Medical Students' Knowledge of Fertility Awareness-Based Methods of Family Planning.

PubMed

Danis, Peter G; Kurz, Sally A; Covert, Laura M

2017-01-01

Traditional medical school curricula have not addressed fertility awareness-based methods (FABMs) of family planning. The objective of this study was to assess (1) 3-year medical students' knowledge of FABMs of family planning, (2) their confidence in utilizing that knowledge in patient care, and (3) to implement focused education on FABMs to improve knowledge and confidence. Third-year medical students at one institution in the United States were given a 10-question assessment at the beginning of their OB-GYN rotation. Two lectures about FABMs and their clinical applications were given during the rotation. Students were given the same questions at the end of the rotation. Each questionnaire consisted of eight questions to assess a student's knowledge of FABMs and two questions to assess the student's confidence in sharing and utilizing that information in a clinical setting. McNemar's test was used to analyze the data. Two hundred seventy-seven students completed a pretest questionnaire and 196 students completed the posttest questionnaire. Medical knowledge improved from an initial test score of 38.99% to final test score of 53.57% ( p  < 0.05). Confidence in sharing FABM information with patients (0 = very uncomfortable; 5 = very comfortable) improved from 1.51 to 3.00 ( p  < 0.05). Confidence in utilizing FABM to diagnose and treat gynecologic/reproductive problems (0 = not very confident and 5 = very confident) improved from 1.01 to 3.15 ( p  < 0.05). Medical schools may not include FABMs in OB-GYN curriculum; however, to patients, these methods remain a sought after and valid form of family planning. This study shows that brief, focused education can increase medical students' knowledge of and confidence with FABMs of family planning.

A family planning study in Kuala Pilah, Peninsular Malaysia.

PubMed

Vimala Thambypillai

1982-12-01

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

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

PubMed

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

2015-01-01

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

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

PubMed

Barber, Sarah L

2007-03-01

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

On the efficiency of multiple media family planning promotion campaigns.

PubMed

1999-01-01

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

Field Plan and Implementation Package for the Ethnographic Component of the Child and Family Mental Health Project Evaluation.

ERIC Educational Resources Information Center

Macias, Jose; And Others

This report contains the field plan and implementation procedures which were utilized for the observational/focused ethnographic component of Head Start's Child and Family Mental Health (CFMH) Evaluation Project. The introductory section of the document provides the reader with an overview of the Head Start program, its mental health goals, the…

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

PubMed

Memon, Arbia; Hamid, Saima; Kumar, Ramesh

2017-01-01

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

An exploratory analysis of behavioral health care use within families.

PubMed

Lave, Judith R; Peele, Pamela B; Xu, Ying; Scholle, Sarah H; Pincus, Harold Alan

2002-06-01

The authors studied enrollees in employer-sponsored managed health plans to determine the extent of multiple behavioral health consumers within families, use of behavioral health services by employees who have another family member using such services, congruence of diagnoses between two family members using behavioral health services, and the effect on covered charge per behavioral health consumer when other family members use behavioral health services. Claims data from 911 plans sold or managed by a single managed behavioral health care company were examined. The plans provided coverage for 724,789 employees and covered about 1.7 million lives. Family members of employees were identified by the relationship codes on the claims. Service utilization rates were calculated for employees overall and for employees who had spouses or children who used behavioral health services. Mean and median covered charges were determined and were examined by number and type of consumers in the family. The use of behavioral health services was greater among employees whose children or spouses used behavioral health services. Utilization rates varied by the child's or spouse's diagnoses. More than 50 percent of male employees whose children received treatment for a depressive disorder also received such treatment. Congruence of diagnoses within families was noted. Covered charges per person generally increased with the number of family members who used behavioral health services. Greater knowledge about patterns of use of behavioral health services within families may help in improving access to care and developing more effective family interventions.

Planning Ahead or Living a Day at a Time? A Family History of AD and Retirement Planning.

PubMed

Zick, Cathleen D; Smith, Ken R; Mayer, Robert N

2016-09-01

We assess whether a family history of Alzheimer's disease (AD) is associated with the odds that healthy family members' engage in retirement planning activities. This is a cross-sectional study utilizing individual-level data from the Utah Population Database that have been linked to Medicare records and to responses from a retirement planning survey. Engagement in 3 retirement planning activities was estimated as a function of the number of parents and grandparents diagnosed with AD along with a set of fundamental socioeconomic and demographic covariates. Adults who had a parent with AD were 86% more likely to have seen a professional financial advisor and 40% less likely to plan to retire before age 65. Caregiving costs and/or knowledge of the familial risk of developing AD may provide adult children with a forewarning of their own future financial needs that, in turn, motivates them to engage in retirement planning. © The Author(s) 2016.

Evaluation of service quality in family planning clinics in Lusaka, Zambia.

PubMed

Hancock, Nancy L; Vwalika, Bellington; Sitali, Elizabeth Siyama; Mbwili-Muleya, Clara; Chi, Benjamin H; Stuart, Gretchen S

2015-10-01

To determine the quality of contraceptive services in family planning clinics in Lusaka, Zambia, using a standardized approach. We utilized the Quick Investigation of Quality, a cross-sectional survey tool consisting of a facility assessment, client-provider observation and client exit interview, in public-sector family planning clinics. Data were collected on availability of seven contraceptive methods, information given to clients, interpersonal relations between providers and clients, providers' technical competence and mechanisms for continuity and follow-up. Data were collected from five client-provider observations and client exit interviews in each of six public-sector family planning clinics. All clinics had at least two contraceptive methods continuously available for the preceding 6 months. Most providers asked clients about concerns with their contraceptive method (80%) and told clients when to return to the clinic (87%). Most clients reported that the provider advised what to do if a problem develops (93%), described possible side effects (89%), explained how to use the method effectively (85%) and told them when to come for follow-up (83%). Clients were satisfied with services received (93%). This application of the Quick Investigation of Quality showed that the participating family planning clinics in Lusaka, Zambia, were prepared to offer high-quality services with the available commodities and that clients were satisfied with the received services. Despite the subjective client satisfaction, quality improvement efforts are needed to increase contraceptive availability. Although clients perceived the quality of care received to be high, family planning service quality could be improved to continuously offer the full spectrum of contraceptive options. The Quick Investigation of Quality was easily implemented in Lusaka, Zambia, and this simple approach could be utilized in a variety of settings as a modality for quality improvement. Copyright © 2015 Elsevier Inc. All rights reserved.

24 CFR 984.203 - FSS family selection procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Action Plan. (c) Motivation as a selection factor—(1) General. a PHA may screen families for interest, and motivation to participate in the FSS program, provided that the factors utilized by the PHA are those which solely measure the family's interest, and motivation to participate in the FSS program. (2...

24 CFR 984.203 - FSS family selection procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Action Plan. (c) Motivation as a selection factor—(1) General. a PHA may screen families for interest, and motivation to participate in the FSS program, provided that the factors utilized by the PHA are those which solely measure the family's interest, and motivation to participate in the FSS program. (2...

24 CFR 984.203 - FSS family selection procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Action Plan. (c) Motivation as a selection factor—(1) General. a PHA may screen families for interest, and motivation to participate in the FSS program, provided that the factors utilized by the PHA are those which solely measure the family's interest, and motivation to participate in the FSS program. (2...

24 CFR 984.203 - FSS family selection procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Action Plan. (c) Motivation as a selection factor—(1) General. a PHA may screen families for interest, and motivation to participate in the FSS program, provided that the factors utilized by the PHA are those which solely measure the family's interest, and motivation to participate in the FSS program. (2...

24 CFR 984.203 - FSS family selection procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Action Plan. (c) Motivation as a selection factor—(1) General. a PHA may screen families for interest, and motivation to participate in the FSS program, provided that the factors utilized by the PHA are those which solely measure the family's interest, and motivation to participate in the FSS program. (2...

Paying for family planning.

PubMed

Lande, R E; Geller, J S

1991-11-01

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

A dynamic family planning and health campaign.

PubMed

1986-11-01

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

Understanding low uptake of contraceptives in resource-limited settings: a mixed-methods study in rural Burundi.

PubMed

Ndayizigiye, M; Fawzi, M C Smith; Lively, C Thompson; Ware, N C

2017-03-15

Family planning can reduce deaths, improve health, and facilitate economic development in resource-limited settings. Yet, modern contraceptive methods are often underused. This mixed-methods study, conducted in rural Burundi, sought to explain low uptake of contraceptives by identifying utilization barriers. Results may inform development of family planning interventions in Burundi and elsewhere. We investigated uptake of contraceptives among women of reproductive age in two rural districts of Burundi, using an explanatory sequential, mixed-methods research design. We first assessed availability and utilization rates of modern contraceptives through a facility-based survey in 39 health clinics. Barriers to uptake of contraceptives were then explored through qualitative interviews (N = 10) and focus groups (N = 7). Contraceptives were generally available in the 39 clinics studied, yet uptake of family planning averaged only 2.96%. Greater uptake was positively associated with the number of health professionals engaged and trained in family planning service provision, and with the number of different types of contraceptives available. Four uptake barriers were identified: (1) lack of providers to administer contraception, (2) lack of fit between available and preferred contraceptive methods, (3) a climate of fear surrounding contraceptive use, and (4) provider refusal to offer family planning services. Where resources are scarce, availability of modern contraceptives alone will likely not ensure uptake. Interventions addressing multiple uptake barriers simultaneously have the greatest chance of success. In rural Burundi, examples are community distribution of contraceptive methods, public information campaigns, improved training for health professionals and community health workers, and strengthening of the health infrastructure.

Spousal veto over family planning services.

PubMed Central

Cook, R J; Maine, D

1987-01-01

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

Development of an outcome measurement system for service planning for children and youth with special needs

PubMed Central

Kertoy, M K; Russell, D J; Rosenbaum, P; Jaffer, S; Law, M; McCauley, D; Gorter, J W

2013-01-01

Aim This study described the process used in developing an outcome measurement framework for system planning to improve services for children and youth with special needs and their families in a Canadian province. The study reports the results of several parent-completed measures, which would be useful in service planning as well as the acceptability and utility of these measures for use by families and service centres. Methods/results Development of a theoretical framework, consultation with key stakeholders, testing the utility of selected outcome measures and initial dissemination of results were critical elements in the successful development of an outcome system. Consultation with stakeholders confirmed use of the International Classification of Functioning, Disability and Health and the child-within-family-within community model as theoretical frameworks while building valuable partnerships and identifying potential barriers to implementation. Pilot testing showed three outcome measures were feasible for families to complete and the measures provided information about services for children that was valuable to families as well as service providers. Gaps in service delivery were identified and the need for better communication between service providers and communities to facilitate integrated services was highlighted. Conclusion The findings from this study can be used to implement an outcome measurement system for children with special needs and may serve as a resource for international researchers who are working to develop valid tools as well as outcome systems that are useful for system planning. PMID:22845889

Knowledge, attitude and practices on family planning services among adolescents in secondary schools in Hai District, northern Tanzania.

PubMed

Dangat, Celina M; Njau, Bernard

2013-01-01

Almost 65% of the Tanzanian population is under the age of 24 and almost 20 % of the population is aged 15-24 years. Yet, this important group faces many significant health challenges, such as early sexual debut, early pregnancies, risky behaviours and sexually transmitted infections. The objective of this study was to assess knowledge, attitudes and practices on family planning services among adolescents in secondary schools in Hai District in northern Tanzania. A cross sectional study was conducted between April and June 2011 among 316 randomly selected students in 10 secondary schools using a self administered pre-tested questionnaire. Median age of participants was 17 years (15-19 years). Two-thirds (67.4%) of the respondents had adequate level of knowledge on family planning services (FPS) and the most popular source of information was the radio (65.8 %). Being in a lower class (χ2 =8.6; P<0.02) and attending co education schools (χ2 =12.9; P< 0.001) were predictors of inadequate level of knowledge on FPS. Most, 71.2% (225/316) respondents reported that FPS should not be used by adolescents and mentioned several reasons against its use. Less than 6 % (18/316) of all respondents had used FPS in their lifetime, with 44.4 % (8/18) in the past month, 33.3 %(6/18) in the past year, and 22.3 % (4/18) in the past 5 years. In conclusion, most secondary school students in Hai District do not utilize family planning services despite of adequate level of knowledge on FPS. Interventions to improve utilization of FPS among secondary school students should address barriers to low utilization of FPS mentioned in this study.

Is quality of care a key predictor of perinatal health care utilization and patient satisfaction in Malawi?

PubMed

Creanga, Andreea A; Gullo, Sara; Kuhlmann, Anne K Sebert; Msiska, Thumbiko W; Galavotti, Christine

2017-05-22

The Malawi government encourages early antenatal care, delivery in health facilities, and timely postnatal care. Efforts to sustain or increase current levels of perinatal service utilization may not achieve desired gains if the quality of care provided is neglected. This study examined predictors of perinatal service utilization and patients' satisfaction with these services with a focus on quality of care. We used baseline, two-stage cluster sampling household survey data collected between November and December, 2012 before implementation of CARE's Community Score Card© intervention in Ntcheu district, Malawi. Women with a birth during the last year (N = 1301) were asked about seeking: 1) family planning, 2) antenatal, 3) delivery, and 4) postnatal care; the quality of care received; and their overall satisfaction with the care received. Specific quality of care items were assessed for each type of service, and up to five such items per type of service were used in analyses. Separate logistic regression models were fitted to examine predictors of family planning, antenatal, delivery, and postnatal service utilization and of complete satisfaction with each of these services; all models were adjusted for women's socio-demographic characteristics, perceptions of the closest facility to their homes, service use indicators, and quality of care items. We found higher levels of perinatal service use than previously documented in Malawi (baseline antenatal care 99.4%; skilled birth attendance 97.3%; postnatal care 77.5%; current family planning use 52.8%). Almost 73% of quality of perinatal care items assessed were favorably reported by > 90% of women. Women reported high overall satisfaction (≥85%) with all types of services examined, higher for antenatal and postnatal care than for family planning and delivery care. We found significant associations between perceived and actual quality of care and both women's use and satisfaction with the perinatal health services received. Quality of care is a key predictor of perinatal health service utilization and complete patient satisfaction with such services in Malawi. The current heightened attention toward perinatal health services and outcomes should be coupled with efforts to improve the actual quality of care offered to women in this country.

Treatment Fidelity Among Family Health Promoters Delivering a Physical Activity and Nutrition Intervention to Immigrant and Refugee Families.

PubMed

Bronars, Carrie A; Hanza, Marcelo M; Meiers, Sonja J; Patten, Christi A; Clark, Matthew M; Nigon, Julie A; Weis, Jennifer A; Wieland, Mark L; Sia, Irene G

2017-04-01

Lack of treatment fidelity can be an important source of variation affecting the credibility and utility of outcomes from behavioral intervention research. Development and implementation of a well-designed treatment fidelity plan, especially with research involving underserved populations, requires careful conceptualization of study needs in conjunction with what is feasible in the population. The purpose of this article is to review a fidelity-monitoring plan consistent with the National Institutes of Health Behavior Change Consortium guidelines (e.g., design, training, delivery, receipt, and enactment) for an intervention trial designed to improve physical activity and nutrition among immigrant and refugee families. Description of the fidelity monitoring plan is provided and challenges related to monitoring treatment fidelity in a community-based participatory intervention for immigrant and refugee families are discussed.

Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC): a qualitative study.

PubMed

Adams, Sherri; Cohen, Eyal; Mahant, Sanjay; Friedman, Jeremy N; Macculloch, Radha; Nicholas, David B

2013-01-19

The Medical Home model recommends that Children with Special Health Care Needs (CSHCN) receive a medical care plan, outlining the child's major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs) of children with medical complexity (CMC). This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15) and parents (n = 15) of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how and when to best utilize care plans within family-centered models of care.

Perinatal AIDS: Permanency Planning for the African-American Community.

ERIC Educational Resources Information Center

Taylor-Brown, Susan; And Others

1992-01-01

Conducted a retrospective chart review utilizing Norwood's model on the families of the 83 infants whose cord blood was positive for maternal HIV antibodies or who were congenitally infected with HIV. Discusses implications for permanency planning in the context of their impact on the African-American community. (KS)

Structural Determinants in Family Planning Service Utilization in Ethiopia: EDHS 2011 Analysis

PubMed Central

Gizachew Balew, Jembere; Cho, Yongtae; Tammy Kim, Clara; Ko, Woorim

2015-01-01

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

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

PubMed

Taniguchi, H

1985-11-01

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

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

PubMed Central

2010-01-01

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

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

PubMed

Qureshi, Asma M

2010-11-09

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

Treatment Fidelity among Family Health Promoters Delivering a Physical Activity and Nutrition Intervention to Immigrant and Refugee Families

ERIC Educational Resources Information Center

Bronars, Carrie A.; Hanza, Marcelo M.; Meiers, Sonja J.; Patten, Christi A.; Clark, Matthew M.; Nigon, Julie A.; Weis, Jennifer A.; Wieland, Mark L.; Sia, Irene G.

2017-01-01

Lack of treatment fidelity can be an important source of variation affecting the credibility and utility of outcomes from behavioral intervention research. Development and implementation of a well-designed treatment fidelity plan, especially with research involving underserved populations, requires careful conceptualization of study needs in…

Maternal and child health and family planning service utilization in Guatemala: implications for service integration.

PubMed

Seiber, Eric E; Hotchkiss, David R; Rous, Jeffrey J; Berruti, Andrés A

2005-07-01

Does the utilization of modern maternal and child health (MCH) services influence subsequent contraceptive use? The answer to this question holds important implications for proposals which advocate MCH and family planning service integration. This study uses data from the 1995/6 Guatemalan Demographic Health Survey and its 1997 Providers Census to test the influence of MCH service utilization on individual contraceptive use decisions. We use a full-information maximum likelihood regression model to control for unobserved heterogeneity. This model produces estimates of the MCH effect, independent of individual women's underlying receptiveness to MCH and contraceptive messages. The results of the analysis indicate that the intensity of MCH service use is indeed positively associated with subsequent contraceptive use among Guatemalan women, even after controlling for observed and unobserved individual- , household- , and community-level factors. Importantly, this finding holds even after controlling for the unobserved factors that 'predispose' some women to use both types of services. Simulations reveal that, for these Guatemalan women, key determinants such as age and primary schooling work indirectly through MCH service use to increase contraceptive utilization.

[Diversification is the financial alternative for family planning].

PubMed

Castro Villamil, R

1991-12-01

During the 1960s, when family planning services were institutionalized in Colombia by PROFAMILIA, abundant foreign assistance was readily available. Few questions were asked about the longterm funding of family planning programs or the need for financial self-sufficiency. The emphasis was on program development without great attention to costs. Beginning around the early 1980s, international donors began to place a higher priority and greater investment in the incipient family planning programs of less developed countries. At present a greater number and higher quality of services are being demanded from PROFAMILIA at the lowest possible cost. Efficiency has replaced efficacy as the overriding goal. PROFAMILIA, due to its excellent results, has lost priority in the eyes of international donors. It has therefore reoriented its financing strategies toward a short, medium, and long term plan to reduce its financial dependence on international donor agencies. Self-sufficiency could be increased through various means, including total government subsidy, charging fees for services and materials sufficient to cover program costs, establishing services and marketing programs aside from family planning programs for the specific purpose of obtaining funds to cover program deficits, or establishing accounting and operational controls to reduce costs through greater efficiency. But large government subsidies are unlikely in a time of budgetary constraints, and raising fees for family planning users would exclude a large number of low-income clients from the family planning program. Cost reduction and implementation of diversified programs should therefore be emphasized for the present. The diversified program should be related to family planning so that use can be made of idle resources. PROFAMILIA has emphasized surgical procedures and medical consultations to utilize clinic facilities more fully and to increase income without increasing fixed costs. In 1990, foreign donations accounted for 47.3% of PROFAMILIA income and PROFAMILIA contributed the rest. 18.1% came from family planning activities, 20.2% from surgical procedures, consultations, sales of medications, and laboratory services, and 20.2% from service contracts, national donations, interest, and other sources. In the same year, family planning programs accounted for 68.9% of expenditures, diversification programs for 11.5%, technical assistance for 8.6%, and administration for 11%. The income and expenditure data indicate that the diversification programs make a significant financial contribution to the family planning program, at the same time reducing dependency on international donor agencies.

Family planning education.

PubMed

Hamburg, M V

1983-02-01

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

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

PubMed

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

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

Measuring the usefulness of family planning job aids following distribution at training workshops.

PubMed

Tumlinson, Katherine; Hubacher, David; Wesson, Jennifer; Lasway, Christine

2010-09-01

A job aid is a tool, such as a flowchart or checklist, that makes it easier for staff to carry out tasks by providing quick access to needed information. Many public health organizations are engaged in the production of job aids intended to improve adherence to important medical guidelines and protocols, particularly in resource-constrained countries. However, some evidence suggests that actual use of job aids remains low. One strategy for improving utilization is the introduction of job aids in training workshops. This paper summarizes the results of two separate evaluations conducted in Uganda and the Dominican Republic (DR) which measured the usefulness of a series of four family planning checklists 7-24 months after distribution in training workshops. While more than half of the health care providers used the checklists at least once, utilization rates were sub-optimal. However, the vast majority of those providers who utilized the checklists found them to be very useful in their work.

The politics of Latin American family-planning policy.

PubMed

Weaver, J L

1978-07-01

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

Varying family planning strategies across age categories: differences in factors associated with current modern contraceptive use among youth and adult women in Luanda, Angola.

PubMed

Prata, Ndola; Bell, Suzanne; Weidert, Karen; Nieto-Andrade, Benjamin; Carvalho, Adelaide; Neves, Isilda

2016-01-01

The objective of this study is to identify factors associated with current modern contraceptive use among Angolan women. By differentiating according to age groups (15-24 and 25-49 years), this study aimed to help family planning program planners better tailor interventions to improve utilization of modern contraception. A household survey was used to collect data from 1,545 women of reproductive age living in Luanda Province, Angola. Data on sociodemographic characteristics, reproductive behavior and intentions, contraceptive knowledge and use, and attitudes and beliefs regarding contraception and abortion were collected. The analyses were stratified based on age: 15-24 years (youth) and 25-49 years (adult). Multivariate logistic regression models were built for each age group, adding different subsets of variables in groups to see how relationships changed across the models. Common factors associated with modern contraceptive use among all ages include education level, perceived contraceptive accessibility, contraceptive knowledge, communication with partner about family planning in last year, and self-efficacy. Exposure to family planning information in the media in the last few months, perceived partner approval of family planning, and marital status were all positively associated with current modern contraceptive use among women aged 15-24 years. Meanwhile, receiving information about family planning from a pharmacy in the last year was uniquely associated with current modern contraceptive use among women aged 25-49 years. Young women in Luanda, Angola seem to have a unique set of factors affecting their contraceptive use. These findings highlight the need for family planning programs to cater services and messages toward specific age groups.

Activities pattern of planned settlement’s residence and its influence toward settlement design

NASA Astrophysics Data System (ADS)

Nirfalini Aulia, Dwira

2018-03-01

Everyday activity of residents in a housing area will create activities pattern. Utilization of public spaces in a housing area with repeating activities pattern will affect the design of public spaces. Changes in public space usage in a housing area happen as a result of residents’ activities pattern. The goal of this paper is to identify residents’ activity pattern and connect its influence towards public spaces utilization in planned housing in micro and urban area in macro. Housing residents classified into four respondent groups based on marriage status which is unmarried, single parents, the family without child and family with a child. The method used in this research is the qualitative descriptive approach. Research finding showed that housing area with housing facilities capable of creating happiness and convenience for its residents doing their activities in public spaces.

The Traditional Birth Attendant in Maternal and Child Health and Family Planning: A Guide to Her Training and Utilization.

ERIC Educational Resources Information Center

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…

An all time low utilization of intrauterine contraceptive device as a birth spacing method--a qualitative descriptive study in district Rawalpindi, Pakistan.

PubMed

Khan, Amna; Shaikh, Babar Tasneem

2013-02-09

Pakistan was among the leading countries in south Asia which started the family planning program in late 50s, forecasting the need to control the population. Despite this early intervention, fertility rate has declined but slower in Pakistan as compared to most other Asian countries. Pakistan has almost a stagnant contraceptive prevalence rate for more than a decade now, perhaps owing to the inadequate performance of the family planning programs. The provision and use of long term contraceptives such as IUCD has always been low (around 2%) and associated with numerous issues. Married women who want to wait before having another child, or end childbearing altogether, are not using any long term method of contraception. A descriptive qualitative study was conducted from May to July 2012, to explore and understand the perceptions of women regarding the use of IUCDs and to understand the challenges/issues at the service provider's end. Six FGDs with community women and 12 in-depth interviews were conducted with family planning providers. The data was analyzed using the Qualitative Content Analysis approach. The study revealed that the family planning clients are reluctant to use IUCDs because of a number of myths and misconceptions associated with the method. They have reservations about the provider's capability and quality of care at the facility. Private health providers are not motivated and are reluctant to provide the IUCDs because of inadequate counseling skills, lack of competence and improper supporting infrastructure. Government programs either do not have enough supplies or trained staff to promote the IUCD utilization. Besides a well-designed community awareness campaign, providers' communication and counseling skills have to be enhanced, as these are major contributing factors in IUCD acceptance. Ongoing training of all family planning service providers in IUCD insertion is very important, along with strengthening of their services.

Accessibility of long-term family planning methods: a comparison study between Output Based Approach (OBA) clients verses non-OBA clients in the voucher supported facilities in Kenya.

PubMed

Oyugi, Boniface; Kioko, Urbanus; Kaboro, Stephen Mbugua; Gikonyo, Shadrack; Okumu, Clarice; Ogola-Munene, Sarah; Kalsi, Shaminder; Thiani, Simon; Korir, Julius; Odundo, Paul; Baltazaar, Billy; Ranji, Moses; Muraguri, Nicholas; Nzioka, Charles

2017-03-27

The study seeks to evaluate the difference in access of long-term family planning (LTFP) methods among the output based approach (OBA) and non-OBA clients within the OBA facility. The study utilises a quasi experimental design. A two tailed unpaired t-test with unequal variance is used to test for the significance variation in the mean access. The difference in difference (DiD) estimates of program effect on long term family planning methods is done to estimate the causal effect by exploiting the group level difference on two or more dimensions. The study also uses a linear regression model to evaluate the predictors of choice of long-term family planning methods. Data was analysed using SPSS version 17. All the methods (Bilateral tubal ligation-BTL, Vasectomy, intrauterine contraceptive device -IUCD, Implants, and Total or combined long-term family planning methods -LTFP) showed a statistical significant difference in the mean utilization between OBA versus non-OBA clients. The difference in difference estimates reveal that the difference in access between OBA and non OBA clients can significantly be attributed to the implementation of the OBA program for intrauterine contraceptive device (p = 0.002), Implants (p = 0.004), and total or combined long-term family planning methods (p = 0.001). The county of residence is a significant determinant of access to all long-term family planning methods except vasectomy and the year of registration is a significant determinant of access especially for implants and total or combined long-term family planning methods. The management level and facility type does not play a role in determining the type of long-term family planning method preferred; however, non-governmental organisations (NGOs) as management level influences the choice of all methods (Bilateral tubal ligation, intrauterine contraceptive device, Implants, and combined methods) except vasectomy. The adjusted R 2 value, representing the percentage of the variance explained by various models, is larger than 18% for implants and total or combined long-term family planning. The study showed that the voucher services in Kenya has been effective in providing long-term family planning services and improving access of care provided to women of reproductive age. Therefore, voucher scheme can be used as a tool for bridging the gap of unmet needs of family planning in Kenya and could potentially be more effective if rolled out to other counties.

Shared Decision-Making in Youth Mental Health Care: Using the Evidence to Plan Treatments Collaboratively.

PubMed

Langer, David A; Jensen-Doss, Amanda

2016-12-02

The shared decision-making (SDM) model is one in which providers and consumers of health care come together as collaborators in determining the course of care. The model is especially relevant to youth mental health care, when planning a treatment frequently entails coordinating both youth and parent perspectives, preferences, and goals. The present article first provides the historical context of the SDM model and the rationale for increasing our field's use of SDM when planning psychosocial treatments for youth and families. Having established the potential utility of SDM, the article then discusses how to apply the SDM model to treatment planning for youth psychotherapy, proposing a set of steps consistent with the model and considerations when conducting SDM with youth and families.

Shared Decision-Making in Youth Mental Health Care: Using the Evidence to Plan Treatments Collaboratively

PubMed Central

Langer, David A.; Jensen-Doss, Amanda

2017-01-01

The shared decision-making (SDM) model is one in which providers and consumers of health care come together as collaborators in determining the course of care. The model is especially relevant to youth mental health care, when planning a treatment frequently entails coordinating both youth and parent perspectives, preferences, and goals. The present paper first provides the historical context of the SDM model and the rationale for increasing our field's use of SDM when planning psychosocial treatments for youth and families. Having established the potential utility of SDM, the paper then discusses how to apply the SDM model to treatment planning for youth psychotherapy, proposing a set of steps consistent with the model and considerations when conducting SDM with youth and families. PMID:27911081

Quality of family planning services in primary health centers of Jimma Zone, Southwest Ethiopia.

