. This will require efforts from government, private industry, and private voluntary organizations. USAID has developed a contraceptive marketing project worldwide to promote birth control sales and family planning. Another program helps private sector companies promote their own family planning services.

Family planning among Nigerian postsecondary female students.

PubMed

Oyeka, I C

1986-01-01

This study examines the level of knowledge, attitude, and practice of family planning among postsecondary female students in an urban area of Anambra State, Nigeria. Although only a few of the women sampled expressed knowledge of modern contraceptive methods, the majority had favorable attitudes toward family planning. Among those who had knowledge of family planning, those who had attended a coeducational secondary school were more familiar with modern contraceptive methods, and those who had attended an all-girls' secondary school were more familiar with the rhythm method. Of the 23.3 percent who had ever practiced family planning, almost half had used rhythm; only a very small minority had ever used the pill. Among those who had ever used contraception and who had a positive attitude toward family planning, the greatest proportion was made up of older, married Protestant women.

Indonesia's family planning program works toward self-sufficiency.

PubMed

Kunii, C

1989-07-01

Started in 1970, the Indonesian Family Planning Program is doing very well. It is coordinated by the National Family Planning Coordinating Board (BKKBN). Many new acceptors are being enrolled daily. Its aim is to reduce to 1971 fertility rate of 50% in 1990. Strategy factors are listed. The following paper, "BKKBN and the Expanding Role of Private Sector Family Planning Services and Commercial Contraceptive Sales in Indonesia," by Dr. Haryono Suyono is introduced. Another article, "A breakthrough in Family Planning Promotional Strategy," by Mr. Sumarsono is also introduced. This article deals with the marketing aspect of Indonesia's family planning program.

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed Central

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-01-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific. PMID:21729919

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-07-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific.

Women's experiences with family planning.

PubMed

Gupte, M

1994-06-01

India's family planning programs target rural women because they do not have political power. Interviews with those in Maharashtra show their lack of choice and low access to resources and their need for safe contraception. In 2 rural villages, for every dead child, a woman bears, on average, 2 more children. When a child dies, villagers first suspect the mother of having performed voodoo or witchcraft. Other suspected women are deserted women, widows, and menstruating women. Health and family planning services are not based on people's perceptions of body, anatomy, illness, and cure. People are not informed about interventions, particularly contraception. Women are not comfortable with contraceptives, and when physician ignore genuine symptoms and sequelae, it reinforces women's suspicions about contraceptives. Sterilizations performed in camps result in more side effects than individually performed sterilizations. During 1975-1977, women were kidnapped and sterilized under very unhygienic conditions. Common complaints after sterilization are menstrual disturbances and lower back pain. Many private physicians treat these complaints by performing hysterectomy. Women rarely are involved in the decision-making process determining whether or not they should undergo sterilization. They are often given false promises, if they accept sterilization. Indian women have little choice in contraceptives. The low biodegradability of condoms poses a disposal problem. Health workers often dispose of IUDs, pills, and condoms which they claim have been accepted. Auxiliary nurse midwives are pressured to meet family planning targets, so they harass women to accept contraception. Village women do not trust them. Health workers often steal cases from each other. Many complain that minorities are responsible for the population explosion, but the minority's family size is basically the same as that of the majority. Low access to general health services and harassment to fulfill family

Rakhaine community embraces family planning.

PubMed

Chowdhury, S M

1994-01-01

The Rakhaines are a small, tightly knit community of 15,000 people who occupy parts of the coastal and hilly districts of southern Bangladesh. It is a closed community with different ethnic origins and religion from other Bangladeshis. As such, they have been largely unreached by government health and family planning services. In response to the need to bring services to these people, contact was established between the Family Planning Association of Bangladesh (FPAB) and the Rakhaine in 1987 in the interest of improving family health and well-being among the Rakhaine people through the introduction of maternal and child health care and family planning. The Family Planning Services for the Rakhaine Community project of the FPAB began in Cox's Bazar and Harbang in late 1987, and spread gradually over the hilly terrain inhabited by the Rakhaine to now serve 2000 couples. Although family planning was the focal point, the project also incorporated schemes for income generation, maternal and child health care, and sanitation. At baseline, less than 25% of reproductive age couples were using contraception, but this proportion grew to 69% by 1993, higher than the national contraceptive prevalence rate of approximately 40%. Used by 41% of married women of reproductive age, the pill is the most preferred contraceptive method, followed by sterilization among 10% of women. The efforts of fieldworkers were crucial to program success. The author notes that current users have been using contraception on average for just over two years. Moreover, the level of tetanus toxoid immunization rose to 60% of pregnant women, while 75% of children are now immunized against major life-threatening diseases. Some costs are recovered, but not enough to finance the project.

Should family planning include STD services?

PubMed

Finger, W R

1994-05-01

Recent reviews suggest that the addition of programs aimed at preventing and controlling sexually transmitted diseases (STDs), specifically human immunodeficiency virus (HIV), to existing family planning programs does not necessarily dilute overall program effectiveness. In Colombia, Mexico, and Jamaica, where condom distribution and/or information to prevent HIV transmission was integrated into the activities of family planning field workers, no negative effect on the image of condoms as a pregnancy prevention method was observed and there was a great demand on the part of family planning clients for information about acquired immunodeficiency syndrome (AIDS). In Brazil, family planning staff are receiving training in HIV risk assessment and the counseling of women in partner negotiation skills. However, steps must be taken to reach men since it is their high-risk behavior that puts most women at risk of HIV. Both separate STD clinics for men and condom social marketing projects have yielded promising results. Obstacles to the addition of STD services to family planning programs include the need to treat male partners as well as female clients, a shortage of diagnostic tools and antibiotics for treatment, and the fact that the majority of women with STDs are asymptomatic. Indicative of the increased attention being given this approach, however, is the recent release of guidelines by the US Agency for International Development Office of Population on how family planning programs should approach integration. Suggested activities include condom promotion, behavior change, counseling, information, contraceptive development, and selected efforts at STD treatment.

Family planning funding cuts and teen childbearing.

PubMed

Packham, Analisa

2017-09-01

Publicly funded family planning clinics provide low-cost and free contraception to nearly 1.5 million teens each year. In recent years, several states have considered legislation to defund family planning services, although little is known about how these cuts affect teen pregnancy. This paper fills this knowledge gap by exploiting a policy change in Texas that reduced funding for family planning services by 67% and resulted in over 80 clinic closures. I estimate the effects of the funding cuts on teen health outcomes using a difference-in-differences approach that compares the changes in teen birth rates in Texas counties that lost family planning funding to changes in counties outside of Texas with publicly funded clinics. I find that reducing funding for family planning services in Texas increased teen birth rates by approximately 3.4% over four years with effects concentrated 2-3 years after the initial cuts. Copyright © 2017 Elsevier B.V. All rights reserved.

Family planning studies the teachers' survey. Part 2: fertility differentials and practice of family planning.

PubMed

Kamel, W H; Hanna, A T; Kamel, N A; Wahdan, M H

1970-06-01

This study deals with biologic and socioeconomic fertility differentials of married female teachers in the Alexandria Governorate who were surveyed via questionnaire from October 1966 to February 1967. It also shows fertility patterns of educated working women, their opinions about family planning, their use of contraceptives, and their knowledge and use of family planning services. Of the 3893 teachers who responded, 65%, or 2626, were married and 92.5% were of childbearing age. The average age was 32.70 years; the average duration of marriage was 7.18 years. Half had just 1 or 2 children, with an inverse relationship between educational attainment and number of children. The number of children increased with the age of the teacher, but there was an inverse relationship between age at marriage and number of children. Just over 25% of the pregnancies ended in abortion, with an average of .64 abortions per teacher. There was a direct relationship between age of teacher and frequency of abortion. Teachers who married when they were under 20 were the most likely to abort. 13% of the teachers were pregnant at the time of the study. An inverse relationship existed between the desire to be pregnant and the number of surviving children. Statistics for married teachers over 45 who had completed their fertility indicate that the average teacher is likely to have 1.02 abortions, 3.1 deliveries, and 2.6 living children. All teachers favored family planning. 77.3% were currently practicing it, most in the 30-44 age group. 42% had consulted private doctors; 44.3% were prac ticing without medical advice; and only 14.8% went to a family planning center. The pill and the IUD were the most popular method, being used by 59.7%. Among those with children, those with no boys were the least likely to use contraceptives. Teachers, with their frequent contact with young people and parents, are seen as a good conduit for information about family planning. However, most teachers themselves

Islam and family planning: changing perceptions of health care providers and medical faculty in Pakistan

PubMed Central

Mir, Ali Mohammad; Shaikh, Gul Rashida

2013-01-01

ABSTRACT A USAID-sponsored family planning project called “FALAH” (Family Advancement for Life and Health), implemented in 20 districts of Pakistan, aimed to lower unmet need for family planning by improving access to services. To enhance the quality of care offered by the public health system, the FALAH project trained 10,534 facility-based health care providers, managers, and medical college faculty members to offer client-centered family planning services, which included a module to explain the Islamic viewpoint on family planning developed through an iterative process involving religious scholars and public health experts. At the end of the FALAH project, we conducted a situation analysis of health facilities including interviews with providers to measure family planning knowledge of trained and untrained providers; interviewed faculty to obtain their feedback about the training module; and measured changes in women's contraceptive use through baseline and endline surveys. Trained providers had a better understanding of family planning concepts than untrained providers. In addition, discussions with trained providers indicated that the training module on Islam and family planning helped them to become advocates for family planning. Faculty indicated that the module enhanced their confidence about the topic of family planning and Islam, making it easier to introduce and discuss the issue with their students. Over the 3.5-year project period, which included several components in addition to the training activity, we found an overall increase of 9 percentage points in contraceptive prevalence in the project implementation districts—from 29% to 38%. The Islam and family planning module has now been included in the teaching program of major public-sector medical universities and the Regional Training Institutes of the Population Welfare Department. Other countries with sizeable Muslim populations and low contraceptive prevalence could benefit from this module

Family Planning: Bosnian, Russian, Spanish, Nuer.

ERIC Educational Resources Information Center

Anoka County Community Health and Environmental Services, Coon Rapids, MN.

This guide provides information in English, Bosnian, Russian, Spanish, and Nuer on family planning. Topics covered include a variety of birth control methods: abstinence, condoms, contraceptive foam, birth control pills, the Depo-Provera shot, the Norplant implant, diaphragms, intrauterine devices, natural family planning, sterilization, and the…

Video: useful tool for delivering family planning messages.

PubMed

Sumarsono, S K

1985-10-01

In 1969, the Government of Indonesia declared that the population explosion was a national problem. The National Family Planning Program was consequently launched to encourage adoption of the ideal of a small, happy and prosperous family norm. Micro-approach messages are composed of the following: physiology of menstruation; reproductive process; healthy pregnancy; rational family planning; rational application of contraceptives; infant and child care; nutrition improvement; increase in breastfeeding; increase in family income; education in family life; family health; and deferred marriage age. Macro-approach messages include: the population problem and its impact on socioeconomic aspects; efforts to cope with the population problem; and improvement of women's lot. In utilizing the media and communication channels, the program encourages the implementation of units and working units of IEC to produce IEC materials; utilizes all possible existing media and IEC channels; maintains the consistent linkage between the activity of mass media and the IEC activities in the field; and encourages the private sector to participate in the production of IEC media and materials. A media production center was set up and carries out the following activities: producing video cassettes for tv broadcasts of family planning drama, family planning news, and tv spots; producing duplicates of the video cassettes for distribution to provinces in support of the video network; producing teaching materials for family planning workers; and transfering family planning films into video cassettes. A video network was developed and includes video monitors in family planning service points such as hospitals, family planning clinics and public places like bus stations. In 1985, the program will be expanded by 50 mobile information units equipped with video monitors. Video has potentials to increase the productivity and effectiveness of the family planning program. The video production process is

Domestic, international family planning programs at risk.

PubMed

Turnbull, W; Kaeser, L

1998-02-01

The US government has subsidized family planning services domestically and abroad for three decades. For most of that period, the support has been provided with the broad-based backing of both US lawmakers and the general public. However, recent polling indicates that public support for family planning programs remains strong, but not necessarily among legislators. Since Republicans gained control of the US House of Representatives in 1995, a well-organized opposition to government-subsidized family planning has developed. The House leadership has launched attacks to defund and abolish Title X, the core domestic family planning program, and the US Agency for International Development's (USAID) population assistance program. Although these attempts failed, a parallel strategy is being pursued to raise anxieties about the programs and chip away at members' support for them. Family planning supporters in Congress and the White House are on the defensive. Rather than fighting for funding increases and new program initiatives, family planning advocates have been forced to try to just hold their ground. Even though they rest intact, Title X and USAID funding has suffered and the programs' base of congressional support has been seriously compromised. With the current Republican domination of the House, Title X and USAID face an uncertain future.

Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali

PubMed Central

Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan

2017-01-01

Background: Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Program Description: Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. Methods and Results: The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Conclusion: Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing

Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali.

PubMed

Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan

2017-06-27

Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing, can successfully create demand for a broad range of family

More about natural family planning.

PubMed

Gallagher, J

1983-11-01

When properly taught and practised, natural family planning can be a highly effective form of birth regulation. Recent studies indicate low failure rates of less than three pregnancies per 100 women years for couples with a strong motivation to follow the method. Studies show that pregnancy rates are high when the rules for avoiding pregnancy are not adhered to. Successful natural family planning can lead to heightened self esteem and marital enrichment.

Integrating postabortion care, menstrual regulation and family planning services in Bangladesh: a pre-post evaluation.

PubMed

Biswas, Kamal K; Pearson, Erin; Shahidullah, S M; Sultana, Sharmin; Chowdhury, Rezwana; Andersen, Kathryn L

2017-03-11

In Bangladesh, abortion is restricted except to save the life of a woman, but menstrual regulation is allowed to induce menstruation and return to non-pregnancy after a missed period. MR services are typically provided through the Directorate General of Family Planning, while postabortion care services for incomplete abortion are provided by facilities under the Directorate General of Health Services. The bifurcated health system results in reduced quality of care, particularly for postabortion care patients whose procedures are often performed using sub-optimal uterine evacuation technology and typically do not receive postabortion contraceptive services. This study evaluated the success of a pilot project that aimed to integrate menstrual regulation, postabortion care and family planning services across six Directorate General of Health Services and Directorate General of Family Planning facilities by training providers on woman-centered abortion care and adding family planning services at sites offering postabortion care. A pre-post evaluation was conducted in the six large intervention facilities. Structured client exit interviews were administered to all uterine evacuation clients presenting in the 2-week data collection period for each facility at baseline (n = 105; December 2011-January 2012) and endline (n = 107; February-March 2013). Primary outcomes included service integration indicators such as provision of menstrual regulation, postabortion care and family planning services in both facility types, and quality of care indicators such as provision of pain management, provider communication and women's satisfaction with the services received. Outcomes were compared between baseline and endline for Directorate General of Family Planning and Directorate General of Health Services facilities, and chi-square tests and t-tests were used to test for differences between baseline and endline. At the end of the project there was an increase in menstrual

Old and new ways: family planning in Kenya.

PubMed

Antarsh, L

1989-04-01

Kenya has the highest fertility rate in the world. The average woman has 8 children. Further, urban areas attract people from rural areas leaving fewer people to farm the finite land or raise cattle. Therefore a reduced need for children to partake in agricultural activities exists. Nevertheless many barriers to family planning continue in Kenya. Family planning services are scarce especially in rural areas. Husbands must agree to their wives undergoing voluntary sterilization by going to the clinic to sign a consent form. Children are highly valued. Succession of the generations is important. The higher a woman's fertility the more valuable she is to husband. The continuance of legal polygamy fosters competition among a man's wives to have many sons with the 1 having the most being his most prized wife. In spite of these obstacles, the president of Kenya promotes family planning through his speeches and requires the Ministry of Health (MOH) to provide family planning services at all government hospitals. Moreover, church hospitals also provide family planning services. Additionally, articles that cover teenage pregnancy and family planning programs appear in daily newspapers. The MOH and the National Council on Population and Development are organizing a network of government and nongovernment organizations that provide family planning services to the public. A sample of these organizations include the Family Planning Association of Kenya, an influential women's organization (Mandeleo ya Wanawake), and several church organizations. The Association for Voluntary Surgical Contraception's regional office has promoted minilaparotomies under local anesthesia since 1986. They are now used in maternal and child health programs in government hospitals, mission hospitals, and in several family planning clinics.

[Effect of development of rural commodity economy on family planning].

PubMed

Chen, X

1986-05-01

The paper discusses the effects of the changes of rural income level on family planning practice based a survey of 200 rural families in a affluent vegetable producing area of suburban Beijing. In 1984, 99.7% of child birth followed the local birth planning, and 99.1% of families with one child received One Child Certificates. The annual per capita income of the 200 families was 1,092 yuan (1 US$ = 3.7 yuan) in 1984 even higher than the community average. The number of children was negatively associated with the per capita income and per capita consumption except families with 4 children, most of whom have grown up. The rural mechanization in the community has greatly increased the need for skills and technology rather than strong laborers. The provision of community welfare programs and the increased living standard changed the value of children and also changed people's perception in favor of gender equality. Among families with 1 or 2 children, most preferred to have girls. And among families with more children, the preferred family size is smaller than the actual size, which shows a tendency towards favoring a small family. Among 1 child families, 58.7% considered 1 boy and 1 girl to be ideal, and 37.7% was happy with the only child. As the community becomes richer, both the community and individual families increased their investment in education. The spending on education per child was over 2 times as high in 1 child families than the families with more children. The educational status of parents is positively associated with the exception of children's future education and current spending on education. The concern of parents over children's education is an important factor in improving the quality of labor force. Women of higher education status are more acceptable to contraception and family planning policy. The relatively high level of education of the community has been conducive to it fertility decline.

Assessing Family Planning Service Quality And User Experiences In Social Franchising Programme - Case Studies From Two Rural Districts In Pakistan.

PubMed

Azmat, Syed Khurram; Ali, Moazzam; Hameed, Waqas; Awan, Muhammad Ali

2018-01-01

Studies have documented the impact of quality family planning services on improved contraceptive uptake and continuation, however, relatively little is known about their quality of service provision especially in the context of social franchising. This study examined the quality of clinical services and user experiences among two models in franchised service providers in rural Pakistan. This facility-based assessment was carried out during May-June 2015 at the 20 randomly selected social franchise providers from Chakwal and Faisalabad. In our case, a franchise health facility was a private clinic (mostly) run by a single provider, supported by an assistant. Within the selected health facilities, a total 39 user-provider interactions were observed and same users were interviewed separately. Most of the health facilities were in the private sector. Comparatively, service providers at Greenstar Social Marketing/Population Services International (GSM/PSI) model franchised facilities had higher number of rooms and staff employed, with more providers' ownership. Quality of service indices showed high scores for both Marie Stopes Society (MSS) and GSM/PSI franchised providers. MSS franchised providers demonstrated comparative edge in terms of clinical governance, better method mix and they were more user-focused, while PSI providers offered broader range of non-FP services. Quality of counselling services were similar among both models. Service providers performed well on all indicators of interpersonal care however overall low scores were noted in technical care. For both models, service providers attained an average score of 6.7 (out of the maximum value of 8) on waste disposal mechanism, supplies 12.5 (out of the maximum value of 15), user-centred facility 2.7 (out of the maximum value of 4), and clinical governance 6.5 (out of the maximum value of 11) and respecting clients' privacy. The exit interviews yielded high user satisfaction in both service models. The

34 CFR 300.24 - Individualized family service plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Individualized family service plan. 300.24 Section 300... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.24 Individualized family service plan. Individualized family service plan or IFSP has the meaning given the term in section 636 of the...

Impact of the Urban Reproductive Health Initiative on family planning uptake at facilities in Kenya, Nigeria, and Senegal.

PubMed

Winston, Jennifer; Calhoun, Lisa M; Corroon, Meghan; Guilkey, David; Speizer, Ilene

2018-01-05

The 2012 London Summit on Family Planning set ambitious goals to enable 120 million more women and adolescent girls to use modern contraceptives by 2020. The Urban Reproductive Health Initiative (URHI) was a Bill & Melinda Gates Foundation funded program designed to help contribute to these goals in urban areas in India, Kenya, Nigeria, and Senegal. URHI implemented a range of country-specific demand and supply side interventions, with supply interventions generally focused on improved service quality, provider training, outreach to patients, and commodity stock management. This study uses data collected by the Measurement, Learning & Evaluation (MLE) Project to examine the effectiveness of these supply-side interventions by considering URHI's influence on the number of family planning clients at health facilities over a four-year period in Kenya, Nigeria, and Senegal. The analysis used facility audits and provider surveys. Principal-components analysis was used to create country-specific program exposure variables for health facilities. Fixed-effects regression was used to determine whether family planning uptake increased at facilities with higher exposure. Outcomes of interest were the number of new family planning acceptors and the total number of family planning clients per reproductive health care provider in the last year. Higher program component scores were associated with an increase in new family planning acceptors per provider in Kenya (β = 18, 95% CI = 7-29), Nigeria (β = 14, 95% CI = 8-20), and Senegal (β = 7, 95% CI = 3-12). Higher scores were also associated with more family planning clients per provider in Kenya (β = 31, 95% CI = 7-56) and Nigeria (β = 26, 95% CI = 15-38), but not in Senegal. Supply-side interventions have increased the number of new family planning acceptors at facilities in urban Nigeria, Kenya, and Senegal and the overall number of clients in urban Nigeria and Kenya. While tailoring

Use of family planning methods in Kassala, Eastern Sudan

PubMed Central

2011-01-01

Background Investigating use and determinants of family planning methods may be instructive in the design of interventions to improve reproductive health services. Findings Across sectional community-based study was conducted during the period February-April 2010 to investigate the use of family planning in Kassala, eastern Sudan. Structured questionnaires were used to gather socio-demographic data and use of family planning. The mean ± SD of the age and parity of 613 enrolled women was 31.1 ± 7 years and 3.4 ± 1.9, respectively. Only 44.0% of these women had previously or currently used one or more of the family planning methods. Combined pills (46.7%) and progesterone injection (17.8%) were the predominant method used by the investigated women. While age, residence were not associated with the use of family planning, parity (> five), couple education (≥ secondary level) were significantly associated with the use of family planning. Husband objection and religious beliefs were the main reasons of non-use of family planning. Conclusion Education, encouragement of health education programs and involvement of the religious persons might promote family planning in eastern Sudan. PMID:21356106

Capturing Complexities of Relationship-Level Family Planning Trajectories in Malawi.

PubMed

Furnas, Hannah E

2016-09-01

In a transitioning fertility climate, preferences and decisions surrounding family planning are constantly in flux. Malawi provides an ideal case study of family planning complexities as fertility preferences are flexible, the relationship context is unstable, and childbearing begins early. I use intensive longitudinal data from Tsogolo la Thanzi-a research project in Malawi that follows young adults in romantic partnerships through the course of their relationship. I examine two questions: (1) What are the typical patterns of family planning as young adults transition through a relationship? (2) How are family planning trajectories related to individual and relationship-level characteristics? I use sequence analysis to order family planning across time and to contextualize it within each relationship. I generate and cluster the family planning trajectories and find six distinct groups of young adults who engage in family planning in similar ways. I find that family planning is complex, dynamic, and unique to each relationship. I argue that (a) family planning research should use the relationship as the unit of analysis and (b) family planning behaviors and preferences should be sequenced over time for a better understanding of key concepts, such as unmet need. © 2016 The Population Council, Inc.

Capturing Complexities of Relationship-Level Family Planning Trajectories in Malawi

PubMed Central

Furnas, Hannah E.

2017-01-01

In a transitioning fertility climate, preferences and decisions surrounding family planning are constantly in flux. Malawi provides an ideal case study of family planning complexities as fertility preferences are flexible, the relationship context is unstable, and childbearing begins early. I use intensive longitudinal data from Tsogolo la Thanzi—a research project in Malawi that follows young adults in romantic partnerships through the course of their relationship and allows me to ask two questions: (1) What are the typical patterns of family planning as young adults transition through a relationship? (2) How are family planning trajectories related to individual and relationship-level characteristics? I use sequence analysis to order family planning across time and to contextualize it within each relationship. I generate and cluster the family planning trajectories and find six distinct groups of young adults who engage in family planning in similar ways. I find that family planning is complex, dynamic, and unique to each relationship. I argue that (a) family planning research should use the relationship as the unit of analysis and (b) family planning behaviors and preferences should be sequenced over time for a better understanding of key concepts, such as unmet need. PMID:27517867

Natural family planning.

