Chick, P; Nixon, J
Data were obtained from 1,810 consecutive women who attended a central metropolitan (Brisbane) Family Planning Clinic during a 5 week period in 1982. Young women in particular formed the major client group with 32% being under 20 years of age. The client population was skewed towards women of upper socioeconomic status (SES). There was no SES disproportion in the use of oral contraceptives or IUD's. However, diaphragm use occurred disproportionately in women of upper SES groups; postcoital contraception was sought by and limited to, women of SES classes A and B only. The clinic satisfied a need for women with a history of failed or absent contraception and 15% had already had a termination of pregnancy by the time they first presented at the clinic.
Swenson, I E
The purpose of this study was to assess the client records of adolescents attending a teen family planning clinic to determine the reported episodes of sexually transmitted diseases, sexual abuse, alcohol and drug use, and other dysfunctional situations in the family. In addition, information about the initiation of sexual activity and sexual partners was assessed in the record review. Data were obtained from a county health department located in a metropolitan area of a southeastern state. A review of the records of 183 adolescents 15 years of age or younger provided information on ethnicity, grade in school, and assessment data from the clinic interviews and exams. Twenty-five clients said they were not sexually active when they came to the family planning clinic for the first time, and were brought to the clinic by a parent (usually the mother). Those clients who came without parents said they were sexually active. Forty-one percent had their first sexual experience between 12 and 13 years of age, 18% between the ages of 14 and 15, and the remainder before the age of 12. While over 7% specifically stated that they had been sexually abused or raped, an additional 19% described situations in the home or exhibited symptoms associated with a history of sexual abuse. Eleven percent had a history of two to three different sexually transmitted diseases, and 26% had three or more diseases. Seventy-two percent indicated that there was conflict in the home; several had left home because of abuse. Fourteen percent admitted using drugs, mostly cocaine or marijuana, and 17% reported that they used alcohol at least occasionally.
Costa, Eleonora C V; Oliveira, Rosa; Ferreira, Domingos; Pereira, M Graça
Women account for 30% of all AIDS cases reported to the Health Ministry in Portugal and most infections are acquired through unprotected heterosexual sex with infected partners. This study analyzed socio-demographic and psychosocial predictors of consistent condom use and the role of education as a moderator variable among Portuguese women attending family planning clinics. A cross-sectional study using interviewer-administered fully structured questionnaires was conducted among 767 sexually active women (ages 18-65). Logistic regression analyses were used to explore the association between consistent condom use and the predictor variables. Overall, 78.7% of the women were inconsistent condom users. The results showed that consistent condom use was predicted by marital status (being not married), having greater perceptions of condom negotiation self-efficacy, having preparatory safer sexual behaviors, and not using condoms only when practicing abstinence. Living with a partner and having lack of risk perception significantly predicted inconsistent condom use. Less educated women were less likely to use condoms even when they perceive being at risk. The full model explained 53% of the variance in consistent condom use. This study emphasizes the need for implementing effective prevention interventions in this population showing the importance of taking education into consideration.
Humphreys, J T; Henneberry, J F; Rickard, R S; Beebe, J L
Women attending family planning clinics in Colorado during 1988 were screened for Chlamydia trachomatis infection by enzyme immunoassay (EIA, Chlamydiazyme, Abbott Laboratories; Abbott Park, IL). Cervical specimens from 11,793 women attending 22 family planning clinics were analyzed. Patient history and physical exams were used to assess risk factors for infection. A total of 913 individuals (7.7%) had positive culture results for C. trachomatis. Multivariate analysis showed that infection was significantly related to endocervical bleeding, cervical mucopurulent discharge, a new sexual partner in the last 3 months or multiple previous sexual partners (greater than 3) in the last year, pregnancy, the use of oral contraceptives, and age. Increased odd ratios were observed for the combination of endocervical bleeding and mucopurulent discharge and sexual history that included partners over the previous year as well as the most recent 3 months. A combination of these criteria was used to selectively screen women attending Colorado family planning clinics on an ongoing basis. A cost-benefit analysis employing a model reported previously showed a significant financial benefit associated with universal screening over either selective screening or no screening for C. trachomatis in this population.
Background Complementary medicines (CMs) are widely used by women. Although, women in Australia are frequent users of CM, few studies have examined their utilisation by women attending a family planning service. The aim of this study was to examine (i) the extent of and type of CM, (ii) women’s views about safety and efficacy, and (iii) the factors influencing women’s decision-making. Methods A cross-sectional survey using a convenience sample of 221women aged greater than 18 years attending a family planning (FP) service was undertaken over a two week period in Sydney, Australia. An anonymous self-administered questionnaire was designed to examine women’s current and previous use of CMs, their attitudes towards safety and effectiveness, the factors influencing their decision-making, and their disclosure of CM use to a FP health professional. Demographic questions were designed to describe the diversity of the participants. Logistic regression was used to examine the association between CM use and demographics. Results Sixty-seven percent of women surveyed were currently using CMs, and 83% reported use during the previous 12 months. Most respondents utilised CMs to maintain their general health or for prevention of ill health. Over 30% of women lacked information to make an informed response to questions examining their views about the safety of CMs. Forty-four percent of participants stated they discussed their use of CMs with their FP providers. The main reason why women did not mention CMs was they did not see the relevance to their consultation (43%). Lower rates of CM use were found for younger women (OR 0.24, 95% CI 0.09-0.61), and those not completing high school (OR 0.44, 95% 0.20-1.00). Conclusion The use of CM is very common among women attending an Australian FP clinic, however our findings may not be generalisable to all women. We identified a notable gap in women’s awareness of the potential for interactions between CM and prescribed
Choi, Kyung-Hee; Wojcicki, Janet; Valencia-Garcia, Dellanira
Safe sex skills training often teach women to be assertive in condom use negotiations. However, it has been suggested that assertiveness training may be inappropriate for women who lack power in their sexual relationship. Our qualitative study of 62 women attending a family planning clinic explored various communication styles they used to introduce and negotiate female condom use in their sexual relationships. We further examined how different introduction and negotiation styles were related to actual use of the device. The device was introduced using a direct, semidirect, indirect, or nonverbal communication approach. Use of the female condom was negotiated by avoiding sex, using humor, discussing the possibility of using the condom, or being argumentative with partners. The outcome of introducing and negotiating female condom use was often mediated by other factors including partner characteristics, relationship power dynamics, situational context, and use of additional discourse strategies (e.g., describing the female condom as a sexual toy or taking the opportunity to educated partners about the female condom). Less direct approaches appeared to be as effective in facilitating use of the female condom as more direct approaches. Female condom introduction and negotiation styles that continued to engage their partners by using additional discourse strategies led to more frequent use of the device. Implications of our findings for HIV risk reduction program development are discussed.
Lillo G, Eduardo; Lizama I, Sandra; Medel C, Jorge; Martínez T, M Angélica
In order to determine the prevalence of bacterial vaginosis (BV) among women attending a family health Center and to evaluate the accuracy of Amsel's diagnostic procedure relative to Nugent scoring for diagnosing this condition, we obtained vaginal specimens from 100 women under 50 years attending a FPC from April to November of 2006. Women were enrolled consecutively on a schedule basis and were not selected by symptoms of genital infection. VB was diagnosed in 32% women, without significant differences by age (p=0,114). 87.5% women declared one sexual partner in the last 6 months. The Amsel's method had a sensitivity of 62.1%, and a specificity of 92.3%, with positive and negative predictive values of 81.8% and 83.3% respectively, being the presence of clue cells the most accurate parameter. Nevertheless, the lack of microscopes in the clinical practice limits the use of the Amsel's criteria. In conclusion, VB is a prevalent infection in the study population, being not associated with age or sexual activity. Diagnosis should be performed by the Nugent method.
Verderese, Maria de Lourdes; Turnbull, Lily M.
The publication provides guidelines for assisting developing countries in determining strategies for the utilization and training of traditional birth attendants (TBAs). TBA's are persons (usually women in rural areas) who assist the mother at childbirth and who initially acquired their skills through experience rather than formal training. After…
V, Srividya; Kumar, Jayanth
Introduction: The extent of acceptance of contraceptive methods still varies within societies. Reliance on sterilisation is appearing earlier in marriage and among ever-younger ages and lower parities. Aim and Objective: To study the family planning practices adopted by women who undergo tubectomy before the acceptance of tubectomy. Material and Methods: Cross–sectional study of tubectomy acceptors who attended a corporation referral maternity home in Bangalore, India by interview method using a pre–designed a pre–tested structured questionnaire. Results: Majority 295(73.9%) of the study subjects had not practised any method of contraception before they underwent sterilisation. Increase in the education levels of the study subjects was associated with an increase in the contraceptive use (temporary methods) before they accepted tubectomy; this association was found to be statistically significant (p<0.0001). PMID:24086862
Predicting Neisseria gonorrhoeae and Chlamydia trachomatis infection using risk scores, physical examination, microscopy, and leukocyte esterase urine dipsticks among asymptomatic women attending a family planning clinic in Kenya.
Tyndall, M W; Kidula, N; Sande, J; Ombette, J; Temmerman, M
This cross sectional study presents a risk scoring system that would identify women at highest risk for sexually transmitted infections (STIs). 1058 randomly selected women participated in the study in Nairobi, Kenya; of these, 1048 participants were included in the analysis. The study was conducted from May 1994 to July 1995 at a clinic sponsored by the Family Planning Association of Kenya. Information pertaining to the demographic, behavioral and social characteristics of the participants was gathered. In addition, a clinical algorithm, which includes physical examination, microscopy, and leukocyte esterase (LE) urine dipsticks, was employed to detect gonorrhea and chlamydia infections among asymptomatic women. The results revealed that the prevalence of STIs, including HIV-1, was high among women attending this urban family planning clinic. Standard demographic, behavioral, and clinical characteristics were only weakly associated with infection, resulting in poor sensitivity and specificity calculations in the risk scores. Detection of cervical infections gave a sensitivity of 85% and a specificity of 30%. A positive LE urine dipstick had a sensitivity of 63% and a specificity of 47%. Although the addition of physical examination and LE dipstick to the work-up improved the sensitivity of case detection, it did not improve the overall validity of the scoring system.
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.…
Henan scored excellent results in planned parenthood work last year. The natural population growth rate fell to 9.53/1000, a fall of 3.35/1000 from the 1979 level. The province victoriously fulfilled the population plan assigned by the state. Some 320,000 couples with 1 child have taken out single-child certificates. The provincial CCP Committee recently convened a planned parenthood meeting. Provincial CCP Committee 1st Secretary Liu Jie and Secretaries Dai Suli and Zhang Shude spoke at the meeting. Li Xiuzhen, deputy director of the State Council's planned parenthood leading group and director of its administrative office, also attended and spoke at the meeting. The speakers stressed: Party committees and government at all levels must strengthen leadership over planned parenthood, put this work in an important place on their agenda, resolve to promote this work, and succeed in grasping the 2 items of production together. We must further publicize and implement the Central Committee's open letter, vigorously advocate that each couple should have only 1 child, strictly control the birth of a 2nd child, and take resolute measures to prevent the birth of more than 2. We must put ideological education in the primary position. CCP and CYL members and cadres at all levels must take the lead in practicing planned parenthood.
Statistical analysis plan for the family-led rehabilitation after stroke in India (ATTEND) trial: A multicenter randomized controlled trial of a new model of stroke rehabilitation compared to usual care.
Billot, Laurent; Lindley, Richard I; Harvey, Lisa A; Maulik, Pallab K; Hackett, Maree L; Murthy, Gudlavalleti Vs; Anderson, Craig S; Shamanna, Bindiganavale R; Jan, Stephen; Walker, Marion; Forster, Anne; Langhorne, Peter; Verma, Shweta J; Felix, Cynthia; Alim, Mohammed; Gandhi, Dorcas Bc; Pandian, Jeyaraj Durai
Background In low- and middle-income countries, few patients receive organized rehabilitation after stroke, yet the burden of chronic diseases such as stroke is increasing in these countries. Affordable models of effective rehabilitation could have a major impact. The ATTEND trial is evaluating a family-led caregiver delivered rehabilitation program after stroke. Objective To publish the detailed statistical analysis plan for the ATTEND trial prior to trial unblinding. Methods Based upon the published registration and protocol, the blinded steering committee and management team, led by the trial statistician, have developed a statistical analysis plan. The plan has been informed by the chosen outcome measures, the data collection forms and knowledge of key baseline data. Results The resulting statistical analysis plan is consistent with best practice and will allow open and transparent reporting. Conclusions Publication of the trial statistical analysis plan reduces potential bias in trial reporting, and clearly outlines pre-specified analyses. Clinical Trial Registrations India CTRI/2013/04/003557; Australian New Zealand Clinical Trials Registry ACTRN1261000078752; Universal Trial Number U1111-1138-6707.
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…
Schreiber, Courtney A; Traxler, Sarah
Family planning and reproductive health services are uniquely impacted by policy and politics in the United States. Recent years have witnessed an unprecedented number of abortion restrictions, and research funding has decreased in related areas. Despite this, both the science and the implementation of improved family planning and abortion methods have progressed in the past decade. This article reviews the current state of family planning, as well as technologies and patient care opportunities for the future.
Government sponsored family planning programs have had major success in declining birth rates in Barbados, China, Cuba, Hong Kong, Indonesia, Korea, Mexico, Singapore, Sri Lanka, Taiwan, and Thailand. Non- government programs have had similar success in Brazil and Colombia. These programs have been estimated as preventing over 100 million births in China and 80 million in India. Research indicates that family planning programs can produce a 30-50% drop in fertility. Family planning information and some contraceptives can be best distributed through community organizations. Research also indicates male opposition has been a major factor in wider acceptance of family planning. Surveys indicate that 50% of the woman who want no additional children are not using any birth control. Many governments do not have the resource and money to implement programs. In the developing countries if those who were able to prevent the unwanted births had birth control, the population increases in those countries would have been 1.3% versus 2.2%. In earlier family planning programs foreign assistance paid over 80% of the cost, and national governments 20%; today this is reversed. The World Bank estimates that for major improvements in population growth and women's health, $7 billion will be needed yearly by the year 2000. The countries that have had the similar goals in development of human resources, social services, health, and education. They have attended to the status of women, female employment, and maternal and child health. Estimates are that 1.3 billion couples and individuals will need family planning services by the year 2000, and this will be a formidable task. This key elements of successful family planning programs are community participation, decentralization, and training.
Morrissey, Taryn W.; Hutchison, Lindsey; Winsler, Adam
Low family income is associated with poor academic achievement among children. Higher rates of school absence and tardiness may be one mechanism through which low family income impacts children's academic success. This study examines relations between family income, as measured by receipt of free or reduced-price lunch, school attendance, and…
Heil, Sarah H.; Gaalema, Diann E.; Herrmann, Evan S.
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
Decker, Michele R.; Miller, Elizabeth; McCauley, Heather L.; Tancredi, Daniel J.; Anderson, Heather; Levenson, Rebecca R.; Silverman, Jay G.
Background/Objectives Adolescent and young adult women are at high risk for both STI/HIV and intimate partner violence (IPV). We evaluate the prevalence of IPV in the past three months and its associations with STI/HIV risk, STI, and related care-seeking over the same time period. Methods Female family planning clinic patients ages 16–29 (n=3,504) participated in a cross-sectional survey in 2011–2012 as a baseline assessment for an intervention study. We examined associations of recent IPV with sexual and drug-related STI/HIV risk behavior, self-reported STI, and STI-related clinical care seeking via logistic regression. Results Recent physical or sexual IPV (prevalence 11%) was associated with recent sexual and drug-related STI/HIV risk, specifically unprotected vaginal sex (AOR 1.93, 95% CI 1.52, 2.44), unprotected anal sex (AOR 2.22, 95% CI 1.51, 3.27) and injection drug use, both their own (AOR 3.39, 95% CI 1.47, 7.79) and their partner’s (AOR 3.85, 1.91, 7.75). IPV was also linked with coercive sexual risk: involuntary condom non-use (AOR 1.87, 95% CI 1.51, 2.33), and fears of requesting condoms (AOR 4.15, 95% CI 2.73, 6.30) and refusing sex (AOR 11.84, 95% CI 7.59, 18.45). STI-related care-seeking was also more common among those abused (AOR 2.49, 95% CI 1.87, 3.31). Conclusions Recent IPV is concurrent with sexual and drug-related STI/HIV risk, including coercive sexual risk, thus compromising women’s agency in STI/HIV risk reduction. Clinical risk assessments should broaden to include unprotected heterosexual anal sex, coercive sexual risk, and IPV, and should promote safety and harm reduction. PMID:24234072
Detzer, M J; Wendt, S J; Solomon, L J; Dorsch, E; Geller, B M; Friedman, J; Hauser, H; Flynn, B S; Dorwaldt, A L
Assessed condom use, barriers to condom use, oral contraceptive use, partnership status and STD history in 457 15-30 year-old women attending four family planning clinics. Subjects were classified into three condom use groups: Non Users (37%); Current Users (33%); and Past Users (30%). Factor analysis revealed five barriers to condom use: Partner's Perception, Peer's Perception, Pleasure/Intimacy, Communication, and Low Perceived Need. Multivariate analyses revealed significant group differences on only two barrier factors: Pleasure/Intimacy and Low Perceived Need. Low Perceived Need accounted for 13.5% of the variance in condom use. Women with low perceived need to use condoms were more likely to use oral contraceptives.
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.
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
Rosenfield, A G
Organizational and content features of various national family planning programs are reviewed. The Thai program is cited as an example of a family planning program organized on a massive unipurpose compaign basis. The Korean and Taiwan programs have utilized special field workers while upgrading the general health care network. 3 major problems with family planning programs are: 1) the lack of experience with such programs; 2) lack of commitment at the highest political levels; and 3) medical conservatism. Utilization of all available contraceptive methods instead of reliance on 1 method would improve most programs. Nursing and auxiliary personnel could be trained to take over the work of physicians in family planning programs. This is already being done with IUD insertion and pill prescription in several programs. The postpartum tubal ligation approach has proven effective and should be extended. There is a place in all national programs for both the private and the commercial sectors. Incentives for clinics, personnel, and acceptors might spread family planning more rapidly.
In 1991, an HIV prevention program advisor and a research/evaluation specialist for family planning programs discussed problems that affected HIV prevention and family planning services in Haiti before and after the coup of the Aristide government. Population activities began aimlessly in 1974 and HIV prevention efforts only began in 1988. After the coup, Haitians lost their newly found hope for meaningful development. All foreign assistance ended and they did not trust the army. In fact, other than essential child survival activities, no health and family planning services operated for several weeks. The situation grew worse after the economic embargo. 3 months after the coup, the US considered adding family planning assistance. Still little movement of condom, family planning, and health supplies left Port-au-Prince for the provinces which adversely affected all health related efforts. Condoms could no longer be distributed easily either in the socially marketed or US supplied condom distribution programs. Before the coup, HIV prevention and family planning programs depended on peer educators to educate the public (this approach made these programs quite successful), but the 2 experts feared that they would not return to those roles and that these programs would need to completely rebuild. Another concern was the large scale urban-rural migration making it difficult for them to continue care. Early in the AIDS epidemic, the Haitian government was on the defensive because the US considered Haitians as a high risk group so it did little to prevent HIV transmission. After 1988, HIV prevention activities in Haiti centered on raising awareness and personalizing the epidemic. The AIDS specialist noted, however, that a major obstacle to increasing knowledge is that AIDS is just 1 of many fatal diseases in Haiti. Moreover few health professionals in Haiti have ever had public health training.
Morrissey, Taryn W; Hutchison, Lindsey; Winsler, Adam
Low family income is associated with poor academic achievement among children. Higher rates of school absence and tardiness may be one mechanism through which low family income impacts children's academic success. This study examines relations between family income, as measured by receipt of free or reduced-price lunch, school attendance, and academic achievement among a diverse sample of children from kindergarten to 4th grade (N = 35,419) using both random and within-child fixed-effects models. Generally, results suggest that the receipt of free or reduced-price lunch and duration of receipt have small but positive associations with school absences and tardies. Poor attendance patterns predict poorer grades, with absences more associated with grades than tardies. Given the small associations between receipt of free or reduced-price lunch and school attendance, and between the duration of receipt of free or reduced-price lunch and children's grades, results do not provide strong evidence that absences and tardies meaningfully attenuate relations between the duration of low family income and student achievement; poorer attendance and persistent low income independently predict poorer grades. Implications for policy and future research are discussed.
Davis, M S
Natural family planning includes the calendar (rhythm), basal body temperature, ovulation (mucus), and sympto-thermal methods. Reliability of such methods often is underestimated, but effectiveness of various methods has been reported. Correct understanding and use of proper techniques, primarily abstinence during fertile periods, is imperative for effectiveness. New methods being studied may heighten awareness of fertile times and shorten required periods of abstinence or use of back-up methods.
The focus is in terms of family planning as an exercise in induced social change; the objective is to alter the reproductive patterns of societies sufficiently to bring about a significant reduction in fertility. The year 1974 emerges as the year in which family planning as a social movement achieved maturity and was confirmed as a legitimate area for national policy and programming, a year of determined and varied efforts to reduce population growth. In affirming the rights and responsibilities of people and the obligations of governments in population concerns, the Bucharest Conference conferred its seal of approval on a movement that had made considerable progress since it began early in the 19th century. The evolution of birth control as a social movement which began with Francis Place's printing and distributing contraceptive bills in 1820 was encouraged by other writings in England and the U.S. over the next 50 years. Several overlapping phases can be distinguished in the global response to a new sense of urgence regarding population concerns following World War 2. Moving from a global perspective to consideration of family planning as it exists in the programs of individual countries, the achievement is not so great and the prospects are less hopeful. Although it has had success as a social movement and is now accepted as a government responsibility, family planning programs still have a long way to go before they develop the scope, vigor, and versatility that is required for there to be widespread demographic change. 1 change that is needed is for a stronger and more visible political commitment and commitment on the basis of demographic rather than health or welfare reasons.
The author participated in the family planning project in Bangladesh from August 1, 1977 to December 31, 1979. The population of Bangladesh was 81 million in 1977 with annual increase of 3%, and the government was aiming at zero population growth. The government guidelines emphasized family planning as an effort integrated with other community programs. The use of adult education classes, mass media, and agricultural field workers and the training of paramedical personnel were proposed. The project members' activities involved motivating the public to delay marriages, to space births and to limit the family size to two children (average family size 6.5 children) as well as distributing contraceptives, promoting IUD and sterilization. Sterilization campaign for women in DNN district, 30 km south of Dacca, was carried out as follows. The women who had signed up in advance arrived at the elementary school classroom, where 2 medical teams performed operations using the teachers' desks and the equipment rented from a hospital in Dacca. The general procedure involved a physical examination by a female doctor, checking blood pressure, changing into a brand new native gown, premedication by injection, total anesthesia and operation itself. The equipment was sterilized by boiling. The patients were carried on the stretchers to the other classroom where they recuperated, staying overnight on the straw mats on the mud floor. They went home on foot the next day. The shortage of food and resources, high unemployment rate and low standard of living are some of the social problems Bangladesh faces along with overpopulation.
Ver Ploeg, Michele
Investigates the relationship between family structure and 4-year college enrollment and completion. Uses 1980 High School and Beyond Sophomore cohort and its subsequent followup surveys. Finds that family-income differences can explain much of the differences in college attendance and completion rates between students from disrupted families and…
Early birth control methods practiced by Muslims included a version of rhythm called takwim. Instead of using a thermometer to determine the safe period, the woman pressed her navel hard. If she felt magnetic sensations she was not in the safe period. Withdrawal, called piil, was also used. Old folks prepared juices extracted from roots like safran, pitawali, and when drunk they contracted the uterus and prevented pregnancy. New methods and programs have not gained popularity because of traditional medicines. Some early methods are still used today. To some Muslims sex is sacred and should not be talked about in polite conversation. If a Muslim discusses sex in front of others he has no delicadeza. Muslims must voluntarily accept family planning. If they are forced they reject the idea entirely. Extensive radio drama series have been broadcast since the establishment of the Provincial Population Office in Jolo in 1977. Muslims still believe in having many children as security in cases of tribal or interfamily feuds. Family planning workers in Stanvac, Zamboanga use the economic approach for motivating people. The financial burden of raising a big family is emphasized.
The results of a comparative study of demographic problems in 24 European countries are presented. The focus is on reproductive behavior, including the treatment of infertility, family planning, induced abortion, education for marriage and parenthood, and consultative services. The author notes that changes in the age of sexual maturity, age at marriage, the educational status of women, the impact of mass media, the stability of marriages, the acceptance of sexual intercourse prior to marriage, and the general availability of birth control impose changes on the provision of educational and consultative services. English and Russian abstracts of this article are available separately.
This work consists of a speech read before the Adacemy of Medicine of the Institute of Chile and a brief debate by members of the audience. Misinformed opponents of birth control who argue among other things that family planning is a US plot ignore the fact that the desire to avoid pregnancy dates from the remote past, as attested by evidence from early Egyptian papyruses. Recent sharp declines in human mortality have led to unprecedented population growth. Around the beginning of the modern era the world contained about 250 million people, a population which did not double until the mid 1600s. Today world population doubles in 30 to 35 years, and by the end of the century it may reach 7 billion. The impact of such growth on the food supply, housing, the economy, education, and the environment have been the object of many studies, predominant among them those presented at the World Population Conferences in Rome, Belgrade, and Bucharest. The family planning program in Chile was initiated around 1962 although some activities had been carried out earlier. The Chilean Association for the Protection of the Family, a private organization, grew out of these early efforts and enjoyed considerable success from its earliest days. The natality rate declined from 38/1000 in 1962 to 23.5/1000 in 1977, and infant and maternal mortality also declined. The decline has been concentrated in births after age 30 and in high parity births. The young age structure means that the population will continue to increase for the foreseeable future.
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…
Kirby, M D
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
Daly, K J; Herold, E S
This study examined the characteristics and attitudes of 132 married couples who had received training in use of the symptothermal method of natural family planning (NFP). 61% of respondents were 20-30 years of age and over 2/3 had completed college; 59% were Catholic. The largest group of subjects (35%) became aware of NFP through friends, neighbors, and relatives. 71% said they were drawn to NFP because it represented a safe and healthy alternative to other methods of birth control; only 17% gave moral or religious reasons for learning about NFP. 42% of the sample were using NFP at the time of the survey, 32% had discontinued use, and 25% were using fertility awareness in conjunction with barrier methods (combination-continuers). There was a significant difference between these 3 groups in church attendance: 48% of combination-continuers and 67% of continuers compared with 41% of discontinuers attended church once a week or more. The combination-continuer group had more Catholics (50%) than the discontinuer group (37%) but less than the continuers (76%). No significant differences were found between the 3 groups in terms of age, education, or regularity of menstrual cycle length. Over 3/4 of continuers had been married for less than 5 years compared with about 1/2 of those in the 2 other groups. 69% of continuers believed that NFP is extremely effective compared to 13% of discontinuers and 40% of combination-continuers. Spouses encouraged each other in the use of NFP in 88% of combination-continuer couples and 86% of continuer couples, but only about half of discontinuers received such encouragement. Although most NFP advocates emphasize a nonsexual form of abstinence during the fertile period, the vast majority of respondents in this study defined abstinence to include the possibility of orgasm. Combination-continuers, positioned between continuers and discontinuers or both dissatisfaction with other methods and with abstinence, warrant more attention in future
Pinter, Bojana; Hakim, Marwan; Seidman, Daniel S; Kubba, Ali; Kishen, Meera; Di Carlo, Costantino
Religion is embedded in the culture of all societies. It influences matters of morality, ideology and decision making, which concern every human being at some point in their life. Although the different religions often lack a united view on matters such contraception and abortion, there is sometimes some dogmatic overlap when general religious principles are subject to the influence of local customs. Immigration and population flow add further complexities to societal views on reproductive issues. For example, present day Europe has recently faced a dramatic increase in refugee influx, which raises questions about the health care of immigrants and the effects of cultural and religious differences on reproductive health. Religious beliefs on family planning in, for example, Christianity, Judaism, Islam and Hinduism have grown from different backgrounds and perspectives. Understanding these differences may result in more culturally competent delivery of care by health care providers. This paper presents the teachings of the most widespread religions in Europe with regard to contraception and reproduction.
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…
Some interviews with educated women about their thoughts on family planning, birth spacing, and desired family size are provided. There were rumors that Nigerian women wanted birth spacing because the economy was so bad. There was a question about whether women desired family planning for both birth spacing and family limitation without jeopardizing conjugal felicity, or whether the government campaigns for smaller family size were being effective, or whether the economic realities were forcing rethinking. The responses came from a legal assistant in her early 30s; a health consultant, a 27-years old baby wear dealer, a 27-year old nurse, a 54-years old academician, a 44-year old librarian, a 35-year old pharmacist, and a fashion designer. Mrs. Ige, the legal assistant, married at 28 years believed that family planning was essential and the desired family size was around 4, but more importantly family size was based on the parents ability to provide "adequate" care. The health consultant with 4 children considered that a mother had a life after children and living standards were not improving. The baby war dealer with 2 children believed that family planning provided the opportunity to plan for the education of your children; the number of educated children depended on the ability of society to provide adequate jobs. The nurse was not married and planned to seek counseling in family planning after her first child. The academician with 4 children believed individuals had the right to decide the desired number of children, but should be guided by the principle of having no more than they could adequately care for. The librarian with 4 children thought family planning was nice for helping ladies plan their families according to their means; wealthy families could afford 4-5 children, and middle income earners could only afford 2-3 children. The fashion designer with 2 children said that family planning was necessary for spacing the number of children and giving the
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.
Abraham De D'ornellas, R
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.
Profamilia, the Association for the Welfare of the Colombian Family, was begun in 1965. It includes the largest Planned Parenthood clinic in the world. Profamilia's acceptors have increased from 83 in 1965 to 73,000 in 1972. In addition to the Profamilia service center, Pilot Center, there were 43 clinics in 29 Colombian cities in 1972. In that same year, Profamilia's Education Department carried out 15,265 talks for 208,159 prospective family planning users and gave 6116 film presentations to 163,709 people in urban areas. In rural areas some 6893 conferences and 2542 film presentations were given to over a quarter million people. In 1971 Profamilia began a nonclinical contraceptive distribution project in Risaralda. There is also a voluntary sterilization program. 2000 vasectomies have been performed and they are now averaging 100 per month. 398 family planning information centers were attended by 20,000 individuals in 1972. Profamilia has been a member of the International Planned Parenthood Federation since 1968.
McConnell, Bethany M.; Kubina, Richard M., Jr.
School attendance is a rising issue in public schools. Students regularly absent from school can end up involved in destructive behaviors and dropout of school. Family characteristics are strong determining factors in students' school attendance. This presents the question, "Can family involvement improve public school students'…
The switch in emphasis in population policies from family planning to the development of socioeconomic policies that would encourage smaller families--summed up in the word "developmentalism"--is charted from a 1967 paper by Kinsley Davis to its culmination at the 1974 World Population Conference, when even as staunch a supporter of family planning as John D. Rockefeller came out in support of placing population policy in the context of economic and social development. The real question is, however: To what extent does developmentalism represent a true shift in policy and how much is simply a more sophisticated rhetoric designed to deflect the growing opposition to population control? On the one hand, the endorsement by a man of Rockefeller's stature indicates a significant change. On the other, the changes which the implementation of developmentalism would entail seem irreconcilable with the present political and economic structures of underdeveloped nations and of relations between them and the more developed countries. Further, developmentalism is neither as progressive as its advocates suggest, nor as threatening as its opponents cry. It is, in fact, a prescription for enhancing the effectiveness of family planning through a form of social engineering from the top; its details--more aid, investment, and trade--would involve an expanded Western role in the Third World. It is even suggested that developmentalism might be a cover for the creation of a more stratified society, where marginal members are restricted to their own quarters in an effort to secure political stability and economic growth. In the end, developmentalism might be shortlived, as pressure to step up birth control programs is felt from many quarters.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Notice of Staff Attendance at Southwest Power Pool Strategic Planning... attend the meeting of the Southwest Power Pool, Inc. (SPP) Strategic Planning Committee (SPC), as...
... of Public Health/Center for Communication Programs (CCP). Knowledge for health project. Family planning: a global handbook for providers (2011 update). Baltimore, MD; Geneva, Switzerland: CCP and WHO; 2011; and Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397–404.
The countries discussed in this paper are the francophone countries of West Africa and the Republic of Congo, with comparative references made to North Africa (mainly Morocco, Algeria, and Tunisia). Obstacles to the adoption of family planning in the countries of tropical Africa are a very high mortality rate among children; a socioeconomic…
One of the important decisions taken at the 21st meeting of the World Medical Association held in Madrid during September was to accept the following resolution: "Whereas, population explosion will cause problems of nutrition, and Whereas, unrestricted population increase may leave large segments of the human race in poverty and without adequate education, and Whereas, careful planning and foresightedness may meet these problems, and Whereas, a doctor must always bear in mind the oblications of preserving human life, Now therefore be it resolved that the Council recommends that the Assembly endorse family planning and that each national organization study this situation. Family planning may be assigned to one or other agency, but the final responsibility is on a voluntary personal basis." This resolution, although not particularly strong, is nevertheless a landmark in the history of the WMA. Composed as it is of representatives of the medical associations of member countries, including many that are Catholic, it has not officially supported family planning in the past. No mention of the contraceptive means to be adopted is made; this is to be left to the individual countries, with the emphasis on the free choice of the couples concerned. But what is important is that the WMA has accepted that unrestricted population increase can be deleterious and may require farsighted planning to keep it in check.
Ekerdt, David J.; Sergeant, Julie F.
When adults move to smaller quarters in later life, family members become involved in the management and disposal of possessions—some cherished, some mundane. Interviews were conducted with 14 family members who had participated in a household disbandment by elders. This qualitative analysis describes the various tasks that were undertaken by family members; how family members asserted themselves in the process; how they were an outlet for possessions; the way that some possessions are shared; and implications for family’s story about itself. Household disbandment is a field for all sorts of family practices that can be summarized along three continua that characterize (1) the receiving of goods, (2) the location of agency between elder and family members, and (3) family’s self-understanding. PMID:17047729
Gil-Rivas, Virginia; Kilmer, Ryan P; Larson, Jacqueline C; Armstrong, Laura Marie
Subsequent to the wars in Afghanistan and Iraq, the experiences of military service members (MSVMs) and veterans have garnered increasing attention. A growing body of work has begun to shed light on their reintegration, a process that can bring with it transitions and challenges for service members and their families. Although many families adapt effectively, some have difficulty navigating this process, which can lead to a host of short- and long-term negative consequences for families. The literature to date is not well-developed regarding strategies for supporting successful reintegration of MSVMs and veterans in the context of military families. Guided by the ecological framework, this article summarizes selected evidence regarding factors that influence reintegration and puts forth recommendations for research and practice to promote the wellness of military families. Informed by findings regarding the diverse challenges faced by these families and grounded in the ecological framework, the authors highlight the need to assess both proximal and distal factors related to families' reintegration experiences and the need to intervene at multiple levels and across multiple contexts. Of primary importance, the authors recommend strategies to enhance the capacity of families' natural settings and describe selected capacity- and resource- enhancement approaches for families, neighborhoods, schools, and communities that facilitate resilience and promote wellness. Other recommendations include focusing on the accessibility, integration, and coordination of services; considering the long-view and developing strategies for longer-term support; developing mechanisms for family support; and evaluating efforts to address needs of families and promote family resilience. (PsycINFO Database Record
A diversified pattern of family planning service delivery currently exists, one that is considerably extended through the development of a wide range of supply and distribution channels. In most areas, nongovernmental organizations have played a crucial role in the development of innovative approaches to making contraceptives widely available. In many nations the provision of contraceptives through the national health system continues to be the backbone of the family planning program. Changes in the approach to health care have helped increase the acccessibility and acceptability of family planning services. 2 factors necessitate a close link between contraceptive and health services: the need for medical skills and facilities in the provision of surgical contraceptive methods, and the importance of medical supervision in the continuing use of other methods. A widely used approach integrates contraceptive delivery with other development programs, community-based distribution (CBD) of contraceptives, and commercial retail sales. The cornerstone of CBD is extensive use of community networks and of trained community residents. An effective project requires efficient resupply and distribution mechanisms, carefully designed supervision systems, and medical back-up facilities. CBD has spread to over 40 countries, most of them in Asia and Latin America. Wider use of existing commercial retail outlets is being followed in more than 30 countries. Self-sufficiency of these projects has not been realized, and considerable subsidization continues to be required to maintain their efficiency. Efforts to increase the availability of contraceptives have been facilitated by the widening range of service providers. Nurses, midwives, traditional birth attendants, and members of the community are being trained to perform many family planning tasks in clinical and nonclinical settings. Many of these advances have been made possible by the liberalization of laws and regulations
30 years ago Tunisia achieved independence, and 20 years ago it adopted a family planning policy designed to bring about a balance between demographic and economic growth. Birth control and family planning continue to be a major concern, and services now are provided in over 800 public sector centers -- dispensaries, hospitals, family planning clinics, and mobile teams. 4 out of 10 married women use some form of contraception, and some 30,000 abortions are performed per year by services of the National Office for Family Planning and Population. 2/3 of Tunisians believe that religion has a favorable view of birth control, but there are other sources of resistance to birth control -- sources related to a woman's level of education, her status, and socioeconomic level. The average number of children/woman decreases according to her level of education, from 6.9 among illiterate women to 2.6 among women with a university education. The proportion of illiterate women in Tunisia is close to 50%; the level is as high as 75% among women over age 30. These figures provide the explanation as to why the decline in the birthrate has been so slow. Another major determinant of reproduction rates among Tunisian women is access to employment. Women with jobs have an average of 2 children in contract to women without jobs who normally have more than 4 children. A marked decline occurred in the birthrate between 1966-76, and about 2/3 of Tunisian women now subscribe to the modern family model, i.e., a smaller family oriented toward consumption and comfort. Yet, despite improvements, under the best-case scenario the reproduction rate would be 3.8 children/family at 2000, and a rate of 2.9 would not be achieved until 2020, which is still higher than the rate necessary for simple population replacement -- 2.1. This downward trend would be realized under the combined effects of socioeconomic and cultural changes, i.e., better education, urbanization, declining infant mortality, the
Derzko, Christine M.
Natural Family Planning (NFP) is defined by the World Health Organization (WHO) as “methods for planning or avoiding pregnancies by observation of the natural signs and symptoms of the fertile and infertile phase of the menstrual cycle. It is implicit in the definition of natural family planning, when used to avoid conception that drugs, devices and surgical procedures are not used, there is abstinence from sexual intercourse during the fertile phase of the menstrual cycle, and the act of intercourse, when it occurs, is complete.”1 The fertile period may be determined by using Rhythm, a calculation based on previous cycles, basal body temperature (BBT) charting alone, mucus secretion alone (Billings or Ovulation method), or symptothermal charting (Serena method), which includes observation of both mucus and BBT. The effectiveness of each method is discussed, and the social and psychological profile of couples who use NFP is reviewed. Nfp methods can be used not only to avoid pregnancy, but also to achieve pregnancy and thus are particularly useful in investigating and treating infertility. The function of the Family Life Clinic at St. Michael's Hospital in Toronto is described. PMID:21267296
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…
In July 1972, DANIDA and the Danish Family Planning Association provided delegations from selected countries the opportunity to devise teaching programs on population and family planning topics for 9-to 11-year-olds. Participants from the Arab Republic of Egypt, Indonesia, Korea, Malaysia, and the Philippines attended the meeting with Danish…
Ansari, Arya; Winsler, Adam
Latino children often struggle in school. Early childhood education programmes are seen as critical for fostering children's school readiness. Latino families often choose family childcare (FCC) over centre-based childcare (CBC), yet little is known about the school readiness of Latino children attending FCC. We compared school readiness over the…
Family planning has been practiced in Nangong county, China, since 1971; as a result the population growth rate has dropped from 16.7/1000 to 3.6/1000 in 1979; 98% of women of childbearing age use contraception, and most couples have only 1 child. Before 1971 most couples had 4-5 children; per capita grain rations had to be reduced because of the increase in population, and more grain had to be supplied by the state. 1 child families are now rewarded with an annual monetary bonus, extra grain allocations for the child, free tuition in schools, and preference in job placement and medical treatment. Parents who have more than 2 children are penalized by the withdrawal of 10% of their monthly earnings. The idea of "1 couple 1 child" is a radical change from China's traditional culture, which viewed children especially sons, as an insurance against old age insecurity. Marriage at a later age is also encouraged; in Nangong county none of the men of marriageable age married before 25, and none of the women before 23. As a result of promoting family planning Nangong country has ceased to need grain subsidies from the state, and in recent years has had a 10,000 ton surplus to sell.
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.
This paper examines whether improved access to family planning services for under 16 is likely to help in achieving the aim of reducing underage conceptions. A simple model of rational choice is introduced which suggests that family planning increases rates of underage sexual activity and has an ambiguous impact on underage conception and abortion rates. The model is tested on panel data on regions within the UK using two approaches. The first test is whether the 1984 Gillick ruling had a differential impact on two groups: under 16 for whom access to family planning was restricted by the ruling and older teenagers who were not affected. Secondly, attendance by under sixteens at family planning clinics, suitably instrumented, is used as a proxy for access to family planning. With both approaches, no evidence is found that the provision of family planning reduces either underage conception or abortion rates. Socio-economic variables such as children in care rates and participation rates in post-compulsory education are found to be significant predictors of underage pregnancies.
Market research into contraceptive distribution (especially condoms) has been carried out in Britain by private manufacturers, but the results of this research are generally unavailable. Academics have not used the techniques of market research, preferring their own forms of sociological research and being hampered by limited resources. Attempts to design programs to introduce the provision of free family planning services proved unsuccessful, even though the programs offered supplies, sympathetic personnel, and publicity. Part of this failure is attributed to the lack of any baseline research on the demand for and acceptability of these services in the project areas. These failures are contrasted to a very successful commercial marketing campaign for a brand of condom, and with a commercially designed Dutch program aimed at teenagers. The author urges that those who have a message of social importance to deliver look into the techniques of market research used by industry to alter people's attitudes and buying habits. This will require the provision by local and central government of adequate funds for research into attitudes and needs, which ought to be essential before any family planning campaigns are launched.
Family Health International's (FHI) research and development activities in improving and developing contraceptives and making them available to the public are presented. While FHI, along with other agencies, has been actively promoting and contributing to ongoing international family planning efforts since its creation in 1971, the period 1971-91 has, nonetheless, witness more births, maternal deaths, induced abortions, and infant deaths than over any 20-year span in history. While family sizes have decreased over the period due to greater contraceptive awareness and use, politicians, civil servants, and theologians are indicted as partly responsible for retarding further positive change. The number of women of reproductive ages in developing countries will increase by almost 30% in the 1990s, and the world's population will at least double over the next century. 95% of new births will stem from developing countries. Concerted efforts and global commitments of policymakers must be forthcoming in the battle against both high fertility and AIDS prevention. Specifically, at least 130 million new contraceptive users must be recruited in the 1990s. Surveys and field experiences indicate a large degree of unmet need for contraceptive services, with 50-80% of married women in developing countries expressing their desire to limit or space future births. Demand for contraception only increases once a program is in place; rapid reductions of total fertility are exemplified in the cases of Thailand, Colombia, South Korea, Sri Lanka, and Indonesia. Given the resources and commitment, the number of users could be doubled within 10 years.
David, H P
It is known that unwanted pregnancies have damaging consequences. Despite the fact that 97% of fecund U.S. women have used or expect to use contraception, more than 1/2 of the births were reported by married couples in 1965 as unplanned. The circular relationship between excess fertility and conditions of poverty and their relevance for mental health has been studied; results have shown that in large families there is a great likelihood that the last-born child is unwanted. It is also true that in families with 4 or more children, those in the last half of the birth order are more likely to develop mental illness than their older siblings. One way to reduce unwanted pregnancies is to enable couples to have children only with their own informed consent. Induced abortion must be among the available alternatives for the women desiring it. The role of unregulated fertility in the etiology of mental disorder is seldon explored. Systematic observations of the mental health consequences of unwanted pregnancies are rare. Similarly, the appropriateness of applying family planning concepts in preventive mental health programs has received little attention. Sex education and contraceptive information should be introduced when a girl reaches menarche. Closer work between mental health association, medical schools, general practitioners, etc., is needed urgently. The author maintains that the prevalence of unwanted pregnancies and the appalling numbers of unwanted births in the U.S today represent a mental health problem of undefined but clearly immense proportions.