PubMed

Tafese, Fikru; Woldie, Mirkuzie; Megerssa, Berhane

2013-11-01

Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted to assess the quality of family planning services in primary health centers of Jimma Zone, Southwest Ethiopia. A cross-sectional facility based study was conducted from March 1(st)-25(th), 2011 among family planning clients of government primary health care centers in southwest Ethiopia. Exit interview of 301 family planning clients identified through systematic random sampling technique was carried out using a pre-tested structured questionnaire. Availability of resources was checked using provider interview and inventory checklist. Moreover, a total of 150 consultation sessions were observed using checklist. Descriptive statistics and linear regression coefficients were generated to meet the objective of the study. There was a shortage of some medical equipment, trained staffs, and information education and communication materials (IEC) in all of the family planning clinics. The mean waiting time at the service delivery points and consultation duration were 16.4 and 10.5 minutes, respectively. The providers used at least one information education and communication material in 33.3% of the consultation sessions. The overall satisfaction score was 8.64. Clients' perception on adequacy of information during consultation (β=0.24; ( 95%CI=0.02-0.16) ease of getting the clinic site, short waiting time (β=0.17; 95%CI=0.15-029) and educational level (β=0.09; 95%CI =0.09-0.29) were significantly associated with overall satisfaction. The findings of this study showed that there was lack of critical resources for the provision of quality family planning services in all of the primary health care centers included in the study. This has affected important aspects of service provision including the use of IEC materials during consultations. Hence, it is advisable that health managers of the health facilities and the district health office ensure improved availability of trained personnel, IEC materials and other supplies at the clinics.

Healthcare Provider Perceptions of Causes and Consequences of ICU Capacity Strain in a Large Publicly Funded Integrated Health Region: A Qualitative Study.

PubMed

Bagshaw, Sean M; Opgenorth, Dawn; Potestio, Melissa; Hastings, Stephanie E; Hepp, Shelanne L; Gilfoyle, Elaine; McKinlay, David; Boucher, Paul; Meier, Michael; Parsons-Leigh, Jeanna; Gibney, R T Noel; Zygun, David A; Stelfox, Henry T

2017-04-01

Discrepancy in the supply-demand relationship for critical care services precipitates a strain on ICU capacity. Strain can lead to suboptimal quality of care and burnout among providers and contribute to inefficient health resource utilization. We engaged interprofessional healthcare providers to explore their perceptions of the sources, impact, and strategies to manage capacity strain. Qualitative study using a conventional thematic analysis. Nine ICUs across Alberta, Canada. Nineteen focus groups (n = 122 participants). None. Participants' perspectives on strain on ICU capacity and its perceived impact on providers, families, and patient care were explored. Participants defined "capacity strain" as a discrepancy between the availability of ICU beds, providers, and ICU resources (supply) and the need to admit and provide care for critically ill patients (demand). Four interrelated themes of contributors to strain were characterized (each with subthemes): patient/family related, provider related, resource related, and health system related. Patient/family-related subthemes were "increasing patient complexity/acuity," along with patient-provider communication issues ("paucity of advance care planning and goals-of-care designation," "mismatches between patient/family and provider expectations," and "timeliness of end-of-life care planning"). Provider-related factor subthemes were nursing workforce related ("nurse attrition," "inexperienced workforce," "limited mentoring opportunities," and "high patient-to-nurse ratios") and physician related ("frequent turnover/handover" and "variations in care plan"). Resource-related subthemes were "reduced service capability after hours" and "physical bed shortages." Health system-related subthemes were "variable ICU utilization," "preferential "bed" priority for other services," and "high ward bed occupancy." Participants perceived that strain had negative implications for patients ("reduced quality and safety of care" and "disrupted opportunities for patient- and family-centered care"), providers ("increased workload," "moral distress," and "burnout"), and the health system ("unnecessary, excessive, and inefficient resource utilization"). Engagement with frontline critical care providers is essential for understanding their experiences and perspectives regarding strained capacity and for the development of sustainable strategies for improvement.

Impact of Family Planning Health Education on the Knowledge and Attitude among Yasoujian Women

PubMed Central

Mahamed, Fariba; Parhizkar, Saadat; Shirazi, Alireza Raygan

2012-01-01

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. PMID:22980158

Improving Care for Children With Complex Needs

ClinicalTrials.gov

2017-10-10

Medically Complex Children; Care Coordination; Case Manager; Care Manager; Collaborative Care; Disease Management; Patient Care Team or Organization; Managed Care; Children With Chronic Conditions; Children With Special Health Care Needs; Shared Care Plan; Patient Care Plan; Health Care and Resource Utilization; Adherence to Care; Functional Status and Productivity; Health Related Quality of Life; Satisfaction With Care; Care Coordinator; Family Experience of Care; Quality Health Care

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia.

PubMed

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2013-10-01

To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples' voluntary HIV counselling and testing services in Lusaka, Zambia. Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching. We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long-acting reversible contraceptive (LARC) methods, and that fertility goal based, LARC-focused family planning be offered as an integral part of HIV prevention services.

Desire for more children, contraceptive use and unmet need for family planning in a remote area of Bali, Indonesia.

PubMed

Withers, Mellissa; Kano, Megumi; Pinatih, Gde Ngurah Indraguna

2010-07-01

Exploring fertility preferences in relation to contraceptive use can increase the understanding of future reproductive behaviour and unmet family planning needs. This knowledge can help assist women in meeting their reproductive goals. The influences on the desire for more children and current contraceptive use were examined among 1528 married women of reproductive age in an isolated community in Bali, Indonesia, using multivariate logistic regression analysis. Women who were younger, had fewer living children, had given birth in the past year and had regular access to health services were more likely to desire children. Being older, having fewer living children, not having regular access to health services, having given birth in the past year and having the desire for more children were associated with a lower likelihood of using contraception. Women with regular access to health care are more likely to desire more children, probably because they are confident in their ability to have successful birth outcomes. However, specialized clinics or family planning outreach workers may be required to reduce barriers to service utilization among some groups. The findings of this study identify key target populations for family planning, including older women and postpartum women--groups that may not perceive themselves to be at risk for unintended pregnancy. Meeting unmet need for family planning among these groups could help women meet their fertility goals, as well as reduce maternal morbidity and mortality.

7 CFR 2003.10 - Rural Development State Offices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... to program plans approved for the State by the Under Secretary, and rendering staff advisory and... Multi-Family Housing loans and grants, Community Facility, Water and Waste Disposal, Business and...

42 CFR 59.206 - Evaluation and grant award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY... and health services personnel; (iii) Improvement in the utilization and career development of..., particularly in rural areas, through new or improved approaches to program planning and deployment of resources...

The impact of national health insurance on the utilization of health care services by pregnant women: the case in Taiwan.

PubMed

Chen, L M; Wen, S W; Li, C Y

2001-03-01

Substantially increased funding for health care services occurred in Taiwan after the implementation of a national health insurance plan in 1995. This study attempts to examine the impact of this national health insurance plan on the utilization of prenatal and intrapartum care services. Nationally representative surveys of all pregnant women in Taiwan in 1989 (1,662 participants) and in 1996 (3,626 participants) were included in the analysis. We first compared the distribution of birth characteristics between the two surveys. We then calculated the rate of utilization of various prenatal and intrapartum care services in the two surveys in the overall sample and in subsamples, stratified by maternal education, age, and parity. The utilization of most prenatal and intrapartum care services, especially the complicated laboratory tests, increased in 1996 compared to 1989. For example, the proportion of women who received amniocentesis increased from 1.62% in 1989 to 5.60% in 1996 and German measles testing increased from 5.96% to 27.11%. By contrast, the proportion of women who received consultation services was stable over time, or for family planning, consultation declined from 33.21% to 27.00%. These changes in utilization over time were consistently observed across different maternal education, age, and parity groups. The utilization of prenatal and intrapartum care services, especially for the more expensive services, has substantially increased in Taiwan since the implementation of the national health insurance. For countries considering similar national health insurance plan, it may be helpful to consider cost-containing measures before the implementation of such a plan.

The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Health Care Utilization and Spending Among Carve-In Enrollees.

PubMed

Harwood, Jessica M; Azocar, Francisca; Thalmayer, Amber; Xu, Haiyong; Ong, Michael K; Tseng, Chi-Hong; Wells, Kenneth B; Friedman, Sarah; Ettner, Susan L

2017-02-01

The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA's impact on BH expenditures and utilization among "carve-in" enrollees. We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled in self-insured plans from large employers. An interrupted time series study design with segmented regression analysis estimated monthly time trends of per-member spending and use before (2008-2009), during (2010), and after (2011-2013) MHPAEA compliance (N=179,506,951 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits, medication management, individual and family psychotherapy); intermediate care utilization (structured outpatient, day treatment, residential); and inpatient utilization. MHPAEA was associated with increases in monthly per-member total spending, plan spending, assessment/diagnostic evaluation visits [respective immediate increases of: $1.05 (P=0.02); $0.88 (P=0.04); 0.00045 visits (P=0.00)], and individual psychotherapy visits [immediate increase of 0.00578 visits (P=0.00) and additional increases of 0.00017 visits/mo (P=0.03)]. MHPAEA was associated with modest increases in total and plan spending and outpatient utilization; for example, in July 2012 predicted per-enrollee plan spending was $4.92 without MHPAEA and $6.14 with MHPAEA. Efforts should focus on understanding how other barriers to BH care unaddressed by MHPAEA may affect access/utilization. Future research should evaluate effects produced by the Affordable Care Act's inclusion of BH care as an essential health benefit and expansion of MHPAEA protections to the individual and small group markets.

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia

PubMed Central

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2014-01-01

Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689

Unintended pregnancy and its correlates among currently pregnant women in the Kwango District, Democratic Republic of the Congo.

PubMed

Dhakal, Sarita; Song, Jin Sung; Shin, Dong Eun; Lee, Tae Ho; So, Ae Young; Nam, Eun Woo

2016-06-16

Unintended pregnancy is an important reproductive health problem in both developed and developing countries and is most prominent in low-middle income countries. In the Democratic Republic of the Congo, the total fertility rate is high at 5.9 births per women, and a mother's probabily of dying at an age between 15-49 years is also high (53 %). Women with unintended pregnancies are less likely to utilize available necessary services for their own health and the health of their children. Therefore, unintended pregnancy is a crucial factor of maternal health in the Democratic Republic of the Congo. This study aims to identify the prevalence of unintended pregnancy and its associated factors in the Democratic Republic of the Congo. Data were collected from June 20 to 29, 2014 among women aged 15-49 years who had children younger than 5 years old. The women were from a representative sample of 602 households. Multiple logistic regression analysis was performed to evaluate the associations between the dependent variable and the explanatory variables. Unintended pregnancy was reported in 51.4 % of the respondents. Multivariate logistic regression showed an association between education status (AOR, 3.4; CI, 1.21-9.90) and age of the last child (AOR, 5.17; CI, 1.23-21.70) with an unintended pregnancy. Unintended pregnancies were low among women who owner a cell phone (AOR, 0.18; CI, 0.47-0.73) and those who were aware of family planning method (AOR 0.20; CI, 0.06-0.60). The unintended pregnancy rate high and was significantly associated with female education, previous use of family planning methods, ownership of cell phone, and age of the last child. Maternal health interventions should focus on increasing family planning service utilization, awareness of family planning, and access to communication and income.

Extending Social Cognition Models of Health Behaviour

ERIC Educational Resources Information Center

Abraham, Charles; Sheeran, Paschal; Henderson, Marion

2011-01-01

A cross-sectional study assessed the extent to which indices of social structure, including family socio-economic status (SES), social deprivation, gender and educational/lifestyle aspirations correlated with adolescent condom use and added to the predictive utility of a theory of planned behaviour model. Analyses of survey data from 824 sexually…

Using Commercial Resources in Population Communications Programs.

ERIC Educational Resources Information Center

Sweeney, William O.

The author defines populations communications as all information, education, and other activities which can produce changes in attitudes and behavior towards contraception, family planning, and population growth. He discusses in this paper the effort made in 27 nations to utilize commercial, profit-making goods and services for the purpose of…

FAmily CEntered (FACE) advance care planning: Study design and methods for a patient-centered communication and decision-making intervention for patients with HIV/AIDS and their surrogate decision-makers.

PubMed

Kimmel, Allison L; Wang, Jichuan; Scott, Rachel K; Briggs, Linda; Lyon, Maureen E

2015-07-01

Although the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a chronic illness, disease-specific advance care planning has not yet been evaluated for the palliative care needs of adults with HIV/AIDS. This prospective, longitudinal, randomized, two-arm controlled clinical trial aims to test the efficacy of FAmily CEntered advance care planning among adults living with AIDS and/or HIV with co-morbidities on congruence in treatment preferences, healthcare utilization, and quality of life. The FAmily CEntered intervention arm is two face-to-face sessions with a trained, certified facilitator: Session 1) Disease-Specific Advance Care Planning Respecting Choices Interview; Session 2) Completion of advance directive. The Healthy Living Control arm is: Session 1) Developmental/Relationship History; Session 2) Nutrition. Follow-up data will be collected at 3, 6, 12, and 18 months post-intervention. A total of 288 patient/surrogate dyads will be enrolled from five hospital-based, out-patient clinics in Washington, District of Columbia. Participants will be HIV positive and ≥ 21 years of age; surrogates will be ≥ 18 years of age. Exclusion criteria are homicidality, suicidality, psychosis, and impaired cognitive functioning. We hypothesize that this intervention will enhance patient-centered communication with a surrogate decision-maker about end of life treatment preferences over time, enhance patient quality of life and decrease health care utilization. We further hypothesize that this intervention will decrease health disparities for Blacks in completion of advance directives. If proposed aims are achieved, the benefits of palliative care, particularly increased treatment preferences about end-of-life care and enhanced quality of life, will be extended to people living with AIDS. Copyright © 2015 Elsevier Inc. All rights reserved.

The meaning of early intervention: A parent's experience and reflection on interactions with professionals using a phenomenological ethnographic approach.

PubMed

Lee, Yoon H

2015-01-01

The purpose of this study is to describe how a parent's partnership with professionals progresses and evolves throughout the service provisioning process. Using a phenomenological ethnographic approach, the lived reality of a family is depicted as the parent walks through different stages of the Individualized Family Service Plan process over a 6-month period. Data concerning parent-professional interactions were obtained via observation notes and document reviews whereas data regarding parent perceptions were collected through multiple individual interviews. Overall, the parent conveyed her satisfaction with actual services especially regarding the professionals' knowledge and parental advocacy. However, the parent also indicated frustration with the early intervention planning process and "obligated" partnerships with providers. In particular, the providers' lack of sensitivity was noted, and greater emotional and psychological support was suggested. The overall process of developing partnerships with professionals can be excessively intrusive to the family's lives. Future research directions are offered as a contribution for the development of improved policies for early intervention programs regarding family-centered practice, utilizing the perspectives of families.

Community influences on modern contraceptive use among young women in low and middle-income countries: a cross-sectional multi-country analysis.

PubMed

Mutumba, Massy; Wekesa, Eliud; Stephenson, Rob

2018-04-02

Despite investment in family planning programs and education, unmet need for family planning remains high among young women (aged 15-24) in low and middle-income countries, increasing the risk for unwanted pregnancies and adverse social and reproductive health outcomes. There is a dearth of cross-national research that identifies the differential impact of community level factors among youth in low and middle-income countries (LMICs), which is imperative for the design of structural level interventions aimed at increasing family planning use. Grounded in the socio-ecological framework, this paper utilizes Demographic and Health Survey (DHS) from 52 LMICs to examine the influence of community level reproductive, gender, fertility, literacy and economic indicators on modern contraceptive use among female youth. Analyses are conducted using multi-level logistic regressions with random community-level effects. Our findings highlight the positive influence of community level education attainment and negative influence of gender and fertility related norms on young women's contraceptive use. Additionally, increased exposure to mass media did not positively influence young women's uptake of modern contraceptive methods. Taken together, findings indicate that young women's contraceptive decision-making is greatly shaped by their social contexts. The commonalities and regional variations in community level influences provide support for both structural level interventions and tailored regional approaches to family planning interventions.

Reproductive health information for young women in Kazakhstan: disparities in access by channel.

PubMed

Buckley, Cynthia; Barrett, Jennifer; Adkins, Kristen

2008-01-01

This study explores young women's reliance on reproductive and sexual health information channels, examining the relationship between information sources and reproductive health knowledge. Utilizing 1995 and 1999 Kazakhstan Demographic and Health Surveys, we investigate access to reproductive health knowledge among young women (ages 15-24) during a key period in the development of wide-scale reproductive health programs in Kazakhstan. Despite reproductive health campaigns throughout the 1990s, we find consistently high proportions of young women without family planning information access. Among young women with access to information, few received information from channels most strongly linked to knowledge and behavioral changes (family and medical professionals). Mass media sources and peer information networks remained the most often utilized channels. Urban residence, non-Kazakh ethnicity, older age (20-24), and higher education significantly increased the odds of accessing family planning information among young Kazakhstani women, and these same factors were especially important in terms of the relative odds of accessing medical and parental channels. While overall contraceptive knowledge and prevalence rose in Kazakhstan during the 1990s, we find knowledge varied by the information channel accessed. Findings also indicate that young women, regardless of marital status, possessed consistently low levels of reproductive health knowledge at the decade's end.

Social and traditional practices and their implications for family planning: a participatory ethnographic study in Renk, South Sudan.

PubMed

Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid

2017-01-17

Understanding what determines family size is crucial for programmes that aim to provide family planning services during and after conflicts. Recent research found that development agents in post conflict settings do not necessarily take time to understand the context adequately, translate their context understanding into programming, or adjust programming in the light of changes. South Sudan, a country that has been suffering from war for almost 50 years, has one of the highest maternal death rates and the lowest contraceptive utilization rates in the world. This research used Participatory Ethnographic Evaluation and Research (PEER) to provide a contextualised understanding of social and traditional practices and their implications for family planning. Fourteen women were recruited from 14 villages in Renk County in South Sudan in the period 2010-2012. They were trained to design research instruments, conduct interviews, collect narratives and stories and analyse data to identify, prioritize and address their maternal health concerns. As a result of wars, people are under pressure to increase their family sizes and thus increase the nation's population. This is to compensate for the men perished in war and the high child death rates. Large family size is regarded as a national obligation. Women are caught up in a vicious cycle of high fertility and a high rate of child mortality. Determinants of large family size include: 1) Social and cultural practices, 2) Clan lineage and 3) Compensation for loss of family members. Three strategies are used to increase family size: 1) Marry several women, 2) Husbands taking care of women, and 3) Financial stability. Consequences of big families include: 1) Financial burden, 2) Fear of losing children, 3) Borrowing children and 4) Husband shirking responsibility. The desire to have a big family will remain in South Sudan until families realise that their children will live longer, that their men will not be taken by the war, and that the costs of living will be met. In order to generate demand for family planning in South Sudan, priority should be given first to improve infant and child health.

Provider continuity in family medicine: does it make a difference for total health care costs?

PubMed

De Maeseneer, Jan M; De Prins, Lutgarde; Gosset, Christiane; Heyerick, Jozef

2003-01-01

International comparisons of health care systems have shown a relationship at the macro level between a well-structured primary health care plan and lower total health care costs. The objective of this study was to assess whether provider continuity with a family physician is related to lower health care costs using the individual patient as the unit of analysis. We undertook a study of a stratified sample of patients (age, sex, region, insurance company) for which 2 cohorts were constructed based on the patients' utilization pattern of family medicine (provider continuity or not). Patient utilization patterns were observed for 2 years. The setting was the Belgian health care system. The participants were 4,134 members of the 2 largest health insurance companies in 2 regions (Aalst and Liège). The main outcome measures were the total health care costs of patients with and without provider continuity with a family physician, controlling for variables known to influence health care utilization (need factors, predisposing factors, enabling factors). Bivariate analyses showed that patients who were visiting the same family physician had a lower total cost for medical care. A multivariate linear regression showed that provider continuity with a family physician was one of the most important explanatory variables related to the total health care cost. Provider continuity with a family physician is related to lower total health care costs. This finding brings evidence to the debate on the importance of structured primary health care (with high continuity for family practice) for a cost-effective health policy.

42 CFR 431.55 - Waiver of other Medicaid requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... restrictions on free choice of providers do not apply to family planning services. (3) No waiver under this..., or State. (2) A locality may use any agency or agent, public or private, profit or nonprofit, to act..., utilization review, medical social services, or administrative services. (B) Any entity described in paragraph...

Installation package for SIMS prototype system 2, solar hot water

NASA Technical Reports Server (NTRS)

1978-01-01

The prototype system 2 solar hot water was designed for use in a single family dwelling and consists of the following subsystems: collector, storage, energy transport, and control. Guidelines are presented for utilization in the development of detailed installation plans and specifications. Instruction on operation, maintenance, and repair of the system is discussed.

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

PubMed

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

2015-12-01

Modern contraceptive prevalence was 14.1% in 2007 in Kinshasa, the capital city of the Democratic Republic of the Congo (DRC). Yet virtually nothing was known about the family planning supply environment. Three surveys of health facilities were conducted in 2012, 2013, and 2014 to determine the number, spatial distribution, and attributes of sites providing family planning services. The 2012 and 2013 surveys aimed to identify the universe of family planning facilities while obtaining a limited set of data on "readiness" to provide family planning services (defined as having at least 3 modern methods, at least 1 person training in family planning in the last 3 years, and an information system to track distribution of products to clients) and output (measured by couple-years of protection, or CYP). In contrast, the 2014 survey, conducted under the umbrella of the Performance Monitoring and Accountability 2020 (PMA2020) project, was based on 2-stage cluster sampling. This article provides detailed analysis of the 2012 and 2013 surveys, including bivariate and multivariate analysis of correlates of readiness to provide services and of output. We identified 184 health facilities that reported providing at least 1 contraceptive method in 2012 and 395 facilities in 2013. The percentage of sites defined as "ready" to provide services increased from 44.1% in 2012 to 63.3% in 2013. For the 3-month period between January and March 2013, facilities distributed between 0 and 879.2 CYP (mean, 39.7). Nearly half (49%) of the CYP was attributable to implants, followed by IUDs (24%), CycleBeads (11%), and injectables (8%). In 2013, facilities supported by PEPFAR (n = 121) were more likely than other facilities to be rated as ready to provide services (P<.0001); however, PEPFAR-supported sites generated less CYP on average than sites supported by family planning implementing agencies (P<.0001). Multivariate analysis showed 3 variables were associated with CYP: type of health facility, length of time in operation, and number of contraceptive methods available. Clinics generated higher (3-month) CYP than hospitals and health centers by 65.3 and 61.5 units, respectively (P<.01). The mean CYP for facilities in operation for 4-6 years was 26.9 units higher (P<.05), and 50.2 units higher for those operating 7+ years (P<.01), than the reference group of facilities in operation for 1 year or less. For each additional method available at a facility, CYP increased by almost 8 units (P<.01). Findings from these surveys suggest that lack of physical access is not the defining reason for low contraceptive use in Kinshasa, although it is highly likely that other service-related factors contribute to low service utilization. The results contributed to increasing the momentum for family planning in the DRC in many ways, including mobilizing partners to increase contraceptive access and increasing donor investment in family planning in the DRC. © Kayembe et al.

The influence of contraception, abortion, and natural family planning on divorce rates as found in the 2006-2010 National Survey of Family Growth.

PubMed

Fehring, Richard J

2015-08-01

The purpose of this study was to determine the influence of contraception, abortion, and natural family planning (NFP) on divorce rates of US women of reproductive age. The variables of importance of religion and frequency of church attendance were also included in the analysis. The study involved 5,530 reproductive age women in the (2006-2010) National Survey of Family Growth who indicate that they were ever married. Among the women who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who were currently divorced among the women who never used NFP (x (2) = 5.34, P < 0.21). Odds ratio analysis indicated that ever having an abortion, sterilization, and/or methods of contraception increased the likelihood of divorce - up to two times. Frequency of church attendance decreased the risk of divorce. Although there is less divorce among NFP users the reason might be due to their religiosity. Lay summary: Providers of natural family planning (NFP) frequently mention that couples who practice NFP have fewer divorces compared to couples who use contraception. Evidence for this comment is weak. This study utilized a large data set of 5,530 reproductive age women to determine the influence that contraception, sterilization, abortion, and NFP has on divorce rates. Among the women participants who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who used methods of contraception, sterilization or abortion as a family planning method. Frequency of church attendance also reduced the likelihood of divorce.

Factor associated with experience of modern contraceptive use before pregnancy among women who gave birth in Kersa HDSS, Ethiopia.

PubMed

Musa, Abdulbasit; Assefa, Nega; Weldegebreal, Fitsum; Mitiku, Habtamu; Teklemariam, Zelalem

2016-07-22

Worldwide, every year 289,000 women die related to pregnancy and its complications. Nearly, all of these deaths occur in developing countries and more than half of this deaths occur in sub-Saharan Africa. Report suggested that using contraceptives can reduce this maternal mortality by 44 %. Even if, Ethiopia is one of the countries with highest maternal mortality, only 41 % of married women are using family planning. This analysis aimed at assessing factor associated with experience of contraceptive use before pregnancy among women who gave birth in Kersa Health and Demographic Surveillance System, Ethiopia. This study was part of data generated for Kersa Health and Demographic Surveillance System. Women who gave birth during October 2011 to September 2012 were asked whether they had used contraceptive before getting their last pregnancy. Data were collected by using Kersa Health and Demographic Surveillance System questionnaire. Both bi-variate and multivariate analysis were used to identify associated factors. The proportion of modern contraceptive before pregnancy among the study participants was found to be 383 (40.9 %). The most commonly used modern contraceptives was Injectable contraceptive 270 (70.0 %) followed by oral contraceptives, 66 (17.23 %). Modern contraceptive use was negatively association with being Muslim (AOR = 0.2, 95 % CI = 0.05, 0.72) and being young mother (AOR = 0.44, 95 % CI = 0.22, 0.86). Rural town residence (AOR = 2.23, 95 % CI = 1.15, 4.35) was found to have positive association with utilization of modern contraceptives. Among women giving birth, only a minority had attempted to delay or prevent their recent birth by using contraception. Being young, being Muslim and living in rural area were significantly associated with low utilization of modern contraceptive. Increasing family planning education and involving religious leaders in family planning promotion would improve utilization of modern contraceptive use.

The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Healthcare Utilization and Spending Among Carve-In Enrollees

PubMed Central

Harwood, Jessica M.; Azocar, Francisca; Thalmayer, Amber; Xu, Haiyong; Ong, Michael K.; Tseng, Chi-Hong; Wells, Kenneth B.; Friedman, Sarah; Ettner, Susan L.

2016-01-01

Objective The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA’s impact on BH expenditures and utilization among “carve-in” enrollees. Method We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled in self-insured plans from large employers. An interrupted time series study design with segmented regression analysis estimated monthly time trends of per-member spending and use before (2008–2009), during (2010), and after (2011–2013) MHPAEA compliance (N=179,506,951 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits; medication management; individual and family psychotherapy); intermediate care utilization (structured outpatient; day treatment; residential); and inpatient utilization. Results MHPAEA was associated with increases in monthly per-member total spending, plan spending, assessment/diagnostic evaluation visits (respective immediate increases of: $1.05 [p=0.02]; $0.88 [p=0.04]; 0.00045 visits [p=0.00]), and individual psychotherapy visits (immediate increase of 0.00578 visits [p=0.00] and additional increases of 0.00017 visits/month [p=0.03]). Conclusions MHPAEA was associated with modest increases in total and plan spending and outpatient utilization; e.g., in July 2012 predicted per-enrollee plan spending was $4.92 without MHPAEA and $6.14 with MHPAEA. Efforts should focus on understanding how other barriers to BH care unaddressed by MHPAEA may affect access/utilization. Future research should evaluate effects produced by the Affordable Care Act’s inclusion of BH care as an essential health benefit and expansion of MHPAEA protections to the individual and small group markets. PMID:27632769

Nepal project moves ahead as grass-roots force.

PubMed

1995-06-01

A JOICFP mission to Nepal (April 2-14, 1995) performed several tasks, including the following: 1) collection of materials from nongovernmental organizations, the government, and international agencies in preparation for a National IEC Workshop (November 14-16, 1995) and a National Workshop (November 19-21, 1995) on family planning promotions; 2) arrangements for an external evaluation of the Community-based Sustainable Family Planning/Maternal and Child Health (MCH) Project with Special Focus on Women, which is supported by the United Nations Population Fund (UNFPA); 3) discussions regarding the production of the Nepali version of the videotape, "Rakhee and Mousse," and plans for utilization of US$11,122 of the JOICFP Voluntary Fund (JVF); 4) observation of refresher training for 135 women volunteers from 15 villages in Panchkhal, Kavre District, that was conducted by Sabatri Basnet; and 5) a meeting with the village health committee and women volunteers of the community-based, primary health care unit of Anaikiot. Coordination with the other activities of the Family Planning Association of Nepal and women volunteers to diffuse FP/MCH services and project activities has been a positive development in the project. The mission decided, based on its visits, to formulate technical support in the form of training, provision of quality service, and a referral institute for patients for the project areas of Panchkhal and Sunsari.

Integrating family planning with other social services.

PubMed

Bernales, E H

1982-01-01

Family planning outreach workers in the 43 municipalities of Iloilo Province, Western Visayas, the Philippines, have provided their communities with health, nutrition, educational, and agricultural services since 1973, when the Provincial Development Staff (PDS) began attempting to integrate services. The early work of the PDS was aided by the launching of the National Population and Family Planning Outreach Project in rural areas in 1976 and the creation of the Provincial Population Office (PPO) in 1977. 43% of the Outreach Project cost is borne by the local government, with the Commission on Population covering the rest. It is anticipated that the local goverment will eventually absorb the full cost. The Outreach officers have become an integral part of the planning body of the provincial government, largely due to the creation of the Provincial Consultative Committee on Population (PCCP) in 1979. The PCCP, composed of 22 governmental and private agencies involved in population-related activities, is charged with implementing the national population program in order to utilize all possible resources for provincial development. Its Integrated Provincial Population Plan has become part of the total provincial development plan. The Municipal Population Planning Actions Teams, whose functions are patterned on those of the PCCPs, further strengthen local planning at the municipal level. Full-Time Outreach Workers participate as well in planning at the barangay level. The various community-based projects initiated by the Outreach staff in Iloilo demonstrate a concern with making the population program responsive to the immediate needs of the provincial population. Organizations which teach better farming methods and undertake community projects emphasize local initiative and solutions to problems, and demonstrate the committment of population workers to broader development efforts. Outreach workers are involved in primary health care, social service delivery, income generating projects, and other activities even in backward and inaccessible areas.