PubMed

Bourdillon, C

1982-11-01

Frequently, when one mentions natural family planning methods, the response is doubt, bewilderment, ridicule, or scorn. Much of this is due to the fact that many people know only of the rhythm method, which depends on a calculation based on the menstrual pattern. What many people do not know, including physicians and nurses, is that in Australia Drs. John and Lyn Billings have been scientifically researching natural methods of family planning for 25 years, and they have pioneered this Ovulation Method of family planning. The Billings Ovulation Method depends only on the mucus sign. It is based on a scientific knowledge of the combined fertility of husband and wife, and an understanding of the physiology of the female body through simple observations. Important facts relating to the practice of the method include: ovulation takes place only once in the cycle; mucus is secreted by the cervical mucosa before ovulation; the ovum lives for only 3 days at the most; and the sperms live for 5 days at the most, and only in the presence of this fertile mucus. There a 2 types of mucus. The 1st type to appear is cloudy or white. It is nonslippery, sticky, and breaks when stretched between 2 fingers. The 2nd type is like the part of a hen's egg. It is very slippery, much clearer than the former, and stretches when pulled between 2 fingers. This is fertile mucus, and ovulation occurs on the last day that this is present. Of course, it cannot be recognized as the last day until its absence is observed on the following day. The mucus sign can be both seen and felt. After a few months a woman will readily recognize her fertile time, but daily charting is advocated. Simple signs, representing the various observations, are taught. Once a couple knows and understands their combined fertility through the observation of the mucus sign they can plan their family. Rules of the method are outlined. The self control required by this method can only serve to increase the selfless love and

Federal Republic of Germany: family planning, family policy and demographic policy.

PubMed

Zuhlke, W

1989-01-01

Decades of social change in West Germany and the emergence of an ideology that stresses individualism have altered dramatically procreative behavioral patterns. At present, West Germany is characterized by a low marriage rate (6.1/1000 in 1986), declining fertility (10.3 birth/1000), rising divorce rates (20.1/1000), and increases in the proportion of single-person households (34%). The relationship between family planning, family policy, and demographic policy is unclear and changing. Family planning practice is viewed as a part of comprehensive life planning and is based on factors such as partnership or marital status, sex roles, the conflict between working in the home and having a career, consumer aspirations, and housing conditions. The Government's family policy includes the following components: child benefits, tax relief on children, tax splitting arrangements for married couples, childcare allowance, parental leave, student grants, tax deductions for domiciliary professional help and nursing assistance, and the provision of daycare. Thus, West Germany's family policy is directed more at encouraging and facilitating parenthood and family life than at a setting demographic goals. There is no evidence, however, that such measures will be successful and divergent influences of other policy areas are often more compelling. Nor is there any way to quantify the fertility-costing impact of individual family policy measures. The indistinct nature of family planning policy in West Germany mirrors political differences between the current coalition government, which maintains a traditional view of the family, and the opposition Social-Democratic and Green Parties, which question whether the equality of men and women can be achieved in the context of old family structures.

Systems effects on family planning innovativeness.

PubMed

Lee, S B

1983-12-01

Data from Korea were used to explore the importance of community level variables in explaining family planning adoption at the individual level. An open system concept was applied, assuming that individual family planning behavior is influenced by both environmental and individual factors. The environmental factors were measured at the village level and designated as community characteristics. The dimension of communication network variables was introduced. Each individual was characterized in terms of the degree of her involvement in family planning communication with others in her village. It was assumed that the nature of the communication network linking individuals with each other effects family planning adoption at the individual level. Specific objectives were to determine 1) the relative importance of the specific independent variables in explaining family planning adoption and 2) the relative importance of the community level variables in comparison with the individual level variables in explaining family planning adoption at the individual level. The data were originally gathered in a 1973 research project on Korea's mothers' clubs. 1047 respondents were interviewed, comprising all married women in 25 sample villages having mothers' clubs. The dependent variable was family planning adoption behavior, defined as current use of any of the modern methods of family planning. The independent variables were defined at 3 levels: individual, community, and at a level intermediate between them involving communication links between individuals. More of the individual level independent variables were significantly correlated with the dependent variables than the community level variables. Among those variables with statistically significant correlations, the correlation coefficients were consistently higher for the individual level than for the community level variables. More of the variance in the dependent variable was explained by individual level than by

Observations concerning family planning education in China.

PubMed

Hamburg, M V

1981-11-01

In China, raising the age at marriage is an integral part of the family planning program. The new marriage law sets the minimum age at 22 for men and 20 for women. Marriage is a universal practice, and an unmarried person over 28 is a rarity. For economic purposes, the Central Committee of the People's Republic adopted the 1-child family policy in 1980. Childlessness is not encouraged. An extensive organizational network at the national, provincial, and local governmental levels conducts the family planning program. The media is widely used to publicize the message. Billboards, posters, state-run television, and other media tools regularly promote the virtues of the 1-child family, regardless of the sex of the child. Premarital sex is rare, and sex education, if any, is limited to adults--those about to be married. In Shanghai, physiology education in the middle school does include sex education and reproduction. All hospitals have family planning offices, and services include excellent maternal/child health care and family planning counseling. Family planning services are also found in the workplace. Permission must be obtained from the Production Brigade to marry and to have a child. Inspite of this, the family planning program is not viewed as coercive. When certain segments of the working population want to have more children than have been allocated, adjustments (e.g., delays in marriage or in pregnancy) are made. A unique feature of the program is its use of reward and punishment which varies from province to province, and between rural and urban populations. Economic incentives (monetary subsidies, free education for the children, housing priorities, and pension benefits) are given to those who have 1 child and withheld from those who have 2 children. In some areas, additional economic penalties (payment to state) are required from families with 2 children. Another unique feature is the trend toward later marriage, with 25 or 26 becoming the norm. It appears

A family planning study in Kuala Pilah, Peninsular Malaysia.

PubMed

Vimala Thambypillai

1982-12-01

Realizing that family planning is not making a sufficient impact on the rural people as it is on the urban population, it was decided that the authors would study the attitude and knowledge of a rural community towards family planning. The study sample consisted of 200 Malay married women--100 acceptors and 100 nonacceptors from the Kuala Pilah District. The study went from December 4-22, 1978. A healthy climate of knowledge and attitude exist among rural Malay women. Only 2% of the nonacceptors had not heard of any family planning method; 99% of acceptors and 85% of nonacceptors had discussed family planning with their husbands. There was also evidence to show that the birthrate does decrease as literacy increases. On the other hand, however, only 19% of the respondents approved of family planning practices prior to the birth of the 1st child. Also, there is a dearth of information on family planning in the rural areas and not much has been done in utilizing the 2 popular forms of mass media--radio and television as a means of disseminating information on family planning. The study concludes with a recommendation that there is a need for a sustained effort at improving knowledge and disseminating information as well as for developing the proper attitude towards family planning. It is suggested that community leaders, women's clubs, and private organizations be mobilized to participate more fully in the promotion of family planning.

Improving productivity levels: family planning services for factory workers.

PubMed

Darmokusumo, H V

1989-10-01

In May 1984, the Minister of Manpower in Indonesia, the Chairman of the BKKBN, and representatives of the employers' and workers' organizations of Indonesia issued a joint decree pledging that they would work together to enhance the implementation of the family planning program among workers in the organized sector. 1 objective of the decree is to improve workers' productivity and the standard of living of workers and their families by implementing a family planning program. 1 baseline survey and a clinic-based survey in 5 provinces revealed that 90% of women workers are between 21-40, or are of reproductive age, and are sexually active. Only about 50% are practicing family planning; the other 50% are afraid to practice family planning due to potential side effects of various methods. This fear was most often caused by negative rumors spread by unsatisfied family planning clients. Placing materials for family planning promotion such as instructional posters and video programs advertising contraceptive services in the work setting may increase knowledge and help alleviate some of this fear. Other studies of family planning services show that employees prefer female medical doctors or midwives as service providers, employees are willing to pay for services (but can only afford a small fee), and family planning service points should be near employees' work sites.

Social marketing: the family planning experience.

PubMed

El-ansary, A I; Kramer Oe, J

1973-07-01

The authors explore social marketing applications in the Louisiana model of statewide program for family planning. The marketing concept has 4 major elements: 1) consumer orientation; 2) social process; 3) integrated effort; 4) profitable operation. Success of program and continued growth are the results of defining services needed by consumer; determining market target; taking services to customer; and emphasizing concept of selling family planning rather than giving free birth control method. Another important facet is the recognition of many participants--community agencies, the church, the American Medical Association, funding sources, and hospitals. This project used anyaltical marketing tools and defined services as human services rather than the narrow family planning services. It also extended activities to multinational environment and adapted the product offering to meet these needs.

1981 census of India: some implications for family planning.

PubMed

Ramabhadran, V K

1983-01-01

in India requires that family planning during the 1981-91 decade should be made consistent with the needs and economic well-being of the people. Development must be increasingly population oriented. To indicate what type of developmental activity is to be assigned priority in conjunction with the family planning program, the 15 major States are classified on a demographic transition scale, based on the vital rates for 1980. Class E States in the early stage of transition require a strengthening of family planning and health programs. States in the middle level of transition require that their family planning programs focus on quality and outreach in rural areas. A progressive record of socioeconomic development along with family planning is required in states poised for completion of their demographic transition.

Special Report: Banjul Islam Conference endorses family planning.

PubMed

1979-11-01

44 participants from 12 West African nations met in Banjul, the Gambia, from October 22-26, 1979 and unanimously agreed that family planning is in conformity with Islam. They called for greater involvement of local Muslim leaders in African countries to encourage family planning for the promotion of maternal and child health. The Conference was sponsored by IPPF Africa Region and attended by representatives of Muslim associations, health and family planning workers, teachers, government officials, and experts on Muslim law from Cameroon, The Gambia, Ghana, Guinea, Liberia, Mali, Morocco, Nigeria, Senegal, Sierra Leone, Upper Volta, and Zaire. The Conference members acknowledged that while the Koran, the Sunna, and the concensus of most Islam scholars is that family planning is acceptable within marriage, most traditional religious leaders are ignorant of the fact. Muslim women should be encouraged to take an interest in family planning. Other recommendations were educating Muslims on nutrition, sanitation, and health; to collect views of African Muslim leaders and publicize them; and, to persuade Ministries of Education to include family relations and parenthood in school curricula.

Paying for Performance to Improve the Delivery and Uptake of Family Planning in Low and Middle Income Countries: A Systematic Review.

PubMed

Blacklock, Claire; MacPepple, Ekelechi; Kunutsor, Setor; Witter, Sophie

2016-12-01

Paying for performance is a strategy to meet the unmet need for family planning in low and middle income countries; however, rigorous evidence on effectiveness is lacking. Scientific databases and grey literature were searched from 1994 to May 2016. Thirteen studies were included. Payments were linked to units of targeted services, usually modified by quality indicators. Ancillary components and payment indicators differed between studies. Results were mixed for family planning outcome measures. Paying for performance was associated with improved modern family planning use in one study, and increased user and coverage rates in two more. Paying for performance with conditional cash transfers increased family planning use in another. One study found increased use in the upper wealth group only. However, eight studies reported no impact on modern family planning use or prevalence. Secondary outcomes of equity, financial risk protection, satisfaction, quality, and service organization were mixed. Available evidence is inconclusive and limited by the scarcity of studies and by variation in intervention, study design, and outcome measures. Further studies are warranted. © 2016 The Population Council, Inc.

Family planning uses traditional theater in Mali.

PubMed

Schubert, J

1988-01-01

Mali's branch of the International Planned Parenthood Federation has found a vehicle that effectively conveys the idea of family planning through the use of contraception, a method that blends the country's cultural heritage and modern technology. Despite becoming the first sub-Saharan francophone country to promote family planning, Mali only counted 1% of its population using a modern method of contraception. So with the aid of The Johns Hopkins University/Population COmmunication Services (JHU/PCS), the Association Malienne pour la Protection et la Promotion de la Famille (AMPPF) developed several programs to promote contraception, but none were more successful than the Koteba Project, which used Mali's traditional theater form to communicate the message. While comical, the Koteba generally deals with social issues -- it informs and entertains. This particular Koteba told the story of two government employees, one with two wives and many children, the other with one wife and few children. The first one sees nothing but family problems: fighting wives and delinquent children. The second one, who had used family planning, enjoys a peaceful home. Upon hearing of his friend's successes with family planning, the tormented government employee becomes convinced of its needs, and persuades his wives to accompany him to a family planning clinic. Developed at a cost of approximately US $3000 and televised nationwide, the Koteba proved effective. A survey of 500 people attending an AMPPF clinic revealed that 1/4 of them remembered the program. With the success of the Koteba, JHU/PCS and AMPPF are now exploring other traditional channels of communication.

Some factors affecting acceptance of family planning in Manus.

PubMed

Avue, B; Freeman, P

1991-12-01

This paper examines selected factors affecting the acceptance and delivery of modern family planning from health centres in Manus. A survey was carried out of mothers attending Maternal and Child Health clinics and a written questionnaire was given to health workers. The survey of mothers demonstrated the importance of the husband's approval for contraceptive practice and showed that knowledge about traditional methods of family planning is widespread. The health workers' questionnaire demonstrated a high level of dissatisfaction with the current family planning program delivered by health clinics: 45% found the program ineffective; 68% wrote that health workers' attitudes discouraged mothers from attending for family planning. The perceived and actual benefits and costs of children and the role of men should be assessed locally before planning future family planning programs. Widespread retraining and motivating of health workers is essential if improved coverage is to be achieved through health services. The efficacy of alternative methods of delivery of family planning such as local community-based and social marketing programs should also be investigated.

Promotion of family planning services in practice leaflets.

PubMed

Marshall, M N; Gray, D J; Pearson, V; Phillips, D R; Owen, M

1994-10-08

Providing 75% of family planning services in the United Kingdom, general practitioners are required to produce leaflets which describe the contraceptive services they provide. The authors analyzed information about family planning provided to clients through practice leaflets. 88% of practice leaflets from the 198 practices in Devon were available from the Devon Family Health Services Authority for analysis. It was determined that the leaflets are not being best used to advertise the range and potential of family planning services. Although all practices in Devon offer contraceptive services, only 90% of leaflets mentioned that the services are available. Reference to postcoital contraception and information about services outside the practice for people who might not want to see their family doctor are also sorely lacking. A clear need exists to provide patients with more information. Finally, the authors found that group practices and those with female partners are most likely to give high priority to family planning issues in their leaflets.

Family planning is reducing abortions.

PubMed

Clinton, H R

1997-01-01

This news brief presents the US President's wife's statement on the association between use of family planning and a decline in abortions worldwide. Hillary Rodham Clinton attended the Sixth Conference of Wives of Heads of State and Government of the Americas held in La Paz, Bolivia. The conference was suitably located in Bolivia, a country with the highest rates of maternal mortality in South America. Bolivia has responded by launching a national family planning campaign coordinated between government, nongovernmental, and medical organizations. Half of Bolivian women experience pregnancy and childbirth without the support of trained medical staff. Mortality from abortion complications account for about half of all maternal deaths in Bolivia. Voluntary family planning workers teach women about the benefits of child spacing, breast feeding, nutrition, prenatal and postpartum care, and safe deliveries. Bolivia has succeeded in increasing its contraceptive use rates and decreasing the number of safe and unsafe abortions. Bolivia's program effort was supported by USAID. USAID provided technical assistance and funds for the establishment of a network of primary health care clinics. Mrs. Clinton visited one such clinic in a poor neighborhood in La Paz, which in its first six months of operation provided 2200 consultations, delivered 200 babies, registered 700 new family planning users, and immunized 2500 children. Clinics such as this one will be affected by the US Congress's harsh cuts in aid, which reduce funding by 35% and delay program funding by 9 months. These US government cuts in foreign aid are expected to result in an additional 1.6 million abortions, over 8000 maternal deaths, and 134,000 infant deaths in developing countries. An investment in population assistance represents a sensible, cost-effective, and long-term strategy for improving women's health, strengthening families, and reducing abortion.

Techniques for overcoming community resistance to family planning programs.

PubMed

Palley, H A

1968-01-01

Methods of overcoming resistance to publicly subsidized family planning programs are discussed. The main sources of opposition include groups that oppose family planning for moral reasons, and those who object to the spending of government funds to provide services and information. Such opposition can be weakened by indicating that family planning clinics fulf: 11 important medical needs. Presenting social justification for family planning can help to lower oppostion. In order to secure participation in the programs by low income groups it is essential to have community leaders involved in policy decisions and to use indigenous community paraprofessionals in the clinics. A coalition of representatives of the poor community and the health and welfare system, aided by the community organization, can lead to an effective family planning program.

Uphold "three stresses" to improve family planning implementation.

PubMed

1994-02-01

Shandong Peninsula, China, includes 24 towns, 4 townships, and 1006 villages with a total 1992 population of 754,000. Due to the family planning program (instituted in the mid 1950s), and its emphasis on the "three stresses" since 1983, the rate of natural increase was maintained for the past decade at 6.59/1000. Marriage and childbirth has been deferred and the annual rate of planned births is 99%. Neonatal mortality is below 10/1000 and life expectancy is 76 years. There have been 260,000 births averted. In 1966, national commendation was given for the achievements in family planning. The city now ranks 12th among the top 100 counties that are the most economically developed. Success was linked with an effective IEC programs. Changing public opinion was accomplished by placing family planning slogans and cards in windows of public places and commercial centers. Contests were held, and performances publicized family planning. There are 1162 population schools in the county which have trained 10,000 family planning publicity workers and about 400,000 others since 1987. Radio and television stations have broadcast regular programs on family planning and population twice a week since 1987. Everyone has radio sets and 90% have televisions. IEC promotion has also been concerned with social security and alleviating poverty. Contraceptive prevalence among reproductive age women is now 91%. After 25 years of family planning operation, the "three stresses" were introduced and popularized in 1983. The goal was no early marriages, no early births, no induced abortions, and no unwanted births. The program strengthened family planning agencies, promoted women's services, oversaw birth quotas, and distributed contraceptives at the grassroots level. By 1991, the city began promoting control of population growth and improvement in human resources. The "four priorities" were formulated by the city for acceptors; housing sites, business licenses, recruitment of only-child parents

Advocacy for International Family Planning: What Terminology Works?

PubMed

Huber, Douglas; Martin, Raymond; Bormet, Mona

Advocating for international family planning while avoiding miscommunications with politically and religiously conservative policy makers and the public requires care and clarity with language. We find that terms such as "international family planning" are well received when the meaning is clearly explained, such as "enabling couples to determine the number and timing of pregnancies, including the voluntary use of methods for preventing pregnancy - not including abortion - harmonious with their beliefs and values". Family planning also helps reduce abortions - a powerful message for conservative policy makers and the public. We concur with Dyer et al. (2016) that the messenger is important; we find that many of the most effective advocates are religious leaders and faith-based health providers from the Global South. They know and validate the importance of family planning for improving family health and reducing abortions in their communities. "Healthy timing and spacing of pregnancy" is positive language for policy makers, especially when describing the health impact for women and children. Universal access to contraceptive services is emerging as vital for family health and also to help achieve the Sustainable Development Goals (UN 2015). Language on international family planning will evolve, and clarity of meaning will be foundational for effective advocacy.

Priority strategies for India's family planning programme

PubMed Central

Pachauri, Saroj

2014-01-01

Strategies to accelerate progress of India's family planning programme are discussed and the importance of improving the quality and reach of services to address unmet contraceptive need by providing method choice is emphasized. Although there is a growing demand for both limiting and spacing births, female sterilisation, is the dominant method in the national programme and use of spacing methods remains very limited. Fertility decline has been slower in the empowered action group (EAG) States which contribute about 40 per cent of population growth to the country and also depict gloomy statistics for other socio-development indicators. It is, therefore, important to intensify efforts to reduce both fertility and mortality in these States. A rationale has been provided for implementing integrated programmes using a gender lens because the lack of women's autonomy in reproductive decision-making, compounded by poor male involvement in sexual and reproductive health matters, is a fundamental issue yet to be addressed. The need for collaboration between scientists developing contraceptive technologies and those implementing family planning services is underscored. If contraceptive technologies are developed with an understanding of the contexts in which they will be delivered and an appreciation of end-users’ needs and perspectives, they are more likely to be accepted by service providers and used by clients. PMID:25673535

34 CFR 303.167 - Individualized family service plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Individualized family service plans. 303.167 Section 303... Requirements § 303.167 Individualized family service plans. Each application must include— (a) An assurance that a current IFSP is in effect and implemented for each eligible child and the child's family; (b...

Studies in Family Planning, Volume 2 Number 9.

ERIC Educational Resources Information Center

Population Council, New York, NY.

This paper summarizes family planning activities and accomplishments from 1968 to 1970 in Thailand, with particular emphasis on the Family Health Project conducted by the Ministry of Public Health. This project, in reality a family planning program, provided remarkable success in that it was established with no official national population policy…

34 CFR 303.167 - Individualized family service plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Individualized family service plans. 303.167 Section...-Application Requirements § 303.167 Individualized family service plans. Each application must include— (a) An assurance that a current IFSP is in effect and implemented for each eligible child and the child's family...

Aid for family planning in Egypt.

PubMed

1974-02-01

A $5 million credit has been approved by the International Development Association, an affilate of the World Bank, to help finance a population project in Egypt. The project provides for the construction, equipping and furnishing of 22 general health centers, 12 polyclinics, 3 centers for training nursing teachers and 3 centers for in service training. 100 and 50 multipurpose vehicles will be provided to improve mobility of family planning services. Also included are a study on the maintenance of health facilities, 3 evaluation studies of family planning acceptors, an experimental home visiting program to inform and motivate people on family planning, and assistance in the production of health education material useful for family planning information and motivation. Simple demographic facts illustrate the seriousness of the population problem in Egypt. The current population of 35 million will be double by the year 2000 if the present 2.5% annual increase continues. This will put strains on a country whose population density quadrupled during the last century, and which stands to day at 950 persons per square kilometer of habitable land, a density rivalled by only 2 or 3 other countries in the world. The IDA credit will cover about 1/2 of the project's expense. The Egyptian government will finance the local costs. full text

Managed care quality of care and plan choice in New York SCHIP.

PubMed

Liu, Hangsheng; Phelps, Charles E; Veazie, Peter J; Dick, Andrew W; Klein, Jonathan D; Shone, Laura P; Noyes, Katia; Szilagyi, Peter G

2009-06-01

To examine whether low-income parents of children enrolled in the New York State Children's Health Insurance Program (SCHIP) choose managed care plans with better quality of care. 2001 New York SCHIP evaluation data; 2001 New York State Managed Care Plan Performance Report; 2000 New York State Managed Care Enrollment Report. Each market was defined as a county. A final sample of 2,325 new enrollees was analyzed after excluding those in markets with only one SCHIP plan. Plan quality was measured using seven Consumer Assessment of Health Plans Survey (CAHPS) and three Health Plan Employer Data and Information Set (HEDIS) scores. A conditional logit model was applied with plan and individual/family characteristics as covariates. There were 30 plans in the 45 defined markets. The choice probability increased 2.5 percentage points for each unit increase in the average CAHPS score, and the association was significantly larger in children with special health care needs. However, HEDIS did not show any statistically significant association with plan choice. Low-income parents do choose managed care plans with higher CAHPS scores for their newly enrolled children, suggesting that overall quality could improve over time because of the dynamics of enrollment.

Vanguard family planning acceptors in Senegal.

PubMed

Nichols, D; Ndiaye, S; Burton, N; Janowitz, B; Gueye, L; Gueye, M

1985-01-01

This study examines contraceptive use among clients at the three clinics providing family planning services in Dakar, Senegal in early 1983. Most clients first became interested in family planning following the birth of a child, and most are interested in spacing future pregnancies, although one-third state that they want no more children. The clinic itself was found to be an important determinant of the type of contraceptive used, with only the government-operated clinic providing a balance between IUDs, oral contraceptives, and barrier methods. Nearly half of the clients interviewed said that a lack of knowledge about contraception is the reason for the low contraceptive prevalence rates among Senegalese women; another frequently cited reason was the opposition of the husband. Most clients reported the broadcast media to be the best means of providing family planning information to potential acceptors.

Planning for Impact: A Guide to Planning Effective Family Program.

ERIC Educational Resources Information Center

Hardy, James M.

A document intended to provide program planning guidelines for Young Men's Christian Associations (YMCAs) desirous of working with families, recommends adherence to eight principles and following of five steps. The principles involve planning before action, fact finding and analysis, clear delineation of operational objectives, planning at all…

The health educative role of the nurse in family planning.

PubMed

Kamel, W H; Kamel, N M; El-bindari, A K

1971-12-01

The role of the hospital nurse in family planning is discussed in light of a survey of 156 nurses who completed a family planning training course at the University of Alexandria, Egypt. Such a training course is very important since the nurse plays a key role in family planning counseling as a source of information and reassurance. Tabulation of the survey results showed 64.1% of the nurses had already participated in dissemination of family planning information. The vast majority responded that they benefited from the training. 79.5% knew where family planning services were offered, most citing obstetric hospitals. Only 75.6% said that they could contribute to information dissemination. This figure is distressing, for every nurse is a public health nurse, and her role in family planning is largely motivational. It is considered crucial that nurses be adequately trained in family planning and actively participate in informing and counseling the public.

Spousal veto over family planning services.