World Education, Inc., New York, NY.
This document gives details on a current Thai project whose object is to introduce family planning concepts into adult education programs. Complementary objectives are: (1) Educate 200,000 adults through literacy/family planning programs by 1976; (2) Develop appropriate instructional materials; (3) Add and emphasize family life education in the…
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…
In a developing country with an average life expectancy of 50 years or higher (an age already reached by several less developed nations) unl imited procreation is no longer necessary to insure the survival of 1 or 2 sons. Data from Pakistan computed from the Population Growth Estimation Experiment of 1962-1965 shows that the male mortality ratio for infants under 1 year was 232/1000 but for 1-4 years it was 25/1000 and for 5-14 years, 3/1000. Further study showed that women had an average of about 5 living children and some of these children already had children of their own as a result of early marriage. If a 27-year-old father has a 2-year-old son there is a 77.2% chance the child will survive him. If replacement is permitted in case of death, a campaign of "at least 2 sons" would result in Pakistan of an average family size of 3.6 children, far fewer than is now the case. This strategy should be more acceptable to parents than the present recommendation to restrict the number of children to 2 or 3. There also needs to be economic incentives for small families. Under present conditions the cost per child is small to the average rural family and the reward in prestige is great. The People's Republic of China has used negative incentives effectively. Positive incentives should be just as effective but they must be high enough to offset the current rewards of childbearing. There is also need to find out why so many couples do not practice family planning even though they approve of it and how administrative structure influences the success of a program. It has already been shown in Pakistan that repeat visits bring in far more acceptors than just 1 visit and repeated personal contacts should be maintained with the target population.
Brown, J. B.; Dickie, I.; Brown, L.; Biehn, J.
OBJECTIVE: To identify the factors that contribute to patients' long-term attendance at a family practice teaching unit. DESIGN: Qualitative method of focus groups. SETTING: A community-based family practice teaching unit in southwestern Ontario. PARTICIPANTS: Patients who had been coming to St Joseph's Family Medical Centre for more than 15 years were purposefully selected to participate. METHOD: Five focus groups composed of patients who had been affiliated with one of the three practices at the Centre for more than 15 years explored factors contributing to long-term attendance. MAIN FINDINGS: Four key themes were identified as the primary factors contributing to long-term attendance: the relationship context, the team concept, professional responsibility and attitudes, and comprehensive and convenient care. CONCLUSION: The resource-rich era of medical care, during which participants formulated their views and opinions about the factors contributing to their long-term attendance at a family practice teaching unit, has come to a close. The findings of this study provide important information that could help maintain one of the basic tenets of family medicine-continuity of care. PMID:9154362
In February 1990, the Mexican award winning director and animator, Carlos Carrera, went to Tokyo to oversee the photographing of the color frames (brought from Mexico) of the sex education animated film "Music for Two". The film begins with a warning that it should be shown as part of a sex education program. Further, a trained advisor guides the audience during the recommended discussion following the film. "Music for Two" is set in a large city and features a young female teen who daydreams about imaginary lovers. She soon discovers that her young male next door neighbor is interested in her. The moral of the story is that, once a woman is an adolescent, she must consider her future and have lifelong goals. In order for her to do so, however, she must know her mind and body, appreciate them, and not renounce them. This animated short feature includes both English and Spanish versions targeted to adolescents in their mid to late teens, especially females, in Latin America and the Caribbean. Mr. Carrera predicted that conservative older individuals will most likely not approve of "Music for Two". The Japanese Organization for International Cooperation in Family Planning (JOICFP) and the UNFPA sponsored this animated film and the Mexican Family Planning Foundation (MEXFAM) participated in its production. The Sakura Motion Picture Company in Japan and Kinam SCL International in Mexico coproduced it. The Japanese Ministry of Foreign Affairs underwrote the English version and the UNFPA and IPPF underwrote the Spanish version. Further, in 1989, Mr. Carrera played a major role in a successful sex education animated feature titled "Blue Pigeon". This film was geared to youth in their early to mid teens, however.
Petts, Richard J
Despite numerous studies on adolescent well-being, longitudinal research on the influence of religion on well-being is lacking, and limited studies have looked at how family and religion may work in conjunction with one another to influence adolescent well-being. This study addresses these limitations by using longitudinal data on 5,739 youth to explore whether family structure, changes in family structure, parent-child relationship quality, and religious attendance (overall and with parents) influence trajectories of psychological well-being independently and in conjunction with one another. Results support previous research in showing that parental interaction and attending religious services with parent(s) in late childhood are associated with higher psychological well-being, whereas conflict with parents and residing in a nontraditional family in late childhood are associated with lower well-being among youth. Finally, there is evidence suggesting that attending religious services with parent(s) amplifies the positive influence of parental interaction on psychological well-being, and overall levels of religious attendance over time are less likely to increase well-being among adolescents raised by single parents than for adolescents raised by married parents.
This review of natural family planning (NFP) focuses on the following: components of the fertile phase; sympto-thermal methods; the history and methodology of NFP (calendar rhythm, basal body temperature, cervical mucus--the Billings Ovulation method); special circumstances--periods of erratic ovulation (puberty, lactation, premenopause, discontinuation of ovulation suppression, cervicitis and vaginitis, ovulation suppression by stress and pharmaceuticals); effectiveness of natural family planning; achieving pregnancy; achieving couple autonomy (confidence in the method, periodic abstinence, dynamics of the learning process, and support systems); problem areas; and delivery systems. The number of users of NFP methods increased from 2.8% of currently married couples in 1973 to 3.4% in 1976. In 1979, 75,000 new clients received training in contemporary NFP, while the number increased to over 100,000 in 1980. NFP is planning for achieving or preventing a pregnancy by the timing of intercourse. A couple can, by observing and recording certain natural symptoms and bodily changes that occur in a woman's menstrual cycle and using the information as a guide, learn to identify fertile and infertile phases in the menstrual cycle. Precise prediction of ovulation forms one of the components of delineation of the fertile phase. Billings pioneered the use of cervical mucus as a single parameter for the prediction of ovulation and its application to NFP. Women are instructed to observe their mucus patterns at the vulva, relying primarily on the sensation of wetness and lubrication, the use of the Kegel exercise, palpation with the finger, a "wipe-through" with toilet paper, or a combination of these observations. In the absence of ovulation, the usual changing mucus pattern is also absent. NFP can be used either to achieve or to avoid pregnancy. When NFP is used to avoid pregnancy, one will encounter method-related pregnancies, teaching-related pregnancies due either to poor
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…
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…
Radio is the 1 significant medium of communication available in Kiribati and, consequently, is the most appropriate means of transmitting family planning education. The dismal state of broadcasting early in the 1970s provided an opportunity for family planning. Tutors, nurses, dressers, and radio announcers all were pressed into forming the radio repertory company. Additionally, the women's sections provided plays and items devoted to family planning. A half-hour series of weekly feature programs on family planning would be supported by daily radio spots, news items, and contributions to current affairs programs. The series of feature programs included an educational message, but it was the few second radio spots inserted between local items which created the most interest, knowledge, and controversy about family planning. The campaign was focused primarily on the use of the IUD, and many spots aimed specifically at promoting this method. Another idea was the composition of a family planning song. Clearly, radio plays an important part in coordinating all family planning activities, ranging from staff movements to song competitions. It has been the most effective means of family planning communication.
This Hubei, China, Circular, issued near the end of 1988, provides the following: "The population growth situation in our country is grim. Since 1986, the natural population growth rate has risen continuously. To draw the prompt attention of the whole party and the entire people to the issue of our population, all localities must seriously unfold the activities of publicizing family planning (FP) this winter and next spring, in coordination with education in current affairs. It is necessary to publicize FP in an all-around way and with accuracy, and the activities of publicizing must be carried out effectively in a solid and deep-going way. In the rural areas, stress must be placed on areas where FP work is not carried out well and where there is a prevailing tendency toward early marriage, early child-bearing, and extra-budgetary births. In cities, publicity and education must be conducted especially among the transient population, individual households, and jobless households. During the period of publicity, large-scale street-corner publicity activities must be carried out in cities and towns so as to create strong public opinion and to combine the endeavor to publicize current affairs and policies with the effort to popularize knowledge about contraception and birth-control, to execute measures of contraception and birth control, and to establish FP associations in the countryside."
Dryfoos, J G
During the past decade, the number of family planning clinics receiving support from the federal government has fallen from 5,000 to 4,000 despite a growing demand for their services among poor women and teenagers. At the same time, family planning providers have been under regulatory attack, forced to fend off a "squeal rule" aimed at teenagers and to stop a "gag rule" preventing abortion referral. With the climate in Washington unlikely to change, family planners should consider integrating other services into their network or press to include family planning in other care networks. A new national commission could help break the logjam on federal legislation.
Family Health International's Women's Studies Project, launched in 1993, conducted 26 field studies in 10 diverse developing countries on the impact of family planning use on women's lives. Advisory committees in the participating countries established the research agenda, monitored the research process, and planned dissemination of research results. One of the goals of the project was to encourage the use of research findings to improve the quality of women's reproductive health services. The completed studies confirmed that women's family planning experiences are shaped by factors such as age, culture, place of residence, socioeconomic class, religion, and gender norms. However, two general themes emerged: 1) gender roles play a significant role in influencing women's family planning experiences; 2) family planning affects multiple domains of women's lives--domestic, economic, and community. The research confirmed that women perceive many benefits of family planning use. At the same time, they experience negative consequences such as family disapproval, method side effects, and the uncertainty associated with a redefinition of traditional sex roles. Women are generally satisfied with family planning services, but want more female providers, more emotional support, help with side effects, and more information on contraceptive methods.
Carpenter, Peter G; Fleishman, John A.
Examines factors that influence Australian high school seniors' plans to attend college and their actual entry into college. Uses the Fishbein-Ajzen model of attitude-behavior relations to link intentions to continue school with the realization of those intentions. (RB)
Hilmar, Norman A.
Remarks in this article were made as part of a panel discussion presented at the Planned Parenthood-World Population combined Southeast Council and National Board Meeting, Savannah, Georgia, in May 1970. The problems and consequences of an increasing birth rate are indicated along with the need for reducing present rates of population growth and…
This news insert relays information on the Second National Conference on China's Urban Family Planning Program held in Nanjing, Jiangsu province, during December 1996. Conference participants included Mme. Peng Peiyun as Minister of the State Family Planning Commission and 200 participants from 30 provinces and State Council departments. The conference aimed to discuss the family planning system in relation to the socialist market economy, improvements in delivery of more and better services to reproductive age couples, and more scientific and reasonable family planning management. The conference was sponsored by the State Family Planning Commission. The program offered the opportunity to exchange experiences in implementing urban family planning programs. The first conference was held in Shanghai in 1992. Significant changes have taken place over the past 10 years. There is now a low birth rate, a low rate of natural increase, and changes in attitudes toward fertility. Family planning is a voluntary practice. The urban population has experienced improvements in the quality of life. People demand more and better services and services for maternal and child health and reproductive health. The process of urbanization is accelerating as more people move to cities and towns and new towns are formed. An increasing number of workers are engaged in joint-venture businesses and in the private sector.
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
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
Newman, Lareen A
This article argues that the continuing reluctance on the part of professional and bureaucratic bodies in Australia to provide for and support planned attended homebirth for low-risk women is unfounded according to the research evidence. It also suggests that such lack of support might be encouraging some planned but intentionally unattended homebirths to occur in Australia, particularly as in recent years there appears to have been an increase in popularity in freebirth (or do-it-yourself homebirth). The article calls for RANZCOG and Australian state health departments to support planned attended homebirth for low-risk women in the face of what is now a considerable amount of evidence showing its safety, when compared with unplanned homebirth and hospital birth. The article raises a number of challenging issues for obstetricians, midwives and managers or planners of maternity services.
Kulig, J C
An ethnographic study was conducted within a Cambodian refugee community to discover information about Cambodian women's and men's knowledge and use of family planning methods. This 18-month study included participant observation at community and calendrical events, and within families' homes. Open-ended interviews were conducted with 53 informants from a variety of educational and socio-economic backgrounds. Both women and men were interviewed through a female bilingual interpreter when the informant lacked proficiency in speaking English. Major findings include a lack of knowledge among the sample about how the family planning methods work in the woman's body, and concerns about side-effects. Implications include the need to include Cambodian women and men in the planning and implementation of family planning programmes.
Sparer, G; Okada, L M; Tillinghast, S
The results of 2 cost studies on family planning programs are compared. National Analysts, Inc. studied 45 family planning programs for the program years 1968-1969. Westinghouse Population Center studied 27 family planning projects of 25 agencies for the program year 1970-1971. The Westinghouse projects were considerably larger in terms of operating costs than the National Analysts programs. Comparisons are made by way of multiple graphs and statistical tables. Per patient costs and the distribution of costs between direct medical services and indirect costs are consistent between the 2 studies. The results emphasize economies of scale and diseconomies of very large scale. From a cost basis, the ideal family planning project characteristics are: 1) a patient volume of approximately 3000; 2) a budget size of about $175,000; and 3) an institutional base. Programs with 1-site services were less costly than those with multiple sites or those using private physicians to provide the primary medical services.
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.
Eddosary, Melfy; Ko, Yong Jae; Sagas, Michael; Kim, Hee Youn
The purpose of this study was to identify important factors of consumers' intention to attend professional soccer events among Saudi Arabian soccer fans. To explore the decision-making process of this relatively understudied population, the theory of planned behavior was used as theoretical background. Particularly, this study measured the effect of attitude, subjective norm, perceived behavioral control (time and money), and game importance on intention to attend, and examined the moderating role of commitment. Structural equation modeling (SEM) using 231 Saudi university students (M = 21.9 yr., SD = 1.21) indicate that attitude and game importance were significantly related to attendance intention. The effect of subjective norms was significant only for the low commitment group and game importance was more important for the low than the high commitment group.
Finger, W R
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.
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…
Palamaro Munsell, Eylin; Cook, James R.; Kilmer, Ryan P.; Vishnevsky, Tanya; Strompolis, Melissa
Although a growing body of literature has examined wraparound implementation and fidelity, child and family team (CFT) members' levels of participation and the consistency of their attendance have not been systematically examined. This study explored the relationship between CFT member attendance consistency and the fidelity of wraparound team…
Rodriguez, Erin M.; Donenberg, Geri R.; Emerson, Erin; Wilson, Helen W.; Brown, Larry K.; Houck, Christopher
OBJECTIVE This study examined associations among family environment, coping, and emotional and conduct problems in adolescents attending therapeutic day schools due to mental health problems. METHODS Adolescents (N=417; 30.2% female) ages 13–20 (M=15.25) reported on their family environment (affective involvement and functioning), coping (emotion-focused support-seeking, cognitive restructuring, avoidant actions), and emotional and conduct problems. RESULTS Poorer family environment was associated with less emotion-focused support-seeking and cognitive restructuring, and more emotional and conduct problems. Emotional problems were negatively associated with cognitive restructuring, and conduct problems were negatively associated with all coping strategies. Cognitive restructuring accounted for the relationship between family environment and emotional problems. Cognitive restructuring and emotion-focused support-seeking each partially accounted for the relationship between family functioning and conduct problems, but not the relationship between family affective involvement and conduct problems. CONCLUSIONS Findings implicate the role of coping in the relationship between family environment and adolescent mental health. PMID:25151645
Slesnick, Natasha; Prestopnik, Jillian L.
There is a dearth of research examining treatment engagement and attendance among runaway youth and their families. Such research is needed in order to inform treatment providers on factors associated with engagement and maintenance of these difficult to engage families into counseling. This study examined differential treatment attendance for alcohol abusing runaway youth residing at a local shelter. A traditional office-based family systems approach, Functional Family Therapy (FFT), was compared to a non-traditional, home-based, multi-systemic family therapy approach, Ecologically Based Family Therapy (EBFT). As expected, treatment engagement and attendance was significantly higher for those assigned to EBFT (N = 37) compared to FFT (N = 40). Predictors of treatment attendance (income, family chaos, externalization problems and level of youth substance use) were examined within each treatment modality. Findings suggest that home-based (compared to office-based) treatment modalities may significantly increase treatment attendance and engagement of runaway youth and their families. Non-traditional forms of treatment may need to be considered in order to best meet the needs of highly chaotic and disorganized family systems. PMID:18607515
In Maghreb, men often influence women's family planning decisions including the methods they choose. Traditional religious and cultural customs, as well as legal dicta, emphasize the responsibility of men over wives and family. A survey conducted in Algeria showed that out of 47% of married women in reproductive age who had never used contraception, 12% cited the opposition of their husbands/partners and 4% had quit contraceptive use because of partner pressure. Acceptors also prefer oral contraceptives because of the fear that IUDs can be discovered. The husband is required to sign a written consent form for tubal ligation; de jure in Morocco and de facto in Tunisia and Algeria. Tunisia is the only country which allows abortion on request up to the 3rd month of pregnancy without consent of the partner. In Algeria an Morocco, abortion is illegal except for maternal health or legal reasons with partner approval. In Algerian society, however, women have traditionally used their fertility for negotiating better status in the extended family comprising mother-in-law, father-in-law, son, and daughter-in-law. The only source of power of the daughter-in-law is producing offspring, preferably sons. Family programs in Maghreb must center on the increasing acceptability of family planning programs while sensitizing males to grant more freedom to wives. Such a program is underway through the Moroccan Association for Family Planning. Similarly, in Tunis a new program targeting males has been developed. Partner communication is an essential component of this, particularly in rural areas where family planning is still taboo. The redefinition of male responsibility and equality in decision-making increases the acceptability of family planning and promotes the status of women within the family and society.
Slocker De Arce, C
The motivations which led to creation of a family planning specialty within social medicine are discussed and currently available contraceptive methods are reviewed. Among considerations which lead to family planning are the universal worry about uncontrolled population growth and limited resources, especially in the 3rd World: the earth's population is expected to reach 6.5 billion in the year 2000, but already 2.2 billion persons lack adequate resources. Health education and family planning are needed to promote safe conditions for pregnancy and to avoid pregnancy in cases of genetic deficiency. Family planning is a purely medical problem when the woman has a medical problem that would be life threatening to her or her child in case of pregnancy. Illnesses that may be aggravated by pregnancy include cardiopathy, diabetes, nephropathies, thyroid disease, and tuberculosis. Family planning involves provision of information and counseling for patients suffering such disorders as well as for patients who are infertile. Among psychosocial indications for family planning are 2 major problems of modern society: the quality of life and abortion. Family planning has given women the possibility of becoming sexual companions, but the fact that they and not men must submit themselves to contraceptive methods is a negative psychological factor for the stability of the couple. A great change has occurred in Spanish society, in that marriage used to be the only legitimate context for sexual activity and, for Catholics, the only legitimate sexual activity was that oriented toward procreation. Promiscuity, pornography, and sexual liberties and abuses promote undesired pregnancies and abortions. In addition, premarital and extramarital sexual relations have become more frequent. Some 300,000 abortions occur annually in Spain, but abortion can never be a valued family planning method because of its associated morbidity and mortality, and high costs of hospitalization in cases of
A recently completed World Bank statistical study of family planning in 63 developing countries indicated that countries which experienced a large decline in birth rates between 1960-1977 were more likely to have a family planning program, an official population policy aimed at decreasing the birth rate, and a relatively high level of development than countries which experienced smaller or no decline in birth rates. The 65 countries represented 95% of the population of the developing world. Birth rate declines of 10% or more between 1960-1977 were experienced by: 1) 10 of the 26 countries which had a family planning program and a policy aimed at reducing the birth rate; 2) 6 of the 19 countries which had a family planning program but lacked clearly defined population objectives; and 3) 2 of the 18 countries without any population policy or program. Furthermore, the implementation of a family planning program and the adoption of a population policy were directly related to the development level of the country. This finding suggested that countries need to reach a certain level of development before they have the capacity to develop population programs and policies. When a country is sufficiently advanced to collect population data, awareness of population problems increases and they are more likely to adopt a population policy. In addition, government efficiency increases as development proceeds and governments must have a certain level of efficiency before they can implement effective programs.
... 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 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....
Hamburg, M V
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
El-ansary, A I; Kramer Oe, J
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.
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.
Augusto, Everton Faccini; dos Santos, Larissa Silva; Oliveira, Ledy do Horto dos Santos
Objectives to survey the prevalence of human papillomavirus, associated risk factors and genotype distribution in women who were referred to cervical cancer screening when attended in a Family Health Program. Method we conducted a cross-sectional survey, investigating 351 women. Polymerase chain reaction for DNA amplification and restriction fragment length polymorphism analysis were used to detect and typify the papillomavirus. Results virus infection was detected in 8.8% of the samples. Among the 21 different genotypes identified in this study, 14 were high risk for cervical cancer, and the type 16 was the most prevalent type. The infection was associated with women who had non-stable sexual partners. Low risk types were associated with younger women, while the high risk group was linked to altered cytology. Conclusion in this sample attended a Family Health Program, we found a low rate of papillomavirus infection. Virus frequency was associated to sexual behavior. However, the broad range of genotypes detected deserves attention regarding the vaccine coverage, which includes only HPV prevalent types. PMID:24553709
Lee, S B
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
At a press conference on March 29, 1982, the Family Planning Association of Hong Kong launched a 1-year campaign to encourage men to assume more responsibility in family planning. The campaign will publicize the message that "real men" share family planning responsibilities with their wives. The campaign was developed in response to the Association's recognition that its male clinics were underutilized. Although the Association established its 1st male clinic in 1960, only 1.3% of the Association's clients in 1981 were men. Futhermore, the number of vasectomies performed in recent years had not increased. The campaign will seek to overcome the prevailing attitude that family planning is a women's issue, the reluctance of men to discuss fertility with their physicians, and various misconceptions about male methods. Activities initiated during the 1st few months of the campaign included 1) broadcasting a 30-second television spot to promote the male responsibility message; 2) setting up a mobile exhibit in railway stations and commercial complexes to inform the public about male birth control methods and about the services offered at the Association's male clinics; 3) giving away items which publicize the male clinics such as stickers, match boxes, condom samples, and literature; and 4) selling T-shirts which promote 2 as the ideal family size. In addition, a contest aimed at publicizing male birth control was undertaken jointly by a television magazine, Durex Products, and the Association. The contest engendered considerable interest and 2600 entries were received from men.
The general situation of family planning in Papua New Guinea, several of the relevant traditional beliefs, and a pilot project of community based distribution and family planning education in a rural market town. There is no government policy on population, although community based distribution programs have been active in some areas for 10 years. Papua New Guinea has a crude birth rate of 44/1000, an average of 6 children per family, but has only begun to introduce primary health care. Consequently, the population is expected to double by 2015. The pilot program, in a market town called Maprik in East Sepik Province, targets 44,378 women from surrounding villages, of whom about 800 may be using contraception. A family planning nurse is training 20 members of a Women's Council. In a 4-day course, held in the Council House, community distribution workers discussed family planning, responsible parenthood, sex education, nutrition, environmental and population issues. Ancient taboos and social controls that used to space births are breaking down under the pressure of missionization and westernization. Intercourse is still prohibited during menstruation and breastfeeding. There are specific magic spells and rituals used to insure fertility or abortion: these examples were used to help women understand the concepts of modern family planning methods. The nurse encouraged feedback from the women, and only held one formal teaching session, on record-keeping. For the success of the program, field workers should work from within, and supervise adequately. This will be done with quarterly refresher courses and monthly follow-up in each village.
Goff, Susan B.
Factors which mediate the life decisions of college men and women were examined. Undergraduates (N=107) completed questionnaires about career and family plans, notions of success and failure, integration of two potentially conflicting roles, and the relationship between personal values, life goals, and choices. Results indicated that: (1) women…
Demand for contraception and sterilization among women in Tibet is high. In 1966, when a family planning service team was sent to Namling County by the Maternal and Child Health Hospital (MCHH) of the Region, more than 500 women from six local townships arrived at the county MCHH seeking surgical sterilization. Since only one doctor was available to do ligation, most of the women were turned away; however, they would not leave until they were given a written appointment for a future date. In 1996, a 27-year-old Tibetan mother from Baxoi County, who had 5 children, traveled for 2 days, with 2 of her children, to a county town to be sterilized. A woman from Tingri County, who had 4 children, reached a county hospital only to be asked to return home; again, there were only one or two doctors available. She gave birth to a 5th child and returned to the hospital; again, the doctor was unavailable. Since then, she has delivered a 6th child. According to Bai Lang (secretary of the County Party committee), who spoke before the Regional Family Planning Committee, Namling County's nationally recognized poverty could have been alleviated if family planning had been implemented earlier. Family planning policy has been accepted well there.
Temmerman, M.; Van Braeckel, D.; Degomme, O.
In 1994, the International Conference on Population and Development (ICPD) held in Cairo, Egypt, laid out in its Programme of Action an impressive and ambitious set of goals for improving sexual and reproductive health and rights (SRHR) all over the world, by the target date of 2015 (International Conference on Population and Development 1994). One of these goals was the provision of universal access to a full range of safe and reliable family-planning methods. However, notwithstanding increases in budgets for family planning during the years following the ICPD (Organisation for Economic Co-operation and Development), there has been an alarming neglect from the international community for the topic since the year 2000. As a result, the progress made during the second half of the nineties slowed down considerably between 2000 and 2010; in a sense, one could say that ten years were almost wasted! This is astonishing, the more since meeting the need for family planning would have beneficial impacts on public health, environmental sustainability and social and economic development. In this paper, we explore these impacts and urge for a strong renewed commitment of the global community in the form of a global family planning decade. PMID:24753885
Planned Parenthood--World Population, New York, NY. Katherine Dexter McCormick Library.
As a monthly classified review of literature, this annotated bibliography offers a selection of books and articles recently received by the Katharine Dexter McCormick Library relative to family planning in the United States. Divided into two parts, the first contains book reviews from a variety of sources. They cover the subjects fund raising,…
A description is provided of "Principles of Family Planning," a course designed for graduate nursing students or practicing nurses seeking continuing education credit. The first sections of the course description provide a rationale for the course, information on its curricular placement, scheduling information, and statements of long-range and…
Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert
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.
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
Wallbank, Sonya; Meeusen, Mirjam; Jones, Louise
This paper offers a framework of knowledge, skills and competencies required for professionals working with vulnerable families at risk from not attending their appointment (DNA). It also offers a gap analysis of Higher Education Health Professional courses which identifies where professionals skills need to be further developed. The gap analysis demonstrates that courses appear to teach professionals how to identify and communicate with families; however, not specifically in relation to families who DNA. One of the key factors which appears to be missing from courses is how to identify when vulnerability is increasing with a family. This may mean that families who initially present as stable may fail to be identified when their circumstances are changing and increasing their vulnerability. The gap analysis also shows that professionals are not routinely given the tools needed to creatively engage with families who do not attend. It appears important that professionals are taught why families may not attend appointments, so increasing their desire to engage with families and decrease stigmatising attitudes to families who find compliance with healthcare appointments difficult.
Cook, R J; Maine, D
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
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
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Notice of FERC Staff Attendance at the Entergy ICT Transmission Planning... Commission's ongoing outreach efforts. Entergy ICT Transmission Planning Summit August 23, 2011 (8 a.m.-5...
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
Edwards, Kay P.
Systems concepts are applied to family financial planning using a functional interpretation of systems analyses. The framework can help professionals researching family financial behavior and its outcomes, planning programs, and offering financial services. It can also be used by families in their own financial planning. (Author/JOW)
... 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...
... 34 Education 2 2010-07-01 2010-07-01 false 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...
Hull, T H; Hull, V J; Singarimbun, M
A historical overview and descriptions of family planning programs in Indonesia are presented. 85 million of the 135 million inhabitants of the Indonesian archipelago are concentrated on the island of Java, which comprises about 7% of the Indonesian land mass. The Dutch colonial government preferred a policy ("transmigration") which advocated the redistribution of population from Java to the other islands to relieve overpopulation. This policy was also advocated by President Sukarno after the Indonesian Revolution of 1940. The need for family planning was recognized by small groups, and official policy supported national family planning programs to replace transmigration programs only after Sukarno became president in 1966. The focus of the program was on Java and Bali, the 2 most populous islands. Local clinics became the locus for birth control efforts. Fieldworkers affiliated with the clinics were given the job of advocating birth control use door-to-door. Fieldworkers "incentive programs," area "target" (quota) programs, and "special drives" were organized to create new contraceptive "acceptors." A data reporting system and a research program increase the effectiveness of the family planning drive by ascertaining trends in contraceptive use which can determine where and how money and effort can best be applied. "Village Contraception Distribution Centers" bring the contraceptive means closer to the people than do the clinics. Figures from the years 1969-1977 show the great increase in acceptance of contraceptives by the inhabitants of the Java-Bali area. Steps are now being taken to alleviate the large monthly variations in the number of (often temporary) acceptors caused by the "target programs" and "special drives." The average acceptor is 27-years-old, has 2.6 children, has not finished primary school, and has a husband of low social status. Bali has shown the greatest success in family planning. It is a small island with a highly developed system of local
Singh, J S
Estimates from the UN indicate that world population should finally stabilize at 10.2 billion people, growth stopping around 2100 when the number dying will finally match the number being born. The debate at the August 1984 UN sponsored gathering in Mexico City, the International Conference on Population, promises to be more practical than rhetorical than at the 1974 conference. In 1974 there were 2 opposed views of population growth: population soaring and the world's resources buckling under the strain with family planning viewed as the most effective remedy; and large families were a result of poverty rather than a cause of it and by eliminating poverty one would eliminate the need for large families. Experience gained over the last decade has moved the 2 sides together. Supporters of family planning as the only solution to world poverty found it to be of limited use unless it was related to activities on other issues such as delivery of basic health services, literacy, reductions in child and maternal mortality, and the status of women. Those who argued that development was the best contraceptive found that giving parents financial security helped to pave the way to smaller families but was not sufficient on its own. Vigorous family planning campaigns were still needed to make information and services acceptable and available to those who did decide to limit their families. The comprehensive World Fertility Survey (WFS) provides evidence from 43 developing countries to support this conclusion. The WFS interviewed thousands of women who said that they did not want any more children and found that less than half of these were actually using any form of contraception. Developing countries are now taking an active stance on population. 2/3 of the developing countries, containing 80% of the total population, expressed concerns about high fertility. The Asian governments have worked out their population policies in greatest detail, and most have set precise targets
Schneiderman, Gerald; And Others
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)
Blumenthal, P D; Jacobson, J; Gaffikin, L
In order to obtain information necessary for optimum delivery of services, data were collected on the nature of the services provided at a family planing clinic. Clinic visits were divided into initial, annual, routine, problem, supply, educational and unknown. An analysis of the "problem" visits was undertaken to assess various epidemiologic aspects of such visits and to identify areas of clinic efficiency that could be improved. Problem visits were defined as any visits for which the patient had a presenting complaint. Age, level of education, method of contraception and parity were statistically associated with problem visits. When compared to Pill users, diaphragm users, intrauterine device users and non-users had a higher-than-expected number of problem visits. Less educated women and teenagers had a lower-than-expected number of problem visits when compared to more educated and older women. Socioeconomic status and problem visits were not statistically associated. Problem visits required more time, utilized more medical services and resulted in more referrals to the gynecology clinic than did other visit types. As a result of this analysis, we have increased our educational efforts for patients at high risk of problem visits and have instituted a special problem-oriented family planning clinic in which a full complement of house staff and ancillary personnel are available. This arrangement makes the uncomplicated family planning clinic run more smoothly and efficiently and obviates the need for time-consuming and cost-ineffective referrals.
The Senate Human Resources Subcommittee under the chairmanship of Senator Alan Cranston has completed its work on the Family Planning Services and Population Research Amendments of 1973 (S. 1708) and has referred the bill to the Senate Labor and Public Welfare Committee. Right-to-Life activists are zeroing in on committee members in hopes of amending the bill to prohibit federal funds for sterilization and continued research on abortifacient drugs. If such provisions were to be approved, it would prohibit men from obtaining vasectomies with federal assistance and eliminate what has become a most popular birth control method for couples who have reached their desired family size. Such a prohibition would be especially discriminatory of low income males who cannot afford to finance a vasectomy through the private health care system. Banning use of IUDs by federal family planning agencies could also interfere with valuable cancer research and the treatment of such ailments as asthma and duodenal ulcers. The Senate Labor Committee needs to be fully advised as to the dangerous implications of these provisions and of the public opposition to their enactment. Vocalize your opposition today by urging the committee to exclude such amendments from the legislation they send to the Senate. The committee members are: Chairman: Williams, New Jersy; Randolph, West Virginia; Pell, Rhode Island; Kennedy, Massachusetts; Nelson, Vermont; Mondale, Minnesota; Eagleton, Missouri; Cranston, California; Hughes, Iowa; Hathaway, Maine; Javits, New York; Dominick, Colorado; Schweiker, Pennsylvania; Taft, Ohio; Beall, Maryland; and Stafford, Vermont.
Clarke, Angela T; Marshall, Stephen A; Mautone, Jennifer A; Soffer, Stephen L; Jones, Heather A; Costigan, Tracy E; Patterson, Anwar; Jawad, Abbas F; Power, Thomas J
This study examined the relative contribution of two dimensions of parent engagement, attendance and homework adherence, to parent and child treatment response and explored whether early engagement was a stronger predictor of outcomes than later engagement. The sample consisted of parents of participants (n = 92; M age = 9.4 years, SD = 1.27; 67% male, 69% White) in a 12-session evidence-based family-school intervention for children with attention-deficit/hyperactivity disorder. Attendance was assessed using clinician records, and homework adherence was measured by rating permanent products. Outcomes included parent and teacher ratings of family involvement in education, parenting practices, and child functioning. Accounting for the contributions of baseline scores and attendance, homework adherence was a significant predictor of parental self-efficacy, the parent-teacher relationship, parenting through positive involvement, and the child's inattention to homework and homework productivity. Accounting for the contribution of baseline scores and homework adherence, attendance was a significant predictor of one outcome, the child's academic productivity. Early homework adherence appeared to be more predictive of outcomes than later adherence, whereas attendance did not predict outcomes during either half of treatment. These results indicate that, even in the context of evidence-based practice, it is the extent to which parents actively engage with treatment, rather than the number of sessions they attend, that is most important in predicting intervention response. Because attendance is limited as an index of engagement and a predictor of outcomes, increased efforts to develop interventions to promote parent adherence to behavioral interventions for children are warranted.
Balogun, I A
This refutes the belief common in Nigeria that Islam enjoins its adherents to be polygamous and thereby, indirectly, to procreate many children. This notion occurs not only among non-Muslims but also among Nigerian Muslims, who feel that to be sincere about their faith they must practice polygamy and have so many children they can barely support them. In fact, at the advent of Islam the number of wives was set at a maximum of 4 to counteract the then prevalent practice of having large numbers of wives. In pre-Islamic Arabian society a man could and often did have 10-20 wives. The Qur'an 4:3 is cited to point out that the true intent of the Prophet was to limit the number of wives to at most 4 and to insist that each wife be treated equally. This means that each wife and her children must have separate quarters, not, as is common in Nigeria, be jammed into 1 room with the other wives. The scriptural references regarding birth control can be taken 2 ways. Those who cite them as prohibiting birth control point out that children are a blessing from Allah. Those who read whole passages find many references to the Prophet's approval of coitus interruptus, which was the only family planning method known at the time. It is felt he would also have approved of something more sure and less messy. In many Muslim countries polygamy is dying out because of economic circumstances. In Pakistan the permission of the 1st wife must be obtained before a 2nd can be married. Many Muslim countries also have active family planning programs. The overburdened women would appreciate a chance to practice family planning. It is the alfas and mallams who must be reeducated to the true Islamic precepts on these subjects.
Lederer, Wolfgang; Graube, Stefanie; Feichtner, Angelika; Medicus, Elisabeth
Acute vital crisis in end-of-life situations may result in hospitalization and intensive care without recognizable benefit in many cases. Advance directives regarding indications for resuscitation, hospitalization, and symptomatic treatment help ensure that acute complications can be managed quickly and satisfactorily in the patient’s customary surroundings. A plan was designed and implemented in Austrian nursing homes to provide emergency physicians with rapidly obtainable information on the patient’s current situation, and whether resuscitation attempts and hospitalization are advised or not. This palliative treatment plan is arranged by a physician together with caregivers, close relatives, and the patient or his court-appointed health care guardian or holder of power of attorney. Four years after implementation of the plan, a user satisfaction survey was carried out. The majority of participating nurses, emergency physicians and family doctors judged application and design of the palliative treatment plan positively. However, the low response rate of family doctors indicates nonconformity. In particular, the delegation of symptomatic treatment to nurses proved to be controversial. There is still a need to provide up-to-date information and training for health professionals in order for them to understand advance directives as extended autonomy for patients who have lost their ability to make their own decisions. PMID:27417808
Sonalkar, Sarita; Gaffield, Mary E
The postpartum period offers multiple opportunities for healthcare providers to assist with family planning decision making. However, there are also many changing factors during the first year after delivery that can affect family planning choices. Given that several different documents have addressed WHO guidance on postpartum family planning, the electronic WHO Postpartum Family Planning Compendium (http://srhr.org/postpartumfp) has been introduced. This resource integrates essential guidance on postpartum family planning for clinicians, program managers, and policy makers. The development of the Compendium included consultations with family planning experts, key international stakeholders, and web developers. Once the website had been created, user testing by family planning experts allowed for improvements to be made before the official launch. Future directions are adaptation of the website into a mobile application that can be more easily integrated to low-resource settings, and translation of the content into French and Spanish.
This article describes the aims of family planning (FP) departments to strengthen IEC for the control of population growth and effective improvement in the quality of human resources in China. The IEC directive was promoted by Madam Peng Peiyun of the State Family Planning Commission in May 1997. In 1996, the birth rate was 16.98/1000. The total fertility rate was below replacement level in 1996. These achievements were accomplished with effective IEC over the past 30 years. The Ninth Five Year Plan for 1996-2000 offers many challenges for the national FP program. The aim is to continue to strictly control population growth in order to keep population below 1.3 billion by the year 2000, and below 1.4 billion by the year 2010. The aim is to improve the quality of life, to improve population structure, to meet the needs of reproductive-age women for services, and to promote socioeconomic and sustainable development. IEC needs to be intensified and to use improved techniques. IEC funding should be increased. Information should be promoted about the importance of educating people about the basic national conditions and the state's basic policies. People need to be informed about the need for a balanced population and socioeconomic development at all cadre levels. FP workers need to be encouraged to serve the people's needs "wholeheartedly." The aim is to provide quality services. People need to be informed that the advantages of fewer births are greater prosperity and comfortable living. FP is an integral part of poverty alleviation. The State Commission plans to conduct a new round of training for cadres.
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
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
British Health Secretary Virginia Bottomley and Family Planning Association (FPA) President Anna Ford recently announced some new initiatives to promote wider use of family planning (FP) and contraception which will be carried out by the FPA with a special grant from the Department of Health. The grant will finance 3 FPA projects: 1) the Growing Up project, 3 booklets providing information for parents, young people, and children; 2) an information project at the work place on FP and sexual health for women and men; and 3) a primary health care project to aid general practitioners (G)s) and nurses engaged in the improvement of FP services. 1 in 3 pregnancies is unplanned, and teenage pregnancy rates are rising, thus sex education and public information are vital. The FPA chose St. Valentines Day to introduce How Your Body Changes, its new pamphlet for teenagers. In the UK over 85% of FP services are provided by family doctors and 15% or less by special community FP clinics. those who oppose further closures that health authorities contemplate stress that the special clinics provide: an anonymous service for younger women, especially those aged 16 or under, a wider choice of methods (some GPs do not offer the IUD, the diaphragm, or free condoms), a better service (most GPs are too busy and have had no training in FP, and postgraduate training for nurses and doctors (more clinic closures will impair FP education). Better FP education is crucial, especially for the age group 12-16 in view of over 180,000 legal abortions occurring each year in the UK.
Bertrand, J T; Proffitt, B J; Bartlett, T L
The health care profession is witnessing a shift in focus from the interests and needs of the service provider to those of the potential consumer in an effort to attract and maintain clients. This study illustrates the role that marketing research can play in the development of program strategies, even for relatively small organizations. The study was conducted for Planned Parenthood of Louisiana, a recently organized affiliate that began offering clinical services in May 1984, to provide information on the four Ps of marketing: product, price, place, and promotion. Data from telephone interviews among a random sample of 1,000 women 15-35 years old in New Orleans before the clinic opened confirmed that the need for family planning services was not entirely satisfied by existing service providers. Moreover, it indicated that clinic hours and the cost of services were in line with client interests. The most useful findings for developing the promotional strategy were the relatively low name recognition of Planned Parenthood and a higher-than-expected level of interest that young, low income blacks expressed in using the service.
Bertrand, J T; Proffitt, B J; Bartlett, T L
The health care profession is witnessing a shift in focus from the interests and needs of the service provider to those of the potential consumer in an effort to attract and maintain clients. This study illustrates the role that marketing research can play in the development of program strategies, even for relatively small organizations. The study was conducted for Planned Parenthood of Louisiana, a recently organized affiliate that began offering clinical services in May 1984, to provide information on the four Ps of marketing: product, price, place, and promotion. Data from telephone interviews among a random sample of 1,000 women 15-35 years old in New Orleans before the clinic opened confirmed that the need for family planning services was not entirely satisfied by existing service providers. Moreover, it indicated that clinic hours and the cost of services were in line with client interests. The most useful findings for developing the promotional strategy were the relatively low name recognition of Planned Parenthood and a higher-than-expected level of interest that young, low income blacks expressed in using the service. PMID:3112854
... 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;...
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…
Shivanandan, Mary; Borkman, Thomasina
Natural family planning (NFP) refers to techniques for planning or preventing pregnancy by observation of natural signs of fertility. In using natural family planning to avoid pregnancy, there is abstinence from sexual intercourse during the fertile phase of the menstrual cycle. Social values which are incorporated into the method include couples…
The main points for 1991 Family Planning (FP) Work in China are discussed as follows: 1) strengthen leadership, 2) strengthen grass roots buildup, 3 intensify population plan management and improve the responsibility system, 4) strengthen publicity and promote population and FP education in rural areas, 5) strengthen and establish the legal system for FP management, 6) provide excellent contraceptive and birth control services, 7 perform inservice training conscientiously and technical secondary education earnestly, and 8) coordinate efforts among related departments. Leadership changes involve the 2 top leaders of the Communist Party Committees and governments at each level taking personal responsibility for the implementation of their local population plans and FP work. FP work must have a prominent place on all agendas. The FP service network needs to be accelerated in countries, townships, and villages and grass roots units strengthened in urban areas. Provinces, autonomous regions, and municipalities must work out their local population plans for 1991-95 and 1991-99 according to the national population target. Rational apportionment needs to be considered for prefectures and counties. The emphasis should be on timely and accurate feedback and statistical supervision. The 1990 national population census data should be used to inform everyone about the current population situation. Legal needs entail standardizing documentation and developing local laws and regulations within a comprehensive system. Improvements are needed in such areas as rules and regulations pertaining to the administration of charges for unplanned births, identification of disabled children and approval of the birth quota. Abortion and unplanned births are to be averted through prepregnancy management. The emphasis is on voluntary use of contraception by couples of childbearing age. Inservice training should improve the political, ideological, professional proficiency, and ability to
This document assesses the current status of population and family planning assistance throughout the world and provides brief sketches of the available sources including national governments, intergovernmental agencies such as the UNFPA and other UN entities, and nongovernmental funding, technical assistance, or funding and technical assistance organizations. The descriptions of aid-granting organizations describe their purposes, sources of funding, and activities, and give addresses where further information may be sought. At present about $100 million of the US $1 billion spent for family planning in developing countries each year comes from individuals paying for their own supplies and services, over $400 million is spent by national governments on their own programs, and about $450 million comes from developed country governments and private agencies. Over half of external assistance appears to be channeled through international agencies, and only a few countries provide a substantial proportion of aid bilaterally. In the past decade several governments, particularly in Asia, significantly increased the share of program costs they assumed themselves, and the most populous developing countries, China, India, and Indonesia, now contribute most of the funding for their own programs. Although at least 130 countries have provided population aid at some time, most is given by 12 industrialized countries. The US Agency for International Development (USAID) is the largest single donor, but the US share of population assistance has declined to 50% of all assistance in 1981 from 60% in the early 1970s. Governments of Communist bloc countries have made only small contributions to international population assistance. Most governmental asistance is in cash grant form, but loans, grants in kind, and technical assistance are also provided. Private organizations give assistance primarily to other private organizations in developing countries, and have been major innovators in
Worldwide, there are an estimated 18 million refugees, people who have crossed international borders to escape political conflict, famine, destruction of their natural environment, or other disasters. There are an additional 24 million displaced individuals, people who left their homes but remain in their own countries. Women and children comprise more than 80% of both groups. Following some major event or series of events, these individuals have typically relocated in large number over a short period of time to an area devoid of the necessary basic facilities to support their rapid influx. International agencies, foreign governments, and nongovernmental organizations usually come forward to provide emergency relief as best they are able. With regard to the delivery of health care, health services for refugees are typically designed to meet emergency needs, such as the provision of clean water, the delivery of adequate food supplies, and the treatment of disease. Family planning is generally not provided, especially to refugees in the early stages of relocation. Reproductive health services during this initial phase are instead usually limited to care for pregnant women. Refugees, however, do have sex. In fact, birth rates in refugee camps are typically higher than they are for the host-country population. Refugees and displaced persons have often undergone some degree of psychological trauma and emotional loss. Families are displaced and separated, and loved ones have died. Those fortunate enough to make it to refugee camps and be restored to a reasonable state of health typically find themselves in limbo, away from their cherished homes, and often mourning the loss of friends, spouses, and/or children. These individuals are going to have sexual intercourse for a number of reasons. Sex relieves the boredom of camp life, especially for young people, some people want to replace children who have died or been separated from the family, women with few or no relatives
The 10th International Conference on AIDS/International Conference on STD in Yokohama August 7-12, 1994, attracted 12,000 people from 130 countries to consider the expanding AIDS pandemic. A satellite symposium was held the day before the opening of the conference, August 6, also in Yokohama, to bring participants together to focus upon the importance of providing access to oral contraceptives and the necessity of condoms. This symposium was organized by the Japan Family Planning Association. Speakers called for the authorization of the low-dose oral contraceptive pill for Japanese women; greater condom use against HIV and other STDs; expanding the concept of reproductive health to include maternal and child health, the prevention of STDs, and infertility; clinical approaches and care for HIV-infected individuals during pregnancy and labor; and counseling to pregnant HIV-infected women.