Family allowance and family planning in Chile.

PubMed Central

Plank, S J

1978-01-01

Family allowances designed to promote maternal and child health and welfare could be self-defeating if they stimulated otherwise unwanted births, as often assumed. That assumption, with its public health and demographic implications, needs testing. An attempt to test it was made in Chile in 1969--1970 through interviews with 945 wives receiving an allowance and 690 non-recipients. Recipients practiced contraception significantly more than did non-recipients. This was not explained by wives' educational attainment or employment, the couples' earnings, or number of living children, but was associated with a 50 per cent greater utilization of professional prenatal care by recipients during the most recent pregnancy; women with such care (regardless of allowance status) were 75 per cent more likely than others to control their fertility. Prenatal care was probably sought more by recipients in part because an additional stipend was provided as soon as pregnancy was confirmed, usually at clinics with integrated family planning. Greater family income, attributable to the allowance, probably also contributed to the recipients' better prenatal attention and to contraceptive practice. Noteworthy, too, was the finding that with the number of living children controlled, contraceptive practice was significantly greater amoung couples who had never lost a child. PMID:717610

A Condom Distribution Program for Adolescents: The Findings of a Feasibility Study.

ERIC Educational Resources Information Center

Arnold, Charles B.; Cogswell, Betty E.

This paper describes a family planning service for adolescent males in an inner-city area. The program utilized the distribution of free condoms through local commercial outlets (barber shops, grocery stores, pool hall, restaurant). The proprietors agreed to distribute condoms in the target area which included approximately 3,000 males aged 12-26…

Financial effect of instituting Deficit Reduction Act documentation requirements in family planning clinics in Oregon.

PubMed

Rodriguez, Maria Isabel; Angus, Lisa; Elman, Emily; Darney, Philip D; Caughey, Aaron B

2011-06-01

The study was conducted to estimate the long-term costs for implementing citizenship documentation requirements in a Medicaid expansion program for family planning services in Oregon. A decision-analytic model was developed using two perspectives: the state and society. Our primary outcome was future reproductive health care costs due to pregnancy in the next 5 years. A Markov structure was utilized to capture multiple future pregnancies. Model inputs were retrieved from the existing literature and local hospital and Medicaid data related to reimbursements. One-way and multi-way sensitivity analyses were conducted. A Monte Carlo simulation was performed to simultaneously incorporate uncertainty from all of the model inputs. Screening for citizenship results in a loss of $3119 over 5 years ($39,382 vs. $42,501) for the state and $4209 for society ($63,391 compared to $59,182) for adult women. Among adolescents, requiring proof of identity and citizenship results in a loss of $3123 for the state ($39,378 versus $42,501) and $4214 for society ($63,391 instead of $59,177). Screening for citizenship status in publicly funded family planning clinics leads to financial losses for the state and society. Copyright © 2011 Elsevier Inc. All rights reserved.

Randomized comparison of two Internet-supported fertility-awareness-based methods of family planning.

PubMed

Fehring, Richard J; Schneider, Mary; Raviele, Kathleen; Rodriguez, Dana; Pruszynski, Jessica

2013-07-01

The aim was to compare the efficacy and acceptability of two Internet-supported fertility-awareness-based methods of family planning. Six hundred and sixty-seven women and their male partners were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group. Both groups utilized a Web site with instructions, charts and support. Acceptability was assessed online at 1, 3 and 6 months. Pregnancy rates were determined by survival analysis. The EHFM participants (N=197) had a total pregnancy rate of 7 per 100 users over 12 months of use compared with 18.5 for the CMM group (N=164). The log rank survival test showed a significant difference (p<.01) in survival functions. Mean acceptability for both groups increased significantly over time (p<.0001). Continuation rates at 12 months were 40.6% for the monitor group and 36.6% for the mucus group. In comparison with the CMM, the EHFM method of family planning was more effective. All users had an increase in acceptability over time. Results are tempered by the high dropout rate. Copyright © 2013 Elsevier Inc. All rights reserved.

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

PubMed Central

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

2015-01-01

Background: Modern contraceptive prevalence was 14.1% in 2007 in Kinshasa, the capital city of the Democratic Republic of the Congo (DRC). Yet virtually nothing was known about the family planning supply environment. Methods: Three surveys of health facilities were conducted in 2012, 2013, and 2014 to determine the number, spatial distribution, and attributes of sites providing family planning services. The 2012 and 2013 surveys aimed to identify the universe of family planning facilities while obtaining a limited set of data on “readiness” to provide family planning services (defined as having at least 3 modern methods, at least 1 person training in family planning in the last 3 years, and an information system to track distribution of products to clients) and output (measured by couple-years of protection, or CYP). In contrast, the 2014 survey, conducted under the umbrella of the Performance Monitoring and Accountability 2020 (PMA2020) project, was based on 2-stage cluster sampling. This article provides detailed analysis of the 2012 and 2013 surveys, including bivariate and multivariate analysis of correlates of readiness to provide services and of output. Results: We identified 184 health facilities that reported providing at least 1 contraceptive method in 2012 and 395 facilities in 2013. The percentage of sites defined as “ready” to provide services increased from 44.1% in 2012 to 63.3% in 2013. For the 3-month period between January and March 2013, facilities distributed between 0 and 879.2 CYP (mean, 39.7). Nearly half (49%) of the CYP was attributable to implants, followed by IUDs (24%), CycleBeads (11%), and injectables (8%). In 2013, facilities supported by PEPFAR (n = 121) were more likely than other facilities to be rated as ready to provide services (P<.0001); however, PEPFAR-supported sites generated less CYP on average than sites supported by family planning implementing agencies (P<.0001). Multivariate analysis showed 3 variables were associated with CYP: type of health facility, length of time in operation, and number of contraceptive methods available. Clinics generated higher (3-month) CYP than hospitals and health centers by 65.3 and 61.5 units, respectively (P<.01). The mean CYP for facilities in operation for 4–6 years was 26.9 units higher (P<.05), and 50.2 units higher for those operating 7+ years (P<.01), than the reference group of facilities in operation for 1 year or less. For each additional method available at a facility, CYP increased by almost 8 units (P<.01). Conclusions: Findings from these surveys suggest that lack of physical access is not the defining reason for low contraceptive use in Kinshasa, although it is highly likely that other service-related factors contribute to low service utilization. The results contributed to increasing the momentum for family planning in the DRC in many ways, including mobilizing partners to increase contraceptive access and increasing donor investment in family planning in the DRC. PMID:26681709

Current and future role of voluntary surgical contraception in increasing access to and utilization of family planning services in Africa.

PubMed

Gaym, Asheber

2012-10-01

Voluntary surgical contraception is the most widely utilized method of contraception in the world. High effectiveness, low complication rates and reduced cost in the long term make them the ideal contraceptive choice to diverse group of clients including clients from low resource settings. To assess the current status of utilization and effectiveness of voluntary surgical contraception in Africa and suggest possible future roles in contraceptive method choice. A review of available literature on voluntary surgical contraception and synthesis of information under relevant headings. Despite very high total fertility rates in most countries of Africa, surgical contraceptives still contribute to a very small proportion ofcontraceptive method choice in the continent. Client profile and acceptability studies indicate a large unmet need for permanent contraception in the continent. Lack of information, misconceptions and weak health systems (particularly surgical care) are the major impediments to increasing availability of surgical contraception. Lack of knowledge and low levels of motivation among health care providers may also be significant barriers to access. Ihcreasing availability of information on the safety and effectiveness of these methods to both health care providers and the general population can increase demand and acceptability. Delegating service provision to appropriately trained non-physician providers at primary care settings can assist in increasing accessibility of these important family planning methods.

Determinants of modern contraceptive utilization among married women of reproductive age group in North Shoa Zone, Amhara Region, Ethiopia.

PubMed

Mohammed, Abdurahman; Woldeyohannes, Desalegn; Feleke, Amsalu; Megabiaw, Berihun

2014-02-03

Ethiopia is the second most populous country in Africa with high fertility and fast population growth rate. It is also one of the countries with high maternal and child mortality rate in sub-Saharan Africa Family planning is a crucial strategy to halt the fast population growth, to reduce child mortality and improve maternal health (Millennium Development Goal 4 and 5). Therefore, this study aimed to assess the prevalence and determinants of modern contraceptive utilization among married women of reproductive age group. A community based cross-sectional study was conducted from August 15 to September 1, 2010 among married women aged 15-49 years in Debre Birhan District. Multistage sampling technique was used to select a total of 851 study participants. A pre-tested structured questionnaire was used for gathering data. Bivariate and multivariate logistic regression analyses were performed using SPSS version 16.0 statistical package. Modern contraceptive prevalence rate among currently married women was 46.9%. Injectable contraceptives were the most frequently used methods (62.9%), followed by intrauterine device (16.8%), pills (14%), norplant (4.3%), male condom (1.2%) and female sterilization (0.8%). Multiple logistic regression model revealed that the need for more children (AOR 9.27, 95% CI 5.43-15.84), husband approve (AOR 2.82, 95% CI 1.67-4.80), couple's discussion about family planning issues (AOR 7.32, 95% CI 3.60-14.86). Similarly, monthly family income and number of living children were significantly associated with the use of modern contraceptives. Modern contraceptive use was high in the district. Couple's discussion and husband approval of contraceptives use were significantly associated with the use of modern contraceptives. Therefore, district health office and concerned stakeholders should focus on couples to encourage communication and male involvement for family planning.

Determinants of modern contraceptive utilization among married women of reproductive age group in North Shoa Zone, Amhara Region, Ethiopia

PubMed Central

2014-01-01

Background Ethiopia is the second most populous country in Africa with high fertility and fast population growth rate. It is also one of the countries with high maternal and child mortality rate in sub-Saharan Africa Family planning is a crucial strategy to halt the fast population growth, to reduce child mortality and improve maternal health (Millennium Development Goal 4 and 5). Therefore, this study aimed to assess the prevalence and determinants of modern contraceptive utilization among married women of reproductive age group. Methods A community based cross-sectional study was conducted from August 15 to September 1, 2010 among married women aged 15–49 years in Debre Birhan District. Multistage sampling technique was used to select a total of 851 study participants. A pre-tested structured questionnaire was used for gathering data. Bivariate and multivariate logistic regression analyses were performed using SPSS version 16.0 statistical package. Results Modern contraceptive prevalence rate among currently married women was 46.9%. Injectable contraceptives were the most frequently used methods (62.9%), followed by intrauterine device (16.8%), pills (14%), norplant (4.3%), male condom (1.2%) and female sterilization (0.8%). Multiple logistic regression model revealed that the need for more children (AOR 9.27, 95% CI 5.43-15.84), husband approve (AOR 2.82, 95% CI 1.67-4.80), couple’s discussion about family planning issues (AOR 7.32, 95% CI 3.60-14.86). Similarly, monthly family income and number of living children were significantly associated with the use of modern contraceptives. Conclusion Modern contraceptive use was high in the district. Couple’s discussion and husband approval of contraceptives use were significantly associated with the use of modern contraceptives. Therefore, district health office and concerned stakeholders should focus on couples to encourage communication and male involvement for family planning. PMID:24490810

Self-Determined Goal Selection and Planning by Students with Disabilities across Grade Bands and Disability Categories

ERIC Educational Resources Information Center

Kleinert, Jane O'Regan; Harrison, Elizabeth; Mills, Karen Rose; Dueppen, Brittney M.; Trailor, Ann Michelle

2014-01-01

The purpose of this study was to analyze a large data base of self-selected/self-determined goals developed by students aged 7-21 that had developmental disabilities. Data included 288 goals developed by 205 students involved in the Kentucky Youth Advocacy Project. Students, teachers, Speech/Language pathologists and families utilized the Self…

Workshop on Systems Interconnexions: Standardization, Uniformity and Co-ordination in Population/Family Planning Information Network (Kuala Lumpur, Malaysia, April 12-16, 1976).

ERIC Educational Resources Information Center

Hawaii Univ., Honolulu. East-West Center.

The "information explosion" in the field of population has created a need for proper identification, systematization, dissemination, and utilization of population information. To help meet these needs in the Asian and Pacific regions, the Clearinghouse and Information Section of the Population Division of ESCAP (Economic and Social…

Factors influencing uptake of contraceptive implants in the immediate postpartum period among HIV infected and uninfected women at two Kenyan District Hospitals.

PubMed

Shabiby, Mufida M; Karanja, Joseph G; Odawa, Francis; Kosgei, Rose; Kibore, Minnie W; Kiarie, James N; Kinuthia, John

2015-08-19

Family planning is a cost effective strategy for prevention of mother to child transmission of HIV and reduction of maternal/infant morbidity and mortality. Contraceptive implants are a safe, effective, long term and reversible family planning method whose use remains low in Kenya. We therefore set out to determine and compare the uptake, and factors influencing uptake of immediate postpartum contraceptive implants among HIV infected and uninfected women at two hospitals in Kenya. This cross sectional study targeted postpartum mothers at two Kenyan district hospitals (one urban and one rural). All participants received general family planning and method specific (Implant) counseling followed by immediate insertion of contraceptive implants to those who consented. The data was analyzed by descriptive analysis, T-test, Chi square tests and logistic regression. One hundred eighty-five participants were enrolled (91 HIV positive and 94 HIV negative) with a mean age of 26 years. HIV positive mothers were significantly older (27.5 years) than their HIV negative counterparts (24.5 years), P = 0.001. The two groups were comparable in education, employment, marital status and religious affiliation. Overall, the uptake of contraceptive implants in the immediate postpartum period was 50.3% and higher among HIV negative than HIV positive participants (57% vs. 43%, P = 0.046). Multivariate analysis revealed that a negative HIV status (P = 0.017) and prior knowledge of contraceptive implants (P = 0.001) were independently associated with increased uptake of contraceptive implants. There was a high uptake of immediate postpartum contraceptive implants among both HIV infected and un-infected women; efforts therefore need to be made in promoting this method of family planning in Kenya and providing this method to women in the immediate postpartum period so as to utilize this critical opportunity to increase uptake and reduce the high unmet need for family planning.

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

PubMed Central

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

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers’ perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces—Zhejiang, Hubei and Yunnan—were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources. PMID:29045434

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

PubMed

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

2017-01-01

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

Career Planning in Harmony with Family Values and Needs

NASA Astrophysics Data System (ADS)

Dubey, Archana

2008-03-01

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.

Food management behaviours in food-insecure, lone mother-led families.

PubMed

Sim, S Meaghan; Glanville, N Theresa; McIntyre, Lynn

2011-01-01

Little is known about how food is managed in households where food resources are scarce. In this study, the household food management behaviours utilized by food-insecure, lone mother-led families from Atlantic Canada were characterized, and relationships among these behaviours and diet quality were examined. Thematic analysis of 24 in-depth interviews from a larger study of mother-led, low-income families was integrated with sociodemographic characteristics, food-insecurity status, and four weekly 24-hour dietary recalls for all household members to yield a family behaviour score (FBS) as a summative measure of food management behaviours, and a healthy plate score (HPS) as a measure of diet quality. Five distinct food management behaviours were identified: authoritative, healthism, sharing, structured, and planning behaviours. An increase in the FBS was associated with a proportional increase in the HPS. Authoritative, healthism, and planning food management behaviours were the strongest predictors of the HPS for all household members (p<0.05). The structured management behaviour was related to the degree of food insecurity. The FBS and HPS tools hold promise as a way to identify food-insecure families at risk of low diet quality. The next phase of this research will validate the use of these tools in the practice setting.

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

PubMed

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

2006-05-01

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

Attrition in the RAND Health Insurance Experiment: a response to Nyman.

PubMed

Newhouse, Joseph P; Brook, Robert H; Duan, Naihua; Keeler, Emmett B; Leibowitz, Arleen; Manning, Willard G; Marquis, M Susan; Morris, Carl N; Phelps, Charles E; Rolph, John E

2008-04-01

In a prior article in this journal, John Nyman argues that the effect on health care use and spending found in the RAND Health Insurance Experiment is an artifact of greater voluntary attrition in the cost-sharing plans relative to the free care plan. Specifically, he speculates that those in the cost-sharing plans, when faced with a hospitalization, withdrew. His argument is implausible because (1) families facing a hospitalization would be worse off financially by withdrawing; (2) a large number of observational studies find a similar effect of cost sharing on use; (3) those who left did not differ in their utilization prior to leaving; (4) if there had been no attrition and cost sharing did not reduce hospitalization rates, each adult in each family that withdrew would have had to have been hospitalized once each year for the duration of time they would otherwise have been in the experiment, an implausibly high rate; (5) there are benign explanations for the higher attrition in the cost-sharing plans. Finally, we obtained follow-up health-status data on the great majority of those who left prematurely. We found the health-status findings were insensitive to the inclusion of the attrition cases.

Designing insurance to promote use of childhood obesity prevention services.

PubMed

Rask, Kimberly J; Gazmararian, Julie A; Kohler, Susan S; Hawley, Jonathan N; Bogard, Jenny; Brown, Victoria A

2013-01-01

Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

Modeling the hydrologic and economic efficacy of stormwater utility credit programs for US single family residences.

PubMed

Kertesz, Ruben; Green, Olivia Odom; Shuster, William D

2014-01-01

As regulatory pressure to reduce the environmental impact of urban stormwater intensifies, US municipalities increasingly seek a dedicated source of funding for stormwater programs, such as a stormwater utility. In rare instances, single family residences are eligible for utility discounts for installing green infrastructure. This study examined the hydrologic and economic efficacy of four such programs at the parcel scale: Cleveland (OH), Portland (OR), Fort Myers (FL), and Lynchburg (VA). Simulations were performed to model the reduction in stormwater runoff by implementing bioretention on a typical residential property according to extant administrative rules. The EPA National Stormwater Calculator was used to perform pre- vs post-retrofit comparisons and to demonstrate its ease of use for possible use by other cities in utility planning. Although surface slope, soil type and infiltration rate, impervious area, and bioretention parameters were different across cities, our results suggest that modeled runoff volume was most sensitive to percent of total impervious area that drained to the bioretention cell, with soil type the next most important factor. Findings also indicate a persistent gap between the percentage of annual runoff reduced and the percentage of fee reduced.

Factors influencing use of family planning in women living in crisis affected areas of Sub-Saharan Africa: A review of the literature.

PubMed

Ackerson, Kelly; Zielinski, Ruth

2017-11-01

far too many women continue to die from pregnancy and childbirth related causes. While rates have decreased in the past two decades, some areas of the world such as sub-Saharan Africa continue to have very high maternal mortality rates. One intervention that has been demonstrated to decrease maternal mortality is use of family planning and modern contraception, yet rates of use in sub-Saharan countries with the highest rates of maternal death remain very low. to review available research and summarize the factors that inhibit or promote family planning and contraceptive use among refugee women and women from surrounding areas living in Sub-Saharan Africa. a review of the literature. Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), OVID, power search, and PubMed databases. studies included were: (1) published in English from 2007 to present; (2) primary research; and (3) focused on family planning and contraceptive use among refugee women and women in surrounding areas. Findings were discussed within the framework of the Interaction Model of Client Health Behavior. twelve studies met the inclusion criteria. Utilization of modern contraceptive methods was low. Women were socially influenced to avoid the use of contraceptives by husbands and others in the community. Reasons were a lack of trust in western medicine and the desire to have large families. Low socioeconomic status and proximity of family planning clinics were barriers to access. Women believed that health care providers were unqualified, many described being treated with disrespect in the health clinics. Knowledge and understanding of contraceptives was low; while most women knew different methods were available, there were many misconceptions. Believing that certain contraceptives cause death, infertility and side effects, contributed to fear of use. This lack of knowledge and fear, even with the desire to space and limit births, affected motivation to use contraception. developing new approaches to educating women, men (husbands), community leaders as well as healthcare providers is needed to address the multi-factorial issues that contribute to underuse of family planning services, thus contraceptive use. while lack of access to family planning is a barrier to use, interventions that improve access must be affordable and include education regarding contraceptive methods, preferably from those within the community. However, education and access is not sufficient unless the issue of disrespect by healthcare providers is addressed. Respectful and culturally sensitive care for all women, regardless of socio-economic status or country of origin, must be provided by midwives and other women health providers. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Innovative Strategy to Improve Family-Infant Bonding.

PubMed

Hutcheson, Jamie L; Cheeseman, Susan E

2015-01-01

To improve family-infant bonding while newborns were separated from their parents, work began to develop a new Childbirth Center policy to guide staff in using Apple's FaceTime application with patients. Multidisciplinary meetings were held to obtain consent for the use of FaceTime and to protect patient information. We acquired two iPads and the support needed for updates. The staff was educated, and implementation began in January, 2014. This program improved bonding as evidenced by feedback received from the parents who utilized it. Several parents commented on how much they preferred seeing images of their babies in motion breathing and crying instead of just still pictures. Physicians also used FaceTime while talking with parents about plans of care. Since our implementation, we have utilized FaceTime with 46 infants to impact bonding in our Special Care nursery. This process enhances the delivery of relationship-based care with our patients.

Family planning to promote physical activity: a randomized controlled trial protocol.

PubMed

Quinlan, Alison; Rhodes, Ryan E; Blanchard, Chris M; Naylor, Patti-Jean; Warburton, Darren E R

2015-10-05

Physical activity is associated with the reduction of several chronic conditions in adults. Additionally, physical activity is extremely important for children for their development and cognitive functioning and also to create a physically active lifestyle that continues into adulthood. Despite the known benefits of physical activity, only one in five adults are achieving the public health recommendations of 150 minutes of moderate-to-vigorous physical activity per week and only 13 % of boys and 6 % of girls between the ages of 5 and 17 years are meeting the guidelines of 60 minutes per day. This study aims to evaluate whether a planning condition improves adherence to regular physical activity compared to an education-only control condition among families. Families are eligible if there is at least one child between the ages of 6 and 12 years who is not meeting the Canadian Physical Activity Guidelines. A six-month longitudinal randomized controlled trial will be used to compare the two conditions. Materials will be delivered at baseline with 'booster' sessions at six weeks and three months. Participants will be assessed at baseline and at six months with a fitness test, as well as questionnaires and accelerometery at baseline, six weeks, three months and six months. A total of 137 families have been recruited thus far from Greater Victoria. This study is ongoing and recruitment will continue until December 2015 with the target goal of reaching 160 families. This protocol describes the implementation of a randomized controlled trial that utilizes planning strategies to try and increase physical activity among families. Research findings could be useful in public health in providing effective strategies to families to help decrease sedentary lifestyles. Additionally, findings may help to inform future interventions aimed at increasing physical activity among families. This trial was registered on June 5, 2012 with the Clinical Trials Registry maintained by the National Library of Medicine at the National Institutes of Health. The registration ID is NCT01882192.

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

42 CFR 441.20 - Family planning services.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

'Women now wear trousers': men's perceptions of family planning in the context of changing gender relations in western Kenya.

PubMed

Withers, Mellissa; Dworkin, Shari L; Zakaras, Jennifer M; Onono, Maricianah; Oyier, Beryl; Cohen, Craig R; Bukusi, Elizabeth A; Grossman, Daniel; Newmann, Sara J

2015-01-01

Gender inequity has been closely linked with unmet need for family planning among women in sub-Saharan Africa but the factors related to male family planning disapproval are not well-understood. This qualitative study explored men's perspectives of gender roles and cultural norms as they pertain to family planning. Twelve small group meetings were held with 106 married men in Nyanza Province, Kenya. Shifting gender relations made the definitions of manhood more tenuous than ever. Men's previous identities as sole breadwinners, which gave them significant control over decision-making, were being undermined by women's increasing labour force participation. While many men viewed family planning positively, fears that family planning would lead to more female sexual agency and promiscuity or that male roles would be further jeopardised were widespread and were major deterrents to male family planning approval. By addressing such fears, gender-sensitive programmes could help more men to accept family planning. Increased family planning education for men is needed to dispel misconceptions regarding family planning side-effects. Focusing on the advantages of family planning, namely financial benefits and reduced conflict among couples, could resonate with men. Community leaders, outreach workers and healthcare providers could help shift men's approval of joint decision-making around family size to other reproductive domains, such as family planning use.

Nearly half of families in high-deductible health plans whose members have chronic conditions face substantial financial burden.

PubMed

Galbraith, Alison A; Ross-Degnan, Dennis; Soumerai, Stephen B; Rosenthal, Meredith B; Gay, Charlene; Lieu, Tracy A

2011-02-01

High-deductible health plans-typically with deductibles of at least $1,000 per individual and $2,000 per family-require greater enrollee cost sharing than traditional plans. But they also may provide more affordable premiums and may be the lowest-cost, or only, coverage option for many families with members who are chronically ill. We surveyed families with chronic conditions in high-deductible plans and families in traditional plans to compare health care-related financial burden-such as experiencing difficulty paying medical or basic bills or having to set up payment plans. Almost half (48 percent) of the families with chronic conditions in high-deductible plans reported health care-related financial burden, compared to 21 percent of families in traditional plans. Almost twice as many lower-income families in high-deductible plans spent more than 3 percent of income on health care expenses as lower-income families in traditional plans (53 percent versus 29 percent). As health reform efforts advance, policy makers must consider how to modify high-deductible plans to reduce the financial burden for families with chronic conditions.

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

PubMed

Furnas, Hannah E

2016-09-01

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

Capturing Complexities of Relationship-Level Family Planning Trajectories in Malawi

PubMed Central

Furnas, Hannah E.

2017-01-01

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

Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan

PubMed Central

Memon, Zahid; Zaidi, Shehla; Riaz, Atif

2016-01-01

Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers. PMID:26925902

Sustainability of community based family planning services: experience from rural Ethiopia.

PubMed

Genna, Shimeles; Fantahun, Mesganaw; Berhane, Yemane

2006-01-01

The important role of active Community Based Reproductive Health Services (CBRHS), formerly known us Community Based Distribution (CBD) of family planning program, in increasing contraceptive uptake has been reported from several studies. However, the sustainability of project based services has not been documented in Ethiopia. This study was conducted to assess the effectiveness and sustainability of community based Family planning services in rural communities of Ethiopia. The study was carried out in three sets of 30 peasant villages selected from five districts of Eastern Showa Zone in Ethiopia. Comparison was made between never former; and current CBRHS areas. Relevant information was collected using a structured and pre-tested questionnaire. The respondents were women in the reproductive age groups (15-49 years). Knowledge about contraception was higher in both former and current CBRHS communities as compared to never CBRHS areas [MH-OR (95% CI) = 6.89 (4.69, 10.17) and 12.48 (7.84, 20.25)], respectively. Ever use of modern contraception was significantly greater among women from former and current CBRHS communities as compared to never CBRHS communities [MH-OR (95% CI) = 3.75 (2.54, 5.97) and 5.72 (3.93, 9.39), respectively]. Current use of modern contraception methods was however significantly better only in current CBRHS areas [MH-OR (95% CI) = 2.42; (1.16, 5.37)]; there was no statistically significant difference with former CBRHS areas [MH-OR (95% CI) = 1.13; (0.51, 2.49)]. Results of this study indicate that the effect of CBRHS in raising the level of modern contraception use in rural communities is transient. In order to sustain the effects of a good community based family planning services appropriate mechanisms must be designed to motivate and enable women to continuously utilize the services.

The family planning movement within the African Region of the International Planned Parenthood Federation. Le mouvement pour la planification familiale dans la Region Afrique de la Federation Internationale pour la Planification Familiale.

PubMed

Sozi, M K

1984-09-01

The African Region of International Planned Parenthood Federation (IPPF) was established in 1971 to: encourage and sustain voluntary groups, provide information about family planning as a basic right, provide limited family planning services where acceptable and needed, and eventually influence change in public opinion so that governments could accept some responsibility for family planning programs. Today almost all of Anglophone Africa is covered by IPPF-funded activities, progress is being made in Francophone Africa, and Lusophone Africa is a target for the 1980s. National family planning associations and the IPPF have laid a firm foundation for family planning and raised its credibility to acceptable levels. However, both inadequate logistic infrastructures for the smooth flow of services and overcaution in adopting innovative methods such as community-based delivery systems to those not easily reached by coventional delivery systems have led service to lag behind demand. Leaders at all levels must join efforts to solve this dilemma. Family planning associations are the best suited channels for family planning work in the African Region, but they lack the capacity to cover all needs. As a result, these associations are shiftingg their efforts toward supplementing government work in this area. Although the government response has been far from uniform, governments have shown an ability to accommodate the operations of family planning organizations and have integrated family planning into national health services. Although 19 governments in the Region consider the fertility levels in their countries to be satisfactory and a few consider fertility too low, family planning is accepted as an instrument for the promotion of family welfare. The importance of national leadership in promoting and implementing family planning programs is increasingly recognized. Parliamentarians can formulate national policies favorable to family planning, promote awareness among their constituencies, and vote for more resources for the family planning effort.

Effect of premium, copayments, and health status on the choice of health plans.

PubMed

Naessens, James M; Khan, Mahmud; Shah, Nilay D; Wagie, Amy; Pautz, Rebecca A; Campbell, Claudia R

2008-10-01

Explore effects of comorbidity and prior health care utilization on choice of employee health plans with different levels of cost sharing. Mayo Clinic employees in Rochester, Minnesota (MCR) under age 65 in January 2004; N = 20,379. Assessment of a natural experiment where self-funded medical care benefit options were changed to contain costs within a large medical group practice. Before the change, most employees were enrolled in a plan with first dollar coverage, while 18% had a plan with copays and deductibles. In 2004, 3 existing plans were replaced by 2 new options, one with lower premiums and higher out-of-pocket costs and the other with higher premiums, a lower coinsurance rate, and lower out-of-pocket maximums. Data on employees were merged across insurance claims, medical records, eligibility files, and employment files for 2003 and 2004. As the number of chronic comorbidities among family members increased, the probability of choosing high-premium option also increased. Seventy-two percent of employees with at least 1 family member with comorbidity chose the high-cost option versus 54.7% of employees with no comorbidities. High-premium and low-premium plans seem to subdivide population into discrete risk categories, which may adversely affect the future stability of the insurance plan options. Various factors affect decision making of employees regarding the choice of plan with different levels of cost-sharing. In a natural experiment setting where all options were redesigned, the health status of employees and their dependents played a very significant role in plan choice.