PubMed Central

Cook, R J; Maine, D

1987-01-01

In many countries a spouse, usually the husband, can veto a partner's use of family planning services. Where spousal veto acts as a barrier to family planning services it represents a serious threat to the lives and health of women and children. Removal of spousal authorization requirements has been shown to increase the use of family planning services. The Family Guidance Association of Ethiopia, for example, removed their requirement in 1982 and clinic utilization increased by 26 per cent within a few months. Courts of several countries have held that spousal veto practices violate principles of personal privacy and autonomy and the right to health care. The effect of such judgements has been to reinforce rights to sexual nondiscrimination found, for example, in national constitutions and the Convention on the Elimination of All Forms of Discrimination against Women. This article discusses the nature and application of spousal veto practices, explains how such requirements can violate certain human rights, and explores possible remedies to this problem, including ministerial, legislative, and judicial initiatives. PMID:3812842

Getting closer to people: family planning provision by drug shops in Uganda

PubMed Central

Akol, Angela; Chin-Quee, Dawn; Wamala-Mucheri, Patricia; Namwebya, Jane Harriet; Mercer, Sarah Jilani; Stanback, John

2014-01-01

ABSTRACT Background: Private-sector drug shops are often the first point of health care in sub-Saharan Africa. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact. Methods: Between September 2010 and March 2011, we trained 139 drug shop operators (DSOs) in 4 districts of Uganda to safely administer intramuscular DMPA (depot medroxyprogesterone acetate) contraceptive injections. In 2012, we approached 54 of these DSOs and interviewed a convenience sample of 585 of their family planning clients to assess clients' contraceptive use and perspectives on the quality of care and satisfaction with services. Finally, we compared service statistics from April to June 2011 from drug shops, community health workers (CHWs), and government clinics in 3 districts to determine the drug shop market share of family planning services. Results: Most drug shop family planning clients interviewed were women with low socioeconomic status. The large majority (89%) were continuing family planning users. DMPA was the preferred contraceptive. Almost half of the drug shop clients had switched from other providers, primarily from government health clinics, mostly as a result of more convenient locations, shorter waiting times, and fewer stock-outs in drug shops. All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy. Three-quarters felt that drug shops offered affordable family planning services. Most of the DMPA clients (74%) were very satisfied with receiving their method from the drug shop and 98% intended to get the next injection from the drug shop. Between April and June 2011, clinics, CHWs, and drug shops in 3 districts delivered equivalent proportions of couple-years of protection, with drug shops leading marginally at 36

A brief introduction to China's family planning programme.

PubMed

Shen, G

1984-08-01

bring free contraceptives directly to the people, and family planning motivators are found in almost all villages, neighborhood committees, factories, and military units. As a result of these efforts, China made great strides in controlling population growth and improving MCH during the last decade. The birth rate declined from 27.93 to 18.62, and the total fertility rate declined from 4.01 to 2.48. 124 million couples were practicing contraception by the end of 1983. 41% used IUDs, 37.4% relied on tubal ligation, 12.9% relied on vasectomy, 5.1% on oral contraceptives, and 1% on other methods. The quality of maternal and child care also improved. 92.7% of all deliveries are now performed by trained midwifes. Infant and maternal mortality rates declined considerablely in recent years. Currently the respective rates are 35.68/1000 live births and 0.5/1000 live births. In 1983 alone, the gross national agricultural and industrial output increased by 46.1%. Since 1979 per capita income increased annually by 18.3% among rural residents and by 10.7% among urban workers. China controls and operates its own population program, but in recent years, it increased its cooperation with UN Fund for Population Activities, other UN agencies, and nongovernment agencies. China recently completed its 3rd national census, and demographic research institutes have been established in 10 universities.

Experience of parenthood, couple relationship, social support, and child-rearing goals in planned lesbian mother families.

PubMed

Bos, Henny M W; van Balen, Frank; van Den Boom, Dymphna C

2004-05-01

The phenomenon of planned lesbian families (i.e., two-mother families in which the child was born to the lesbian relationship) is relatively new and very little research has been conducted among those families. The overall aim of this research was to examine whether planned lesbian mother families differ from heterosexual families on factors that are assumed to influence the parent-child relationship, such as experience of parenthood, child-rearing goals, couple relationship, and social support. A hundred lesbian two-mother families were compared with 100 heterosexual families having naturally conceived children. A variety of measures were used to collect the data, including questionnaires and a diary of activities kept by the parents. Lesbian parents are no less competent or more burdened than heterosexual parents. Both lesbian and heterosexual parents consider it important to develop qualities of independence in their child. However, 'conformity' as a child-rearing goal is less important to lesbian mothers. Furthermore, lesbian social mothers feel more often than fathers in heterosexual families that they must justify the quality of their parenthood. There are few differences between lesbian couples and heterosexual couples, except that lesbian mothers appear less attuned to traditional child-rearing goals and lesbian social mothers appear more to defend their position as mother.

The feminist position on family planning in Spain.

PubMed

Navarro, M V

1984-04-01

The Spanish feminist movement had its origins in the early 1970; in 1975 the first offical feminist conference made the following demands on the public authorities; 1) to abolish all sections of the Criminal Code which restrict women's freedom to control of their own bodies through making illegal information on and the purchase of contraceptives, 2) to decriminalize abortion, 3) to create family planning centers and to legalize contraceptives and provide them through the social security system, and 4) to include sex information in study courses. The distribution and sale of contraceptives was not legalized until 1978 and induced abortion is still a criminal offense. Nevertheless, after the 1975 meetins, a Coordinating Organization was established for the family planning committees that were functioning in the different feminist organizations. The problem of where to obtain contraceptives was solved by a group of feminist women which opened the 1st family planning center in Spain in 19779 This center was managed directly by members of the group. This and similar efforts culminated in the origin of the Movement for Movement for Family Planning that demanded in 1978; 1) the provision of sex information confronting the dominant sexual ideology and which is made a ccompulsory subject from school age, for both sexes; 2) free access to contraception for everyone; 3) the legalization of abortion, 4) the development of extensive information campaign on the problems of conception and contraception; and 5) the creation of independent, self-managed, family planning centers. There is now a Coordinating Organization of Family Planning Centers that was established in 1982. The socialist government is determined to create a public network of family planning centers.

Aligning Funding and Need for Family Planning: A Diagnostic Methodology

PubMed Central

Fan, Victoria Y.; Kim, Sunja; Choi, Seemoon; Grépin, Karen A.

2017-01-01

Abstract With limited international resources for family planning, donors must decide how to allocate their funds to different countries. How can a donor for family planning decide whether countries are adequately prioritized for funding? This article proposes an ordinal ranking framework to identify under‐prioritized countries by rank‐ordering countries by their need for family planning and separately rank‐ordering them by their development assistance for family planning. Countries for which the rank of the need for family planning is lower than the rank of its funding are deemed under‐prioritized. We implement this diagnostic methodology to identify under‐prioritized countries that have a higher need but lower development assistance for family planning. This approach indicates whether a country is receiving less compared to other countries with similar levels of need. PMID:29044592

Comparison of quality of life of Turkish cancer patients and their family caregivers.

PubMed

Yesilbalkan, Oznur Usta; Ozkutuk, Nilay; Ardahan, Melek

2010-01-01

The purpose of this study was to compare the quality of life (QoL) of cancer patients and their family caregivers and determine associations. A total of 93 paired patients and caregivers from an outpatient chemotherapy unit of the oncology units were recruited at a large university hospital in İzmir, all completing the Quality of Life Scale (QoLS). The mean age of patients was 45.2 years, and of their family caregivers was 40.5. The results indicated that the patients perceived a poorer quality of life than their family caregivers. There was a middle and positive correlation between the social participation and work performance dimensions of patients' QoL and social participation and work performance dimension of family caregivers' QoL (r =0.273, p< 0.01). The study revealed that the gender, education level, employment and marital status were not statistically significant factors affecting the patients' quality of life (p> 0.05). Caregivers' employment status was found to have an affect on their quality of life (p < 0.05). Cancer affects not only the patients but also their family caregivers. Both should be taught communication skills, financial planning and distress management skills and be given spiritual support to decrease effects of cancer on their quality of life.

China's first family planning publicity month.

PubMed

Shen, G

1983-05-01

China conducted its 1st nationwide Family Planning Publicity Month in 1983, from New Year's Day to Spring Festival (February 13). The campaign emphasized the rural areas and focused on explaining why family planning is a state policy. The most noticeable achievements of this campaign were that every household became familiar with the fact that family planning is a basic state policy. The majority of the population take this policy seriously, realizing that strict control of population growth is both a good and imperative policy. More than 1,830,000 propaganda columns and photo exhibitions were displayed, 5,900,000 radio and television programs broadcast, 2,010,000 theatrical performances, movie and slide showings presented, and 97,000,000 copies of materials published for public dissemination. The activities were varied and interesting, vivid and lively, and purposeful and persuasive. 1 of the most effective methods of publicizing population control has been the presentation of comparative statistics. This aspect of the campaign was a specific and lively form of education in population theory and practice. The presentation of statistics that show the relationship among population, land use, grain produce, and income enabled the population to reason out why population growth needs to match economic and social development. Another important accomplishment of the publicity month was that a large number of couples of reproductive age became convinced of the need to use contraception. According to the incomplete statistics, 8,860,000 people had surgical operations for birth control. The universal promotion of ligations by either partner of a reproductive couple who already had given birth to a 2nd child was an important development of family planning technique promoted simultaneously with the promotion of IUDs. The increase in the number of people doing family planning work was another achievement of the publicity month. More than 15,240,000 publicity personnel and 760

Private sector joins family planning effort.

PubMed

1989-12-01

Projects supported by the Directorate for Population (S&T/POP) of the U.S. Agency for International Development and aimed at increasing for-profit private sector involvement in providing family planning services and products are described. Making products commercially available through social-marketing partnerships with the commercial sector, USAID has saved $1.1 million in commodity costs from Brazil, Dominican Republic, Ecuador, Indonesia, and Peru. Active private sector involvement benefits companies, consumers, and donors through increased corporate profits, healthier employees, improved consumer access at lower cost, and the possibility of sustained family planning programs. Moreover, private, for-profit companies will be able to meet service demands over the next 20 years where traditional government and donor agency sources would fail. Using employee surveys and cost-benefit analyses to demonstrate expected financial and health benefits for businesses and work forces, S&T/POP's Technical Information on Population for the Private Sector (TIPPS) project encourages private companies in developing countries to invest in family planning and maternal/child health care for their employees. 36 companies in 9 countries have responded thus far, which examples provided from Peru and Zimbabwe. The Enterprise program's objectives are also to increase the involvement of for-profit companies in delivering family planning services, and to improve the efficiency and effectiveness of private volunteer organizations in providing services. Projects have been started with mines, factories, banks, insurance companies, and parastatals in 27 countries, with examples cited from Ghana and Indonesia. Finally, the Social Marketing for Change project (SOMARC) builds demand and distributes low-cost contraceptives through commercial channels especially to low-income audiences. Partnerships have been initiated with the private sector in 17 developing countries, with examples provided from

Family Planning Supply Environment in Kinshasa, DRC: Survey Findings and Their Value in Advancing Family Planning Programming.

PubMed

Kayembe, Patrick; Babazadeh, Saleh; Dikamba, Nelly; Akilimali, Pierre; Hernandez, Julie; Binanga, Arsene; Bertrand, Jane T

2015-12-01

Modern contraceptive prevalence was 14.1% in 2007 in Kinshasa, the capital city of the Democratic Republic of the Congo (DRC). Yet virtually nothing was known about the family planning supply environment. Three surveys of health facilities were conducted in 2012, 2013, and 2014 to determine the number, spatial distribution, and attributes of sites providing family planning services. The 2012 and 2013 surveys aimed to identify the universe of family planning facilities while obtaining a limited set of data on "readiness" to provide family planning services (defined as having at least 3 modern methods, at least 1 person training in family planning in the last 3 years, and an information system to track distribution of products to clients) and output (measured by couple-years of protection, or CYP). In contrast, the 2014 survey, conducted under the umbrella of the Performance Monitoring and Accountability 2020 (PMA2020) project, was based on 2-stage cluster sampling. This article provides detailed analysis of the 2012 and 2013 surveys, including bivariate and multivariate analysis of correlates of readiness to provide services and of output. We identified 184 health facilities that reported providing at least 1 contraceptive method in 2012 and 395 facilities in 2013. The percentage of sites defined as "ready" to provide services increased from 44.1% in 2012 to 63.3% in 2013. For the 3-month period between January and March 2013, facilities distributed between 0 and 879.2 CYP (mean, 39.7). Nearly half (49%) of the CYP was attributable to implants, followed by IUDs (24%), CycleBeads (11%), and injectables (8%). In 2013, facilities supported by PEPFAR (n = 121) were more likely than other facilities to be rated as ready to provide services (P<.0001); however, PEPFAR-supported sites generated less CYP on average than sites supported by family planning implementing agencies (P<.0001). Multivariate analysis showed 3 variables were associated with CYP: type of health

Family Planning Supply Environment in Kinshasa, DRC: Survey Findings and Their Value in Advancing Family Planning Programming

PubMed Central

Kayembe, Patrick; Babazadeh, Saleh; Dikamba, Nelly; Akilimali, Pierre; Hernandez, Julie; Binanga, Arsene; Bertrand, Jane T

2015-01-01

Background: Modern contraceptive prevalence was 14.1% in 2007 in Kinshasa, the capital city of the Democratic Republic of the Congo (DRC). Yet virtually nothing was known about the family planning supply environment. Methods: Three surveys of health facilities were conducted in 2012, 2013, and 2014 to determine the number, spatial distribution, and attributes of sites providing family planning services. The 2012 and 2013 surveys aimed to identify the universe of family planning facilities while obtaining a limited set of data on “readiness” to provide family planning services (defined as having at least 3 modern methods, at least 1 person training in family planning in the last 3 years, and an information system to track distribution of products to clients) and output (measured by couple-years of protection, or CYP). In contrast, the 2014 survey, conducted under the umbrella of the Performance Monitoring and Accountability 2020 (PMA2020) project, was based on 2-stage cluster sampling. This article provides detailed analysis of the 2012 and 2013 surveys, including bivariate and multivariate analysis of correlates of readiness to provide services and of output. Results: We identified 184 health facilities that reported providing at least 1 contraceptive method in 2012 and 395 facilities in 2013. The percentage of sites defined as “ready” to provide services increased from 44.1% in 2012 to 63.3% in 2013. For the 3-month period between January and March 2013, facilities distributed between 0 and 879.2 CYP (mean, 39.7). Nearly half (49%) of the CYP was attributable to implants, followed by IUDs (24%), CycleBeads (11%), and injectables (8%). In 2013, facilities supported by PEPFAR (n = 121) were more likely than other facilities to be rated as ready to provide services (P<.0001); however, PEPFAR-supported sites generated less CYP on average than sites supported by family planning implementing agencies (P<.0001). Multivariate analysis showed 3 variables were

The effectiveness of family-planning programmes.

PubMed

Mauldin, W P

1989-01-01

By the mid-1960s, countries that accounted for 66% of the population of developing countries had adopted policies designed to reduce their rates of population growth; by 1986, the corresponding figure had reached 78%. In the developing regions as a whole, fertility has fallen by more than 30% since 1950. Contraceptive use has risen sharply, and there has been more than 10-fold increase in the number of couples in developing countries who use contraceptives. There is a very strong association between use of contraception and fertility in developing countries. Social and economic modernization is also taking place, although quite unevenly in the developing regions, so that the relationship of modernization is fertility is not very easy to demonstrate. In general, the experience of the developing countries suggest that a strong family- planning program effort can, and does, lead to a more rapid fertility decline than would be likely based only on socioeconomic variables. The effectiveness of family-planning programs can be enhanced by increasing the range of choice of contraceptive methods offered. However, it is difficult to disentangle the various factors that contribute to the effectiveness of family-planning programs. The public sector is the main supplier of family-planning services in most developing countries, and there is no clear trend towards the reliance on the private sector.

Pakistan: family planning expands in non-governmental organizations.

PubMed

1977-01-01

The Family Planning Association of Pakistan has begun a program of integration of family planning activities with other voluntary welfare agencies. 1 of the more successful projects has been in cooperation with the Family Welfare Cooperative Society of Lahore. Volunteers have provided facilities to very low-income women to help supplement income. At 1st it was knitting, embroidery, and cloth manufacture, but over several years it developed into a complex of several buildings with a comprehensive vocational training center, a showroom, schools for the children of mothers in training, a secretarial school, and a hostel for homeless women there. There is a medical unit, a full-time doctor, and family planning services.

Quality assessment and improvement of post graduate family medicine training in the USA.

PubMed

Hoekzema, Grant S; Maxwell, Lisa; Gravel, Joseph W; Mills, Walter W; Geiger, William; Honeycutt, J David

2016-09-01

In 2013, the World Organisation of Family Doctors published training standards for post-graduate medical education (GME) in Family Medicine/General Practice (FP/GP). GME quality has not been well-defined, other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors (AFMRD) developed a tool that would aid in raising the quality of family medicine residency training in the USA. We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first three years of use by US family medicine residency (FMR) programmes. The RPI uses metrics specific to family medicine training in the USA to help programmes identify strengths and areas for improvement in their educational activities. Our review of three years of experience with the RPI revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a programme improvement mechanism. The RPI is a nationwide, standardised, programme quality improvement tool for family medicine residency programmes in the USA, which was successfully launched as part of AFMRD's strategic plan. Although some initial challenges need to be addressed, it has the promise to aid family medicine residencies in their internal improvement efforts. This model could be adapted in other post-graduate training settings in FM/GP around the world.

Managed Care Quality of Care and Plan Choice in New York SCHIP

PubMed Central

Liu, Hangsheng; Phelps, Charles E; Veazie, Peter J; Dick, Andrew W; Klein, Jonathan D; Shone, Laura P; Noyes, Katia; Szilagyi, Peter G

2009-01-01

Objective To examine whether low-income parents of children enrolled in the New York State Children's Health Insurance Program (SCHIP) choose managed care plans with better quality of care. Data Sources 2001 New York SCHIP evaluation data; 2001 New York State Managed Care Plan Performance Report; 2000 New York State Managed Care Enrollment Report. Study Design Each market was defined as a county. A final sample of 2,325 new enrollees was analyzed after excluding those in markets with only one SCHIP plan. Plan quality was measured using seven Consumer Assessment of Health Plans Survey (CAHPS) and three Health Plan Employer Data and Information Set (HEDIS) scores. A conditional logit model was applied with plan and individual/family characteristics as covariates. Principle Findings There were 30 plans in the 45 defined markets. The choice probability increased 2.5 percentage points for each unit increase in the average CAHPS score, and the association was significantly larger in children with special health care needs. However, HEDIS did not show any statistically significant association with plan choice. Conclusions Low-income parents do choose managed care plans with higher CAHPS scores for their newly enrolled children, suggesting that overall quality could improve over time because of the dynamics of enrollment. PMID:19208091

Religious leaders gain ground in the Jordanian family-planning movement.

PubMed

Underwood, Carol; Kamhawi, Sarah; Nofal, Ahmad

2013-11-01

To assess the effect of a training program designed to enhance the role of Muslim religious leaders (RLs) in promoting family welfare, including reproductive health generally and family planning more specifically. A panel study design was utilized; 136 and 115 RLs completed the self-administered questionnaires at baseline (pre-training) and endline (6 months post-training), respectively. Scales were generated to assess RLs' knowledge of the number of family-planning methods deemed to be acceptable according to Islamic teachings (9 methods, Cronbach α=0.85), attitudes toward family planning (7 statements, Cronbach α=0.67), and preaching and/or counseling on family-planning topics (7 topics, Cronbach α=0.85). Linear regressions controlling for sex, age, and educational attainment showed that, on average, RLs cited more methods deemed acceptable according to Islamic teachings (β=1.381; P<0.001), expressed more positive attitudes toward family planning (β=0.514; P<0.05), and preached and/or counseled on family-planning topics more frequently at endline compared with baseline (β=0.965; P<0.01). Culturally appropriate training for RLs can lead to a deeper understanding of, and appreciation for, reproductive health and family planning, with the effects manifesting as increased preaching and/or counseling about these important topics. © 2013.

Implementing Family Meetings Into a Respiratory Care Unit: A Care and Communication Quality Improvement Project.

PubMed

Loeslie, Vicki; Abcejo, Ma Sunnimpha; Anderson, Claudia; Leibenguth, Emily; Mielke, Cathy; Rabatin, Jeffrey

Substantial evidence in critical care literature identifies a lack of quality and quantity of communication between patients, families, and clinicians while in the intensive care unit. Barriers include time, multiple caregivers, communication skills, culture, language, stress, and optimal meeting space. For patients who are chronically critically ill, the need for a structured method of communication is paramount for discussion of goals of care. The objective of this quality improvement project was to identify barriers to communication, then develop, implement, and evaluate a process for semistructured family meetings in a 9-bed respiratory care unit. Using set dates and times, family meetings were offered to patients and families admitted to the respiratory care unit. Multiple avenues of communication were utilized to facilitate attendance. Utilizing evidence-based family meeting literature, a guide for family meetings was developed. Templates were developed for documentation of the family meeting in the electronic medical record. Multiple communication barriers were identified. Frequency of family meeting occurrence rose from 31% to 88%. Staff satisfaction with meeting frequency, meeting length, and discussion of congruent goals of care between patient/family and health care providers improved. Patient/family satisfaction with consistency of message between team members; understanding of medications, tests, and dismissal plan; and efficacy to address their concerns with the medical team improved. This quality improvement project was implemented to address the communication gap in the care of complex patients who require prolonged hospitalizations. By identifying this need, engaging stakeholders, and developing a family meeting plan to meet to address these needs, communication between all members of the patient's care team has improved.

Comparison of Families with and without a Suicide Prevention Plan Following a Suicidal Attempt by a Family Member.

PubMed

Cho, Heung-Don; Kim, Nam-Young; Gil, Hyo-wook; Jeong, Du-shin; Hong, Sae-yong

2015-07-01

The frequency and extent of the existence of a familial suicide prevention plan may differ across cultures. The aim of this work was, therefore, to determine how common it was for families to develop a suicide prevention plan and to compare the main measures used by families with and without such a plan, after an attempt to commit suicide was made by a member of a family living in a rural area of Korea. On the basis of the presence or absence of a familial suicide prevention plan, we compared 50 recruited families that were divided into 2 groups, with Group A (31 families) employing a familial suicide prevention plan after a suicide attempt by a family member, and Group B (19 families) not doing so. The strategy that was employed most frequently to prevent a reoccurrence among both populations was promoting communication among family members, followed by seeking psychological counseling and/or psychiatric treatment. Contrary to our expectation, the economic burden from medical treatment after a suicide attempt did not influence the establishment of a familial suicide prevention plan. It is a pressing social issue that 38% (19 of 50) of families in this study did not employ a familial suicide prevention plan, even after a family member had attempted suicide. Regional suicide prevention centers and/or health authorities should pay particular attention to these patients and their families.

Family planning and social position of women.

PubMed

Begum, Hasna

1993-04-01

This presentation began with at least three biases: (i) Acceptance of a secular approach to the problem of artificially controlling human reproduction; (ii) acceptance of an absolute egalitarian position in matter of choices and applications of family planning methods; and (iii) acceptance of the view that a small family gives women more opportunities to flourish as humans. The conclusion of the presentation is: though in implementing family planning programmes much deviation from the egalitarian principle could be found, in reality the implementation itself does bring about some opportunities for women to enhance their position in society. Undoubtedly the malpractices in family planning programmes cause death and miseries to women. But, until better methods are invented for both male and female sexes to replace the harmful ones and the male members of the society feel equal responsibility in matters of controlling reproduction, women have now no other choice but to accept the lesser evil.

Objective necessity of socialist family planning: a trial discussion.

PubMed

Li, R

1985-07-01

On the basis of Marx and Engels' prediction and thesis of scientific socialism, socialist China, the most populous nation in the world, is the 1st to have realized the planned management of population reproductive in the history of mankind, thus giving an answer to the problem in practice. This paper makes a tentative exploration of such a necessity in socialist family planning. Engels points out that 1) under private ownership, population reproduction takes class antagonism as the basis, while public ownership of the means of production eradicates it; 2) in capitalist society, the reproduction of the labor force is commodity reproduction--public ownership of the means of production can be divorced from the domain of commodity; and 3) under private ownership, population reproduction is purely the private business of an individual or a family whose economic benefit forms the motive force of population reproduction--public ownership liberates it from one's personal gains making it a public affair. The great significance of family planning to economic development can be recognized as production, consumption, and accumulation. Taking family planning as the basis for the reproduction plan of the labor force is the guarantee of realizing the material production plan. Family planning reflects the trend of the structure and change of consumer requirements and provides the direct and indirect objectives of various items of material production planning; it provides the objective basis for social accumulation and the arrangement of expanding reproduction. 3 conclusions are derived: 1) the building up of the public ownership of the means of production affords man the possibility to regulate the production of matter as well as man, 2) the characteristics of the planned development of a socialist national economy demands the planned production of man, and 3) family planning and the development of a socialist economy demand their mutual congruence.