Caldwell, John C; Phillips, James F; Barkat-e-Khuda
National family planning programs have been an important instrument in accelerating global fertility decline and in restricting ultimate world population to a level probably below ten billion. They began to come into being after 1950 and will probably go out of existence in most of the world's regions by 2050. The archetypal programs were instituted in Asia and North Africa. The end of the twentieth century is an appropriate half-way mark at which to evaluate the twentieth-century programs and to assess what changes in them will be needed for the twenty-first century. Some changes are necessary because dramatic events have occurred: (1) long-term replacement-level fertility has been attained in most of East Asia and some of Southeast Asia, and accordingly, some programs there are being phased out; (2) mainland South Asian fertility has been slower to decline; (3) international donor funding is diminishing and may not be significant during much of the twenty-first century; (4) the 1994 International Conference on Population and Development held in Cairo called for a radical change in programs away from demographic aims and toward reproductive health and the improvement of the situation of women; and (5) the future family planning frontier will be sub-Saharan Africa, for which radically new types of programs may have to be developed. These issues were discussed in January 2000 at a conference held in Dhaka, Bangladesh. A selection of contributions to the conference is published here. This article provides an overview of the issues based partly on this selection and partly on the discussions that took place at the conference.
80% of women using contraception in Zambia use oral contraceptives (OCs), yet they often complain about side effects. 66% of people polled at family planning (FP) clinics prefer OCs and 30% chose condoms. Nevertheless only 10% of the 60% of married couples familiar with FP use contraception. This contributes to Zambia having 1 of the highest annual population growth rates in the world (3.4%). The Planned Parenthood Association of Zambia (PPAZ) thinks that if males become more knowledgeable about FP, the population growth would slow down. At least 60% of men in Zambia approve of their wives using FP, yet they are slow to use male contraception. They say condoms reduce sensation and wives often consider condoms a nuisance. The AIDS epidemic forces men to rethink their views toward condom use, however. Those 30% of men who do use condoms are more likely to use them with their girlfriends or women with whom they are unfamiliar. So they are not using them for FP purposes. Men fear vasectomy because they perceive it to cause impotence. Considerable education to counter this myth is needed to increase the number of vasectomies. Besides some men prefer their wives be sterilized rather than themselves because if the men lose all their children they can have other children with other wives. PPAZ aims programs at men in order to expand their participation and nurture their influence in FP matters. It has a male counseling program serving rural villages along the railroad lines which begin in the northern copper belt and end in urban areas in the south to promote birth spacing. It is working with companies to include FP services in their clinics so men can learn more about FP. FP specialists in Zambia foresee an increase in male support of FP as they realize the difficulty of supporting large families during the economic crises.
Hallowell, N.; Murton, F.; Statham, H.; Green, J. M.; Richards, M. P.
OBJECTIVES: To describe women's information needs prior to genetic counselling for familial breast or ovarian cancer. DESIGN: Prospective study including semistructured telephone interviews before genetic counselling, observations of consultations, completion of postal questionnaires, and face-to face interviews within two months of counselling. SUBJECTS: 46 women attending genetic counselling for familial breast or ovarian cancer. MAIN OUTCOME MEASURES: Subjects' understanding of process and content of genetic counselling before attending and attitudes about their preparation for the counselling session. RESULTS: Although all women interviewed before the clinic expected to discuss their risk of developing cancer and risk management options, there was evidence of a lack of knowledge about the process and content of genetic counselling, 17 (37%) women said they did not know what else would happen. Most women interviewed after counselling viewed it positively, but 26 (65%) felt they had been inadequately prepared and 11 (28%) felt that their lack of preparation meant that they could not be given an accurate estimation of their risk of cancer. CONCLUSIONS: Some women felt that they did not obtain optimum benefit from genetic counselling because they were inadequately prepared for it. We suggest that cancer family history clinics should provide women with written information about the process and content of genetic counselling before their clinic attendance. PMID:9022494
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.
Easterlin, R A; Wongboonsin, K; Ahmed, M A
A new "supply-demand" measure of family planning demand is compared with others commonly used to target prospective family planning clients. In analyses of data from six cross-sectional surveys the new measure consistently explains past contraceptive use better than the others. Time series analysis for two countries yields similar results. Family planning program officials may wish to consider exploring the use of this measure to target prospective clients.
... Emergencies › Pets Pets Your Plan Should Include All Family Members The best way to protect your household ... Cabinet Red Cross Stories Governance Career Opportunities Military Families Disaster Relief What We Do Disaster Relief Health ...
Blonna, R; McNally, K; Grasso, C
To increase public awareness of family planning services in New Jersey, the Family Planning Program of the State Department of Health conducted an intermediary marketing campaign using free public service advertising on mass transit. In 1986, the year of the campaign, 237 calls were made to the advertised hotline, resulting in a like number of referrals to family planning service providers. Also, 2664 new patients examined in the state's family planning agencies in 1986 cited exposure to the media campaign as the reason for their visits. The results of the campaign and their implications for other public service agencies are discussed.
Haldar, Dibakar; Saha, Indranil; Paul, Bobby; Mukherjee, Abhijit; Ray, Tapobrata Guha
India is the first country in the world to implement a family planning program, and this program has succeeded in generating universal knowledge about family planning methods. In spite of this, there exists a wide gap between knowledge and acceptance of family planning methods reflecting an unmet need for contraception. Different communication channels used to disseminate knowledge like television, radio, and newspapers aim to change the family planning methods. Being a didactic method, these have the least potential to change the attitudes of the people. This article represents the tip of the iceberg of the fate arising out of incomplete information provided through mass media not supported by a formal family planning program. One primipara woman after getting pregnant took an emergency contraceptive pill and attended a clinic with vaginal bleeding, abdominal pain, and pallor. Ultimately she underwent suction evacuation and survived. This indicates that mass media should not be a substitute, but rather a supplement to the routine program of the health worker to promote contraception.
Navot, Noa; Jorgenson, Alicia Grattan; Vander Stoep, Ann; Toth, Karen; Webb, Sara Jane
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…
Sumarsono, S K
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
This article describes expanded access to family planning (FP) services through community welfare offices in Washington state, US. The government aim is to decrease unintended pregnancies and to help families achieve self-sufficiency. The staff must be sensitive and respectful of clients served. The team effort includes contacting clients in other community locations to offer FP education. The approach is characterized as "1-stop shopping" that includes FP, welfare, access to jobs, training, and medical coupons. Preventing unintended pregnancies is cost effective. A state (90%) investment of $40/person for contraceptives is good business compared to $400/person as a 50/50 state/federal investment in prenatal and delivery costs. The program began in 1992, by educating staff members in community services offices (CSOs) about FP issues. In 1994, the program hired registered nurses and nurse practitioners at CSOs to provide FP services. Almost all CSOs now have nurses, and there are 8 full exam clinics. A resource handbook for CSO workers and FP nurses was compiled by state and local FP personnel. CSOs typically assign 1 staff member to FP, usually on a part time basis. Close collaboration between nurses and CSO workers usually involves more creative strategies and outreach projects. For example, in 1 CSO in Washington, the FP worker offers contraceptive counseling, pregnancy tests, and sexually transmitted disease prevention. Contraceptives are provided at a separate time with local private providers or at health department clinics. CSOs continue to provide counseling regardless of referrals to private clinics. The project is growing and forming collaborations with other FP groups. These 1-stop sites offer accessible, familiar, and comfortable services.
In Latin America, many rural people build dwellings in settlements on the cities' fringes without permission from the authorities. The authorities make several unsuccessful attempts to drive them away, but eventually ignore them. In the 1960s, family planning (FP) associations were concerned about how they can serve the shantytowns, which needed their services but had no social services at all, e.g., water supply and sanitation. In the early 1970s, PROFAMILIA Colombia began a new form of FP service delivery in rural areas by training someone from the community who believed in FP to distribution (CBD) programs provided more FP than all of PROFAMILIA's 60 clinics. In 1973, PROFAMILIA started its URBAN CBD program in the slums of Bogota and learned that the people wanted FP. The CBD movement spread throughout urban and rural Latin America. Brazil's BEMFAM developed the world's largest CBD program. By 1985, 10,365 distribution posts operated in Latin America and, by 1991, there were 26,423. In urban slums in the 1980s, Mexico's MEXFAM began using community doctors, who tend to be new medical graduates. Often the community and the doctors respect each other so much that many doctors remain in the shantytowns beyond their required time. The residents' acceptance of FP provided by people who understand the community shows how they want to plan their lives and better themselves. In addition, they have taken the chance to seek a better life by leaving hopeless situations in rural areas and by building dwellings for themselves, even though they had no money, land, or even basic necessities. In Peru, shantytown residents were moved to the desert and supplied with basic construction materials. They built a community, Villa El Salvador, now complete with tree-lined streets, shops, schools, and movies. Shantytown dwellers may have the solution to Latin America's problems.
Altman, Miriam; Meis, Alexandra
The American K-12 grade education system is experiencing a truancy crisis. Nationally, 15%, or 7.5 million students, miss an entire month of school annually , with that rate frequently doubling or even tripling among students from underserved communities . Research has identified attendance as one of three primary indicators of high school…
Mount, Jill Katherine
Background and objective. Latinos are the largest ethnic minority in the U.S. and by 2050 they are estimated to become one quarter of the population, yet only one in ten has a college degree. More Latino women (Latinas) are currently attending college than Latino men. To date research has focused on their experiences and where they obtain support…
Worth, George; And Others
This year's annual review of family planning in Korea and Taiwan is represented in three articles. The first, "Korea/Taiwan 1970: Report on the National Family Planning Programs," separately views the program administration, budget, personnel, and evaluation, as well as the various methods employed in controlling the number of births,…
Population Council, New York, NY.
A new design for government family planning programs is proposed in "Family Planning Programs: An Economic Approach," the principal article in this monthly publication of The Population Council. The design is intended primarily for low-income countries that seek large and rapid reductions in fertility. Thirteen elements of the proposed system of…
Population Council, New York, NY.
A typology of incentives and the general effects of incentives for family planning are discussed in "Incentives in the Diffusion of Family Planning Innovations," the first of three studies in this monthly publication of The Population Council. A brief review of the history of incentives and their present status in the fields is given, together…
Grosse, S D
This article uses a comparative case study approach to relate policy outcomes in terms of family planning to the patterns of political forces observed in the 3 Maghrib states of Algeria, Morocco, and Tunisia. It is suggested that official support for a strong family planning program may be linked to recognition of the problem of low labor absorption and to concrete steps taken to counter the problem. The article discusses different vantage points for approaching the political context of family planning and distinguishes between the use of family planning as an instrument of social policy and as an instrument of economic policy. Ideological reasons for opposition to or support of family planning are then outlined. The colonial experience of the 3 states is differentiated and a chronological account of their family planning programs is provided. The political systems and leadership of the 3 countries are separately discussed in greater detail, after which the influence of elite groups on family planning programs and activities in each country is assessed. Developments in the 3 countries since 1978 are then sketched. The author concludes that the relative importance of policies toward employment and women's status in connection with support for family planning has probably varied over time, with economics playing a greater role in the 1970s. The activities of non-regime political actors were found to be very significant in formulation of population policies in Algeria and Morocco but less so in Tunisia.
nearly exclusive breastfeeding to remain amenorrheic and thus avoid pregnancy. The lactational amenorrhea method was reported to be up to 98...effective when exclusive breastfeeding and amenorrhea were present (Kennedy et al., 1991). The basal body temperature method requires the woman to measure...natural family planning-lactational amenorrhea method interface: Observations from a prospective study of breastfeeding users of natural family planning
... 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...
In the US, the efforts of Chris Smith, a Republican member of the House of Representatives from New Jersey, have led to Congressional approval of two restrictions on US aid to foreign family planning (FP) programs. The first restriction prohibits the US from funding any organization that performs abortion with its own funds, even in countries where abortion is legal (except in cases of life endangerment, rape, or incest). The bill specifies that President Clinton can waive this prohibition only at a cost of $44 million to the already reduced FP funding. The second restriction prohibits US funding of any group that engages in abortion-related lobbying and is, in effect, a "gag rule" that would punish organizations for engaging in activities that would be protected in the US by the First Amendment of the Constitution. Clinton has threatened to veto the legislation even though this means that he will risk losing his ability to pay dues owed to the UN or to provide backing to the International Monetary Fund. Smith's actions reflect efforts to eliminate federal funding of domestic and international FP programs despite the fact that polls continually demonstrate the widespread approval of the US public for such programs.
This article examines the impact of the campaign known as "Bringing New Marital and Reproductive Styles into Tens of Thousands of Households" on family planning in China. The awareness campaign, which started in October 1998, was established to increase the effectiveness of family planning and introduce progressive lifestyles among the population through an interactive and service-oriented approach focusing on the needs of human beings. The program emphasizes the following elements: 1) late marriage; 2) late childbirth; 3) fewer childbirth; 4) gender equality; 5) male participation in family planning; 6) dissemination of family planning and reproductive health knowledge; 7) healthier births and quality of education; 8) enhanced self-care capabilities; 9) higher quality of life; and 10) healthier lifestyles. A face-to-face approach was used to encourage public participation and increase the appeal of family planning programs to ordinary people. Efforts are also being made to expose rural residents to new ideas and lifestyles.
Melunsky, Nina; Crellin, Nadia; Dudzinski, Emma; Orrell, Martin; Wenborn, Jennifer; Poland, Fiona; Woods, Bob
Reminiscence therapy has the potential to improve quality of life for people with dementia. In recent years reminiscence groups have extended to include family members, but carers’ experience of attending joint sessions is undocumented. This qualitative study explored the experience of 18 family carers attending ‘Remembering Yesterday Caring Today’ groups. Semi-structured interviews were transcribed and subjected to thematic analysis. Five themes were identified: experiencing carer support; shared experience; expectations (met and unmet), carer perspectives of the person with dementia’s experience; and learning and comparing. Family carers’ experiences varied, with some experiencing the intervention as entirely positive whereas others had more mixed feelings. Negative aspects included the lack of respite from their relative, the lack of emphasis on their own needs, and experiencing additional stress and guilt through not being able to implement newly acquired skills. These findings may explain the failure of a recent trial of joint reminiscence groups to replicate previous findings of positive benefit. More targeted research within subgroups of carers is required to justify the continued use of joint reminiscence groups in dementia care. PMID:24381218
The historical and current demography of Africa in this discussion focuses on the context of population policy, contraceptive use, reproductive behavior, polygamy, and economic impacts. Sub-Saharan Africa countries have the highest rate of population growth in the world. 50% are aged under 20 years, and 20% are aged under five years. Urban areas are growing at the fastest rates in the world (5-6% annually). Population density remains low, except for areas where there is high soil fertility. Many African countries recognize the need for population policies. The most important donor to Africa, the World Bank, has pressured African governments to adopt family planning (FP) programs. A major World Bank study has shown that more FP services are desired by African women. Family expenditures for the 1980s for FP were estimated at $100 million annually, of which $53 million was provided by donors. Further expansion in the program is needed. The World Bank targeted contraceptive use at 25% of African married couples. Except for Egypt and North African countries, contraceptive use is around 3-4%. Another perspective on population reduction is to expand programs for child spacing and postnatal nutrition of mothers and infants. There has been a failure to turn health systems around to low-cost preventive health, particularly in rural areas. Infant mortality must be reduced before fertility will decline. Population growth can be slowed by changing the status of African women (high social status and recognition are associated with high fertility), age of marriage, child spacing, agricultural productivity, and nutrition. Demographic data on Africa have only become available during the past 25 years. African demographers are in short supply and require training abroad. Demographic data gaps and reliability problems are offset by the recent availability and quantity of survey data. Historical demography has produced conflicting results. Although some investigators, such as Ester
Dulli, Lisa S; Eichleay, Marga; Rademacher, Kate; Sortijas, Steve; Nsengiyumva, Théophile
ABSTRACT Objective The primary objective of this study was to test the effectiveness of integrating family planning service components into infant immunization services to increase modern contraceptive method use among postpartum women. Methods The study was a separate sample, parallel, cluster-randomized controlled trial. Fourteen randomly selected primary health facilities were equally allocated to intervention (integrated family planning and immunization services at the same time and location) and control groups (standard immunization services only). At baseline (May–June 2010), we interviewed postpartum women attending immunization services for their infant aged 6 to 12 months using a structured questionnaire. A separate sample of postpartum women was interviewed 16 months later after implementation of the experimental health service intervention. We used linear mixed regression models to test the study hypothesis that postpartum women attending immunization services for their infants aged 6–12 months in the intervention facilities will be more likely to use a modern contraceptive method than postpartum women attending immunization services for their infants aged 6–12 months in control group facilities. Results We interviewed and analyzed data for 825 women from the intervention group and 829 women from the control group. Results showed the intervention had a statistically significant, positive effect on modern contraceptive method use among intervention group participants compared with control group participants (regression coefficient, 0.15; 90% confidence interval [CI], 0.04 to 0.26). Although we conducted a 1-sided significance test, this effect was also significant at the 2-sided test with alpha = .05. Among those women who did not initiate a contraceptive method, awaiting the return of menses was the most common reason cited for non-use of a method. Women in both study groups overwhelmingly supported the concept of integrating family planning
Van Roosmalen, J
The 1991 world population report of the UNFPA projects a world population of 8.504 billion by 2025. The prevalence of the use of modern contraceptives increased from 9% in previous years to an average of 51% at the present time: to 70% in East Asia, to 60% in Latin America, but only to 17% in Africa. 20% of pregnancies are unwanted, the prevention of which would reduce the expected population by 2.2 billion people in 2100. Without birth control programs today there would be 412 million more people in Asia, Latin America, and Africa; and in 2100 1.48 billion would live on Earth instead of 10 billion forecast by the World Bank. The aim of UNFPA is to increase contraceptive prevalence form 51% to 59% by 2000: from 381 million users in 1991 to 567 million acceptors. Only 15% of men use contraceptives, although the prevention of sexually transmitted diseases especially AIDS makes the use of condoms highly advisable. In the report scant mention is made of breast feeding as a family planning method, although the Bellagio Consensus of 1988 states that if a woman almost exclusively breast feeds during lactation amenorrhea a more than 98% protection against pregnancy is offered during the 1st 6 months postpartum. During this period no additional contraception is necessary until the 1st menstruation occurs. Women in Bangladesh taking an oral contraceptive after delivery had shorter birth intervals than women exclusively relying on breast feeding. The Working Group of Medical Development Association issued guidelines concerning contraceptive methods including subdermal implant of levonorgestrel, although excessively strict standards can foil the contraceptive needs of the Third World. Their reproductive mortality is mainly determined by an extremely high maternal mortality rather than by complications from contraceptive use.
Gibson, David; Noble, Dorinda N.
Describes the Residential Services for Parents program, which provides residential service for single mothers and their families. The program provides a variety of services including help with income, housing, abuse and other family dysfunctions, and prevention of separation. The program is effective in keeping families together. (GH)
American Council of Life Insurance, Washington, DC. Education and Community Services.
This publication for teachers focuses on one specific content area of consumer education--financial planning. The first major section begins by identifying eight competencies in financial planning education. It describes the financial planning process used to anticipate changes in moving from one stage of life to another, choosing the options, and…
Oden, Walter E.
A project to raise the percentage of student attendance to 95 percent or above was initiated at Brownsville Junior High in Miami, Florida. The school is geographically located in a low socioeconomic area and the students are 80 percent black. The program included the use of community resources and incentives of frisbees, yo-yos, t-shirts,…
The Income Generating Activities program for Family Planning Acceptors was introduced in Indonesia in 1979. Capital input by the Indonesian National Family Planning Coordination Board and the UN Fund for Population Activities was used to set up small businesses by family planning acceptors. In 2 years, when the businesses become self-sufficient, the loans are repaid, and the money is used to set up new family planning acceptors in business. The program strengthens family planning acceptance, improves the status of women, and enhances community self-reliance. The increase in household income generated by the program raises the standards of child nutrition, encourages reliance on the survival of children, and decreases the value of large families. Approximately 18,000 Family Planning-Income Generating Activities groups are now functioning all over Indonesia, with financial assistance from the central and local governments, the World Bank, the US Agency for International Development, the UN Population Fund, the Government of the Netherlands, and the Government of Australia through the Association of South East Asian Nations.
Vital population statistics for Hong Kong are mentioned. The 1st efforts at providing birth control services in Hong Kong began in 1936 with the Eugenics League. The League was reorganized and formed into the Family Planning Association of Hong Kong (FPAHK) in 1950. The government began providing family planning services in 1974. Although there is no governmental incentive/disincentive policy, certain laws and practices do have the effect of encouraging population growth limitation. These are described. The FPAHK directs its efforts toward motivational activities. The Association is encouraging the concept of male responsibility for family planning. Personal visits to fisherfolk families have been instituted to combat their tendencies toward large families. Various separate activities of the government program and the FPAHK are discussed.
Torres, A; Forrest, J D
Almost five million women were enrolled in family planning clinics in the United States in 1983, eight percent more than in 1981. The number of family planning provider agencies declined slightly, from 2,504 to 2,462, but the number of clinic sites that could be identified increased slightly, from 5,124 to 5,174. Family planning clinics operate in three-quarters of U.S. counties; in 1975, the last time county coverage was checked, four-fifths of the counties had clinics. About one in 20 women who are exposed to the risk of unintended pregnancy and live in unserved counties are teenagers or low-income women. Nonmetropolitan counties are more likely to be without clinics than are metropolitan counties. Overall, there are 417,000 low-income women and 249,000 teenagers at risk of unintended pregnancy living in counties where there are no family planning clinics. In 1983, health departments constituted six in 10 of all family planning agencies and served two-fifths of all family planning clinic patients; Planned Parenthood affiliates accounted for fewer than one in 10 agencies and served more than one-quarter of all patients. Hospitals and all other agencies served about one-third of the total 1983 caseload. These patterns were similar to those reported for 1981. Family planning clinics continue to serve primarily low-income women: Four-fifths of the nearly five million clinic patients in 1983 had family incomes below 150 percent of the federally defined poverty level. About 1.6 million women aged 19 and younger were served, representing one-third of all clinic patients in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)
Tata, N H
The overall population problem of the world is discussed briefly. The author asserts that rapid population growth has serious social and political implications and imposes serious restraints on economic progress. It is also linked to problems of urbanization. Family planning is a way out. The state alone is not enough to make family planning successful, it must be supported by the different segments of society. Employers have a major social responsibility in this respect. After this general introduction, and the assertion of the basic role of the employer in family planning programs, the author deals with the specific situation in India in terms of 1) its population problem, 2) progress and impact of the Indian family planning program, and 3) the role of employers in the promotion of family planning in India; a detailed section is devoted to the family planning centers of the Tata group of companies (Tata textile units, chemicals, iron and steel, engineering and locomotive, etc.). The author enumerates the measures to promote effective participation by employers, which include 1) an organized framework, 2) assistance to employers, and 3) removal of disincentives. The author concludes by saying that the efforts of employers to limit population growth need to be supplemented by international cooperation and action.
There is renewed interest in natural family planning (NFP) as the Philippine Population Program enters the 1980s. Much of this interest is due to the realization that, properly practiced, NFP can be a highly effective means of birth spacing. In 1978 the Special Committee to Review the Philippine Population Program recommended that more efforts be made to promote NFP. The different methods of NFP are reviewed. Sex without intercourse, coitus interruptus, and prolonged nursing are not officially recognized as NFP methods by the Program. The rhythm method was first described independently by Drs. Hermann Knaus of Austria and Kyusaku Ogino of Japan in the 1930s. Ogino's method of calculating a woman's fertile period is based on the lengths of the last 12 menstrual cycles which she recorded on a calendar. The advantages of rhythm are that it is inexpensive, it requires only the cost of charts which may be homemade, there are no physical side effects, control is in the woman's hands, and it is acceptable to people who consider it their duty to follow religious teachings. Disadvantages include: keeping constant, accurate records of cycles for long periods of time; the need for perseverance and correct interpretation of the chart; the possible need for medical advice and help; and the fear that something might upset a woman's cycle and change the time of ovulation. The continuation rates of rhythm acceptors in the Philippines are unimpressive. A study of 142 women revealed a high pregnancy/failure rate--25% for a 12-month period compared to 0 with oral contraception (OC) and the IUD's 2%. The basal body temperature method helps determine the unsafe period with some accuracy. Its premise is that there are slight but detectable changes in a woman's body temperature during her cycle. These changes herald ovulation. A special thermometer must record temperature changes of 0.1 degree Farenheit. This instrument and the charts are the only expenses involved. The reviewers of the
Presswell, N J
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
Elfenbein, Iris M.; And Others
The first of a series on personal and family financial planning (PFFP) education, this publication presents five papers examining the need for educational programs that emphasize the use of financial resources in ways that contribute to family stability. C. Raymond Anderson discusses the inability of many individuals to realistically manage…
Family characteristics in terms of parental education and income are an important influence on individual's participation in higher education. In India it could be found that categorically those who are out of the higher education system belong to marginalized groups due to their economic class, caste, gender, religion etc. despite massive…
For graduate medical education trainees, as well as contemporary practitioners, developing skills in recognizing compassion fatigue and practising self-care is vital to professional sustainability. The field of palliative medicine is no exception. In our fellowship programme, we use John Stone's poem, 'Talking to the Family,' to engage trainees in a professional development workshop on personal experiences and strategies for self-care.
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…
International Planned Parenthood Federation, London (England).
Population growth trends and family planning activities in Africa, America, Asia, Europe, and Oceania are summarized in this booklet developed by the International Planned Parenthood Federation. Narrative information for each continent gives a resume of population growth trends, reasons for the trends, population problems, policy formation, family…
Piotrow, Phyllis T., Ed.
Analysis of Latin America's demographic situation has led many to believe that the present rapid rates of population growth, the highest anywhere in the world, must be reduced in order to prevent catastrophe. Family planning associations, affiliated with the International Planned Parenthood Federation (IPPF), have been organized in 29 Latin…
Planned Parenthood--World Population, New York, NY. Katherine Dexter McCormick Library.
Abstracts of current publications in the fields of population and family planning are contained in this monthly acquisitions list of the Katherine Dexter McCormick Library, Planned Parenthood, New York. Organized in two parts, Part 1 contains an annotated list of the books most recently acquired by the Library, marked with its Library call number,…
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.
Navarro, M V
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.
Carlin, E M; Russell, J M; Sibley, K; Boag, F C
The objective was to evaluate an integrated family planning clinic (FPC) established by genitourinary medicine (GUM) staff held within a GUM women-only clinic at the John Hunter Clinic, London. A retrospective case note review of women attending the FPC during the first year January-December 1992 was performed. Data were extracted on: prior STDs, parity and pregnancies terminated; screening for STDs, serology and cervical cytology; contraception on first attendance, that supplied, and outcome over the subsequent year 1993. 113 women, 13-41 years old, attended the FPC. 45 were new attenders, 6 had previously tested antibody positive for the human immunodeficiency virus (HIV), 7 were intravenous drug users; 61 (54%) had a history of sexually transmitted disease (STD); 20 (17.7%) were using no contraception; 37 (32.7%) had previous termination of pregnancy (TOP) with 70 TOPs in total. Within 3 months of FPC attendance, 89 (78.8%) women had genital STD screening performed; syphilis, HIV and hepatitis B serology, together with cervical cytology were performed in 77, 18, 13, and 62 women, respectively. Infections identified were similar to those identified in the GUM clinic, although the prevalence of Chlamydia trachomatis in diagnosed infections was commoner in FPC attenders and epidemiological treatment commoner in GUM attenders. No high grade cytology abnormalities were detected. No positive syphilis or new HIV-positive results were identified; 5 women were found to be hepatitis B surface antibody positive. Contraception was changed in 60.8%. Most frequently supplied was the combined oral contraceptive pill (COCP). At the first FPC attendance 6 women required post coital contraception (PCC) and 5 were already pregnant: 3 suspected it, and 2 were unaware. During the year 3 women conceived; 2 used COCP, but were noncompliant; 1 used a diaphragm with unclear compliance. 7 of the 8 pregnancies were terminated. Over the following year, 1992-93, contraception was supplied
Carlin, E M; Russell, J M; Sibley, K; Boag, F C
OBJECTIVE--To evaluate an integrated family planning clinic (FPC) established by genitourinary medicine (GUM) staff held within a GUM women-only clinic (WOC). DESIGN--A retrospective case note review of women attending the FPC during the first year January-December 1992. RESULTS--One hundred and thirteen women, aged 13-41 years, attended the FPC; 45 were new attenders, six had previously tested antibody positive for the human immunodeficiency virus (HIV), seven were intravenous drug users; 54% had a history of sexually transmitted disease (STD); 17.7% were using no contraception; 32.7% had previous termination of pregnancy (TOP) with 70 TOPs in total. Within three months of FPC attendance 89 (78.8%) women had genital STD screening performed; syphilis, HIV and hepatitis B serology, together with cervical cytology were performed in 77, 18, 13 and 62 women respectively. Infections identified were similar to those identified in the GUM clinic but the prevalence of Chlamydia trachomatis in diagnosed infections was commoner in FPC attenders and epidemiological treatment commoner in GUM attenders. No high grade cytology abnormalities were detected. No positive syphilis or new HIV positive results were identified; five women were found to be hepatitis B surface antibody positive. Contraception was changed in 60.8%. Most frequently supplied was the combined oral contraceptive pill (COCP). At the first FPC attendance six women required post coital contraception (PCC) and five were already pregnant, three suspected it, two were unaware. During the year three women conceived; two used COCP, but were non compliant; one used a diaphragm with unclear compliance. Seven of the eight pregnancies were terminated. Over the following year, 1992-93, contraception was supplied to 42 women; four required PCC; two intentional pregnancies occurred. Only one of the TOP women returned. CONCLUSION--An integrated FPC provides co-ordinated sexual health care. Pregnancy, TOP and FPC re-attendance
Ugwu, Dorothy N.; Adamuti-Trache, Maria
This study examines the post-graduation plans of international science and engineering doctoral students at a public research-intensive university, and the extent to which graduate school experiences influence post-graduation plans. The study is grounded in Tinto's Integration Model as well as Berry's Acculturation Model. Study findings highlight…
Hen, Itay; Rieffel, Eleanor G.; Do, Minh; Venturelli, Davide
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
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.
Woodward, G L; Leake, J L; Main, P A
The City of North York Public Health Department (NYPHD) operates a school-based dental programme that provides preventive and treatment services to children according to evidence-based practice guidelines. This programme and private dental practices (PDP) represent the only sources of dental care for children in North York. The purpose of our study was to compare the oral health and family characteristics of clients from the NYPHD and PDP using a dental examination and a parent interview. Results showed that NYPHD and PDP clients had similar levels of fluorosis, calculus, and periodontal health, but NYPHD clients had experienced greater levels of decay. Clients of the NYPHD and PDP also had significantly different family characteristics, many of which were significantly associated with the presence of one or more decayed primary or permanent teeth. Multivariate logistic regression identified mother's immigration history, past caries experience, and parents' rationale for scheduling their child's dental appointments as the principle risk makers for dental decay. When compared with PDP clients, the NYPHD serves higher-needs children who otherwise might not receive care.
Rosales Aujang, Enrique; Felguérez Flores, Jesús Alberto
The Caesarean section is commonly related to the effects it produces in maternal and perinatal morbidity and mortality; however, little has been studied about the influence that C-Section exerts in familiar planning. This cross-sectional study analyzes the relationship between the rate of Caesarean section during 19 years and the rates of natality, of maternal mortality, and perinatal mortality, as well as the accepted contraceptive methods during such surgical procedure.
Bowen, D L
Attitudes toward family size and family planning in villages in pre-Saharan Maghreb were assessed through a questionnaire administered to 75 women 13-44 years of age and 40 men. The ksars in which the interviews were conducted were located in Arab Sebbah Ziz, a rural population area. Children are important in this region, both as a source of agricultural help and to care for their parents in old age. The total fertility rate in Morocco is 7.4. Among male respondents in this study, 36.5% wanted 10 or more children. Although female respondents expressed the belief that they had no control over family size, the largest proportion (37.5%) wanted 5-6 children and only 7.5% wanted 9-10 children. All the men in the ksar of Mengara had some awareness of the concept of family planning, but the women indicated a lack of knowledge. When family planning was explained to female respondents, the characteristic response was a reluctance to interfere with God's will. Even respondents who did not want more children expressed a reluctance to do anything active to prevent pregnancy. Women in the ksar of Okba displayed a more active interest in family planning, especially to prevent the adverse health effects caused by continuous childbearing. The main reason for not using family planning was fear of side effects. There was also awareness of the beneficial effects of birth spacing on child health. The Moroccan family planning program emphasizes the use of oral contraception; there appears to be marked resistance to the IUD. These findings indicate that mass media efforts and increased availability of family planning supplies are not sufficient measures to expand family planning acceptance. Women must learn what family planning involves, how it applies to their lives, the benefits and disadvantages of available methods before they can reach decisions about contraceptive usage. The causal relationship between numerous and frequent pregnancies and poor health must also be stressed. An
In 1990 the Census Leading Group under the State Council, the State Family Planning Commission, and the Ministry of Public Security issued a circular on census and family planning calling for various localities to do a good job in registering children who were born beyond the state target. The circular provides the following: "1. To strictly enforce the policy for family planning and allow no children who were born beyond the state target to register themselves for residence, it is necessary to clarify issues to the local cadres. While acknowledging their enthusiasm in implementing the state policy for family planning, we must ask them to allow some children who were born beyond the state target to register themselves for the census and residence on the basis of the relevant regulations of the State Council. 2. It is necessary to carry out ideological work well among those cadres who did not report the number of children who were born beyond the state plan because of political reasons or material benefits, so that they will report childbirths and have those children registered. In general, no further investigation will be made as long as the children born beyond the state target have truthfully registered themselves during this census. However, those who continuously refuse to tell the truth will be severely dealt with when they are caught. 3. It is necessary to strengthen propaganda and education work among the masses who dare not report the births of children beyond the state target for fear of possible punishment, and make them understand that the census is aimed at managing state affairs and providing scientific data for working out various policies for social and economic developments. Therefore, it is necessary to report things as they are." The circular also provides that "Family planning is China's basic state policy. It is wrong to give birth to any child beyond the state target. It is impermissable to do so. From now on, we still need to enforce the
Mahamed, Fariba; Parhizkar, Saadat; Raygan Shirazi, Alireza
The aim of this study was to determine the effect of health education on the knowledge and attitude regarding family planning and contraception's method among the women who obligatory attended the Premarital Counseling Center in Yasouj city, Iran. An experimental study was carried out and a total of 200 women were selected for the study using convenience sampling method among women who attended in the health centre in order to utilize the necessary premarital actions. Respondents were divided by two experimental and control groups randomly. A pre-evaluation was done on the knowledge and attitude on family planning using a structured questionnaire. After which, the health education for experimental group was done within four educational sessions during 4 consecutive weeks and control group underwent traditional education method. Post evaluation was utilized for any changes regarding their knowledge and attitude among the respondents immediately after the intervention. Independent and paired t-test was used to evaluate the mean knowledge and attitude scores differences among both groups. RESULTS showed that there was a significant improvement in respondents' knowledge and attitude after educational program in experimental group (p<0.001), while no significant difference was observed in knowledge and attitude of control group. The finding also indicated that age was significantly associated with the level of respondents' knowledge. These results deal the effectiveness of the educational method. In conclusion, the educational method is effective in increasing the knowledge and improving the attitude of women regarding family planning in Yasouj compared to current used educational method. Future educational programs need to incorporate the features that have been associated with successful interventions in the past, as well as including their own evaluation procedures.
King, Michael; Nazareth, Irwin
Background The morbidity of gay, lesbian or bisexual people attending family practice has not been previously assessed. We compared health measures of family practice attendees classified as lesbian, gay and bisexual. Methods We conducted a cross-sectional, controlled study conducted in 13 London family practices and compared the responses of 26 lesbian and 85 bisexual classified women, with that of 934 heterosexual classified women and 38 gay and 23 bisexual classified men with that of 373 heterosexual classified men. Our outcomes of interest were: General health questionnaire; CAGE questionnaire; short form12; smoking status; sexual experiences during childhood; number of sexual partners and sexual function and satisfaction. Results In comparison to people classified as heterosexuals: men classified as gay reported higher levels of psychological symptoms (OR 2.48, CI 1.05–5.90); women classified as bisexual were more likely to misuse alcohol (OR 2.73, 1.70–4.40); women classified as bisexual (OR 2.53, 1.60–4.00) and lesbian (OR 3.13, 1.41–6.97) and men classified as bisexual (OR 2.48, 1,04, 5.86) were more likely to be smokers and women classified as bisexual (OR 3.27, 1.97–5.43) and men classified as gay (OR 4.86, 2.28–10.34) were much more likely to report childhood sexual experiences in childhood. Psychological distress was associated with reporting sexual experiences in childhood in men classified as gay and bisexual and women classified as heterosexual. Men classified as bisexual (OR 5.00, 1.73–14.51) and women classified as bisexual (OR 2.88, 1.24- 6.56) were more likely than heterosexuals to report more than one sexual partner in the preceding four weeks. Lesbian, gay and bisexual classified people encountered no more sexual function problems than heterosexuals but men classified as bisexual (OR 2.74, 1.12–6.70) were more dissatisfied with their sex lives. Conclusion Bisexual and lesbian classified people attending London general practices
... GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does one apply for a family planning services grant? (a) Application for a grant under this subpart shall... 42 Public Health 1 2010-10-01 2010-10-01 false How does one apply for a family planning...
... GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.5 What requirements must be met by a family planning project? (a) Each project supported under this part must: (1... project as long as the entire project offers a broad range of family planning services. (2)...
... GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does one apply for a family planning services grant? (a) Application for a grant under this subpart shall... 42 Public Health 1 2011-10-01 2011-10-01 false How does one apply for a family planning...
... GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.5 What requirements must be met by a family planning project? (a) Each project supported under this part must: (1... project as long as the entire project offers a broad range of family planning services. (2)...
Cooke, Richard; French, David P
Meta-analysis was used to quantify how well the Theories of Reasoned Action and Planned Behaviour have predicted intentions to attend screening programmes and actual attendance behaviour. Systematic literature searches identified 33 studies that were included in the review. Across the studies as a whole, attitudes had a large-sized relationship with intention, while subjective norms and perceived behavioural control (PBC) possessed medium-sized relationships with intention. Intention had a medium-sized relationship with attendance, whereas the PBC-attendance relationship was small sized. Due to heterogeneity in results between studies, moderator analyses were conducted. The moderator variables were (a) type of screening test, (b) location of recruitment, (c) screening cost and (d) invitation to screen. All moderators affected theory of planned behaviour relationships. Suggestions for future research emerging from these results include targeting attitudes to promote intention to screen, a greater use of implementation intentions in screening information and examining the credibility of different screening providers.
Schenker, J G; Rabenou, V
The world population explosion has caused political leaders to look upon national and regional birth control projects as vital. Support for regulation of individual fertility has been evident in all cultures, and at all times, even in those societies in which social and religious rules have favoured the abundant production of children. As the secularization of Western society and scientific enquiry gained momentum during the modern period, knowledge of reproduction increased and was applied to control human population growth. The various methods of contraception and their development through the years from the ancient ideas to the modern era are presented. Each approach to fertility control has its advantages and disadvantages. No one method is perfect for everyone, for every clinical setting, and in every culture. Higher levels of fertility have been associated with 'traditional', religious prohibitions on some forms of birth control, 'traditional' values about the importance of children and the priority of family, and 'traditional' family and gender roles reinforced by religion. The attitude of the main religious groups to contraceptive practice is discussed.
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.
Cuca, R; Pierce, C S
Experiments in the delivery of family planning services are an important means of testing new approaches on a relatively small scale. Over the past 20 years, extensive experimental efforts have explored such key aspects of service delivery as personnel, the use of mass media, integration of family planning with other services, intensive efforts and camps, incentive payments to acceptors, and inudation or community-based distribution. Approaches that proved successful have often been incorporated into regular programs. An examination of the methodology and findings of family planning experiments, based on a survey of 96 projects testing various approaches, highlights successes, failures, and continuing problems. The discussion of past experience halps point to criteria that might be followed in formulating future experimental projects.
Bos, Henny M W; van Balen, Frank; van den Boom, Dymphna C
One hundred planned lesbian-parent families (i.e., two-mother families in which the child was born to the lesbian relationship) were compared with 100 heterosexual-parent families on child adjustment, parental characteristics, and child rearing. Questionnaires, observations, and a diary of activities were used to collect the data. The results show that especially lesbian social mothers (i.e., nonbiological mothers) differ from heterosexual fathers on parental characteristics (e.g., more parental justification and more satisfaction with the partner as coparent) and child rearing (e.g., more parental concern and less power assertion). Child adjustment is not associated with family type (lesbian-parent families vs. heterosexual-parent families), but is predicted by power assertion, parental concern, and satisfaction with the partner as coparent.
de Montigny, F
Last month, the author presented the first two steps necessary in the development of a nursing care plan. This care plan utilized Sister Callista Roy's conceptual model and was designed to evaluate the family system. The readers became familiar with the Joly family, whose family system was evaluated (this included Diane and Jessie). Analysis of the collected data identified two nursing diagnoses and the author explained the way that nursing diagnosis is derived. The first identified nursing diagnosis revealed a threat to the beneficiary, the second diagnosis revealed a threat to the family system. This second article is devoted to the three other steps involved in the development of a nursing care plan that will assist the nurse in developing a systematic strategy in caring for this type of family. The planning step consists of the identification of objectives for care. These objectives must be specific, measurable and realistic as well as able to answer the question: "What changes are intended for this family?" Suggestions are offered for objective development. Once the objectives are finalized, the nurse chooses pertinent and realistic interventions that permit her/him, as well as Diane, to attain the identified objectives. The nurse's interventions are centred around stimuli that are increased, decreased or maintained by the goal of modifying or reinforcing observed behaviors. In the care plan example developed for the Joly family, the identified interventions are not all inclusive and serve as suggestions. During the course of the interventions the nurse must constantly readjust and adapt the interventions to fit with changing needs.(ABSTRACT TRUNCATED AT 250 WORDS)
Congressional legislation seeking to overturn US government restrictions on international family planning assistance face a possible presidential veto. Dating back to the Reagan years, the 1984 Mexico City Policy prohibits foreign nongovernmental organizations (NGO) receiving US money from performing or actively promoting abortion as a family planning method. Even if abortion is legal in that particular country, the agency involved may not even discuss abortion as one of the medical options of a pregnant woman. In line with the Mexico City Policy, the US has withdrawn funding from both the International Planned Parenthood Federation, the largest NGO in the population field, and the Family Planning International Assistance, the international division of the Planned Parenthood federation of America. One of the effects of the Mexico City Policy has been to make family planning more controversial, and to increase opposition to birth control. In addition to the Mexico City Policy, the Reagan years also saw the implementation of a policy that denies funding to the UNFPA, charged by the US of "co-managing" China's population program that engages in coercive abortion and involuntary sterilization. The UNFPA has denied such charges. So far, President George Bush -- previously a supporter of family planning programs -- has sided with opponents of abortion, and has threatened a veto threat may soon be tested, since Congress has drafted a foreign aid appropriations bill that has includes a measure saying that NGOs should be treated in the same manner as their governments, which are exempt from the Mexico City Policy so long as US funds are not used to support abortions.