University/School District Reflection in Teacher Education: A Collaborative Inquiry Approach. (The Portland State University/East Multnomah County Project: "Classroom As Families" Teacher Education Program).

ERIC Educational Resources Information Center

Driscoll, Amy; Nagel, Nancy

This study describes two phases of the planning of a professional development center for teaching and teacher education, utilizing a reflective and collaborative inquiry approach. Two themes guided the study: (1) the dissonance between teacher education and teaching; and (2) preparation of teachers to respond to the changing population of children…

Costs and utilization of public sector family planning services in Pakistan.

PubMed

Abbas, Khadija; Khan, Adnan Ahmad; Khan, Ayesha

2013-04-01

The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector. We used overall budgets and time allocation by health and population departments to estimate the total costs of FP by these departments, costs per woman served, and costs per couple-year of protection (CYP). The public sector is the predominant provider of FP to the poorest and is the main provider of female sterilization services. The overall costs of FP in the public sector are USD 55 per woman served, annually (USD 17 per CYP). Within the public sector, the population welfare departments provide services at USD 72 per woman served, annually (USD 17 per CYP) and the health departments at USD 39 per woman per year (USD 29 per CYP). While the public sector has a critical niche in serving the poor and providing female sterilization, its services are considerably more expensive compared to international and even some Pakistani non-government organization (NGO) costs. This reflects inefficiencies in services provided, client mistrust in the quality of services provided, and inadequate referrals, and will require specific actions for improving referrals and the quality of services.

Nearly Half of Families In High-Deductible Health Plans Whose Members Have Chronic Conditions Face Substantial Financial Burden

PubMed Central

Galbraith, Alison A.; Ross-Degnan, Dennis; Soumerai, Stephen B.; Rosenthal, Meredith B.; Gay, Charlene; Lieu, Tracy A.

2015-01-01

High-deductible health plans – typically with deductibles of at least $1,000 per individual and $2,000 per family -- require greater enrollee cost sharing than traditional plans. But they also may provide more affordable premiums and may be the lowest-cost, or only, coverage option for many families with members who are chronically ill. We surveyed families with chronic conditions in high-deductible plans and families in traditional plans to compare health care-related financial burden – such as experiencing difficulty paying medical or basic bills or having to set up payment plans. Almost half (48 percent) of the families with chronic conditions in high-deductible plans reported health care-related financial burden, compared to a fifth of families (21 percent) in traditional plans. Almost twice as many lower-income families in high-deductible plans spent more than 3 percent of income on health care expenses as lower-income families in traditional plans (53 percent versus 29 percent). As health reform efforts advance, policy makers must consider how to modify high-deductible plans to reduce the financial burden for families with chronic conditions. PMID:21289354

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

ERIC Educational Resources Information Center

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

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

Family Planning & Literacy.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

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

OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA

PubMed Central

Ouma, S.; Turyasima, M.; Acca, H.; Nabbale, F.; Obita, K. O.; Rama, M.; Adong, C. C.; Openy, A.; Beatrice, M. O.; Odongo-Aginya, E. I.; Awor, S.

2016-01-01

Background Uganda’s rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. Objective To determine obstacles to family planning use among rural women in Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Atiak Health Centre IV, Amuru District, rural Northern Uganda. Subjects Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. Results There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programme. Conclusions In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty. PMID:27099401

OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA.

PubMed

Ouma, S; Turyasima, M; Acca, H; Nabbale, F; Obita, K O; Rama, M; Adong, C C; Openy, A; Beatrice, M O; Odongo-Aginya, E I; Awor, S

Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. To determine obstacles to family planning use among rural women in Northern Uganda. A descriptive cross-sectional analytical study. Atiak Health Centre IV, Amuru District, rural Northern Uganda. Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning programme. In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty.

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

PubMed

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

2015-07-01

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

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

PubMed

Hirshbein, N

1992-04-01

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

Family planning and maternal and child health services.

PubMed

Singh, A

1975-12-01

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

Vouchers in Fragile States: Reducing Barriers to Long-Acting Reversible Contraception in Yemen and Pakistan

PubMed Central

Boddam-Whetham, Luke; Gul, Xaher; Al-Kobati, Eman; Gorter, Anna C

2016-01-01

ABSTRACT In conflict-affected states, vouchers have reduced barriers to reproductive health services and have enabled health programs to use targeted subsidies to increase uptake of specific health services. Vouchers can also be used to channel funds to public- and private-service providers and improve service quality. The Yamaan Foundation for Health and Social Development in Yemen and the Marie Stopes Society (MSS) in Pakistan—both working with Options Consultancy Services—have developed voucher programs that subsidize voluntary access to long-acting reversible contraceptives (LARCs) and permanent methods (PMs) of family planning in their respective fragile countries. The programs focus on LARCs and PMs because these methods are particularly difficult for poor women to access due to their cost and to provider biases against offering them. Using estimates of expected voluntary uptake of LARCs and PMs for 2014 based on contraceptive prevalence rates, and comparing these with uptake of LARCs and PMs through the voucher programs, we show the substantial increase in service utilization that vouchers can enable by contributing to an expanded method choice. In the governorate of Lahj, Yemen, vouchers for family planning led to an estimated 38% increase in 2014 over the expected use of LARCs and PMs (720 vs. 521 expected). We applied the same approach in 13 districts of Punjab, Khyber Pakhtunkhwa (KPK), and Sindh provinces in Pakistan. Our calculations suggest that vouchers enabled 10 times more women than expected to choose LARCs and PMs in 2014 in those areas of Pakistan (73,639 vs. 6,455 expected). Voucher programs can promote and maintain access to family planning services where existing health systems are hampered. Vouchers are a flexible financing approach that enable expansion of contraceptive choice and the inclusion of the private sector in service delivery to the poor. They can keep financial resources flowing where the public sector is prevented from offering services, and ensure that alternative sources are available for reproductive health services such as family planning. Programs should consider using vouchers in fragile states to facilitate access to family planning services and support the countries’ health systems. PMID:27540129

Knowledge, Attitude and Practice of Contraception among Postpartum Women Attending Kathmandu Medical College Teaching Hospital.

PubMed

Bajracharya, A

2015-01-01

Background Failure to plan a pregnancy can adversely affect the health of the family as a whole. High parity is related to increased maternal, perinatal and infant deaths and is associated with nutritional problems of both mother and child. Hence, good knowledge, attitude and practice of family planning among women are important. This study is aimed to determine the knowledge, attitude and practice of contraception among the postpartum women attending Kathmandu Medical College Teaching Hospital. Objective To determine the knowledge, attitude and the practice of various contraceptive methods among the postpartum women. Method A cross-sectional observational study was conducted in the department of Obstetrics and Gynecology on 400 postpartum women (within 42 days of delivery) who delivered and came for follow-up in this institution. All the postnatal women were interviewed with pre-designed questionnaire and information on sociodemographic variable, awareness and knowledge of various contraceptive methods, previous and current use of family planning methods, source of information, utilization and reasons for use/non-use of family planning methods were obtained. Data collected were entered and analyzed using SPSS 20. The results were presented as percentages, means, tables and charts. Result Majority of the participants 363 (90.8%) were aware of contraceptive usage. Amongst 60.5% of women who had previously used contraception, OCPs were the commonest one. Maximum number of participants (60.35%) had used modern contraceptives in the past. The most common source of information on contraception was media (55.7%). The reason of using contraception was spacing between the subsequent pregnancies, while the most common reason of discontinuation or not willing to use family planning methods was husband being abroad, fear of side effects and not knowing which contraceptives to use. Conclusion The contraceptive awareness and knowledge among the postpartum women was high but their usage was low. Hence, efforts should be made to educate the public about safety and convenience of modern methods of contraceptives. Health care personnels should also counsel the clients for adopting the contraceptives according to their need.

Utilizing Genomics through Family Health History with the Theory of Planned Behavior: Prediction of Type 2 Diabetes Risk Factors and Preventive Behavior in an African American Population in Florida.

PubMed

Seaborn, Cynthia; Suther, Sandra; Lee, Torhonda; Kiros, Gebre-Egziabher; Becker, Alan; Campbell, Ellen; Collins-Robinson, Jackie

2016-01-01

African Americans are disproportionately affected by type 2 diabetes. The purpose of this study was to assess to what extent African Americans' knowledge and awareness of family health history and related risk factors for developing type 2 diabetes influence their likelihood of adopting a preventive behavior. This study employed an anonymous pencil-and-paper, self-administered survey consisting of two sections. Section 1 was a modified version of the US Surgeon General's Family Health History Initiative and the American Diabetes Association Diabetes Risk Factor Survey. Section 2 of the survey was based on the constructs of the theory of planned behavior. Over 394 African American participants completed the survey. 'Perceived behavioral control' was the strongest predictor of 'likelihood of adopting preventive behavior'. Participants were aware of their family history as a risk factor for type 2 diabetes, but it was not a significant predictor of behavior modifications based on that knowledge. The lack of perceived risk in this population shows the importance of not only knowing one's risk factors but translating those risk factors to a more personalized form that fits into the current lifestyle of the individual in a meaningful way. © 2016 S. Karger AG, Basel.

Factors influencing food preparation behaviours: findings from focus groups with Mexican-American mothers in southern California.

PubMed

Smith, Teresa M; Dunton, Genevieve F; Pinard, Courtney A; Yaroch, Amy L

2016-04-01

The purpose of the present study was to explore food preparation behaviours, attitudes, meal planning and shopping among Mexican-American mothers. Data were collected through four focus groups with mothers of Mexican origin/ancestry who considered themselves to be the primary food preparer. Topics included food preparation behaviours and influencers (culture, family, attitudes, barriers, meal planning and shopping). Data were analysed using a qualitative grounded theory approach. All focus groups were audio recorded, transcribed verbatim and coded for themes. Data were collected in southern California, USA in 2013. Of the sample of twenty-one Mexican-American mothers, thirteen were born outside the USA and the mean household size was five members. Participants reported that food was often prepared using traditional staples and food preparation behaviours were learned from maternal family members. Participants also suggested that health was influenced by foods eaten and how they were prepared. Salient factors influencing food preparation behaviours included culture and tradition, maternal family members' food preparation behaviours, food preparation self-efficacy and attitudes towards healthy eating. Time and busy schedules were cited as barriers. Future interventions should consider utilizing family-based approaches and teaching culturally relevant food preparation skills, especially to youth, while reinforcing more healthful dietary practices.

The health educative role of the nurse in family planning.

PubMed

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

1971-12-01

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

From theory to application: using performance measures for contraceptive care in the Title X family planning program.

PubMed

Loyola Briceno, Ana Carolina; Kawatu, Jennifer; Saul, Katie; DeAngelis, Katie; Frederiksen, Brittni; Moskosky, Susan B; Gavin, Lorrie

2017-09-01

The objective was to describe a Performance Measure Learning Collaborative (PMLC) designed to help Title X family planning grantees use new clinical performance measures for contraceptive care. Twelve Title X grantee-service site teams participated in an 8-month PMLC from November 2015 to June 2016; baseline was assessed in October 2015. Each team documented their selected best practices and strategies to improve performance, and calculated the contraceptive care performance measures at baseline and for each of the subsequent 8 months. PMLC sites implemented a mix of best practices: (a) ensuring access to a broad range of methods (n=7 sites), (b) supporting women through client-centered counseling and reproductive life planning (n=8 sites), (c) developing systems for same-day provision of all methods (n=10 sites) and (d) utilizing diverse payment options to reduce cost as a barrier (n=4 sites). Ten sites (83%) observed an increase in the clinical performance measures focused on most and moderately effective methods (MME), with a median percent change of 6% for MME (from a median of 73% at baseline to 77% post-PMLC). Evidence suggests that the PMLC model is an approach that can be used to improve the quality of contraceptive care offered to clients in some settings. Further replication of the PMLC among other groups and beyond the Title X network will help strengthen the current model through lessons learned. Using the performance measures in the context of a learning collaborative may be a useful strategy for other programs (e.g., Federally Qualified Health Centers, Medicaid, private health plans) that provide contraceptive care. Expanded use of the measures may help increase access to contraceptive care to achieve national goals for family planning. Published by Elsevier Inc.

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

PubMed

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

2018-05-09

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-07-01

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

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

PubMed

Roemer, R

1968-09-12

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

Ready to sell our program. Anybody who is interested in learning Indonesian experience is invited to take part in the BKKBN's international training program.

PubMed

Suyono, H

1996-01-01

The Indonesian Family Planning Program was officially launched in 1970 when President Suharto developed the National Family Planning Coordinating Board (BKKBN) to administrate the national family planning program. The inauguration of the family planning program came at the heels of a special demand by the people with very strong support of the ulama. The program was subsequently developed and expanded into remote areas in 1976. In 1992, a family-based approach to family planning was implemented in which every village family was made responsible for family planning. The program is based upon a very strong political commitment at the highest level as well as at the provincial, district, subdistrict, and village levels; it continuously innovates; every community can name its family planning program as it likes; and there is constant feedback to the community. Indonesia's family planning program strategies are as follows: it is suggested that couples in which the wife is aged 20-30 years have only two children; it is recommended that women over age 30 have no more children due to the comparatively high risks of pregnancy at that age; considerable effort is given to encourage youths to not become pregnant and bear children; numerous chairmen of small community family planning groups are appointed; and social and cultural conditions have been created in which people work for family planning activities. People interested in learning from the Indonesian experience in family planning may participate in the BKKBN's international training program.

Resource Allocation Algorithms for the Next Generation Cellular Networks

NASA Astrophysics Data System (ADS)

Amzallag, David; Raz, Danny

This chapter describes recent results addressing resource allocation problems in the context of current and future cellular technologies. We present models that capture several fundamental aspects of planning and operating these networks, and develop new approximation algorithms providing provable good solutions for the corresponding optimization problems. We mainly focus on two families of problems: cell planning and cell selection. Cell planning deals with choosing a network of base stations that can provide the required coverage of the service area with respect to the traffic requirements, available capacities, interference, and the desired QoS. Cell selection is the process of determining the cell(s) that provide service to each mobile station. Optimizing these processes is an important step towards maximizing the utilization of current and future cellular networks.

Variations in resource utilization among medical specialties and systems of care. Results from the medical outcomes study.

PubMed

Greenfield, S; Nelson, E C; Zubkoff, M; Manning, W; Rogers, W; Kravitz, R L; Keller, A; Tarlov, A R; Ware, J E

1992-03-25

To examine whether specialty and system of care exert independent effects on resource utilization. Cross-sectional analysis of just over 20,000 patients (greater than or equal to 18 years of age) who visited providers' offices during 9-day periods in 1986. Patient- and physician-provided information was obtained by self-administered questionnaires. Offices of 349 physicians practicing family medicine, internal medicine, endocrinology, and cardiology within health maintenance organizations, large multispecialty groups, and solo practices or small single-specialty group practices in three major US cities. Indicators of the intensity of resource utilization were examined among four medical specialties (family practice, general internal medicine, cardiology, and endocrinology) and five systems of care (health maintenance organization, multispecialty group-fee-for-service, multispecialty group-prepaid; solo practice and single-specialty group-fee-for-service, and solo practice and single-specialty group-prepaid) before and after controlling for the mix of patients seen in these offices. The indicators of resource utilization were hospitalizations, annual office visits, prescription drugs, and common tests and procedures, with rates estimated on both a per-visit and per-year basis. Variation in patient mix was a major determinant of the large variations in resource use. However, increased utilization was also independently related to specialty (cardiology and endocrinology), fee-for-service payment plan, and solo and single-specialty group practice arrangements. After adjusting for patient mix, solo practice/single-specialty groups-fee-for-service had 41% more hospitalizations than health maintenance organizations. General internists had utilization rates somewhat greater than family physicians on some indicators. Although variations in patient mix should be a major determinant of variations in resource use, the independent effects of specialty training, payment system, and practice organization on utilization rates need further explication. The 2- and 4-year outcomes now being analyzed will provide information critical to interpretation of the variations reported herein.

Use of family planning methods in Kassala, Eastern Sudan

PubMed Central

2011-01-01

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

Overcoming Barriers to Family Planning through Integration: Perspectives of HIV-Positive Men in Nyanza Province, Kenya

PubMed Central

Steinfeld, Rachel L.; Newmann, Sara J.; Onono, Maricianah; Cohen, Craig R.; Bukusi, Elizabeth A.; Grossman, Daniel

2013-01-01

This study explored barriers to and facilitators of using family planning services among HIV-positive men in Nyanza Province, Kenya. From May to June 2010, in-depth interviews were conducted with 30 men receiving care at 15 HIV clinics. The key barriers to the use of family planning included concerns about side effects of contraceptives, lack of knowledge about contraceptive methods, myths and misconceptions including fear of infertility, structural barriers such as staffing shortages at HIV clinics, and a lack of male focus in family planning methods and service delivery. The integration of family planning into HIV clinics including family planning counseling and education was cited as an important strategy to improve family planning receptivity among men. Integrating family planning into HIV services is a promising strategy to facilitate male involvement in family planning. Integration needs to be rigorously evaluated in order to measure its impact on unmet need for contraception among HIV-positive women and their partners and assure that it is implemented in a manner that engages both men and women. PMID:23738057

"Before the war we had it all": Family planning among couples in a post-conflict setting.

PubMed

Warren, Nicole; Alvarez, Carmen; Makambo, Maphie Tosha; Johnson-Agbakwu, Crista; Glass, Nancy

2017-08-01

There is little evidence about family planning knowledge, attitudes, and use among couples in post-conflict Democratic Republic of the Congo. We used qualitative descriptions to analyze data from 75 participants. Intimate partner violence (IPV) was common among participants. They were aware of family planning methods; however, IPV and fears of side effects were barriers to use. Although participants were concerned about the cost of large families, had positive attitudes toward family planning, and intended to use it, actual use was uncommon. The need for family planning was acute because of war-related poverty. Couples negotiated, but men had strong influence over family planning decisions. Couples saw health workers as a valuable resource. Interventions in this setting should include a couple-based approach that addresses IPV as well as family planning content.

High-deductible health plans.

PubMed

2014-05-01

High-deductible health plans (HDHPs) are insurance policies with higher deductibles than conventional plans. The Medicare Prescription Drug Improvement and Modernization Act of 2003 linked many HDHPs with tax-advantaged spending accounts. The 2010 Patient Protection and Affordable Care Act continues to provide for HDHPs in its lower-level plans on the health insurance marketplace and provides for them in employer-offered plans. HDHPs decrease the premium cost of insurance policies for purchasers and shift the risk of further payments to the individual subscriber. HDHPs reduce utilization and total medical costs, at least in the short term. Because HDHPs require out-of-pocket payment in the initial stages of care, primary care and other outpatient services as well as elective procedures are the services most affected, whereas higher-cost services in the health care system, incurred after the deductible is met, are unaffected. HDHPs promote adverse selection because healthier and wealthier patients tend to opt out of conventional plans in favor of HDHPs. Because the ill pay more than the healthy under HDHPs, families with children with special health care needs bear an increased cost burden in this model. HDHPs discourage use of nonpreventive primary care and thus are at odds with most recommendations for improving the organization of health care, which focus on strengthening primary care.This policy statement provides background information on HDHPs, discusses the implications for families and pediatric care providers, and suggests courses of action. Copyright © 2014 by the American Academy of Pediatrics.

Translations on People’s Republic of China, Number 379

DTIC Science & Technology

1977-05-03

TECHNOLOGICAL Family Planning, Birth Control Linked to Learning- From-Ta-chai (Various sources, various dates) 18 Family Planning Work Well Done in...Nan-kung-hsien Female Labor Force Liberated Through Birth Control Two Counties Hailed for Good Family Planning Work Careful Records Kept on Women...CSO: 4006 17 SCIENTIFIC AND TECHNOLOGICAL FAMILY PLANNING, BIRTH CONTROL LINKED TO LEARNING-FROM-TA-CHAI Family Planning Work Well Done in Nan-kung

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

PubMed

Kunii, C

1989-07-01

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

Implementation and acceptability of strategies instituted for engaging men in family planning services in Kibaha district, Tanzania.

PubMed

Msovela, Judith; Tengia-Kessy, Anna

2016-11-21

Men as the main decision makers in most of African families have an important role to play towards acceptance of family planning methods. This study sought to identify strategies used to engage men in family planning services and determine the extent to which men in Kibaha district in Tanzania accept these interventions. We conducted a cross sectional study using both quantitative and qualitative techniques. We used a questionnaire to interview a random sample of 365 of currently married or cohabiting men who had at least one child under the age of five years. We further conducted in-depth interviews with health workers involved in delivering reproductive health services as well as community dispensers of family planning commodities. Descriptive analysis was used to determine the extent to which men were engaged in family planning services. The data from the indepth interviews were analysed manually according to the predetermined themes, guided by the grounded theory to identify the existing strategies used to encourage male involvement in family planning services. According to the key informants, strategies that are used to encourage men to engage in family planning services include invitations through their spouses, either verbally or by using partner notification cards, incorporating family planning messages during monthly meetings and community outreach reproductive health programs. Of 365 men responding to the questionnaire, only 31 (8.4%) said they were invited to accompany their spouses to family planning clinics. Among them, 71% (22/31) visited family planning clinics. A third (32%) of the respondents had heard of community health meetings and only 20.7% of them attended these meetings. More than a third (12/34) of men who attended these meeting asserted that family planning messages targeting men featured in the agenda and subsequently half of them visited health facilities for family planning services. Existing strategies such as invitations to clinics and community sensitization have shown to encourage men to engage in family planning services. However, these interventions reach few men and hence there is a need to rolling them up to improve uptake of family planning services.

Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora.

PubMed

Sabri, Bushra; Huerta, Julia; Alexander, Kamila A; St Vil, Noelle M; Campbell, Jacquelyn C; Callwood, Gloria B

2015-11-01

This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women.

Understanding advance care planning within the South Asian community.

PubMed

Biondo, Patricia D; Kalia, Rashika; Khan, Rooh-Afza; Asghar, Nadia; Banerjee, Cyrene; Boulton, Debbie; Marlett, Nancy; Shklarov, Svetlana; Simon, Jessica E

2017-10-01

Advance care planning (ACP) is a process of reflection on and communication of a person's future health-care preferences. Evidence suggests visible minorities engage less in ACP. The South Asian ethnic group is the largest visible minority group in Canada, and information is needed to understand how ACP is perceived and how best to approach ACP within this diverse community. To explore perspectives of South Asian community members towards ACP. Peer-to-peer inquiry. South Asian community members who graduated from the Patient and Community Engagement Research programme (PaCER) at the University of Calgary utilized the PaCER method (SET, COLLECT and REFLECT) to conduct a focus group, family interviews and a community forum. Fifty-seven community-dwelling men and women (22-86 years) who self-identified with the South Asian community in Calgary, Alberta, Canada. The concept of ACP was mostly foreign to this community and was often associated with other end-of-life issues such as organ donation and estate planning. Cultural aspects (e.g. trust in shared family decision making and taboos related to discussing death), religious beliefs (e.g. fatalism) and immigration challenges (e.g. essential priorities) emerged as barriers to participation in ACP. However, participants were eager to learn about ACP and recommended several engagement strategies (e.g. disseminate information through religious institutions and community centres, include families in ACP discussions, encourage family physicians to initiate discussions and translate materials). Use of a patient engagement research model proved highly successful in understanding South Asian community members' participation in ACP. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

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

PubMed

Munyakazi, A

1990-12-01

Rwanda's official family planning policy dates back to 1981 and creation of the National Office of Population (ONAPO). Among its other function, ONAPO monitors proper use of family planning methods and studies the integration of family planning services into public health. Pilot family planning programs began in the prefectures of Butare, Kigali, and Ruhengeri and were extended to the other 7 around 1985. The development of family planning services in Rwanda is based on their integration into existing services, especially those devoted to maternal-child health. In 1989, 277 of the 350 health centers of all kinds in Rwanda and 12 secondary posts offered family planning services. The rate of integration was 79.4%. 185 of the 277 health services with family planning services were in the public sector. As of December 1989, the rate of integration in different prefectures varied from a high of 95.5% in Kibungo to a low of 64.9% in Gisenyi. Integration is particularly weak in health facilities administered by the Catholic Church. The 2 strategies to confront this situation are continuing dialogue with Catholic Church officials and creation of secondary family planning posts to improve accessibility to family planning for populations served by Church health services. The number of new and continuing family planning users increased from 1178 and 1368 respectively in 1982 to 66,950 and 104,604 through September 1990. There is wide variation from 1 prefecture to another in recruitment of new acceptors and in the number of acceptors per health facility. Recruitment of new acceptors is greatest in Ruhengeri, followed by Kigali and Byumba. As of September 1990, 28,943 women used pills, 2037 used IUDs, 66,515 used injectables, 3051 used barrier methods, 2888 used auto-observation methods, 343 used implants, and 588 were sterilized. The overall rate of contraceptive prevalence increased from .9% in 1983 to 6.2% in 1989 and 10% in 1990. The strategy for promoting family planning has included training of personnel, improvement of supervision, regular supply of contraceptive equipment and supplies to health supervision, regular supply of contraceptive equipment and supplies to health centers, diversification of available methods, and addition of secondary family planning posts to improve accessibility. Obstacles still affecting Rwanda's family planning program include the pronatalist cultural orientation, which is being confronted by a vigorous IEC program. The reluctance of Catholic-affiliated health services to offer modern family planning methods, the shortage of trained family planning workers, contraceptive supply problems, and geographic inaccessibility of family planning services are other serious problems. To confront these problems, ONAPO plans to begin social marketing program, create more secondary health planning posts, promote integration of family planning services into the vaccination program, strengthen efforts to motivate postpartum women, and undertake a community distribution program for condoms and spermicides.

Family planning providers' perspectives on family planning service delivery in Ibadan and Kaduna, Nigeria: a qualitative study.

PubMed

Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna

2013-01-01

In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.

Aligning Funding and Need for Family Planning: A Diagnostic Methodology

PubMed Central

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

2017-01-01

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

[Family planning in Benin: what future?].

PubMed

Danlodji, R

1993-01-01

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

From a lifestyle revolution in a small village in Japan. Interview [with Chojiro Kunii].

PubMed

1990-10-01

In this interview, Chojiro Kunii, JOICFP chairman and president of the Japan Family Planning Organization (JFPA), addresses the status of family planning in Japan and the world, and explains how a people-oriented approach can make family planning effective - evident from the successful Integrated Family Planning, Nutrition and Parasite-Control Project (IP). According to Chojiro, poverty and social instability in Japan shortly after World War II forced many women to resort to illegal abortions. But beginning in the early 1950s, the government introduced family planning, and by the middle of the decade, population growth had ceased to be a problem. On the contrary, by the 1960s, worries centered around labor shortages and an aging population, which some blamed on family planning. Chojiro, however, defends family planning, since its focus in on maternal and child health. For family planning worldwide, one of the most pressing issues is adolescent sex, and Chojiro says that the JFPA has begun conducting research on the subject. As far as the approach towards family planning, Chojiro stresses the importance of a people-oriented, humanistic strategy. He says that the World Population Conference held in Bucharest, Romania is an example of an inhumane approach. Many of the speakers focuses only on reducing birth rates, and not on reducing infant mortality rates. Besides, a people oriented approach can be extremely effective, evident from the Integrated Family Planning, Nutrition and Parasite-Control Project. Chojiro first introduced the idea of combining family planning and parasite control in Japan; since then, JOICFP has helped other countries develop similar programs. Finally, Chojiro points out the need for international cooperation in promoting family planning.

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

PubMed

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

2018-05-01

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

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

PubMed Central

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

2018-01-01

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

Greater involvement of HIV-infected peer-mothers in provision of reproductive health services as "family planning champions" increases referrals and uptake of family planning among HIV-infected mothers.

PubMed

Mudiope, Peter; Musingye, Ezra; Makumbi, Carolyne Onyango; Bagenda, Danstan; Homsy, Jaco; Nakitende, Mai; Mubiru, Mike; Mosha, Linda Barlow; Kagawa, Mike; Namukwaya, Zikulah; Fowler, Mary Glenn

2017-06-27

In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic. The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification and referral of HIV Positive mothers in need of FP services; and accompanied referred mothers to FP clinics. We compiled and compared the average proportions of mothers in need that were referred and took up FP in the pre-intervention (3 months), intervention (6 months), and post-intervention(3 months) periods using interrupted time series with segmented regression models with an autoregressive term of one. Overall, during the intervention, the proportion of referred mothers in need of FP increased by 30.4 percentage points (P < 0.001), from 52.7 to 83.2 percentage points. FP uptake among mothers in need increased by over 31 percentage points (P < 0.001) from 47.2 to 78.5 percentage points during the intervention. There was a positive non-significant change in the weekly trend of referral β 3  = 2.9 percentage points (P = 0.077) and uptake β 3  = 1.9 percentage points (P = 0.176) during the intervention as compared to the pre-intervention but this was reversed during the post intervention. Over 57% (2494) mothers took up Depo-Provera injectable-FP method during the study. To support overstrained health care work force in post-natal clinics, peers in trained effective family planning can be a valuable addition to clinic staff in limited-resource settings. The study provides additional evidence on the utilization of peer mothers in HIV care, improves health services uptake including family planning which is a common practice in many donor supported programs. It also provides evidence that may be used to advocate for policy revisions in low-income countries to include peers as support staff especially in busy clinic settings with poor services uptake.