Work-Family Planning Attitudes among Emerging Adults

ERIC Educational Resources Information Center

Basuil, Dynah A.; Casper, Wendy J.

2012-01-01

Using social learning theory as a framework, we explore two sets of antecedents to work and family role planning attitudes among emerging adults: their work-family balance self-efficacy and their perceptions of their parents' work-to-family conflict. A total of 187 college students completed a questionnaire concerning their work-family balance…

[Family physicians attitude towards quality indicator program].

PubMed

Shani, Michal; Nakar, Sasson; Azuri, Yossi

2012-10-01

Quality indicator programs for primary care are implanted throughout the world improving quality in health care. In this study, we have assessed family physicians attitudes towards the quality indicators program in Israel. Questionnaires were distributed to family physicians in various continuing educational programs. The questionnaire addressed demographics, whether the physician dealt with quality indicators, time devoted by the physician to quality indicators, pressure placed on the physician related to quality indicators, and the working environment. A total of 140 questionnaires were distributed and 91 (65%) were completed. The average physician age was 49 years (range 33-65 years]; the average working experience as a family physician was 17.8 years (range 0.5-42); 58 physicians were family medicine specialist (65.9%). Quality indicators were part of the routine work of 94% of the physicians; 72% of the physicians noted the importance of quality indicators; 84% of the physicians noted that quality indicators demand better team work; 76% of the physicians noted that quality indicators have reduced their professional independence. Pressure to deal with quality indicators was noted by 72% of the family physicians. Pressure to deal with quality indicators was related to reduced loyalty to their employer (P = 0.001), reducing their interest to practice family medicine (p < 0.001), and increasing their burnout at work (p = 0.001). It is important that policy makers find the way to leverage the advantages of quality indicator programs, without creating a heavy burden on the work of family physicians.

Effectiveness of advance care planning with family carers in dementia nursing homes: A paired cluster randomized controlled trial.

PubMed

Brazil, Kevin; Carter, Gillian; Cardwell, Chris; Clarke, Mike; Hudson, Peter; Froggatt, Katherine; McLaughlin, Dorry; Passmore, Peter; Kernohan, W George

2018-03-01

In dementia care, a large number of treatment decisions are made by family carers on behalf of their family member who lacks decisional capacity; advance care planning can support such carers in the decision-making of care goals. However, given the relative importance of advance care planning in dementia care, the prevalence of advance care planning in dementia care is poor. To evaluate the effectiveness of advance care planning with family carers in dementia care homes. Paired cluster randomized controlled trial. The intervention comprised a trained facilitator, family education, family meetings, documentation of advance care planning decisions and intervention orientation for general practitioners and nursing home staff. A total of 24 nursing homes with a dementia nursing category located in Northern Ireland, United Kingdom. Family carers of nursing home residents classified as having dementia and judged as not having decisional capacity to participate in advance care planning discussions. The primary outcome was family carer uncertainty in decision-making about the care of the resident (Decisional Conflict Scale). There was evidence of a reduction in total Decisional Conflict Scale score in the intervention group compared with the usual care group (-10.5, 95% confidence interval: -16.4 to -4.7; p < 0.001). Advance care planning was effective in reducing family carer uncertainty in decision-making concerning the care of their family member and improving perceptions of quality of care in nursing homes. Given the global significance of dementia, the implications for clinicians and policy makers include them recognizing the importance of family carer education and improving communication between family carers and formal care providers.

Comparison of Families with and without a Suicide Prevention Plan Following a Suicidal Attempt by a Family Member

PubMed Central

Cho, Heung-Don; Kim, Nam-Young; Gil, Hyo-wook; Jeong, Du-shin

2015-01-01

The frequency and extent of the existence of a familial suicide prevention plan may differ across cultures. The aim of this work was, therefore, to determine how common it was for families to develop a suicide prevention plan and to compare the main measures used by families with and without such a plan, after an attempt to commit suicide was made by a member of a family living in a rural area of Korea. On the basis of the presence or absence of a familial suicide prevention plan, we compared 50 recruited families that were divided into 2 groups, with Group A (31 families) employing a familial suicide prevention plan after a suicide attempt by a family member, and Group B (19 families) not doing so. The strategy that was employed most frequently to prevent a reoccurrence among both populations was promoting communication among family members, followed by seeking psychological counseling and/or psychiatric treatment. Contrary to our expectation, the economic burden from medical treatment after a suicide attempt did not influence the establishment of a familial suicide prevention plan. It is a pressing social issue that 38% (19 of 50) of families in this study did not employ a familial suicide prevention plan, even after a family member had attempted suicide. Regional suicide prevention centers and/or health authorities should pay particular attention to these patients and their families. PMID:26130963

An approach to family planning for Indochinese refugee women.

PubMed

Presswell, N J

1982-08-01

Family planning services were introduced in Vietnam by the Americans about 20 years ago, but on a limited basis. Many of the Vietnamese refugee women have had no contact with such services. Abortion was illegal until 1975 in South Vietnam, but since the takeover, abortion clinics have been available as part of the public hospital system. Family planning was available in some of the refugee camps. Most of the Vietnam refugees fled their country by boat. Before their acceptance by Australia, the Vietnamese refugees have health checks by the Australian Commonwealth Health Department in the country of transit. Shortly after their arrival in Australia, health screening is done by the State Health Department. The majority of refugees are accommodated in migrant hostels for the 1st 3-12 months. Family planning is incorporated into Eastbridge Hostel's orientation program. During participation in some family planning discussion groups with the Indochinese refugees, it was observed that the women were particularly shy and hesitant to talk about sexual concerns in a large group or in mixed company. As personal matters are dealt with in the family, it is preferable to have a female as a discussion leader and interpreter. Visual aids such as a display of contraceptive devices, a model showing female anatomy and a family planning film for non-English speaking migrants are particularly useful. As a female doctor using a female interpreter the aim was to provide an accessible service for Indochinese women with family planning inquiries or gynecological problems. It is important that the interpreter is present in the consulting room. Nonverbal cues are most important and particular attention should be paid to establishing eye contact with the patient. Simple miming techniques or the use of diagrams may be helpful in reinforcing the work of the interpreter. When listening to the patient, it is useful to look and listen for nonverbal cues from them. Between February 1980 and May 1981

Phase Transitions in Planning Problems: Design and Analysis of Parameterized Families of Hard Planning Problems

NASA Technical Reports Server (NTRS)

Hen, Itay; Rieffel, Eleanor G.; Do, Minh; Venturelli, Davide

2014-01-01

There are two common ways to evaluate algorithms: performance on benchmark problems derived from real applications and analysis of performance on parametrized families of problems. The two approaches complement each other, each having its advantages and disadvantages. The planning community has concentrated on the first approach, with few ways of generating parametrized families of hard problems known prior to this work. Our group's main interest is in comparing approaches to solving planning problems using a novel type of computational device - a quantum annealer - to existing state-of-the-art planning algorithms. Because only small-scale quantum annealers are available, we must compare on small problem sizes. Small problems are primarily useful for comparison only if they are instances of parametrized families of problems for which scaling analysis can be done. In this technical report, we discuss our approach to the generation of hard planning problems from classes of well-studied NP-complete problems that map naturally to planning problems or to aspects of planning problems that many practical planning problems share. These problem classes exhibit a phase transition between easy-to-solve and easy-to-show-unsolvable planning problems. The parametrized families of hard planning problems lie at the phase transition. The exponential scaling of hardness with problem size is apparent in these families even at very small problem sizes, thus enabling us to characterize even very small problems as hard. The families we developed will prove generally useful to the planning community in analyzing the performance of planning algorithms, providing a complementary approach to existing evaluation methods. We illustrate the hardness of these problems and their scaling with results on four state-of-the-art planners, observing significant differences between these planners on these problem families. Finally, we describe two general, and quite different, mappings of planning

Perceptions of family planning among low-income men in Western Kenya.

PubMed

Wambui, T; Ek, A-C; Alehagen, S

2009-09-01

Men have rarely been involved in either receiving or providing information on sexuality, reproductive health or birth spacing. They have also been ignored or excluded in one way or the other from participating in many family planning programmes as family planning is viewed as a woman's affair. To describe the perceptions of family planning among low-income men in Western Kenya. A qualitative study using focus group interviews and content analysis was conducted, with 64 men aged 15-54 years participating actively. Perceptions of family planning were manifold. For example, some perceived it as meaning having the number of children one is able to provide for. Most men knew about traditional and modern methods of birth control, although their knowledge was poor and misconceived. Modern methods were thought to give side effects, discouraging family planning. Low instances of family planning were also because of the fact that culturally, children are considered wealth. A law advocating family size limitation was regarded as necessary for the future. Men's perceptions of family planning are manifold. Their knowledge about contraception is poor and sometimes misconceived. Preferences regarding a child's gender are strong, thus attitudes and cultural beliefs that might hinder family planning have to be considered. A policy on male contraception and contraceptive services is seen as necessary.

Assessing family planning service-delivery skills in Kenya.

PubMed

Valadez, J J; Transgrud, R; Mbugua, M; Smith, T

1997-06-01

This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.

Workshop on promotion of reproductive health and family planning held.

PubMed

1997-09-01

Two reproductive health advocacy networks have been established in two districts in eastern Africa to help promote family planning and reproductive health among the people in this area. The districts are the Suhum-Kraboa-Coaltar and the New Juaben Municipality. To enhance the performance of the network, a 4-day workshop was held at Koforidua for the members to prepare an action plan for their advocacy and map out areas of collaboration between the public and the private sector group. The workshop, organized by the Futures Group International based in the US with support from the USAID, was attended by 30 participants from nongovernmental organizations and public offices. In an address, Ms. Patience Adow, the Regional Minister observed that through the idea of family planning has been promoted in the country over the past two decades, the country continues to experience a population growth rate of about 2.8%. She expressed the hope that the workshop will equip the participants with the relevant skills to develop and implement their advocacy strategy effectively. Dr. J. E. Taylor, Medical Administrator of the Koforidua Central Hospital, who chaired the function in a bid to improve the health of women and the quality of life of the people. The Ministry of Health as part of its medium term strategic plan has developed the national reproductive health and service policy.

Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care.

PubMed

Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T

2017-08-01

The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

PubMed

Thatte, Nandita; Choi, Yoonjoung

2015-04-01

Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be

Thai midwives brought into family planning.

PubMed

1974-03-01

In Thailand "granny" midwives are being tested and trained to take part in modern family planning and public health programs. In Malaysia a survey of conditions relating to an increase in induced early termination or abortion of pregnancies is in progress. The International Development Research Centre (IDRC) supports these projects as well as others in Asia. Local paramedical workers, like the "barefoot doctors" in China, are being trained. In Thailand a growth plan is attempting to reduce the annual rate of population increase from about 3.3% to 2.5%. Many granny midwives have been contacted. Several methods of incentive and training are being tried and will be evaluated. Eventually granny midwives in all of Thailand's 60,000 villages will be enlisted in the national planning program. Of Thailand's 6 million married women of reproductive age less than half use modern birth control methods. Abortion is illegal in Thailand which is a predominantly Buddhist country. The project in Malaysia is being carried out by the University of Malaysia and the Federation of Family Planning Associations. Abortion is also illegal in Islamic Malaysia, although there are illegal abortion clinics. Trends so far reported to IDRC indicate that 1) lower class women are more cooperative interviewees than others, 2) most couples use some method of birth control, 3) many wish to interrupt their pregnancies, 4) poorer families have more children than wealthier ones, 5) the Chinese and Indian people show a greater tendency to limit families than do the Malays, and 6) most couples want 3 or 4 children.

A Small Library in Family Planning.

ERIC Educational Resources Information Center

Planned Parenthood Federation of America, Inc., New York, NY.

This annotated listing of books is intended as a reference for anyone seeking an authoritative introduction to population and family planning information, as a world, family, or individual concern. For each entry, the International Standard Book Number (ISBN) is provided if available. The number preceding each reference represents the…

Islamic logics, reproductive rationalities: family planning in northern Pakistan.

PubMed

Varley, Emma

2012-01-01

This paper explores the use of Islamic doctrine and jurisprudence by family planning organizations in the Gilgit-Baltistan region of northern Pakistan. It examines how particular interpretations of Islam are promoted in order to encourage fertility reductions, and the ways Muslim clerics, women and their families react to this process. The paper first discusses how Pakistan's demographic crisis, as the world's sixth most populous nation, has been widely blamed on under-funding for reproductive health services and wavering political commitment to family planning. Critics have called for innovative policy and programming to counter 'excessive reproduction' by also addressing socio-cultural and religious barriers to contraceptive uptake. Drawing on two years of ethnographic research, the paper examines how family planning organizations in Gilgit-Baltistan respond to this shift by employing moderate interpretations of Islam that qualify contraceptive use as a 'rational' reproductive strategy and larger families as 'irrational'. However, the use of Islamic rhetoric to enhance women's health-seeking agency and enable fertility reductions is challenged by conservative Sunni ulema (clergy), who seek to reassert collective control over women's bodies and fertility by deploying Islamic doctrine that honors frequent childbearing. Sunnis' minority status and the losses incurred by regional Shia-Sunni conflicts have further strengthened clerics' pronatalist campaigns. The paper then analyses how Sunni women navigate the multiple reproductive rationalities espoused by 'Islamized' family planning and conservative ulema. Although Islamized family planning legitimizes contraceptive use and facilitates many women's stated desire for smaller families, it frequently positions women against the interests of family, community and conservative Islam.

[Family planning at the turn of the 21st century].

PubMed

Trias, M

1994-06-01

This work constitutes a plea for the widest possible acceptance and encouragement of family planning throughout the world in order to avoid the irreversible environmental damage that will inevitably come with excessive numbers. Limitation of reproduction, preferably voluntarily, is possible by means of the effective and generally safe contraceptive methods now available. Preservation of the environment will require effective antipollution policies and an unwelcome control of the rampant consumerism of contemporary culture. Alarm among demographers in developed countries concerning exponential population increase developed about a half-century ago, only shortly after the feminist-led struggle for reproductive freedom provided a moral and juridical foundation for family planning. The demographic focus was not used to promote family planning among Third World countries, as that would have been viewed as heavy handed intrusion into the most intimate realm of domestic life. Instead, the nondemographic benefits such as improved maternal and child health and family well-being were stressed. It may be time to modify the focus. Ecologists must strive for a radical transformation of consumerist culture but must not ignore the pressure of numbers. Satisfying the needs of the world's most impoverished will greatly increase pressure on resources. Family planning has been accepted by the majority of the world's couples, but the unsatisfied demand has been estimated to amount to 100 million couples throughout the world. Providing information and services for such couples is the greatest challenge facing family planning programs. Many enemies of family planning have lost influence, but some critics from within family planning programs have deflected attention from the tasks of service delivery and may have postponed progress in some areas. Feminists who object to the concentration on female methods, developmentalists who believe that contraception will be accepted eventually as

Men in Bangladesh play a role in family planning.

PubMed

Ahsan, S B

1992-08-01

More and more men are convincing their wives to use family planning in Bangladesh. In this conservative, Moslem country, women are not allowed to leave the homes so husbands must go to buy methods especially rural areas. 70% of women who use oral contraceptives (OCs), IUDs, or condoms report that their husbands obtain these method for them. many couples are poor peasants. Contraceptive prevalence is not 23.2%. Female sterilization and OCs are the 2 most popular methods (9% each) followed by condoms (2%), IUD (1.7%), and vasectomy (1.5%). The total fertility rate is 4.8 which is higher than the goal of 3.5 Bangladesh hoped to reach by 1995. In 1975, 30% of women believed fate determines family size but now only 8% think that. Attitude changes about family size have occurred despite illiteracy and poverty. Traditional religious beliefs are still prevalent in rural areas making it difficult for wives to speak to their husbands about family planning. Husband-wife communication is more open among urban, middle class couples. The long lasting hormonal implant, Norplant, holds promise as a means for Bangladesh to reach its goal. About 4500 women now have Norplant and government and nongovernment clinics plan to insert it into around 20,000 more women. A study of 2586 potential acceptors of Norplant at family clinics in Bangladesh 3 other developing countries shows that counseling diminishes the anxiety women and their husbands experience about Norplant and its side effects. A study in Bangladesh reveals higher continuation rates of Norplant for women whose husbands underwent counseling than for those whose husbands did not undergo counseling. Family planning advertisements on the radio, TV, and in newspapers have convinced couples to use family planning, but the advertisements tend to not explaining how to use family planning. Men are key to the changes in attitude about family planning in Bangladesh.

Compulsion in family planning: the fundamental considerations.

PubMed

Pethe, V P

1979-03-01

Focus is on some of the basic issues and considerations involved in the question of compulsion in family planning, which in terms of current contraceptive technology, only means compulsory sterilization. Pressures have been increasing to implement more stringent measures to control population growth in most of the developing countries throughout the world. During the Emergency in India (1975-1977) the government at that time, along with some individuals and groups, deemed it necessary to adopt the drastic measure of compulsory sterilization. The six sections of the discussion deal with the following: 1) compulsory family planning as rational or ethical choice basic issues; 2) neo-Malthusian thesis on compulsion - fallacies, dangers and inadequacies; 3) ethical and philosophical problems - premise of irresponsible procreation; 4) individual rights versus societal interests; 5) elitism in social policy and cost benefit considerations; and 6) international consensus against compulsion. All forums, under the auspices of the United Nations, of which India is a member, have rejected coercion and reiterated repeatedly that every individual has a basic human right to decide how many children to have and at what intervals. The most recent forum to endorse the human right to family size was the World Population Conference held at Bucharest in 1974. The 14 conditions spelled out by the United Nations Fund for Population Activity for effecting a free and responsible choice in family size may form a sound basis for a comprehensive policy concerning family planning in India. The coercive measures adopted during the Emergency are responsible for a backlash in India and retarding the progress of the family planning movement.

Reproductive health and family planning needs among HIV-infected women in Sub-Saharan Africa.

PubMed

Sarnquist, Clea C; Rahangdale, Lisa; Maldonado, Yvonne

2013-03-01

Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa. Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion. Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.

CFSC (Community and Family Study Center) study finds birth rates falling everywhere - family planning (family planning) is a factor.

PubMed

1978-08-01

The findings of the Community and Family Study Center study, based on estimated crude birthrates and total fertility rates for 1968 and 1975, indicate that there has been a significant reduction in fertility levels of both developed and developing countries. Despite regional variations, the estimates show an average proportional decline of 8.5% in total fertility rates between 1968 and 1975. Of the 148 nations studied, 113 were in developing regions and 35 in the developed regions. Information on important social and economic development factors, such as life expectancy, literacy, percent of labor force in agriculture, per capita income, and family planning program strength were gathered for each country. Analyses of these data are reported in "The Public Interest" (to be published) "Population Reference Bulletin," October 1978, and a paper presented at the 1978 Population Association of America Meetings in Atlanta, Georgia. The recent change in fertility affected 81% of the world's population, primarily the peoples of Asia, Latin America, and North America. The total fertility rate in the world in 1968 was 4635 and declined to 4068 in 1975. More substantial declines occurred in Asia and Latin America, where the number of fewer births 1000 women would bear under a given fertility schedule declined by 845 births and 617 births, respectively. As more research is conducted to investigate the underlying causes of this decline, it is likely to confirm the important role that family planning programs have had in developing nations. Although major improvements in the socioeconomic well-being of the developing areas continue as an essential goal, the need to maintain the organized provision of family planning services should not be understated.

Farmers knew prosperity lies in family planning: Prof. Gao Yuanxiang.

PubMed

1997-09-01

This brief article summarizes a speech given by the Director of Population Studies in Hebei, China, on family planning and sustainable development. Concurrent with the implementation of the family planning policy over the past 20 years was the implementation of development policies in rural areas. Agricultural policy shifted from support of the commune system to a land-leasing system. The land-leasing system is an improvement that inspires farmers to become wealthy and modernized. The new rural administration encourages modernization that releases manpower, and thus, frees farmers to concentrate on improving production and farming techniques rather than on increasing reproduction. Farmers decide on working time allocation and investment. Surplus agricultural laborers are migrating to cities in search of better work opportunities. Legal measures are needed to help migrants adapt to development. Urban living requires a one-child policy, while a two-child policy is acceptable in poor and mountainous rural areas. "The education of family planning must be mandatory." Under the new policies, people must become committed to family planning. Farmers are beginning to discover the benefits of family planning. Farmer's enlightenment occurred as a result of the family planning and poverty alleviation efforts during the late 1980s and 1990s. Farmers appreciate the government assistance and now believe that family planning benefits individuals and enhances their honor and responsibility. The benefits of the policy will continue into the future. "Sustainable population development is an important part of economic development." China is entering the new century with a new type of demographic structure, a new cultural system of family planning, and practical efforts.

On the efficiency of multiple media family planning promotion campaigns.

PubMed

1999-01-01

This article presents the result of a study conducted by Miriam N. Jato on the impact of multimedia family planning communication campaigns on contraceptive use. The study was conducted in Tanzania, where a government program integrated family planning into maternal and child health care services in 1988, while in 1992 a private-sector condom-marketing program begun and a national population policy for wider distribution of family planning information was adopted by the government. In less than 3 years, contraceptive use was found to have doubled to a level of 11.3% and the total fertility rate declined from an average of 6.3 to 5.8 live births. The result of the study indicates that exposure to media sources of family planning messages was directly associated with increased contraceptive use. Moreover, the use of modern methods increased among women who were exposed to a greater number of media sources, as did discussion of family planning with spouses and attendance of health facilities. The programmatic implications of the results confirm that utilization of multiple media channels in the promotion of family planning and other reproductive issues must be continued, with emphasis on media sources that reach large audiences.

Effectiveness of Family Planning Methods

MedlinePlus

... women in a year Effectiveness of Family Planning Methods Implant Reversible Intrauterine Device (IUD) Permanent Male Sterilization ... 0.5 % Diaphragm 12 % How to make your method most effective After procedure, little or nothing to ...

Men Too--a retrospective view of the Family Planning Association's male responsibility campaign.

PubMed

Wellings, K

1986-01-01

England's Family Planning Association's (FPA) MEN TOO campaign evolved from the recognition that men seemed to receive less support and encouragement than women in their involvement in the emotional aspects of relationships, family planning, and child rearing. Created out of a concern for balancing the selective attention given to men and women, the longterm goal of the MEN TOO campaign was to support the growing number of men who are concerned about increasing their participation in emotional expression, family planning, child rearing and related areas and to explore ways of improving the information and education services that contribute to a better understanding of these issues. The shortterm project goals were to: raise the "unspoken issues" for public debate; encourage more communication and an improved quality in personal and sexual relationships; and raise the support for effective contraceptive use in sexual relationships. Prior to the publicity campaign a select bibliography, a document outlining the need for and general aims of the MEN TOO project, and a report indicating that family planning services needed to be more flexible and accommodating to men were prepared. A press conference officially launched the MEN TOO project. During the autumn of 1984 and the spring of 1985 public service announcements were transmitted on all 9 of the independent television stations participating in the scheme. The FPA's 1-day conference, "Men, Sex and Relationships" in March 1985, in London. 400 delegates, attended both professional and laypersons, about 1/3 of them men. To give the initial impetus to changing the general atmosphere within family planning clinics and to changing staff attitudes toward men, a letter was sent from the FPA's Secretary General to all District Medical Officers, with copies to Senior Family Planning Officers and to District Health Education Officers, describing the campaign and expressing the hope that more men would come forward to seek

Tay Sachs and Related Storage Diseases: Family Planning

ERIC Educational Resources Information Center

Schneiderman, Gerald; And Others

1978-01-01

Based on interviews with 24 families, the article discusses family planning and the choices available to those families in which a child has previously died from Tay-Sachs or related lipid storage diseases. (IM)

Quality planning in Construction Project

NASA Astrophysics Data System (ADS)

Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

2017-12-01

The purpose of this paper is to investigate deeper on the factors that contribute to the effectiveness of quality planning, identifying the common problems encountered in quality planning, practices and ways for improvements in quality planning for construction projects. This paper involves data collected from construction company representatives across Malaysia that are obtained through semi-structured interviews as well as questionnaire distributions. Results shows that design of experiments (average index: 4.61), inspection (average index: 4.45) and quality audit as well as other methods (average index: 4.26) rank first, second and third most important factors respectively.

Birth control and family planning

MedlinePlus

... page: //medlineplus.gov/ency/article/001946.htm Birth control and family planning To use the sharing features ... please enable JavaScript. Your choice of a birth control method depends on a number of factors, including ...

Can Family Planning Service Statistics Be Used to Track Population-Level Outcomes?