Liu, Hueiming; Lindley, Richard; Alim, Mohammed; Felix, Cynthia; Gandhi, Dorcas B C; Verma, Shweta J; Tugnawat, Deepak Kumar; Syrigapu, Anuradha; Ramamurthy, Ramaprabhu Krishnappa; Pandian, Jeyaraj D; Walker, Marion; Forster, Anne; Anderson, Craig S; Langhorne, Peter; Murthy, Gudlavalleti Venkata Satyanarayana; Shamanna, Bindiganavale Ramaswamy; Hackett, Maree L; Maulik, Pallab K; Harvey, Lisa A; Jan, Stephen
Introduction We are undertaking a randomised controlled trial (fAmily led rehabiliTaTion aftEr stroke in INDia, ATTEND) evaluating training a family carer to enable maximal rehabilitation of patients with stroke-related disability; as a potentially affordable, culturally acceptable and effective intervention for use in India. A process evaluation is needed to understand how and why this complex intervention may be effective, and to capture important barriers and facilitators to its implementation. We describe the protocol for our process evaluation to encourage the development of in-process evaluation methodology and transparency in reporting. Methods and analysis The realist and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) frameworks informed the design. Mixed methods include semistructured interviews with health providers, patients and their carers, analysis of quantitative process data describing fidelity and dose of intervention, observations of trial set up and implementation, and the analysis of the cost data from the patients and their families perspective and programme budgets. These qualitative and quantitative data will be analysed iteratively prior to knowing the quantitative outcomes of the trial, and then triangulated with the results from the primary outcome evaluation. Ethics and dissemination The process evaluation has received ethical approval for all sites in India. In low-income and middle-income countries, the available human capital can form an approach to reducing the evidence practice gap, compared with the high cost alternatives available in established market economies. This process evaluation will provide insights into how such a programme can be implemented in practice and brought to scale. Through local stakeholder engagement and dissemination of findings globally we hope to build on patient-centred, cost-effective and sustainable models of stroke rehabilitation. Trial registration number CTRI/2013
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
birth control . This policy, however, has generated contentious debate for over two decades, resulting in frequent clarification and modification of U.S. international family planning programs. In 1984, controversy arose over U.S. population aid policy when the Reagan Administration introduced restrictions, which became known as the "Mexico City policy." The Mexico City policy denies U.S. funds to foreign nongovernmental organizations (NGOs) that perform or promote abortion as a method of family planning -- even if the activities are undertaken with non-U.S. funds.
An, Y; Yu, Q
How Bazhong County of Sechuan Province, China, carries out family planning through a combination of what are termed vertical and horizontal services is described. Vertical service refers to assistance such as premarital education, prenatal hygiene, child health care, and family planning, while horizontal service refers to household assistance for married women. Premarital education is designed to help young people acquire sufficent knowledge about family planning, hygiene, and eugenics, and stresses the disadvantages involved in marriages between close relatives. Prenatal hygiene provides safe and convenient medical accommodations for delivery of the child as well as maternal care. Child health services assure that the best facilities are to be made available for physical examinations, vaccinations, and medical treatment. The family planning program involves comprehensive measures such as distribution of contraceptives and safe sterilization. In addition, the county provides medical assistance for couples unable to have children. Horizontal service providing household assistance for married women promotes scientific farming (e.g., how to use fertilizer), helps people increase their income by teaching them skills, and provides social services to improve life style and education. These vertical and horizontal services have brought about substantial improvements in the standard of living, family harmony, and population control.
Planned parenthood is a major event concerning the vital interests of each family and individual and the prosperity and development of China. An excessive population growth rate has limited an improvement of the people's living standards and has adversely affected economic growth. Planned parenthood should be encouraged in accordance with China's Constitution and the provisions of the new marriage law. Late marriage and childbirth is a way of showing one's responsiblity toward the next generation. Eugenics is an important aspect of planned parenthood. Giving birth to physically unhealthy or mentally retarded children will place additional burdens on the family and society. In promoting planned parenthood it is necessary to do ideological and educational work in a patient and meticulous way. Planned parenthood must be widely propagated. Late marriage, late birth, and eugenics must be encouraged, and the advantages and significance of the 1 child family must be publicized. It is necessary to make early and realistic efforts to ensure the success of ideological work in planned parenthood, contraceptive measures, and birth programs. This will prevent unwanted conceptions and help achieve the goal of bringing the population under control. It is also necessary to strengthen work regarding maternity and child care and to popularize scientific knowledge concerning nursing babies.
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.
Palma Cabrera, Y; Suarez Morales, J
Great efforts have been made to measure contraceptive prevalence in Mexico and to assess various aspects of differential usage. At present, 63.1% of fertile aged women in union are estimated to use a method. State prevalence rates ranged from 77.2% of couples in Baja California Sub to 46.3% in Oaxaca. In general, northern states and Mexico City had the highest prevalence rates and states in the center and south had the lowest. Results of the 1988 Survey of Determinants of Contraceptive Prevalence permit identification of sociocultural variables related to contraceptive usage. The data show that residents of the northwestern states have a considerably higher educational level and proportion urban than do those of the center or southeast. The southeast lagged the center in indicators of household characteristics and services, income, and infant mortality, and also had a higher rate of female labor force participation. The states of the center had a lower rate of contraceptive usage at 54.8% than did those of the southeast at 56.4%. The rate for the northwest states was 71.8%. Knowledge of contraceptive methods in the northwest and center was nearly universal, but almost one-fourth of rural women in the southeast reported not knowing a method. Reasons for not using a method varied in the three regions. Problems of access, lack of knowledge, and fear of side effects were the principal factors in the southeast. Opposition of the woman or spouse or religious beliefs were the main factors in the center. No significant barriers of culture or access were identified in the northwest. The average ideal family size was around 3.5 children in all three regions. The survey results demonstrate that having children was highly valued in all three regions. Children were more highly valued in the southeast for companionship, aid, and economic contribution; in the center as sources of affective relations; and in the northwest for satisfaction or personal fulfillment of the woman.
Ackerman, Alan; And Others
To determine whether various indices of "acculturation" would predict attitudes towards family planning was the major purpose of a survey conducted among a highly educated group of Navajo people at Navajo Community College (NCC). Owned and operated by the Navajo Tribe, NCC served as a target survey model due to its 90% population of…
Chaves, Lushanhya Coutinho; And Others
A family planning clinic which was part of a large public maternity hospital in Salvador Bahia, Brazil received a grant to expand its services and to evaluate a service model focusing on client counseling and education. The counseling, education, and service provision process included individual pre-consultation with a nurse, group education and…
Yard Plan of the Brundage, Parish, Simmons Families et al. Circa 1940s - The Smokey Hollow Community, Informal boundaries by street name: North to South: East Jefferson Street to East Van Buren Street. West to East: South Gadsden Street to Marvin Street., Tallahassee, Leon County, FL
Reis, Janet; And Others
Describes a pilot family planning program in an inner-city pediatric practice. Male adolescents were more likely to accept contraceptives if the provider first raised the topic of birth control to them. Identified a desire for anonymity/confidentiality and embarrassment or discomfort as the key reasons for not seeking contraceptives. Emphasizes…
Johnson, Leanor Boulin; Staples, Robert E.
Describes the Young Inner-City Males Project, a pilot project to provide culturally relevant family life planning services to young minority males in Los Angeles. The project offered goal-directed support to promote sexual responsibility and reduce unwanted pregnancies. (FMW)
Johnson, Leanor Boulin; Staples, Robert E.
Reports on a program aimed at young Black, Spanish-speaking, Asian, and American Indian males in relation to family life education, planning, and parental concerns. The project develops an approach to the promotion of sexual responsibility and reduction of unwanted pregnancy through support and assistance to potential unwed fathers. (Author)
The author provides a global review of family planning techniques and their impact on national birth rates. Sterilization, the pill, and intrauterine devices are the most popular methods of contraception worldwide. Abortion, where it is legal, is also extremely popular. In countries such as the United States where population control is not an…
Carter, Marion W.; Tregear, Michelle L.; Lachance, Christina R.
Context Community engagement may include activities that involve community members in the design, implementation, and evaluation of services. The objective of this systematic review was to evaluate the evidence on this kind of community engagement in U.S. family planning programs, including its effects on various health outcomes, its perceived value, and the barriers and facilitators to implementation. Evidence acquisition Using an analytic approach drawn from U.S. Preventive Services Task Force, multiple databases were searched for articles published from 1985 through February 2011 that described studies about community engagement related to family planning. In 2011, relevant articles were reviewed, summarized, and assessed for potential bias using a standardized abstraction process. An updated, targeted review for the 2011–2014 period was conducted in early 2015. Evidence synthesis Eleven papers related to family planning were included. All were qualitative, descriptive, and at high risk for bias. Engagement strategies involved various methods for developing educational materials, program development, or program evaluation. All studies reported benefits to community engagement, such as more-appropriate educational materials or more community support for programs. Barriers to engagement included the substantial time and resources required. Four more articles were identified in the targeted, additional search. Conclusions Community engagement is described as beneficial across the included studies, but the body of evidence for community engagement in family planning is relatively small. Given the high value ascribed to community engagement, more research and documentation of the various approaches taken and their relative strengths and weaknesses are needed. PMID:26190842
Population Council, New York, NY.
Presented in the principal article, "Planning, Starting, and Operating an Educational Incentives Project," is a summary of activities to date in an educational savings project in Taiwan. The incentive project is designed to reward those couples who limit their family size, by providing funds for their children's secondary and higher education. To…
Schwartz, Dana Belmonte; Darabi, Katherine F.
New adolescent patients (N=150) at a large urban clinic were interviewed to determine what events or advice led to their decision to approach a family planning clinic for the first time. The roles of pregnancy scares, advice from significant others, and situational factors in motivating service use are presented. Program implications of these…
Tsui, Amy O.; McDonald-Mosley, Raegan; Burke, Anne E.
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
Leo, Robert J.; And Others
After a brief summary of the findings of a 1979 study of Personal and Family Financial Planning (PFFP) programs at member institutions of the League for Innovation in the Community College (LICC), this two-part monograph provides information on selected PFFP programs. Part I presents in-depth descriptions of the implementation, subject coverage,…
This method advocated the use of exclusive or nearly exclusive breastfeeding to remain amenorrheic and thus avoid pregnancy. The lactational amenorrhea ...method was reported to be up to 98% effective when exclusive breastfeeding and amenorrhea were present (Kennedy et al., 1991). The basal...C. (1991). The natural family planning-lactational amenorrhea method interface: Observations from a prospective study of breastfeeding users of
... 34 Education 2 2014-07-01 2013-07-01 true Individualized family service plan. 300.24 Section 300.24 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...
... 34 Education 2 2013-07-01 2013-07-01 false Individualized family service plan. 300.24 Section 300.24 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...
Hosken, Fran P.
Repressive attitudes toward female sexuality by Third World men and ignorance of the basic biology of the female reproductive system by Third World women have led to the failure of family planning efforts. Use of the "Universal Childbirth Picture Book," which illustrates the female reproductive system, is recommended. (IS)
Sweeney, William O.
In this paper, the author outlines the historical development of information and education programs for population control and family planning, arguing that communications activities should receive as much emphasis as the health services program. The public information aspect includes use of mass media, advertising and promotion, public relations…
Harris, William G.; And Others
Attitudes of black leaders and a general black population sample toward birth control and family planning issues were "Pro Birth Control" and "Genocide Fears." The leaders questioned held positions in twenty national black organizations, while the general population samples were taken from Philadelphia, Pennsylvania, and Charlotte, North Carolina.…
Mostajo, P; Foreit, K
Fertility intentions and reproductive risk were used to segment Peru's potential market for contraceptives using data from the 1991-92 Demographic and Health Survey. The four programmatic groups of fertile-aged women in union included 41.4% not wanting more children and at high risk, 30.5% not wanting more children and at moderate or low risk, 12.8% wanting to space, and 15.4% wanting a child in the near future. 84.6% of fertile-aged married women thus needed a contraceptive method to avoid unwanted pregnancy or high risk pregnancy. A range of appropriate methods was identified for each of the four programmatic groups based on method efficacy, clinical contraindications, and legal restrictions. Projections of the prevalence, method mix, and sources of service took into account the range of appropriate methods, local preferences for particular methods, local availability of health posts and infrastructure, and the rational use of limited resources. The four programmatic groups were disaggregated by age to take into account recommendations for use of oral contraceptives, surgical sterilization, and IUDs. The segmentation by source of supply was done separately for type of method and rural or urban residence. Marital status, proportion of fertile-aged women, socioeconomic status and other factors were heterogeneously distributed within and between the 13 planning regions. An estimated 7% of women were infertile, 23.9% were at low reproductive risk, 25.6% at medium risk, and 50.5% at high risk because of age, parity, or a history of abortion, neonatal death, prematurity, or cesarean delivery. Among women not wanting more children at high and medium or at low risk, respectively, 66.6% and 65.1% were using a method, but only 30.0% and 32.0% were using an appropriate method. The projected method mix and sources of supply are presented for Lima as an illustration of application of the methodology. The projected method mix for Lima eliminates use of natural methods
Cho, Heung-Don; Kim, Nam-Young; Gil, Hyo-wook; Jeong, Du-shin; Hong, Sae-yong
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.
Davoren, M. P.; Harrington, J. M.; Shiely, F.; Perry, I. J.; McHugh, S. M.
Summary The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community‐based lifestyle programmes among families of overweight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed‐method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition. PMID:27862851
Kelleher, E; Davoren, M P; Harrington, J M; Shiely, F; Perry, I J; McHugh, S M
The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community-based lifestyle programmes among families of overweight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed-method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition.
... SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.3 Who is eligible to apply for a family planning services grant? Any public or nonprofit private entity in... 42 Public Health 1 2011-10-01 2011-10-01 false Who is eligible to apply for a family...
... SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.3 Who is eligible to apply for a family planning services grant? Any public or nonprofit private entity in... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible to apply for a family...
Stevens, Lindsay M
A major health care goal in the United States is increasing the proportion of pregnancies that are planned. While many studies examine family planning from the perspective of individual women or couples, few investigate the perceptions and practices of health care providers, who are gatekeepers to medicalized fertility control. In this paper, I draw on 24 in-depth interviews with providers to investigate how they interpret and enact the objective to "plan parenthood" and analyze their perspectives in the context of broader discourses about reproduction, family planning, and motherhood. Interviews reveal two central discourses: one defines pregnancy planning as an individual choice, that is as patients setting their own pregnancy intentions; the second incorporates normative expectations about what it means to be ready to have a baby that exclude poor, single, and young women. In the latter discourse, planning is a broader process of achieving middle-class life markers like a long-term relationship, a good job, and financial stability, before having children. Especially illuminating are cases where a patient's pregnancy intention and the normative expectations of "readiness" do not align. With these, I demonstrate that providers may prioritize normative notions of readiness over a patient's own intentions. I argue that these negotiations of intention and readiness reflect broader tensions in family planning and demonstrate that at times the seemingly neutral notion of "planned parenthood" can mask a source of stratification in reproductive health care.
Bouzidi, M; Jones, M
In 1970, a Dutch medical team began work in the city of El Kef in Tunisia on a project designed to bring family planning into rural areas. The project aimed to persuade the rural people to use urban health centers, but this approach failed partly because of the remoteness of the communities and their reluctance to discuss personal matters with strangers. Funded by UNFPA, a new project began to recruit and train local girls as home health visitors or aides-familiales, an approach which became the central focus of the El Kef project. The International Planned Parenthood Federation (IPPF) took over the project and expanded it to include nutrition, health care, health education, family planning, disease prevention and domestic crafts. 4 goals were fixed for the project: total vaccination coverage for children; elimination of severe malnutrition; reduction of infant mortality; and use of family planning practice by at least 1/2 the women of childbearing age. An efficient recordkeeping system enabled the project to be carefully evaluated and provides much-needed data, showing where it has achieved its aims and where new efforts should be directed. The project resulted in large numbers of women receiving ante-natal advice, child care and family planning from their local health centers. 860 pregnant women were followed up during the 3-year study period. Some 57% of pregnant women went for advice; only 15% went for postnatal care, but 50% of the women under 50 attended child welfare sessions during the study period for weight checks, nutrition advice, vaccination and treatment for minor ailments. Over the 3 years, the number of contraceptive users more than trebled, from 14% to 54%. The IUD was the most popular method. The most successful aspect of the project was the emphasis on maternal and child health, and the home visits were the most motivating feature. Vaccination became more popular. A further aspect of the project was the training in home improvement skills, like
Frisiras, S; Lagiou, A; Sourtzi, P; Vidalaki, M
The Greek Family Planning Association (GFPA) completed in march 1990 a 3-year effort to evaluate whether sex education was an integral part of the school curricula. It was reported by a representative of the Pedagogical Institute in the Ministry of Education and Religion that important efforts have been made. The findings were presented at the 2nd Sex Education and Health seminar in March, 1990. Greek primary schools have 1 teacher for all lessons; but specialists in various fields of the secondary school curricula. Primary school books have various references and pictures on human reproduction. Equality of the sexes socially and culturally is represented, as well as good health messages on nutrition and hygiene. Noticeably absent, however, is any reference to human sexuality, nude human body or sex organ pictures, or other non-traditional family models. Family planning and contraception are also missing; teacher training or special courses are needed. Secondary school books have clear but limited messages. For example, there is a whole page on the philosophy and aims of family planning, but parenthood is only presented in the context of traditional marriage without contraception. It is recommended that legislative support be engaged to insure that sex education programs are systematic, age-specific, and a continuous activity from the primary level. Another important role in the implementation and curriculum development of sex education is one played by teachers and health professionals, those in touch with young people. GFPA needs to compile basic guidelines for those teaching sex education.
This report describes the general population, use of contraception, and suggestions for initiating a family planning program in the rural sections of the Gouvernorat of Mahdia, Tunisia. The locales examined are Chorbane, D'Essouassi and D'Ouled Chamakh, which make up 81,000 people, out of a total of 260,000 in the Gouvernorat. The population is growing at 3.1% yearly, with a mean age of 23 (median 17), or 45% under 15 years old. The density is 50 persons/sq km. About 17% of men and 2% of women are literate. Many men emigrate to find work. 75% of the people work in agriculture, the rest as laborers or textile workers. Housing is primitive, 97% with no facilities and 4 persons per room. There are a total of 12 health centers in the area, including 1 field hospital, 2 centers with family planning clinics. Data from 1981 showed that family planning acceptors in the region comprised 330 women sterilized; 612 who had abortions; 3400 on pills; 1366 with IUDs; and 830 using other methods. The contraception data were collected from records of mobile teams only. Recent data suggests that 50% of women currently covered were sterilized in campaigns 5 years ago. Their mean age is 40 years and they have 7-8 children. Pill or IUD users average 33 years with 5.5 children. Women cite hostility of their husbands toward contraception, especially in the common situation where spouses are away 6 months of the year working. There is also a fear of losing a child, since half of women interviewed have lost 1 or 2 children. On the other hand, 50% of women who have 7 or more children do not want any more pregnancies. This information suggests several opportunities for introducing family planning, such as spacing methods, especially for lactating women and educating husbands on the value of planning.
Walcott, Melonie M; Ehiri, John; Kempf, Mirjam C; Funkhouser, Ellen; Bakhoya, Marion; Aung, Maung; Zhang, Kui; Jolly, Pauline E
The objective of this study was to identify the association between gender norms and family planning practices among men in Western Jamaica. A cross-sectional survey of 549 men aged 19 to 54 years attending or visiting four government-operated hospitals was conducted in 2011. Logistic regression models were used to identify factors associated with taking steps to prevent unwanted pregnancy, intention to have a large family size (three or more children), and fathering children with multiple women. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated from the models. Reduced odds for taking steps to prevent unwanted pregnancy among men with moderate (AOR = 0.5; 95% CI = 0.3-0.8) and high (AOR = 0.3; 95% CI = 0.1-0.6) support for inequitable gender norms was observed. Desiring large family size was associated with moderate (AOR = 2.0; 95% CI = 1.3-2.5) and high (AOR = 2.6; 95% CI = 1.5-4.3) support for macho scores. For men with two or more children (41%), there were increased odds of fathering children with multiple women among those who had moderate (AOR = 2.1; 95% CI = 1.0-4.4) and high (AOR = 2.4; 95% CI = 1.1-5.6) support for masculinity norms. Support for inequitable gender norms was associated with reduced odds of taking steps to prevent unwanted pregnancy, while support for masculinity norms was associated with desiring a large family size and fathering children with multiple women. These findings highlight the importance of including men and gender norms in family planning programs in Jamaica.
Dunphy, Eoin J; Conlon, Sarah C; O’Brien, Sarah A; Loughrey, Emer; O’Shea, Brendan J
Background End-of-life planning means decision making with patients, formulating and recording decisions regarding their end-of-life care. Although clearly linked with benefits including improved quality of life, reduced hospital admissions, and less aggressive medical care, it is still infrequently undertaken and is regarded as challenging by healthcare professionals. Aim To ascertain the feasibility of improving the identification of patients at high risk of dying in general practice and the acceptability of providing patients identified with an end-of-life planning tool. Design and setting Exploratory prospective cross-sectional study in four general practices. Method Patients at high risk of dying were identified during routine consulting by their GP, using the Supportive and Palliative Care Indicators Tool (SPICT). Patients identified were invited to participate, and provided with Think Ahead — an end-of-life planning tool, which has been used previously in general practice. Participants completed telephone surveys, assessing their response to Think Ahead, and the acceptability of the GP raising end-of-life issues during routine consulting. Results Provision of Think Ahead to a purposive sample of preterminal patients identified by GPs was feasible, acceptable to most patients, and somewhat effective in increasing discussion among families and in practice on end-of-life planning. Conclusion The SPICT and Think Ahead tools were mostly acceptable, effective, and enabling of discussions on end-of-life care in general practice. PMID:27432607
Mariner, W K
On May 23, 1991, the US Supreme Court upheld federal regulations that prohibit federally funded family planning programs from counseling about or referring for abortion. As a result, government benefits may now entail substantial costs. The regulations changed the nature of government-assisted family planning from comprehensive care and counseling to limited services and government-prescribed information. The reasoning in Rust v Sullivan allows government to limit freedom of speech in federally funded programs. The decision may have been influenced by antiabortion sentiment, but it does not affect the legality of abortion. Instead, it sets a precedent for government control of whether and how health care can be discussed wherever government pays some of the bills. PMID:1739169
Responses to the second worldwide survey of 80 nations on their population policy can be divided into 3 categories. First are countries with large official programs of family planning in existence: Egypt, Kenya, Tunisia, Barbados, Colombia, Panama, Trinidad and Tobago, China, India, Iran, Japan, Nepal, Pakistan, Philippines, Republic of Viet-nam, Singapore, Sri Lanka, Thailand, Turkey, Denmark, Netherlands, United Kingdom, Yugoslavia, Canada, and Fiji. Madagascar and New Zealand are starting programs. The second category is countries that encourage private family planning programs: Tanzania, Mexico, Israel, Cambodia, Bahrain, Jordan, Laos, Syria, Austria, France, West Germany, Finland, and Norway. Third are listed countries that do not officially support, or that forbid contraception: Gabon, Malawi, Zambia, Greece, Italy, and Spain. Thus Asia and North Africa have the most ambitious programs, but Europe and North America practice contraception universally.
Background Providing women with contraceptive methods following abortion is important to reduce repeat abortion rates, yet evidence for effective post-abortion family planning interventions are limited. This protocol outlines the evaluation of a mobile phone-based intervention using voice messages to support post-abortion family planning in Cambodia. Methods/Design A single blind randomised controlled trial of 500 participants. Clients aged 18 or over, attending for abortion at four Marie Stopes International clinics in Cambodia, owning a mobile phone and not wishing to have a child at the current time are randomised to the mobile phone-based intervention or control (standard care) with a 1:1 allocation ratio. The intervention comprises a series of six automated voice messages to remind clients about available family planning methods and provide a conduit for additional support. Clients can respond to message prompts to request a phone call from a counsellor, or alternatively to state they have no problems. Clients requesting to talk to a counsellor, or who do not respond to the message prompts, receive a call from a Marie Stopes International Cambodia counsellor who provides individualised advice and support regarding family planning. The duration of the intervention is 3 months. The control group receive existing standard of care without the additional mobile phone-based support. We hypothesise that the intervention will remind clients about contraceptive methods available, identify problems with side effects early and provide support, and therefore increase use of post-abortion family planning, while reducing discontinuation and unsafe method switching. Participants are assessed at baseline and at 4 months. The primary outcome measure is use of an effective modern contraceptive method at 4 months post abortion. Secondary outcome measures include contraception use, pregnancy and repeat abortion over the 4-month post-abortion period. Risk ratios will be used as
Balancing career and family! Balancing what you love and who you love!! It is such an attention getting topic. And yet, if you really think about it, people have been doing it for ages. What makes it challenging in today's world is the dual income families that throw off-balance of traditional style of balancing family and profession. Balancing family and career is not as difficult. The question is more meaningful when you ask how do you find the right balance, and in fact, what is the right balance? How do you know you are there? Happiness at home and self esteem due to work is genderless issue however, it is essentially talked more in the context of women. Some of the things that could be helpful in achieving the right balance, are time management, proper prioritization, asking for help, a caring family, friends, and most importantly colleagues. In the portfolio of professional passions, it is important to identify the areas that are conducive to possibilities of changing family needs, international families, spouse's career and job relocation, etc. So, the bottom line question is whether it is possible to find a right balance between family and career? I would submit to you that with passion, courage, open- mindedness, and proper career planning, it is definitely possible. We just need to utilize the same techniques in choosing and sustaining the right balance that we use in identifying research topics and executing it. This discussion will look into further details of the challenges of balancing family and career from the perspective of also an immigrant, and possible ways of overcoming them.
Reviews features of President Bill Clinton's proposed $22 billion child care plan, a set of spending measures and tax credits designed to make child care more affordable, available, and safe for low- and middle-income families. Features noted include Head Start and after-school programs, and business tax credits. (HTH)
Many women still die as a result of pregnancy or childbirth and yet there are an increasing number of women who wish to regulate their fertility and space or limit their child-bearing. This paper, outlining some success stories, elucidates the family planning challenges and identifies key messages to indicate the role that IPPF can play in the 21st century. Issues such as advocacy for sexual and reproductive health and rights, increased male participation, serving the interests of marginalized groups, appropriate technology, quality of care and cooperation between various partners, all need to be addressed to improve sexual and reproductive health including family planning in the 21st century.
Toohey, J V; Valenzuela, G J
A Spanish language family planning education program utilizing the dynamics of values clarification has been designed and implemented in the state of Oaxaca, Mexico. The design of the program features three basic personality identification activities to help individuals identify other dimensions of adult life expression than child rearing. In addition, a series of simple and precise scenarios specifically related to family planning are presented. Each scenario is accompanied by a set of valuing questions that direct the learner to respond to the scenario. The activity booklet is entitled, "Clarification De Valores En La Planificacion Familar." The booklet requires the learner to make responses to the learning materials. Responses are then used as a basis for inferring that people are comprehending and above all personalizing knowledge about themselves and their culture and family planning. The program is cross cultural and can be used in Spanish speaking communities in the U.S. Its English language form can be used with English speaking target populations. Statistical analysis of seven critical categories of the program indicated that the shifts in attitudes from pre-to post-values, whether positive or negative (desirable or undesirable), were not significant at the .05 level of confidence. It should, however, be noted that small shifts in the rate of natural increase, or rate of natural decrease for population growth can have a dramatic effect on population growth when multiplied by time.
The family planning movement in Japan began when the total number of births in 1947-1949 reached 8 million and the birthrate reached 34 per 1000. This, combined with declining mortality, led to obvious population pressure. As a result of family planning efforts, birthrates fell below 20 per 1000 in 1955 and since 1960 have remained at 17-18 per 1000. Birth control is not new to Japan. It was only 100 years ago that abortion and infanticide were forbidden by law. Moral and religious objections to induced abortion and contraception were not powerful. In 1950 the Eugenic Protection Law was passed and induced abortions increased rapidly, reaching a maximum of 1,170,000 in 1955. Few were done for hereditary diseases. Family planning developed as a reaction to this unforseen widespread practice of induced abortion. Since then efforts to replace induced abortion by contraception have been pursued by the government's Population Problems Council and many nongovernmental voluntary groups. Induced abortions decreased to 843,000 in 1965 and birthrates fell from 19.4 to 18.5 in the same 1955-1965 period. Although total population increased by 9 million, the number of births increased by only 90,000 in these 10 years.
A 1971 survey by the Center for Family Planning Program Development consisted of a questionnaire mailed to health and welfare directors in 50 states and 5 federal jurisdictions concerning their family planning policies and administrative practices. 52 agencies responded; Guam, Mississippi, and Louisiana did not. The major funding for state health agencies was allocated by HEW and by maternal and child health (MCH) formula grants under Title 5 of the Social Security Act. 11 states made additional expenditures of $1.7 million for a variety of purposes. 21 states required local welfare departments to purchase services under the Medicaid program established by Title 19 of the Social Security Act. Administration was assigned to specific organizations within the state health agencies. 31 states reported a total of 128 full-time professional personnel, with 90 assigned at state headquarters level. In general, on a state-by-state basis, the full-time staff does not correspond to the size of the appropriations. Survey findings were useful measures of resource commitments to family planning services by state health and welfare agencies and provided data on future levels of resource requirements.
This article summarizes and discusses the documents concerning family planning promulgated by the Communist Party, National People's Congress and the Government of China since the start of China's family planning program. In 1955 a document was issued entitled the Directive Concerning Population Control pointing out that the public should be made aware of birth control. In 1965 the summary of the 2nd Conference on Urban Work discussed ways of explaining the significance of family planning, to make it a voluntary action of the people. In 1980 the necessity of 1 child per couple was pointed out and policies were formulated regarding ideological and political education. During the 80's several documents were issued which stressed the voluntariness and initiative of the people in practicing birth control, and that any type of coercion was prohibited. For 30 years the fundamental practice of strengthening publicity and education and opposing coercion has remained unchanged no matter how birth policies have been scored in population control since 1979.
Moliner Tena, M A; Moliner Tena, J
183 women attending the family planning clinic in Burriana, Castellon, were interviewed for this survey of the perceived quality of family planning services. The anonymous, self-administered questionnaire was adapted from two existing questionnaires, SERVQUAL and SERVPERF, developed for commercial marketing. Attitudes were measured using a 7-part Likert type scale. The first 20 items referred to different aspects of quality, the second 4 measured satisfaction, total quality, the importance of the service, and reported use, and the final 6 examined respondent characteristics. 28 incompletely completed questionnaires were eliminated, leaving 155. The results indicate that perceived quality and client satisfaction were both high. Using factorial analysis of principal components, 6 factors were identified that explained 63.3% of the variance. The components were high personal attention of services, limited bureaucracy, modern facilities and equipment, professionalism and competence of the staff, accessibility and easy transportation, and reputation and layout. The Cronbach alpha coefficients, which measure internal consistency, were not acceptable for 3 factors. The overall results suggest that marketing tools can be adapted to the needs of health services.
Background Northern Uganda experienced severe civil conflict for over 20 years and is also a region of high HIV prevalence. This study examined knowledge of, access to, and factors associated with use of family planning services among people living with HIV (PLHIV) in this region. Methods Between February and May 2009, a total of 476 HIV clinic attendees from three health facilities in Gulu, Northern Uganda, were interviewed using a structured questionnaire. Semi-structured interviews were conducted with another 26 participants. Factors associated with use of family planning methods were examined using logistic regression methods, while qualitative data was analyzed within a social-ecological framework using thematic analysis. Results There was a high level of knowledge about family planning methods among the PLHIV surveyed (96%). However, there were a significantly higher proportion of males (52%) than females (25%) who reported using contraception. Factors significantly associated with the use of contraception were having ever gone to school [adjusted odds ratio (AOR) = 4.32, 95% confidence interval (CI): 1.33-14.07; p = .015], discussion of family planning with a health worker (AOR = 2.08, 95% CI: 1.01-4.27; p = .046), or with one's spouse (AOR = 5.13, 95% CI: 2.35-11.16; p = .000), not attending the Catholic-run clinic (AOR = 3.67, 95% CI: 1.79-7.54; p = .000), and spouses' non-desire for children (AOR = 2.19, 95% CI: 1.10-4.36; p = .025). Qualitative data revealed six major factors influencing contraception use among PLHIV in Gulu including personal and structural barriers to contraceptive use, perceptions of family planning, decision making, covert use of family planning methods and targeting of women for family planning services. Conclusions Multilevel, context-specific health interventions including an integration of family planning services into HIV clinics could help overcome some of the individual and structural barriers to accessing family planning
Dupras, A; Levy, J J; Tremblay, R
The authors present the results of a survey conducted among the Quebec population on family planning, contraception and abortion. 57.9% of the people questioned were women and 42.1% were men. Concerning the ideal size for the family, 40.5% prefer a smaller family with a maximum of 2 children, 36.9% desire 3 children and 14% 4 or more. 71.1% agree with the idea of a free choice concerning maternity. Only 26.6% agree with the Catholic Church attitude concerning contraception. 44.8% consider the information provided on the subject of contraception as sufficient and 40.5% consider it as insufficient. 84.8% are in favor of the introduction of a contraception information program in the schools. People in Quebec tend to accept abortion if the pregnancy and maternity endanger the life or health of the mother or of the child. 40.9% think that it is too difficult to obtain an abortion. The opinion concerning abortion has evolved toward a liberalization since 1970. It is concluded that a large majority of the population in Quebec is in favor of family planning. (Summary in ENG).
China's family planning program is described in reference to its goals, approaches, and achievements. Between 1949-83, China's population increased from 541 million to 1,024,950,000. The population has a young age structure, and the median age is 22.9 years. 80% of the population is rural, and 90% of the population lives in the southeastern region of the country. In view of this demographic situation, the government recognizes the need to control population growth. China's goals for the year 2000 are to increase industrial and agricultural input by 400% and to keep population size below 1.2 billion in order to ensure that per capita income increases. In accordance with these goals, the government, in 1979, began advocating a 1-child policy. To ensure the survival of single children, the government also launched a program to upgrade maternal and child health (MCH). In some rural areas and among certain minority groups, the 1-child restriction is not applied. Family size goals will vary with time. These variations will reflect the need to maintain a balance between economic growth and population growth. A variety of incentives are used to promote the 1-child family. For example, single children receive medical and educational benefits, and in some rural areas, the parents of single children can obtain additional land contracts. Economic disincentives are also used. The government seeks to obtain compliance with the policy primarily through educating the public about the consequences of uncontrolled population growth. All channels of the mass media are used to deliver the messages, and the publicity campaign is especially intensive in rural areas. A comprehensive plan to provided family planning and population education for middle school students is currently being implemented. Each local area develops its own fertility control plan. This plan is then incorporated into the nation's overall plan and the overall plan is implemented from above. Family planning workers
Bonner, Gloria J; Wang, Edward; Wilkie, Diana J; Ferrans, Carol E; Dancy, Barbara; Watkins, Yashika
Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. Cardiopulmonary resuscitation, mechanical ventilation, and tube feeding were end-of-life treatments discussed in the ACT-Plan. In a four-week pre/posttest two-group design at urban adult day care centers, 68 caregivers were assigned to the ACT-Plan or attention-control health promotion conditions. Findings strongly suggest that the ACT-Plan intervention is feasible and appropriate for African American caregivers. Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.
Mendez, Francisco; Lopez, Felipe; Brambila, Carlos; Burkhart, Marianne
Background Public sector health care providers in rural Guatemala have infrequently offered family planning information and services in routine visits. This operations research project tested a strategy to modify certain practices that prevent health workers from proactively screening clients' needs and meeting them. Methods The research design was quasi-experimental with a pretest-posttest-follow-up comparison group design. Health districts, which comprise health centers and posts, were purposively assigned to intervention or comparison groups to assure comparability of the two groups. The strategy was based on a job-aid designed to guide health workers in screening clients' reproductive intentions and family planning needs, help them to offer contraceptive methods if the woman expressed interest, and facilitate the provision of the method chosen at the time of the visit. The strategy was implemented at intervention sites during a period of six months. Upon completion of post-intervention measurements, the strategy was scaled up to the comparison sites, and a follow-up assessment was conducted nine months later. Results were evaluated by conducting three rounds of exit interviews with women exposed to the risk of unwanted pregnancy. Results Study results showed a two to five-fold increase in providers' screening of clients' reproductive intentions. The proportion of clients who received information about contraceptives increased from 8% at the baseline to 42% immediately post-intervention, and 36% at the follow-up survey. The intervention also proved successful in improving the role service providers play in offering women a chance to ask questions and assisting women in making a selection. The proportion of women who received a method, referral or appointment increased and remained high in the intervention group, although no change was seen in the comparison group after their participation in the strategy. Conclusion The easy-to-use job aid developed for this
Kayembe, Patrick; Babazadeh, Saleh; Dikamba, Nelly; Akilimali, Pierre; Hernandez, Julie; Binanga, Arsene; Bertrand, Jane T
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 US decision since the 1960s to link foreign policy with family planning and population control is noteworthy for its intention to change the demographic structure of foreign countries and the magnitude of the initiative. The current population ideologies are part of the legacy of 19th century views on science, morality, and political economy. Strong constraints were placed on US foreign policy since World War II, particularly due to presumptions about the role of developing countries in Cold War ideology. Domestic debates revolved around issues of feminism, birth control, abortion, and family political issues. Since the 1960s, environmental degradation and resource depletion were an added global dimension of US population issues. Between 1935 and 1958 birth control movements evolved from the ideologies of utopian socialists, Malthusians, women's rights activists, civil libertarians, and advocates of sexual freedom. There was a shift from acceptance of birth control to questions about the role of national government in supporting distribution of birth control. Immediately postwar the debates over birth control were outside political circles. The concept of family planning as a middle class family issue shifted the focus from freeing women from the burdens of housework to making women more efficient housewives. Family planning could not be taken as a national policy concern without justification as a major issue, a link to national security, belief in the success of intervention, and a justifiable means of inclusion in public policy. US government involvement began with agricultural education, technological assistance, and economic development that would satisfy the world's growing population. Cold War politics forced population growth as an issue to be considered within the realm of foreign policy and diplomacy. US government sponsored family planning was enthusiastic during 1967-74 but restrained during the 1980s. The 1990s has been an era of redefinition of
Carron, J M
The Paraguayan Center for Population Studies (CEPEP) has always carefully planned its activities, but a process of strategic planning beginning in 1989 allowed several shortcomings in the planning process to be identified and corrected. The planning strategy had previously been strongly vertical, with only departmental directors and the executive director fully involved. Other office personnel and clinic directors were prevented from contributing in any meaningful way by bureaucratic obstacles and their lack of an overall vision of the organization's mission. Although CEPEP had devoted considerable effort to diagnosis and evaluation prior to developing its plans, the type of evaluation conducted was not appropriate for analyzing medium and longterm trends and needs. Improved planning required continuous analysis of the organization as a whole, rather then evaluation of specific projects, and it required a frank and realistic analysis of the internal organization in relation to CEPEP's goals and its short, medium, and longterm strategies. CEPEP planning suffered from overly general objectives and failed to prioritize goals. Assignment of human and financial resources tended to reproduce the distribution of resources of the preceding year rather than being guided by the plan. New and innovative programs were not funded immediately; available funds were assigned almost exclusively to existing programs. New projects tended to be implemented only because an international donor appeared with the idea and a disposition to fund it. Such projects were often unrelated to planned activities, of short duration, and of dubious relevance to CEPEP goals. The plenary meetings, committee work, and seminars for CEPEP's strategic planning were time consuming but productive. They provided a foundation for CEPEP to redefine its goals and strategies. New plans call for a strong component of activities designed to change the attitude of the government toward family planning, and open the
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…
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…
Dunn, Sheila; Guilbert, Edith; Soon, Judith; Norman, Wendy
Background: 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. Methods: 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. Results: 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. Conclusion: Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada. PMID
Brindis, Claire; And Others
The California Office of Family Planning (OFP), a branch of the Family Health Division, Department of Health Services, was established in 1973 to provide assistance and services relating to the planning of families. In July 1989, state appropriations for OFP were cut by two-thirds, leaving $12 million to support the provision of family planning…
Fisher, A A; Carlaw, R W
This report discusses the experience of a two-year family planning and maternal/child health project in Nepal. Although the project was planned as an experimental field research endeavor, a series of unanticipated events repeatedly compromised the internal validity of the project and forced design changes. While unexpected events are common in the history of most field projects, they present the research evaluator with the fundamental dilemma of trying to maintain a high degree of internal validity without sacrificing external validity. Rigid research designs with tight control over the introduction and measurement of experimental variables may serve to increase internal validity but they may also create an atypical and artificial situation that fails to mirror real field conditions and thus threatens external validity.
Stephenson, Rob; Tsui, Amy Ong; Knight, Rodney
The paper examines the validity of two indices of sustainability: family planning programme sustainability (PSI) and outcome sustainability (OSI) developed by Tsui and Knight (1997) by applying their original method to recent data. The indices succeed in identifying the directional path of programme and outcome sustainability. Close correlations are found between PSI and OSI predicted values and actual programme and outcome values. The indices provide a repeatable method for measuring sustainability, although they are sensitive to data measurement errors. The indices provide a policy tool for funding decisions but should be used with other data sources to judge sustainability.
Kakoko, Deodatus C; Ketting, Evert; Kamazima, Switbert R; Ruben, Ruerd
Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health facilities. Majority of public facilities (95.4%) offered family planning services, whereas more than half of private facilities (52.1%) did not offer those. Public facilities were more likely to offer modern contraceptives as compared to private facilities. However, private facilities were more likely to offer counseling on natural methods of family planning [AOR = 2.12 (1.15-3.92), P < or = 0.001]. Public facilities were more likely to report having guidelines or protocols for family planning services and various kinds of visual aids for family planning and STIs when compared to private facilities. This comparative analysis entails the need to enforce the standards of family planning services in Tanzania.
Critchlow, D T
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
Klaus, H; Bryan, L M; Bryant, M L; Fagan, M U; Harrigan, M B; Kearns, F
Fertility awareness is experiential learning about cyclic fertility. This awareness, used as a family planning method, differs from contraception because it does not isolate the procreative capacity of either partner. The acceptability and effect of teaching fertility awareness on teen sexual activity and decision making was tested in a multisite pilot program which taught fertility awareness via the prospective marker of the cervical mucus (ovulation method of natural family planning). 200 US and 35 Guatemalan volunteer women ages 15-17 in a structured 1 year curriculum, monitored cycle charting and explored the implications of experiencing one's signs of fertility. Control subjects were recruited from the general population and from family planning clinics. 9% of the US study group were sexually active prior to entry. By cycle 12, 1/2 had discontinued activity. Conception rate was 0.0044. The continuation rate dropped from 90% at cycle 7 to 71% at cycle 8 due to scheduling constraints for 2 classes and to 57% at cycle 12. Postprogram follow-up of early leavers showed only 1/3 the expected rate of onset of sexual activity and pregnancy. Parent involvement correlated positively with postponement and/or discontinuation of sexual activity. Reported movement away from peer group pressure appeared 3 months after entry.