The roles of men in family planning - a study of married men at the UKM primary care clinic.

PubMed

Ling, Jes; Tong, S F

2017-01-01

Traditionally, family planning initiatives were concentrated on women despite it being a family matter. As family dynamics evolved over the years, fathers' involvement in family planning has become crucial in enhancing the family well-being. This study aimed to identify the role played by men in family planning activities and the association of socio-economic characteristics with these roles. This was a cross-sectional study carried out in a university primary care clinic. All married male attendees to the clinic, aged 50 years and below, were approached to answer a set of self-administered questionnaires, asking for their involvement in family planning practices. The data were analysed using descriptive and inferential statistics. There were 167 participants in the study. A high proportion of men participated in the discussions regarding previous pregnancies (60.42%), future child planning (89.76%) and desired family size (89.76%). However, the discussions on the usage of family planning methods (FPMs; 39.16%) were significantly low. Socio-economic factors associated with higher likelihood of men discussing family planning activities were older age ( p < 0.0), higher education level ( p = 0.010), higher monthly income ( p < 0.001) and longer duration of marriage ( p = 0.0049). The level of participation of men varied in the discussions of four family planning activities. The roles taken by men in family planning were associated with older age and higher socio-economic class. The majority of men needs to be encouraged to play a more active role in the discussion of FPMs.

Men and family planning in Portugal.

PubMed

Vicente, A

1993-10-01

Although family planning services in Portugal are open to everybody, male and female, and they are free of charge, it is mostly women who are using the services, since family planning services have integrated maternal health care. Between 1978 and 1981, the Commission for the Portuguese Commission for Equality and Women's Rights implemented a family planning information, education, and communication project under technical and financial aid by the United Nations Population Fund. During a training course for a group of 12 women, which took place in the small town Vialonga near Lisbon in 1992, all women said that their husbands did not play any role in family planning. The choice of the method was their sole responsibility. In 1988, data were gathered by the General Direction of Primary Health Care from the local health services. 17.6% of women used the pill, and 28% practiced coitus interruptus. Condom use amounted to 5.7%. Other methods were the IUD (7.3%), natural methods (3.6%), spermicides (2.6%), the diaphragm (0.3%), and sterilization (female 3.6%; male 0.3%). In 1992, the Commission published a study on family planning, involving 638 men and 882 women, which concluded that the responsibility for family planning was no longer exclusively with women and that young, single people were in favor of family planning information sessions. The Portuguese Constitution states that the state shall promote a wider knowledge of family planning methods and responsible parenthood. The Health Secretary of State ordered the integration of family planning into the National Health Service in 1976. A 1984 law, Sex Education and Family Planning, and a 1985 Government Order constitute the legal framework for the practice of family planning. The Commission for Equality and Women's Rights has been implementing information, education, and communication activities since 1976. One of the members of the Consultative Council is the Association for Family Planning, which has also been disseminating information, training, and counselling since it was founded in 1967.

Provision of family planning services in Tanzania: a comparative analysis of public and private facilities.

PubMed

Kakoko, Deodatus C; Ketting, Evert; Kamazima, Switbert R; Ruben, Ruerd

2012-12-01

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.

Practice-Informed Approaches to Addressing Substance Abuse and Trauma Exposure in Urban Native Families Involved with Child Welfare.

PubMed

Lucero, Nancy M; Bussey, Marian

2015-01-01

Similar to families from other groups, urban-based American Indian and Alaska Native ("Native") family members involved with the child welfare system due to substance abuse issues are also often challenged by untreated trauma exposure. The link between these conditions and the history of genocidal policies aimed at destroying Native family ties, as well as experiences of ongoing discrimination, bring added dimensions for consideration when pro- viding services to these families. Practice-based evidence indicates that the trauma-informed and culturally responsive model developed by the Denver Indian Family Resource Center (DIFRC) shows promise in reducing out-of-home placements and re-referrals in urban Native families with substance abuse and child welfare concerns, while also increasing caregiver capabilities, family safety, and child well-being. This article provides strategies from the DIFRC approach that non-Native caseworkers and supervisors can utilize to create an environment in their own agencies that supports culturally based practice with Native families while incorporating a trauma-informed understanding of service needs of these families. Casework consistent with this approach demonstrates actions that meet the Active Efforts requirement of the Indian Child Welfare Act (ICWA) as well as sound clinical practice. Intensive and proactive case management designed specifically for families with high levels of service needs is a key strategy when combined with utilizing a caseworker brief screening tool for trauma exposure; training caseworkers to recognize trauma symptoms, making timely referrals to trauma treatment by behavioral health specialists experienced in working with Native clients, and providing a consistent service environment that focuses on client safety and worker trustworthiness. Finally, suggestions are put forth for agencies seeking to enhance their cultural responsiveness and include increasing workers' understanding of cultural values, worldview, and historical issues; working from a relational perspective; listening deeply to families' experiences; and being open to incorporating traditional healing and cultural practice into service plans.

Factors Associated with Incidence of Induced Abortion in Hamedan, Iran.

PubMed

Hosseini, Hatam; Erfani, Amir; Nojomi, Marzieh

2017-05-01

There is limited reliable information on abortion in Iran, where abortion is illegal and many women of reproductive age seek clandestine abortion to end their unintended pregnancy. This study aims to examine the determinants of induced abortion in the city of Hamedan, Iran. The study utilizes recent data from the 2015 Hamedan Survey of Fertility, conducted in a representative sample of 3,000 married women aged 15-49 years in the city of Hamedan, Iran. Binary logistic regression models are used to examine factors associated with the incidence of abortion. Overall, 3.8% of respondents reported having had an induced abortion in their life. Multivariate results showed that the incidence of abortion was strongly associated with women's education, type of contraceptive and family income level, after controlling for confounding factors. Women using long-acting contraceptive methods, those educated under high school diploma or postsecondary education, and those with high level of income were more likely to report having an induced abortion. The high incidence of abortion among less or more educated women and those with high income level signifies unmet family planning needs among these women, which must be addressed by focused reproductive health and family planning programs.

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

PubMed Central

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

2018-01-01

Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013–14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014–2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in nursing schools, allowing students to operate as community-based distributors. While major challenges remain, significant progress in family planning has been made in the DRC, which should be judged not in comparison with sub-Saharan African countries with high mCPR and mature programs, but rather with those starting from much further behind. PMID:29602865

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

PubMed

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

2018-03-21

Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013-14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014-2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in nursing schools, allowing students to operate as community-based distributors. While major challenges remain, significant progress in family planning has been made in the DRC, which should be judged not in comparison with sub-Saharan African countries with high mCPR and mature programs, but rather with those starting from much further behind. © Kwete et al.

NASA Tech House: An early evaluation

NASA Technical Reports Server (NTRS)

1977-01-01

An architect-engineering firm, as well as university participants, performed system studies, evaluated construction methods, performed cost effectiveness studies, and prepared construction drawings which incorporated the selected technology features into a final design. A Technology Utilization House (Tech House) based on this design was constructed at the NASA Langley Research Center in Hampton, Virginia. The Tech House is instrumented so that the performance of the design features and energy systems can be evaluated during a planned family live-in period. As such, the house is both a demonstration unit and a research laboratory. The Tech House is to demonstrate the kind of single-family residence that will probably be available within the next five years.

Social marketing -- playing an important role in public health.

PubMed

1997-01-01

Over the past few years, social marketing has grown dramatically in importance throughout the world for its comprehensive approach of creating both demand and supply for essential health products for maternal and child health, AIDS prevention, and family planning for lower-income families in developing countries. The Society for Family Health (SFH) utilizes the techniques of social marketing to serve the health needs of Zambia. Social marketing involves the marketing of health products at affordable prices utilizing the existing wholesale and retail infrastructure. In this manner, health products can be accessed at thousands of outlets, and not just in clinics and hospitals, by encouraging clients who can afford to pay small amounts to obtain contraceptives from nearby chemists, private clinics, and other outlets at affordable prices. In this way, the activities carried out by SFH complement the programs of the Ministry of Health. A key ingredient of social marketing is the implementation of information, education, and communication (IEC) campaigns that motivate behavioral change. Hence, by the use of attractive packaging, persuasive communication, and the promise of high-quality contraceptives at an affordable price, social marketing encourages contraceptive usage. Therefore, social marketing creates demand for essential health products while ensuring their constant availability at affordable prices.

The Role of Public-Sector Family Planning Programs in Meeting the Demand for Contraception in Sub-Saharan Africa.

PubMed

Bongaarts, John; Hardee, Karen

2017-06-01

Commonly used indicators of contraceptive behavior in a population-modern contraceptive prevalence (mCPR), unmet need for contraception, demand for contraception and demand satisfied-are not well-suited for evaluating the progress made by government family planning programs in helping women and men achieve their reproductive goals. Trends in these measures in 26 Sub-Saharan African countries between 1990 and 2014 were examined. Trends in a proposed new indicator, the public-sector family planning program impact score (PFPI), and its relationship to mCPR and the family planning effort score were also assessed. Case studies were used to review public family planning program development and implementation in four countries (Nigeria, Ethiopia, Rwanda and Kenya). The four commonly used indicators capture the extent to which women use family planning and to which demand is satisfied, but shed no direct light on the role of family planning programs. PFPI provides evidence that can be used to hold governments accountable for meeting the demand for family planning, and was closely related to policy developments in the four case-study countries. PFPI provides a useful addition to the indicators currently used to assess progress in reproductive health and family planning programs.

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

PubMed

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

2016-05-24

Nigeria has the highest population in sub-Saharan Africa with high birth and growth rates. There is therefore need for family planning to regulate and stabilize this population. This study examined the relationship between access to mass media messages on family planning and use of family planning in Nigeria. It also investigated the impacts of spatio-demographic variables on the relationship between access to mass media messages and use of family planning. Data from the 2013 demographic and health survey of Nigeria which was conducted in all the 36 states of Nigeria, and Abuja were used for the study. The sample was weighted to ensure representativeness. Univariate, bivariate and binary logistic regressions were conducted. The relationship between each of the access to mass media messages, and the family planning variables were determined with Pearson correlation analysis. The correlation results showed significant but weak direct relationships between the access to mass media messages and use of family planning at p < 0.0001 with access to television messages (r = 0.239) being associated with highest use of family planning. Some of the results of the adjusted regression analysis showed that access to television messages (OR = 1.2.225; p < 0.0001), and radio messages (OR = 1.945; p < 0.0001) increase the likelihood of the use of family planning. The adjusted regression model also indicated increased likelihood in the use of family planning by respondents with secondary education (OR = 2.709; p < 0.0001), the married (OR = 1.274; p < 0.001), and respondents within the highest wealth quintiles (OR = 3.442; p < 0.0001). There exist significant variations within spatio-demographic groups with regards to having access to mass media messages on family planning, and on the use of family planning. The results showed that access to mass media messages increases the likelihood of the use of family planning. Also people with higher socioeconomic status and those from the Southern part of the country make more use of family planning. There is need to improve the socioeconomic status of the populations. Also, the quality and regularity of mass media messages should be improved, while other communication avenues such as traditional institutions, blogs, and seminars for youths should be used to make family planning messages more acceptable.

Improving productivity levels: family planning services for factory workers.

PubMed

Darmokusumo, H V

1989-10-01

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

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

PubMed

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

2009-09-01

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

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

PubMed

Chen, E C

1981-12-01

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

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

PubMed Central

Mir, Ali Mohammad; Shaikh, Gul Rashida

2013-01-01

ABSTRACT A USAID-sponsored family planning project called “FALAH” (Family Advancement for Life and Health), implemented in 20 districts of Pakistan, aimed to lower unmet need for family planning by improving access to services. To enhance the quality of care offered by the public health system, the FALAH project trained 10,534 facility-based health care providers, managers, and medical college faculty members to offer client-centered family planning services, which included a module to explain the Islamic viewpoint on family planning developed through an iterative process involving religious scholars and public health experts. At the end of the FALAH project, we conducted a situation analysis of health facilities including interviews with providers to measure family planning knowledge of trained and untrained providers; interviewed faculty to obtain their feedback about the training module; and measured changes in women's contraceptive use through baseline and endline surveys. Trained providers had a better understanding of family planning concepts than untrained providers. In addition, discussions with trained providers indicated that the training module on Islam and family planning helped them to become advocates for family planning. Faculty indicated that the module enhanced their confidence about the topic of family planning and Islam, making it easier to introduce and discuss the issue with their students. Over the 3.5-year project period, which included several components in addition to the training activity, we found an overall increase of 9 percentage points in contraceptive prevalence in the project implementation districts—from 29% to 38%. The Islam and family planning module has now been included in the teaching program of major public-sector medical universities and the Regional Training Institutes of the Population Welfare Department. Other countries with sizeable Muslim populations and low contraceptive prevalence could benefit from this module. PMID:25276535

34 CFR 300.24 - Individualized family service plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

26 CFR 1.125-4 - Permitted election changes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the number of an employee's family members or dependents who may benefit from coverage under the plan... that individual becomes applicable or is increased under the family member plan. With respect to group... includes payments described in section 105(c). (5) Family member plan. A family member plan means a...

26 CFR 1.125-4 - Permitted election changes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the number of an employee's family members or dependents who may benefit from coverage under the plan... that individual becomes applicable or is increased under the family member plan. With respect to group... includes payments described in section 105(c). (5) Family member plan. A family member plan means a...

26 CFR 1.125-4 - Permitted election changes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the number of an employee's family members or dependents who may benefit from coverage under the plan... that individual becomes applicable or is increased under the family member plan. With respect to group... includes payments described in section 105(c). (5) Family member plan. A family member plan means a...

26 CFR 1.125-4 - Permitted election changes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the number of an employee's family members or dependents who may benefit from coverage under the plan... that individual becomes applicable or is increased under the family member plan. With respect to group... includes payments described in section 105(c). (5) Family member plan. A family member plan means a...

Reliability and validity of the adolescent health profile-types.

PubMed

Riley, A W; Forrest, C B; Starfield, B; Green, B; Kang, M; Ensminger, M

1998-08-01

The purpose of this study was to demonstrate the preliminary reliability and validity of a set 13 profiles of adolescent health that describe distinct patterns of health and health service requirements on four domains of health. Reliability and validity were tested in four ethnically diverse population samples of urban and rural youths aged 11 to 17-years-old in public schools (N = 4,066). The reliability of the classification procedure and construct validity were examined in terms of the predicted and actual distributions of age, gender, race, socioeconomic status, and family type. School achievement, medical conditions, and the proportion of youths with a psychiatric disorder also were examined as tests of construct validity. The classification method was shown to produce consistent results across the four populations in terms of proportions of youths assigned with specific sociodemographic characteristics. Variations in health described by specific profiles showed expected relations to sociodemographic characteristics, family structure, school achievement, medical disorders, and psychiatric disorders. This taxonomy of health profile-types appears to effectively describe a set of patterns that characterize adolescent health. The profile-types provide a unique and practical method for identifying subgroups having distinct needs for health services, with potential utility for health policy and planning. Such integrative reporting methods are critical for more effective utilization of health status instruments in health resource planning and policy development.

Family planning gets a new boost.

PubMed

Ponle, B

1993-01-01

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

Randomized field experiments for program planning, development, and evaluation: an illustrative bibliography.

PubMed

Boruch, R F; Mcsweeny, A J; Soderstrom, E J

1978-11-01

This bibliography lists references to over 300 field experiments undertaken in schools, hospitals, prisons, and other social settings, mainly in the U.S. The list is divided into 10 major categories corresponding to the type of program under examination. They include: criminal and civil justice programs, mental health, training and education, mass media, information collection, utilization, commerce and industry, welfare, health, and family planning. The main purpose of the bibliography is to provide evidence on feasibility and scope of randomized field tests, since despite their advantages, it is not always clear from managerial, political, and other constraints on research that they can be mounted. Dates of publications range from 1944 to 1978.

Impediments to media communication of social change in family planning and reproductive health: experiences from East Africa.

PubMed

Kagurusi, Patrick T

2013-09-01

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.

Men and Family Planning. Worldwatch Paper 41.

ERIC Educational Resources Information Center

Stokes, Bruce

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

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

ERIC Educational Resources Information Center

Armstrong, Kay A.; And Others

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

Changes in contraceptive use following integration of family planning into ART Services in Cross River State, Nigeria.

PubMed

McCarraher, Donna R; Vance, Gwyneth; Gwarzo, Usman; Taylor, Douglas; Chabikuli, Otto Nzapfurundi

2011-12-01

One strategy for meeting the contraceptive needs of HIV-positive women is to integrate family planning into HIV services. In 2008 in Cross River State, Nigeria,family planning was integrated into antiretroviral (ART) services in five local government areas. A basic family planning/HIV integration model was implemented in three of these areas, and an enhanced model in the other two. We conducted baseline interviews in 2008 and follow-up interviews 12-14 months later with 274 female ART clients aged 18-45 in 2009 across the five areas. Unmet need for contraception was high at baseline (28-35 percent). We found that modern contraceptive use rose in the enhanced and basic groups; most of the increase was in consistent condom use. Despite an increase in family planning counseling by ART providers, referrals to family planning services for noncondom methods were low. We conclude by presenting alternative strategies for family planning/HIV integration in settings where large families and low contraceptive use are normative.

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

PubMed

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

2011-12-01

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

Setting the record straight.

PubMed

Moran, T

1998-12-01

This article examines the effect of the proposed limitation of funds for family planning direct services by the Texas Department of Health (TDH). A plan was unveiled by the TDH that called for cuts from Title V (Maternal and Child Health) to phase out family planning direct service delivery and increase population-based services. This proposal would mean that by 2000 at least 28,500 low-income women would have difficulty in receiving family planning services and obstetrical and gynecological services. During the 1998 Scripps Howard Texas poll, it was shown that majority of Texans support addition in public funding of family planning services for poor women, but it would result to a more expensive tax increase. Advocates of family planning were apprehensive on the effect of inaccessible family planning services among young and poor women. On the other hand, promoters of the Title V cuts claimed that family planning service is like any other clinical service that would be ineffective unless it takes into account the community and prevention dynamics.

Some factors affecting acceptance of family planning in Manus.

PubMed

Avue, B; Freeman, P

1991-12-01

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

Health status, sexual and drug risk, and psychosocial factors relevant to postrelease planning for HIV+ prisoners.

PubMed

Feaster, Daniel J; Reznick, Olga Grinstead; Zack, Barry; McCartney, Kathleen; Gregorich, Steven E; Brincks, Ahnalee M

2013-10-01

The prevalence of HIV infection among male prison inmates is significantly higher than in the U.S. population. Adequate planning to ensure continued medication adherence and continuity of care after release is important for this population. This study describes the prerelease characteristics of 162 incarcerated HIV-positive men (40 from jails and 122 from prisons). The results include a demographic description of the sample and the participants' sexual risk behaviors, substance use, health status and HIV medication adherence, health care utilization, mental health, and family and social support. The results highlight a potentially high level of need for services and low levels of support and social connectedness. Postrelease planning should include support for improving HIV medication adherence as well as reducing both sexual and injection drug-related transmission risk for these individuals.

A community-based, mixed-methods study of the attitudes and behaviors of men regarding modern family planning in Nigeria.

PubMed

Akaba, Godwin; Ketare, Nathaniel; Tile, Wilfred

2016-10-01

To investigate the knowledge, attitudes, and extent of involvement of men in family planning in Nigeria, and to evaluate spousal communication regarding family planning. A community-based, mixed-methods study enrolled participants in Gwagwalada, Abuja, Nigeria between January 11 and June 30, 2012. Quantitative surveys including semi-structured interviews were used to collect information from married men regarding their knowledge and attitudes to modern family planning. The qualitative components constituted focus group discussion sessions and in-depth interviews that included married men, married women, religious leaders, community leaders, and family-planning providers. Quantitative surveys were completed by 152 men; 99 (65.1%) reported that they would accompany their wives to family-planning clinics in the future, 116 (76.3%) reported approving of the use of modern contraception by their wives, and 132 (86.8%) reported wanting to know more about family planning. Both quantitative and qualitative aspects of the study indicated that husbands were the major decision makers regarding family size, choice of contraceptive, and pregnancy timing. In terms of fertility goals and family planning, men were the primary decision makers; consequently, obtaining their support and commitment to family planning is of crucial importance in Nigeria. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

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

PubMed

Aziz, Mirette; Ahmed, Sabra; Ahmed, Boshra

2017-12-01

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

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case–control study

PubMed Central

2014-01-01

Background Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. Methods A case–control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15–49 years were interviewed using structured questionnaires. A logistic regression was fitted. Results Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. Conclusion While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates. PMID:25117887

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study.

PubMed

Eliason, Sebastian; Awoonor-Williams, John K; Eliason, Cecilia; Novignon, Jacob; Nonvignon, Justice; Aikins, Moses

2014-08-13

Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted. Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.

Family planning and health: the Narangwal experiment.

PubMed

Faruqee, R

1983-06-01

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

Self-reliance through FP program.

PubMed

1988-03-01

The Yogyakarta Chapter of the Indonesian Planned Parenthood Association (IPPA), having been successful in bringing about a realization by the local community of the importance of family planning, has broadened its activities in an effort to further promote family welfare. Since 1980, the organization has begun a number of projects designed to increase the income of its client population. Given the fact that family planning acceptors of IPPA's Yogyakarta Chapter range from government officials' wives to farmers and school dropouts, its family income increase projects have been varied. Skills in such areas as bee breeding and hairdressing have been taught, and credit cooperatives have been established. These projects have been integrated with the group's family planning activities and have been paid for entirely with local funds. An integrated family planning/income increase project currently being operated by the Yogyakarta Chapter of IPPA is known as KBP2K. Along with the attempt to increase family income, the project aims to expand the acceptance of family planning and to retain existing acceptors in the family planning program. As of the 3rd quarter of 1987, 235 people had participated in the project and 59 new acceptors had been acquired. Family planning education was provided and classes were taught in various handicraft industries. Studies have revealed that the income levels of program participants significantly increased.

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

PubMed

Amin, R; Mariam, A G

1986-12-01

The changes in levels of knowledge about different contraceptive methods in Bangladesh between 1969-79 were assessed. 2 surveys provided the data: the 1969 National Impact Survey (NIS) of family planning and the 1979 Contraceptive Prevalence Survey (CPS) from Bangladesh. Both surveys were nationally representative and retrospective, containing detailed questions of pregnancy histories, socioeconomic background, family planning knowledge and attitude, and contraceptive practices. The sampling frames for both surveys consisted of all households in Bangladesh from which national probability samples of married women between the ages of 10-50 were selected and stratified by urban-rural residence. Unprompted data were analyzed. Apparently, the National Family Planning Program (NFPP) was successful in communicating general knowledge of family planning among the masses in Bangladesh. In terms of absolute level, the increase in general knowledge of family planning was from 46.3% in 1969 to 82.8% in 1979. With the exception of the oral contraceptive (OC), absolute increase in knowledge of specific family planning methods or a variety of methods was far less than that of general knowledge of family planning. Knowledge of condoms, female sterilization, and male sterilization increased between 1969-79, yet in terms of absolute levels these increases were far less than those of either general knowledge of family planning or knowledge of OCs. The percentages of couples reporting knowledge of the IUD, vaginal methods, rhythm, injection, or induced abortion either decreased or slightly increased between 1969-79. Nearly 40% of couples had knowledge of only 1 method; fewer couples knew of 2 or more methods. There were relative increases in the knowledge of OCs and female sterilization, an 8-fold increase in knowledge of the OC and a 6-fold increase in knowledge of female sterilization between 1969-79. Respondents from the urban areas or those who attended schools were more likely to know about different contraceptive methods. Despite government orders stipulating that each household be visited every month by a family planning worker, face-to-face contact with family planning extension workers continued to be very low. In view of poor field worker performance, the government has made various modifications in the NFPP operation aimed at strengthening information and service delivery programs, yet recent evidence shows their continuing ineffectiveness. The low levels of knowledge about different family planning methods and low level of contact between family planning workers and family planning target couples show that the NFPP, by failing to inform married couples of wider choice of methods, missed many potential new acceptors of family planning methods.

Energy conserving site design case study: Shenandoah, Georgia. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The case study examines the means by which energy conservation can be achieved at an aggregate community level by using proper planning and analytical techniques for a new town, Shenandoah, Georgia, located twenty-five miles southwest of Atlanta's Hartsfield International Airport. A potentially implementable energy conservation community plan is achieved by a study team examining the land use options, siting characteristics of each building type, alternate infrastructure plans, possible decentralized energy options, and central utility schemes to determine how community energy conservation can be achieved by use of pre-construction planning. The concept for the development of mixed land uses as amore » passively sited, energy conserving community is based on a plan (Level 1 Plan) that uses the natural site characteristics, maximizes on passive energy siting requirement, and allows flexibility for the changing needs of the developers. The Level 2 Plan is identical with Level 1 plan plus a series of decentraized systems that have been added to the residential units: the single-family detached, the apartments, and the townhouses. Level 3 Plan is similar to the Level 1 Plan except that higher density dwellings have been moved to areas adjacent to central site. The total energy savings for each plan relative to the conventional plan are indicated. (MCW)« less

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

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

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

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

ERIC Educational Resources Information Center

Swartz, Barbara

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

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

PubMed

Harvey, P D

1984-01-01

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

My university. What I learned from the Productive Cooperative Movement to Promotion of Humanistic Family Planning.

PubMed

Kunii, C

1990-07-01

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.

Rural-Urban Differences in Awareness and Use of Family Planning Services Among Adolescent Women in California.

PubMed

Yarger, Jennifer; Decker, Martha J; Campa, Mary I; Brindis, Claire D

2017-04-01

The purpose of this study was to compare awareness and use of family planning services by rural and urban program site among a sample of adolescent women before participation in the federal Personal Responsibility Education Program in California. We conducted a secondary analysis of survey data collected from youth before participation in California's Personal Responsibility Education Program. Bivariate and multivariate analyses were conducted for a sample of 4,614 females ages 14-18 years to compare awareness and use of family planning services between participants at rural and urban program sites, controlling for the program setting and participant demographic, sexual, and reproductive characteristics. Overall, 61% of participants had heard of a family planning provider in their community, and 24% had visited a family planning provider. Awareness and use of family planning services were lower among rural participants than urban participants. After adjusting for the program setting and participant characteristics, rural participants were less likely to know about a family planning provider in their community (odds ratio, .64; 95% confidence interval, .50-.81) or receive family planning services (odds ratio, .76; 95% confidence interval, .58-.99) than urban participants. Findings suggest that adolescents in rural areas face greater barriers to accessing family planning services than adolescents in urban areas. Targeted efforts to increase awareness and use of family planning services among adolescents in rural areas and among other underserved populations are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Old and new ways: family planning in Kenya.

PubMed

Antarsh, L

1989-04-01

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

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

PubMed

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

2013-10-01

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

The behavior of Italian family physicians regarding the health problems of women and, in particular, family planning (both contraception and NFP).

PubMed

Girotto, S; Del Zotti, F; Baruchello, M; Gottardi, G; Valente, M; Battaggia, A; Rosa, B; Fedrizzi, P; Campanella, M; Zumerle, M; Bressan, F

1997-01-01

The hospital-centered trend that has dominated medical culture and the management of health care during this entire century has, in the last few years, undergone a reversal in Italy. Conditions in other countries suggest that similar changes have or will become increasingly common. The family physician today manages many of the functions previously handled by hospitals and specialists. In the field of reproductive health, family physicians are responsible not only for diagnosis and treatment, but also for prevention and education. The present study considers this new context with the objective of investigating the knowledge and behavior of Italian family physicians in the field of women's health, with particular regard to family planning (including natural family planning), through (1) a qualitative study (focus groups) of a small group of family physicians and (2) a questionnaire sent to 500 family physicians throughout Italy. The results of the focus group are summarized in the form of obstacles that the family physician finds in providing family planning services and proposals for change. The results indicate that because of their holistic approach, the family physician is an appropriate provider of family planning services although continued use of specialists' services, changes in logistics of the family physicians' practice, increased gender sensitivity, and additional training and information are necessary. The results of the questionnaire (121 responses, 24.2%) indicate that the Italian family physician currently lacks certain important information about family planning and would require logistical support to provide these services but is interested in acquiring information and is an appropriate family planning provider. An additional challenge for encouraging family practitioners to provide natural methods is that they favor a "medical" approach rather than a "behavioral" one in their treatment preferences for several other conditions.

Prevalence, psychosocial correlates and service utilization of depressive and anxiety disorders in Hong Kong: the Hong Kong Mental Morbidity Survey (HKMMS).

PubMed

Lam, Linda Chiu-Wa; Wong, Corine Sau-Man; Wang, Min-Jung; Chan, Wai-Chi; Chen, Eric Yu-Hai; Ng, Roger Man-Kin; Hung, Se-Fong; Cheung, Eric Fuk-Chi; Sham, Pak-Chung; Chiu, Helen Fung-Kum; Lam, Ming; Chang, Wing-Chung; Lee, Edwin Ho-Ming; Chiang, Tin-Po; Lau, Joseph Tak-Fai; van Os, Jim; Lewis, Glyn; Bebbington, Paul

2015-09-01

Data on mental disorder prevalence and health service utilization required to inform healthcare management and planning are lacking in Hong Kong. The current study determined the prevalence of common mental disorders (CMD), and examined the patterns of mental health service utilization and associated factors. We analyzed data from the Hong Kong Mental Morbidity Survey (HKMMS) of 5,719 Chinese adults aged 16-75 years in the general Hong Kong population, using the Chinese Revised Clinical Interview Schedule (CIS-R). The weighted prevalence estimate for any past-week CMD was 13.3 %, with mixed anxiety and depressive disorder being the most frequent diagnoses. CMD was positively associated with female gender, being divorced or separated, alcohol misuse, substance dependence, lack of regular physical exercise, and a family history of mental disorder. Among individuals with CMD, only 26 % had consulted mental health services in the past year; less than 10 % consulted general practitioners or family physicians. Lack of mental health service usage was significantly more likely in men and those with lower educational attainment. Apart from attention to psychosocial risks, health and lifestyle factors are important considerations for mental health promotion. Service utilization for individuals with CMD in Hong Kong remains suboptimal, and would be enhanced by strengthening community primary care.