PubMed

Magnani, Robert J; Ross, John; Williamson, Jessica; Weinberger, Michelle

2018-03-21

The need for annual family planning program tracking data under the Family Planning 2020 (FP2020) initiative has contributed to renewed interest in family planning service statistics as a potential data source for annual estimates of the modern contraceptive prevalence rate (mCPR). We sought to assess (1) how well a set of commonly recorded data elements in routine service statistics systems could, with some fairly simple adjustments, track key population-level outcome indicators, and (2) whether some data elements performed better than others. We used data from 22 countries in Africa and Asia to analyze 3 data elements collected from service statistics: (1) number of contraceptive commodities distributed to clients, (2) number of family planning service visits, and (3) number of current contraceptive users. Data quality was assessed via analysis of mean square errors, using the United Nations Population Division World Contraceptive Use annual mCPR estimates as the "gold standard." We also examined the magnitude of several components of measurement error: (1) variance, (2) level bias, and (3) slope (or trend) bias. Our results indicate modest levels of tracking error for data on commodities to clients (7%) and service visits (10%), and somewhat higher error rates for data on current users (19%). Variance and slope bias were relatively small for all data elements. Level bias was by far the largest contributor to tracking error. Paired comparisons of data elements in countries that collected at least 2 of the 3 data elements indicated a modest advantage of data on commodities to clients. None of the data elements considered was sufficiently accurate to be used to produce reliable stand-alone annual estimates of mCPR. However, the relatively low levels of variance and slope bias indicate that trends calculated from these 3 data elements can be productively used in conjunction with the Family Planning Estimation Tool (FPET) currently used to produce annual m

Bibliography of Family Planning and Population, Volume 1 Number 3.

ERIC Educational Resources Information Center

Linzell, Dinah, Comp.

Compiled from the world's research literature, this bi-monthly classified list of references on population and family planning emphasizes recently published material, primarily journal literature. Topics covered include: population and fertility; reproductive behaviour; the family; education in population, family planning, and sex; family…

Getting closer to people: family planning provision by drug shops in Uganda.

PubMed

Akol, Angela; Chin-Quee, Dawn; Wamala-Mucheri, Patricia; Namwebya, Jane Harriet; Mercer, Sarah Jilani; Stanback, John

2014-11-13

Private-sector drug shops are often the first point of health care in sub-Saharan Africa. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact. Between September 2010 and March 2011, we trained 139 drug shop operators (DSOs) in 4 districts of Uganda to safely administer intramuscular DMPA (depot medroxyprogesterone acetate) contraceptive injections. In 2012, we approached 54 of these DSOs and interviewed a convenience sample of 585 of their family planning clients to assess clients' contraceptive use and perspectives on the quality of care and satisfaction with services. Finally, we compared service statistics from April to June 2011 from drug shops, community health workers (CHWs), and government clinics in 3 districts to determine the drug shop market share of family planning services. Most drug shop family planning clients interviewed were women with low socioeconomic status. The large majority (89%) were continuing family planning users. DMPA was the preferred contraceptive. Almost half of the drug shop clients had switched from other providers, primarily from government health clinics, mostly as a result of more convenient locations, shorter waiting times, and fewer stock-outs in drug shops. All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy. Three-quarters felt that drug shops offered affordable family planning services. Most of the DMPA clients (74%) were very satisfied with receiving their method from the drug shop and 98% intended to get the next injection from the drug shop. Between April and June 2011, clinics, CHWs, and drug shops in 3 districts delivered equivalent proportions of couple-years of protection, with drug shops leading marginally at 36%, followed by clinics (33%) and CHWs (31

Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews.

PubMed

Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-Ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

2017-01-01

Despite a general understanding that exit interviews being conducted at service providers' facilities may influence clients' responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients' perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels - nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients' responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings.

Is it safe? Talking to teens with HIV/AIDS about death and dying: a 3-month evaluation of Family Centered Advance Care (FACE) planning – anxiety, depression, quality of life

PubMed Central

Lyon, Maureen E; Garvie, Patricia A; Briggs, Linda; He, Jianping; Malow, Robert; D’Angelo, Lawrence J; McCarter, Robert

2010-01-01

Purpose To determine the safety of engaging HIV-positive (HIV+) adolescents in a Family Centered Advance Care (FACE) planning intervention. Patients and methods We conducted a 2-armed, randomized controlled clinical trial in 2 hospital-based outpatient clinics from 2006–2008 with HIV+ adolescents and their surrogates (n = 76). Three 60–90 minutes sessions were conducted weekly. FACE intervention groups received: Lyon FCACP Survey©, the Respecting Choices® interview, and completion of The Five Wishes©. The Healthy Living Control (HLC) received: Developmental History, Healthy Tips, Future Planning (vocational, school or vocational rehabilitation). Three-month post-intervention outcomes were: completion of advance directive (Five Wishes©); psychological adjustment (Beck Depression, Anxiety Inventories); quality of life (PedsQL™); and HIV symptoms (General Health Self-Assessment). Results Adolescents had a mean age, 16 years; 40% male; 92% African-American; 68% with perinatally acquired HIV, 29% had AIDS diagnosis. FACE participants completed advance directives more than controls, using time matched comparison (P < 0.001). Neither anxiety, nor depression, increased at clinically or statistically significant levels post-intervention. FACE adolescents maintained quality of life. FACE families perceived their adolescents as worsening in their school (P = 0.018) and emotional (P = 0.029) quality of life at 3 months, compared with controls. Conclusions Participating in advance care planning did not unduly distress HIV+ adolescents. PMID:22096382

Ambivalence in pregnancy intentions: The effect of quality of care and context among a cohort of women attending family planning clinics in Kenya.

PubMed

Wekesa, Eliud; Askew, Ian; Abuya, Timothy

2018-01-01

Ambivalence in pregnancy intentions is well-documented in sub-Saharan African (SSA) settings and has been associated with inconsistent use of contraception, thereby exposing women using contraception to the possibility of unintended pregnancies. A better understanding of the potential role for client counseling interventions in enabling women to achieve their pregnancy intentions is essential for aiding program efforts to reduce unintended pregnancies. To measure ambivalence in pregnancy intentions longitudinally and determine its association with the quality of care received, controlling for demographic, socio-economic and contextual factors among a cohort of family planning (FP) clients in Kenya. This paper uses data drawn from a prospective cohort study of FP clients to investigate the relationship between the quality of care received during FP service delivery and the decisiveness of their pregnancy intentions over time. The study tests the hypothesis that higher quality of care enables women to be less ambivalent about their pregnancy intentions. Binary logistic regression with random effects and multinomial logistic regression were used to assess the predictive effect of the quality of care received by a woman on the decisiveness or ambivalence of her pregnancy intentions, and on any shifts in ambivalence over time, controlling for background characteristics. The study recruited 1,957 women aged 15-49 years attending twelve family planning clinics in four counties in Central Kenya; of these, 1,053 women were observed for four rounds of data collection over a period of 24 months and form the sample for analysis. A substantial proportion (43%) of women expressed ambivalence about their intentions to become pregnant at some point during the study period, while over half (57%) remained unequivocal throughout the study. Almost one third of women (31%) shifted from being unequivocal to ambivalent and 12% shifted from ambivalence to being unequivocal. Women

Region 7 Quality Management Plan

EPA Pesticide Factsheets

To document adherence to EPA Order 5360.1 A2, EPA requires each organizational unitto develop a quality management plan per the specifications in EPA Requirements for QualityManagement Plans, EPA QA R-2.

Family planning and family vision in mothers after diagnosis of a child with autism spectrum disorder

PubMed Central

Navot, Noa; Jorgenson, Alicia Grattan; Stoep, Ann Vander; Toth, Karen; Webb, Sara Jane

2016-01-01

The diagnosis of a child with autism has short- and long-term impacts on family functioning. With early diagnosis, the diagnostic process is likely to co-occur with family planning decisions, yet little is known about how parents navigate this process. This study explores family planning decision making process among mothers of young children with autism spectrum disorder in the United States, by understanding the transformation in family vision before and after the diagnosis. A total of 22 mothers of first born children, diagnosed with autism between 2 and 4 years of age, were interviewed about family vision prior to and after their child’s diagnosis. Grounded Theory method was used for data analysis. Findings indicated that coherence of early family vision, maternal cognitive flexibility, and maternal responses to diagnosis were highly influential in future family planning decisions. The decision to have additional children reflected a high level of adaptability built upon a solid internalized family model and a flexible approach to life. Decision to stop childrearing reflected a relatively less coherent family model and more rigid cognitive style followed by ongoing hardship managing life after the diagnosis. This report may be useful for health-care providers in enhancing therapeutic alliance and guiding family planning counseling. PMID:26395237

Family planning and family vision in mothers after diagnosis of a child with autism spectrum disorder.

PubMed

Navot, Noa; Jorgenson, Alicia Grattan; Vander Stoep, Ann; Toth, Karen; Webb, Sara Jane

2016-07-01

The diagnosis of a child with autism has short- and long-term impacts on family functioning. With early diagnosis, the diagnostic process is likely to co-occur with family planning decisions, yet little is known about how parents navigate this process. This study explores family planning decision making process among mothers of young children with autism spectrum disorder in the United States, by understanding the transformation in family vision before and after the diagnosis. A total of 22 mothers of first born children, diagnosed with autism between 2 and 4 years of age, were interviewed about family vision prior to and after their child's diagnosis. Grounded Theory method was used for data analysis. Findings indicated that coherence of early family vision, maternal cognitive flexibility, and maternal responses to diagnosis were highly influential in future family planning decisions. The decision to have additional children reflected a high level of adaptability built upon a solid internalized family model and a flexible approach to life. Decision to stop childrearing reflected a relatively less coherent family model and more rigid cognitive style followed by ongoing hardship managing life after the diagnosis. This report may be useful for health-care providers in enhancing therapeutic alliance and guiding family planning counseling. © The Author(s) 2015.

Donor funding for family planning: levels and trends between 2003 and 2013.

PubMed

Grollman, Christopher; Cavallaro, Francesca L; Duclos, Diane; Bakare, Victoria; Martínez Álvarez, Melisa; Borghi, Josephine

2018-05-01

The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning disaggregated by donor, recipient country and year are not available for recent years. We estimate international donor funding for family planning in 2003-13, the period covering the introduction of reproductive health targets to the Millennium Development Goals and up to the beginning of FP2020, and compare funding to unmet need for family planning in recipient countries. We used the dataset of donor disbursements to support reproductive, maternal, newborn and child health developed by the Countdown to 2015 based on the Organization for Economic Cooperation and Development Creditor Reporting System. We assessed levels and trends in disbursements supporting family planning in the period 2003-13 and compared this to unmet need for family planning. Between 2003 and 2013, disbursements supporting family planning rose from under $400 m prior to 2008 to $886 m in 2013. More than two thirds of disbursements came from the USA. There was substantial year-on-year variation in disbursement value to some recipient countries. Disbursements have become more concentrated among recipient countries with higher national levels of unmet need for family planning. Annual disbursements of donor funding supporting family planning are far short of projected and estimated levels necessary to address unmet need for family planning. The reimposition of the US Global Gag Rule will precipitate an even greater shortfall if other donors and recipient countries do not find substantial alternative sources of funding.

Donor funding for family planning: levels and trends between 2003 and 2013

PubMed Central

Grollman, Christopher; Cavallaro, Francesca L; Duclos, Diane; Bakare, Victoria; Martínez Álvarez, Melisa; Borghi, Josephine

2018-01-01

Abstract The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning disaggregated by donor, recipient country and year are not available for recent years. We estimate international donor funding for family planning in 2003–13, the period covering the introduction of reproductive health targets to the Millennium Development Goals and up to the beginning of FP2020, and compare funding to unmet need for family planning in recipient countries. We used the dataset of donor disbursements to support reproductive, maternal, newborn and child health developed by the Countdown to 2015 based on the Organization for Economic Cooperation and Development Creditor Reporting System. We assessed levels and trends in disbursements supporting family planning in the period 2003–13 and compared this to unmet need for family planning. Between 2003 and 2013, disbursements supporting family planning rose from under $400 m prior to 2008 to $886 m in 2013. More than two thirds of disbursements came from the USA. There was substantial year-on-year variation in disbursement value to some recipient countries. Disbursements have become more concentrated among recipient countries with higher national levels of unmet need for family planning. Annual disbursements of donor funding supporting family planning are far short of projected and estimated levels necessary to address unmet need for family planning. The reimposition of the US Global Gag Rule will precipitate an even greater shortfall if other donors and recipient countries do not find substantial alternative sources of funding. PMID:29534176

A family planning project in Rhodesia.

PubMed

Duffy, W

1970-12-01

Discussions with 552 man and 254 women in Rhodesia explored their reasons for nonacceptance of family planning. Reasons given include: a desire for many children for personal, economic and tribal security reasons; fear of high mortality; need for children as a labor resource; will of God; and personal pride in many sons. A change in attitudes toward acceptance of family planning may be attained by effective communication (not merely transmission of information), by involvement of community innovators; and by personalized persuasion thru material and child welfare services. The use of trained midwives concentrating on ante and postnatal care would be an asset to the program.

A Study of Women Who Drop-Out of Family Planning Clinics.

ERIC Educational Resources Information Center

Armstrong, Kay A.; And Others

Inconsistent use of contraceptives or discontinuance of family planning services places women at risk of unintended pregnancies. Dropping out of family planning clinics also could mean interrupting gynecological care. Nonetheless, approximately 20% of adolescent family planning patients and nearly 25% of adult patients do not return for a second…

Family Planning and Deforestation: Evidence from the Ecuadorian Amazon.

PubMed

Sellers, Samuel

2017-06-01

Despite an abundant body of literature exploring the relationship between population growth and forest cover change, comparatively little research has explored the forest cover impacts of family planning use, which is a key determinant of the rate of population growth in many developing country contexts. Using data from a farm-level panel survey in the Northern Ecuadorian Amazon, this paper addresses whether family planning use impacts forest cover change. Longitudinal model results show that after controlling for household life cycle and land use variables, family planning use did not have an independent effect on deforestation, reforestation, or net forest loss between 1990 and 2008. Forest cover change patterns appear indicative of farm life cycle effects. However, family planning use is associated with reduced subsequent fertility among households, suggesting that the relationship between population growth from births and forest cover change may be limited in this setting.

Family Planning and Deforestation: Evidence from the Ecuadorian Amazon

PubMed Central

Sellers, Samuel

2017-01-01

Despite an abundant body of literature exploring the relationship between population growth and forest cover change, comparatively little research has explored the forest cover impacts of family planning use, which is a key determinant of the rate of population growth in many developing country contexts. Using data from a farm-level panel survey in the Northern Ecuadorian Amazon, this paper addresses whether family planning use impacts forest cover change. Longitudinal model results show that after controlling for household life cycle and land use variables, family planning use did not have an independent effect on deforestation, reforestation, or net forest loss between 1990 and 2008. Forest cover change patterns appear indicative of farm life cycle effects. However, family planning use is associated with reduced subsequent fertility among households, suggesting that the relationship between population growth from births and forest cover change may be limited in this setting. PMID:29056808

Social attitudes of Filipinos towards family planning interest groups.

PubMed

1992-08-01

Some results are provided from the 1991 Social Weather Survey conducted in 1991 for the Legislators' Committee on Population and Development. The sample included both males and females (84% Roman Catholic, 7% other indigenous Christians, 7% Protestants, 1.2% Muslims, 0.2% without a religion, and 0.1% Buddhists). Surprising findings are that the public does not feel restricted from using family planning methods due to religious rules, schooling teachings, or a physician's advice. Most people hold that politicians generally support family planning. Only 19% are reported to believe that governors are against family planning, and 16% report that their mayors are against family planning. According to stated voting intentions, incumbent government officials perceived to be anti-family planning risk not being reelected. 96% of the survey respondents believe that it is important to have control over one's fertility. Awareness of family planning methods is directly related to socioeconomic class, education, and urban location. 21% say that their religion forbids tubal ligation and 26% say that ligation should never be practiced. 22% say that their religion allows ligation. Among people who believe that religion bans ligation, 10% approve of ligation at any time and 44% stipulate that there are times when it may be practiced. Another interesting finding was that school teaching had more influence on beliefs than religion. When schools said that rhythm was not allowed, 40% agreed. When religion taught that rhythm was not allowed, only 21% agreed. 9% of persons who were sectarian educated and 5% among non-sectarian educated persons believed that ligation should not be practiced.

Group versus individual family planning counseling in Ghana: a randomized, noninferiority trial.

PubMed

Schwandt, Hilary M; Creanga, Andreea A; Danso, Kwabena A; Adanu, Richard M K; Agbenyega, Tsiri; Hindin, Michelle J

2013-08-01

Group, rather than individual, family planning counseling has the potential to increase family planning knowledge and use through more efficient use of limited human resources. A randomized, noninferiority study design was utilized to identify whether group family planning counseling is as effective as individual family planning counseling in Ghana. Female gynecology patients were enrolled from two teaching hospitals in Ghana in June and July 2008. Patients were randomized to receive either group or individual family planning counseling. The primary outcome in this study was change in modern contraceptive method knowledge. Changes in family planning use intention before and after the intervention and intended method type were also explored. Comparisons between the two study arms suggest that randomization was successful. The difference in change in modern contraceptive methods known from baseline to follow-up between the two study arms (group-individual), adjusted for study site, was -0.21, (95% confidence interval: -0.53 to 0.12) suggesting no difference between the two arms. Group family planning counseling was as effective as individual family planning counseling in increasing modern contraceptive knowledge among female gynecology patients in Ghana. Copyright © 2013 Elsevier Inc. All rights reserved.

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Water quality management plans. 130.6... QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM... and certified and approved updates to those plans. Continuing water quality planning shall be based...

The role of family planning communications--an agent of reinforcement or change.

PubMed

Chen, E C

1981-12-01

Results are presented of a multiple classification analysis of responses to a 1972 KAP survey in Taiwan of 2013 married women aged 18-34 designed to determine whether family planning communication is primarily a reinforcement agent or a change agent. 2 types of independent variables, social demographic variables including age, number of children, residence, education, employment status, and duration of marriage; and social climate variables including ever receiving family planning information from mass media and ever discussing family planning with others, were used. KAP levels, the dependent variables, were measured by 2 variables each: awareness of effective methods and awareness of government supply of contraceptives for knowledge, wish for additional children and approve of 2-child family for attitude, and never use contraception and neither want children nor use contraception for practice. Social demographic and attitudinal variables were found to be the critical ones, while social climate and knowledge variables had only negligible effects on various stages of family planning adoption, indicating that family planning communications functioned primarily as a reinforcement agent. The effects of social demographic variables were prominent in all stages of contraceptive adoption. Examination of effects of individual variables on various stages of family planning adoption still supported the argument that family planning communications played a reinforcement role. Family planning communications functioned well in diffusing family planning knowledge and accessibility, but social demographic variables and desire for additional children were the most decisive influences on use of contraception.

Perspectives on family planning services among adolescents at a Boston community health center.

PubMed

Johnson, Katherine M; Dodge, Laura E; Hacker, Michele R; Ricciotti, Hope A

2015-04-01

The aim of this project was to investigate adolescent perspectives on family planning services at a community-health center, with the intent to inform health center programs aimed at stemming the adolescent pregnancy rate. This project was cross-sectional and employed mixed methods, including surveys and interviews, for the purposes of quality improvement. The project was conducted in the obstetrics and gynecology clinic at an urban community health center in Boston. Twenty adolescent females (age 16-20) who used services at the health center. Participants were individually interviewed to assess perspectives on family planning services and to identify major influences on methods of pregnancy prevention. Major themes were categorized into contraceptive usage, reproductive health knowledge, adult influence and communication, barriers to contraceptive care and expectations of a family planning clinic. All participants were sexually active and 80% had experienced pregnancy. Reproductive health knowledge was variable and in many cases limited. Concern about disapproval was a prominent barrier to going to a clinician for contraception or advice and parents were not often involved in the initial contraception discussion. Other barriers to use of contraception included forgetting to use the methods and fear of side effects. We identified several potentially modifiable factors, including lack of knowledge, concern for provider disapproval and fear of side effects that may limit effective use of family planning services by adolescents. Further attention should be paid to these factors in designing and improving youth-friendly services in ob-gyn clinics. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Birth control, population control, and family planning: an overview.

PubMed

Critchlow, D T

1995-01-01

This overview of the US birth control movement reflects on the emergence of family planning policy due to the efforts of Margaret Sanger, feminists, and the civil rights movement, the eugenics motive to limit "deviant" populations, and the population control movement, which aims to solve social and economic problems through fertility control. Population control moved through three stages: from the cause of "voluntary motherhood" to advance suffrage and women's political and social status, to the concept of "birth control" promoted by socialist feminists to help empower women and the working class, to, from 1920 on, a liberal movement for civil rights and population control. Physicians such as Dr. Robert Latou Dickinson legitimized the movement in the formation of the Committee on Maternal Health in 1925, but the movement remained divided until 1939, when Sanger's group merged with the American Birth Control League, the predecessor of the present Planned Parenthood Federation of America. A key legal decision in 1939 in the United States v. One Package amended the Comstock Act and allowed for the distribution of birth control devices by mail to physicians. Sanger, after a brief retirement, formed the International Planned Parenthood Federation and supported research into the pill. Eugenicists through the Committee on Maternal Health supported Christopher Tietze and others developing the pill. Final constitutional access to contraception based on the right to privacy was granted in Griswold v. Connecticut. The ruling in Eisenstadt v. Baird in 1972 extended this right to unmarried persons. The right to privacy was further extended in the Roe v. Wade decision in 1973 on legal abortion. The argument for improving the quality of the population remained from the formation of the Population Reference Bureau in 1929 through the 1960s. Under the leadership of Rockefeller, population control was defined as justified on a scientific and humanitarian basis. US government support

An invisible benefit: integrated project on family planning and parasite control has expanded operations multi-dimensionally.

PubMed

Taniguchi, H

1985-11-01

Resolutions adopted by the 12th Annual Asian Parasite Control/Family Planning (APCO/FP) Conference held in Colombo, Sri Lanka urge the incorporation of quality of life issues of all dimensions in projects of all participating countries. 1 study discussed during the conference concerned health volunteers of the integrated project in Sri Lanka, which analyzes motivating factors which make community young people work on a voluntary basis. Another topic covered was the role of women in the achievement of primary health care. Video reports were presented by Bangladesh on family planning and parasite control activities, Brazil on utilization of existing organizations to improve successful integrated projects, China on making twin concerns of family planning and primary health care, Indonesia on strengthening urban FP/MCH clinics, Korea on health promotion through the integrated project, Malaysia on the NADI program, the Philippines on the Cebu model of integrated health care, and Thailand on fee charging urban programs.

Advertising family planning in the press: direct response results from Bangladesh.

PubMed

Harvey, P D

1984-01-01

In 1977 and again in 1982, a series of couponed ads were run in three major Bangladeshi newspapers to test the relative effectiveness of different family planning themes. The ads offered a free booklet about methods of family planning (1977) or "detailed information on contraceptives" (1982) in the context of family health, the wife's happiness, the children's future, and family economics. The most effective ads, by a highly significant margin, were those stressing the importance of family economics (food and shelter) and the children's (sons') future. The least effective ads stressed the benefits of family planning for the wife.

The impact of a family planning multimedia campaign in Bamako, Mali.

PubMed

Kane, T T; Gueye, M; Speizer, I; Pacque-Margolis, S; Baron, D

1998-09-01

An integrated multimedia campaign featuring family planning messages saturated the 900,000-person city of Bamako, Mali, for three months during the spring of 1993. With traditional theater and music, family planning messages were repeatedly broadcast on radio and television that conveyed information about modern contraceptive methods, the need for male sexual responsibility, the health and economic advantages of family planning, the need for communication between spouses, and that Islam, the predominant faith of Mali, does not oppose family planning. A separate sample pretest-post-test quasi-experimental research design was used to evaluate the effects of the campaign and exposure to specific messages on changes in contraceptive knowledge, attitudes, and practice. Results indicate a high level of exposure to and agreement with the messages. A dramatic drop was found in the proportion of men and women who believe that Islam opposes family planning. Logistic regression results indicate that contraceptive knowledge and use and more favorable attitudes toward family planning are positively associated with intensity of exposure to the project interventions, after controlling for relevant variables.

Community forum. 1. Family planning. Palaces of advice.

PubMed

Bunting, J

1983-01-19

Completed questionnaires were collected from 130 respondents attending child health clinics (CHCs) in Corringham, Stanford, East Tilbury, and Billericay to investigate the source chosen by patients using CHCs for family planning information and materials, and why they made this choice. Criteria for inclusion were that all subjects were attending a CHC and by definition had at least 1 child; all subjects were female and of reproductive age; and all were at that time using some family planning method. 23 respondents indicated that they went to more than 1 source for advice. No respondents went to their midwife and only 4% sought the advice of their health visitor. Approximately equal proportions of respondents indicated that they went to their general practitioner and to family planning clinics, these 2 groups together forming 4/5 of all answers. 8% of respondents indicated they were dissatisfied with the advice given or obtained. 24 respondents (partners) used the condom, 56 oral contraceptives, 5 the IUD, 9 the diaphragm, 2 the condom and rhythm, 1 the condom and withdrawal, 1 withdrawal, and 2 partners had had a vasectomy. In the Essex statistics, in addition 5% were not using any method of contraception and 1% were using chemicals only. The most interesting variation between this study and the Essex Family Planning Center statistics are: almost twice as many study respondents use the condom and 3 times as many Essex clients as survey patients use the IUD. 1/5 expressed dissatisfaction with their method of contraception. Respondents obtained their supplies free in equal numbers from the Family Planning Center and family doctor, but 19% chose or were forced by circumstances to pay for their supplies. 73% reported no problems in getting supplies; 7% indicated problems and 20% did not respond to this question. Criticism can be divided into 3 categories: variation in cost of supplies between sources of service; clinic too far away; and occasionally an overnight wait

Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

PubMed Central

2010-01-01

Background To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. Methods The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. Results In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). Conclusions These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services. PMID:21062460

Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

PubMed

Qureshi, Asma M

2010-11-09

To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services.