Hargrove, Byron K.; Inman, Arpana G.; Crane, Randy L.
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…
Berry, L.G.; Brown, M.A.; Wright, T.; White, D.L.
The national evaluation of the Weatherization Assistance Program (WAP) consists of five separate studies. The Single-Family Study is one of three studies that will estimate program energy savings and cost effectiveness in principal WAP submarkets. This report presents the experimental plan for the Single-Family Study, which will be implemented over the next three years (1991--1993). The Single-Family Study will directly estimate energy savings for a nationally representative sample of single-family and small multifamily homes weatherized in the 1989 program year. Savings will be estimated from gas and electric utility billing records using the Princeton Scorekeeping Method (PRISM). The study will also assess nonenergy impacts (e.g., health, comfort, safety, and housing affordability), estimate cost effectiveness, and analyze factors influencing these outcomes. For homes using fuels such as wood, coal, fuel oil, kerosene, and propane as the primary source of space conditioning, energy savings will be studied indirectly. The study will assemble a large nationally representative data base. A cluster sampling approach will be used, in which about 400 subgrantees are selected in a first stage and weatherized homes are selected in a second range. To ensure that the Single-Family Study is able to identify promising opportunities for future program development, two purposively selected groups of subgrantees will be included: (1) subgrantees that install cooling measures (such as more efficient air conditioning equipment or radiant barriers), and (2) exemplary subgrantees that use state-of-the-art technologies and service delivery procedures (such as advanced audit techniques, blower door tests, infrared scanners, extensive client education, etc.). These two groups of subgrantees will be analyzed to identify the most effective program elements in specific circumstances. 14 refs., 4 figs., 3 tabs.
Winter, L; Breckenmaker, L C
Experimental service protocols tailored to the needs of teenage family planning patients were developed that emphasized indepth counseling, education geared to an adolescent's level of development, and the provision of reassurance and social support. These protocols were tested against usual service delivery practices in a study involving 1,261 patients under 18 years of age at six nonmetropolitan family planning clinics. A comparison with teenagers obtaining services at control sites found that six months after their first clinic visit, patients at the experimental sites were more likely to be using a method, were less likely to experience difficulty in dealing with problems, were more likely to continue using their method despite problems and had learned more during the educational session. Teenage patients at the experimental clinics were also less likely to have become pregnant within one year than those who went to control clinics. Attrition during the year following the first study visit was similar among both groups; patient satisfaction was very high, and equivalent at experimental and control sites. The data show that the extra time and effort required to meet the special needs of teenagers is justified by their improved contraceptive use, greater knowledge and lower pregnancy rates.
The family planning (FP) concept has traditionally been, and is closely related to, sexual and reproductive health. At the International Conference on Population and Development held in Cairo in 1994, FP is recognized as a health strategy that, properly applied, can contribute to the development of nations. Over the past years we have found that the benefits are not only aimed at preventing unwanted pregnancies, there by preventing induced abortions and maternal death, but it also improves child health, facilitating access to education for children in the world, it promotes the empowerment of women not only in the workplace but also in other areas such as politics and thus, the concept of gender; it helps to reduce poverty by stimulating economic development and increasing the standard of living of people . This means that it not only contributes to one but to the eight Millennium Development Goals by 2015. Despite the evidence of its benefits, there are still social, cultural, political or religious barriers that cause an unmet need in Family Planning, which does not respect the right of individuals to choose and decide the number of children they want, and prevent the experience of a healthy sexuality.
A post-independence (1992-93) decree issued by the Estonian Ministry of Social Affairs permits abortion on request up to 12 weeks of gestation and, on medical grounds, up to 20 weeks. According to reports received by the Estonian Medical Statistical Bureau, the 1994 abortion rate was 53.8/1000 women of reproductive age. Among women under 20 years of age, the abortion rate declined from 55.5/1000 in 1992 to 41.5/1000 in 1994. Only mini-abortions and abortions performed for medical reasons are free of charge; women with health insurance pay 50% of the cost of most procedures. Funds from abortion fees are used to subsidize contraception for full-time students, women in the first postpartum year, and women who had an induced abortion in the past three months. All other women must pay the full price of contraception. In 1994, only 234 out of every 1000 fertile women were using effective forms of contraception (IUDs and hormonal methods). However, the birth rate has been declining rapidly since 1990 and the rate of natural increase became negative in 1993 (-4.0). The fact that abortion but not contraception is subsidized has facilitated reliance on abortion as a family planning method. Recommended, to reduce the abortion rate and improve the family planning situation in Estonia, are improved contraceptive counseling, including pre- and post-abortion services, and school-based sex education.
Ballweg, J A; MacCorquodale, D W
Pregnancy prevention techniques are classified into 2 general categories as the coitus-connected and coitus-independent. The former include rhythm, withdrawal, condom, and foam while the latter include such methods as oral contraception, IUDs, and male and female sterilization. The use of contraception hinges on motivation and the acceptability of the method. This article is a report on 1 particular study where data was collected in 1971-1972 through 1321 interviews resulting from a series of audits of family planning clinics with the purpose of determining the accuracy of information reported in clinic records and ascertaining the number of acceptors who had discontinued use of a family planning method or moved from the area served by the clinic. The findings revealed that: 1) Coitus-independent methods are more effective in the prevention of pregnancy that coitus-dependent ones, 2) Women who change from a coitus-dependent method are more likely to change to a coitus-independent method, while the changes from the latter method are usually to a method in the same general category, 3) In this population the IUD provides the maximum protection from conception with the minimum likelihood of program dropout.
Valadez, J J; Transgrud, R; Mbugua, M; Smith, T
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.
World Health Organization, Copenhagen (Denmark). Regional Office for Europe.
A review is given of the status of family planning education at medical, nursing, and midwifery schools in seven European countries. The report is presented in 11 sections. Section one, an introduction, explains the scope of the study and defines family planning to include birth control, pregnancy and delivery, problems of adolescents, family life…
Since 1969 the International Planned Parenthood Federation has worked with the government of Botswana in setting up family planning services. An evaluation of the family planning aspects of the program were carried out. This is a summary of three research studies and some general comments. Included is: (1) an introduction to Botswana and the…
Harvey, P D
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.
Joshi, Beena; Velhal, Gajanan; Chauhan, Sanjay; Kulkarni, Ragini; Begum, Shahina
Background & objectives: Preventing unintended pregnancies among people living with HIV (PLHIV) is one of the strategies of WHO for preventing parent-to-child transmission (PPTCT). Given the limitation of only condom use, the objective of this study was to improve use of dual contraceptive methods among HIV infected women. Methods: An experimental study among HIV positive women was conducted at two tertiary care level hospitals in Mumbai. Linking HIV with family planning services was the focus of intervention at one site and standard level of care was maintained at the control site. At each site, 150 HIV+ve women attending counselling and testing centres, who did not intend to get pregnant in the next one year and were eligible to use dual methods, were enrolled and followed up to one year. Results: At the end of one year, 60 per cent women in the intervention group reached Family Planning Centres compared to eight per cent in the control group. There was three times more acceptance and continuation of use of dual methods along with increase in consistent use of condoms and less number of unplanned pregnancies in the intervention group than the control group. Interpretation & conclusions: The study findings demonstrate that linking HIV and family planning services may facilitate the uptake of dual methods of contraception without reducing consistent condom use among HIV infected women. The PPTCT programmes need to focus on the component of Prong 2 of PPTCT which aims to prevent unintended pregnancies among HIV positive women. PMID:27377503
Fauveau, V; Wojtyniak, B; Chakraborty, J; Sarder, A M; Briend, A
OBJECTIVE--To examine the impact on mortality of a child survival strategy, mostly based on preventive interventions. DESIGN--Cross sectional comparison of cause specific mortality in two communities differing in the type, coverage, and quality of maternal and child health and family planning services. In the intervention area the services were mainly preventive, community based, and home delivered. SUBJECTS--Neonates, infants, children, and mothers in two contiguous areas of rural Bangladesh. INTERVENTIONS--In the intervention area community health workers provided advice on contraception and on feeding and weaning babies; distributed oral rehydration solution, vitamin A tablets for children under 5, and ferrous fumarate and folic acid during pregnancy; immunised children; trained birth attendants in safe delivery and when to refer; treated minor ailments; and referred seriously ill people and malnourished children to a central clinic. MAIN OUTCOME MEASURES--Overall and age and cause specific death rates, obtained by a multiple step "verbal autopsy" process. RESULTS--During the two years covered by the study overall mortality was 17% lower among neonates, 9% lower among infants aged 1-5 months, 30% lower among children aged 6-35 months, and 19% lower among women living in the study area than in those living in the control area. These differences were mainly due to fewer deaths from neonatal tetanus, measles, persistent diarrhoea with severe malnutrition among children, and fewer abortions among women. CONCLUSIONS--The programme was effective in preventing some deaths. In addition to preventive components such as tetanus and measles immunisation, health and nutrition education, and family planning, curative services are needed to reduce mortality further. PMID:2390566
Mulcaire-Jones, George; Fehring, Richard J.; Bradshaw, Megan; Brower, Karen; Lubega, Gonzaga; Lubega, Paskazia
Various fertility indicators are used by natural family planning methods to identify the fertile and infertile phases of a woman's menstrual cycle: mucus observations, cycle-day probabilities, basal body temperature readings, and hormonal measures of LH and estrogen. Simplified NFP methods generally make use of a single fertility indicator such as cycle-day probabilities (Standard Days Method) or mucus observations (Billings Ovulation Method). The Couple Bead Method integrates the two simplest fertility indicators, cycle-day probabilities and mucus observations, expanding its applicability to all women, regardless of cycle regularity and length. In determining cycle-day probabilities, the Couple Bead Method relies on a new data set from ultrasound-derived determinants of gestational age that more directly define the day of conception and the fertile window. By using a visual-based system of inexpensive colored beads, the Couple Bead Method can be used by couples of all educational and income levels. Lay Summary: Natural family planning methods provide education in regard to the signs of a woman's body which indicate if she is possibly fertile or not. Two important signs are the day of her menstrual cycle and her observations of bleeding and cervical mucus or dryness. The Couple Bead Method teaches a couple how to observe these signs and chart them with a system of colored beads. The Couple Bead Method can be used by women with regular or irregular cycles. The bead sets are inexpensive and consist of a length of plastic cord, colored “pony beads” and safety pins. PMID:27833183
Severy, L J; McKillop, K
A sample of 665 low-income women from a predominantly rural area of north central Florida rated the value of 25 features of family planning providers and reported their perceptions of how characteristic each feature was of different types of providers. A well-trained, trustworthy and friendly staff, the presence of a doctor if you need one and a staff that is gentle with the examination were the most desirable features of family planning services. The respondents' perceptions of public health clinics suggest that the strongest qualities of such facilities are that they treat people from different backgrounds, accept Medicaid, are easy to find and teach you how to avoid pregnancy and how to take care of yourself and stay healthy. Features thought most characteristic of private physician services were a well-trained staff, privacy and the presence of a doctor if you need one. Voluntary organizations were seen as providing services for people of different backgrounds, having a friendly staff, serving as a referral agency and teaching about staying healthy and avoiding pregnancy. However, voluntary organizations were rated lower than public health clinics or private physicians on nearly all features. The total scores for public health clinics and private physicians were not significantly different from each other, but both were noticeably higher than the score for voluntary organizations. Ethnicity affected ratings dramatically, with black respondents clearly more favorable toward public health clinics and private physicians than white respondents; conversely, whites were more positive toward voluntary organizations than were blacks. For many of these low-income respondents, the high ratings of private physicians may have represented their expectations rather than their actual experience.
Yoshio Furuya, who authored the 1951 legislative guidelines for family planning in Japan, designated 3 villages to model family planning upon his return from the United States in 1950. The instructors were public health nurses, midwives and regular nurses who had been trained and certified by the National Public Health Institute. They showed film strips and slides, and distributed contraceptives and medication. Population Research Group also embarked on the New Life Style Movement among Japanese industries in 1951. The new life style was said to have 3 pillars: family planning, career planning, and family morals. The idea of family planning was welcomed at the beginning by industries because it would mean less dependents of employees to provide financial aid for. The movement lasted only several years. In 1955, the International Family Planning Federation and the Japan Family Planning Federation co-sponsored the Fifth International Family Planning Conference in Tokyo. 572 participants including Margaret Sanger delivered 91 papers on techniques and practices of family planning. Soon after the conference, the Family Planning Study Committee was organized, and they met once a month to discuss socio-cultural implications of family planning, theory and practice of contraception, maternal and child health. Many of the committee members were idealistic/feminist public health officials but there were no women among them. A post-war family planning movement approved by the Japanese government resulted in the dramatic reduction in the birth rate from 34.3% in 1947 to 17.2% in 1957. Midwives played an important role in enforcing the policy but they were excluded from policy making.
MacFarland, Thomas W.
This report examined place of class attendance at Nova Southeastern University (NSU) from calendar years 1990 through 1994. The various distance models employed by NSU, which support the opportunity to offer classes at non-campus locations, were also identified in this report. During 1994, nearly two-thirds of all university students attended…
To determine the attitudes of Indian children and adolescents toward family planning, a sample of 863 high school students (aged 10-18 years) from the state of Andhra Pradesh was asked 2 operational questions ("have you heard about family planning" and "why does India need family planning?") to measure levels of family planning awareness, and 2 additional questions to measure approval of family planning ("do you think family planning is a good thing" and "which is better, a big family or a small family?"). Other variables considered were religion, socioeconomic status, education, political knowledge, and media exposure. 70% of the respondents had heard of family planning. 49% were able to state a reason for family planning (FP), while 32% were able to grasp the causal connection between population growth and economic development. Of the students who had heard of FP, 85% believed that FP was good, while 14% favored large families. The findings reflected the higher level of approval of the Andhra Pradesh youth towards FP compared with their adults; this was attributed to generational differences, and possibly to the lower level of education of Indian adults. Religion exhibited a strong effect on youth's attitudes toward FP, with Hindu children exhibiting a more favorable attitude compared with their Muslim counterparts who felt that family planning was bad and large families were good. Although education appears to be the critical determinant of family planning awareness, the results suggest that overall, the integral element of the socialization process is exposure to a modernizing environment. Nevertheless, reduction of population growth rate still largely depends on the Indian government's provision of educational opportunities to its youth.
Local publications about population in Rwanda over the past 3 years have tended either to view population growth and high density as advantageous because they lead to more intensive use of resources and hence development, or to view Rwanda as regressing economically and socially because of its very rapid population growth. It is questionable whether Rwanda's development goals can be attained without bringing down the rate of population growth. Population pressure in some rural areas has become catastrophic, yet parents do not see their large families as a problem because they expect their children once grown to make their living elsewhere. Local authorities should help to communicate the concept that only demographic stability will allow achievement of communal development goals. The advantages of smaller families should be discussed. Rwanda's policy of increasing agricultural production has encountered numerous obstacles. Subdivision of plots through inheritance, sale, or sharecropping is a problem in itself and also tends to increase erosion. None of the methods of increasing plot size by collectivization or resettling the population is without serious drawbacks. The best solution appears to be encouragement of better cultivation techniques through extension agents and demonstration projects at the local level. Artisanal activities and manual labor should be promoted to provide employment at the communal level. Community development projects should be decentralized and carefully planned to meet local needs.
Vessey, M P; Lawless, M
The Oxford-Family Planning Association contraceptive study involves over 17 000 women who were recruited at 17 clinics in England and Scotland during the interval 1968-74 and have been followed up ever since. This paper describes the survey methods, the characteristics of the participants, the progress of the study, the main results and publications to date, and the proposals for future work. Although the study was originally mainly concerned with the benefits and risks of oral contraceptives it has, in fact, contributed to knowledge about a wide variety of birth control methods. The data on efficacy are of special value in that they cover all methods of contraception in common use and have been derived from a homogeneous and closely observed population. The mortality figures, while limited in extent, have supplemented the findings in the Royal College of General Practitioners study. Reports on morbidity from many different diseases have been published; these have documented both beneficial and harmful effects of various contraceptive methods. The study data on return of fertility after discontinuation of contraception are unique, while contributions have also been made to knowledge about outcome of pregnancy in those stopping contraception to have a planned baby or becoming accidentally pregnant while using a birth control method. The study, which is supported by the Medical Research Council, is currently funded until mid-1989.
Liang, J; Peng, Z
Recently, the Party's Central Committee held numerous meetings to study the problem of family planning. The main goal of these meetings was to find a correct family planning policy, which should be based on common sense, support from the people, and reasonable work from the cadres. Family planning policies and regulations should be realistic and creative. In the implementation of policies, different methods should be adopted for varied situations, and there should also be appropriate guiding principles for different categories. To cope with a new situation, creative methods and approaches should be chosen in order to implement the family planning policy. The correct method will ensure complete implementation of the policy. In family planning work, the first step is the improvement of ideological education, so that the people may have a correct understanding of the need for family planning. In the technical management work of family planning, a constant improvement in the quality of service should be the goal. Through practical working experience in family planning, some rules and regulations will be found, and they should be used to promote the management level and the level of family planning work in general.
As part of the preparations for the 1994 UN International Conference on Population and Development, an expert group meeting on family planning (FP), health, and family well-being was held in India on October 26-30, 1992. The group focused on the following issues: 1) society and FP, a review of existing FP programs, and the implementation of FP programs (including quality of services and human resources development, unreached populations, adolescent fertility, diffusion of innovative activities, community-based distribution systems and social marketing, and future contraceptive requirements and logistics management needs); 2) FP and health (including safe motherhood and child survival, the interdependence of services, sexually transmitted diseases [STDs], and AIDS); 3) FP and family well-being (including family size, family structure, child development, fertility decline, and family support systems); and 4) the involvement of people in FP programs (community participation, cost of supplies and service, contraceptive research and development, and a reexamination of the roles of various agencies). Both developed and developing countries were considered, with an emphasis on the latter. After reviewing the progress made in implementing the World Population Plan of Action adopted in Bucharest in 1974, the expert group drafted 35 recommendations to governments, donors, and other agencies. Governments are asked to support FP programs as a cost-effective component of a development strategy, to provide opportunities for women to participate in public policy processes, to support the family through public policies and programs, to increase investments in FP and reproductive and maternal and child health, to increase support to the health and education sectors to achieve basic human rights, to provide safe access to counseling and abortion services, and to include STD/HIV education and prevention in the work of FP programs. FP programs should receive support and funding and
Ijadunola, Macellina Y; Abiona, Titilayo C; Ijadunola, Kayode T; Afolabi, Olusegun T; Esimai, Olapeju A; OlaOlorun, Funmilola M
This study assessed men's awareness, attitude, and practice of modern contraceptive methods, determined the level of spousal communication, and investigated the correlates of men's opinion in family planning decision making in Ile-Ife, Nigeria. Quantitative methodology was employed in this cross-sectional descriptive design using a structured household questionnaire to collect information from 402 male study participants. A multistage sampling procedure was employed. Eighty-nine percent of men approved of the use of family planning while only about 11 percent disapproved of it. Eighty percent of men had ever used contraception while 56 percent of them were current users. Spousal communication about family planning and other family reproductive goals was quite poor. The socio-demographic correlates of men's opinions included religion, marriage type, educational attainment, and occupation (p < 0.05). The study concluded that male involvement in family planning decision making was poor and their patronage of family planning services was low.
American anti-abortion politics is blocking family planning (FP) funding around the world. US Representative Chris Smith, a Republican of New Jersey, attempted to amend a proposal that would require health-care providers of federal workers who cover prescription drugs to also pay for prescribed contraceptives. Smith's amendment would have exempted any contraceptive that inhibits implantation. This action was defeated but clearly revealed that this anti-abortion politician's agenda is also anti-FP. The right-wing has hampered Clinton administration efforts to support reproductive rights. There is a link between FP and the survival of the planet from an environmentalist point of view that recognizes the extreme danger of the resource depletion attendant upon overpopulation. The Vatican's opposition to reproductive rights has resulted in serious restrictions on the delivery of reproductive health care in cases where public hospitals have merged with Roman Catholic health corporations. The population problem is "fixable" but efforts to do so remain deadlocked by a vocal minority of conservatives.
Pineda, M A; Bertrand, J T; Santiso, R; Guerra, S
As community-based distribution (CBD) systems for the delivery of contraceptive methods are implemented in developing countries around the world, there is growing interest in making these programs more effective. Previous research on the CBD program in Guatemala indicated the importance of the role of the spouse: those community volunteers (called "distributors") who received assistance from their spouses were more effective in selling contraceptives than those who did not. The current experiment was designed to test the effect of providing the spouses of distributors with a formal 3-day training course on family planning and contraceptives. "Effect" was operationally measured in terms of the level of contraceptive sales. To this end sales data were compared for the experimental group (33 distributors whose spouses received the training) and the control group (33 distributors whose spouses wanted to attend the training but could not because their primary occupation did not allow them to be absent) for periods of 6 months prior to and 6 months following the training. The results indicate that sales among the experimental group increased significantly, whereas no such increase was found among the controls. This suggests a strategy for increasing the effectiveness of community volunteer workers that has received relatively little attention in the literature to date. PMID:6867260
France, M M
A prospective study conducted among clients attending New Zealand Association of Natural Family Planning clinics confirmed that lactational amenorrhea is an effective means of avoiding pregnancy in the first 6 months postpartum. The 110 mothers who were fully breast feeding, not giving a pacifier, amenorrheic, and early postpartum in a 12-month period during 1991-92 were offered either the lactational amenorrhea method or the usual fertility awareness charting method. The former method was selected by 70 women, primarily because of its simplicity, and 34 (48.6%) women continued to meet all the study criteria 6 months after the birth of their baby. The early introduction of supplementary solid foods was a significant cause of lack of continued eligibility. In contrast, only 19.5% of women using the fertility awareness method were still fully breast feeding and amenorrheic at 6 months postpartum. None of the mothers using the lactational amenorrhea method conceived during the study period; however, there were 2 pregnancies in the fertility awareness group.
Guilhem, Dirce; Azevedo, Anamaria Ferreira
This study is an ethical reflection on the formulation and application of public policies regarding reproductive health in Brazil. The Integral Assistance Program for Women's Health (PAISM) can be considered advanced for a country in development. Universal access for family planning is foreseen in the Brazilian legislation, but the services do not offer contraceptive methods for the population in a regular and consistent manner. Abortion is restricted by law to two cases: risk to the woman's life and rape. This reality favors the practice of unsafe abortion, which is the third largest cause of maternal death in Brazil. Legal abortion is regulated by the State and the procedure is performed in public health centers. However, there is resistance on the part of professionals to attend these women. Prenatal care is a priority strategy for promoting the quality of life of these women and of future generations. Nonetheless, it is still difficult for these women to access the prenatal care services and to have the required number of consultations. Moreover, managers and health professionals need to be made aware of the importance of implementing the actions indicated by the public policies in the area of sexual and reproductive health, favoring respect for autonomy in a context of personal freedom.
This research seeks to measure children's awareness of and support for family planning in India, on the premise that they are indications of future fertility behavior. The survey was conducted in June-August 1975 in 6 districts of Andhra Pradesh State, including schools in cities, small towns and villages. The 863 respondents included Hindus and Muslims, various caste groups, 3 language groups, and students in the 6th to 12th classes. Children's awareness of family planning was operationalized through 2 questions: "Have you heard about family planning?" and "Which is better, a big family or a small family?". Results show that 70% had heard of family planning and that approval of family planning is extensive, with only 14% of the sample expressing a preference for large families. Awareness of family planning is clearly correlated in the expected direction with exposure to a modernizing environment, particularly education. Exposure to media and political involvement are also correlated with awareness. Support for family planning is most highly correlated with religion, with Muslim children less approving than Hindu. Party identification and political knowledge are both associated with higher approval. Education and the index of modernity are the only indicators of modernization that correlate with approval.
Mahasarakham province in Thailand has adopted family planning as its primary development policy. Although not a new issue, family planning until now has been largely ignored by most government sectors. Most consider family planning to be the sole responsibility of the Ministry of Public Ealth (MOPH), and this is why family planning has not been as successful as it should be. Discussion covers the general problem (rapid population increase, limited arable land, productivity, social and economic development, and deforestation), problems of family planning in the past (trained personnel and accessibility and government sectors ignoring or hindering family planning programs), integrated rural development (motivation, mobilizing teamwork, the integrated approach, mobile medical team, family planning for both the rich and the poor, and emphasis on vasectomy and IUD), objectives of the family planning program, and implementation. Mahasarakham uses an integrated rural development approach that emphasizes 9 development components: family planning, fisheries development, vegetable growing, water purification, rice banks, soy beans, using anchovies for natural fish sauce, insect extermination by electricity, and fuel from rice banks. All of these components contribute to the development of a better quality of rural life. The major problem is population growth, which at 1.8% remains high. Mahasarakham will promote the family planning program as the top priority, and this service will be brought to the people. The objectives of the family planning program are: to reduce the population growth rate Mahasarakham to zero growth within 2-3 years: to provide access to family planning services to all people in Mahasarakham; to educate people about family planning to increase its acceptance: to initiate a proper rural development program in Mahasarakham; and to promote intergovernmental cooperation by means of the integrated approach, which will have good results in later rural
Curdt-Christiansen, Xiao Lan
This ethnographic inquiry examines how family languages policies are planned and developed in ten Chinese immigrant families in Quebec, Canada, with regard to their children's language and literacy education in three languages, Chinese, English, and French. The focus is on how multilingualism is perceived and valued, and how these three languages…
Sai, Fred T.
This essay discusses family health needs in the developing world, their priorities, and the standards of health required, with particular reference to family planning. The author takes into account medical, social, and economic factors that influence those concerns. Some of the material presented in this essay first appeared in other international…
Poland is a country that, according to official sources, is 95% Catholic. The Catholic Church (CC) has a great deal of political power for 3 main reasons: 1) a strong Catholic tradition among Polish families, 2) the role of the Polish CC as the main supporter of the political opposition during the communist dictatorship, 3) the Polish Pope serves as an important authority for many Polish people. When democratic freedoms were won 10 years ago, the CC was poised and ready to exercise its considerable influences to further its own agenda. This can be seen in may areas: since last autumn, children receive religious instruction in state run schools, masses from St. Peter's are broadcast each week on state television, scientific congresses are being opened with High Mass and blessings, the armed forces make pilgrimages to the shrine of the Black Madonna of Czestochowa, and there was High Mass and Christmas blessing in the Polish Parliament. The Church is calling for an end of the separation of church and state. The current 1956 abortion law allows free abortions in state funded hospitals in cases of rape, socio-economic, or medical grounds in the 1st trimester. A current senate bill would allow abortion only to save the mother's life. The CC is currently trying to associate this law with the old communist totalitarian dictatorship and likens it to the Nazi Holocaust. In Poland there are 39 million people, and 600,000 abortions with a ratio of 70-100 abortions/100 live births. The main factors influencing this high rate are: 1) no sex education, 2) very low contraceptive use rates, 3) easy access to abortion, 4) CC opposition to contraception. Family planning in Poland is in a crisis that it may not come out of. Abortion, divorce, sex education, and contraception are all opposed by the CC which means that it will use its powerful influence to criminalize these practices.
Lopez, Edward M.; Gallimore, Ronald; Garnier, Helen; Reese, Leslie
Seventy-three Latino middle school students participated in a longitudinal study of the preschool antecedents of their mathematics achievement. Path analysis indicated that family resources (parents' educational level, occupation, and income) predicted home literacy activities, which predicted combined early Spanish literacy and English language…
Fraser, S E
The limitation of population growth in China to about 1.7% annually is, in large part, the result of changing sexual norms which have been brought about by community-wide sexual education. These changes include elevating the status of women, dismissing the traditional striving for male children as "old fashioned," and emphasizing responsible parenthood. About 6% of China's population is made up of minority peoples, some 54 distinctive groups including a few such as the Khalkhas and Sibos who have virtually been saved from extinction during the past 25 years. For these groups the growth rate is 6% and the central government in Peking stresses to visitors that for minorities there is no limitation of family size but that health of the mother is stressed. Conversations with Chinese health workers indicate that rural women are much more in favor of family planning than their husbands and are much more willing to be sterilized when the acceptable family size of 2 or 3 children is reached. However, men are becoming more willing to use condoms which are available without cost from village health workers. There is little sex education in the schools. Physiology is included as a minor part of general biology. Young people are cautioned not to "fall in love" at too early an age or else they will not keep their minds on their studies and will get married too early. Emphasis is on late marriage, 25 for women and 27 for men. Only a modest glance at population or sexually oriented topics are encouraged until marriage is contemplated. Then sex education is given in great variety and detail. It is the opinion of doctors and health workers that sex education is a matter for the married, not the single. Chinese society has little external sexual stimuli, nudity or seminudity is not acceptable except at the beach or the swimming pool, and the young people are generally taught to be circumspect. There is none of the advertising which permeates Western culture. It is understandable
Candlin, C.; Lucas, J.
A study investigates the roles and frames of reference of a family planning counselor as she offers information and counsel to her client and examines the implications for the training of counselors. First, the ideology of family planning counseling is discussed, focusing on the counselor's need to find an appropriate place on the counseling…
This document explores risks to the health and lives of women and children that can be avoided or reduced by family planning. Emphasis throughout is on case studies and statistics from developing nations. Data are presented in expository and chart form. Information is presented in four chapters. Chapter I, Child Health and Family Planning,…
Piotrow, Phyllis T., Ed.
This publication describes successful family planning programs throughout the world. Discussed in detail are programs in Colombia, Mauritius, Maharashtra, the People's Republic of China, Sri Lanka, and the United States. Photographs illustrate the articles and, in some cases, family planning vital statistics are given. The Draper World Population…
Hudson, Lucy; Almeida, Connie; Bentley, Dawn; Brown, Josie; Harlin, Daria; Norris, Judy
Family reunification is not always possible for children who have been removed from the care of their biological parents because of abuse or neglect. Concurrent planning puts into place a secondary plan for a permanent home should family reunification prove to be impossible. Working in four diverse communities around the country in an innovative…
Speert, Kathryn H.; Wishik, Samuel M.
The Division of Social and Administrative Sciences of the International Institute for the Study of Human Reproduction at Columbia University has compiled this list of terms used in indexing the literature for family planning program evaluation. This thesaurus should prove of direct use to the indexer of documents describing family planning program…
Hossain, Mian Bazle
At the request of the government of Bangladesh the International Center for Diarrheal Disease Research, Bangladesh established the Maternal and Child Health-Family Planning (MCH-FP) Extension Project in 1982. This paper discusses: (1) the design of the MCH-FP; (2) the major characteristics of the national health and family planning program under…
Maryland State Dept. of Education, Baltimore.
This document presents design concepts and considerations for planning and developing middle and high school family and consumer sciences education facilities. It includes discussions on family and consumer sciences education trends and the facility planning process. Design concepts explore multipurpose laboratories and spaces for food/nutrition…
Rossier, Clémentine; Bradley, Sarah E K; Ross, John; Winfrey, William
Despite renewed interest in postpartum family planning programs, the question of the time at which women should be expected to start contraception after a birth remains unanswered. Three indicators of postpartum unmet need consider women to be fully exposed to the risk of pregnancy at different times: right after delivery (prospective indicator), after six months of amenorrhea (intermediate indicator), and at the end of amenorrhea (classic indicator). DHS data from 57 countries in 2005-13 indicate that 62 percent (prospective), 43 percent (intermediate), and 32 percent (classic) of women in the first year after a birth have an unmet need for contraception (40 percent when including abstinence). While the protection afforded by postpartum abstinence and lactational amenorrhea lowers unmet need, further analysis shows that women also often rely on these methods without being actually protected. Programs should acknowledge these methods' widespread use and inform women about their limits. Also, the respective advantages of targeting the postnatal period, the end of six months of amenorrhea/exclusive breastfeeding, or the resumption of sexual intercourse to offer contraceptive services should be tested.
Hopkins, Kristine; Aiken, Abigail R. A.; Stevenson, Amanda; Hubert, Celia; Grossman, Daniel; Potter, Joseph E.
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
Tierney, Michael L.
The Timmons Savings Plan, which encourages families to save toward college costs, is analyzed. This plan allows for periodic (non-tax deductible) contributions to an account administered by the U.S. Department of the Treasury. The amount deposited would be matched by the federal government in exchange for the government's earning the interest on…
Bos, Henny M. W.; Van Balen, Frank; Van Den Boom, Dymphna C.
Background: 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…
... 45 Public Welfare 2 2011-10-01 2011-10-01 false Who submits a Tribal Family Assistance Plan? 286.70 Section 286.70 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN...
Withrow-Robinson, Brad; Sisock, Mary; Watkins, Susan
Succession planning is an important step for families owning woodlands and farms that wish to maintain the character of the land and continue the families' connection to it. We introduce Ties to the Land, an educational curriculum that helps families communicate more effectively about the fate of their land and how to transition to future…
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Who submits a Tribal Family Assistance Plan? 286.70 Section 286.70 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN...
Bannister, Rosella; And Others
This manual for teacher trainers and staff development specialists contains information and materials for an 18-hour personal and financial planning workshop for secondary teachers. Part A is a guide for workshop directors. It defines personal and family financial planning, provides background information on financial planning education, and…
Jivanjee, Pauline; Kruzich, Jean M.; Friesen, Barbara J.; Robinson, Adjoa
Family participation in educational planning for children with disabilities is believed to result in plans that are more responsive to the child's needs and that lead to better social, emotional, and educational outcomes. Participation in educational planning is also a fundamental right of parents and a cornerstone of special education…
The focus of this article is on 1) the intended socioeconomic benefit of Chinese family planning (FP) versus the benefit of the maternal production sector, 2) the estimated costs of FP work, 3) and the principal ways to lower FP costs. Marxian population theory, which is ascribed to in socialist China, states that population and socioeconomic development are interconnected and must adapt to each other and that an excessively large or small population will upset the balance and retard development. Malthusians believe that large populations reduce income, and Adam Smith believed that more people meant a larger market and more income. It is believed that FP will bring socioeconomic benefits to China. The socioeconomic benefit of material production is the linkage between labor consumption and the amount of labor usage with the fruits and benefits of labor. FP invests in human, material, and financial resources to reduce the birth rate and the absolute number of births. The investment is recouped in population. The increased national income generated from a small outlay to produce an ideal population would be used to improve material and cultural lives. FP brings economic benefits and accelerates social development (ecological balances women's emancipation and improvement in the physical and mental health of women and children, improvement in cultural learning and employment, cultivation of socialist morality and new practices, and stability). In computing FP cost, consideration is given to total cost and unit cost. Cost is dependent on the state budget allocation, which was 445.76 million yuan in 1982 and was doubled by 1989. World Bank figures for 1984 affixed the FP budget in China at 979.6 million US dollars, of which 80% was provided by China. Per person, this means 21 cents for central, provincial, prefecture, and country spending, 34 cents for rural collective set-ups, 25 cents for child awards, and various subsidies, 15 cents for sterilization, and 5 cents for
Based on experiences with the Productive Cooperative Movement and the Parasite Control Movement in Japan, the Japanese Family Planning Movement began in April 1954. The resultant private and nonprofit Japan Family Planning Association (JFPA) followed and it served to help Japan achieve its goal of reducing fertility by promoting family planning. It did so by publishing a monthly newsletter on family planning, hosting meetings and national conventions, spreading information via the mass media, and selling contraceptives and educational materials. JFPA earned funding from these sales with no support from the government thereby establishing self dependence and freedom to speak candidly to the government. The JFPA learned that families wanted to improve their standard of living and were willing to limit family size to 2 children. After the birth rate peaked in 1955, the birth rate and the number of illegal abortions decreased. In the 1950s, JFPA joined the International Planned Parenthood Federation and subsequently learned of the problems faced by developing countries. Based on the successful reduction of fertility in Japan and a strong economic base, JFPA and the government were in a position to organize an international cooperation program for family planning. Therefore, the leader of JFPA resigned to found the Japanese Organization for International Cooperation in Family Planning which promotes family planning in developing countries via its integrated family planning, nutrition, and parasite control program. A steering committee composed of leaders from government, universities, and private organizations sets the policies for the program in each country. It is to the Japanese government's advantage to work with private organizations instead of providing all social services because they are flexible and provide administrative stability and national expenses are minimized.
Spieler, J; Shuler, A
The current status of natural family planning (NFP) was reviewed. There is renewed interest in NFP, and many couples who find other methods unacceptable for medical, safety, or personal reasons are turning to NFP methods. The percent of contraceptive users who rely on behavioral methods in developing countries in 35% in Peru, 20%-25% in Haiti, Philippines, and Sri Lanka, and average 7.5% for the remaining 23 developing countries. IN the US about 4.7% of all contraceptive users rely on behavioral methods. Worldwide, rhythm is the most commonly used form of behavior fertility control, but this method is not promoted by most NFP programs. The 3 modern methods of NFP are 1) the basal body temperature method, 2) the cervical mucus, or Billings method, and 3) the sympto-thermal method. All these methods rely on physical signs and symptoms to detect ovulation and require sexual abstinence during the fertile phase of the menstrual cycle. The basal body temperature method requires women to detect the slight rise in temperature which occurs at the time of ovulation. The method is 94%-97% effective if intercourse is restricted to the postovulatory phase of the cycle. Disadvantages of the method are that intercourse must be restricted to only 7-13 days of the cycle, women must take their temperature daily, the method cannot be used during fever episodes, and the method is inappropriate for use during lactation or near menopause. The cervical mucus method is based on observing cervical mucus changes during the cycle. These changes signal the fertile and infertile phases of the cycle. According to a World Health Organization study, 93% of the women instructed in the method were able to detect mucus changes, and illiterate women were as adept at identifying these changes as university graduates. Findings also indicated that the method was 97% effective if abstinence was practiced during 15 days of the cycle, but use-effectiveness was only about 80%. This method has the advantage
Cabigon, J; Magsino, E
An operations research study in the Philippines sought to uncover determinants of the sustainability of employment-based family planning (FP) programs offered in industrial settings where the Philippine Center for Population and Development (PCPD) had provided assistance in implementing Responsible Parenthood/FP-Maternal Health (RP/FP-MH) Programs. Qualitative data were gathered through observations and interviews with the target population and with company management and program implementers. Based on this study, the following recommendations were made: 1) training outputs should be echoed to employees immediately; 2) RP/FP-MCH team members should be recruited from each level of the work force; 3) an appropriate IEC (information, education, and communication) strategy should be devised to respond to the short time-frame in which employees can participate; 4) team-building training should be incorporated as a regular activity early in the contract period; 5) sectoral targeting should be used within a given company; 6) training programs should be designed for each of the three types of team members and should overlap the basic topics; 7) teamwork and mutual assistance should be encouraged; 8) the work of the teams should be rewarded; 9) commendable initiative of liaison officers should be sustained; 10) representatives of the PCPD should maintain a close relationship with the teams through PCPD staff visits to the companies; 11) management requires more intensive orientation on the RP/FP-MH program; 12) PCPD support should be withdrawn gradually until the companies are able to sustain the program themselves; 13) it may be helpful to require a company to meet rigid criteria in order to take part in the PCPD project; 14) OR should be continued; and 15) the concept and practice of quality of care should be introduced to service delivery and training of staff and motivators.
Because so many Americans can afford to save for children's college costs but do not, it is proposed that employers take a more active role in promoting college financial planning. Possible solutions include company-sponsored contributory accounts, educational savings plans; payroll deduction plans, educational annuity programs, subsidized or…
The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than
Piotrow, P T; Rimon, J G
Good communication about family planning is needed for many reasons: 1) what many people think they know about family planning is wrong, 2) about 25% of the Asian population (600 million people) are between the ages of 10 and 19 and they need to be informed, 3) individuals must want to use family planning so they will use it regularly and effectively, and 4) people hear competing messages from those opposed to family planning. The authors make the following predictions for the field of family planning IEC in the 1990s: 1) family planning communication will have many different audiences, so messages and media will have to be developed for very specific groups; 2) more time will be spent on research, learning about specific audiences, the media, and background before developing messages, and messages and products will be carefully tested before being widely distributed; 3) peer groups will be used more to reach peer groups; 4) entertainment will reach and teach wider audiences about family planning, AIDS, and sexual responsibility (promoting "enter-education," a combination of entertainment and education); 5) audiences will participate more actively in different kinds of family planning communication, including community mobilization and individual involvement; 6) family planning messages will be much more personal, using human interest stories to capture and persuade the audience; 7) multiple media will be used more and more to get the message across; 8) the best quality family planning entertainment materials will be able to compete with commercial products and produce revenue; 9) campaigns and other communications will be oriented towards large regional markets; 10) more creative and more sympathetic communication in clinics and by health care providers will increase acceptance and continuation rates for many methods; 11) communication among family planning professionals will increasingly depend on effective national population information centers that can use
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
Drake, Jennifer Kidwell; Thi Thanh, Luu Huong; Suraratdecha, Chutima; Thi Thu, Ha Phan; Vail, Janet G
Viet Nam has high modern contraceptive prevalence (68%), with most services received through the public sector. As the country transitions to middle-income status, Viet Nam's donors have ceased donations of contraceptive supplies, causing a large projected shortfall in the family planning budget. In response, the Ministry of Health has decided to prioritize free or subsidized contraceptives for poor and vulnerable groups, while enhancing social marketing and sales of contraceptives in the free market. To support planning for this "total market approach", a descriptive exploratory study was conducted with 38 public and private sector family planning stakeholders to gain their perceptions of the proposals. There was a high level of support for government leadership of public-private coordination and stewardship of the entire family planning system. Key information gaps were identified regarding how the reforms can promote equitable access to family planning and financial sustainability in pricing. The government's experience with this transition may yield valuable guidance for other settings.
Rovin, Kimberly; Hardee, Karen; Kidanu, Aklilu
Global climate change is felt disproportionately in the world's most economically disadvantaged countries. As adaption to an evolving climate becomes increasingly salient on national and global scales, it is important to assess how people at the local-level are already coping with changes. Understanding local responses to climate change is essential for helping countries to construct strategies to bolster resilience to current and future effects. This qualitative research investigated responses to climate change in Ethiopia; specifically, how communities react to and cope with climate variation, which groups are most vulnerable, and the role of family planning in increasing resilience. Participants were highly aware of changing climate effects, impacts of rapid population growth, and the need for increased access to voluntary family planning. Identification of family planning as an important adaptation strategy supports the inclusion of rights-based voluntary family planning and reproductive health into local and national climate change adaptation plans.
Zakiyah, Neily; van Asselt, Antoinette D. I.; Roijmans, Frank; Postma, Maarten J.
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
Gulzar, Jamshaid; Ali, Moazzam; Kuroiwa, Chushi
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.
Bailey, Martha J.; Malkova, Olga; Norling, Johannes
This paper provides new evidence that family planning programs are associated with a decrease in the share of children and adults living in poverty. Our research design exploits the county roll-out of U.S. family planning programs in the late 1960s and early 1970s and examines their relationship with poverty rates in the short and longer-term in public census data. We find that cohorts born after federal family planning programs began were less likely to live in poverty in childhood and that these same cohorts were less likely to live in poverty as adults. PMID:25346655
Beanblossom, Gary F.
College populations may differ greatly, not only in terms of traditional academic variables such as high school grades and test performances, but also in terms of student interests, values, educational aspirations, occupational plans, and socio-economic background. The recognition of biographic variables as potential predictors of academic success…
Lash, Denise N; Smith, Jane Ellen; Rinehart, Jenny K
Obesity has become a world-wide epidemic; in the United States (U.S.) approximately two-thirds of adults are classified as overweight or obese. Military veterans' numbers are even higher, with 77% of retired or discharged U.S. veterans falling in these weight categories. One of the most common methods of changing one's weight is through dieting, yet little is known regarding the factors that facilitate successful dieting behavior. The current investigation tested the Theory of Planned Behavior's (TPB) ability to predict dietary intention and future dieting in a sample of 84 overweight and obese patients attending medical clinics at a Veterans Affairs Hospital in the southwestern part of the U.S. Participants primarily were male (92%) and ethnic/racial minorities (58%). Perceived need and anticipated regret were added to the standard TPB model. While the TPB predicted dietary intention, it did not significantly account for improved dietary behaviors. Anticipated regret significantly enhanced the basic TPB's ability to predict intention to diet, while perceived need did not. These findings highlight the difficulty in predicting sustained change in a complex behavior such as dieting to lose weight. The need for more work with older, overweight/obese medical patients attending veterans' facilities is stressed, as is the need for such work with male patients and ethnic minorities in particular.