42 CFR 59.4 - How does one apply for a family planning services grant?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false How does one apply for a family planning services grant? 59.4 Section 59.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does...

42 CFR 59.4 - How does one apply for a family planning services grant?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false How does one apply for a family planning services grant? 59.4 Section 59.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does...

42 CFR 59.4 - How does one apply for a family planning services grant?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false How does one apply for a family planning services grant? 59.4 Section 59.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does...

42 CFR 59.4 - How does one apply for a family planning services grant?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How does one apply for a family planning services grant? 59.4 Section 59.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does...

42 CFR 59.4 - How does one apply for a family planning services grant?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false How does one apply for a family planning services grant? 59.4 Section 59.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does...

[On family planning and socialist cultural civilization].

PubMed

Yin, G; Cao, J; Yin, W

1984-03-29

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

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

PubMed

Cho, K S

1976-04-01

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

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

PubMed

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

1997-03-01

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

An empirical investigation of female labor-force participation, fertility, age at marriage, and wages in Korea.

PubMed

Lee, B S; Mcelwain, A M

1985-07-01

The Korean experience raises questions about the assumption that successful economic development and equitable income distribution are preconditions for rapid fertility declines. During the 1960-70 decade, the total fertility rate in Korea declined by 36% and the crude birth rate fell by 33%, in the absence of significant economic development. This paper uses data from the 1974 Korean Fertility Survey to explore the relationships between the factors responsible for this rapid fertility decline. A simultaneous equation model of fertility, age at marriage, extent of labor force participation during marriage, quality of children, and wages is developed and tested. Rather than to provide definitive measures of these interrelationships, the aim was to investigate the utility of treating several variables as being jointly determined. The results suggest that parental education affects fertility by influencing age at marriage, implying that adult education programs will have little effect on marital fertility. There was some evidence that working women whose jobs are compatible with child care have more children than nonworking women, a finding that should be considered in planning increased job opportunities for women. Urbanized women and those who work before marriage tend to marry later than their less urbanized counterparts or women who do not work prior to marriage. Finally, women who used modern methods of birth control had significantly lower fertility than nonusers of modern methods. There is concern that the Government has reduced budgetary appropriations to family planning since the goal of reducing the annual population growth rate from 3% in 1960 to 2% in 1970 was achieved. It is suggested that family planning expenditures should be deployed to areas such as urban slums that have not yet been reached by family planning programs.

The advance care planning experiences of people with dementia, family caregivers and professionals: a synthesis of the qualitative literature.

PubMed

Ryan, Tony; Amen, Karwan M; McKeown, Jane

2017-10-01

There exists compelling evidence that advance care planning (ACP) remains a key factor in the delivery of appropriate end of life care and facilitates the timely transition to palliative care for people with dementia. Take up of ACP within the dementia population is low, especially when compared with other conditions. Quantitative research has helped in identifying some of the key factors in enabling or inhibiting the use of ACP within the dementia population. Qualitative research can, however, shed further light upon the experiences of all. We carried out a search of the qualitative literature addressing the ACP experiences of people with dementia, family caregivers and professionals. An approach to qualitative synthesis involving coding of original text, developing descriptive themes and generating analytical themes was utilized. We identified five papers and subsequently five analytical themes: breadth and scope of future planning; challenges to ACP; postponing ACP; confidence in systems and making ACP happen for people with dementia. The synthesized findings shed light on the ongoing challenges of the use and further development of ACP in the population of people with dementia. In particular attention is drawn to the difficulties in the timing of ACP and the preference for informal approaches to planning within the families of people affected by dementia. The ACP capacity of the workforce is also addressed. The paper reveals considerable complexity in undertaking ACP in a context of dementia. It is suggested that the preference for informal approaches and the timing of initial conversations be considered and that the skills of those involved in initiating discussions should be given primacy.

Individualized Education Program Development Among Racially/Ethnically Diverse Children and Adolescents with Health Conditions.

PubMed

Hinojosa, Melanie Sberna; Hinojosa, Ramon; Nguyen, Jennifer; Bright, Melissa

2017-03-01

Background Black, Hispanic, and low income children bear a greater burden of chronic health conditions compared to wealthier white counterparts. Under federal law, schools provide services to children when their health conditions impair learning. These school services, called individualized education programs (IEPs) can reduce disparities in school outcomes. This paper examines the extent to which children with health conditions have an IEP plan, an important first step in understanding service utilization. Method Andersen's Behavioral Model was used to examine IEP plan presence by using the 2012 National Survey of Children's Health. School aged children (6-17), with at least one health condition (N = 16,496) were examined using multivariable logistic regression analysis to understand predisposing (age, sex, race/ethnicity), enabling (family and neighborhood), and need (health related) factors as predictors of having an IEP plan. Race/ethnicity interaction terms tested for moderating effects of race/ethnicity on the relationship between predisposing, enabling and need factors and having an IEP plan. Results Hispanic children were 93.4 % (OR = .066) less likely and Black children were 87.9 % (OR = .121) less likely to have an IEP plan compared to White children. Black, Hispanic, and Multiracial children were more likely to have an IEP plan if they had more family and neighborhood resources (OR range 1.37-1.62) and greater health needs and health care needs (OR range 1.29-2.57). Conclusion The Behavioral Model was useful in predicting the presence of IEP plans among racially/ethnically diverse children with health conditions as an important step in understanding disparities in healthcare access in schools.

Family Planning Handbook for Doctors.

ERIC Educational Resources Information Center

Kleinman, Ronald L., Ed.

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

Techniques for overcoming community resistance to family planning programs.

PubMed

Palley, H A

1968-01-01

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

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

PubMed Central

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

2015-01-01

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

[Some psychological problems in family planning work].

PubMed

Chen, J

1983-11-29

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

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

ERIC Educational Resources Information Center

Linzell, Dinah, Comp.

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

24 CFR 599.507 - Tax incentives utilization plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Tax incentives utilization plan....507 Tax incentives utilization plan. (a) Preliminary plan. Within six months of designation, the CoRA must prepare and submit to HUD a preliminary tax incentives utilization plan for achieving the State...

IPPF Co-operative Information Service (ICIS). November 1978.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This is a bibliography of family planning material available from the International Planned Parenthood Cooperative Information Service library and documentation services. Entries are made under the following categories: reference books, biographies, family planning and bio-medical science, social sciences related to family planning, international…

Proceedings of the National Conference on the Delivery of Family Planning Services in Rural America (1st, Atlanta, Georgia, October, 1977).

ERIC Educational Resources Information Center

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…

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

PubMed

1994-01-01

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

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

PubMed

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

2018-01-05

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

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

PubMed

1989-01-01

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Keysa, T.P.

Characteristics of design, construction, performance, and educational opportunity are described for a small, simple passive solar community center in Christian Bend, Tennessee. This 2500-square-foot structure was designed in cooperation with this community of 75 families by TVA architects and was built entirely by volunteer labor. An educational process paralleled all phases of this building, begining with programming sessions, continuing through design, construction, occupation, and operation of the space. The direct gain building utilizes energy planning in both the interior and exterior. Earth berming and utilization of natural topography aid in the building's compatibility with both summer and winter climatic events.more » In addition to microclimatic design, interior space planning aids in naturally tempering spaces from extremes in climate. Extensive use of buffer spaces, an airlock entry, and placement of glazing areas (for direct gain and natural and induced ventilation) aid in the natural energy utilization and distribution in the interior spaces. Unique aspects include a double roof, which aids both in prevention of heat loss and in induced ventilation, and other operable garage door type roll down insulated shutters over the south facing aperture areas utilized both as night insulation and as a radiation barrier. This is the other major unique factor in this building. It has been designed both as an energy efficient community center for business as usual, and as an evacuation point and temporary shelter in th event of natural (flood) or man-induced (nuclear) disaster.« less

The meaning and experience of bereavement support: A qualitative interview study of bereaved family caregivers.

PubMed

Kirby, Emma; Kenny, Katherine; Broom, Alex; MacArtney, John; Good, Phillip

2017-06-21

Experiences of bereavement can be stressful and are frequently complicated by emotional, familial, and financial issues. Some-though not all-caregivers may benefit from bereavement support. While considered standard within palliative care services in Australia, bereavement support is not widely utilized by family caregivers. There is little research focused on the forms of bereavement support desired or required by family caregivers, how such care is viewed, and/or how bereavement support is experienced. This study examined the experiences of bereaved family caregivers and their impressions of and interactions with bereavement support. This paper reports on one aspect of a broader study designed to explore a range of experiences of patients and caregivers to and through palliative care. Focusing on experiences of bereavement, it draws on qualitative semistructured interviews with 15 family caregivers of palliative care patients within a specialist palliative care unit of an Australian metropolitan hospital. The interviews for this stage of the study were initiated 3-9 months after an initial interview with a family caregiver, during which time the palliative patient had died, and they covered family caregivers' experiences of bereavement and bereavement support. Interviews were digitally audiotaped and transcribed in full. A thematic analysis was conducted utilizing the framework approach wherein interview transcripts were reviewed, key themes identified, and explanations developed. The research identified four prevalent themes: (1) sociocultural constructions of bereavement support as for the incapable or socially isolated; (2) perceptions of bereavement support services as narrow in scope; (3) the "personal" character of bereavement and subsequent incompatibility with formalized support, and (4) issues around the timing and style of approaches to being offered support. Systematic pre-bereavement planning and careful communication about the services offered by palliative care bereavement support centers may improve receipt of support among bereaved family caregivers in need.

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

PubMed

Smyth, I

1994-06-01

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

The weight of Thai infants exclusively breast-fed and formula-fed from birth to four months.

PubMed

Chavalittamrong, B; Jirapinyo, P

1987-05-01

The 18-month Industry-Based Family Planning Project, which involved 30 industrial establishments located in Metro Manila (Philippines), combined a heavy interpersonal component, through a network of trained in-plant volunteers (IPVs), with an intensive in-plant information campaign. The latter made use of seminars, audiovisual presentations, posters, brochures, leaflets, photo exhibits, and contests. Training of the project staff -- 5 project officers and a project coordinator -- included providing them with the knowledge, attitudes, and skills necessary to carry out their tasks. Tasks were: to transfer to the IPVs knowledge of the concept of responsible parenthood and the various family planning methods, skills in motivating other workers, and responding to rumors and misconceptions about family planning methods; to act as resource persons on responsible parenthood and family planning methods in the industry setting; and to provide the technical support to the IPVs on responsible parenthood. The campaign plan centered on strategies which would help achieve the project objective, i.e., to increase the demand for and the availability of family planning information and services using nongovernment and government organizations. Basically, the plan addressed 2 segments of the industrial sector: the workers as the primary audience and the company managers as the secondary target. According to the program's pro-choice policy, a wide range of approved family planning services were made available to interested employees either by accredited company clinics or outside family planning service centers. Services by outside family planning service clinics were delivered via referrals or, in some instances, at the company's "doorstep." The end-of-project evaluation and the analysis of data gathered from reports and records maintained by the companies and by the Population Center Foundation (PCF) indicate that, after 18 months of operation, the project was able to substantially achieve its objective. It increased the demand for family planning information and services among workers in 30 industrial establishments located in Metro Manila. The more frequently mentioned sources of information on responsible parenthood and family planning were project-related personnel. Additionally, the different family planning methods became more widely known in the companies.

Levels, trends and reasons for unmet need for family planning among married women in Botswana: a cross-sectional study.

PubMed

Letamo, Gobopamang; Navaneetham, Kannan

2015-03-31

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. This study used secondary data from a cross-sectional survey that was conducted to provide a snapshot of health issues in Botswana. Nationally representative population survey data. 2601 married or in union women aged 15-49 years who participated in the 2007 Botswana Family Health Survey were included in the analysis. 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. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Family planning use among urban poor women from six cities of Uttar Pradesh, India.

PubMed

Speizer, Ilene S; Nanda, Priya; Achyut, Pranita; Pillai, Gita; Guilkey, David K

2012-08-01

Family planning has widespread positive impacts for population health and well-being; contraceptive use not only decreases unintended pregnancies and reduces infant and maternal mortality and morbidity, but it is critical to the achievement of Millennium Development Goals. This study uses baseline, representative data from six cities in Uttar Pradesh, India to examine family planning use among the urban poor. Data were collected from about 3,000 currently married women in each city (Allahabad, Agra, Varanasi, Aligarh, Gorakhpur, and Moradabad) for a total sample size of 17,643 women. Participating women were asked about their fertility desires, family planning use, and reproductive health. The survey over-sampled slum residents; this permits in-depth analyses of the urban poor and their family planning use behaviors. Bivariate and multivariate analyses are used to examine the role of wealth and education on family planning use and unmet need for family planning. Across all of the cities, about 50% of women report modern method use. Women in slum areas generally report less family planning use and among those women who use, slum women are more likely to be sterilized than to use other methods, including condoms and hormonal methods. Across all cities, there is a higher unmet need for family planning to limit childbearing than for spacing births. Poorer women are more likely to have an unmet need than richer women in both the slum and non-slum samples; this effect is attenuated when education is included in the analysis. Programs seeking to target the urban poor in Uttar Pradesh and elsewhere in India may be better served to identify the less educated women and target these women with appropriate family planning messages and methods that meet their current and future fertility desire needs.

Care planning for pressure ulcers in hospice: the team effect.

PubMed

Eisenberger, Andrew; Zeleznik, Jomarie

2004-09-01

The standards of care for patients at risk for or with a pressure ulcer in hospitals and nursing homes focus on prevention and ulcer healing using an interdisciplinary approach. Although not a primary hospice condition, pressure ulcers are not uncommon in dying patients. Their management in hospices, particularly the involvement of family caregivers, has not been studied. The objective of this study is to identify the factors that influence care planning for the prevention and treatment of pressure ulcers in hospice patients and develop a taxonomy to use for further study. A telephone survey was conducted with 18 hospice directors of clinical services and 10 direct-care nurses. Descriptive qualitative data analysis using grounded theory was utilized. The following three themes were identified: (1) the primary role of the hospice nurse is an educator rather than a wound care provider; (2) hospice providers perceive the barriers and burdens of family caregiver involvement in pressure ulcer care to be bodily location of the pressure ulcer, unpleasant wound characteristics, fear of causing pain, guilt, and having to acknowledge the dying process when a new pressure ulcer develops; and (3) the "team effect" describes the collaboration between family caregivers and the health care providers to establish individualized achievable goals of care ranging from pressure ulcer prevention to acceptance of a pressure ulcer and symptom palliation. Pressure ulcer care planning is a model of collaborative decision making between family caregivers and hospice providers for a condition that occurs as a secondary condition in hospice. A pressure ulcer places significant burdens on family caregivers distinct from common end-of-life symptoms whose treatment is directed at the patient. Because the goals of pressure ulcer care appear to be individualized for a dying patient and their caregivers, the basis of quality-of-care evaluations should be the process of care rather than the outcome of an incident pressure ulcer.

24 CFR 599.507 - Tax incentives utilization plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... utilization plan for achieving the State and local commitments made at the time of application as required by... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Tax incentives utilization plan. 599....507 Tax incentives utilization plan. (a) Preliminary plan. Within six months of designation, the CoRA...

Family planning among Nigerian postsecondary female students.

PubMed

Oyeka, I C

1986-01-01

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

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

ERIC Educational Resources Information Center

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

2016-01-01

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

34 CFR 303.167 - Individualized family service plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

26 CFR 1.36B-0 - Table of contents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... health plan. (d) Family and family size. (e) Household income. (1) In general. (2) Modified adjusted... credit payment. (k) Exchange. (l) Self-only coverage. (m) Family coverage. (n) Rating area. (o) Effective...) Applicable benchmark plan. (1) In general. (2) Family coverage. (3) Silver level plan not covering a taxpayer...

26 CFR 1.36B-0 - Table of contents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... health plan. (d) Family and family size. (e) Household income. (1) In general. (2) Modified adjusted... credit payment. (k) Exchange. (l) Self-only coverage. (m) Family coverage. (n) Rating area. (o) Effective...) Applicable benchmark plan. (1) In general. (2) Family coverage. (3) Silver level plan not covering a taxpayer...

Studies in Family Planning, Volume 2 Number 9.

ERIC Educational Resources Information Center

Population Council, New York, NY.

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

34 CFR 303.167 - Individualized family service plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Three Methods of Assessing Values for Advance Care Planning

PubMed Central

Karel, Michele J.; Moye, Jennifer; Bank, Adam; Azar, Armin R.

2016-01-01

Advance care planning ideally includes communication about values between patients, family members, and care providers. This study examined the utility of health care values assessment tools for older adults with and without dementia. Adults aged 60 and older, with and without dementia, completed three values assessment tools—open-ended, forced-choice, and rating scale questions—and named a preferred surrogate decision maker. Responses to forced-choice items were examined at 9-month retest. Adults with and without dementia appeared equally able to respond meaningfully to questions about values regarding quality of life and health care decisions. People with dementia were generally as able as controls to respond consistently after 9 months. Although values assessment methods show promise, further item and scale development work is needed. Older adults with dementia should be included in clarifying values for advance care planning to the extent that they desire and are able. PMID:17215205

Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora

PubMed Central

Sabri, Bushra; Huerta, Julia; Alexander, Kamila A.; St.Vil, Noelle M.; Campbell, Jacquelyn C.; Callwood, Gloria B.

2016-01-01

Objective This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). Methods We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. Results A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. Conclusion There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women. PMID:26548679

Association between women's autonomy and family planning outcome in couples residing in Isfahan.

PubMed

Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila

2014-09-01

One of the important factors in the prediction of family planning outcome is paying attention to women's role in decision making concerning fertility and household affairs. With the improvement of women's status and autonomy, their control over fertility is expected to increase. The present study aimed to investigate the association between women's autonomy and family planning outcome of the couples residing in Isfahan. This is cross-sectional study. Two hundred and seventy women of childbearing age, eligible for family planning and residing in Isfahan, were selected through random cluster sampling and they filled a researcher-made questionnaire. Women's autonomy was measured with the questions on their decision-making autonomy concerning household affairs and physical mobility autonomy. The association between women's autonomy and family planning outcome was analyzed through statistical methods. The results showed that the mean of women's decision-making, physical mobility, and general autonomy was 50. Women's autonomy had a direct significant association with the type of contraception method (P = 0.01) and the length of usage of their present contraception method (P = 0.04) as well as where they received family planning services (P = 0.02). Analysis of data revealed women with higher autonomy used a more efficient contraception method and continued their contraception method for a longer time, which leads to improvement of couples' family planning outcome. Therefore, family planning services should be planned and provided with women's autonomy under consideration.

Family Planning in the 1980's: Challenges and Opportunities. Report of the International Conference on Family Planning in the 1980's (Jakarta, Indonesia, April 26-30, 1981).

ERIC Educational Resources Information Center

Population Council, New York, NY.

Strategic and operational issues throughout the world formed the focus of the International Conference on Family Planning. The objectives of the conference were to review the accomplishments of family planning over the past decade, assess the challenges and opportunities for the 1980's, and identify means to strengthen commitment to family…

Quasi-experimental Study of Systematic Screening for Family Planning Services among Postpartum Women Attending Village Health and Nutrition Days in Jharkhand, India.

PubMed

Balasubramaniam, Sudharsanam; Kumar, Somesh; Sethi, Reena; Charurat, Elaine; Lalchandani, Kamlesh; Schuster, Anne; Sood, Bulbul

2018-01-25

Systematic screening helps increase family planning uptake through integration with other services, including immunization. Though successfully demonstrated at health facilities, this strategy has not been demonstrated in communities. This study assessed the effectiveness of systematic screening to increase postpartum family planning use during community health days in India without adversely affecting immunization services. The study was conducted during 180 individual Village Health and Nutrition Days in Jharkhand, India. All health workers were trained in postpartum family planning counseling. Intervention providers were also trained in systematic screening. 217 postpartum women aged 15-49 years participated in baseline and endline exit interviews and routine service statistics were analyzed from 2,485 facility visits at affiliated health centers. No difference in family planning service use was found in the intervention group, but significantly fewer interviewed women reported receiving family planning services at endline in the comparison group (p = 0.014). Family planning acceptance at affiliated health centers increased significantly in intervention areas (p < 0.001) but not in comparison areas, while immunization service use increased in both groups (p = 0.002 intervention, p < 0.001 comparison). The use of the postpartum systematic screening tool appears to increase acceptance of family planning services when integrated with community-based services in Jharkhand.

Islam is for family planning. Husbands and wives can stop pregnancy for medical, psychological, social and/or financial reasons.

PubMed

Tantawi, M S

1996-01-01

The author believes that all religions have the common objective of offering happiness to all humans, discussing religious matters must depend upon correct knowledge of the facts and the proper understanding of relevant issues, differing opinions are accepted as long as they foster discussion intent upon revealing the truth, children can be the source of happiness if taught morality and ethics, God created the universe and everything is running according to a perfect discipline, and the Islamic Shari'ah has laid the foundation for a detailed system characterized by clear rules to guide humans in their communities on how to enjoy their rights and respect their duties. He discusses the meaning of family planning, explains that family planning is allowed from the religious point of view, and explains that there are no official fatwa which approve of family planning. The call for family planning contradicts no Koranic verses and it is useless for governments to issue laws on family planning. Family planning does not contradict Islam faith and belief in destiny, and any method approved by knowledgeable senior doctors which fails to violate the rules of Shari'ah are approved by Islam. Islam is a religion supportive of family planning.

Socioeconomic Determinants of the Utilization of Antenatal Care and Child Vaccination in India.

PubMed

Zuhair, Mohd; Roy, Ram Babu

2017-11-01

Antenatal care and child vaccination services are adopted worldwide to reduce the risk of child mortality, maternal mortality, and burden of infectious diseases. This article examines the effect of socioeconomic factors on the utilization of antenatal care and child vaccination services in India. The generalized linear model has been used along with the Indian National Family Health Survey data for the period 2005-2006. The analysis shows that the health insurance plan has a significant effect on the use of antenatal care but not in the child vaccination. Furthermore, there is inequality in the utilization of antenatal care as well as child vaccination services and it is positively related to the wealth. The study suggests that there is a need to improve the socioeconomic status of the financially weaker section of the society for improving the use of child and maternal care services.

Care to Plan: An Online Tool That Offers Tailored Support to Dementia Caregivers.

PubMed

Gaugler, Joseph E; Reese, Mark; Tanler, Richard

2016-12-01

Even with the advent of evidence-based interventions, an ongoing concern in clinical practice is how to help dementia caregivers determine what type of support is best for them absent a laborious process of trial and error. To help address this practice gap, the present study developed and tested the feasibility of "Care to Plan" (CtP), an online resource for dementia caregivers (e.g., relatives or unpaid nonrelatives) that generates tailored support recommendations. Care to Plan was developed using an iterative prototype and testing process with the assistance of a 29-member Community Advisory Board. A parallel-convergent mixed methods design (quan + QUAL) was used that included a post-CtP survey and a brief semistructured interview to capture in-depth information on the utility and feasibility of CtP. The sample included 30 caregivers of persons with dementia. The integrated qualitative and quantitative data indicated that CtP was simple and easy to understand, the streamlined visual layout facilitated utility, and the individualized recommendations could meet the needs of users. Key barriers to use included the need for additional features (e.g., video introductions of caregiver support types) to further guide dementia caregivers' potential use of tailored support. The multiple data sources underscore the high feasibility and utility of CtP. By describing, identifying, and prioritizing support, CtP could help to improve the care planning process for dementia caregivers. Future dissemination efforts should aim to demonstrate how CtP can be implemented seamlessly within current family caregiver support systems. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Training at a faith-based institution matters for obstetrics and gynecology residents: results from a regional survey.

PubMed

Guiahi, Maryam; Westhoff, Carolyn L; Summers, Sondra; Kenton, Kimberly

2013-06-01

Prior data suggest that opportunities in family planning training may be limited during obstetrics and gynecology (Ob-Gyn) residency training, particularly at faith-based institutions with moral and ethical constraints, although this aspect of the Ob-Gyn curriculum has not been formally studied to date. We compared Ob-Gyn residents' self-rated competency and intentions to provide family planning procedures at faith-based versus those of residents at non-faith-based programs. We surveyed residents at all 20 Ob-Gyn programs in Illinois, Indiana, Iowa, and Wisconsin from 2008 to 2009. Residents were queried about current skills and future plans to perform family planning procedures. We examined associations based on program and residents' personal characteristics and performed multivariable logistic regression analysis. A total of 232 of 340 residents (68%) from 17 programs (85%) returned surveys. Seven programs were faith-based. Residents from non-faith-based programs were more likely to be completely satisfied with family planning training (odds ratio [OR]  =  3.4, 95% confidence limit [CI], 1.9-6.2) and to report they "understand and can perform on own" most procedures. Most residents, regardless of program type, planned to provide all surveyed family planning services. Despite similar intentions to provide family planning procedures after graduation, residents at faith-based training programs were less satisfied with their family planning training and rate their ability to perform family planning services lower than residents at non-faith-based training programs.

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

PubMed

Piotrow, P T

1973-01-01

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

"But I wasn't told to": lack of education and workplace policy as barriers in the provision of family planning information.

PubMed

Bell, Melissa M

2015-01-01

Access to family planning has been identified as critical to public health. Improving the linkage between medical and social services could result in improved access to care for those most at risk of unintended pregnancy. This study used a survey based on Alfred Bandura's social cognitive theory (1986) to increase the understanding of the barriers social workers confront in the provision of family planning information to clients. Although moral disagreement with family planning presented a barrier for some, workplace policy, participation in family planning trainings, and working in an urban setting were of greater value in understanding barriers.

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

PubMed Central

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

2016-01-01

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

[FEMALE SURGEONS SHOULD BE AWARE OF THE IMPORTANCE OF A CLEAR VISION FOR THEIR CAREER AND LIFE PLANS TO ACHIEVE THEIR CAREER DEVELOPMENT.: A SURVEY OF 20 FEMALE SURGEONS AT THE DEPARTMENT OF SURGERY AND ONCOLOGY, KYUSHU UNIVERSITY].

PubMed

Nagayoshi, Kinuko; Mori, Hitomi; Kameda, Chizu; Nakamura, Katsuya; Ueki, Takashi; Tanaka, Masao

2015-05-01

A shortage of surgeons has been a serious problem in recent years. There is an urgent need to utilize female surgeons who tend to resign because of bearing and raising of children. To examine possible measures to deal with the issue, we performed questionnaire survey about work-life balance and career planning on 20 female surgeons in the Department of Surgery and Oncology, Kyushu University. The response rate was 80.0%. In the 16 respondents, seven were unmarried and nine were married. A large fraction of the respondents recognized the importance of work-life-balance. Female surgeons have many difficulties to continue working with good work-life balance; therefore, understanding and cooperation of both their spouses and coworkers is considered to be necessary. Married female surgeons considered that improvement of the working environment and sufficient family support were more important for good work-life balance compared to those who were unmarried. Female surgeons should recognize the importance of improvement of their environment, including the workplace and the family to continue working with good work-life balance in youth and should have the prospects about their career plan of their own.

Developing Federal Clinical Care Recommendations for Women.

PubMed

Godfrey, Emily M; Tepper, Naomi K; Curtis, Kathryn M; Moskosky, Susan B; Gavin, Loretta E

2015-08-01

The provision of family planning services has important health benefits for the U.S. Approximately 25 million women in the U.S. receive contraceptive services annually and 44 million make at least one family planning-related clinical visit each year. These services are provided by private clinicians, as well as publicly funded clinics, including specialty family planning clinics, health departments, Planned Parenthoods, community health centers, and primary care clinics. Recommendations for providing quality family planning services have been published by CDC and the Office of Population Affairs of the DHHS. This paper describes the process used to develop the women's clinical services portion of the new recommendations and the rationale underpinning them. The recommendations define family planning services as contraceptive care, pregnancy testing and counseling, achieving pregnancy, basic infertility care, sexually transmitted disease services, and preconception health. Because many women who seek family planning services have no other source of care, the recommendations also include additional screening services related to women's health, such as cervical cancer screening. These clinical guidelines are aimed at providing the highest-quality care and are designed to establish a national standard for family planning in the U.S. Published by Elsevier Inc.

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

PubMed

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

1998-09-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2018-03-01

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

Afghanistan's population: planning to avoid a crisis.

PubMed

Rosenthal, J E

1973-07-09

Though the population of Afghanistan is exploding (AID estimates net growth rate at 2.5%), private, governmental, and foreign efforts should avert a crisis. The family-planning situation in this developing nation is discussed. The Afghan Family Guidance Association (AFGA), formed in July 1968, is a private organization but has semi-official status. AFGA runs 6 clinics in Kabul and 13 in the provinces. AFGA family Guides talk of mothers about their health and their children's health and about the desirability and methods of spacing children. In a pilot project several male Family Guides approach husbands with information about family planning. The Afghan government's family-planning program, scheduled to begin this year, has had its way paved by the work of the AFGA. The government plans to establish 280 basic health centers within 5 years. AID gives $1 million annually for family-planning projects, supplies, and services in Afghanistan. AID also is providing $1.7 million to finance the first demographic study of the nation.

Emergency preparedness in obstetrics.

PubMed

Haeri, Sina; Marcozzi, David

2015-04-01

During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future.

Regional inequalities of child mortality in peninsular Malaysia with special reference to the differentials between Perlis and Kuala Terengganu.