Engaging Men in Family Planning: Perspectives From Married Men in Lomé, Togo.

PubMed

Koffi, Tekou B; Weidert, Karen; Ouro Bitasse, Erakalaza; Mensah, Marthe Adjoko E; Emina, Jacques; Mensah, Sheila; Bongiovanni, Annette; Prata, Ndola

2018-05-09

Family planning programs have made vast progress in many regions of sub-Saharan Africa in the last decade, but francophone West Africa is still lagging behind. More emphasis on male engagement might result in better outcomes, especially in countries with strong patriarchal societies. Few studies in francophone West Africa have examined attitudes of male involvement in family planning from the perspective of men themselves, yet this evidence is necessary for development of successful family planning projects that include men. This qualitative study, conducted in 2016, explored attitudes of 72 married men ages 18-54 through 6 focus groups in the capital of Togo, Lomé. Participants included professional workers as well as skilled and unskilled workers. Results indicate that men have specific views on family planning based on their knowledge and understanding of how and why women might use contraception. While some men did have reservations, both founded and not, there was an overwhelmingly positive response to discussing family planning and being engaged with related decisions and services. Four key findings from the analyses of focus group responses were: (1) socioeconomic motivations drive men's interest in family planning; (2) men strongly disapprove of unilateral decisions by women to use family planning; (3) misconceptions surrounding modern methods can hinder support for family planning; and (4) limited method choice for men, insufficient venues to receive services, and few messages that target men create barriers for male engagement in family planning. Future attempts to engage men in family planning programs should pay specific attention to men's concerns, misconceptions, and their roles in family decision making. Interventions should educate men on the socioeconomic and health benefits of family planning while explaining the possible side effects and dispelling myths. To help build trust and facilitate open communication, family planning programs that

Family Planning and Family Vision in Mothers after Diagnosis of a Child with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Navot, Noa; Jorgenson, Alicia Grattan; Vander Stoep, Ann; Toth, Karen; Webb, Sara Jane

2016-01-01

The diagnosis of a child with autism has short- and long-term impacts on family functioning. With early diagnosis, the diagnostic process is likely to co-occur with family planning decisions, yet little is known about how parents navigate this process. This study explores family planning decision making process among mothers of young children with…

Postpartum family planning: current evidence on successful interventions.

PubMed

Blazer, Cassandra; Prata, Ndola

2016-01-01

We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations.

The Impact of Desired Family Size Upon Family Planning Practices in Rural East Pakistan

ERIC Educational Resources Information Center

Mosena, Patricia Wimberley

1971-01-01

Results indicated that women whose desired family size is equal to or less than their actual family size have significantly greater frequencies practicing family planning than women whose desired size exceeds their actual size. (Author)

The United States commitment to international family planning and population programs.

PubMed

Piotrow, P T

1973-01-01

The U.S. government's policy towards birth control has changed from Eisenhower's opinion in 1959 that birth control was not the government's business to the present broad federal support allotted of family planning. The legistature was the main vehicle for mounting support of family planning with the approval of Presidents Kennedy, Johnson and Nixon. The Agency for International Development's budget for population activities in 1973 was $1,982,000,000 or 6.3% of its total foreign appropriations. Since family planning is an integral part of development, continued U.S. assistance in the field of population and family planning is necessary.

Men's knowledge and spousal communication about modern family planning methods in Ethiopia.

PubMed

Berhane, Adugnaw; Biadgilign, Sibhatu; Amberbir, Alemayehu; Morankar, Sudhakar; Berhane, Alemayehu; Deribe, Kebede

2011-12-01

This study attempted to determine knowledge, approval and communication about family planning methods among married men in Ethiopia. A cross-sectional study was conducted among a representative sample of 738 married males in Amhara Region. All 738 (100%) of the respondents had heard of family planning. About 558 (75.6%) mentioned the importance of using contraceptives for birth spacing and 457 (61.9%) to limit birth. Four hundred and forty-five (60.3%) of participants had ever discussed family planning with their wives. Thirty-three (33.0%) of the respondents reported that they were the sole decision makers in their families. About 597 (80.9%) approved the use of contraceptives. However, some participants did not discuss and approve family planning with their partner. This recalled an intensive effort has been taken by the concerned body to reach the country's targeted family planning coverage by involving men in reproductive health endeavor to enhance the discussion and agreement about family planning usage.

Women's experiences after Planned Parenthood's exclusion from a family planning program in Texas.

PubMed

Woo, C Junda; Alamgir, Hasanat; Potter, Joseph E

2016-04-01

We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006-2010 (NSFG). (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. Requiring low-income family planning patients to switch healthcare providers has adverse consequences. Copyright © 2016 Elsevier Inc. All rights reserved.

Family quality of life of Chinese families of children with intellectual disabilities.

PubMed

Hu, X; Wang, M; Fei, X

2012-01-01

The concepts of quality of life and family quality of life (FQOL) are increasingly being studied in the field of intellectual disabilities (ID) in China as important frameworks for: (1) assessing families' need for supports and services; (2) guiding organisational and service delivery system changes; and (3) evaluating quality family outcomes. The present study focused on exploring the perceptions of Chinese families who have a child with an ID regarding FQOL as well as examining the factor structure of FQOL concept from Chinese families. The Chinese version of the Family Quality of Life Scale was used to survey Chinese families living in the urban and suburban areas of Beijing who have a child with ID. A total of 442 families participated in this study. Confirmatory factor analysis was used to test the factor structure of FQOL. Multivariate analysis was also used to examine group differences among families in terms of family demographic variables. A five-factor structure of the FQOL construct was found in the Chinese sample, suggesting a similar factor structure found from US families in the literature. Different living conditions (e.g. housing and transportation) tended to affect significantly families' satisfaction ratings of their FQOL. It is also found that family income and severity of disability of the child are predictors of families' satisfaction ratings of FQOL. The preliminary findings of this study suggest a cross-cultural factor structure comparability of FQOL between samples in the USA and China. Results call for further examination of the family-centred service and support as a mediator on the interactive relationship between family characteristics, family needs and FQOL outcomes. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews

PubMed Central

Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

2017-01-01

Purpose Despite a general understanding that exit interviews being conducted at service providers’ facilities may influence clients’ responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients’ perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. Methods A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels – nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Results Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients’ responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Conclusion Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings. PMID:29760573

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China

PubMed Central

Richards, Esther; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers’ perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces—Zhejiang, Hubei and Yunnan—were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China.

PubMed

Jiang, Hong; Xu, Jieshuang; Richards, Esther; Qian, Xu; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable

Parental Stress, Family-Professional Partnerships, and Family Quality of Life: Families of Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hsiao, Yun-Ju

2013-01-01

The purpose of this study was to investigate the relationship among the quality of life of families that have at least one child with autism spectrum disorder, parental stress level, and partnerships between the family and professionals. Also, parent perceptions of parental stress, family quality of life, and family-professional partnerships were…

Knowledge of family planning methods in Bangladesh, 1969-1979: trends and implications.

PubMed

Amin, R; Mariam, A G

1986-12-01

The changes in levels of knowledge about different contraceptive methods in Bangladesh between 1969-79 were assessed. 2 surveys provided the data: the 1969 National Impact Survey (NIS) of family planning and the 1979 Contraceptive Prevalence Survey (CPS) from Bangladesh. Both surveys were nationally representative and retrospective, containing detailed questions of pregnancy histories, socioeconomic background, family planning knowledge and attitude, and contraceptive practices. The sampling frames for both surveys consisted of all households in Bangladesh from which national probability samples of married women between the ages of 10-50 were selected and stratified by urban-rural residence. Unprompted data were analyzed. Apparently, the National Family Planning Program (NFPP) was successful in communicating general knowledge of family planning among the masses in Bangladesh. In terms of absolute level, the increase in general knowledge of family planning was from 46.3% in 1969 to 82.8% in 1979. With the exception of the oral contraceptive (OC), absolute increase in knowledge of specific family planning methods or a variety of methods was far less than that of general knowledge of family planning. Knowledge of condoms, female sterilization, and male sterilization increased between 1969-79, yet in terms of absolute levels these increases were far less than those of either general knowledge of family planning or knowledge of OCs. The percentages of couples reporting knowledge of the IUD, vaginal methods, rhythm, injection, or induced abortion either decreased or slightly increased between 1969-79. Nearly 40% of couples had knowledge of only 1 method; fewer couples knew of 2 or more methods. There were relative increases in the knowledge of OCs and female sterilization, an 8-fold increase in knowledge of the OC and a 6-fold increase in knowledge of female sterilization between 1969-79. Respondents from the urban areas or those who attended schools were more likely to

Malaysia family-planning centers strive to maintain gains won in 15-year period.

PubMed

Roemer, R

1968-09-12

Family planning in Malaysia is discussed. Family planning began in Malaysia about 15 years ago through the efforts of voluntary family Planning Associations in the various Malay states. In 1966 the Malaysian Parliament passed the National Family Planning Act setting up the National FAmily Planning Board to formulate policies and methods for the promotion and spread of family planning knowledge and practice on the grounds of health of mothers and children and welfare of the family. In 1967, the board set a target of 40,000 new acceptors of family planning and 90% of the target was reached. This represents 3% of the child-bearing married women aged 15-49. The target for 1968 of 65,000 new acceptors is being achieved. A survey of acceptors is to be carried out from December 1968 to April 1969 to ascertain how many women who accepted family planning continue to practice it. Malaysia's crude birth rate declined from 46.2 in 1957 to 37.3 in 1966 before the government program was instituted. Abortion attempts have been frequent. The main method of contraception used is oral contraceptives. According to a 1957 survey, 31% of the married women in the metropolitan areas and 2% of rural women were using contraception. Presently, in Malaysia there is a need to: 1) train personnel to provide services, 2) inform and motivate families to accept family planning, 3) continue a broad educational program, 4) reform Malaysia's antiquated abortion law, and 5) integrate family planning services more fully into the general health services of the country.

Access to mass media messages, and use of family planning in Nigeria: a spatio-demographic analysis from the 2013 DHS.

PubMed

Ajaero, Chukwuedozie K; Odimegwu, Clifford; Ajaero, Ijeoma D; Nwachukwu, Chidiebere A

2016-05-24

higher socioeconomic status and those from the Southern part of the country make more use of family planning. There is need to improve the socioeconomic status of the populations. Also, the quality and regularity of mass media messages should be improved, while other communication avenues such as traditional institutions, blogs, and seminars for youths should be used to make family planning messages more acceptable.

Family Planning and the Burden of Unintended Pregnancies

PubMed Central

Tsui, Amy O.; McDonald-Mosley, Raegan; Burke, Anne E.

2010-01-01

Family planning is hailed as one of the great public health achievements of the last century, and worldwide acceptance has risen to three-fifths of exposed couples. In many countries, however, uptake of modern contraception is constrained by limited access and weak service delivery, and the burden of unintended pregnancy is still large. This review focuses on family planning's efficacy in preventing unintended pregnancies and their health burden. The authors first describe an epidemiologic framework for reproductive behavior and pregnancy intendedness and use it to guide the review of 21 recent, individual-level studies of pregnancy intentions, health outcomes, and contraception. They then review population-level studies of family planning's relation to reproductive, maternal, and newborn health benefits. Family planning is documented to prevent mother-child transmission of human immunodeficiency virus, contribute to birth spacing, lower infant mortality risk, and reduce the number of abortions, especially unsafe ones. It is also shown to significantly lower maternal mortality and maternal morbidity associated with unintended pregnancy. Still, a new generation of research is needed to investigate the modest correlation between unintended pregnancy and contraceptive use rates to derive the full health benefits of a proven and cost-effective reproductive technology. PMID:20570955

Family planning and development.

PubMed

Barnett, B

1994-08-01

Women in many countries are of only very low social standing with limited control over resources and the circumstances in which they live. Levels of infant and child mortality are also very high in many areas of the world. In the attempt to rear progeny which survive into adulthood, these women bear many children. Children are a source of labor and power who can gather fuel, cook, fetch water, perform other chores, and ultimately provide security for elderly parents. Were rates of infant and child mortality to decline and women to have more opportunity to earn livelihoods on their own, however, they would not need to bear quite so many children. Levels of fertility would decline in keeping with the goals of family planning programs around the world. The direct relationship between women's poverty, women's lack of autonomy, and high fertility requires one to address the complete range of women's reproductive needs instead of focusing narrowly upon the distribution of contraceptives. To that end, some family planning and economic development programs have merged to provide contraceptive services which are linked with broader efforts to improve health, education, and employment. Program experiences are discussed.

Family Quality of Life of Chinese Families of Children with Intellectual Disabilities

ERIC Educational Resources Information Center

Hu, X.; Wang, M.; Fei, X.

2012-01-01

Background: The concepts of quality of life and family quality of life (FQOL) are increasingly being studied in the field of intellectual disabilities (ID) in China as important frameworks for: (1) assessing families' need for supports and services; (2) guiding organisational and service delivery system changes; and (3) evaluating quality family…

Smart patient, smart community: improving client participation in family planning consultations through a community education and mass-media program in Indonesia.

PubMed

Kim, Young Mi; Bazant, Eva; Storey, J Douglas

In health care consultations, patients often receive insufficient information from providers and communicate little with providers about their needs or concerns. This study evaluated a combined community education and mass media intervention to improve clients' participation in family planning consultations. A household survey was conducted with 1,200 women in three sub-districts (two intervention and one control) of West Java province in Indonesia. A comparison of post-campaign findings among family planning clients suggests that the intervention as a whole had a positive effect on client participation, specifically the number of clients who prepared questions to ask the service provider prior to a family planning visit in the past year. Multivariate analyses showed that the "Smart Card" intervention and elements of the "Sahabat" (Friend) mass media campaign were positively associated with clients' preparation of questions and question asking behavior during family planning consultations, indicating that a combined community education and mass-media approach can improve client communication with providers and improve the quality of family planning counseling.

Family Planning and Integration. IPPF Bibliography Series. November 1978.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This document is a bibliography of materials that present family planning in comprehensive programs for the alleviation of poverty and deprivation. It contains 141 entries. Some of the items describe projects or approaches in which family planning is combined with a single function such as midwifery. The other entries cover programs of varying…

WOMEN’S EMPOWERMENT AND FAMILY PLANNING: A REVIEW OF THE LITERATURE

PubMed Central

PRATA, NDOLA; FRASER, ASHLEY; HUCHKO, MEGAN J.; GIPSON, JESSICA D.; WITHERS, MELLISSA; LEWIS, SHAYNA; CIARALDI, ERICA J.; UPADHYAY, USHMA D.

2017-01-01

Summary This paper reviews the literature examining the relationship between women’s empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web of Science search engines in May 2013 to examine literature published between January 1990 and December 2012. Among the 46 articles included in the review, the majority were conducted in South Asia (n = 24). Household decision-making (n = 21) and mobility (n = 17) were the most commonly examined domains of women’s empowerment. Findings show that the relationship between empowerment and family planning is complex, with mixed positive and null associations. Consistently positive associations between empowerment and family planning outcomes were found for most family planning outcomes but those investigations represented fewer than two-fifths of the analyses. Current use of contraception was the most commonly studied family planning outcome, examined in more than half the analyses, but reviewed articles showed inconsistent findings. This review provides the first critical synthesis of the literature and assesses existing evidence between women’s empowerment and family planning use. PMID:28069078

Dr. Haryono Suyono, National Family Planning Coordinating Board, Indonesia.

PubMed

1986-11-01

The goal of the Indonesian family planning program has been to institutionalize both the concept and the norm of a small, happy and prosperous family in a manner that is acceptable to all. To this end, a larger role for the private sector in family planning (FP) has been promoted. While the government program has been very effective in the villages, it was not as effective in the urban areas where there are more diverse populations. Several meetings were held to develop a strategy for FP programs in the urban areas involving both the nongovernment organizations (NGOs) and commercial enterprises. It was agreed that several model programs would be developed through the NGOs with funds coming from both international health organizations and the National Family Planning Coordinating Board. It was hoped that the NGOs would develop into self-sufficient organizations. 1 urban activity that has just started is a specially designed social marketing project aimed at increasing the involvement and commitment of males through a condom distribution scheme. Another promising development is the shifting of the management and implementation of FP programs from the government to the community itself. A primary emphasis is to activate the private sector to expand its role in providing FP information and services. The overall strategy is to create a climate that will make it easier for people to increase their role in family planning service delivery and acceptance through mobilization of resources, funds, facilities and infrastructure so that acceptors will gradually pay for family planning services by themselves according to their needs.

Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysis.

PubMed

Barden-O'Fallon, Janine

2017-05-08

Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. Results show that FBOs are less likely to offer FP services than other managing authorities (p < 0.05). For example, 69% of FBOs in Kenya offer FP services compared to 97% of public facilities and 83% of other private facilities. Offering long-acting or permanent methods in faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). Results from this analysis indicate that there is room for improvement in

Family Quality of Life of South African Families Raising Children with Autism Spectrum Disorder.

PubMed

Schlebusch, Liezl; Dada, Shakila; Samuels, Alecia E

2017-07-01

This article describes the family quality of life among families who are raising a young child with autism spectrum disorder. Survey research was conducted with 180 families of children with autism spectrum disorder who were receiving disability-related services in the Gauteng province of South Africa. The principle measure used was the Beach Center Family Quality of Life Scale to assess five subdomains: family interaction, parenting, emotional well-being, material/physical well-being, and disability-related support. Results indicated that families felt the most satisfied with disability-related support and the least satisfied with the family's emotional well-being. Family income, family type, and the severity level of autism were significantly associated with how satisfied families felt about their quality of life.

Family planning choice behaviour in urban slums of Bangladesh: an econometric approach.

PubMed

Barkat, A; Rahman, M U; Bose, M L

1997-03-01

Bangladesh's urban population is projected to account for 26% of the country's total population by the year 2000 and 37% by 2015. A 1991 Bangladesh census report found that about 21 million of the total 111.5 million population were living in urban areas. 1551 currently-married women of reproductive age in 1551 households sampled from a representative sample of 91 slums in the metropolitan areas of Dhaka, Chittagong, and Khulna participated in a study of family planning behavior choice. 673 of the women were practicing family planning. The authors describe the construction of the econometric model used for analysis. Economic status as indicated by household income was found to considerably influence people's decisions concerning family planning practices. Higher women's educational status is also positively correlated with family planning practice. Husband's educational status has a less significant effect upon family planning practice. The change of a person from non-Muslim to Muslim has an insignificant, though positive, impact upon family planning practice. The more a woman feels empowered, being over age 19 years, the greater the number of living children, and the lower the level of preference for sons, the more likely a woman is to practice family planning.

[Family planning status and dissemination of contraceptive methods in urban slum areas].

PubMed

Cho, K S

1976-04-01

In May 1974 the Korean Government adopted an urban slum family planning project. The Korean Institute for Family Planning conducted a survey of 414 married women aged 20-44 in Jeonnam province, Yeo soo city. 85% of the women had heard or seen the term "family planning" before, and health centers and family planning fieldworkers ranked high (47%) as sources. 76.6% approved of the concept of family planning, and 79% indicated they agreed with the slogan "Daughter-son, without distinction: stop at 2 and raise them well." 50.5% of the women said they decided to practice contraception; of those currently practicing (25.8%) 37.4% were using the loop and 29% were taking the pill. 65% of the 414 respondents reported that they were born in rural areas, and 53.4% said they belonged to the lower class. 14% had never attended a family planning meeting, and 71% had never received any family planning materials. More than 1/2 of the women were under age 34, and their ideal number of children was 3.4. The average number of living children was 3.2, but a considerable proportion wanted no additional children.

Rural development and family planning behavior in Bangladesh Villages.

PubMed

Alauddin, M

1979-01-01

Variarion in knowledge and usage of contraceptive methods was examined across Bangladesh villages. It was hypothesized that the variation can be explained by 3 sets of factors measured at the village level: development programs, family planning program efforts, and given environmental and socioeconomic conditions. The data were drawn from the Bangladesh Fertility Survey and the 1974 Bangladesh Population Census. The 3 sets of factors taken together explained a greater proportion of the variance in knowledge and contraceptive usage than each of the sets taken either singly or in paired combination. Knowledge of clinical contraceptive methods was found to be affected more by development programs than by either family planning or environmental and socioeconomic conditions. Despite the fact that both development and family planning variables have independent and about equal effects on ever use of contraception, each of them separately is not likely to produce as much contraceptive usage as would both of them jointly. In terms of policy, if both development and family planning programs are provided to the villages, the effect on fertility may be maximized.

Reproductive health/family planning and the health of infants, girls and women.

PubMed

Sadik, N

1997-01-01

The 1994 International Conference on Population and Development developed international consensus amongst health providers, policy makers, and group representing the whole of civil society regarding the concept of reproductive health and its definition. In line with this definition, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. Reproductive health care saves lives and prevents significant levels of morbidity through family planning programmes, antenatal, delivery and post-natal services, prevention and management programmes for reproductive tract infections (including sexually transmitted diseases and HIV/AIDS), prevention of abortion and management of its complications, cancers of the reproductive system, and harmful practices that impact on reproductive function. Reproductive health care needs are evident at all stages of the life cycle and account for a greater proportion of disability adjusted life years (DALYS) in girls and women than in boys and men. Reproductive health protects infant health by enabling birth spacing and birth limitation to be practiced through family planning. The prevention and early detection of reproductive tract infections, including sexually transmitted diseases and HIV, through the integration of preventive measures in family planning service delivery not only improves the quality of care provided but is also directly responsible for improvement in survival and health of infants. Addressing harmful practices such as son preference, sex selection, sexual violence and female genital mutilation complements the positive impact of planned and spaced children through family planning services on infant mortality and the reproductive health of young girls and women. They are also in addition to prenatal, delivery and postnatal services, positive determinants of low maternal mortality and

[The pharmacist should play an active role in family planning].

PubMed

Portes, M

1983-01-01

Although pharmacies now dispense primarily modern products originating in large multinational corporations, the community pharmacist has not been replaced by any ultramodern technological advance. Many thousand persons acquire family planning products in pharmacies. The pharmacist works many hours a day, is always available, and provides free advice to his clients. Pharmacists are consulted daily on numerous topics, especially on family planning. Many prsons in rural areas are without the services of a physician and rely on pharmacists all the more. Pharmacists could orient the public on family planning in general, help in choosing the most appropriate of available methods, and refer patients to physicians in case of problems. Participants at the recent International Conference on the Role of Retail Pharmacists in Family Planning, held in Alexandria, Egypt, concluded that pharmacists should cooperate with physicians and other health professionals to provide family planning services and should participate in elaboration of laws regulating the manufacture, storage, prices, and distribution of contraceptives. The prices of contraceptive supplies to the consumer could be reduced if taxes and import duties were removed, if supplies were produced locally, or if supplies were subsidized by some donor organization.

Core competency model for the family planning public health nurse.

PubMed

Hewitt, Caroline M; Roye, Carol; Gebbie, Kristine M

2014-01-01

A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance. © 2014 Wiley Periodicals, Inc.

Development and Validation of a Gender Ideology Scale for Family Planning Services in Rural China

PubMed Central

Yang, Xueyan; Li, Shuzhuo; Feldman, Marcus W.

2013-01-01

The objectives of this study are to develop a scale of gender role ideology appropriate for assessing Quality of Care in family planning services for rural China. Literature review, focus-group discussions and in-depth interviews with service providers and clients from two counties in eastern and western China, as well as experts’ assessments, were used to develop a scale for family planning services. Psychometric methodologies were applied to samples of 601 service clients and 541 service providers from a survey in a district in central China to validate its internal consistency, reliability, and construct validity with realistic and strategic dimensions. This scale is found to be reliable and valid, and has prospects for application both academically and practically in the field. PMID:23573222

Air Quality Implementation Plans

EPA Pesticide Factsheets

States must develop plans to attain and maintain air quality standards. These plans, known as SIPs, are submitted to EPA for approval. This web site contains information about this process and the current status of the submittals.

Law and family planning.