In accordance with Central Committee Document no. 7 which calls for family planning work reform, China's Yuncheng Prefecture established changes in its family planning System. Yuncheng Prefecture contains 13 counties, 211 townships, 3292 administrative villages, and a population of 3,850,000. Propaganda technique leadership stations were implemented in 70% of the prefectures and counties, propaganda technique service stations in 90% of the townships, 1829 service rooms and 475 services in the villages. The Central Committee has frequently stated that controlling population growth entails strategic responsibility; the establishment of service nets is the primary step for fulfilling that responsibility. Methods in its establishment include: 1) Comprehensive planning: determining which districts have leadership and are receptive; 2) Proper selection of enthusiastic and educated personnel; 3) Adequate equipment at service sites; 4) Coordination of service net efforts with public health departments; 5) Accomplishing the following 5 services through administrative and professional management: propaganda, technology, policy, eugenics, and social welfare. The social advantage of the service nets is the creation in 2 years of a specialized group form the agrarian community who will become a systematic force which will guarantee continuous family planning work. As a consequence of the establishment service nets, more couples now desire only 1 child; unplanned 2nd births in 1984 decreased 12% from 1983. The multiple child rate fell 4.83% for those years. Family planning work has become more economical and efficient.
Obimakinde1, A.M.; Ladipo, M.M.; A.E. Irabor
Background: Individuals with somatization may be the most difficult to manage because of the diverse and frequent complaints across many organ systems. They often use impressionistic language to describe circumstantial symptoms which though bizarre, may resemble genuine diseases. The disorder is best understood in the context "illness" behaviour, masking underlying mental disorder, manifesting solely as somatic symptoms or with comorbidity. Objective: To evaluate somatization symptoms and explore its comorbidity in order to improve the management of these patients. Methods: A cross-sectional survey of 60 somatizing patients who were part of a case-control study, selected by consecutive sampling of 2668 patients who presented at the Family Medicine Clinic of University College Hospital Ibadan, Nigeria between May-August 2009. Data was collected using the ICPC-2, WHO- Screener and Diagnostic Schedule and analysed with SPSS 16. Results: There were at least 5 symptoms of somatization in 93.3% of the patients who were mostly females. Majority had crawling sensation, "headache", unexplained limb ache, pounding heart, lump in the throat and insomnia. The mean age at onset was 35yrs with 90% having recurrence of at least 10yrs.Approximately 54% had comorbidity with cardiovascular disease being the most prevalent. Conclusions: The study revealed that somatization is not a specific disease but one with a spectrum of expression. This supports proposition that features for the diagnosis of somatization could be presence of three or more vague symptoms and a chronic course lasting over two years. It is important to be conversant with pattern of symptoms and possible comorbidity for effective management of these patients. PMID:26069465
el Tom, A R; Lauro, D; Farah, A A; McNamara, R; Ali Ahmed, E F
In 1980, the Department of Community Medicine of the University of Khartoum designed an operations research project to test the possibility of getting village midwives to be involved in the delivery of maternal and child health and family planning (MCH/FP) services. From 1981-1983 the project was implemented by the University of Khartoum in cooperation with the Ministry of Health. The project area covered 100 km. It encompassed a largely agrarian population of 93,000 in 90 villages north of Khartoum along the banks of the Nile. The focus was on training and supervising village midwives. Information was provided on contraceptives for birth spacing, distribution of oral contraceptives, and referral for other methods. Also provided to midwives was information for mothers on oral rehydration therapy for children with diarrhea, and distribution of oral rehydration solution packets. Nutrition education was given midwives with emphasis on breastfeeding and weaning procedures. Information was also supplied about vaccination for children under 5 years of age (in collaboration with the Sudan Expanded Program on Immunization). The project was expensive, particularly regarding incentive payments for supervisors and midwives. The project had a very good start, but when incentive payments were withdrawn, it almost collapsed. At first, what midwives could do to provide maternal and child health services was targeted, but as the project went on, there was more concern for involvement of midwives in broader rural health delivery. The project area was a conservative, Islamic one. An extension area was selected 5 hours travelling time from Khartoum in Shendi District of Nile Province. The project was begun in 60 villages of 75,000 inhabitants. The land stretched for 120 km along both banks of the Nile. In the extension area, a small fee (US$.025) was charged per cycle, half going to the midwives, and half towards the health teams' expenses. 21 health zones were created, and a health
Herrera Miranda, J L
In 1984, a team of specialists from the National Population Council and the Ministry of Health evaluated the availability of family planning services in 5 health regions of Peru: a sector of Lima, Arequipa, San Martin, Cuzco, and Cajamarca. The numbers of women aged 15-49 years in the health regions, the numbers subject to Ministry of Health programming, the numbers of acceptors, and the percentage of coverage respectively were 1,357,298, 906,675, 83,542, and 9.21% in Lima; 183,168, 122,356, 4789, and 3.91% in Arequipa; 77,427, 51,721, 1610, and 3.11% in San Martin; 283,088, 189,103, 7695, and 4.07% in Cuzco; and 120,375, 80,411, 1181, and 1.47% in Cajamarca. There were 98,817 acceptors in the 5 regions, and the coverage was 7.32%. The differences in coverage achieved in the 5 regions were due to different financial and professional resources in the different regions as well as to differences in sociodemographic characteristics and especially degree of urbanism. A better distribution and more rational utilization of budgetary and professional resources would permit a levelling of the regional rates of coverage and an increase of the total coverage. The number of acceptors of condoms and other methods, pills, and IUDs respectively were 17,034, 30,117, and 36,391 in Lima; 2176, 1830, and 783 in Arequipa; 352, 751, and 507 in San Martin; 2879, 3507, and 1309 in Cuzco, 250, 445, and 486 in Cajamarca, and 22,691, 36,650, and 39,476 in all 5 regions. Of the 98,817 acceptors, 23.0% chose condoms and others, 37.1% pills, and 39.9% chose IUDs. Regional variations in methods selected depended primarily on the professional resources available. In areas where more physicians were available there were higher rates of IUD use.
Alexandrescu, R; Tuchendria, E
Family planning was for a long time prohibited in Romania. This has reduced the demand for contraceptives. Even though contraceptives were made accessible and their use promoted since the beginning of December 1989, abortion has still been the preferred form of fertility regulation, as the people of Romania are unaware of the advantages of contraception. The purpose of the present survey was to assess the level of sexual knowledge, attitudes and practice of teenagers and young people from urban areas of Romania and to identify if there was any significant difference in terms of age, education and sexual activity. A baseline examination was undertaken in which data were collected from 279 students who attended five high schools and six post high schools from the Moldavia cities, Iassy, Piatra-Neamt and Bîrlad. Students were asked to complete a self administered questionnaire, and a 97.5% response rate for the whole survey was achieved. Difference between answers were tested using chi-square test from 2x2 table and median test, average. A P-value <0.05 was considered to be significant. The study established that knowledge, attitudes and practice vary by age (adolescents (< or =19y) vs young people (>19y)) and education (high school vs post high school) in some regards. At the aggregate level, regarding knowledge, a statistically significant difference was found between adolescents and young people; but no statistically significant difference was found between high school and post high school students. Apart from lack of basic knowledge the study confirmed that many false beliefs regarding contraceptives are held by the survey participants. People who were sexually active were no better informed than the rest of survey participants, but they had a significantly higher percentage of positive attitudes regarding effectiveness of pills and withdrawal. Both, the knowledge and attitudes of students necessarily required appropriate sex education which, ideally should be
Gibbs, Susannah E.; Choiriyyah, Ifta; Sonenstein, Freya L.; Astone, Nan M.; Pleck, Joseph H.; Dariotis, Jacinda K.
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
Savela, Alexandra E.; O'Brien, Karen M.
This study examined how college women's instrumentality and expectations about combining work and family predicted early career development variables. Specifically, 177 undergraduate women completed measures of instrumentality (i.e., traits such as ambition, assertiveness, and risk taking), willingness to compromise career for family, anticipated…
Coopers & Lybrand, Washington, DC.
Guidance on how to make college affordable, especially for middle-income families, is provided. Although college tuition and fees have more than doubled over the past 10 years and will continue to increase, traditional student aid programs have not kept pace with inflation and are earmarked chiefly for students from low-income families. The…
Van Riper, Marcia
The purpose of the present investigation, which was guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, was twofold: (a) to describe maternal perceptions of parental and family adaptation in families raising a child with Down syndrome, and (b) to examine linkages between family demands, family resources, family problem solving and coping, and family adaptation in families of children with Down syndrome. Seventy-six mothers completed mailed questionnaires. Seventy percent of the mothers rated their family's overall functioning as either a 4 or a 5 on a 5-point scale (1 = poor; 5 = excellent). In their written comments, most mothers reported that their family was doing well or very well. Three family variables (i.e., family demands, family resources, and family problem-solving communication) were significantly associated with family adaptation. These results provide support for the belief that many families of children with Down syndrome respond to "a change of plans" with resilience. That is, they are able to endure, survive, and even thrive in the face of ongoing challenges associated with raising a child with Down syndrome.
Kabir, M; Islam, M A
A sample of 871 currently married urban Bangladeshi women was used to assess the impact of mass media family planning programmes on current contraceptive use. The analyses suggested that radio had been playing a significant role in spreading family planning messages among eligible clients; 38% of women with access to a radio had heard of family planning messages while the figures for TV and newspaper were 18.5% and 8.5% respectively. Education, number of living children and current contraceptive use were important predictors of exposure to any mass media family planning messages. There was a negative relationship between breast-feeding and the current use of contraception indicating a low need for contraception among women who were breast-feeding.
Newbold, K Bruce; Willinsky, Jacqueline
Cultural impacts on health experiences and behaviours are profound in the area of reproductive health and family planning. Explored through interviews with family planning healthcare professionals, this paper evaluates their experiences in providing family planning and reproductive healthcare to immigrants in the Greater Toronto and Hamilton area of Ontario, Canada. Results reveal the complexity of delivering care to members of this group, particularly when dealing with language barriers, situations when professional and non-professional interpreters are used, and instances where healthcare professionals realize that they themselves have misconceptions and misunderstandings about other cultures. The paper concludes by discussing future research options and implications for the delivery of reproductive health family planning services to this population.
Johnson, Doug; Ugaz, Jorge
We use a unique dataset that includes an objective measure of the quality of family planning counseling from 927 private health facilities in Lagos State, Nigeria, to determine which variables at the facility and provider levels are most closely correlated with the quality of family planning counseling. Our data on quality come from mystery client surveys in which the clients posed as women seeking family planning counseling. We find that quality is strongly associated with the cadre of provider, with doctors delivering substantially higher-quality counselling than nurses. Doctors not only outperform nurses overall, but also perform better on each category of quality and spend nearly three minutes longer on average counseling the mystery client. Location, fees charged for the service, and facility type are also strongly correlated with quality. The degree to which a facility specializes in family planning and facility size are only weakly predictive of quality.
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.
Espey, Eve; Cosgrove, Ellen; Ogburn, Tony
The US problems of high unintended pregnancy and abortion can be successfully addressed with a systems approach that focuses on reducing barriers to contraception and improving opportunities to expand access. The ability to reduce unintended pregnancy depends on making family planning services available to all. A comprehensive approach requires policy change to improve funding for and access to family planning, to provide comprehensive sex education and to reduce insurance and religious barriers to contraceptives.
Bradley, H; Bedada, A; Tsui, A; Brahmbhatt, H; Gillespie, D; Kidanu, A
Integrating voluntary HIV counselling and testing (VCT) with family planning and other reproductive health services may be one effective strategy for expanding VCT service delivery in resource poor settings. Using 30,257 VCT client records with linked facility characteristics from Ethiopian non-governmental, non-profit, reproductive health clinics, we constructed multi-level logistic regression models to examine associations between HIV and family planning service integration modality and three outcomes: VCT client composition, client-initiated HIV testing and client HIV status. Associations between facility HIV and family planning integration level and the likelihood of VCT clients being atypical family planning client-types, versus older (at least 25 years old), ever-married women were assessed. Relative to facilities co-locating services in the same compound, those offering family planning and HIV services in the same rooms were 2-13 times more likely to serve atypical family planning client-types than older, ever-married women. Facilities where counsellors jointly offered HIV and family planning services and served many repeat family planning clients were significantly less likely to serve single clients relative to older, married women. Younger, single men and older, married women were most likely to self-initiate HIV testing (78.2 and 80.6% respectively), while the highest HIV prevalence was seen among older, married men and women (20.5 and 34.2% respectively). Compared with facilities offering co-located services, those integrating services at room- and counsellor-levels were 1.9-7.2 times more likely to serve clients initiating HIV testing. These health facilities attract both standard material and child health (MCH) clients, who are at high risk for HIV in these data, and young, single people to VCT. This analysis suggests that client types may be differentially attracted to these facilities depending on service integration modality and other facility
Creanga, Andreea A.; Galavotti, Christine; Wamalwa, Emmanuel
Introduction Use of family planning (FP) is powerfully shaped by social and gender norms, including the perceived acceptability of FP and gender roles that limit women’s autonomy and restrict communication and decision-making between men and women. This study evaluated an intervention that catalyzed ongoing community dialogues about gender and FP in Siaya county, Nyanza Province, Kenya. Specifically, we explored the changes in perceived acceptability of FP, gender norms and use of FP. Methods We used a mixed-method approach. Information on married men and women’s socio-demographic characteristics, pregnancy intentions, gender-related beliefs, FP knowledge, attitudes, and use were collected during county-representative, cross-sectional household surveys at baseline (2009; n11 = 650 women; n12 = 305 men) and endline (2012; n21 = 617 women; n22 = 317 men); exposure to the intervention was measured at endline. We assessed changes in FP use at endline vs. baseline, and fitted multivariate logistic regression models for FP use to examine its association with intervention exposure and explore other predictors of use at endline. In-depth, qualitative interviews with 10 couples at endline further explored enablers and barriers to FP use. Results At baseline, 34.0% of women and 27.9% of men used a modern FP method compared to 51.2% and 52.2%, respectively, at endline (p<0.05). Exposure to FP dialogues was associated with 1.78 (95% CI: 1.20–2.63) times higher odds of using a modern FP method at endline for women, but this association was not significant for men. Women’s use of modern FP was significantly associated with higher spousal communication, control over own cash earnings, and FP self-efficacy. Men who reported high approval of FP were significantly more likely to use modern FP if reporting high approval of FP and more equitable gender beliefs. FP dialogues addressed persistent myths and misconceptions, normalized FP discussions, and increased its
Rosales Aujang, Enrique; Felguérez Flores, Jesús Alberto
Familiar planning is an important branch of the preventive medicine that can have a great impact on the health of the humanity. The present study is an evaluation by a cross section of the effects obtained by the program of familiar planning during a period of 15 years in the Aguascalientes Delegation of the Mexican Institute of the Social Security, establishing therefore a diagnosis and identifying elements that can contribute in the suitable planning of strategies to improve the quality of the attention and to respond to social and health necessities of the population.
Hartmann, Miriam; Gilles, Kate; Shattuck, Dominick; Kerner, Brad; Guest, Greg
Research suggests that spousal communication and male involvement in decision making can positively influence family-planning use and continuation. However, few existing studies explore the dynamics of this communication and how they factor into family-planning decision making. Building upon a recent evaluation of a theory-based male-involvement intervention in Malawi, this study aimed to fill this gap by examining the role of communication in the intervention's success, through semi-structured in-depth interviews with male participants and female partners of study participants. Results support the idea that communication is an integral component of successful interventions to increase male involvement in family planning. Participants reported improvements in spousal communication, increased frequency of communication, and an increase in shared decision making as a result of the study, which directly contributed to their family-planning use. This effect was often mediated through increased knowledge or reduced male opposition to family planning. Further analysis of communication and decision-making dynamics revealed shifts in gendered communication norms, leading to improvements in spousal relationships in addition to contraceptive uptake. This study shows that interventions can and should encourage spousal communication and shared decision making, and it provides an effective model for involving men in family-planning use.
In 1988 the Yunnan, China Family Planning Commission, the Public Security Department, and the Industrial and Commercial Administrative Bureau issued Trial Regulations aimed at getting a "good grasp of family planning controls" on individual entrepreneurs and the mobile population in the urban areas of Yunnan--groups in which there is a large number of excessive births. The Trial Regulations provide the following: "Individual entrepreneurs and the mobile population are great in number and work in a great variety of trades: their dwellings are scattered, and they are highly mobile. Thus the task of family planning regarding these people is heavy and difficult. Industrial and commercial administrative departments and public security and other departments must closely cooperate with family planning departments so as to strengthen family planning control over these people. At the same time, it is necessary to apply specific methods for strengthening family planning control when the mobile population, individual entrepreneurs, and temporary workers, forest workers, construction workers and so on apply for temporary residence permits, take out forestry licenses, and sign construction contracts."
... family member after he or she returns home: Personal care: bathing, eating, dressing, toileting Household care: cooking, ... the other hand, there may be a more personal relationship if you hire an individual directly, and ...
Fontbonne, Annick; Cesse, Eduarda Ângela Pessoa; Sousa, Islândia Maria Carvalho de; Souza, Wayner Vieira de; Chaves, Vera Lúcia de Vasconcelos; Bezerra, Adriana Falangola Benjamin; Carvalho, Eduardo Freese de
The SERVIDIAH study (Evaluation of Health Services for Diabetic and Hypertensive Subjects) was conducted in 2010 in the State of Pernambuco, Brazil. A multi-stage random sample of 785 hypertensive and 823 diabetic patients was drawn from 208 Family Health Strategy (FHS) units selected throughout 35 municipalities. Patients underwent a structured interview and weight, height, blood pressure and HbA1c levels (for diabetic patients) were measured. Mean age was approximately 60 years, and women were overrepresented in the sample (70%). 43.7% of hypertensive subjects and 25.8% of diabetic subjects achieved adequate blood pressure control and 30.5% of diabetic subjects had HbA1c levels below 7%. Despite 70% of the patients being overweight or obese, few had adhered to a weight-loss diet. The study of this representative sample of hypertensive and diabetic patients attended by the FHS in the State of Pernambuco shows that improvements in the management of hypertension and diabetes are needed in order to prevent the occurrence of serious and costly complications, especially given the context of increasing incidence of these two conditions.
Anderson, Annie S; Caswell, Stephen; Macleod, Maureen; Steele, Robert Jc; Berg, Jonathan; Dunlop, Jacqueline; Stead, Martine; Eadie, Douglas; O'Carroll, Ronan E
The current work aimed to assess health behaviors, perceived risk and control over breast/colorectal cancer risk and views on lifestyle advice amongst attendees at cancer family history clinics. Participants attending the East of Scotland Genetics Service were invited to complete a questionnaire (demographic data, weight and height, health behaviors and psycho-social measures of risk and perceived control) and to participate in an in-depth interview. The questionnaire was completed by 237 (49 %) of attendees, ranging from 18 to 77 years (mean age 46 (±10) years). Reported smoking rates (11 %) were modest, most (54 %) had a BMI > 25 kg/m(2), 55 % had low levels of physical activity, 58 % reported inappropriate alcohol intakes and 90 % had fiber intakes indicative of a low plant diet. Regression analysis indicated that belief in health professional control was associated with higher, and belief in fatalism with poorer health behavior. Qualitative findings highlighted doubts about the link between lifestyle and cancer, and few were familiar with the current evidence. Whilst lifestyle advice was considered interesting in general there was little appetite for non-tailored guidance. In conclusion, current health behaviors are incongruent with cancer risk reduction guidance amongst patients who have actively sought advice on disease risk. There are some indications that lifestyle advice would be welcomed but endorsement requires a sensitive and flexible approach, and the acceptability of lifestyle interventions remains to be explored.
Ganginis Del Pino, Heather V; O'Brien, Karen M; Mereish, Ethan; Miller, Matthew J
An instrument was developed to measure the extent to which people consider future children and romantic partners when planning for a career (i.e., the PLAN scale). Two independent factor-analytic studies of a total of 726 college women were conducted to assess the factor structure and psychometric properties of this measure. Results suggested that the PLAN represents a general Considering Future Family When Making Career Plans factor and 2 domain-specific factors: Considering Children and Prioritizing and Compromising for Partner. Suggestions for future research and practice using the PLAN scale are provided.
Wehmeyer, Michael L.; Morningstar, Mary; Husted, Doris
Part of a series designed to provide practical resources on topics essential to the process of preparing individuals with disabilities for adulthood, this manual focuses on family involvement in transition planning and implementation. Chapter 1, "Overview and Introduction," discusses the history of family involvement in education, and the…
Keeny, S. M., Ed.
An annual review, third in a series, covers developments in the field of population and family planning in East Asia. For each of the 10 countries involved (Hong Kong, Indonesia, South Korea, Laos, Malaysia, Phillipines, Singapore, Taiwan, Thailand, and South Vietnam) there is an article written by the agent responsible for the family planning…
Planned Parenthood--World Population, Austin, TX. Southwest Region.
The information in this directory is designed to promote continuity in family planning services for migrant families in mid-continent streams. It provides professional personnel with a new tool to help meet the distinctive needs of individual migrants. Names, addresses, schedules, methods, and fee information of service agencies (health…
Littlefield, Carla N.; And Others
This guide, written for health managers and clinicians, provides information to meet the family planning needs of migrant farmworkers of Mexican culture. The promotion of maternal and child health for migrant farmworker families has brought attention to the incidence of high risk pregnancies among this population. Research indicates that a need…
Family planning programs in sub-Saharan Africa (42 countries and 450 million population), the fastest growing and poorest region in the world, need effective communications campaigns to educate people about the benefits of contraception, help change attitudes about fertility control and family size, and provide information about available…
Popp, Tierney K.; You, Hyun-Kyung
The mediating role of parental satisfaction in the relation between family involvement in early intervention service planning and parental self-efficacy was explored. Participants included families of children with disability or delay involved in early intervention (n = 2586). Data were examined upon entry into early intervention (T1) and at…
Eto, Kumi; Koch, Pamela; Contento, Isobel R.; Adachi, Miyuki
Objective: To examine associations between Theory of Planned Behavior variables and the family meal frequency. Methods: Fifth-through seventh-grade students (n = 236) completed a self-administered questionnaire in their classrooms. The relationships between Theory of Planned Behavior variables (intention, attitudes, subjective norms, and perceived…
This document contains final regulations relating to cafeteria plans that reflect changes made by the Family and Medical Leave Act of 1993 (Act). The final regulations provide the public with guidance needed to comply with the Act and affect employees who participate in cafeteria plans.
Minke, Kathleen M.; Scott, M. M.
This naturalistic study analyzed videotape recordings of nine individualized family service plan meetings in early intervention programs attempting to actively involve parents in the planning process. Results indicated that parents have attained partial decision-making power, but greater attention to parent participation is needed in goal setting,…
International Planned Parenthood Federation, London (England).
Population growth trends and family planning activities in Africa, America, Asia, Europe, and Oceania are summarized in this booklet developed by the International Planned Parenthood Federation. Narrative information for each continent gives a resume of population growth trends, reasons for the trends, population problems, policy formation, family…
The author discusses a multi-media library and information center in population and family planning which is associated with a Planned Parenthood affiliate and provides many segments of the community with educational materials and services and strengthens the affiliate's programs. (Author)
Television, an effective and specific tool for education at a distance, could perhaps boost Rwanda's family planning education effort. Rwanda's first television broadcast on family planning appeared in December 1992 during the opening of the Television Rwandaise (TVR) network. 2 programs were shown that were intended to increase awareness of population problems and propose appropriate and lasting solutions, with a special emphasis on family planning. The spread of television in developing countries has made it an effective tool to influence family planning behavior among a growing share of the population. The moving images of television are able to attract and hold the attention of viewers. The images seen on television may be remembered longer than works heard on the radio or read. Amusing television programs may arouse emotions capable of leading to behavior modifications. Television can bring abstract ideas like family planning to life and can also give them effective value. To take advantage of the potential benefits of television, programs should explain the contraceptive methods carefully and inform viewers of where to go for family planning services. Programming should be adapted to local cultural realities, and should be interesting. Programming for television should follow the rules of careful preparation, pretesting, evaluation, and revision of any communications campaign. Potential or real disadvantages of television as a tool for family planning campaigns include high cost and the inaccessibility of television to the rural and urban poor most in need of family planning. Personnel with technical knowledge of family planning and of broadcast communications may be in short supply. Television allows communication in one direction only, with little opportunity for viewers to pose questions or register reactions. The lack of repetition is a shortcoming for individuals who require repeated exposure in order to grasp the meaning. Television programming may be
Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene
ABSTRACT Background: The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Methods: Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. Results: In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (<25 years old) were significantly more likely to obtain their method from a drug shop or pharmacy than another type of facility. In both countries, family planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and
Khowaja, Yasmin; Karmaliani, Rozina; Hirani, Shela; Khowaja, Asif Raza; Rafique, Ghazala; McFarlane, Judith
Background: Recently, parenting programs to address behavioural and emotional problems associated with child maltreatment in developing countries have received much attention. There is a paucity of literature on effective parent education interventions in the local context of Pakistan. This study aimed to assess the feasibility of offering a 6-week parenting program for mothers of pre-school children attending family health centres (FHCs) in Karachi, the largest metropolitan city of Pakistan. Methods: A pilot quasi-experimental trial was conducted. Two FHCs were selected, one as the intervention and the second as the control. A total of 57 mothers of pre-school children (n = 30 intervention; n = 27 control) participated in this study. Mothers in the intervention group received SOS Help for parents module, while mothers in the control group received information about routine childcare. A parenting scale (PS) was administered before the program was implemented and repeated 2 weeks after the program was completed in both groups. Statistical analysis was performed to compare participants’ attributes. Descriptive analysis was conducted to compare pre- and post-test mean scores along with standard deviation for parenting subscales in the intervention and control groups. Results: A total of 50 mothers (n = 25 intervention; n = 25 control) completed the 6-week program. Attrition was observed as 5/30 (17%) in the intervention arm and 2/27 (2%) in the control arm. Mothers commonly reported the burden of daily domestic and social responsibilities as the main reason for dropping out. Furthermore, the majority of participants in the control group recommended increasing the duration of weekly sessions from 1 to 1.5 hours, thereby decreasing the program period from 6 to 4 weeks. Mothers in intervention group reported substantial improvement in parenting skills as indicated by mean difference in their pre- and post-test scores for laxness and over-reactivity. Conclusion
Mauldin, W P
) segura de traducir las estadísticas de servicio en práticas y tal vez aún datos sobre suministro comercial en datos sabre tasas de natalidad. Esto incluye, par ejemplo, los esfuerzos para consolidar observaciones coma "cinco años-mujer de usa de IUD, a 400 condones equivalen a la prevención de un nacimiento," y esfuerzos como los de Pakistán de calcular tasas coma "años de protección de una pareja contra el embarazo."In the belief that a decrease in the rate of population growth will increase economic development, more than ten countries have inaugurated family planning programs in the past fifteen years. To provide a model for measuring the immediate, intermediate, and long-term effects of any such program, the authors use the Taiwan evaluation.The model suggests that a good system of evaluation should include monthly statistics on (1) participants, who are grouped by characteristics; (2) the distribution of supplies, reported at first by the characteristics of recipients, but after by gross volume only; (3) family planning activities of private physicians to measure the catalytic effect on the private sector; (4) new contacts and amount of advertising in mass media; (5) costs broken down by areas and by cost categories; and (6) distribution of commercial supplies. In addition, the program should conduct 300-400 interviews every 6-12 months to learn the rates of continuation and the rates and reasons for discontinuation. Finally, a KAP survey should be conducted every two years.The administration of the evaluation should be close to the director for policy decisions and for the ultimate work of evaluation-the finding of new ways to measure the main goal of change in fertility by the translation of statistics on Services provided and commercial supplies into birth rate data.
Bawah, A A; Akweongo, P; Simmons, R; Phillips, J F
The Navrongo experiment, a family planning and health project in northern Ghana, has demonstrated that an appropriately designed, community-based family planning program can produce a change in contraceptive practice that had been considered unattainable in such a setting. Simultaneously, however, evidence suggests that newly introduced family planning services and contraceptive availability can activate tension in gender relations. In this society, where payment of bridewealth signifies a woman's requirement to bear children, there are deeply ingrained expectations about women's reproductive obligations. Physical abuse and reprisals from the extended family pose substantial threats to women; men are anxious that women who practice contraception might be unfaithful. Data from focus-group discussions with men and women are examined in this report and highlight the strains on gender relations resulting from contraceptive use. The measures taken to address this problem and methods of minimizing the risk of adverse social consequences are discussed.
Hopkins, Kristine; White, Kari; Linkin, Fran; Hubert, Celia; Grossman, Daniel; Potter, Joseph E.
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 education programs are commonly designed by expert educators who are far removed, in location and experience, from their target audiences. Educators operate on the premise that their job is simply to develop strategies to successfully transfer their knowledge to the target audience. Judgements are often colored by a determination not to offend local sensibilities, which can lead educators to uncritically adopt the local wisdom about what is and is not culturally acceptable. A proper exploration of sexuality is absent from most family planning programs. Usual features of expert-designed family planning programs are an admonishment about people having too many children (the stick), a clear rationale for having fewer children (the carrot), the provision of detailed contraceptive information (the means), and the encouragement of individuals to exercise some personal control over their fertility (the ends). This standard model, although widely used throughout the Pacific, was not adopted by the Family Planning Federation of Australia in its regional family planning education work. The Federation, in conjunction with the independent Family Planning Association in the South Pacific, has taken a more participatory, learner-focused approach that values the contribution of the audience in all phases of the program. There is a huge need to target men, particularly young, unmarried men. The Federation found that not only did Pacific men want to view and discuss the women's documentary video Taboo Talk about family planning issues, they wanted their own men's version. The Federation soon discovered that attempts to meet the requests can easily flounder on the issue of language. The Federation has worked with the target audience to develop a lexicon of acceptable words for reproductive health education.
Rosenman, Martin F.
A pilot survey, administered in 1972, was designed to assess a rough cross section of attitudes toward birth control in both black and white neighborhoods. A survey of 41 male and 39 female white residents of Decatur, Georgia, was conducted primarily to get an indication of how attitudes held by whites relate to feelings about family planning…
Zabin, L S
Several ideologies of the present Administration appear to converge as they impinge upon family planning--themes which are not restricted to reproductive health but which interact in ways particularly threatening to its achievements of the last decade. Most of these ideologies are clear, articulated objectives of the present government such as overall budget reduction and the return of budgetary control to the states. Others are responsive to the influence of the so called "moral mojority." Essentially, the federal government can affect family planning delivery through 4 different routes: through the allocation of funds; through specific legislation; and through regulation or organizational structure (areas in the hands of the executive branch alone). There have been recent and prime examples of all 4 routes, all directed at weakening the federal family planning program which has grown steadily stronger with bipartisan support in the last decades. Major sources of family planning support are reviewed in order to indicate the areas of change or of serious risk to the field. By retaining the categorical funding of Title 10 (half of the federal money in the family planning field has, for some years, come through Title 10 of the Public Health Service Act) in 1981, Congress reasserted the importance it places upon fertility regualtion against Administration pressure to block-grant. Despite an approximately 23% cut, this funding remains the single best hope for the field in these tight money times. In the language of the House Budget Committee report, Congress expressed its intention that an emphasis upon family planning be retained in the Maternal and Child Health block grant. It is no surprise that under the pressure of funding cuts that intention has not been honored. An upsurge in the use of Medicaid funding by family planning providers has increased the proportion of family planning funds from this source. In Title 20 of the Social Security Act (Social Services) it
Fruge, Don L.; Green, Karen O.
Intended for parents and legal guardians of mentally retarded persons, the manual provides guidelines for estate planning. An overview of definitions, causes, and prevalence factors in retardation is followed by reviews of the major financial assistance governmental programs such as Medicare, and Supplemental Security Income, and of legal…
Byington, Teresa A.; Whitby, Peggy J. S.
Parents play important roles as advocates for their child with a disability. Advocacy is the process of striving to improve the quality of life for someone else. The Individuals With Disabilities Education Act (IDEA) requires parents and professionals to work together to design a service delivery plan for children with disabilities. An…
individual characteristics; family variables, including composition and life cycle stage; member duty requirements and career history; conditions created by...Laboratory Zita M. Simutis, Director September 1990 DTIC ELECTE S 5Op CT 29 190L 28 0- i9 United States Army Research Institute for the Behavioral and...FROM86/II TO 88/03 1 1990 , September I 258 16. SUPPLEMENTARY NOTATION Contracting Officer’s Representative, D. Bruce Bell. Caliber Associates is a
Jamieson, D J; Buescher, P A
Data on approximately 45,000 North Carolina women who gave birth in 1989 and 1990 and received prenatal care in public health facilities were studied to assess the effects in a low-income population of prior family planning services on low birth weight and adequacy of prenatal care. Women who had used family planning services in the two years before conception were significantly more likely than those who had not used such services to have a birth-to-conception interval of greater than six months. They were also more likely to receive early and adequate prenatal care and to be involved in a food supplement program and maternity care coordination. In addition, the family planning participants were less likely than the nonparticipants to be younger than 18 and were somewhat less likely to deliver a low-birth-weight infant. Though the results of this retrospective study must be interpreted with caution because of such factors as self-selection into family planning programs, they suggest that family planning services may improve birth weight and use of prenatal health services among low-income women.
Zeyneloğlu, Simge; Kısa, Sezer Kısa; DelibaŞ, Leyla
This study assesses the determinants of family planning methods use by Turkish married men in South East Anatolia. A descriptive and cross-sectional survey research design was used among 1,352 men aged 20 to 52 years who lived in South East Turkey. A pilot-tested questionnaire was used to collect data. Descriptive statistics, chi-square, and multivariate regression analysis were used. The rate of nonusage of contraceptive methods among the participants was 60.4%. Within the nonusers, 34.9% reported a religious prohibition and 9.4% had misconceptions about family planning. Chi-square analysis determined four factors that were significantly related to the men's usage of contraception. These factors are the following: the men's age, educational level, number of existing children, and their perception of their household income level. These four factors were also subjected to multivariate regression analysis, the results of which were used to compute odds ratios for each value of each factor indicating the likelihood for using contraception by men within each group. Male-specific family planning programs can make an important contribution to the overall efforts to improve the usage of contraceptives by men. It is important to note that family planning services and education programs related to family planning should be appropriate for men.
In 1979, the National Family Planning Program's (NFPP) multiservice mobile unit pilot project was implemented to deliver a full complement of clinical and nonclinical family planning services to remote Thai villages by transporting nurses, physicians, and supplies by van. 15 provinces with the lowest family planning achievement in 1978 were selected to participate in the project for 1 year; one refused. Funding was allocated for mobile unit trips and promotional billboards. Implementation at the time of data analysis averaged 9.8 province-months, sufficient to reveal trends in project achievement. 9579 new acceptors were reported after 805 mobile trips in the 14 provinces, an average of 12 new acceptors/trip. New acceptor recruitment costs were estimated at $6.20/client. Based on Thai data for continuation rates, an estimated 18,238 couples years of protection (CYP) were achieved by the mobile unit. In comparison to other family planning services' mobile units, the multiservice unit had the lowest operating costs, but the most expensive cost/CYP. The effectiveness of the promotional billboards was assessed by comparing acceptor rates in provinces with and without billboards. Overall, the provinces with billboards showed less of an increase in new acceptors. When months of project implementation are controlled, a positive effect of the billboards is suggested. While demonstrating that all modern contraception can be delivered via mobile units to remote villages, there is inadequate acceptance of the highly effective family planning methods to justify the cost of transporting staff and equipment.
Gatchalian, J; Aganon, M
16 couples from each of 3 barrios in the Philippines - Barrio Santiago 1, Barrio Santiago 2, and Barrio Dolores - were randomly selected to make up homogeneous groups of young potential family planning acceptors. The objectives were 3-fold: 1) to increase the rural workers' knowledge and awareness of population issues and family planning in order to motivate them to adopt practices; 2) to assist a trade union in integrating population education into its workers' educational program; and 3) to test the effectiveness of 2 different population education strategies. Couples from Barrio Santiago 1 underwent the integrated approach, those from Barrio Dolores the conventional approach, and those from Barrio Santiago 2 served as the control group. Both strategies made use of the same teaching methods. The relative effectiveness of the 2 strategies was gauged through an evaluation of the respondents' knowledge, attitude and practice of family planning 3 months after the training course. The following were among the results: 1) both the conventional and integrated educational strategies worked toward a higher level of knowledge and a more favorable attitude toward family planning; 2) there was no statistical significant difference between the 2 educational strategies in terms of attitude change and increase in knowledge; and 3) the study demonstrates the benefits of integrating family planning into the overall effort of trade unions to educate and inform their members.
Realizing the potential of commercial marketing in changing the attitude and behavior of the target audience in the early years of the 4th 5-year development plan, the National Family Planning Program tried to develop new ventures in communicating the concept of the small family norm to the people. The condom was chosen as the 1st product to be sold through the social marketing project because male awareness about family planning was still low. Based on audience research, the pricing, packaging, and branding of the product was developed. The most accepted brand name was Dua Lima because it has a neutral meaning, is easily remembered, and can be described in sign language. The last reason is very important because most consumers have difficulty communicating about condoms in the sales outlet. Social marketing has proved effective because of strong public relations activities and the involvement of formal and informal leaders. This experiment has convinced family planning management that social marketing is workable for promoting the small family norm. In 1987, under the new program of self-sufficiency in family planning, the private sector is invited to participate by providing family planning services for target audiences, using the principles of self-sufficiency and self-support. There are 2 principal activities; 1) the IEC campaign, and 2) product (contraceptive) selling. IEC activities include a media campaign public relations work. Product selling is done through commercial channels such as pharmaceutical firms, drug stores, private doctors, and midwives. It was decided that the campaign would be aided by a name and logo. The blue circle was chosen because it is unique, communicative, and simple. The social marketing of contraceptives in Indonesia can be considered a breakthrough in communication strategy for a national development program.
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.
Dehnavieh, Reza; Kalantari, Ali Reza; Jafari Sirizi, Mohammad
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
Jekauc, Darko; Völkle, Manuel; Wagner, Matthias O; Mess, Filip; Reiner, Miriam; Renner, Britta
In the processes of physical activity (PA) maintenance specific predictors are effective, which differ from other stages of PA development. Recently, Physical Activity Maintenance Theory (PAMT) was specifically developed for prediction of PA maintenance. The aim of the present study was to evaluate the predictability of the future behavior by the PAMT and compare it with the Theory of Planned Behavior (TPB) and Social Cognitive Theory (SCT). Participation rate in a fitness center was observed for 101 college students (53 female) aged between 19 and 32 years (M = 23.6; SD = 2.9) over 20 weeks using a magnetic card. In order to predict the pattern of participation TPB, SCT and PAMT were used. A latent class zero-inflated Poisson growth curve analysis identified two participation patterns: regular attenders and intermittent exercisers. SCT showed the highest predictive power followed by PAMT and TPB. Impeding aspects as life stress and barriers were the strongest predictors suggesting that overcoming barriers might be an important aspect for working out on a regular basis. Self-efficacy, perceived behavioral control, and social support could also significantly differentiate between the participation patterns.
El-Khoury, Marianne; Thornton, Rebecca; Chatterji, Minki; Kamhawi, Sarah; Sloane, Phoebe; Halassa, Mays
This article evaluates the effects of involving men in family planning counseling in Jordan using a randomized experiment. We randomly assigned a sample of 1,247 married women to receive women-only counseling, couples counseling, or no counseling. We measured the effects of each type of counseling on family planning use, knowledge, attitudes, and spousal communication about family planning. Compared to no counseling, couples counseling led to a 54 percent increase in uptake of modern methods. This effect is not significantly different from the 46 percent increase in modern method uptake as a result of women-only counseling. This outcome may be due, in part, to lower rates of compliance with the intervention among those assigned to couples counseling compared to women-only counseling. To realize the possible added benefits of involving men, more tailored approaches may be needed to increase men's participation.
Bertrand, J T; Santiso, R; Cisneros, R J; Mascarin, F; Morris, L
Recent contraceptive prevalence surveys in Guatemala, El Salvador, and panama included a module on family planning communications. This module provided useful feedback on the reach of each program and facilitated comparisons between countries. While almost all women in El Salvador have been reached by family planning messages, the percentage of women reached was lower in Panama and Guatemala. In all three countries rural, less educated, and unemployed women who worked inside the home or not at all were least likely to have seen or heard the messages. Exposure to family planning communications emerged as a strong correlate of contraceptive use, as shown in two separate analyses. These findings underscore the importance of communications in promoting contraceptive use.
Alfsen, G C; Hokstad, S
The Sexual Information Clinic in Oslo was founded more than 20 years ago. The clinic is the largest family planning centre in Norway, treating 4,000-6,000 patients per year. In recent years the treatment of venereal diseases has become the major component of the daily work. The authors describe the different groups of patients who visit the clinic. The meanage of the patients is 21 years. The high number of legal abortions among younger women and the rising incidence of sexually transmitted diseases prove the continued existence of a need for family planning centres. The authors discuss the situation of family planning centres in Norway in general and stress the importance of their work. They argue that all venereal diseases should be treated free of charge.
Mello, Michelle Marie; Powlowski, Marcus; Nañagas, Juan M P; Bossert, Thomas
Compared to neighboring countries, the Philippines has high fertility rates and a low prevalence of modern-method contraception use. The Philippine government faces political and cultural barriers to addressing family planning needs, but also legal barriers erected by its own policies. We conducted a review of laws and policies relating to family planning in the Philippines in order to examine how the law may facilitate or constrain service provision. The methodology consisted of three phases. First, we collected and analyzed laws and regulations relating to the delivery of family planning services. Second, we conducted a qualitative interview study. Third, we synthesized findings to formulate policy recommendations. We present a conceptual model for understanding the impact of law on public health and discuss findings in relation to the roles of health care provider regulation, drug regulation, tax law, trade policies, insurance law, and other laws on access to modern-method contraceptives.
Cottingham, Jane; Germain, Adrienne; Hunt, Paul
In this report, we describe how human rights can help to shape laws, policies, programmes, and projects in relation to contraceptive information and services. Applying a human rights perspective and recognising the International Conference on Population and Development and Millennium Development Goal commitments to universal access to reproductive health including family planning, we support measurement of unmet need for family planning that encompasses more groups than has been the case until recently. We outline how human rights can be used to identify, reduce, and eliminate barriers to accessing contraception; the ways in which human rights can enhance laws and policies; and governments' legal obligations in relation to contraceptive information and services. We underline the crucial importance of accountability of states and identify some of the priorities for making family planning available that are mandated by human rights.
Wade, K B; Sevilla, F; Labbok, M H
This paper reports the results of a 12-month implementation study documenting the process of integrating the Lactational Amenorrhea Method (LAM) into a multiple-method family planning service-delivery organization, the Céntro Médico de Orientación y Planificación Familiar (CEMOPLAF), in Ecuador. LAM was introduced as a family planning option in four CEMOPLAF clinics. LAM was accepted by 133 breastfeeding women during the program's first five months, representing about one-third of postpartum clients. Seventy-three percent of LAM acceptors were new to any family planning method. Follow-up interviews with a systematic sample of 67 LAM users revealed that the method was generally used correctly. Three pregnancies were reported, none by women who were following LAM as recommended. Service providers' knowledge of LAM resulted in earlier IUD insertions among breastfeeding women. Relationships with other maternal and child health organizations and programs were also established.
Kagurusi, Patrick T
The media has been employed to increase uptake of Family Planning through behaviour change communication (BCC). Understanding the barriers encountered in effectively undertaking this function would increase the strategy's effectiveness. Sixty journalists from East Africa participated in trainings to enhance their BCC skills for Family Planning in which a qualitative study was nested to identify barriers to effective Family Planning BCC in the region's media. The barriers were observed to be insufficient BCC skills, journalists' conflict of interest, interests of media houses, inaccessible sources of family planning information, editorial ideologies and absence of commercially beneficial demand. Coupled with the historical ideologies of the media in the region, the observed barriers have precipitated ineffective family planning BCC in the regions media. Effective BCC for family planning in the regions media requires capacity building among practitioners and alignment of the concept to the media's and consumers' aspirations.