PubMed

Brehm, U

1993-05-01

In Peninsular Malaysia child mortality rates (5q0) vary from 13 to 63 per thousand at district level. The spatial pattern is closely associated with the regional distribution of socio-economic factors. But due to multicollinearity it is difficult to isolate the influence of socio-economic variables from other variables by employing aggregated data. However, individual data collected in a case-control-study that was conducted in Perlis and Kuala Terengganu confirm the important role of socio-economic factors. So it should be possible to achieve a further reduction of child mortality by raising the income and educational level of the under-privileged groups. Apart from that, as the case of Perlis shows, the provision of family planning and preventive medical services may also contribute to lower child mortality independent from socio-economic changes. But, as the comparison with Kuala Terengganu shows, the utilization of family planning and preventive medical services is not only influenced by the accessibility to, but also by the socio-culturally determined acceptability of such services.

New awareness campaign increases appeal of family planning.

PubMed

1999-06-01

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.

Family planning funding cuts and teen childbearing.

PubMed

Packham, Analisa

2017-09-01

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

78 FR 48679 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... (GPRA) and HHS, to guide financial and program planning and evaluation, and to respond to inquiries... identifier HHS-OS-19606-30D for reference. Information Collection Request Title: Family Planning Annual...) administers and oversees the Title X Family Planning Program. The Family Planning Annual Report (FPAR) is an...

78 FR 29370 - Agency Information Collection Activities; Proposed Collection; Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

... HHS, to guide financial and program planning and evaluation, and to respond to inquiries about the... identifier HHS-OS-19606-60D for reference. Information Collection Request Title: Family Planning Annual...) administers and oversees the Title X Family Planning Program. The Family Planning Annual Report (FPAR) is an...

Practical Suggestions for Family Planning Education.

ERIC Educational Resources Information Center

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

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

Determinants of unmet need for family planning in rural Burkina Faso: a multilevel logistic regression analysis.

PubMed

Wulifan, Joseph K; Jahn, Albrecht; Hien, Hervé; Ilboudo, Patrick Christian; Meda, Nicolas; Robyn, Paul Jacob; Saidou Hamadou, T; Haidara, Ousmane; De Allegri, Manuela

2017-12-19

Unmet need for family planning has implications for women and their families, such as unsafe abortion, physical abuse, and poor maternal health. Contraceptive knowledge has increased across low-income settings, yet unmet need remains high with little information on the factors explaining it. This study assessed factors associated with unmet need among pregnant women in rural Burkina Faso. We collected data on pregnant women through a population-based survey conducted in 24 rural districts between October 2013 and March 2014. Multivariate multilevel logistic regression was used to assess the association between unmet need for family planning and a selection of relevant demand- and supply-side factors. Of the 1309 pregnant women covered in the survey, 239 (18.26%) reported experiencing unmet need for family planning. Pregnant women with more than three living children [OR = 1.80; 95% CI (1.11-2.91)], those with a child younger than 1 year [OR = 1.75; 95% CI (1.04-2.97)], pregnant women whose partners disapproves contraceptive use [OR = 1.51; 95% CI (1.03-2.21)] and women who desired fewer children compared to their partners preferred number of children [OR = 1.907; 95% CI (1.361-2.672)] were significantly more likely to experience unmet need for family planning, while health staff training in family planning logistics management (OR = 0.46; 95% CI (0.24-0.73)] was associated with a lower probability of experiencing unmet need for family planning. Findings suggest the need to strengthen family planning interventions in Burkina Faso to ensure greater uptake of contraceptive use and thus reduce unmet need for family planning.

Delayed and forgone care for families with chronic conditions in high-deductible health plans.

PubMed

Galbraith, Alison A; Soumerai, Stephen B; Ross-Degnan, Dennis; Rosenthal, Meredith B; Gay, Charlene; Lieu, Tracy A

2012-09-01

High-deductible health plans (HDHPs) are an increasingly common strategy to contain health care costs. Individuals with chronic conditions are at particular risk for increased out-of-pocket costs in HDHPs and resulting cost-related underuse of essential health care. To evaluate whether families with chronic conditions in HDHPs have higher rates of delayed or forgone care due to cost, compared with those in traditional health insurance plans. This mail and phone survey used multiple logistic regression to compare family-level rates of reporting delayed/forgone care in HDHPs vs. traditional plans. We selected families with children that had at least one member with a chronic condition. Families had employer-sponsored insurance in a Massachusetts health plan and >12 months of enrollment in an HDHP or a traditional plan. The primary outcome was report of any delayed or forgone care due to cost (acute care, emergency department visits, chronic care, checkups, or tests) for adults or children during the prior 12 months. Respondents included 208 families in HDHPs and 370 in traditional plans. Membership in an HDHP and lower income were each independently associated with higher probability of delayed/forgone care due to cost. For adult family members, the predicted probability of delayed/forgone care due to cost was higher in HDHPs than in traditional plans [40.0% vs 15.1% among families with incomes <400% of the federal poverty level (FPL) and 16.0% vs 4.8% among those with incomes ≥400% FPL]. Similar associations were observed for children. Among families with chronic conditions, reporting of delayed/forgone care due to cost is higher for both adults and children in HDHPs than in traditional plans. Families with lower incomes are also at higher risk for delayed/forgone care.

[The press and family planning].

PubMed

Abraham De D'ornellas, R

1987-01-01

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

[Journalism and family planning in Guinea-Bissau. Putting the accent on birth spacing].

PubMed

Vaz, C

1989-05-01

A conference on awareness in the mass media of the problems of family planning was held in March 1989 at Bissau by the Guinean Association for Education and Promotion of Family Health (AGEPSF). Representatives of radio, a daily newspaper, and the national press agency discussed the objectives of AGEPSF and the benefits of family planning with specialists in different sectors of national life. The secretary general of AGEPSF affirmed the interest of the government in creating a health organization to coordinate national policy in family planning and to diffuse information on family planning. The family planning objective of the AGEPSF is not limitation of births but rather spacing to promote maternal and child health. AGEPSF is a member of the International Planned Parenthood Federation and maintains relations with similar organizations throughout the world. According to the director of the national maternity hospital, family planning is a sensitive topic but it has become accepted in numerous countries as marriage in rural areas and abortions in urban areas are widespread practices in Africa with potentially grave consequences. The general director of the National Institute for Studies and Research placed the theme of family planning in the context of Guinea-Bissau by citing the low level of education, the almost insignificant number of literate women, and the lack of health services in rural areas as the principal causes of increasing infant mortality in the country. African countries should create favorable conditions, elevate the level of living of their populations, and develop concrete health actions to reduce infant and maternal mortality.

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

PubMed

1997-09-01

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

Providing general and preconception health care to low income women in family planning settings: perception of providers and clients.

PubMed

Bronstein, Janet M; Felix, Holly C; Bursac, Zoran; Stewart, M Kathryn; Foushee, H Russell; Klapow, Joshua

2012-02-01

This study examines both provider and client perceptions of the extent to which general health concerns are addressed in the context of publicly supported family planning care. A mail survey of family planning providers (n = 459) accepting Medicaid-covered clients in Arkansas and Alabama gathered data on reported actions and resource referral availability for ten categories of non-contraceptive health concerns. A telephone survey of recent family planning clients of these providers (n = 1991) gathered data on the presence of 16 health concerns and whether and how they were addressed by the family planning provider. Data were collected in 2006-2007. More than half (56%) of clients reported having one or more general health concerns. While 43% of those concerns had been discussed with the family planning providers, only 8% had been originally identified by these providers. Women with higher trust in physicians and usual sources of general health care were more likely to discuss their concerns. Of those concerns discussed, 39% were reportedly treated by the family planning provider. Similarly, over half of responding providers reported providing treatment for acute and chronic health conditions and counseling on health behaviors during family planning visits. Lack of familiarity with referral resources for uninsured clients was identified as a significant concern in the provision of care to these clients. Greater engagement by providers in identifying client health concerns and better integration of publicly supported family planning with other sources of health care for low income women could expand the existing potential for delivering preconception or general health care in these settings.

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

PubMed

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

2017-09-27

Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from accessing their preferred method or force them to pay out of pocket. Leveraging UHC-oriented schemes to sustain and further increase family planning progress will require that governments take deliberate steps to (1) target poor and informal sector populations, (2) include family planning in benefits packages, (3) ensure sufficient financing for family planning, and (4) reduce nonfinancial barriers to access. Through these steps, countries can increase financial protection for family planning and better ensure the right to health of poor and marginalized populations. © Fagan et al.

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

PubMed Central

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

2017-01-01

ABSTRACT Background: Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. Methods: We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from accessing their preferred method or force them to pay out of pocket. Conclusion: Leveraging UHC-oriented schemes to sustain and further increase family planning progress will require that governments take deliberate steps to (1) target poor and informal sector populations, (2) include family planning in benefits packages, (3) ensure sufficient financing for family planning, and (4) reduce nonfinancial barriers to access. Through these steps, countries can increase financial protection for family planning and better ensure the right to health of poor and marginalized populations. PMID:28765156

Couple based family planning education: changes in male involvement and contraceptive use among married couples in Jimma Zone, Ethiopia.

PubMed

Tilahun, Tizta; Coene, Gily; Temmerman, Marleen; Degomme, Olivier

2015-07-21

Family planning contributes substantially in achieving the Millennium Development Goals. Recently, male involvement has gained considerable attention in family planning programs but the implementation thereof remains a challenge. In that context, our study aimed at measuring the effect of a six-month-long family planning education program on male involvement in family planning, as well as on couples' contraceptive practice. We conducted a quasi-experimental research among 811 married couples in Jimma Zone, southwest Ethiopia. Our study consisted of an intervention and a control group for comparative purpose; and surveyed before and after the implementation of the intervention. The intervention consisted of family planning education, given to both men and women at the household level in the intervention arm, in addition to monthly community gatherings. During the intervention period, households in the control group were not subject to particular activities but had access to routine health care services. We obtained follow-up data from 760 out of 786 (96.7%) couples who were originally enrolled in the survey. Findings were compared within and between groups before and after intervention surveys. At the baseline, contraceptive use in both control and intervention households were similar. After the intervention, we observed among men in the intervention arm a significantly higher level of willingness to be actively involved in family planning compared to the men in the control arm (p < 0.001). In addition, the difference between spouses that discussed family planning issues was less reported within the control group, both in the case of men and women ((p = 0.031) and (p < 0.001)) respectively. In general, a significant, positive difference in male involvement was observed. Concerning contraceptive use, there was change observed among the intervention group who were not using contraception at baseline. This study showed that family planning educational intervention, which includes both spouses and promotes spousal communication, might be useful to foster contraceptive practice among couples. The results also offer practical information on the benefits of male involvement in family planning as a best means to increase contraceptive use. Thus, providing opportunities to reinforce family planning education may strengthen the existing family planning service delivery system.

Malaysia implements the integrated approach.

PubMed

1977-01-01

Malaysia has implemented an integrated approach in providing family planning services to eligible couples. In 1964 the government of Malaysia adopted a national family planning program, and implementation began in the urban areas and extended into the rural areas. Other agencies are involved in providing family planning services and information including the Federation of Family Planning Associations, the Ministry of Health, the National Family Planning Board, and the Federal Land Development Authority. The number of women practicing contraception has increased from 20,726 in 1967 to 533,646 by 1976. and other methods, 3.9%, respectively. There has been an increase in the percentage of acceptors between ages 15-29 from 56% in 1968 to 71.3% in 1975. The 2nd Malaysian national plan will use a multidisciplinary approach to the problem.

Promotion of family planning services in practice leaflets.

PubMed

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

1994-10-08

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

End of life care: The experiences of advance care planning amongst family caregivers of people with advanced dementia - A qualitative study.

PubMed

Ashton, Susan Elizabeth; Roe, Brenda; Jack, Barbara; McClelland, Bob

2016-09-01

End of life decisions for people with advanced dementia are reported as often being difficult for families as they attempt to make appropriate and justified decisions. To explore the experiences of advance care planning amongst family caregivers of people with advanced dementia. Qualitative research including a series of single cases (close family relatives). A purposive sample of 12 family caregivers within a specialist dementia unit was interviewed about their experiences of advance care planning between August 2009 and February 2010. Family caregivers need encouragement to ask the right questions during advance care planning to discuss the appropriateness of nursing and medical interventions at the end of life. Advance care planning can be facilitated with the family caregiver in the context of everyday practice within the nursing home environment for older people with dementia. © The Author(s) 2014.

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

NASA Technical Reports Server (NTRS)

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

2014-01-01

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

Focus on training at CAFS.

PubMed

Azorbo, S; Muna, C

1993-01-01

The training and technical assistance programs of the Center for African Family Studies (CAFS), which is part of the International Planned Parenthood Federation for the African Region, were described. Programs included service delivery, management development, family life education, family planning communication, and research monitoring and evaluation. Several courses were offered: a week-long contraceptive technology update course for trainers and supervisors of family planning programs. Management training needs were filled through a 6-week middle level management course, a 2-week senior level management course, a 4-week community based family planning program course, a 6-week financial management of family planning and reproductive health programs course, and a 5-week course in leadership skills for management of women and health programs. Family life education courses were offered under the CAFS Women and Health Program for teachers, curriculum developers, youth leaders, and those working with young people for 3 weeks. Course issues of discussion included population and development, the family in contemporary African life, and policy legislation and laws to promote young people's health and social psychological and ethical aspects of adolescent sexuality. Family planning communication training programs were directed to strengthening IEC knowledge and skills over a 4-week period for senior and middle level personnel. The 3-week press course aimed to train journalists in print and electronic media for French-speaking countries who could gain cover population and family planning issues. The family planning research and evaluation course over 4 weeks aimed to increase the knowledge and skills of health personnel in project design, implementation, monitoring, and evaluation, in order to conduct assessment of program effectiveness. The course was directed to senior and middle level manager researchers, population project directors, and personnel of women-centered projects.

Association between women's autonomy and family planning outcome in couples residing in Isfahan

PubMed Central

Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila

2014-01-01

Background: One of the important factors in the prediction of family planning outcome is paying attention to women's role in decision making concerning fertility and household affairs. With the improvement of women's status and autonomy, their control over fertility is expected to increase. The present study aimed to investigate the association between women's autonomy and family planning outcome of the couples residing in Isfahan. Materials and Methods: This is cross-sectional study. Two hundred and seventy women of childbearing age, eligible for family planning and residing in Isfahan, were selected through random cluster sampling and they filled a researcher-made questionnaire. Women's autonomy was measured with the questions on their decision-making autonomy concerning household affairs and physical mobility autonomy. The association between women's autonomy and family planning outcome was analyzed through statistical methods. Results: The results showed that the mean of women's decision-making, physical mobility, and general autonomy was 50. Women's autonomy had a direct significant association with the type of contraception method (P = 0.01) and the length of usage of their present contraception method (P = 0.04) as well as where they received family planning services (P = 0.02). Conclusions: Analysis of data revealed women with higher autonomy used a more efficient contraception method and continued their contraception method for a longer time, which leads to improvement of couples’ family planning outcome. Therefore, family planning services should be planned and provided with women's autonomy under consideration. PMID:25400671

Scoping study of integrated resource planning needs in the public utility sector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Garrick, C J; Garrick, J M; Rue, D R

Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.

A binary logistic regression model with complex sampling design of unmet need for family planning among all women aged (15-49) in Ethiopia.

PubMed

Workie, Demeke Lakew; Zike, Dereje Tesfaye; Fenta, Haile Mekonnen; Mekonnen, Mulusew Admasu

2017-09-01

Unintended pregnancy related to unmet need is a worldwide problem that affects societies. The main objective of this study was to identify the prevalence and determinants of unmet need for family planning among women aged (15-49) in Ethiopia. The Performance Monitoring and Accountability2020/Ethiopia was conducted in April 2016 at round-4 from 7494 women with two-stage-stratified sampling. Bi-variable and multi-variable binary logistic regression model with complex sampling design was fitted. The prevalence of unmet-need for family planning was 16.2% in Ethiopia. Women between the age range of 15-24 years were 2.266 times more likely to have unmet need family planning compared to above 35 years. Women who were currently married were about 8 times more likely to have unmet need family planning compared to never married women. Women who had no under-five child were 0.125 times less likely to have unmet need family planning compared to those who had more than two-under-5. The key determinants of unmet need family planning in Ethiopia were residence, age, marital-status, education, household members, birth-events and number of under-5 children. Thus the Government of Ethiopia would take immediate steps to address the causes of high unmet need for family planning among women.

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

ERIC Educational Resources Information Center

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

2017-01-01

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

Use of maternal-child health services and contraception in Guatemala and Panama.

PubMed

Warren, C W; Monteith, R S; Johnson, J T; Santiso, R; Guerra, F; Oberle, M W

1987-04-01

This paper presents data from 2 recent maternal-child health (MCH) and family planning surveys in Guatemala and Panama and examines the extent to which the use of contraception is influenced by the use of MCH services as compared with the influence of an increase in parity. Fieldwork was initiated in July 1984 but not completed until April 1985. A total of 8240 women aged 15-49 years, of all marital statuses, completed interviews, representing 91% of households with eligible respondents. The findings suggest that utilization of MCH services and parity independently are associated with a woman's decision to use contraception. The study also found 2 groups that appear to be particularly in need of both MCH and family planning services: high parity women and Indians. Nonuse of MCH and family planning services may be due in part to their strong cultural beliefs. In both Guatemala and Panama, improved health care services for these 2 groups should be a priority. Contraceptive use in Panama was over twice as high as in Guatemala. However, method choice and residence-ethnicity patterns of use were similar in each country. In both countries and in all residence-ethnicity groups, female sterilization was the most prevalent method in use, followed by oral contraceptives, except for Panama rural Indians. In Panama, contraceptive use increases up to ages 30-34 and then declines, with a sharp decline for women 40-44. In Guatemala, contraceptive use is generally low for ages 15-24, then increases to a fairly constant level for ages 25-39.

Determinants of use of health facility for childbirth in rural Hadiya zone, Southern Ethiopia.

PubMed

Asseffa, Netsanet Abera; Bukola, Fawole; Ayodele, Arowojolu

2016-11-16

Maternal mortality remains a major global public health concern despite many international efforts. Facility-based childbirth increases access to appropriate skilled attendance and emergency obstetric care services as the vast majority of obstetric complications occur during delivery. The purpose of the study was to determine the proportion of facility delivery and assess factors influencing utilization of health facility for childbirth. A cross-sectional study was conducted in two rural districts of Hadiya zone, southern Ethiopia. Participants who delivered within three years of the survey were selected by stratified random sampling. Trained interviewers administered a pre-tested semi-structured questionnaire. We employed bivariate analysis and logistic regression to identify determinants of facility-based delivery. Data from 751 participants showed that 26.9% of deliveries were attended in health facilities. In bivariate analysis, maternal age, education, husband's level of education, possession of radio, antenatal care, place of recent ANC attended, planned pregnancy, wealth quintile, parity, birth preparedness and complication readiness, being a model family and distance from the nearest health facility were associated with facility delivery. On multiple logistic regression, age, educational status, antenatal care, distance from the nearest health facility, wealth quintile, being a model family, planned pregnancy and place of recent ANC attended were the determinants of facility-based childbirth. Efforts to improve institutional deliveries in the region must strengthen initiatives that promote female education, opportunities for wealth creation, female empowerment and increased uptake of family planning among others. Service related barriers and cultural influences on the use of health facility for childbirth require further evaluation.

Mothers and meals. The effects of mothers' meal planning and shopping motivations on children's participation in family meals.

PubMed

McIntosh, William Alex; Kubena, Karen S; Tolle, Glen; Dean, Wesley R; Jan, Jie-sheng; Anding, Jenna

2010-12-01

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. Copyright © 2010 Elsevier Ltd. All rights reserved.

Men and family planning in Africa. Les hommes et la planification familiale en Afrique.

PubMed

Diallo, A

1984-09-01

Male responsibility with regard to family planning and its practice is a major action focus of the International Planned Parenthood Federation. The campaign has been aimed at developing programs to educate men about family planning, encouraging men to practice contraception, and changing the attitudes of male opinion leaders. Since the African male's opinion is paramount within the family unit, the village, and the broader society, this approach is considered essential to the success of family planning efforts in Africa. Although a wide range of programs in Anglophone Africa are now oriented toward men, little progress has been made in the Francophone countries. Obstacles include traditionalism, pro-natalism, illiteracy, religion, and a hostility to Western concepts. Efforts have further been hindered by the way that family planning has been promoted in the region in the past: as a birth spacing method to improve maternal and child health. Medical and paramedical personnel in the region have been trained to treat only mothers and children, not couples or families. However, women's changing status and increased awareness of the connection between demography and development have created an atmosphere more favorable to well designed family welfare programs that are integrated with other development activities. If family planning is to become entrenched in the African region, attention must be given to 3 areas: information and education, integrated development, and research and training. Within the framework of educational activities, men can be made aware that they may practice contraception without any threat to their virility. Given the complexity of the task of introducing family planning on a broad scale in Africa, an integrated appraoch (social, cultural, health, economic, political, and legislative), involving both governments and voluntary organizations as well as the population, is required. Decision makers must be convinced to give family planning a central role in primary health care. Key to the implementation of this strategy is the selection of promoters who have a knowledge of the area in which they work, a commitment to family planning, and the necessary communication skills.

The effect of Employee Assistance Programs use on healthcare utilization.

PubMed

Zarkin, G A; Bray, J W; Qi, J

2000-04-01

To estimate the effect of Employee Assistance Program (EAP) use on healthcare utilization as measured by health claims. A unique data set that combines individual-level information on EAP utilization, demographic information, and health insurance claims from 1991 to 1995 for all employees of a large midwestern employer. Using "fixed-effect" econometric models that control for unobserved differences between individuals' propensities to use healthcare resources and the EAP, we perform our analyses in two steps. First, for those employees who visited the EAP, we test whether post-EAP claims differ from pre-EAP claims. Second, we combine claims data of individuals who went to an EAP with those of individuals who did not use an EAP to test whether differences in utilization exist between EAP users and nonusers. From the EAP we obtained the date of first EAP contact for all employees who used the service, and from the company's human resources department we obtained limited demographic data on all employees. We obtained healthcare utilization claims data on all employees and their dependents from the company's two healthcare plans: a fee-for-service (FFS) plan and a health maintenance organization (HMO) plan. We found that going to an EAP substantially increases both the probability of an alcohol, drug abuse, or mental health (ADM) claim and the number of ADM claims in the same quarter as EAP contact. The increased probability of an ADM claim persists for approximately 11 quarters after the initial contact, while the increased ADM charges persist for approximately six quarters after the initial EAP contact. Our results strongly suggest that the EAP is able to identify behavioral and other health problems that may affect workplace performance and prompt EAP users to access ADM and other healthcare. Consistent with the stated goals of many EAPs, including the one examined in this study, this process should improve individuals' health, family functioning, and workplace performance.

The effect of Employee Assistance Programs use on healthcare utilization.

PubMed Central

Zarkin, G A; Bray, J W; Qi, J

2000-01-01

OBJECTIVE: To estimate the effect of Employee Assistance Program (EAP) use on healthcare utilization as measured by health claims. DATA SOURCES: A unique data set that combines individual-level information on EAP utilization, demographic information, and health insurance claims from 1991 to 1995 for all employees of a large midwestern employer. STUDY DESIGN: Using "fixed-effect" econometric models that control for unobserved differences between individuals' propensities to use healthcare resources and the EAP, we perform our analyses in two steps. First, for those employees who visited the EAP, we test whether post-EAP claims differ from pre-EAP claims. Second, we combine claims data of individuals who went to an EAP with those of individuals who did not use an EAP to test whether differences in utilization exist between EAP users and nonusers. DATA COLLECTION METHODS: From the EAP we obtained the date of first EAP contact for all employees who used the service, and from the company's human resources department we obtained limited demographic data on all employees. We obtained healthcare utilization claims data on all employees and their dependents from the company's two healthcare plans: a fee-for-service (FFS) plan and a health maintenance organization (HMO) plan. PRINCIPAL FINDINGS: We found that going to an EAP substantially increases both the probability of an alcohol, drug abuse, or mental health (ADM) claim and the number of ADM claims in the same quarter as EAP contact. The increased probability of an ADM claim persists for approximately 11 quarters after the initial contact, while the increased ADM charges persist for approximately six quarters after the initial EAP contact. CONCLUSIONS: Our results strongly suggest that the EAP is able to identify behavioral and other health problems that may affect workplace performance and prompt EAP users to access ADM and other healthcare. Consistent with the stated goals of many EAPs, including the one examined in this study, this process should improve individuals' health, family functioning, and workplace performance. PMID:10778825

Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.

PubMed

White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

2017-10-20

To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.

Utilizing program evaluation as a strategy to promote community change: evaluation of a comprehensive, community-based, family violence initiative.

PubMed

Kaufman, Joy S; Crusto, Cindy A; Quan, Michael; Ross, Ellen; Friedman, Stacey R; O'Rielly, Kim; Call, Stephanie

2006-12-01

This paper describes the authors' work in a community that received Federal funding for an integrated system of care to reduce the impact and incidence of exposure to violence for children less than six years of age. The paper includes a review of the conceptual framework that guided the work of the authors and provides a brief overview of the issue of family violence, the impact of this violence on young children, and the Federal response to this issue. In addition, a description of the Initiative and the community in which it was based is provided along with some aspects of the evaluation plan. Finally, the authors discuss how their work with this Initiative depicts an approach to facilitating change within communities.

Fear, opposition, ambivalence, and omission: Results from a follow-up study on unmet need for family planning in Ghana.

PubMed

Staveteig, Sarah

2017-01-01

Despite a relatively strong family planning program and regionally modest levels of fertility, Ghana recorded one of the highest levels of unmet need for family planning on the African continent in 2008. Unmet need for family planning is a composite measure based on apparent contradictions between women's reproductive preferences and practices. Women who want to space or limit births but are not using contraception are considered to have an unmet need for family planning. The study sought to understand the reasons behind high levels of unmet need for family planning in Ghana. A mixed methods follow-up study was embedded within the stratified, two-stage cluster sample of the 2014 Ghana Demographic and Health Survey (GDHS). Women in 13 survey clusters who were identified as having unmet need, along with a reference group of current family planning users, were approached to be reinterviewed within an average of three weeks from their GDHS interview. Follow-up respondents were asked a combination of closed- and open-ended questions about fertility preferences and contraceptive use. Closed-ended responses were compared against the original survey; transcripts were thematically coded and analyzed using qualitative analysis software. Among fecund women identified by the 2014 GDHS as having unmet need, follow-up interviews revealed substantial underreporting of method use, particularly traditional methods. Complete postpartum abstinence was sometimes the intended method of family planning but was overlooked during questions about method use. Other respondents classified as having unmet need had ambivalent fertility preferences. In several cases, respondents expressed revised fertility preferences upon follow-up that would have made them ineligible for inclusion in the unmet need category. The reference group of family planning users also expressed unstable fertility preferences. Aversion to modern method use was generally more substantial than reported in the GDHS, particularly the risk of menstrual side effects, personal or partner opposition to family planning, and religious opposition to contraception.

Fear, opposition, ambivalence, and omission: Results from a follow-up study on unmet need for family planning in Ghana

PubMed Central

2017-01-01

Introduction Despite a relatively strong family planning program and regionally modest levels of fertility, Ghana recorded one of the highest levels of unmet need for family planning on the African continent in 2008. Unmet need for family planning is a composite measure based on apparent contradictions between women’s reproductive preferences and practices. Women who want to space or limit births but are not using contraception are considered to have an unmet need for family planning. The study sought to understand the reasons behind high levels of unmet need for family planning in Ghana. Methods A mixed methods follow-up study was embedded within the stratified, two-stage cluster sample of the 2014 Ghana Demographic and Health Survey (GDHS). Women in 13 survey clusters who were identified as having unmet need, along with a reference group of current family planning users, were approached to be reinterviewed within an average of three weeks from their GDHS interview. Follow-up respondents were asked a combination of closed- and open-ended questions about fertility preferences and contraceptive use. Closed-ended responses were compared against the original survey; transcripts were thematically coded and analyzed using qualitative analysis software. Results Among fecund women identified by the 2014 GDHS as having unmet need, follow-up interviews revealed substantial underreporting of method use, particularly traditional methods. Complete postpartum abstinence was sometimes the intended method of family planning but was overlooked during questions about method use. Other respondents classified as having unmet need had ambivalent fertility preferences. In several cases, respondents expressed revised fertility preferences upon follow-up that would have made them ineligible for inclusion in the unmet need category. The reference group of family planning users also expressed unstable fertility preferences. Aversion to modern method use was generally more substantial than reported in the GDHS, particularly the risk of menstrual side effects, personal or partner opposition to family planning, and religious opposition to contraception. PMID:28759624

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

Background A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. Study design A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Conclusion Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate further evidence on costs, cost-effectiveness, and affordability, and to support increased funding and investments in family planning programs. PMID:27992552

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

ERIC Educational Resources Information Center

Mosena, Patricia Wimberley

1971-01-01

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

Taking the hassle out of wellness: Do peers and health matter?

PubMed

Danagoulian, Shooshan

2018-03-01

Despite substantial financial incentives provided by the Affordable Care Act and employers, employee enrollment in wellness programs is low. This paper studies enrollment in a wellness program offered along an employer-provided health insurance plan. Two factors are considered in the choice of health plan with wellness: the effect of peer choices and family health on plan choice. Using exclusively obtained data of health insurance plan choice and utilization, this paper compares similar plans and focuses on a subsample of new employees. Result show that peers affect own choice of health insurance: a 10 percentage point rise in the share of colleagues enrolled in Aetna Wellness increases the probability of own enrollment in the plan by up to 3.9 percentage points. This result suggests that lack of experience with a wellness program are key to employee reluctance to enroll. Health effect on probability of enrollment in Aetna Wellness ranges from a 3 percentage point decline to a 3 percentage point rise depending on the measure, suggesting that while wellness programs appeal to low- to medium-intensity users of medical services, they do not appeal to individuals with more severe medical conditions which might benefit most from better coordinated medical care.