PubMed

Kirby, M D

1984-03-17

This discussion of law and family planning reviews some recent reports of the Australain Law Reform Commission (ALRC), the law as it affects family planning and the sexuality of young people with reference to the Irish dilemma, the law's approach in Ingland, Canada, and the US. The ALRC works only on references recived by it from the Federal Attorney General. No reference so far received has been specific to the issues of family planning, but some past and present projects are partly relevant. The most recent report of the ALRC, tabled in Federal Parliament in December 1983 related to privacy protection. An issue that arose in this inquiry related to the subject of the rights to privacy of young people. In a discussion paper the ALRC had suggestd that young persons between the ages of 12-16 should have certain defined legal protection of privacy, even against their parents. Specifically, the ALRC was thinking of medical advice and school counseling. Obviously the issue of contraceptive advice was raised in this context, and never has a tenative proposal of the ALRC engendered so much bitter criticism. The Commission modified its proposal on this topic and the details of the revised proposals are disclosed in its report. Clearly, the rights of young people in regard to sexual advice, education, and treatment are matters of great controversy and strongly divided community opinion. In Australia there are some who are totally opposed to family planning for themselves, their children, and even for others. Such opposition exists in the medical profession. Presumably, such people base their views on strongly held moral principles. They generally believe that contraception interferes in the ways of nature. Far from being promoted by open discussion and instruction in the schools, such matters are intimate concerns of a small circle, principally the family. In dealing with those aspects that concern the rights of parents in thes matters, attention turns to England's Gillick

Comparison of family planning in Cuba and Ireland.

PubMed

Smyth, Suzie; Stronge, Shirley

2015-08-26

Family planning gives individuals and couples control and choice over the number of children they have and the timing of their births. Developments in reproductive health have resulted in major changes in the options for family planning, providing more choice and control over fertility. This article explores reproductive health in the Republic of Cuba and the Republic of Ireland, with a focus on contraceptive use and termination of pregnancy as methods of family planning. The predominant religion in both countries is Catholicism, which promotes the right to life of the unborn child. The two countries have adopted different approaches to the availability of both contraception and termination of pregnancy. Cuba has offered free access to contraception and termination of pregnancy since the 1960s to reduce maternal mortality. In Ireland, contraception was not widely available until 1995 and termination of pregnancy is available only in extremely limited circumstances.

Factors determining family planning in Catalonia. Sources of inequity

PubMed Central

2012-01-01

Introduction In recent decades, the foreign population in Spain has increased significantly, particularly for Catalonia, an autonomous region of Spain (2.90% in 2000 and 15.95% in 2010) and in particular Girona province (6.18% in 2000 and 21.55% in 2010). Several studies have shown a lower use of family planning methods by immigrants. This same trend is observed in Spain. The objective of this paper is to determine the existence of differences and possible sources of inequity in the use of family planning methods among health service users in Catalonia (Spain) by sex, health status, place of birth and socioeconomic conditions. Methods Data were taken from an ad-hoc questionnaire which was compiled following a qualitative stage of individual interviews. Said questionnaire was administered to 1094 Catalan public health service users during 2007. A complete descriptive analysis was carried out for variables related to public health service users’ sociodemographic characteristics and variables indicating knowledge and use of family planning methods, and bivariate relationships were analysed by means of chi-square contrasts. Considering the use (or non-use) of family planning methods as a dependent variable and a set of demographic, socioeconomic and health status variables as explanatory factors, the relationship was modelled using mixed models. Results The analysed sample is comprised of 54.3% women and 45.7% men, with 74.3% natives (or from the EU) and 25.7% economic immigrants. 54.8% use some method of family planning, the condom (46.7%) and the pill (28.0%) being the two most frequently used methods. Statistical modelling indicates that those factors which most influence the use of family planning methods are level of education (30.59% and 39.29% more likelihood) and having children over 14 (35.35% more likelihood). With regard to the origin of the user, we observe that patients from North Africa,sub. Saharan Africa and Asia are less likely to use family planning

Factors determining family planning in Catalonia. Sources of inequity.

PubMed

Saurina, Carme; Vall-Llosera, Laura; Saez, Marc

2012-07-20

In recent decades, the foreign population in Spain has increased significantly, particularly for Catalonia, an autonomous region of Spain (2.90% in 2000 and 15.95% in 2010) and in particular Girona province (6.18% in 2000 and 21.55% in 2010). Several studies have shown a lower use of family planning methods by immigrants. This same trend is observed in Spain. The objective of this paper is to determine the existence of differences and possible sources of inequity in the use of family planning methods among health service users in Catalonia (Spain) by sex, health status, place of birth and socioeconomic conditions. Data were taken from an ad-hoc questionnaire which was compiled following a qualitative stage of individual interviews. Said questionnaire was administered to 1094 Catalan public health service users during 2007. A complete descriptive analysis was carried out for variables related to public health service users' sociodemographic characteristics and variables indicating knowledge and use of family planning methods, and bivariate relationships were analysed by means of chi-square contrasts. Considering the use (or non-use) of family planning methods as a dependent variable and a set of demographic, socioeconomic and health status variables as explanatory factors, the relationship was modelled using mixed models. The analysed sample is comprised of 54.3% women and 45.7% men, with 74.3% natives (or from the EU) and 25.7% economic immigrants. 54.8% use some method of family planning, the condom (46.7%) and the pill (28.0%) being the two most frequently used methods. Statistical modelling indicates that those factors which most influence the use of family planning methods are level of education (30.59% and 39.29% more likelihood) and having children over 14 (35.35% more likelihood). With regard to the origin of the user, we observe that patients from North Africa,sub. Saharan Africa and Asia are less likely to use family planning methods (36.68%, 38.59% and 70

The Work-Family Interface and Sleep Quality.

PubMed

Magee, Christopher A; Robinson, Laura D; McGregor, Alisha

2017-01-18

This article investigated whether work-to-family conflict (WFC) and work-to-family enrichment (WFE) were associated with employee sleep quality. WFC and WFE reflect the potential for experiences at work to negatively and positively influence nonworking life respectively, and may have implications for sleep quality. In this article, we examined whether WFC and WFE were linked with sleep quality via hedonic balance (i.e., positive affect relative to negative affect). The sample included 3,170 employed Australian parents involved in the Household Income and Labour Dynamics in Australia (HILDA) Survey. Information on WFC, WFE, hedonic balance, sleep quality, and relevant covariates was collected through a structured interview and self-completion questionnaire. WFC was associated with poorer sleep quality (β = .27, p < .001), and this relationship was stronger in males than females and in dual parent-single income families. WFC was also found to be indirectly associated with poor sleep quality via a lower hedonic balance (β = .17, 99% confidence interval [.14, .20]). WFE was not directly associated with sleep quality, but was indirectly associated with better sleep quality via a higher hedonic balance (β = -.04 [-.07, -.02]). These results indicate that aspects of the work-family interface are associated with employee sleep quality. Furthermore, affective experiences were found to link WFC and WFE with sleep quality. Workplace interventions that target WFC and WFE may have implications for employee sleep.

Do consumer reports of health plan quality affect health plan selection?

PubMed Central

Spranca, M; Kanouse, D E; Elliott, M; Short, P F; Farley, D O; Hays, R D

2000-01-01

OBJECTIVE: To learn whether consumer reports of health plan quality can affect health plan selection. DATA SOURCES: A sample of 311 privately insured adults from Los Angeles County. STUDY DESIGN: The design was a fractional factorial experiment. Consumers reviewed materials on four hypothetical health plans and selected one. The health plans varied as to cost, coverage, type of plan, ability to keep one's doctor, and quality, as measured by the Consumer Assessment of Health Plans Study (CAHPS) survey. DATA ANALYSIS: We used multinomial logistic regression to model each consumer's choice among health plans. PRINCIPAL FINDINGS: In the absence of CAHPS information, 86 percent of consumers preferred plans that covered more services, even though they cost more. When CAHPS information was provided, consumers shifted to less expensive plans covering fewer services if CAHPS ratings identified those plans as higher quality (59 percent of consumers preferred plans covering more services). Consumer choices were unaffected when CAHPS ratings identified the more expensive plans covering more services as higher quality (89 percent of consumers preferred plans covering more services). CONCLUSIONS: This study establishes that, under certain realistic conditions, CAHPS ratings could affect consumer selection of health plans and ultimately contain costs. Other studies are needed to learn how to enhance exposure and use of CAHPS information in the real world as well as to identify other conditions in which CAHPS ratings could make a difference. PMID:11130805

Family Planning Legislation. Report on a Survey. EURO Reports and Studies 85.

ERIC Educational Resources Information Center

Swartz, Barbara

This study reviews and analyzes family planning legislation in seven countries of the Mediterranean region: Greece, Italy, Morocco, Portugal, Spain, Tunisia, and Turkey. Part 1, a general review, specifically focuses on the role of religion in the development of family planning programs, laws with an indirect effect on family planning (minumum age…

7 CFR 634.23 - Water quality plan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 6 2012-01-01 2012-01-01 false Water quality plan. 634.23 Section 634.23 Agriculture... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.23 Water quality plan. (a) The participant's water quality plan, developed with technical assistance by the NRCS or its...

7 CFR 634.23 - Water quality plan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 6 2014-01-01 2014-01-01 false Water quality plan. 634.23 Section 634.23 Agriculture... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.23 Water quality plan. (a) The participant's water quality plan, developed with technical assistance by the NRCS or its...

7 CFR 634.23 - Water quality plan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 6 2013-01-01 2013-01-01 false Water quality plan. 634.23 Section 634.23 Agriculture... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.23 Water quality plan. (a) The participant's water quality plan, developed with technical assistance by the NRCS or its...

Promoting family planning through women's development.

PubMed

Gulhati, K

1986-12-01

Private initiatives in developing countries have been successful in increasing women's desire for family planning by enabling them to earn more income. These approaches have incorporated a woman-to-woman strategy in which women train others not only in how to earn an income from producing and marketing products, but also in the skills needed to establish and manage their own organizations. Private voluntary organizations play an especially crucial role in training project managers. The Center for Development and Population Activities, for example, has held 19 Women in Management workshops and channels funds and technical assistance for projects in health, family planning, nutrition, and income generation. Women who move from managerial to policymaking positions are most able to help other women raise their political, social, and economic status.

Women’s Experiences Seeking Publicly Funded Family Planning Services in Texas

PubMed Central

Hopkins, Kristine; White, Kari; Linkin, Fran; Hubert, Celia; Grossman, Daniel; Potter, Joseph E.

2015-01-01

CONTEXT Little is known about low-income women’s and teenagers’ experiences accessing publicly funded family planning services, particularly after policy changes are made that affect the cost of and access to such services. METHODS Eleven focus groups were conducted with 92 adult women and 15 teenagers in nine Texas metropolitan areas in July–October 2012, a year after legislation that reduced access to subsidized family planning was enacted. Participants were recruited through organizations that serve low-income populations. At least two researchers independently coded the transcripts of the discussions and identified main themes. RESULTS Although most women were not aware of the legislative changes, they reported that in the past year, they had had to pay more for previously free or low-cost services, use less effective contraceptive methods or forgo care. They also indicated that accessing affordable family planning services had long been difficult, that applying and qualifying for programs was a challenge and that obtaining family planning care was harder than obtaining pregnancy-related care. As a result of an inadequate reproductive health safety net, women experienced unplanned pregnancies and were unable to access screening services and follow-up care. Teenagers experienced an additional barrier, the need to obtain parental consent. Some women preferred to receive family planning services from specialized providers, while others preferred more comprehensive care. CONCLUSION Women in Texas have long faced challenges in obtaining subsidized family planning services. Legislation that reduced access to family planning services for low-income women and teenagers appears to have added to those challenges. PMID:25639913

Family planning and married fulfillment.

PubMed

Burke, C

1989-01-01

Large numbers of children typified the Catholic family until the 60s when there was a general societal change towards smaller families. This change, which even affected Catholics, is thought to derive from 3 sources. The population explosion and its complimentary disadvantages, a change towards more egocentric values, and an increase in the importance of material values. The Western world is aging fast and fertility rates are falling to the point that an overall effect of population reduction is occurring. Children have become only an optional, instead of necessary as in previous generations, part of most couples' lifestyles in West. Careers, social status, gadgets, vacations, ease, and comfort are now commonly seen as more self- fulfilling than children. The Catholic church believes that the only reasons for family planning are natural methods used out of necessity. Vatican II clearly states that the purpose of marriage is the raising of children. It has become the opinion of many that marriage and children are only accidentally connected and that the 2 are not bound inseparably. It is the authors contention that this dualistic view of marriage and children is false. The author feels that through a marriage people can draw each other out of themselves and towards their children. Sacrificing oneself for one's children is the natural end to marriage. The author admits that family planning has been a great good to the world for the couples that need it to survive, but that couples that can have children should do so.

Policy guidelines for collective bargaining and family planning.

PubMed

Finnigan, O D; Parulan, D

1973-01-01

The benfits of establishing family planning through collective bargaining to both labor and management are discussed. Until workers can be convinced that their children will receive health care, education and employment, and that they will be economically secure in old age, it is difficult to convince them of the many benefits of child spacing and small family size. In 1953, it was calculated by management in a Japanese steel factory that about 70% of all acidents could be attributable to difficulties in the private lives of employees. In order to ease problems in the home, collective agreements were initiated by management in the Nippon Express Company to provide family planning services. Labor agreed as long as the workers were to share in the economic awards which came from participation. Costs of implementing the family planning programs were fully offset by the decrease in expenditure on family allowances, confinement, nursing, and so on. In India some ten estates began a program in which a certain amount of money is paid into an account for every month that a woman does not become pregnant. If the woman becomes pregnant, she forfeits a substantial amount of the fund. This money comes directly from the funds which would normally have to be set aside to provide for maternity and child support programs. Certain guidelines are presented in the paper to outline the areas of responsibility of labor and management in the provision of family planning services. Among the many possibilities mentioned is the idea that both labor and management could look into the conceivability of plowing back a portion of whatever savings are accrued by management into a pension scheme to compensate workers for the loss of labor caused by having fewer children than were previously anticipated.

Why some family planning program fail.

PubMed

1976-04-01

40 experts representing Nepal, Malaysia, Thailand, Singapore, Korea, and the Philippines participated in a 3-day workshop in Manila in March 1976 for the purpose of discussing and proposing ways of dealing with the financial problems confronting the population programs of the individual countries. The Inter-Governmental Coordinating Committee for Southeast Asia Family/Population Planning sponsored the workshop. The recommendations made at the meeting were: 1) standardization of financing reporting procedures by the region's country programs on family planning; 2) closer coordination between donor agencies and policy-making bodies of country programs in the disbursement of funds; 3) frequent exchanges of experiences, ideas, technicaL knowledge, and other matters pertaining to the financial management of such programs; and 4) inclusion of applicable financial management topics in the training of clinical staffs and those involved in follow-up operations. Additionally, a proposal was made that national population organizations or committees develop research and evaluation units. Workshop discussion sessions focused on financial planning and management, accounting and disbursement of funds, use and control of foreign aid, cost of effectiveness and benefit analysis, and financial reporting.

Factors affecting public dissatisfaction with urban family physician plan: A general population based study in Fars Province.

PubMed

Imanieh, Mohammad Hadi; Mirahmadizadeh, Alireza; Imani, Bahareh

2017-11-01

Understanding the level of public satisfaction with a family physician plan as well as the relevant factors in this respect, can be employed as valuable tools in identifying quality of services. To determine the factors affecting public dissatisfaction with an urban family physician plan in Iran. This cross-sectional study was conducted from January 2014 through June 2015 on Fars Province residents in Iran, selected based on cluster sampling method. The data collection instrument was comprised of a two-part checklist including demographic information and items related to dissatisfaction with the family physician plan, specialists, para-clinic services, pharmacy, physicians on shift work, emergency services, and family physician assistants. Data were described by SPSS 20. In this study, 1,020 individuals (524 males, 496 females) were investigated. Based on the results, the most frequent factor affecting dissatisfaction with physicians was their single work shifts and unavailability (53%). In terms of dissatisfaction with family physicians' specialist colleagues and para-clinic services, the most common factors were related to difficulty in obtaining a referral form (41.5%) and making appointments (21.6%), respectively. Given the level of dissatisfaction with pharmacies, the significant factor was reported to be excessive delay in medication delivery (31.6%); and in terms of physicians on shift work and emergency services, the most important factor was lower work hours for family physicians (9.2%). It seems that, the most common causes of dissatisfaction with the urban family physician plan are due to the short duration of services, obtaining a referral form and making appointments, and providing prescribed medications.

[Family and career planning in young physicians].

PubMed

Buddeberg-Fischer, Barbara; Stamm, Martina; Klaghofer, Richard

2008-01-01

The study investigates in what way physicians integrate their desire to have children into their career planning. Within the framework of a prospective cohort study of Swiss medical school graduates on career development of young physicians, beginning in 2001, 534 participants (285 women, 249 men) were assessed in January 2007, in terms of having children, planning to have children, the career aspired to and the work-family balance used or planned. Among the study participants, 19% (54) of the women and 24% (59) of the men have children. Of the others 88% plan to start a family in the future. Female physicians with children are less advanced in their careers than women without children; for male physicians no such difference can be observed. Of the female physicians with children or the desire for children 42% aspire to work in a practice, 28% to a clinical and only 4% to an academic career. Of the male physicians with children or the desire for children one third aspire to work in a practice, one third to a clinical and 14% to an academic career. The preferred model of work repartition of female physicians with children is father full time/mother part time or both parents part time; the preferred model of male physicians is father full time/mother part time or not working. Children are an important factor in the career and life planning of physicians, female physicians paying more attention to an even work-family balance than male physicians. Copyright 2008 S. Karger AG, Basel.

30 CFR 28.31 - Quality control plans; contents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Quality control plans; contents. 28.31 Section... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.31 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the management of quality, including: (1...

Estimating family planning program effects on U.S. fertility rates.

PubMed

Cutright, P; Jaffe, F S

1977-08-01

An evaluation was undertaken of the effects on U. S. fertility rates of the national family planning program. 1968-1969 family planning enrollment data were linked to 1970 census data in the same areas to derive an objective measure of the impact of organized clinical family planning programs on the 1969-70 fertility rates of subgroups of women defined by age, race, marital status, economic status, and racial composition of their area. Multivariate modelling was used to control for spurious effects of irrelevant variables. Results of the multivariate modelling show significant reductions of marital fertility among the low socioeconomic groups served by the program; no effects were exhibited by groups not served. Cumulative fertility of all groups, black and white, at all age and socioeconomic levels was affected by the program. A plausible explanation for these results lies in antecedent factors which led to the presence or absence of family planning clinics in any particular area in 1969 and its 1969 enrollment level. Communities more favorably disposed to provision of birth control services would have been more likely than other areas to apply for federal funding of family planning programs when it became available in the middle 1960s. Due to an earlier start, their programs were flourishing by 1969.

Expanding HIV testing and counselling into communities: Feasibility, acceptability, and effects of an integrated family planning/HTC service delivery model by Village Health Teams in Uganda.

PubMed

Brunie, Aurélie; Wamala-Mucheri, Patricia; Akol, Angela; Mercer, Sarah; Chen, Mario

2016-10-01

Improving HIV testing and counselling (HTC) requires a range of strategies. This article reports on HTC service delivery by Village Health Teams (VHTs) in Uganda in the context of a model integrating this new component into pre-existing family planning services. Eight health centres from matched pairs were randomly allocated to intervention or control. After being trained, 36 VHTs reporting to selected facilities in the intervention group started offering HTC along with family planning, while VHTs in the control group provided family planning only. Proficiency testing was conducted as external quality assurance. A survey of all 36 VHTs and 137 family planning clients in the intervention group and 119 clients in the control group and a review of record data were conducted after 10 months. Survey responses by VHTs and their clients in the intervention group demonstrate knowledge of counselling messages and safe testing. External quality assessment results provide additional evidence of competency. Eighty per cent of the family planning clients surveyed in the intervention group received an HIV test during the intervention; 27% of those were first-time testers. More clients had ever tested for HIV in the intervention group compared with the control; clients also retested more often. Findings indicate that this model is feasible and acceptable for expanding quality HTC into communities. This study was registered with ClinicalTrials.gov, number [NCT02244398]. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

48 CFR 37.604 - Quality assurance surveillance plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

48 CFR 37.604 - Quality assurance surveillance plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

48 CFR 37.604 - Quality assurance surveillance plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

48 CFR 37.604 - Quality assurance surveillance plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

48 CFR 37.604 - Quality assurance surveillance plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

A family planning program that pays for itself.

PubMed

1987-07-01

In Japan, the condom is the method of choice of 82% of all contraceptive users. The Japan Family Planning Association covers about 3% of the total condom market through a well-organized social marketing scheme. Mobile guidance teams, equipped with a vehicle, supply contraceptives to health centers, independent midwives, and maternity hospitals in 17 prefectures and collect payment for condoms distributed after their previous visit. As an incentive, organizations and health institutions receive a commission for the condoms they supply. Japan's largest condom manufacturer provides supplies to the Family Planning Association at a very low price. The contraceptive social marketing program pays for its own promotion, and the Family Planning Association is able to support its other activities from the income it earns. The program was designed to complement rather than compete with commercial marketing channels such as pharmacies, which supply 60% of the 660 million condoms purchased in Japan each year.

Family planning and fertility decline: a global overview.

PubMed

Tabah, L

1977-01-01

Family planning and development policy concerns are not incompatible. The emphasis on development policies at the 1974 World Population Conference at Bucharest did not mean that world governments had lost interest in the population and family planning issue. Although worldwide attitudes toward family planning have become more and more favorable, this has not yet meant great impact on world demographic trends. The "inertia factor," i.e., the effects of high birthrates in the previous generation, will camouflage declining birthrates for some time to come. The trend of fertility reduction which was perceptible only among small populations a few years ago is also becoming manifest in larger Third World countries. Mortality rate declines have slowed down but there is no rising mortality due to starvation in any country. At present, food demand exceeds availability for 80% of the Third World population. It is predicted that the food deficit will increase 70% by the year 2000.

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Water quality management plans. 130.6... QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM... when they are needed to address water quality problems. (1) Total maximum daily loads. TMDLs in...

Utilizing grassroots workers in family planning programs in India: prospects and problems.

PubMed

Mani, S B

1991-01-01

In order to rapidly expand the network of delivery systems and speed up the process of acceptance of family planning messages and methods, a shift took place in the Indian family planning program from the bureaucratic "clinical" approach to the people oriented "extension" approach. As a result, there is an increasing emphasis on moving the family planning efforts closer to the grassroots level. A key methodological issue centers on the proper selection, cultural acceptability, and the effectiveness of the grassroots workers who are to be trained and through whom family planning motivational messages and methods are to be introduced. The Indian government, from time to time, has trained and utilized different groups of grassroots workers in its family planning promotional efforts. Anthropological field studies were conducted in two different regions in India to examine the potential and actual roles of two groups of grassroots workers--opinion leaders and traditional birth attendants--in the delivery of family planning services in the rural areas. These studies revealed that while the traditional birth attendants can be trained and utilized to a limited extent in promoting family planning efforts, especially to the eligible female clients, the role of the opinion leaders in such efforts is at best questionable. Based on these field studies, cultural and technical (including bureaucratic) problems in training and utilizing opinion leaders and traditional birth attendants are explored in detail. Modifications in the training program strategies are suggested to improve and expand the family planning delivery system in rural India.

[Psychosocial research and family planning services in Mexico].

PubMed

Urbina Fuentes, M; Vernon Carter, R

1985-01-01

Psychosocial and service studies round out data from the demographic and contraceptive prevalence studies that have been conducted every 3 years since 1976 in Mexico. The studies can be formative, providing basic information for development of a program, or evaluative, indicating how well a program is performing. Among formative psychosocial studies in Mexico have been knowledge, attitude, and practice (KAP) studies, which are usually helpful in the initial stages of family planning program implementation. A 1964 study of knowledge and practice in 7 Mexican cities showed that attitudes toward family planning were more traditional and disapproving in Mexico City than in other areas, but that many women wanted no more children. About 1/4 of the population of Mexico City knew no contraceptive methods and about 1/2 knew only less effective traditional methods. By 1979, 72% of women knew at least 1 effective method. KAP studies have demonstrated differences in the family size desires of men and women and in the determinants of attitudes toward birth control. Formative studies of surgical contraception have been psychologically oriented, and have helped provide a rational basis for making the operation accessible to the public. Despite some passing problems, most women have adapted to sterilization and their libidos have normalized by 18 months postoperative. Studies of the knowledge and attitudes of physicians conducted in the early days of family planning programs have helped in the design of programs to inform them of the advantages and side affects of contraceptive methods. Other studies have helped identify traditional midwives with large practices in rural areas who could be trained to deliver family planning services and have demonstrated that they develop a good understanding of contraindications and side effects of oral contraceptives. Teaching materials for IEC programs have been evaluated with small samples, but minimal attention has been given to research on

Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People.

PubMed

Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna

2017-03-24

Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the

Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People

PubMed Central

Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna

2017-01-01

ABSTRACT Background: Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention—youth-friendly social franchisee training and quality monitoring—with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Methods: Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees—private providers accredited by MSM—are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher

[The family planning program in Rwanda: assessment of ten years (1981-1991) and prospects].