Sufrin, Carolyn; Baird, Sara; Clarke, Jennifer; Feldman, Elizabeth
Purpose Incarcerated women around the globe are predominantly of reproductive age. Most of these women have been pregnant before, and many want to be sexually active and avoid pregnancy upon release. Yet few of these women are on a regular method of contraception. Providing contraceptive services for women in custody benefits individual and public health goals of reducing unintended pregnancy. This policy briefing reviews evidence for an unmet need for family planning in the correctional setting, and policy implications for expanding services. The paper aims to discuss these issues. Design/methodology/approach The authors describe four model programs in the USA with established contraceptive services on site, highlighting practical steps other facilities can implement. Findings Correctional facilities health administrators, providers, advocates, and legislators should advance policies which should counsel women on family planning and should make a range of contraceptive methods available before release, while remaining sensitive to the potential pressure these women may feel to use birth control in this unique environment. Practical implications Family planning services for incarcerated women benefits individuals, facilities, and the community. Social implications Policies which enable correctional facilities to provide comprehensive family planning to incarcerated women - including reproductive life goals counseling and contraceptive method provision - promote equity in access to critical reproductive health services and also provide broad scale population level benefits in preventing unintended pregnancy or enabling counseling for healthy pregnancies for a group of women who often have limited access to such services. Originality/value This policy briefing highlights an area of health care in prisons and jails which gets little attention in research and in policy circles: family planning services for incarcerated women. In addition to reviewing the importance of
Mosha, Idda H; Ruben, Ruerd
Family planning utilization in Tanzania is low. This study was cross sectional. It examined family planning use and socio demographic variables, social networks, knowledge and communication among the couples, whereby a stratified sample of 440 women of reproductive age (18-49), married or cohabiting was studied in Mwanza, Tanzania. A structured questionnaire with questions on knowledge, communication among the couples and practice of family planning was used. Descriptive statistics and Logistic regression were used to identify factors associated with family planning (FP) use at four levels. The findings showed that majority (73.2%) of respondents have not used family planning. Wealth was positive related to FP use (p=.000, OR = 3.696, and 95% C.I = 1.936 lower and upper 7.055). Religion was associated with FP use (p=.002, OR =2.802, 95% C.I = 1.476 lower and 5.321 upper), communication and FP use were significantly associated, (p=.000, OR = 0.323 and 95% C.I = 0.215) lower and upper = 0.483), social network and FP use (p=.000, OR = 2.162 and 95% C.I = 1.495 lower and upper =3.125) and knowledge and FP use(p=.000, OR = 2.224 and 95% C.I = 1.509 lower and upper =3.278). Wealth showed a significant association with FP use (p=.001, OR = 1.897, 95% C.I = 0.817 lower and 4.404).Urban area was positively associated with FP use (p= .000, OR = 0.008 and 95% C.I = 0.001 lower and upper =0.09), semi urban was significant at (p= .004, OR = 3.733 and C.I = 1.513 lower and upper =9.211). Information, education and communication materials and to promote family planning in Tanzania should designed and promoted.
Seuc, Armando; Rahimi, Asma; Festin, Mario; Temmerman, Marleen
Abstract Objective To develop a global research agenda that will guide investment in effective interventions to satisfy the large unmet need for modern methods of family planning. Methods In a global survey, experts on contraception were invited to identify and rank the types of research that would be needed – and the knowledge gaps that would have to be filled – to reduce the unmet need for family planning in the next decade. The experts were then asked to score the research on a given topic in terms of the likelihood of its leading to an intervention that would: (i) be deliverable, affordable and sustainable; (ii) substantially reduce the unmet need for contraceptives; (iii) be effective and efficient in improving health systems; (iv) be ethically implemented; and (v) improve equity in the target population. The overall scores were then ranked. Findings Most of the topics that received the 15 highest scores fell into three categories: implementation of policies in family planning; the integration of services to address barriers to contraceptive use; and interventions targeted at underserved groups, such as adolescents. Conclusion Experts on contraception gave top priority ranking to research on improving the implementation and integration of health services and on strengthening the health systems supporting family planning services. The results of the exercise may help decision-makers, researchers and funding agencies to develop a clear and focused approach to satisfying the global need for family planning and reach the target set by the Family Planning 2020 initiative. PMID:24623902
The government of Nangong City, a newly instituted city with a relatively large proportion of agricultural workers has integrated family planning into the building up of mental civilization. As a result, in 1986, the family planning practice rate was 98.4%. One way the government accomplished this was by developing production to eliminate poverty, to show that population development has a significant impact on socioeconomic development. To help change people's attitudes about family planning, the government 1) used publicity, such as speechmaking, mass media, and courses in population theory; 2) awarded those who made contributions; 3) carried out publicity and education in accordance with characteristics of different groups of people; and 4) encouraged bridegrooms to live with their wives' families if the wives' parents had had no son. Another technique the government used as the popularization of scientific knowledge about population theory, physiology and hygiene, birth control, and eugenics and health in births. A 4th method was to popularize knowledge of laws and regulations, such as of early marriage and consanguineous marriage. 5th, the government developed social security undertakings: 1) giving priority to single-child families and 2) taking care of the elderly. Finally, the government improved maternal and child care by 1) providing premarital health care; 2) creating a project for healthier births and better upbringing; 3) family planning workers showing warm concern for reproductive women; and 4) controlling women's diseases and providing health care knowledge, as well as family planning services. These 6 activities have resulted in 1) the decreasing momentum of per capita arable land being controlled, 2) 1-child couples having more time to learn, 3) the development of educational undertakings, 4) a change in people's traditional practices, and 5) improvement in the understanding of patriotism.
Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren
ABSTRACT Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30–70 percentage points within 1–3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women
McFarlane, D R
The Reagan Administration sought to decentralize many federal programs by (1) consolidating categorical grants into black grants; (2) reducing their funding; and (3) relying more upon state fiscal support. This study examines the effects of this decentralist policy upon the federal family planning program. Two periods are analyzed: (1) FY 1976-1981, the period immediately prior to the Reagan Administration and (2) FY 1982-1987, the period during the Reagan Administration. Findings show that a more decentralized program produced less responsiveness to individual state needs for family planning, and that these effects could have been predicted from the previous period.
Bauman, K E
OBJECTIVES: This paper describes the magnitude of effects for family planning programs evaluated with true experimental designs. METHODS: Studies that used true experimental designs to evaluate family planning programs were identified and their results subjected to meta-analysis. RESULTS: For the 14 studies with the information needed to calculate effect size, the Pearson r between program and effect variables ranged from -.08 to .09 and averaged .08. CONCLUSIONS: The programs evaluated in the studies considered have had, on average, smaller effects than many would assume and desire. PMID:9146451
Nepal is a poor country which is short on food and suffering from a low level of child survival. High population growth further impedes social and economic development in the country. As such, population policy and socioeconomic policy should work together to create voluntary demand for a smaller family norm and family planning. Both government and non-government organizations (NGO's) have thus far worked to check population growth. NGOs have made important contributions in the health, population, and anti-poverty arenas. While successful on a small scale, however, NGO programs have only limited potential for expansion. Successful NGO efforts have therefore served mainly as examples of that which might be achieved elsewhere. Broader potential exists for NGO participation in health care and family planning. NGOs have in fact worked to reduce population growth in Nepal since the late 1950s. This paper reviews the role of NGOs in family planning programs with special attention to the work of the Family Planning Association of Nepal (FPAN). The FPAN has 17 branch offices, 4 action units, and 8 special projects working in 25/75 districts with over 700 staff and a substantial body of volunteers. The association particularly emphasizes contraception for the young, child spacing, and child and maternal welfare. The conceptual framework of population growth and the role of NGOs, the structure of population growth in Nepal, and practical strategic suggestions are presented.
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
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
Socialist market economies and planned economies differ in that planned economies have decision-making power concentrated at the top levels of administration, and government sets mandatory macrolevel planning. Socialist market economies have decentralized decision making, and government's role is in setting rules and regulations. The market provides information and prices in a socialist market economy, while in a planned economy the government supplies information. Material interests are the stimulus in a market economy, while ideology is the stimulus in planned economies. Externalities or market failures prevent the market from realizing maximum efficiency in resource allocation. Commodity production is best when the social marginal cost equals social marginal efficiency. Externalities can be handled by internalization, taxation or subsidies, or administrative intervention. Externalities in reproduction are costs within the family that are lower than the social costs. Family costs usually do not include consumption of scarce natural resources. Costs vary between rural and urban areas. In a rural area with limited natural resources, lower birth rates in a village mean a greater amount of natural resources per person. If externalities are internalized, resources could be allocated per family which equalized distribution between families so that high birth rates could be contained. Another solution to high birth rates would be to impose fines. In real life, externalities are localized at the village level; poverty in one village affects the region. Under the current Chinese socialist market economy, economic decisions and reproductive decisions are decentralized. Population control regulation exists by province and stipulates the age of childbearing, the conditions determining second children, and the length of birth interval. Each province is subject to macro central government plans which include quotas for birth rates and the number of births per province. Family
Gatmaitan, Michelle; Brown, Teresa
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…
Vouking, Marius Zambou; Evina, Christine Danielle; Tadenfok, Carine Nouboudem
The World Health Organization (WHO) estimated in 2012 that 287,000 maternal deaths occurred in 2010; sub-Saharan Africa (56%) and Southern Asia (29%) accounted for the global burden of maternal deaths. Men are also recognized to be responsible for the large proportion of ill reproductive health suffered by their female partners. Male involvement helps not only in accepting a contraceptive but also in its effective use and continuation. The objectives were to assess men's knowledge, attitude, and practice of modern contraceptive methods; determine the level of spousal communication about family planning decision making; and investigate the correlates of men's opinion about their roles in family planning decision making. We searched the following electronic databases from January 1995 to December 2013: Medline, Embase, CINAHL, LILAS, International Bibliography of Social Sciences, Social Services Abstracts, and Sociological Abstracts. Along with MeSH terms and relevant keywords, we used the Cochrane Highly Sensitive Search Strategy for identifying reports of articles in PubMed. There were no restrictions to language or publication status. Of 137 hits, 7 papers met the inclusion criteria. The concept of family planning was well known to men. In the Nigerian study, almost (99%) men were aware of the existence of modern contraceptives, and most of them were aware of at least two modern methods. Awareness of the condom was highest (98%). In the Malawi study, all of the participants reported that they were not using contraception before the intervention. In Ethiopia, above 90% of male respondents have supported and approved using and choosing family planning methods, but none of them practiced terminal methods. Generally, more male respondents disagreed than agreed that men should make decisions about selected family planning issues in the family. Decision-making dynamics around method choice followed a slightly different pattern. According to female participants
The Egyptian family planning program has been successful in that it has rapidly improved its service delivery system. In 1993 the Ministry of Health (MOH) had 3492 facilities providing family planning services in 21 governorates, and 10,714 physicians and 12,638 nurses took part in the program. As a result, 716,000 clients obtained family planning services from the MOH facilities, 15% more than in 1992. The achievements have been brought about by the System Development Project (SDP) that was started in 1987 which has upgraded the MOH family planning service delivery system in 21 out of 26 governorates. The initial goal of the SDP was to reduce the birth rate from 38/1000 population in 1986 to 35/1000 in 1993. The birth rate in 1994 is estimated to have dropped to 30/1000. New and improved IEC materials were designed and distributed. The clinics were reequipped for improved services. Training was conducted for doctors and nurses. Technical guidelines were developed in order to provide high quality service. Because injectables contain a hormone that causes amenorrhea in 80 to 85% of women, they might not be as popular as the IUD. In the end injectables and Norplant will be more popular in Upper Egypt than in Lower Egypt. Condoms are available throughout the country. Pills are available in clinics and also can be bought at any of around 18,000 pharmacies. At the impact of the family planning program the fertility level has been falling. The total fertility rate was 5.3 in 1979-1980. By 1994 it had dropped to 3.7 (2.9 in the urban areas and 4.9 in the rural areas). Infant mortality decreased by half between 1972 and 1992. More young women are using contraception for spacing rather than for limiting the number of children after having obtained the desired family size. Nevertheless, according to the Egypt Demographic and Health Survey 1992, the current family planning services have not reached one in five married women wishing to use family planning.
Clark, Emily; Goodhart, Clare
Abstract Background The total fertility rate in Uganda is 5.9 children per woman, and women admit to having nearly two more children than they actually want. The maternal mortality rate remains stubbornly high. Family planning saves lives. It prevents maternal deaths by delaying motherhood, helping women limit their family size and avoid unwanted pregnancies. It also reduces infant mortality. Setting USHAPE (Ugandan Sexual Health and Pastoral Education) is an initiative run in conjunction with the Royal College of General Practitioners in south-west Uganda. USHAPE aims to disseminate positive messages about modern contraception in an attempt to dispel fears and misconceptions and address the high rate of unmet need. Question The aim was to determine the rate of unmet need for family planning among women of reproductive age in the population local of Kisiizi hospital and to use the successful USHAPE model to train health workers to address this need. Methods 100 patients were screened in the outpatient department to determine the level of unmet need by asking 2 questions. Level 1 training aims enhance every staff member’s knowledge, so that the responsibility for family planning is adopted by the whole institution. Level 2 trains clinicians to become full family planning providers, with the necessary communication, educational and practical skills. Results The screening for unmet need for contraception revealed that 51% have an unmet need, which is higher than the national average of 38%. Sixty-eight members of staff at Kisiizi trained to a basic level and a further 32 staff have been trained to Level 2 higher level. Conclusions/Discussion The USHAPE approach has begun to tackle some of the barriers to accessing family planning, but there are further areas which need development. Our cascade model of training, involves training Ugandan USHAPE trainers with the aim of future scale up and long-term development. PMID:28250846
Catholic groups and individuals united in a public rally in Manila's Rizal Park to decry a "cultural dictatorship," which promotes abortion, homosexuality, lesbianism, sexual perversion, condoms, and artificial contraception. Government spokesmen responded that condoms and contraception were part of government policy to spread family planning knowledge and informed choices among the population. Cardinal Jaime Sin and former president Corazon Aquino joined forces to lead the movement against the national family planning program in the largest demonstration since the ouster of Ferdinand Marcos in 1986. Also criticized was the 85-page draft action plan for the International Conference on Population and Development (ICPD) scheduled for September 1994. Cardinal Sin accused President Clinton of using the action plan to promote worldwide abortion. Under the administration of President Fidel Ramos, family planning funding has quintupled and the number of family planning workers has increased from 200 to 8000. President Ramos has gone the farthest of any administration in opposing the Church's positions on contraception and abortion, although years ago Fidel Ramos and Cardinal Sin were allies in the effort to push out Ferdinand Marcos. The population of the Philippines is 85% Catholic, and laws reflect the Church's doctrine against divorce and abortion. The current growth rate is 2.3%, and the goal is to reduce growth to 2.0% by 1998, the end of Ramos's term in office. The population target is in accord with demographic goals proposed in the UN draft action plan. The Vatican has opposed the language in the plan and may have encouraged other religious leaders to join those opposed to the "war against our babies and children." Sin said that contraceptive distribution was "intrinsically evil" and should be stopped now. Ramos's administration stated that their policies and programs are not "in the hands of the devil" and there is support for the Church on family values and
Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta
ABSTRACT In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda’s CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda’s CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda’s CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621
Kress, Victoria E.; Adamson, Nicole A.; Paylo, Matthew J.; DeMarco, Carrie; Bradley, Nicole
Counselors are regularly confronted with children and adolescents who reside in violent or potentially violent living environments. In this article, safety plans are presented as a tool that counselors can use to promote the safety of children living in unsafe family situations. Ethics-related counseling issues that should be considered when…
Conly, Shanti R.
This report summarizes the evidence that family planning can reduce deaths of children under 5 years of age at a reasonable cost. The report also: (1) identifies the major reproductive factors associated with child mortality; (2) estimates the approximate reduction in child mortality that could be achieved through improved childbearing patterns;…
Listyawardani, Dwi; Hariastuti, Iswari
Systems thinking is needed due to the growing complexity of the problems faced family planning field workers in the external environment that is constantly changing. System thinking ability could not be separated from efforts to develop learning for the workers, both learning at the individual, group, or organization level. The design of the study…
Mwaikambo, Lisa; Speizer, Ilene S.; Schurmann, Anna; Morgan, Gwen; Fikree, Fariyal
This study presents findings from a systematic review of evaluations of family planning interventions published between 1995 and 2008. Studies that used an experimental or quasi-experimental design or had another way to attribute program exposure to observed changes in fertility or family planning outcomes at the individual or population levels were included and ranked by strength of evidence. A total of 63 studies were found that met the inclusion criteria. The findings from this review are summarized in tabular format by the type of intervention (classified as supply-side or demand-side). About two-thirds of the studies found were on demand generation type-programs. Findings from all programs revealed significant improvements in knowledge, attitudes, discussion, and intentions. Program impacts on contraceptive use and use of family planning services were less consistently found and less than half of the studies that measured fertility or pregnancy-related outcomes found an impact. Based on the review findings, we identify promising programmatic approaches and propose directions for future evaluation research of family planning interventions. PMID:21834409
Ma, Pei-Wen Winnie; Yeh, Christine J.
The authors explore how individual and familial factors predict educational and career aspirations, plans, and vocational outcome expectations of urban, Chinese immigrant youths. Participants were 265 Chinese immigrant high school students in New York City. The results indicated that higher self-reported English language fluency and career-related…
Schölmerich, Vera L. N.; Kawachi, Ichiro
Scholars and practitioners frequently make recommendations to develop family planning interventions that are "multilevel." Such interventions take explicit account of the role of environments by incorporating multilevel or social-ecological frameworks into their design and implementation. However, research on how interventions have…
Planned Parenthood--World Population, Austin, TX. Southwest Region.
The directory is intended to serve those working at providing migrant workers with family planning services. Covering 46 states, it lists agencies and their addresses, schedules, appropriate contacts, and birth control methods available and fees charged (if any). The directory should be of particular help in providing a continuity of service to…
De Souza, Roger-Mark
The article by Potts et al, "The Pill is Mightier than the Sword," points out that family planning has an important role to play in building peace by increasing women’s empowerment and their agency, ultimately helping peacebuilding efforts. Evidence has demonstrated that family planning programs are cost effective, produce quick results, help women and couples meet their desired fertility levels, and produce a multitude of benefits around economic productivity, community engagement, conservation, resilience, and peacebuilding. In order for policy audiences from a variety of sectors, including conflict and peacebuilding, to appreciate these benefits, it is important to find common ground and articulate co-benefits that will help them appreciate and value the role of family planning, as it were, give them sugar to help the pill go down. This commentary examines how resilience, peacebuilding and family planning efforts need to focus on co-benefits in order to build on the successful interventions and opportunities that Potts et al highlight. PMID:26927398
West, James S.; Hunady, Ronald J.
This information packet is designed to help Ohio's high school and middle/junior high school teachers develop a plan to communicate and market the state's work and family life program to various constituencies (students, parents, guidance counselors, school boards, and the general public). Discussed first are the rationale for and intended results…
Fiebig, Jennifer Nepper; Braid, Barbara L.; Ross, Patricia A.; Tom, Matthew A.; Prinzo, Cara
A multiple logistic regression model was used to determine the associations between the role of acculturation, perception of educational barriers, need for family kin support, vocational planning, and expectations for attaining future vocational goals against the demographic variables (gender, age, being the oldest child, the first to attend…
Mount San Antonio Coll., Walnut, CA.
This update of the 1998 Plan for the 21st Century was designed to augment the California Community College Family and Consumer Sciences in the 21st Century packet, produced in 1996. It summarizes a variety of activities, products and events that have taken place over the past two years, and suggests resources and contacts for learning more about…
Jackson, Audrey R.
Knowledge of the existence of birth control clinics is seen as a function of proximity to clinics, friendliness of neighborhood, and propensity to discuss birth control with neighbors. A conceptual model is developed to illustrate variables contributing to the diffusion of birth control information in a public health family planning program.…
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…
Bush, Ruth; Mentzer, Danielle R.; Grisaffi, Danielle; Richter, Julie
Newspaper reports of female college seniors modifying their career plans to opt out of work before they enter the workforce challenge the assumption that because many recent college graduates were raised in dual-income families, they would expect to have a substantial workforce role. Using a questionnaire format, this study examines postgraduation…
Ridgley, Robyn; Snyder, Patricia; McWilliam, R. A.
We discuss the utility of a coding system designed to evaluate the amount and type of parent talk during individualized family service plan (IFSP) meetings. The iterative processes used to develop the "Parent Communication Coding System" (PCCS) and its associated codes are described. In addition, we explored whether PCCS codes could be…
Kumaran, T V; Norbert, S A
Over the past few years advancements in family welfare programs have occurred in India. One state in the Indian Union, Tamil Nadu, has had significant success in its family planning strategies. Examined is the fertility trends over a period of years within this area. Focus is on fertility decline, calculated from changing birthrates. Decline was differentiated in terms of crude birth rates. Chosen were standardized birth rates adjusted for age (females 15-49 years old), and standardized birth rates adjusted for both age structure and marital status. Family planning programs in Tamil Nadu were classified according to periods of years - 1956-1971 as the pre-intensive program period, and 1971-1986 as the intensive program period. Methodology included simple correlation and regression with additional computations, and multilinear regression measuring impacts on fertility decline of a small number of various factors. Conclusions drawn showed a swift decline in fertility in Tamil Nadu from 1971-1988, more so than during the period of 1956-1971. Family welfare programs were examined as well as through 4 key variables: infant mortality rates, female employment, female educational attainment, and family planning utilization. All 4 variables have shown a positive influence on fertility decline in Tamil Nadu. Both crude and standardized birth rates, as shown by measuring births averted during 1986, can be effectively used in producing births averted in any particular future time period.
Abdulrazaq, A G; Kabir, S; Mohammad, N S; Suleiman, I H
Army barracks in Nigeria have low contraceptive prevalence rates (CPRs) and many children per family. The aim of this interventional study, involving 963 married women, is to determine the impact of health education on family planning knowledge, attitudes, and practices among married barrack women. The intervention group attended a 50-minute health talk and demonstrations on family planning methods. In the intervention group, the mean knowledge score rose significantly, from 5.5 points to 7.8 points post-intervention (t = -16.7281, p = 0.0000, df = 460). In addition, the CPR increased significantly, from 11.8% at baseline to 22.4% post-intervention (McNemar's chi2 = 125.41, p = 0.0000). Such significant changes were not noted in the control group. We conclude that health education is an effective intervention for improving knowledge about and attitudes towards contraceptives and their use among married women in military barracks in Nigeria. Intense and sustained health education is therefore recommended in addressing the low CPR in Nigeria.
The operations research and technical assistance (OR/TA) project in The Population Council has concentrated on fertility and infant mortality issues in Latin American and the Caribbean for more than a decade through INOPAL. INOPAL is an acronym for Investigacion Operacional en Planificacion Familiar y Atencion Materno-Infantil para America Latina y el Caribe (Operations Research in Family Planning and Maternal-Child Health in Latin America and the Caribbean). In March 1995, the project entered its third phase, INOPAL III, with the renewal of its contract from the United States Agency for International Development (USAID). To facilitate communication between INOPAL, collaborating agencies, and USAID, INOPAL Director James Foreit moved from Peru to a Council office in Washington, D.C. INOPAL has six objectives: 1) to test the integration of family planning and reproductive health services; 2) to increase access to family planning; 3) to develop strategies to reach special populations; 4) to improve the sustainability of family planning programs; 5) to improve service quality; and 6) to institutionalize operations research capability in the region. INOPAL II conducted 61 subprojects in 12 countries in collaboration with 24 USAID cooperating agencies and other international organizations. The project established new services for postpartum women, adolescents, and rural women; improved program quality and financial sustainability; increased vasectomy promotion and the range of available contraceptives; and developed new modes of service delivery. A key finding of INOPAL II operations research was the importance of increasing cost-effectiveness to ensure program sustainability. INOPAL III will work toward all six objectives, with an emphasis on integrating reproductive health and family planning services. Operations research and technical assistance (OR/TA) subprojects will focus on the prevention and treatment of sexually transmitted diseases, perinatal and postpartum
Measuring and tracking the quality of healthcare is a critical part of improving service delivery, clinic efficiency and health outcomes. However, no standardized or widely accepted tool exists to assess the quality of clinic-based family planning services in low- and middle-income countries. The objective of this literature review was to identify widely used public domain quality assessment tools with existing or potential application in clinic-based family planning programmes. Using PubMed, PopLine, Google Scholar and Google, key terms such as 'quality assessment tool', 'quality assessment method', 'quality measurement', 'LMIC', 'developing country', 'family planning' and 'reproductive health' were searched for articles, identifying 20 relevant tools. Tools were assessed to determine the type of quality components assessed, divided into structure and process components, level of application (national or facility), health service domain that can be assessed by the tool, cost and current use of the tool. Tools were also assessed for shortcomings based on application in a low- and middle-income clinic-based family planning programme, including personnel required, re-assessment frequency, assessment of structure, process and outcome quality, comparability of data over time and across facilities and ability to benchmark clinic results to a national benchmark. No tools met all criteria, indicating a critical gap in quality assessment for low- and middle-income family planning programmes. To achieve Universal Health Coverage, agreed on in the Sustainable Development Goals and to improve system-wide healthcare quality, we must develop and widely adopt a standardized quality assessment tool.
Objectives The objectives of this study are: (1) to estimate the prevalence of unmet need for family planning among married women using Botswana Family Health Survey 2007 data and (2) to identify risk factors for unmet need for family planning among married women. Design This study used secondary data from a cross-sectional survey that was conducted to provide a snapshot of health issues in Botswana. Setting Nationally representative population survey data. Participants 2601 married or in union women aged 15–49 years who participated in the 2007 Botswana Family Health Survey were included in the analysis. Primary outcome Unmet need for family planning, which was defined as the percentage of all fecund married women who are not using a method of contraception even though they do not want to get pregnant. Results Married women who had unmet need for family planning were 9.6% in 2007. Most of the unmet need was for limiting (6.7%) compared to spacing (2.9%). Unmet need for family planning was more likely to be among women whose partners disapproved of family planning, non-Christians, had one partner and had never discussed family planning with their partner. Women of low parity, aged 25–34 years, and greater exposure to mass media, were less likely to have experienced unmet need. The patterns and magnitude of covariates differed between unmet need for limiting and for spacing. Conclusions The prevalence of unmet need for family planning was low in Botswana compared to other sub-Saharan African countries. The findings from this study reemphasise the importance of women's empowerment and men's involvement in women's sexual and reproductive healthcare needs and services. Different approaches are needed to satisfy the demand for family planning for spacing and limiting. PMID:25829370
Mistik, S; Naçar, M; Mazicioğlu, M; Cetinkaya, F
As men play a prominent role in reproduction, it is therefore extremely useful to assess and encourage them to be involved in contraception, particularly in developing countries, where contraceptive goals have not been reached. This study was carried out in Kayseri, Turkey, in order to determine the attitudes and behavior of married men concerning family planning. A questionnaire was presented to 123 married men. In our study, 91.9% of men approved of family planning, but only 54.4% actually used any contraceptive methods; 66.7% of the men said that the decision should be a joint one, 66.4% wanted to limit their family size. Approximately one fourth of the men had never heard of voluntary sterilization. No one in the study group was aware of the mini-pill, diaphragm or Norplant. In the study group, 26.8% of the men did not want their wives to use intrauterine devices and 31.7% of them did not agree with women using the contraceptive pills. Among those unwilling to use a condom (46.3%), 70.1% stated that it might interrupt intercourse. If a contraceptive pill for males could be used, 25.2% of members of the group would be prepared to use it. Only 17.5% men in the study group had contacted a doctor or a health foundation to obtain information. The main sources of family planning information were TV/radio, followed by friends and newspapers/magazines. In order to encourage men's involvement in family planning, the use of mass media and continual training programs, to try to reach both men and women, could be very useful.
Cohen, S A
In November 1996 during her address to the Sixth Conference of Wives of Heads of State and Government of the Americas in La Paz, Colombia, and in her weekly newspaper column, US first lady Hillary Rodham Clinton pledged her own and the Clinton administration's complete support for reversing the severe reduction in funds for the international family planning program imposed by the 104th Congress. This revelation reflected the administration's preparation for a strong and vocal defense of the international family planning program, which will be facing its greatest political test in February 1997. Bolivia has the highest maternal mortality rate in South America, and half the deaths are due to illegal, unsafe abortions. Mrs. Clinton presented a $2.25 million USAID award to a $5 million Pan American Health Organization program that aims to reduce maternal mortality. In her December 3, 1996, column, she used family planning campaigns in Bolivia as an illustration of sensible, cost-effective, and long-term strategies for improving women's health, strengthening families, and reducing the abortion rate. Such programs educate people about the benefits of birth spacing, breast feeding, good nutrition, prenatal and postpartum visits, and safe deliveries. Mrs. Clinton has also visited other poor countries to learn about the special needs and conditions of women's lives. UN Ambassador Madeleine Albright has recently been nominated to be the first female Secretary of State. Many people see her commitment to improving the status of women through development efforts and her recognition of the close relationship between development and diplomacy as encouraging. The concern and commitment of these two powerful women could prove valuable in the upcoming test for international family planning aid. Congress must vote on a resolution to approve Clinton's report that the reduced funding is having a negative impact no later than February 28. If both the House and the Senate pass the
Tan Boon Ann
The findings of the final phase of a 3-phase multivariate areal analysis study undertaken by the Economic and Social Commission for Asia and the Pacific (ESCAP) in 5 countries of the Asian and Pacific Region, including Malaysia, to examine the impact of family planning programs on fertility and reproduction are reported. The study used Malaysia's administrative district as the unit of analysis because the administration and implementation of socioeconomic development activities, as well as the family planning program, depend to a large extent on the decisions of local organizations at the district or state level. In phase 1, existing program and nonprogram data were analyzed using the multivariate technique to separate the impact of the family planning program net of other developmental efforts. The methodology in the 2nd phase consisted of in-depth investigation of selected areas in order to discern the dynamics and determinants of efficiency. The insights gained in phase 2 regarding dynamics of performance were used in phase 3 to refine the input variables of the phase 1 model. Thereafter, the phase 1 analysis was repeated. Insignificant variables and factors were trimmed in order to present a simplified model for studying the impact of environmental, socioeconomic development, family planning programs, and related factors on fertility. The inclusion of a set of family planning program and development variables in phase 3 increased the predictive power of the impact model. THe explained variance for total fertility rate (TFR) of women under 30 years increased from 71% in phase 1 to 79%. It also raised the explained variance of the efficiency model from 34% to 70%. For women age 30 years and older, their TFR was affected directly by the ethnic composition variable (.76), secondary educational status (-.45), and modern nonagricultural occupation (.42), among others. When controlled for other socioeconomic development and environmental indicators, the
Curry, Dora Ward; Rattan, Jesse; Nzau, Jean Jose; Giri, Kamlesh
ABSTRACT In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). SAFPAC's strategy focuses on 4 broad interventions drawn from public health best practices in more stable settings: competency-based training for providers, improved supply chain management, regular supervision, and community mobilization to influence attitudes and norms related to family planning. Between July 2011 and December 2013, the initiative reached 52,616 new users of modern contraceptive methods across the 5 countries (catchment population of 698,053 women of reproductive age), 61% of whom chose long-acting methods of implants or intrauterine devices. Prudent use of data to inform decision making has been an underpinning to the project's approach. A key approach to ensuring sustained ability to train and supervise new providers has been to build capacity in clinical skills training and supervision by establishing in-country training centers. In addition, monthly supervision using simple checklists has improved program and service quality, particularly with infection prevention procedures and stock management. We have generally instituted a “pull” system to manage commodities and other supplies, whereby health facilities place resupply orders as needed based on actual consumption patterns and stock-alert thresholds. Finally, reaching the community with
Curry, Dora Ward; Rattan, Jesse; Nzau, Jean Jose; Giri, Kamlesh
In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). SAFPAC's strategy focuses on 4 broad interventions drawn from public health best practices in more stable settings: competency-based training for providers, improved supply chain management, regular supervision, and community mobilization to influence attitudes and norms related to family planning. Between July 2011 and December 2013, the initiative reached 52,616 new users of modern contraceptive methods across the 5 countries (catchment population of 698,053 women of reproductive age), 61% of whom chose long-acting methods of implants or intrauterine devices. Prudent use of data to inform decision making has been an underpinning to the project's approach. A key approach to ensuring sustained ability to train and supervise new providers has been to build capacity in clinical skills training and supervision by establishing in-country training centers. In addition, monthly supervision using simple checklists has improved program and service quality, particularly with infection prevention procedures and stock management. We have generally instituted a "pull" system to manage commodities and other supplies, whereby health facilities place resupply orders as needed based on actual consumption patterns and stock-alert thresholds. Finally, reaching the community with mobilization
Tucker, Corinna Jenkins; Barber, Bonnie L.; Eccles, Jacquelynne S.
Investigated the frequency of advice about life plans that older adolescents in always-married (n=544) and divorced (n=95) families received from mothers, fathers, and siblings. Findings suggest that adolescents from both types of families rely on mothers for advice, but adolescents from divorced families depended less often on fathers and…
Phillips, John A., Jr.
This paper describes a program intended to increase student attendance in a Savannah, Georgia, inner city high school. The author maintains that shifting the accountability for attendance to the students through peer pressure was perhaps the most significant reason for gains in attendance. He believes that a successful attendance increase program…
Bos, Henny M W; van Balen, Frank
The study assessed the extent to which children between eight and 12 years old in planned lesbian families in the Netherlands experience stigmatization, as well as the influence of protective factors (relationship with parents, social acceptance by peers, contact with children from other families headed by lesbian mothers or gay fathers) on their psychological adjustment (conduct problems, emotional symptoms, hyperactivity, self-esteem). Data were collected by questionnaires filled out by the mothers and by the children themselves. The children in the sample generally reported low levels of stigmatization. However, boys more often reported that, in their view, they were excluded by peers because of their non-traditional family situation. Girls more often reported that other children gossiped about the fact that they had two lesbian mothers. Higher levels of stigmatization were associated with more hyperactivity for boys and lower self-esteem for girls. Having frequent contact with other children who have a lesbian mother or gay father protects against the negative influence of stigmatization on self-esteem. Findings support the idea that children in planned lesbian families benefit from the experience of meeting other children from similar families.
Xiao, S H
After the Third Meeting of the Eleventh People's Congress, the entire responsibility for agricultural production was transferred to a lower level. Peasants in various areas have adopted the so called production responsibility system, and the phenomenon of an increased population rate has also appeared in some areas. In this article, the author discusses how to solve these problems created by the new situation. The 1st step is try to control population growth through socialist propaganda education, administrative measures, economic incentives and punishments, and family planning work. The 2nd step is to popularize the practice of having only 1 child per household in the rural areas. The 2nd and 3rd child in each family should be controlled and prohibited. This policy formulated by the Central Government should be carried out thoroughly. Families which follow the policy and have only 1 child should be encouraged with economic rewards, and those families which have 2 or more children should be punished economically. The 3rd step is to establish a national work team to be in charge of family planning and birth control. There should be an ideological unity among the nation's leadership. Party members and cadres should establish themselves as good examples for the people so that the population control work may become successful.
Horn, Marjorie C.; Mosher, William D.
The National Survey of Family Growth is a periodic survey conducted by the National Center for Health Statistics, and designed to produce national estimates of statistics on fertility, family planning, and aspects of maternal and child health that are closely related to childbearing. This report presents statistics based on data collected in the…
Miller, P L
The paper describes a research project which is developing expert computer systems to critique a physician's plan of medical management. In particular, the paper outlines the evolution of three computer systems: ATTENDING, a system designed to critique anesthetic management, ESSENTIAL-ATTENDING, a domain-independent system-building system, and VQ-ATTENDING, a prototype system implemented using ESSENTIAL-ATTENDING to critique aspects of ventilator management. The goals of the research project are to explore the critiquing approach in several different medical domains, to understand the design problems involved in implementing such systems, and to help other researchers build critiquing systems in further domains.
Illinois Community College Board, 2014
This document contains Illinois' State Plan for Adult Education and Family Literacy under Title II of the Workforce Investment Act of 1998 for July 1, 1999, through June 30, 2015. The plan is comprised of the following sections: (1) Eligible agency certifications and assurances; (2) Description of the steps to ensure direct and equitable access;…
In 1987 98.4% of Nangong City participated in family planning. Since 1980 the average annual rate of natural growth has been 6.07/1000, with the multiple child rate averaging .89%. In the city's efforts to bring family planning into the mainstream of spiritual civilization, a program of comprehensive management and various services were launched. The program was based on the "cures," i.e., ways in which to overcome or conquer problems. The 6 cures, or steps, were: 1) Develop production--alleviate poverty, 2) Change old habits and customs--cure the old. 3) Grasp well the universality of science and technology, culture, contraception, and eugenics--cure stupidity. 4) Popularize legal knowledge--cure blindness. 5) Develop social welfare services--cure anxieties. 6) Strengthen public health for women and children--cure sickness.
De Souza, Roger-Mark
For the many individuals and communities experiencing natural disasters and environmental degradation, building resilience means becoming more proficient at anticipating, preventing, recovering, and rebuilding following negative shocks and stresses. Development practitioners have been working to build this proficiency in vulnerable communities around the world for several decades. This article first examines the meaning of resilience as a component of responding to disasters and some of the key components of building resilience. It then summarises approaches to resilience developed by the Rockefeller and Packard Foundations, the Intergovernmental Panel on Climate Change, USAID and DFID, which show how family planning services can contribute to resilience. Next, it gives some examples of how family planning has been integrated into some current environment and development programmes. Finally, it describes how these integrated programmes have succeeded in helping communities to diversify livelihoods, bolster community engagement and resilience, build new governance structures, and position women as agents of change.
Keyonzo, Nelson; Nyachae, Paul; Kagwe, Peter; Kilonzo, Margaret; Mumba, Feddis; Owino, Kenneth; Kichamu, George; Kigen, Bartilol; Fajans, Peter; Ghiron, Laura; Simmons, Ruth
This paper describes how the Urban Reproductive Health Initiative in Kenya, the Tupange Project (2010-2015), successfully applied the ExpandNet approach to sustainably scale up family planning interventions, first in Machakos and Kakamega, and subsequently also in its three core cities, Nairobi, Kisumu and Mombasa. This new focus meant shifting from a "project" to a "program" approach, which required paying attention to government leadership and ownership, limiting external inputs, institutionalizing interventions in existing structures and emphasizing sustainability. The paper also highlights the project's efforts to prepare for the future scale up of Tupange's interventions in other counties to support continuing and improved access to family planning services in the new context of devolution (decentralization) in Kenya.
David, H P; Morgall, J M; Osler, M; Rasmussen, N K; Jensen, B
The findings of this study suggest that, compared to the United States, Danish health care policies and family planning services delivery systems are, in the aggregate, more conducive to the promotion of effective contraceptive practice, more instrumental in conveying information to high-risk groups, and more successful in reducing the incidence of unintended pregnancies and induced abortions. One of the major reasons for this difference may stem from the positive and nonambivalent climate of public opinion about sexuality in Denmark and the manner in which health care and family planning services are delivered to all segments of the population regardless of age, income, or location of residence. Research in reproductive behavior is greatly facilitated by the existence of automated population registers.
Over the past three decades, with a combination of new technology, rising female literacy rates, and strengthened family planning programs, the world has seen dramatic increases in the use of contraception, with corresponding declines in fertility and population growth rates. At the International Conference on Population and Development, Cairo in 1994, parties pledged a tripling of funding for reproductive health programs in developing countries. Many demographers believe that making such programs more widely available to women would extend the decline in birth rates and shift the world towards the low scenario of United Nations population projections over the next century and a half. By examining the costs and impacts of such programs, in view of the links between population and carbon emissions, this paper shows that extension of voluntary family planning could make a large and cost-effective contribution to the greenhouse gas limitation goals of the Kyoto Protocol that was negotiated in 1997.
Haider, Sadia; Stoffel, Cynthia; Donenberg, Geri; Geller, Stacie
Minority women and adolescent females of all races and ethnicities are disproportionately aﬀected by unintended pregnancy in the United States. Adolescents also experience an additional proportion of the burden compared to other age groups, as 82% of pregnancies among women 19 years old and younger are unintended. Moreover, minority and adolescent mothers are at increased risk for having preterm deliveries, low birth weight infants, and other complications. Unintended pregnancy continues to be an important public health problem in the United States, and prevention through family planning is urgently needed. This review presents an overview of the US demographics for unintended pregnancy among both minority and adolescent women and identifies current and past eüorts to reduce unintended pregnancy, specifically among minority and adolescent females, through contraception and family-planning programs.
Simmons, R; Baqee, L; Koenig, M A; Phillips, J F
Using participant observation data on worker-client exchanges from Bangladesh, this article examines the interface between a government family planning program and the rural women it serves. Case material focuses first on the program function typically identified in the literature: meeting unmet demand for contraception by providing convenient supply. Functions that have been less recognized are then illustrated: (1) the worker's role in reducing fear of contraceptive technology; (2) her effort to address religious barriers, child mortality risks, and high fertility preferences; and (3) her role in mobilizing male support. The range of functions performed by the female family planning worker in the cases discussed here demonstrates that her role transcends the boundaries of what is conventionally implied by the concept of supply. She acts as an agent of change whose presence helps to shift reproductive decision-making away from passivity, exposing women long secluded by the tradition of purdah to the modern notion of deliberate choice.
Agarwal, Smisha; Lasway, Christine; L’Engle, Kelly; Homan, Rick; Layer, Erica; Ollis, Steve; Braun, Rebecca; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa
Abstract To address low contraceptive use in Tanzania, a pilot intervention using a mobile job aid was developed to guide community health workers (CHWs) to deliver integrated counseling on family planning, HIV, and other sexually transmitted infections (STIs). In this article, we describe the process of developing the family planning algorithms and implementation of the mobile job aid, discuss how the job aid supported collection of real-time data for decision making, and present the cost of the overall system based on an evaluation of the pilot. The family planning algorithm was developed, beginning in June 2011, in partnership with the Tanzania Ministry of Health and Social Welfare based on a combination of evidence-based tools such as the Balanced Counseling Strategy Plus Toolkit. The pilot intervention and study was implemented with 25 CHWs in 3 wards in Ilala district in Dar es Salaam between January 2013 and July 2013. A total of 710 family planning users (455 continuing users and 255 new users) were registered and counseled using the mobile job aid over the 6-month intervention period. All users were screened for current pregnancy, questioned on partner support for contraceptive use, counseled on a range of contraceptives, and screened for HIV/STI risk. Most new and continuing family planning users chose pills and male condoms (59% and 73%, respectively). Pills and condoms were provided by the CHW at the community level. Referrals were made to the health facility for pregnancy confirmation, injectable contraceptives, long-acting reversible contraceptives and HIV/STI testing. Follow-up visits with clients were planned to confirm completion of the health facility referral. The financial cost of implementing this intervention with 25 CHWs and 3 supervisors are estimated to be US$26,000 for the first year. For subsequent years, the financial costs are estimated to be 73% lower at $7,100. Challenges such as limited client follow-up by CHWs and use of data by
Wang, V L
The transformation of the Chinese society was political and economic by revolution; it was also social and cultural through mass education. Group decisions have been used to induce social change in the Chinese society and applied extensively to the family planning program. The methods which Kurt Lewin developed to change food habits, have been perfected on a grand scale of myriad ways by the Chinese.
Morwe, Keamogetse G.; Tshitangano, Takalani
Background Many young men continue to disregard the importance of contraception and family planning in South Africa. The fact that even university students also do not take contraception and family planning seriously poses a serious threat to their own health and well-being. Aim This paper aims at investigating the attitudes of male students towards contraception and the promotion of female students’ sexual health rights and well-being at the University of Venda. Methods Quantitative research method is used to determine how attitudes of 60 male students towards contraception can jeopardise the health and well-being of both male and female students. Results This study reveals that the majority of 60 male students at the University of Venda have a negative attitude towards contraceptives. As a result, male students at the University of Venda are not keen on using contraceptives. Male students’ negative attitude and lack of interest in contraceptives and family planning also limit progress in achieving the Millennium Development Goals on primary health care, especially with regard to sexual and reproductive health and well-being of female students at the University of Venda. Conclusion The fact that more than half of the male students interviewed did not take contraception and family planning seriously poses a serious threat to health and well-being of students, including violation of female students’ sexual and reproductive health rights in South Africa. This calls for radical health promotion and sexual and reproductive rights programmes which should specifically target male students at the University of Venda. PMID:27542288
Raymond, Elizabeth G; Coeytaux, Francine; Gemzell-Danielsson, Kristina; Moore, Kirsten; Trussell, James; Winikoff, Beverly
Family planning methods that act when administered after fertilisation would have substantial benefits: they could be used longer after sex than current emergency contraceptives, and potentially a woman could use them only on relatively rare occasions when her menstrual period is delayed. Although such methods would displease abortion opponents, they would likely be welcomed by many women. Research to develop post-fertilisation fertility control agents should be pursued.
Background During the post-partum period, most women wish to delay or prevent future pregnancies. Despite this, the unmet need for family planning up to a year after delivery is higher than at any other time. This study aims to assess fertility intention, contraceptive usage and unmet need for family planning amongst women who are six weeks postpartum, as well as to identify those at greatest risk of having an unmet need for family planning during this period. Methods Using the NICHD Global Network for Women’s and Children’s Health Research’s multi-site, prospective, ongoing, active surveillance system to track pregnancies and births in 100 rural geographic clusters in 5 countries (India, Pakistan, Zambia, Kenya and Guatemala), we assessed fertility intention and contraceptive usage at day 42 post-partum. Results We gathered data on 36,687 women in the post-partum period. Less than 5% of these women wished to have another pregnancy within the year. Despite this, rates of modern contraceptive usage varied widely and unmet need ranged from 25% to 96%. Even amongst users of modern contraceptives, the uptake of the most effective long-acting reversible contraceptives (intrauterine devices) was low. Women of age less than 20 years, parity of two or less, limited education and those who deliver at home were at highest risk for having unmet need. Conclusions Six weeks postpartum, almost all women wish to delay or prevent a future pregnancy. Even in sites where early contraceptive adoption is common, there is substantial unmet need for family planning. This is consistently highest amongst women below the age of 20 years. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed in the majority of sites in order to reduce unmet need and to improve both maternal and infant outcomes, especially amongst young women. Study registration Clinicaltrials.gov (ID# NCT01073475) PMID:26063346
Wang, V L
The transformation of the Chinese society was political and economic by revolution; it was also social and cultural through mass education. Group decisions have been used to induce social change in the Chinese society and applied extensively to the family planning program. The methods which Kurt Lewin developed to change food habits, have been perfected on a grand scale of myriad ways by the Chinese. PMID:1275117
Spring, Hannah; Datta, Saugato; Sapkota, Sabitri
Despite the provision of free and subsidized family planning services and clients’ demonstrated intentions to delay pregnancies, family planning uptake among women who receive abortion and postabortion services at Sunaulo Parivar Nepal (SPN), one of Nepal’s largest non-governmental sexual and reproductive health (SRH) providers, remains low. Through meetings, interviews, and observations with SPN’s stakeholders, service providers, and clients at its 36 SRH centers, we developed hypotheses about client- and provider-side barriers that may inhibit postabortion family planning (PAFP) uptake. On the provider side, we found that the lack of benchmarks (such as the performance of other facilities) against which providers could compare their own performance and the lack of feedback on the performance were important barriers to PAFP uptake. We designed several variants of three interventions to address these barriers. Through conversations with team members at SPN’s centralized support office and service providers at SPN centers, we prioritized a peer-comparison tool that allows providers at one center to compare their performance with that of other similar centers. We used feedback from the community of providers on the tools’ usability and features to select a variant of the tool that also leverages and reinforces providers’ strong intrinsic motivation to provide quality PAFP services. In this paper, we detail the process of identifying barriers and creating an intervention to overcome those barriers. The intervention’s effectiveness will be tested with a center-level, stepped-wedge randomized control trial in which SPN’s 36 centers will be randomly assigned to receive the intervention at 1-month intervals over a 6-month period. Existing medical record data will be used to monitor family planning uptake. PMID:27446891
Aziz, N L
Dr. Aziz was very pleased to note that the workshop/seminar was able to achieve one of its most important objectives, that of an interchange of family planning experiences between countries of varying socioeconomic and cultural characteristics. She mentioned the difficulty of convincing people and governments of the merits of family planning and how the integrated approach has definitely supplemented and complemented the family planning program in her country by way of establishing credibility of family planning workers both at the community and governmental levels. Integrating family planning and parasite control has proven beneficial in many ways: people appreciate the program; it stimulated more research in parasitology; it helped make family planning a way of life; and it contributed to a more dynamic approach in family planning. The Latin American countries will be implementing similar projects in their respective countries. Although the approach will vary from country to country, the main approach will be basically the same. Dr. Aziz said that they will be pleased to offer assistance to these countries if requested to do so.
Ozyurda, F; Durmusoglu, M
1390 women aged 15-44 were surveyed between February-June 1988 in the vicinity of the Park Health Education Center by the Ankara University School of Medicine, Department of Public Health. Within this sample, the survey focused on the knowledge, attitude and behavior of the 1082 married women, regarding birth control. Birth control pills, IUDs, and condoms were classified as effective modern birth control methods. Other less effective traditional methods were classified as ineffective. Analysis of the data indicated 74.2% of the subjects resort to some form of birth control while 66.2% use an effective modern method. Age, education, work status, number of children and type and location of housing influence family planning decisions. In general, the women using birth control are primary school graduates aged between 25-39, living in urban areas for at least 5 years. Most have 2 to 3 children and have had an abortion. The most frequently used method of birth control is the IUD. It is notable that 29.5% use the ineffective withdrawal method. 58.62% of the women who do not use birth control, avoid family planning because of their husbands. These women have 2 or more children and are illiterate or primary school graduates between the ages of 25-35 when they are most likely to become pregnant. Family planning services should be geared towards educating these families, especially the husbands. Education services should also target families using the withdrawal method and the 35-44 age group of women who show a low percentage of contraceptive use.
Thomsen, R J
The Soviet model for both obstetrical and gynecological care and family planning provision seems entrenched in the Soviet Far East as found during a July 1991 visit to the Magadan and Chukotka Regions. Modern birth control is minimally practiced, but does include use of the older Soviet Loop intrauterine contraceptive device (IUD), recent introduction of the new Soviet Copper-T IUD and sporadic availability of condoms and foreign made birth control pills. Without male or female surgical sterilizations being performed, the consequence is that the major form of family planning is first trimester abortion. During this visit, I introduced the use of the NORPLANT Subdermal Contraceptive System and the Copper-T380A IUD to physicians at Anadry and Pevek regional hospitals. Gynecological surgery was also performed and fairly typical ob-gyn care units were toured. Ob-Gyn physicians in the Soviet Far East were found to be highly motivated. They look to the West for help in upgrading family planning and ob-gyn health care in the face of severe shortages after a half decade of perestroika.
Sharma, V; Sharma, A
Community leaders are known to play a crucial role in the diffusion of innovations. The government of India started an ambitious programme for the training of opinion leaders in family planning, so as to provide a boost to its National Family Planning (Welfare) Programme. The present study attempts to analyse the knowledge, attitudes and practices of opinion leaders who had been trained in such Orientation Training Camps, vis a vis their untrained counterparts from the same geopolitical region. There was a highly significant difference between the knowledge of the two groups (p < 0.001) and a minor difference in their attitudes towards family planning (p = 0.18), but the practices of opinion leaders from both the groups were identical, thus pointing to a significant KAP-gap in the trained group. Opinion leaders from both the groups were engaged in minimal or negligible motivational work among their followers for acceptance of contraception, and only a very limited few from both the groups had themselves adopted any method of modern contraception.
Policies relating to contraceptive services (population, family planning and reproductive health policies) often receive weak or fluctuating levels of commitment from national policy elites in Southern countries, leading to slow policy evolution and undermining implementation. This is true of Kenya, despite the government's early progress in committing to population and reproductive health policies, and its success in implementing them during the 1980s. This key informant study on family planning policy in Kenya found that policy space contracted, and then began to expand, because of shifts in contextual factors, and because of the actions of different actors. Policy space contracted during the mid-1990s in the context of weakening prioritization of reproductive health in national and international policy agendas, undermining access to contraceptive services and contributing to the stalling of the country's fertility rates. However, during the mid-2000s, champions of family planning within the Kenyan Government bureaucracy played an important role in expanding the policy space through both public and hidden advocacy activities. The case study demonstrates that policy space analysis can provide useful insights into the dynamics of routine policy and programme evolution and the challenge of sustaining support for issues even after they have reached the policy agenda. PMID:18653676
Policies relating to contraceptive services (population, family planning and reproductive health policies) often receive weak or fluctuating levels of commitment from national policy elites in Southern countries, leading to slow policy evolution and undermining implementation. This is true of Kenya, despite the government's early progress in committing to population and reproductive health policies, and its success in implementing them during the 1980s. This key informant study on family planning policy in Kenya found that policy space contracted, and then began to expand, because of shifts in contextual factors, and because of the actions of different actors. Policy space contracted during the mid-1990s in the context of weakening prioritization of reproductive health in national and international policy agendas, undermining access to contraceptive services and contributing to the stalling of the country's fertility rates. However, during the mid-2000s, champions of family planning within the Kenyan Government bureaucracy played an important role in expanding the policy space through both public and hidden advocacy activities. The case study demonstrates that policy space analysis can provide useful insights into the dynamics of routine policy and programme evolution and the challenge of sustaining support for issues even after they have reached the policy agenda.
West, M O
In line with a general tendency of nationalists to hold pro-natalist views, African nationalists in Zimbabwe took a hostile position to family planning upon its introduction in 1957, arguing that it was part of a conspiracy to control the black population. However, it was only after the unilateral declaration of independence in 1965 by the white settlers under Ian Smith that an official policy aimed at reducing African fertility emerged. The African nationalists waged a consistent propaganda campaign against this policy, and the facilities that were established under it, as well as their personnel, became military targets during the guerrilla war in the late 1970s. After independence in 1980, the triumphant nationalists tried to maintain their pro-natalist position. But, with a postwar 'baby boom' pushing the birth rate close to four per cent by the mid-1980s, the officials in charge of economic and social development concluded that society could not sustain such a high fertility rate. Consequently, there was a reversal of policy, and by 1990 Zimbabwe had become an internationally recognized leader of family planning among developing countries. For the most part, however, these changes have taken place without any real input by African women, who remained largely excluded from the male-dominated circles in which decisions about family planning were made.
Gizachew Balew, Jembere; Cho, Yongtae; Tammy Kim, Clara; Ko, Woorim
Family planning coverage has improved in Ethiopia in the last decade, though fertility is still about 5.8 in the rural setup. In this paper, the major structural determinants of family planning service were analyzed using a multilevel model from 8906 individual women observation in the 2011 EDHS data. The results show that there is a big variation in family planning use both at the individual and between group levels. More than 39% of the variation in FP use is explained by contextual cluster level differences. Most of the socioeconomic predictors; respondent's education, ethnicity, and partners' education as well as employment status and urbanization were found to be significant factors that affect FP use. Similarly health extension visit and media access were found to be strong factors that affect FP service at both individual and cluster levels. This evidence concludes that addressing these contextual factors is very crucial to strengthen FP use and fertility reduction in the nation, beyond individual behavioral changes. PMID:26783520
This issue of Population Briefs contains articles on researches conducted by the Population Council concerning the delivery of quality of care, contraceptive development, safe abortion, family planning, demography, and medical anthropology. The cover story focuses on a systematic data collection tool called Situation Analysis that helps managers in program evaluation. This tool has a handbook entitled "The Situation Analysis Approach to Assessing Family Planning and Reproductive Health Services" that contains all the information needed to conduct a Situation Analysis study. The second article reports about a new contraceptive method, the two-rod levonorgestrel, which was developed at the Population Council and was recently approved by the US Food and Drug Administration. The third article reports on a medical abortion procedure that was proven to be safe, effective, and acceptable to women in developing countries. Moreover, the fourth article presents initial findings of the Community Health and Family Planning Project conducted in Northern Ghana. The fifth article discusses the paper written by the Population Council demographer, Mark Montgomery entitled "Learning and lags in mortality perceptions". Finally, the sixth article deals with another paper that reports on women's health perceptions and reproductive health in the Middle East.
The government of Bangladesh is currently testing and implementing strategies to change its family planning program from a reliance on field-workers who conduct home visits to a conventional fixed-site delivery system. Researchers have made two suggestions: First, the program should encourage women to switch from nonclinical methods delivered by family planning workers to more cost-effective clinical methods such as sterilization, and second, field-workers should not be resupplying nonclinical methods, but should focus their attention on motivating nonusers to practice contraception. Longitudinal data from the Maternal and Child Health-Family Planning Extension Project of the International Centre for Diarrhoeal Disease Research, Bangladesh, are analyzed to show that a better strategy might be to target visits to women according to their educational level and area of residence. For uneducated women living far from clinics, access to contraceptives is likely to be a problem, and home visits for resupply might have a larger impact on the contraceptive prevalence rate than would field-workers' visits to motivate nonusers.
Tran, Nhan T; Hallerdin, Jule M; Flowers-Maple, Charon; Moskosky, Susan B
Since 2001, the U.S. Department of Health and Human Services' Office of Family Planning (OFP), in collaboration with the Minority AIDS Initiative, has provided supplemental grant funds to Title X-funded family planning service delivery sites to expand the availability of human immunodeficiency virus (HIV) prevention services. This work has resulted in three major outcomes: (1) increased institutional capacity for the delivery of HIV-prevention services at Title X family planning service delivery sites, (2) the successful implementation of HIV-prevention services at these sites, and (3) the identification of HIV-positive individuals who were referred to care services. These efforts resulted in a total of 539,667 unduplicated individuals being tested for HIV. These tests resulted in the identification of 1,692 HIV-positive individuals who otherwise may not have been tested for HIV. More than 85% of the HIV-positive cases were detected among clients who self-identified as members of racial/ethnic minority groups. The integration of HIV-prevention services is a feasible and effective strategy for detecting HIV infection among women, including women in racial/ethnic minority groups.
Gu, B; Xie, Z
Focus group discussions were conducted in China's Pingluo County, Ningxia Hui Autonomous Region, and Sihui County, Guangdong Province among reproductive age women with only daughters, mothers-in-law, unmarried women aged 23 years and older, and women business persons and cadres. The topic of discussion was the status of women, gender differences in employment, education, marriage, family life, childbearing, and elderly care in counties that have above average fertility rates. There were also several groups of men, mixed gender groups with husbands working away from home, local family planning workers, and rural intellectuals. The findings showed that there is more access to education for girls and a higher employment rate for young women. Daughters receive education to the highest level affordable. Enrollments are equal for boys and girls. Women's employment is not challenged by husbands, and work is available in a variety of locations. Business ownership and operation is encouraged. By middle age, women generally do not work in enterprises, but at home or on contracted farmland. Equal rights within the family are generally accepted. Husbands turn over their salary to wives for family expenses. Girls receive the same care after birth as boys. Women's status is improving. Improvements in social status have also involved sacrifices. Women complained that the workload on the farm has increased with adult males away working in cities. Women bear the burden of family planning, including in some cases side effects from oral pills and recovery from sterilizations. One women remarked that there were burdens in bearing children, taking oral pills, having IUD insertions, and having induced abortions; men should bear 50% of the responsibility. The burden of women without sons is harder, and women may also feel inferior as the last in their family line. One family with 6 daughters accepted the fine of RMB 7000 yuan for having another child, which turned out to be a son. One
Edwards, Marie Patricia; Throndson, Karen; Dyck, Felicia
Conflict over treatment plans is a cause of concern for those working in critical care environments. The purpose of this study was to explore and describe critical care nurses' perceptions of their roles in situations of conflict between family members and health-care providers in intensive care units. Using a qualitative descriptive design, 12 critical care nurses were interviewed individually and 4 experienced critical care nurses participated in focus group interviews. The roles described by the nurses were as follows: providing safe, competent, quality care to patients; building or restoring relationships of trust with families; and supporting other nurses. The nurses highlighted the level of stress when conflict arises, the need to be cautious in providing care and communicating with family members, and the need for support for nurses. More research related to working in situations of conflict is required, as is enhanced education for critical care nurses.
Paek, Hye-Jin; Lee, Byoungkwan; Salmon, Charles T; Witte, Kim
This study hypothesized a multilevel model to examine the contextual effects of gender norms, exposure to health-related radio programs, interpersonal communication, and social capital on family planning behavior in Uganda. The results of hierarchical linear modeling showed that all of the four variables were significant predictors of family planning behavior. The authors found that gender norms as a contextual factor significantly interacted with the individual-level perceived benefit. The significant cross-level interaction effect was also observed between individuals' interpersonal communication and contextual variation in listening to a health-related radio program. Practical implications for family planning communication campaigns are discussed.
McIntosh, William Alex; Kubena, Karen S; Tolle, Glen; Dean, Wesley R; Jan, Jie-sheng; Anding, Jenna
Participation in family meals has been associated with benefits for health and social development of children. The objective of the study was to identify the impact of mothers' work of caring through planning regularly scheduled meals, shopping and cooking, on children's participation in family meals. Parents of children aged 9-11 or 13-15 years from 300 Houston families were surveyed about parents' work, meal planning for and scheduling of meals, motivations for food purchases, importance of family meals, and children's frequency of eating dinner with their families. The children were interviewed about the importance of eating family meals. Hypotheses were tested using path analysis to calculate indirect and total effects of variables on the outcome variable of frequency of children eating dinner with their family. Mothers' belief in the importance of family meals increased likelihood of children eating dinner with families by increasing likelihood that mothers planned dinner and that dinners were regularly scheduled. Mothers' perception of time pressures on meal preparation had a negative, indirect effect on the frequency of children's participation in family dinners by reducing mothers' meal planning.
Background In Brazil, a Ministry of Health report revealed women who underwent an abortion were predominantly in the use of contraceptive methods, but mentioned inconsistent or erroneously contraceptive use. Promoting the use of contraceptive methods to prevent unwanted pregnancies is one of the most effective strategies to reduce abortion rates and maternal morbidity and mortality. Therefore, providing post-abortion family planning services that include structured contraceptive counseling with free and easy access to contraceptive methods can be suitable. So the objective of this study is to determine the acceptance and selection of contraceptive methods followed by a post-abortion family planning counseling. Methods A cross-sectional study was carried out from July to October 2008, enrolling 150 low income women to receive post-abortion care at a family planning clinic in a public hospital located in Recife, Brazil. The subjects were invited to take part of the study before receiving hospital leave from five different public maternities. An appointment was made for them at a family planning clinic at IMIP from the 8th to the 15th day after they had undergone an abortion. Every woman received information on contraceptive methods, side effects and fertility. Counseling was individualized and addressed them about feelings, expectations and motivations regarding contraception as well as pregnancy intention. Results Of all women enrolled in this study, 97.4% accepted at least one contraceptive method. Most of them (73.4%) had no previous abortion history. Forty of the women who had undergone a previous abortion, 47.5% reported undergoing unsafe abortion. Slightly more than half of the pregnancies (52%) were unwanted. All women had knowledge of the use of condoms, oral contraceptives and injectables. The most chosen method was injectables, followed by oral contraceptives and condoms. Only one woman chose an intrauterine device. Conclusion The acceptance rate of post
De Zordo, Silvia
This paper examines family planning in Brazil as biopolitics and explores how the democratization of the State and of reproductive health services after two decades of military dictatorship (1964-1984) has influenced health professionals' and family planning users' discourses and practices. Do health professionals envisage family planning as a 'right' or do they conceive it, following the old neo-Malthusian rationale, as a 'moral duty' of poor people, whose 'irrational' reproduction jeopardizes the family's and the nation's well being? And how do their patients conceptualize and embody family planning? To answer these questions, this paper draws on 13 months of multi-sited ethnographic research undertaken between 2003 and 2005 in two public family planning services in Salvador da Bahia, where participant observation was undertaken and unstructured interviews were conducted with 11 health professionals and 70 family planning users, mostly low income black women. The paper examines how different bio-political rationalities operate in these services and argues that the old neo-Malthusian rationale and the current, dominant discourse on reproductive rights, gender equality and citizenship coexist. The coalescence of different biopolitical rationalities leads to the double stigmatization of family planning users as 'victims' of social and gender inequalities and as 'irrational' patients, 'irresponsible' mothers and 'bad' citizens if they do not embody the neo-Malthusian and biomedical rationales shaping medical practice. However, these women do not behave as 'docile bodies': they tactically use medical and non-medical contraceptives not only to be good mothers and citizens, but also to enhance themselves and to attain their own goals.
Alan Guttmacher Inst., New York, NY.
Although family planning services in rural America are becoming more accessible to women who need and want them, only one-fourth of low- and marginal-income nonmetropolitan women at risk of unintended pregnancy have been served by organized family planning programs. About 150 participants, generally providers of family planning services in…
Mukaba, Thibaut; Binanga, Arsene; Fohl, Sarah; Bertrand, Jane T
Building on expressed support from the Prime Minister to the Ministries of Health and Planning, the country's new family planning commitment grew out of: (1) recognition of the impact of family planning on maternal mortality and economic development; (2) knowledge sharing of best practices from other African countries; (3) participatory development of a national strategic plan; (4) strong collaboration between stakeholders; (5) effective advocacy by champions including country and international experts; and (6) increased donor support. The question becomes: Will the favorable policy environment translate into effective local programming?
Ahmed, Tahera; Jakaria, S M
Only 15% of births in Bangladesh in 2007 were delivered at health facilities, but the increase over previous years has been significant, and treatment-seeking from a medically trained provider for obstetric complications has also increased. A programme to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh in 2004. The training, for community-based health and family planning fieldworkers, covers 74 essential midwifery skills and danger signs for referral. Training of trainers and supervisors for the fieldworkers was also initiated. By the end of 2008 an estimated 4,000 out of a proposed 13,500 skilled birth attendants and 50 of 4,000 proposed supervisors had been trained and were working in 56 districts. There needs to be a full evaluation of the programme and whether it has reduced maternal deaths. Bangladesh now needs to decide how long to invest in this programme and/or whether to train a new cadre of fully qualified midwives, as proposed by the Nursing Council. We believe this programme can only be an interim measure, not a long-term solution, as more women decide to seek institutional delivery and professional midwifery care. For the moment, though, task-shifting seems to have yielded beneficial results and important insights into human resources planning for safe motherhood in Bangladesh.
Nicassio, P M
A study was conducted to determine the way in which stereotypes of machismo and femininity are associated with family size and perceptions of family planning. A total of 144 adults, male and female, from a lower class and an upper middle class urban area in Colombia were asked to respond to photographs of Colombian families varying in size and state of completeness. The study illustrated the critical role of sex-role identity and sex-role organization as variables having an effect on fertility. The lower-class respondents described parents in the photographs as significantly more macho or feminine because of their children than the upper-middle-class subjects did. Future research should attempt to measure when this drive to sex-role identity is strongest, i.e., when men and women are most driven to reproduce in order to "prove" themselves. Both lower- and upper-middle-class male groups considered male dominance in marriage to be directly linked with family size. Perceptions of the use of family planning decreased linearly with family size for both social groups, although the lower-class females attributed more family planning to spouses of large families than upper-middle-class females. It is suggested that further research deal with the ways in which constructs of machismo and male dominance vary between the sexes and among socioeconomic groups and the ways in which they impact on fertility.
In Egypt the current use of family planning methods nearly doubled from 1980 to 1992. The toughest obstacles to the promotion of family planning are the deeply rooted pronatalism, the high rate of illiteracy, and low use of print media. The early efforts of the 1960s through the 1970s helped raise people's awareness of the problem, but traditional attitudes to family planning persisted. The Information, Education and Communication (IEC) Center established in 1979 in the State Information Service (SIS) of the Ministry of Information spearheaded the IEC efforts for family planning throughout the country. The Egyptian Contraceptives Prevalence Survey conducted in 1984 showed that the current use of family planning methods had increased 6.1% from the 1980 level, and that 56% of married women wished to stop having children, but were afraid of side effects of contraceptive use. The SIS/IEC Center launched a creative mass media campaign using TV spots and dramas. It also pioneered community-based public communication activities on population and family planning by organizing population communication forums. The local communication work is implemented by each of the 60 regional offices of SIS. Other government agencies, such as Health Insurance Organization, also launched IEC campaigns promoting their own services. Non-governmental organizations (NGOs) such as the Family of the Future and the Clinical Service Improvement Project also engaged in social marketing of contraceptives. The use of family planning methods mounted between 1980 and 1992 from 24% to nearly 48%, and the method of choice shifted from the pill to the IUD. The country's crude birth rate declined steadily from 40 per 1000 population in 1985 down to 29/1000 in 1992. The six major factors for success included an innovative communication program, religious support, political commitment, an improved service delivery system, involvement of NGOs, and the economic influence. The Egyptian experience in family
McCullough, L B; Coverdale, J; Bayer, T; Chervenak, F A
On the basis of a review of the literature, ethical clinical guidelines for the prevention of pregnancy in women with chronic mental illness have been developed. Such women are characterized as having chronically and variably impaired autonomy in terms of their ability to make decisions about health care, including family planning. The overall strategy should be to restore impaired autonomy in health care decision making. The decision-making process involves 6 steps: 1) attending to information provided by the physician; 2) absorbing, retaining, and recalling this information; 3) cognitive understanding of the significance of the information for the woman and any potential offspring; 4) evaluation of these consequences; 5) expression of both cognitive and evaluative understanding; and 6) communication of a decision based on such understanding. Patients who can negotiate this process are capable of informed consent; those who cannot should be provided with interventions aimed at improving impaired aspects of decision making. Patients who are irreversibly near the thresholds for autonomous decision making can at least assent to medical care and should be presented with alternatives that are consistent with their values. More complex is the management of patients who are irreversibly below thresholds of autonomy in their decision-making abilities. In such cases, consideration must be given to the patient's interests (e.g.., whether pregnancy is likely to pose significant mental health and physical benefits or risks), risks to possible future children (genetic and social), and the social costs. In no case is it ethically justifiable to force the most impaired mentally ill woman to accept surgical sterilization.
Char, Arundhati; Saavala, Minna; Kulmala, Teija
It has been widely documented in patrilocal and strongly patrilineal settings in India that the presence and influence of mothers-in-law in the household may affect fertility decisions made by young couples. However, not much is known about how intra-family relationships per se influence choice of contraceptive method and timing of use. To understand patterns of family planning decision-making, we carried out short, open-ended interviews in rural Madhya Pradesh in 2005 with 60 mothers-in-law, 60 sons and 60 daughters-in-law from the same families. Mothers-in-law were found to have an important influence on family decisions pertaining to activities within the household. They were also likely to influence the number of sons their daughters-in-law had and the timing of their daughters-in-law being sterilised, but they did not seem to have the same authority or influence with regard to decisions on the use of reversible contraceptive methods, which were mainly being made by young couples themselves. The findings show the flexibility and transformability of intra-family interactions, even within a hierarchically-ordered kinship system that is often considered an obstacle to improving reproductive health and gender equity. Given the right information, and availability of and access to reversible methods, young couples in rural Madhya Pradesh are increasingly making contraceptive choices for themselves.
Majestic, Ann L.
Considers the North Carolina statutes that define the process for admitting students to public schools and ensuring their attendance. Examines cases relating to issues of school admission and compulsory attendance. (MLF)
Hutchison, Lauren A; Raffin-Bouchal, Donna S; Syme, Charlotte A; Biondo, Patricia D; Simon, Jessica E
Objectives Advance care planning is the process by which people reflect upon their wishes and values for healthcare, discuss their choices with family and friends and document their wishes. Readiness represents a key predictor of advance care planning participation; however, the evidence for addressing readiness is scarce within the renal failure context. Our objectives were to assess readiness for advance care planning and barriers and facilitators to advance care planning uptake in a renal context. Methods Twenty-five participants (nine patients, nine clinicians and seven family members) were recruited from the Southern Alberta Renal Program. Semi-structured interviews were recorded, transcribed and then analyzed using interpretive description. Results Readiness for advance care planning was driven by individual values perceived by a collaborative encounter between clinicians and patients/families. If advance care planning is not valued, then patients/families and clinicians are not ready to initiate the process. Patients and clinicians are delaying conversations until "illness burden necessitates," so there is little "advance" care planning, only care planning in-the-moment closer to the end of life. Discussion The value of advance care planning in collaboration with clinicians, patients and their surrogates needs reframing as an ongoing process early in the patient's illness trajectory, distinguished from end-of-life decision making.
Since 1976, the Integrated Family Planning and Parasite Control (IP) has been conducted by the Population and Community Development Association (PDA) through the financial support of the Japanese Organization for International Cooperation in Family Planning (JOICFP). Family planning was integrated with other activities starting with parasite control and then environmental sanitation. In 1976, PDAs activities were focused on a community-based delivery (CBD) system for contraception in rural Thailand. In the IPs first years, the PDA conducted mass treatment campaigns using both the local plant "maklua" and modern medicines. Various motivational activities were included, such as letting children see the parasites under a microscope. Many villagers showed up for treatment. Later, however, they were reinfected and failed to get further treatment. Since 1981, the major emphasis of the IP rural program has been to push building of latrines and improved water resources. PDA has started a major project for safe storage of rainwater. Some 11,300 liter bamboo-reinforced concrete rainwater storage tanks are being built in northeast Thailand. Giant water jars for rainwater catchment with a 2000-liter capacity are produced. The financing of PDAs environmental sanitation construction activities is unique. Villagers pay back the cost of the raw materials of the tank, latrine, or jar they received. Repayments go into a revolving fund which can be lent to other families. Peer pressure has made repayment levels approach or exceed 100% in target districts. Villagers are trained to produce the casings, bricks, and other things needed for building. Individuals from building crews are selected and given special training in construction techniques and are taught the potential health benefits of each activity. These people become village sanitation engineers. Villagers can engage in income-generating activities and receive technical assistance from the PDA. The IP has taken on a community
Garcia, Leila Posenato; Ocké-Reis, Carlos Octávio; de Magalhães, Luís Carlos Garcia; Sant'Anna, Ana Claudia; de Freitas, Lúcia Rolim Santana
Spending on health insurance represents an important share of private expenditure on health in Brazil. The study aimed to describe the evolution of spending on private health insurance plans of Brazilian families, according to their income. Data from the Family Budget Surveys (POF) 2002-2003 and 2008-2009 were used. To compare the spending figures among the surveys, the Consumer Price Index (IPCA) was applied. The proportion of families with private health insurance expenses remained stable in both surveys (2002-2003 and 2008-2009), around 24%. However, the household spending on health insurance plans increased. Among those families who spent money oh health insurance plans, the average spending increased from R$154.35 to R$183.97. The average spending on health insurance plans was greater with increasing household income, as well as portions of the family income and total expenditure committed to these expenses. Spending on health insurance is concentrated among higher-income families, for which it was the main component of total health expenditure.
Hodgson, Eric J.; Collier, Charlene; Hayes, Laura; Curry, Leslie; Fraenkel, Liana
Background Significant racial disparities exist in the US unplanned pregnancy rate. We conducted a qualitative study using the theory of planned behavior as a framework to describe how low-income, African-American women approach family planning. Study Design Structured focus groups were held with adult, low-income, non-pregnant, African-American women in Connecticut. Data were collected using a standardized discussion guide, and audio-taped and transcribed. Four, independent researchers coded the transcripts using the constant comparative method. Codes were organized into over-arching themes. Results Contraceptive knowledge was limited with formal education often occurring after sexual debut. Attitudes about contraception were overtly negative with method effectiveness being judged by the experience of side effects. Family and friends strongly influence contraceptive decisions while male partners are primarily seen as a barrier. Contraceptive pills are perceived as readily accessible although compliance is considered a barrier. Conclusions Contraception education should occur before sexual debut, should involve trusted family and community members, and should positively frame issues in terms of achieving life goals. PMID:23177266
A pilot study to evaluate the efficacy of adding a structured home visiting intervention to improve outcomes for high-risk families attending the Incredible Years Parent Programme: study protocol for a randomised controlled trial
Background Antisocial behaviour and adult criminality often have their origins in childhood and are best addressed early in the child’s life using evidence-based treatments such as the ‘Incredible Years Parent Programme’. However, families with additional risk factors who are at highest risk for poor outcomes do not always make sufficient change while attending such programmes. Additional support to address barriers and improve implementation of positive parenting strategies while these families attend the Incredible Years Programme may improve overall outcomes. The study aims to evaluate the efficacy of adding a structured home visiting intervention (Home Parent Support) to improve outcomes in families most at risk of poor treatment response from the Incredible Years intervention. This study will inform the design of a larger prospective randomised controlled trial. Methods/design A pilot single-blind, parallel, superiority, randomised controlled trial. Randomisation will be undertaken using a computer-generated sequence in a 1:1 ratio to the two treatments arranged in permuted blocks with stratification by age, sex, and ethnicity. One hundred and twenty six participants enrolled in the Incredible Years Parent Programme who meet the high-risk criteria will be randomly allocated to receive either Incredible Years Parent Programme and Home Parent Support, or the Incredible Years Parent Programme alone. The Home Parent Support is a 10-session structured home visiting intervention provided by a trained therapist, alongside the usual Incredible Years Parent Programme, to enhance the adoption of key parenting skills. The primary outcome is the change in child behaviour from baseline to post-intervention in parent reported Eyberg Child Behavior Inventory Problem Scale. Discussion This is the first formal evaluation of adding Home Parent Support alongside Incredible Years Parent Programme for families with risk factors who typically have poorer treatment outcomes
Using the community-based health planning and services program to promote skilled delivery in rural Ghana: socio-demographic factors that influence women utilization of skilled attendants at birth in Northern Ghana
Background The burden of maternal mortality in sub-Saharan Africa is enormous. In Ghana the maternal mortality ratio was 350 per 100,000 live births in 2010. Skilled birth attendance has been shown to reduce maternal deaths and disabilities, yet in 2010 only 68% of mothers in Ghana gave birth with skilled birth attendants. In 2005, the Ghana Health Service piloted an enhancement of its Community-Based Health Planning and Services (CHPS) program, training Community Health Officers (CHOs) as midwives, to address the gap in skilled attendance in rural Upper East Region (UER). The study determined the extent to which CHO-midwives skilled delivery program achieved its desired outcomes in UER among birthing women. Methods We conducted a cross-sectional household survey with women who had ever given birth in the three years prior to the survey. We employed a two stage sampling techniques: In the first stage we proportionally selected enumeration areas, and the second stage involved random selection of households. In each household, where there is more than one woman with a child within the age limit, we interviewed the woman with the youngest child. We collected data on awareness of the program, use of the services and factors that are associated with skilled attendants at birth. Results A total of 407 households/women were interviewed. Eighty three percent of respondents knew that CHO-midwives provided delivery services in CHPS zones. Seventy nine percent of the deliveries were with skilled attendants; and over half of these skilled births (42% of total) were by CHO-midwives. Multivariate analyses showed that women of the Nankana ethnic group and those with uneducated husbands were less likely to access skilled attendants at birth in rural settings. Conclusions The implementation of the CHO-midwife program in UER appeared to have contributed to expanded skilled delivery care access and utilization for rural women. However, women of the Nankana ethnic group and uneducated
Meiksin, Rebecca; Meekers, Dominique; Thompson, Susan; Hagopian, Amy; Mercer, Mary Anne
Patriarchal traditions and a history of armed conflict in Timor-Leste provide a context that facilitates violence against women. More than a third of ever-married Timorese women report physical and/or sexual domestic violence (DV) perpetrated by their most recent partner. DV violates women's rights and may threaten their reproductive health. Marital control may also limit women's reproductive control and healthcare access. Our study investigated relationships between DV and marital control and subsequent family planning, maternal healthcare, and birth outcomes in Timor-Leste. Using logistic regression, we examined 2009-2010 Demographic and Health Survey data from a nationally representative sample of 2,951 women in Timor-Leste. We controlled for age, education, and wealth. We limited our analyses of pregnancy- and birth-related outcomes to those from the 6 months preceding the survey. Rural women with controlling husbands were less likely than other rural women to have an unmet need for family planning (Adj. OR 0.6; 95 % CI 0.4-0.9). Rural women who experienced DV were more likely than other rural women to have an unplanned pregnancy (Adj. OR 2.6; 95 % CI 1.4-4.8), fewer than four antenatal visits (Adj. OR 2.3; 95 % CI 1.1-4.9), or a baby born smaller than average (Adj. OR 3.1; 95 % CI 1.4-6.7). DV and marital control were not associated with the tested outcomes among urban women. Given high rates of DV internationally, our findings have important implications. Preventing DV may benefit both women and future generations. Furthermore, rural women who experience DV may benefit from targeted interventions that mediate associated risks of negative family planning, maternal healthcare, and birth outcomes.
Cinamon, Rachel Gali; Hason, Iris
This study examines 15 at-risk Israeli youngsters' work and family plans and the perceived barriers and resources influencing the realization of those plans. In-depth interviews analyzed by Consensual Qualitative Research (CQR) demonstrate the complexity of the future awaiting these youths. Participants perceive work mainly as a means of obtaining…
Place, Patricia; And Others
This survey sought to identify the status of state policies on Individual Family Service Plans (IFSP) required by Public Law 99-457. The survey found that every state plans to develop or review IFSP policies, even the three states who said they had existing policies which they thought might currently meet the Part H requirements on service…
Bertera, R L; Green, L W
Graduate Turkish midwives were trained in triage rules for determining family planning home visit frequency based on risk of couples. In a sample of 542 couples followed for six months, modern contraceptive use increased 22 per cent among high-risk and about 15 per cent among moderate- and low-risk couples. After making assumptions about the fecundity, contraceptive success, and pregnancy complications, the estimated average cost per complication averted was $61 for high-risk, $177 for moderate-risk and $526 for low-risk couples. PMID:112875
Chaudhury, R H
Of 388 married men (professors, government officials, and businessmen) who responded to a questionnaire asking whether they would recommend abortion as a method of family planning, 216 (56%) said yes. Support for abortion was positively associated with level of education, level of wife's and father's education, income, and educational upward mobility (difference between son's and father's educational level); it was negatively associated with rural background (number of years spent in a village). A U-shaped relationship was found between age and support for abortion; the middle-age group (40-49) gave more support than the younger or higher age group.
Curry, Dora Ward; Rattan, Jesse; Huang, Shuyuan; Noznesky, Elizabeth
ABSTRACT 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
Misono, Stephanie; Marmor, Schelomo; Roy, Nelson; Mau, Ted; Cohen, Seth M
Objective To identify factors associated with the likelihood of attending voice therapy among patients referred for it in the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure. Study Design Prospectively enrolled cross-sectional study. Setting CHEER network of community and academic sites. Methods Data were collected on patient-reported demographics, voice-related diagnoses, voice-related handicap (Voice Handicap Index-10), likelihood of attending voice therapy (VT), and opinions on factors influencing likelihood of attending VT. The relationships between patient characteristics/opinions and likelihood of attending VT were investigated. Results A total of 170 patients with various voice-related diagnoses reported receiving a recommendation for VT. Of those, 85% indicated that they were likely to attend it, regardless of voice-related handicap severity. The most common factors influencing likelihood of VT attendance were insurance/copay, relief that it was not cancer, and travel. Those who were not likely to attend VT identified, as important factors, unclear potential improvement, not understanding the purpose of therapy, and concern that it would be too hard. In multivariate analysis, factors associated with greater likelihood of attending VT included shorter travel distance, age (40-59 years), and being seen in an academic practice. Conclusions Most patients reported plans to attend VT as recommended. Patients who intended to attend VT reported different considerations in their decision making from those who did not plan to attend. These findings may inform patient counseling and efforts to increase access to voice care.
The basic elements of a successful family planning (FP) program are variable between countries. Providing better access to modern contraceptives, access to general and reproductive health care, and increasing economic and educational opportunities contribute to reducing fertility rates. Effective distribution is constrained by rural, isolated populations and cultural attitudes. Indonesia has used floating clinics located on boats to reach inaccessible areas; Norplant and hormonal injection availability also contribute to the 53% contraceptive prevalence rate. The Japanese Organization for International Cooperation in Family Planning has shipped bicycles to developing countries. The result has been improved status among peers and greater program success. Contraceptive social marketing programs (CSM) have been successful in some countries to distribute contraceptives through local channels such as shops and stalls; people seem willing to pay also. CSM has been successful in Egypt in increasing condom sales. IUD use increased from 11% to 42% between 1975-88 with CSM. Multimedia promotion that is carefully researched and targeted is another way to increase contraceptive prevalence (CP) rates. A Brazilian multimedia vasectomy campaign led to an 80% monthly increase in Pro-Pater male health clinics. 240,000 women in Turkey were encouraged through multimedia efforts to switch to modern methods. In Zimbabwe, men have been the target of efforts to educate them about the advantages of small families. Women are recruited to implement FP services in INdia and in poor neighborhoods; an increase from 12% to 61% was achieved. Highly motivated workers with a respect for the community's values is essential to any successful FP program as is government support. China's policy has drawn criticism; China has welcomed a UN program which provides financial motivation. Thailand has been successful due to the commitment between public and private sectors; in 17 years CP rose from 10% to
In 1995, in the US, nonlegislative proposals in 11 states centered on efforts to expand Medicaid eligibility for family planning services with three approved; while legislation in six states sought to mandate private insurance coverage of contraceptives. By the end of 1995, at least 11 states had requested permission to waive current federal rules in order to expand Medicaid eligibility for family planning services. These demonstration programs were approved in three states and had the potential of increasing the availability of family planning services for low-income women who would not otherwise qualify for Medicaid. Maryland, Rhode Island, and South Carolina extended postpartum coverage beyond the 60-day limit, and other states sought similar measures. In 1995, in six states, bills aimed at increasing the coverage of reversible contraceptive services offered in private health insurance plans were introduced. The California bill would have required insurance plans to cover prescription contraceptives; however, anti-abortion activists forced a veto of the bill. Some state legislators also proposed incentives for the use of contraceptives for women on welfare, particularly endorsing contraceptive implants. These attempts elicited concern about the imposition of involuntary family planning practices on welfare recipients. In 1995, fewer coercive birth control bills were proposed than in the previous two years. Instead, the child exclusion policy was attempted that would deny additional assistance to a child born to a woman on welfare. Reproductive rights advocates strongly opposed both contraceptive implant use requirements and family caps. Several bills were also proposed to expand access to family planning services to low-income women who voluntarily use contraception. Pennsylvania appropriated funds for family planning services for medically indigent women; however, those funds were limited exclusively to nonpregnant women.
Schwadel, Philip; McCarthy, John D.; Nelsen, Hart M.
The relevance of family income for religious participation in the United States has been largely ignored in recent decades. Addressing this neglect, we focus our attention primarily upon white Catholics, the poorer of whom we reason have fewer options to participate in the context of an increasingly middle-class Church. Analyzing the 1972-2006…
Roring, Catherine Mary
Many risk factors have been identified for children entering Kindergarten. Many at-risk children eventually get classified as having a Specific Learning disability. Some of these risk factors include having a primary home language other than English (Hosp & Reschly, 2004), having non-intact families (Pong, 1997), being of minority status…
Carr, Themba; Shih, Wendy; Lawton, Kathy; Lord, Catherine; King, Bryan; Kasari, Connie
Rates of participation in intervention research have not been extensively studied within autism spectrum disorder. Such research is important given the benefit of early intervention on long-term prognosis for children with autism spectrum disorder. The goals of this study were to examine how family demographic factors predicted treatment…
DeGuzman, Pamela B; Schminkey, Donna L; Koyen, Emily A
In 1965, Nancy Milio established a prenatal and family planning clinic in Detroit, Michigan, to address health disparities and limited access to care among low-income, African American, urban women. Women's health disparities persist today nationally and internationally. Using historical methods, this research analyzes how Milio provided women's health services in the context of the social and political environment. Milio empowered neighborhood women to direct, plan, and participate in the care they received. Successful methods to address disparities in access to family and planning and prenatal care should include empowered participation from the women these programs are intending to serve.