PubMed

Munyakazi, A

1990-12-01

Rwanda's official family planning policy dates back to 1981 and creation of the National Office of Population (ONAPO). Among its other function, ONAPO monitors proper use of family planning methods and studies the integration of family planning services into public health. Pilot family planning programs began in the prefectures of Butare, Kigali, and Ruhengeri and were extended to the other 7 around 1985. The development of family planning services in Rwanda is based on their integration into existing services, especially those devoted to maternal-child health. In 1989, 277 of the 350 health centers of all kinds in Rwanda and 12 secondary posts offered family planning services. The rate of integration was 79.4%. 185 of the 277 health services with family planning services were in the public sector. As of December 1989, the rate of integration in different prefectures varied from a high of 95.5% in Kibungo to a low of 64.9% in Gisenyi. Integration is particularly weak in health facilities administered by the Catholic Church. The 2 strategies to confront this situation are continuing dialogue with Catholic Church officials and creation of secondary family planning posts to improve accessibility to family planning for populations served by Church health services. The number of new and continuing family planning users increased from 1178 and 1368 respectively in 1982 to 66,950 and 104,604 through September 1990. There is wide variation from 1 prefecture to another in recruitment of new acceptors and in the number of acceptors per health facility. Recruitment of new acceptors is greatest in Ruhengeri, followed by Kigali and Byumba. As of September 1990, 28,943 women used pills, 2037 used IUDs, 66,515 used injectables, 3051 used barrier methods, 2888 used auto-observation methods, 343 used implants, and 588 were sterilized. The overall rate of contraceptive prevalence increased from .9% in 1983 to 6.2% in 1989 and 10% in 1990. The strategy for promoting family planning

Cabinet decision creating a family planning section in the Ministry of Manpower.

PubMed

1989-01-01

As of April 1, 1989 the Indonesian Ministry of Manpower will contain a family planning section within its regular structure. It will be part of a newly created Sub-directorate for Workers Welfare, which also contains sections for health facilities/services and for nutrition and other welfare services. The family planning section is to be staffed by 8 full-time officials who are responsible for population, family welfare, and family planning programs in the Ministry of Manpower.

Family Planning in the Context of Latin America's Universal Health Coverage Agenda.

PubMed

Fagan, Thomas; Dutta, Arin; Rosen, James; Olivetti, Agathe; Klein, Kate

2017-09-27

Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from accessing their preferred method

Family Planning in the Context of Latin America's Universal Health Coverage Agenda

PubMed Central

Fagan, Thomas; Dutta, Arin; Rosen, James; Olivetti, Agathe; Klein, Kate

2017-01-01

ABSTRACT Background: Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. Methods: We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

40 CFR 130.6 - Water quality management plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

Family-Centered Early Intervention Visual Impairment Services through Matrix Session Planning

ERIC Educational Resources Information Center

Ely, Mindy S.; Gullifor, Kateri; Hollinshead, Tara

2017-01-01

Early intervention visual impairment services are built on a model that values family. Matrix session planning pulls together parent priorities, family routines, and identified strategies in a way that helps families and early intervention professionals outline a plan that can both highlight long-term goals and focus on what can be done today.…

Paying for family planning.

PubMed

1998-09-12

Both houses of the US Congress have passed bills to require that all health plans for federal employees which pay for prescription medications also cover prescription contraceptives approved by the US Food and Drug Administration (USFDA). Of these, the five most commonly prescribed are contraceptive pills, implantable levonorgestrel (Norplant), long-acting injectable medroxyprogesterone acetate (Depo-provera), IUDs, and the diaphragm. Differences between the two bills are now being worked out by a joint House-Senate committee and passage seems almost certain. If a compromise joint bill is passed by both houses, it would cover plans which insure more than 1 million reproductive age women. However, the Equity in Prescription and Contraceptive Coverage (EPICC) Act requiring all US private health plans to cover contraceptive prescriptions is less certain to eventually become legislation. Currently, only 49% of traditional indemnity plans and 39% of health maintenance organizations cover the five most commonly prescribed reversible methods of contraception, while many health plans cover no form of contraception, other than sterilization. The passage of EPICC would expand contraceptive choice for another 45 million US women of childbearing age. Opposition to both bills has come mainly from health insurance and business groups, as well as conservative groups which oppose funding for family planning. Supporters of legislation to expand contraceptive choice for US women should understand that the right to reproductive health and contraceptive services extends beyond US borders, and pressure Congress to bolster US financial support for international population control programs.

Family planning as public policy.

PubMed

1976-08-01

The inclusion of constitutional provisions and laws regarding family planning and the creation of the Population Commission in the Philippines are examples of the growing recognition in many developing countries that proper and humane control of population growth is a key factor in economic progress. Similar provisions have recently appeared in Thailand, Mexico, and the Brazilian state of Rio de Janeiro. Awareness of the need for adequate public education to ensure the success of family planning programs has resulted in the formation of commissions for that purpose in Australia, Belgium, Chile, Ecuador, Egypt, El Salvador, Guatemala, Italy, Mexico, New Zealand, Portugal, and Sri Lanka. Voluntary sterilization is gradually gaining support. 3 South Asian nations (Pakistan, Singapore, and New Zealand) were among 12 to liberalize laws in 1974 and 1975. However, the prevailing opinion is that a massive public education program will have to be waged before acceptance becomes widespread in the region. Singapore's sterilization law can be used as a guideline for other nations in the area contemplating policy changes.

Family Quality of Life: Adaptation to Spanish Population of Several Family Support Questionnaires

ERIC Educational Resources Information Center

Balcells-Balcells, A.; Gine, C.; Guardia-Olmos, J.; Summers, J. A.

2011-01-01

Background: The concept of family quality of life has emerged as a decisive construct in the last decades to improve the capabilities of families and to assess the outcomes of the services and supports they get. The goal of this research is to adapt three instruments to the Spanish population: the "Beach Center Family Quality of Life…

[On family planning policy in Brazil].

PubMed

Berquo, E

1987-01-01

Brazil's population could vary from a minimum of 164.5 million to a maximum of 183.5 million at the turn of the century. The increase in population is due essentially to a decline in mortality, since natality has remained steady, averaging 6.2 children/woman. During the 1st 4 years of the 1980s, a 19% drop in natality was registered, with the greatest reduction occurring in the East-Central (25%) region, testimony to an increased presence of highly effective contraceptive means. 65% of all married women between the ages of 15 and 44 use contraceptives, placing Brazil among the most developed countries (U.S.A., 68%). The main contraceptive method used is sterilization, preferred even by very young women, median age 29, as evidenced by a study in Sao Paulo. The choice of contraceptives, however, is limited. During the military dictatorship family planning was put in the hands of private organizations (BEMFAM since 1965, CEPAIMC since 1975) and recent policies have emphasized a hands-off attitude leaving birth control decisions to the family nucleus. The economic crisis, at the end of the 1970s, modified this position. In order to avoid that, only the wealthy classes have access to family planning means, the government increasingly plays an active role in providing information and assistance. A not-for-profit institution, ABEPF (Brazilian Association for Family Planning Entities), the largest of its kind in Latin America, organizes and promotes private initiative programs. Acting as a true syndicate, each clinic affiliated with the association receives training of professionals and equipment for installation of laboratories and consulting rooms. Various women's rights movements have been active and succeeded in influencing political parties.

Interact. A Plan for Participation in Home & Family Life Programs. Revised. H.E. Bulletin No. 44.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

This guide is intended to assist teachers and vocational administrators in getting parents, students, and members of the community at large to participate in the process of planning and developing a high-quality home and family life education program. The first section discusses the importance of teamwork among parents, students, school, and…

Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

PubMed

Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

2013-10-01

To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

[Some reflections on the introduction of family planning into businesses in Cameroon].

PubMed

Ngambi Kunga

1990-01-01

Cameroon has announced that it favors family planning as a means of improving family welfare. In the local context, family planning would refer to spacing and to a lesser extent limiting births, as well as combatting infertility. This work argues that, at a time of deep economic and financial crisis for Cameroon and of growing need and demand for family planning services, the introduction of employment-based family planning services could reinforce the family planning activities of the government and private agencies. The work broadly outlines national family planning policy, identifies weaknesses of proposed family planning strategies, and points out the advantages of employment-based services. Cameroon's infant mortality rate of 90/1000 live births and maternal mortality of 420/100,000 are partly related to its very high fertility rate, closely spaced births, and early pregnancy. The national family planning program goal is to promote health and wellbeing by preventing early and unwanted pregnancies and illnesses in high-risk groups. A decline in unwanted births would be achieved through voluntary use of contraception. The main strategy would be an ambitious IEC program to inform the population of the advantages of family planning using mass media, print materials, and interpersonal communication. The general objectives of the IEC program would be to reduce maternal mortality to 300/100,000 and infant mortality from 90 to 70/1000 and increase contraceptive prevalence from 3 to 20% by 1994. Family planning services and commercial distribution centers would be created, taking advantage of existing health facilities wherever possible as well as community based systems of service delivery for the population not yet served by the traditional distribution system. Experience with the IEC strategy in other countries demonstrates that there is a great disproportion between the population touched by IEC and contraceptive prevalence. The strategy would probably be more

Family Quality of Life Empowered by Family-Oriented Support

ERIC Educational Resources Information Center

Schippers, Alice; van Boheemen, Marleen

2009-01-01

Professional services for persons with intellectual disabilities (ID) have begun to attach more importance to their environment. The concept of (family-related) quality of life proved to link very well with this idea and lent itself to constructing and evaluating services. One outcome was the emergence of equal partnerships between families,…

Family emergency preparedness plans in severe tornadoes.

PubMed

Cong, Zhen; Liang, Daan; Luo, Jianjun

2014-01-01

Tornadoes, with warnings usually issued just minutes before their touchdowns, pose great threats to properties and people's physical and mental health. Few studies have empirically investigated the association of family emergency preparedness planning and observed protective behaviors in the context of tornadoes. The purpose of this study was to examine predictors for the action of taking shelter at the time of tornadoes. Specifically, this study investigated whether having a family emergency preparedness plan was associated with higher likelihood of taking shelter upon receiving tornado warnings. This study also examined the effects of socioeconomic status and functional limitations on taking such actions. A telephone survey based on random sampling was conducted in 2012 with residents in Tuscaloosa AL and Joplin MO. Each city experienced considerable damages, injuries, and casualties after severe tornadoes (EF-4 and EF-5) in 2011. The working sample included 892 respondents. Analysis was conducted in early 2013. Logistic regression identified emergency preparedness planning as the only shared factor that increased the likelihood of taking shelter in both cities and the only significant factor in Joplin. In Tuscaloosa, being female and white also increased the likelihood of taking shelter. Disability was not found to have an effect. This study provided empirical evidence on the importance of having a family emergency preparedness plan in mitigating the risk of tornadoes. The findings could be applied to other rapid-onset disasters. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

42 CFR 84.41 - Quality control plans; contents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

42 CFR 84.41 - Quality control plans; contents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

42 CFR 84.41 - Quality control plans; contents.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

42 CFR 84.41 - Quality control plans; contents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

42 CFR 84.41 - Quality control plans; contents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

Women-Family in Quality Perspective

ERIC Educational Resources Information Center

Fatimah, Rika P. L.; Aziz, J. Abdul; Ibrahim, K.

2008-01-01

Bringing together women and family in quality perspective brings about interesting discussions in this paper. By integrating previous studies and considering expert opinions, we determine the variables and dimensions with respect to women's existence regarding their roles both in the family and at work. Many activities carried out by women…

Development and Examination of a Family Triadic Measure to Examine Quality of Life Family Congruence in Nursing Home Residents and Two Family Members.

PubMed

Aalgaard Kelly, Gina

2015-01-01

Objective: The overall purpose of this study was to propose and test a conceptual model and apply family analyses methods to understand quality of life family congruence in the nursing home setting. Method: Secondary data for this study were from a larger study, titled Measurement, Indicators and Improvement of the Quality of Life (QOL) in Nursing Homes . Research literature, family systems theory and human ecological assumptions, fostered the conceptual model empirically testing quality of life family congruence. Results: The study results supported a model examining nursing home residents and two family members on quality of life family congruence. Specifically, family intergenerational dynamic factors, resident personal and social-psychological factors, and nursing home family input factors were examined to identify differences in quality of life family congruence among triad families. Discussion: Formal family involvement and resident cognitive functioning were found as the two most influential factors to quality of life family congruence (QOLFC).

Development and Examination of a Family Triadic Measure to Examine Quality of Life Family Congruence in Nursing Home Residents and Two Family Members

PubMed Central

Aalgaard Kelly, Gina

2015-01-01

Objective: The overall purpose of this study was to propose and test a conceptual model and apply family analyses methods to understand quality of life family congruence in the nursing home setting. Method: Secondary data for this study were from a larger study, titled Measurement, Indicators and Improvement of the Quality of Life (QOL) in Nursing Homes. Research literature, family systems theory and human ecological assumptions, fostered the conceptual model empirically testing quality of life family congruence. Results: The study results supported a model examining nursing home residents and two family members on quality of life family congruence. Specifically, family intergenerational dynamic factors, resident personal and social-psychological factors, and nursing home family input factors were examined to identify differences in quality of life family congruence among triad families. Discussion: Formal family involvement and resident cognitive functioning were found as the two most influential factors to quality of life family congruence (QOLFC). PMID:28138474

Prevalence and correlates of intimate partner violence among family planning clients in Conakry, Guinea.

PubMed

Delamou, Alexandre; Samandari, Ghazaleh; Camara, Bienvenu Salim; Traore, Pernamou; Diallo, Fatoumata Guilinty; Millimono, Sita; Wane, Defa; Toliver, Maimouna; Laffe, Kira; Verani, Fabio

2015-12-23

Intimate partner violence (IPV) is a global public health problem that affects women's physical, mental, sexual and reproductive health. Very little data on IPV experience and FP use is available in resource-poor settings, such as in West Africa. The aim of this study was to describe the prevalence, patterns and correlates of IPV among clients of an adult Family Planning clinic in Conakry, Guinea. The study data was collected for four months (March to June 2014) from women's family planning charts and from an IPV screening form at the Adult Family Planning and Reproductive Health Clinic of "Association Guinéenne pour le Bien-Etre Familial", a non-profit organization in Conakry, Guinea. 232 women out of 245 women who attended the clinic for services during the study period were screened for IPV and were included in this study. Of the 232 women screened, 213 (92%) experienced IPV in one form or another at some point in their lifetime. 169 women reported psychological violence (79.3%), 145 reported sexual violence (68.1%) and 103 reported physical violence (48.4%). Nearly a quarter of women reported joint occurrence of the three forms of violence(24%).Half of the IPV positive women were current users of family planning (51.2%) and of these, 77.9% preferred injectable contraceptives. The odds of experiencing IPV was higher in women with secondary or vocational level of education than those with higher level of education (AOR: 8.4; 95% CI 1.2-58.5). Women residing in other communes of Conakry (AOR: 5.6; 95% CI 1.4-22.9) and those preferring injectable FP methods (AOR: 4.5; 95% CI 1.2-16.8) were more likely to experience lifetime IPV. IPV is prevalent among family planning clients in Conakry, Guinea where nine out of ten women screened in the AGBEF adult clinic reported having experienced one or another type of IPV. A holistic approach that includes promotion of women's rights and gender equality, existence of laws and policies is needed to prevent and respond to IPV

The politics of Latin American family-planning policy.

PubMed

Weaver, J L

1978-07-01

In population planning in Latin America the programs are as successful as the government's support of family planning. Colombia is one of the few Latin American countries which has actively exhorted its populace to birth control. If the propensity for large families reflects a belief in the economic or social utility of children, instead of machismo, birthrates will fall with expanded social security and economic welfare programs. If birthrates are the result of machismo, new gender models stressing the positive rewards and social esteem to be gained through responsible parenthood would have to be taught to both adults and children. The position profamily planning in most Latin American countries is generally supported by the ministers, technocrats, corporations, businessmen, middle-class women, doctors, mass media, protestant congregations, and working-class women. Family planning is usually opposed by members of the armed forces, Catholic hierarchy, Catholic lay organizations, oligarchy, university students, leftist intellectuals, Marxist insurgents, Indian communities, and peasants. The portion of the total national populations encompassed by the groups composing the core combination, ideological bias, and stability group ranges from 50-60% in Argentina, Uruguay, and Venezuela to 10-20% in Central America, Bolivia, Ecuador, and Paraguay. Most groups are outside the policy-making process.

Family Needs and Family Quality of Life for Taiwanese Families of Children with Intellectual Disability and Developmental Delay

ERIC Educational Resources Information Center

Chiu, Chun-Yu

2013-01-01

This dissertation consists of four related chapters including an introductory overview of all four chapters, a report on family needs, a report on family quality of life, and a summary of implications for the conceptual framework. Chapter 1, the introductory overview, presents background information of Taiwan and describes the family quality of…

Women, microcredit and family planning practices: a case study from rural Ghana.

PubMed

Norwood, Carolette

2011-01-01

This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women’s demographic background characteristics, membership status and length, and women’s empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.

Air Quality Modeling | Air Quality Planning & Standards | US ...

EPA Pesticide Factsheets

2016-06-08

The basic mission of the Office of Air Quality Planning and Standards is to preserve and improve the quality of our nation's air. One facet of accomplishing this goal requires that new and existing air pollution sources be modeled for compliance with the National Ambient Air Quality Standards (NAAQS).

Family Planning in Five Continents: Africa, America, Asia, Europe, Oceania. November 1975 Update.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This document gives highlights of the family planning situation in countries of the world, together with basic demographic statistics. Its purpose is to provide a quick reference source for those who work in family planning, population, and other related fields. Following a brief history of the pioneering work in family planning, population…

A Selection of Films for Family Planning Programmes.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This catalog gives an annotated listing of selected films available for use in family planning programs. Films are listed alphabetically, geographically by particular country, and by subject. In most cases information is given concerning length, producer, distributor, cost, and rental conditions from the International Planned Parenthood…

Women’s experiences after Planned Parenthood’s exclusion from a family planning program in Texas☆

PubMed Central

Woo, C. Junda; Alamgir, Hasanat; Potter, Joseph E.

2016-01-01

Objective We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. Study Design We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006–2010 (NSFG). Results (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. Conclusions Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. Implications Requiring low-income family planning patients to switch healthcare providers has adverse consequences. PMID:26680757

Development of a Mobile App for Family Planning Providers.

PubMed

Halsall, Viannella; Rogers, Jennifer; Witt, Jacki; Song, Sejun; Nguyen, Hoang Duc Huy; Kelly, Patricia

To provide an overview of lessons learned during the development process of an app for iOS and Android based on national recommendations for providing quality family planning services. After a review of existing apps was conducted to determine whether an app of clinical recommendations for family planning existed, a team of clinicians, training specialists, and app developers created a resource app by first drafting a comprehensive content map. A prototype of the app was then pilot tested using smart tablets by a volunteer convenience sample of women's healthcare professionals. Outcomes measured included usability, acceptability, download analytics, and satisfaction by clinicians as reported through an investigator-developed tool. Sixty-nine professionals tested a prototype of the app, and completed a user satisfaction tool. Overall, user feedback was positive, and a zoom function was added to the final version as a result of the pilot test. Within 3 months of being publicly available, the app was downloaded 677 times, with 97% of downloads occurring on smart phones, 76% downloads occurring on iOS devices, and 24% on Android devices. This trend persisted throughout the following 3 months. Clinicians with an interest in developing an app should consider a team approach to development, pilot test the app prior to wider distribution, and develop a web-based version of the app to be used by clinicians who are unable to access smart devices in their practice setting.

The Impact of Reproductive Health Legislation on Family Planning Clinic Services in Texas

PubMed Central

Hopkins, Kristine; Aiken, Abigail R. A.; Stevenson, Amanda; Hubert, Celia; Grossman, Daniel; Potter, Joseph E.

2015-01-01

We examined the impact of legislation in Texas that dramatically cut and restricted participation in the state’s family planning program in 2011 using surveys and interviews with leaders at organizations that received family planning funding. Overall, 25% of family planning clinics in Texas closed. In 2011, 71% of organizations widely offered long-acting reversible contraception; in 2012–2013, only 46% did so. Organizations served 54% fewer clients than they had in the previous period. Specialized family planning providers, which were the targets of the legislation, experienced the largest reductions in services, but other agencies were also adversely affected. The Texas experience provides valuable insight into the potential effects that legislation proposed in other states may have on low-income women’s access to family planning services. PMID:25790404

Urban family physician plan in Iran: challenges of implementation in Kerman.

PubMed

Dehnavieh, Reza; Kalantari, Ali Reza; Jafari Sirizi, Mohammad

2015-01-01

The Family Physician Plan has recently been implemented in three provinces of Iran on a pilot basis and is going to be implemented throughout Iran in the future. Through a qualitative design, this study aims to determine probable implementation challenges of Family Physician Plan in Kerman. This study was conducted in Kerman in 2013. Data were collected through interviews with 21 experts in the field. Sampling continued until data saturation level was achieved. All interviews were recorded and then analyzed, and main themes and subgroups were extracted from them based on a framework analysis model. most prevalent establishment challenges of Family Physician Plan were classified into policy-making, financial supply, laws and resources. The urban Family Physician Plan can be carried out more effectively by implementing this plan step by step, highlighting the relationships between the related organizations, using new payment mechanisms e.g Per Capita, DRG, make national commitment and proper educational programs for providers, development the health electronic Record, justifying providers and community about advantages of this plan, clarifying regulatory status about providers' Duties and most importantly considering a specific funding source.

Urban family physician plan in Iran: challenges of implementation in Kerman

PubMed Central

Dehnavieh, Reza; Kalantari, Ali Reza; Jafari Sirizi, Mohammad

2015-01-01

Background: The Family Physician Plan has recently been implemented in three provinces of Iran on a pilot basis and is going to be implemented throughout Iran in the future. Through a qualitative design, this study aims to determine probable implementation challenges of Family Physician Plan in Kerman. Methods: This study was conducted in Kerman in 2013. Data were collected through interviews with 21 experts in the field. Sampling continued until data saturation level was achieved. All interviews were recorded and then analyzed, and main themes and subgroups were extracted from them based on a framework analysis model. Results: most prevalent establishment challenges of Family Physician Plan were classified into policy-making, financial supply, laws and resources. Conclusion: The urban Family Physician Plan can be carried out more effectively by implementing this plan step by step, highlighting the relationships between the related organizations, using new payment mechanisms e.g Per Capita, DRG, make national commitment and proper educational programs for providers, development the health electronic Record, justifying providers and community about advantages of this plan, clarifying regulatory status about providers' Duties and most importantly considering a specific funding source. PMID:26913266

National Needs of Family Planning Among US Men Aged 15 to 44 Years

PubMed Central

Gibbs, Susannah E.; Choiriyyah, Ifta; Sonenstein, Freya L.; Astone, Nan M.; Pleck, Joseph H.; Dariotis, Jacinda K.

2016-01-01

Objectives. To estimate national need for family planning services among men in the United States according to background characteristics, access to care, receipt of services, and contraception use. Methods. We used weighted data from the 2006–2010 National Survey of Family Growth to estimate the percentage of men aged 15 to 44 years (n = 10 395) in need of family planning, based on sexual behavior, fecundity, and not trying to get pregnant with his partner. Results. Overall, 60% of men were in need of family planning, defined as those who ever had vaginal sex, were fecund, and had fecund partner(s) who were not trying to get pregnant with partner or partner(s) were not currently pregnant. The greatest need was among young and unmarried men. Most men in need of family planning had access to care, but few reported receiving family planning services (< 19%), consistently using condoms (26%), or having partners consistently using contraception (41%). Conclusions. The need for engaging men aged 15 to 44 years in family planning education and care is substantial and largely unmet despite national public health priorities to include men in reducing unintended pregnancies. PMID:26890180

Stakeholder perceptions of a total market approach to family planning in Nicaragua.

PubMed

Drake, Jennifer Kidwell; Espinoza, Henry; Suraratdecha, Chutima; Lacayo, Yann; Keith, Bonnie M; Vail, Janet G

2011-05-01

To assess private-sector stakeholders' and donors' perceptions of a total market approach (TMA) to family planning in Nicaragua in the context of decreased funding; to build evidence for potential strategies and mechanisms for TMA implementation (including public-private partnerships (PPPs)); and to identify information gaps and future priorities for related research and advocacy. A descriptive exploratory study was conducted in various locations in Nicaragua from March to April 2010. A total of 24 key private-sector stakeholders and donors were interviewed and their responses analyzed using two questionnaires and a stakeholder analysis tool (PolicyMakerTM software). All survey participants supported a TMA, and public-private collaboration, in family planning in Nicaragua. Based on the survey responses, opportunities for further developing PPPs for family planning include building on and expanding existing governmental frameworks, such as Nicaragua's current coordination mechanism for contraceptive security. Obstacles include the lack of ongoing government engagement with the commercial (for-profit) sector and confusion about regulations for its involvement in family planning. Strategies for strengthening existing PPPs include establishing a coordination mechanism specifically for the commercial sector and collecting and disseminating evidence supporting public-private collaboration in family planning. There was no formal or absolute opposition to a TMA or PPPs in family planning in Nicaragua among a group of diverse nongovernmental stakeholders and donors. This type of study can help identify strategies to mobilize existing and potential advocates in achieving articulated policy goals, including diversification of funding sources for family planning to achieve contraceptive security.