Domestic, international family planning programs at risk.

PubMed

Turnbull, W; Kaeser, L

1998-02-01

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

The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.

PubMed

Friedman, Sarah; Xu, Haiyong; Harwood, Jessica M; Azocar, Francisca; Hurley, Brian; Ettner, Susan L

2017-09-01

The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between behavioral health and medical health insurance benefits among the commercially insured. This study determines whether MHPAEA was associated with increased BH expenditures and utilization among a population with substance use disorder (SUD) diagnoses. Claims and eligibility data from 5,987,776 enrollees, 2008-2013, were obtained from a national, commercial, managed behavioral health organization. An interrupted time series study design with segmented regression analysis estimated time trends of per-member-per-month (PMPM) spending and use before (2008-2009), during (2010), and after (2011-2013) MHPAEA compliance. The study sample contained individuals with drug or alcohol use disorder diagnosis during study period (N=2,716,473 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits; medication management; individual, group and family psychotherapy, and structured outpatient care); intermediate care utilization (day treatment; recovery home and residential); and inpatient utilization. Starting at the beginning of the post-parity period, MHPAEA was associated with increased levels of PMPM total and plan spending ($25.80 [p=0.01]; $28.33 [p=0.00], respectively), as well as the number of PMPM assessment/evaluation, individual psychotherapy, and group psychotherapy visits, and inpatient days (0.01 visits [p=0.01]; 0.02 visits [p=0.01]; 0.01 visits [p=0.03]; 0.01days [p=0.01], respectively). Following these initial level changes, MHPAEA was also associated with monthly increases in PMPM total, plan, and patent out-of-pocket spending ($2.56/month [p=0.00]; $2.25/month [p=0.00]; $0.27 [p=0.03], respectively), as well as structured outpatient visits and inpatient days (0.0012 visits/month [p=0.01]; 0.0012days/month [p=0.00]). MHPAEA was associated with modest increases in total, plan, and patient out-of-pocket spending and outpatient and inpatient utilization. These increases, while modest in magnitude, are larger in magnitude than increases detected among a sample of all enrollees (i.e. not only those with SUD diagnoses). Published by Elsevier Inc.

43 CFR 3272.12 - What environmental protection measures must I include in my utilization plan?

Code of Federal Regulations, 2011 CFR

2011-10-01

... must I include in my utilization plan? 3272.12 Section 3272.12 Public Lands: Interior Regulations... MANAGEMENT (3000) GEOTHERMAL RESOURCE LEASING Utilization Plan and Facility Construction Permit § 3272.12 What environmental protection measures must I include in my utilization plan? (a) Describe, at a...

Types of Managed Care Plans

MedlinePlus

... AAP Find a Pediatrician Family Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting ... Your Community Healthy Children > Family Life > Medical Home > Health Insurance > Types of Managed Care Plans Family Life Listen ...

Evaluating a program to build data capacity for core public health functions in local maternal child and adolescent health programs in california.

PubMed

Oliva, Geraldine; Rienks, Jennifer; Chavez, Gilberto F

2007-01-01

To improve local Maternal and Child Health programs' capacity to collect and analyze data to support core public health functions, the California Maternal and Child Health Branch (CAMCHB) and the University of California San Francisco Family Health Outcomes project (FHOP) entered into a cooperative agreement. FHOP utilizes a 6-pronged strategy: face-to-face training, telephone technical assistance, on-site consultation, development of automated analytic tools, development of written guidelines, and web dissemination of data and materials. We evaluated the acceptability and effectiveness of these approaches. Local Health Jurisdiction (LHJ) staff completed a self-administered questionnaire on use of and satisfaction with FHOP's services. A 34-item assessment tool was used to independently evaluate each 5-year community assessment plan submitted by LHJs to the CAMCHB. Administrative data on the use of FHOP's service was also considered. Correlational analyses were done to determine if use of FHOP services and materials was related to more adequate plans. LHJs with higher overall adequacy scores on their plans had an overall higher level of use of FHOP's products and services. LHJs with higher adequacy scores reported calling FHOP for technical assistance more frequently, using FHOP's book - "Developing an Effective Planning Process: A Guide for Local MCH Programs," and using FHOP's automated tools including EpiBC, an EpiINFO based program for birth certificate analysis, and Microsoft Excel data analysis templates. This 6-pronged strategy is well utilized and accepted by local MCH staff and appears to have some degree of association with better quality of local MCH plan documents.

Determinants of contraceptives use amongst youth: an exploratory study with family planning service providers in Karachi Pakistan.

PubMed

Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Hasnain, Farid Ul

2013-01-05

In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers' perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers' improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods.

Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

PubMed Central

Hilliard, Starr; Gutin, Sarah A; Dawson Rose, Carol

2014-01-01

Background Family planning is an important HIV prevention tool for women living with HIV (WLHIV). In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT). In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results Analysis showed that providers’ clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health needs of WLHIV is a critical component in HIV prevention and could increase the success of PMTCT programs. PMID:25540599

Programming the body, planning reproduction, governing life: the '(ir-) rationality' of family planning and the embodiment of social inequalities in Salvador da Bahia (Brazil).

PubMed

De Zordo, Silvia

2012-01-01

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.

A successful integrated project.

PubMed

Zheng, P

1994-10-01

The experiences of the Juxian County Family Planning Committee of Shandong Province, China, were discussed in terms of the integration of family planning with income generation activities in rural areas. The integrated program was initiated in 1988 with pilot programs established by the Qiaoshan Family Planning Association to develop marketable skills in carpet weaving and grass braiding in Xiazhuang Town and Qiaoshan Township. The program gave priority of admission to women with only children and those who practiced family planning. 1400 women were recruited in these factories. Other income generation programs were developed for silkworm breeding and silk reeling, woolen embroidery, and printing. High ranking officials of the China Family Planning Association commended the work in income generation and family planning in Juxian County. This recognition spurred the second phase of development by the county family planning association: the establishment of village operated factories and mills for native products. By the end of 1991, there were 26 such projects in the county and per capita income to women increased by RMB 678 yuan. In the third stage of 1992, the number of association enterprises increased to 196 with recruitment of over 18,000 reproductive age women. The programs were initiated with collective funds from farmers and villages. The 170 projects in 1992 were developed with an investment of 9.6 million yuan, of which 2.26 million yuan was from individuals (23.5%). Emphasis was placed on self-reliance and recruitment of women with one child, women with 2 daughters and tubal ligations, and family planning motivators. The consequences of the integrated program were weakening traditional customs of marriage and childbearing, improvement in socioeconomic status of women, and effective service delivery of family planning and maternal and child health care services.

Determinants of Contraceptives Use amongst Youth: An Exploratory Study with Family Planning Service Providers in Karachi Pakistan

PubMed Central

Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Farid-Ul-Hasnain

2013-01-01

Introduction: In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers’ perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Method: Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Results: Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers’ improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Conclusion: Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods. PMID:23618469

Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique.

PubMed

Hilliard, Starr; Gutin, Sarah A; Dawson Rose, Carol

2014-01-01

Family planning is an important HIV prevention tool for women living with HIV (WLHIV). In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT). In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health needs of WLHIV is a critical component in HIV prevention and could increase the success of PMTCT programs.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-07-01

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

Teaching of Family Planning at Medical Nursing and Midwifery Schools in Certain Countries of the Region.

ERIC Educational Resources Information Center

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…

Advocacy for International Family Planning: What Terminology Works?

PubMed

Huber, Douglas; Martin, Raymond; Bormet, Mona

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

Special Report: Banjul Islam Conference endorses family planning.

PubMed

1979-11-01

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

On the right track. The integrated IEC campaign succeeds in recruiting many acceptors in a fishing commune.

PubMed

Hata, K

1995-01-01

The Population and Family Planning Committee of Quangnam Danang Province's integrated information, education, and communication (IEC) campaign promotes late marriage, having two children, and spacing births from 3 to 5 years. The total fertility rate (TFR) in the province is 3.4. One urgent priority of the committee is to tackle poverty by reducing the rapid rate of natural population increase in rural areas. Xa Cam Ha is a poor, rice-producing commune of population 11,114 in which family planning used to be widely unaccepted among families. TFR in the commune is now slightly less than 3. The steady promotion of the Population and Family Planning Program has encouraged couples to accept and practice family planning such that the rate of natural increase fell from 2.0% in 1985 to 1.8% in 1994. Financial incentives are also offered to family planning acceptors; poor acceptors are eligible for loans from the People's Committee to start income-generating activities. More and more couples are accepting family planning.

Determinants of unmet need for family planning among women in Urban Cameroon: a cross sectional survey in the Biyem-Assi Health District, Yaoundé.

PubMed

Ajong, Atem Bethel; Njotang, Philip Nana; Yakum, Martin Ndinakie; Essi, Marie José; Essiben, Felix; Eko, Filbert Eko; Kenfack, Bruno; Mbu, Enow Robinson

2016-01-20

With the unacceptably high level of unmet need for family planning in Sub-Saharan Africa, reducing unmet need is paramount in the fight against the high levels of induced abortions, maternal and neonatal morbi-mortality. A clear understanding of the determinants of unmet need for family planning is indispensable in this light. The objective of this study was to determine the prevalence of unmet need for family planning in Urban Cameroon while identifying major determinants of unmet need among women in a union in Urban Cameroon. A community based cross sectional study was conducted from March 2015 to April 2015 during which 370 women in a union were recruited using cluster multistep sampling in the Biyem-Assi Health District, Yaounde. Data were collected using a pretested and validated questionnaire. Proportions and their 95% confidence intervals were calculated with the Westoff/DHS method used to estimate unmet need for family planning and the odds ratio used as measure of association with statistical significant threshold set at p-value ≤ 0.05. Of the 370 eligible women included, the mean age was 29.9 ± 6.8 years, and 61.1% were married. The prevalence of unmet need for family planning was 20.4 (16.4-24.8)% with 14.2 (11.2-18.7)% having an unmet need for spacing and 6.2 (3.6-8.7)% an unmet need for limiting. Husband's approval of contraception had a statistically significant protective association with unmet need (AOR = 0.52 [0.30-0.92], p = 0.023), and discussion about family planning within the couple had a highly statistically significant protective association with unmet need (AOR = 0.39 [0.21-0.69], p = 0.001). The major reason for non-use of contraception among women with unmet need was the fear of side effects. The prevalence of unmet need of family planning among women in the Biyem-Assi Health District remains high. Husband's approval of contraception and couples' discussion about family planning are two major factors to be considered when planning interventions to reduce unmet need for family planning. Family planning activities focused on couples or including men could be useful in reducing the rate of unmet need in Cameroon.

Providing family planning and reproductive healthcare to Canadian immigrants: perceptions of healthcare providers.

PubMed

Newbold, K Bruce; Willinsky, Jacqueline

2009-05-01

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.

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

PubMed

Norwood, Carolette

2011-01-01

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

Child saving and child spacing in Africa: the evolution of a concept.

PubMed

Wright, R D

1973-01-01

In 1963 neither the Nigerian Society of Health nor anyone in the power structure of Nigeria would publicly endorse family planning. By early 1968 a family planning day was declared where it was proclaimed that the quality of the people was important not the quantity. However Nigeria still does not have a family planning program that reaches a large percentage of the women at risk. The first phase is a quiet beginning, the second is the achievement of acceptance, the third is to train teachers, and the fourth phase is the establishment of maternal-child care services. This last phase may incorporate the family planning services. Is hoped that this will lead to a more favorable attitude toward family planning.

New laws on population urged.

PubMed

1976-12-03

A workshop on ''Population and the Law'' sponsored by the Family Planning Organization of the Philippines and the International Planned Parenthood Federation recommended the following changes in Philippine law to implement family planning: legalization of abortion for women whose life or health are endangered by pregnancy and those who become pregnant despite contraceptives; delaying age of marriage to 18; extension of family planning incentives and maternity leave to women in government service; allow trained nurses and midwives to dispense contractives; legalize sterilization; include sterilization in medicare benefits; specify by law which contraceptive drugs may be dispensed by nonphysicians and nonpharmacists in rural areas; legalize premarital family planning counseling; declare family planning materials tax exempt; encourage reluctant doctors to practice sterilization through professional regulatory agencies; extend industrial family planning services to women living near the plant; launch massive information drives to advise young people of the hazards of premarital sex; strict enforcement of abortion laws in areas where illegal abortion still exists; grant women equal rights in area of consent for sterilization; and eliminate the stigma of illegitimacy for those born out of wedlock.

Evaluation of Family Planning Programmes, An Example from Botswana. Research for Action No. 2.

ERIC Educational Resources Information Center

Cook, Sheila

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…

The Big Red How-To Guide: Planning a Health Fair for Children and Families.

ERIC Educational Resources Information Center

Foley, Christina A.

Community health fairs usually focus on adult health issues and seldom on child and family health or the link between health and education. This guide's purpose is to assist communities in developing child and family-focused health fairs. The guide is divided into two major sections: pre-planning and planning. The pre-planning section covers steps…

Risk selection into consumer-directed health plans: an analysis of family choices within large employers.

PubMed

McDevitt, Roland D; Haviland, Amelia M; Lore, Ryan; Laudenberger, Laura; Eisenberg, Matthew; Sood, Neeraj

2014-04-01

To identify the degree of selection into consumer-directed health plans (CDHPs) versus traditional plans over time, and factors that influence choice and temper risk selection. Sixteen large employers offering both CDHP and traditional plans during the 2004–2007 period, more than 200,000 families. We model CDHP choice with logistic regression; predictors include risk scores, in addition to family, choice setting, and plan characteristics. Additional models stratify by account type or single enrollee versus family. Risk scores, family characteristics, and enrollment decisions are derived from medical claims and enrollment files. Interviews with human resources executives provide additional data. CDHP risk scores were 74 percent of traditional plan scores in the first year, and this difference declined over time. Employer contributions to accounts and employee premium savings fostered CDHP enrollment and reduced risk selection. Having to make an active choice of plan increased CDHP enrollment but also increased risk selection. Risk selection was greater for singles than families and did not differ between HRA and HSA-based CDHPs. Risk selection was not severe and it was well managed. Employers have effective methods to encourage CDHP enrollment and temper selection against traditional plans.

Upgrading IEC strategy: the happy family coupon campaign.

PubMed

Alberto, C S

1976-01-01

The Information, Education and Communication Division of the Family Planning Organization of the Philippines launched a Happy Family Coupon Campaign, a project to test the feasibility and the potential of a scheme whereby materials were distributed in response to individuals' expressed needs and interest. The project aims were: 1) to reach specific target groups, represented by readers of commercially printed materials; 2) to explore the potential of the mail system as a medium for the distribution of family planning materials; 3) to test the effectiveness of commercial publications as a vehicle for creating demand for family planning information; and 4) to secure feedback regarding preferences for the various family planning materials. The campaign had 2 major components: 1) advertising as a means of informing readers about the availability of certain family planning information materils, and 2) mail service as a channel for delivering requested materials to the respondents. 12 types of informational materials were distributed, each written in English, Filipino, and the Ilocano, Cebuano, and Ilongo dialects. These pamphlets and leaflets are described. The campaign drew a total of 24,226 respondents from August 1974 to December 1975. 58.7% of the respondents had 1-4 children, 26.4% had 5 or more children, and the remaining 14.9% gave no information concerning the number of children. It appears that the project has already achieved a measure of success as indicated by: 1) specific target groups were reached, 2) the potential of the mail system as a channel for the distribution of family planning was not confined to the buyers of the publications, 3) the potential of commercial publications as vehicles for creating demand for family planning information was tested, and 4) feedback regarding preferences of various groups for different family planning materials was obtained.

Family participation in care plan meetings: promoting a collaborative organizational culture in nursing homes.

PubMed

Dijkstra, Ate

2007-04-01

In this study, the author evaluated a project in The Netherlands that aimed to promote family members' participation in care plan meetings at a psychogeriatric nursing home. The small-scale pilot project, which was conducted in four wards of the nursing home, was designed to involve families in health care decisions by allowing family members to participate in care plan meetings. Both qualitative (participant observation and interview) and quantitative (observation matrix and index analysis) approaches were used to evaluate the project. Findings showed family members were involved in approximately half of the interactions, and many of the questions family members asked were not about the illness, but about its effects. This study indicates there is a need for family members to participate in the multidisciplinary care plan meeting.

75 FR 37883 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... Planning and Cost Allocation by Transmission Owning and Operating Public Utilities; Proposed Rule #0;#0...] Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities Issued June 17... Transmission Services by Public Utilities; Recovery of Stranded Costs by Public Utilities and Transmitting...

Family Planning: Bosnian, Russian, Spanish, Nuer.

ERIC Educational Resources Information Center

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

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

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

PubMed

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

2016-12-01

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

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

PubMed

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

1986-01-01

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

Does a wife's education influence spousal agreement on approval of family planning?: Random-effects Modeling using data from two West African Countries.

PubMed

Hossain, Mian; Ahmed, Saifuddin; Rogers, Laurencia

2014-05-01

Spousal approval of family planning is critical for contraceptive use. Both contraceptive use rates and women's education are low in many West-African countries and this study examines the role of wives' education in spousal agreement on approval of family planning in two sub-Saharan West African countries. We used couples' data from Demographic Health Surveys in Senegal and in Niger, conducted in 2005 and 2006, respectively. Multiple logistic regression results using multilevel modeling show that the odds of spousal agreement on approval of family planning were slightly over three times [OR: 3.16; 95% CI: 1.32 to 7.57] in Senegal and were about three times [OR: 3.07; 95% CI: 1.64 to 5.76] in Niger higher for women with more than primary education. Findings suggest that improvement in women's education could lead to spousal agreement on approval of family planning, which may lead to use of family planning in sub-Saharan African countries.

Tay Sachs and Related Storage Diseases: Family Planning

ERIC Educational Resources Information Center

Schneiderman, Gerald; And Others

1978-01-01

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

Using Program Data to Improve Access to Family Planning and Enhance the Method Mix in Conflict-Affected Areas of the Democratic Republic of the Congo

PubMed Central

Ho, Lara S; Wheeler, Erin

2018-01-01

Unmet need for family planning in the conflict-affected area of eastern Democratic Republic of the Congo (DRC) has been reported to be as high as 38%, and women in such conflict settings are often the most at risk for maternal mortality. The International Rescue Committee implements the Family Planning and Post-Abortion Care in Emergencies program in 3 provinces of eastern DRC to provide women and couples access to family planning, including long-acting reversible contraceptives (LARCs). This article presents routine program data from June 2011 through December 2013 from 2 health zones as well as results from a qualitative assessment of family planning clients and of male and female non-users, conducted in 2013. It then describes how these findings were used to make program adjustments to improve access to family planning services and client informed choice and assesses the effects of the program design changes on family planning uptake and method mix using routine program data from January 2014 through December 2016. Between 2011 and 2013, 8,985 clients adopted family planning, with an average 14 clients adopting a method per facility, per month. The method mix remained stable during this period, with implants dominating at 48%. Barriers to uptake identified from the qualitative research were both supply- and demand-related, including misconceptions about certain modern contraceptive methods on the part of providers, users, and other community members. The program implemented several program changes based on the assessment findings, including clinical coaching and supportive supervision to improve provider skills and attitudes, introduction of immediate postpartum insertion of the intrauterine device (IUD) and the levonorgestrel-releasing intrauterine system (LNG-IUS), and behavior change communication campaigns to raise awareness about family planning. After these program changes, the mean number of clients adopting modern family planning per facility, per month increased from 14 to 37 and the percentage of family planning adopters choosing LARCs increased from 50% to 66%. While implants continued to be the most dominant method, reaching 60% of the method mix in 2016, the percentage of clients adopting IUDs increased each year, from 3% in 2014 to 13% in 2016. In total, 39,399 clients started family planning methods during the post-program design change period (2014–2016). Our experience in eastern DRC demonstrates that women and their partners affected by conflict want family planning, and that it is feasible to deliver the full range of modern contraceptive methods when programs are adapted and sensitive to the local context. PMID:29602870

[How to expand and improve the coverage of family planning services: a Latin American viewpoint].

PubMed

Trias, M

1992-12-01

It is probably not possible to implant a family planning program that will have a reasonable demographic impact in areas lacking awareness of the disadvantages of overly high fertility. Rural-urban migration, increasing educational levels, women's labor force participation, and declining infant mortality are all factors that have been found to correlate with demand for family planning services. It has been recognized since the Bucharest World Population Conference in 1974 that development and family planning are both required for the fertility transition to begin. Where these conditions exist, a family planning program appropriate to the needs, limitations, preferences, and expectations of the target population has an excellent chance of success. Expanded and improved coverage results from tailoring programs to the specific groups served. Most programs are directed toward women. It has been found most effective to provide services for men in separate sessions. It is also useful to distinguish between services for adolescents, who require more information and fewer services, for mature women who require more services than information, and for premenopausal women whose needs for information and services are both declining. Contraceptive preferences vary with social class, but family planning programs in developing countries should concentrate on the lower middle and lower classes which comprise 80% of the population. Rural areas and marginal urban areas require special attention. In order to provide services that will attract all potential users, the maximum possible variety of methods should be available. A family planning program offering a variety of methods throughout the country and financially accessible to the population should be successful. Family planning programs, whether public or private, require adequate financial resources and the support or at least tolerance of the government. Knowledge of contraception is now almost universal. A major challenge of family planning programs is to prompt women who say they want to limit their reproduction but who do not practice family planning to adopt a method. Program leadership and interpersonal relations with clients should be competent. The experience of PROFAMILIA in Colombia suggests that charging fees for all services offered by the family planning program is a positive feature allowing the client to avoid feeling like a charity recipient and the program to account for materials and services more easily. Goals and objective indicators stimulate performance and allow progress to be assessed. It is recommended that client education focus on a synthesis of information concerning available methods and provision of somewhat greater detail on the method chosen. Integration of services is usually an enemy of family planning because, despite theoretical advantages, it usually means neglect of family planning in favor of curative care.

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

PubMed

Trias, M

1994-06-01

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

Linking national and global population agendas: case studies from eight developing countries.

PubMed

Lee, K; Walt, G

1995-06-01

This comparative study of the determinants of family planning policy initiation and implementation focuses on four pairs of countries: Zambia/Zimbabwe, Algeria/Tunisia, Pakistan/Bangladesh, and Philippines/Thailand. The conclusion is drawn that global efforts had an influence on national policy makers and on putting family planning issues on the policy agenda. Global impacts were affected by national economic and social conditions and the broader political and economic relations with Western countries. The absolute level of economic development was found to be unrelated to the timing of initiation of family planning on national policy agendas. Stronger national family planning programs occurred in countries where policy makers linked economic development at whatever level with the need to limit population growth. Pakistan and Thailand in the 1960s illustrated this commitment to family planning programs, and Zambia and Algeria illustrated the lack of connection between development and population growth at the policy level and the lack of family planning on the policy agenda. Affiliation with the West during the 1960s meant early initiation of family planning in Pakistan/Bangladesh and Philippines/Thailand. Stronger commitment to program implementation occurred only in Thailand during the 1970s and Zimbabwe during the 1980s. Commitment lessened in the Philippines and Pakistan. Program implementation and national support of family planning were viewed as also dependent upon domestic factors, such as sufficient resources. Algeria/Tunisia and Zambia/Zimbabwe were countries that promoted family planning only after national political ideology shifted and anti-imperialist sentiments subsided. The impact of the international Cairo conference on these countries was minimal in terms of policy change. Most of the countries however desired greater support from donors. Even objections from the Vatican and internal domestic pressures were insufficient to prevent countries such as the Philippines and Pakistan from supporting the Cairo Plan of Action and a family planning and reproductive health agenda. Bangladesh and Pakistan are given as examples of countries where differences in the focus of foreign aid impacted on the national support for social services.

Financing family planning services: is categorical legislation still needed?

PubMed

Mcfarlane, D R; Meier, K J

1991-01-01

Federal and state funds have provided for family planning services in American since the 1960s. Since 1976, services have been funded principally through federal statutes Title X of the Public Health Service Act and Titles V, XIX, and XX of the Social Security Act as well as various state appropriations. While these statutes aim to ensure that women of lower socioeconomic status enjoy access to reproductive health care services, levels of public expenditure in this area vary widely among states. In 1987, public family planning expenditures/woman at risk ranged from $60.16 in Wisconsin to $9.41 in Florida. Within this range of expenditures, the relative importance of each funding source per state varies widely. States with the most robust Title XIX programs, Medicaid, however, have highest per woman family planning expenditures. Upon reviewing the complement of public funding sources and how they are spent at the state level, the authors argue that categorical legislation is still needed to protect access to contraceptive services in America. In particular, of funds from supporting statues, Medicaid is distributed most equitable across the country. These funds paid for 36% of all public outlays for family planning in 1987. Without categorical legislation, however, Medicaid is insufficient to maintain the national family planning effort; the 1987 contribution of $10.49/woman at risk of unwanted pregnancy was insufficient to provide minimum services. Title X requires grantees to follow regulations which ensure state uniformity of quality and service distribution; submission of annual 5-year plans to Congress on how family planning goals will be achieved; and also authorizes monies for training and research. Despite political attacks, family planning funding must remain separate from maternal and child health programs. Such independence will keep these services politically visible; allow use of the more extensive family planning delivery system; catalyze states to spend other monies on family planning; and fuel innovations in service delivery, client education, and new contraceptive technologies. Title X should even be reauthorized under more precise mandates and include a national data collection system, consideration of the shortage of clinicians, and codification of 1981 guidelines reversed by the gag rule.

Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda.

PubMed

Sileo, Katelyn M; Wanyenze, Rhoda K; Lule, Haruna; Kiene, Susan M

2015-12-01

Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda. Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS to identify determinants of family planning service uptake and contraceptive use postpartum. Statistically significant predictors of uptake of family planning services included: education (AOR = 3.03, 95 % CI 1.57-5.83), prior use of contraceptives (AOR = 7.15, 95 % CI 1.58-32.37), partner communication about contraceptives (AOR = 1.80, 95 % CI 1.36-2.37), and perceived need of contraceptives (AOR = 2.57, 95 % CI 1.09-6.08). Statistically significant predictors of contraceptive use since delivery included: education (AOR = 2.04, 95 % CI 1.05-3.95), prior use of contraceptives (AOR = 10.79, 95 % CI 1.40-83.06), and partner communication about contraceptives (AOR = 1.81, 95 % CI 1.34-2.44). Education, partner communication, and perceived need of family planning are key determinants of postpartum family planning service uptake and contraceptive use, and should be considered in antenatal and postnatal family planning counseling.

Family planning: the unfinished agenda.

PubMed

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

2006-11-18

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

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

PubMed

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

2011-05-01

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

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

ERIC Educational Resources Information Center

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

2005-01-01

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

IPPF Co-operative Information Service (ICIS). August 1978.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This booklet contains bibliographies on population education and family planning. The following topics are covered: family planning and biomedical science, social sciences related to family planning, international conferences, Africa, the Americas, Asia, Europe, the Middle East, and Oceania. Each entry gives the author, title, publisher, date, and…

Population Growth: Family Planning Programs.

ERIC Educational Resources Information Center

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

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

42 CFR 456.181 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... evaluation or plan. Utilization Review (UR) Plan: General Requirements ...

42 CFR 456.381 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... evaluation and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... plan. Utilization Review (UR) Plan: General Requirement ...

42 CFR 456.381 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... evaluation and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... plan. Utilization Review (UR) Plan: General Requirement ...

Patent Deployment Strategies and Patent Value in LED Industry

PubMed Central

Wu, Ming-Fu; Chang, Keng-Wei; Zhou, Wei; Hao, Juan; Yuan, Chien-Chung; Chang, Ke-Chiun

2015-01-01

This study applies two variables in the measurement of company patent deployment strategies: patent family depth and earn plan ratio. Patent family depth represents the degree to which certain fields and markets are valued by the patent owner. Earn plan ratio defined as the ratio of the number of patent forward citations to patent family size. Earn plan ratio indicates the degree to which a patent family could be cited by later innovators and competitors. This study applies a logistic regression model in the analysis LED industry data. The results demonstrate that patent value has a positive relationship with the patent family depth, and earn plan ratio. PMID:26098313

Patent Deployment Strategies and Patent Value in LED Industry.

PubMed

Wu, Ming-Fu; Chang, Keng-Wei; Zhou, Wei; Hao, Juan; Yuan, Chien-Chung; Chang, Ke-Chiun

2015-01-01

This study applies two variables in the measurement of company patent deployment strategies: patent family depth and earn plan ratio. Patent family depth represents the degree to which certain fields and markets are valued by the patent owner. Earn plan ratio defined as the ratio of the number of patent forward citations to patent family size. Earn plan ratio indicates the degree to which a patent family could be cited by later innovators and competitors. This study applies a logistic regression model in the analysis LED industry data. The results demonstrate that patent value has a positive relationship with the patent family depth, and earn plan ratio.

Trends in contraceptive use and determinants of choice in China: 1980-2010.

PubMed

Wang, Cuntong

2012-06-01

In China, contraception is the most commonly used practice adopted by couples seeking to limit their number of children and to determine the time interval between births. Since 1980, the implementation of mandatory contraceptive strategy has reduced the fertility rate. Using large-scale data from national statistics and nationally representative sample surveys, the current study aims to assess Chinese trends in contraceptive use and determinants of choice from 1980 to 2010 among married women and men aged 20-49 years. Since 1980, national data on contraceptive methods utilization have been gathered by the National Population and Family Planning Commission of the People's Republic of China (NPFPC). Additionally, data from three roughly representative decennial samples (1988, 1997, 2006) of Chinese women of aged 20 to 57 years have been gathered by the NPFPC through the National Family Planning and Reproductive Health Surveys in China. A relatively stable Chinese mode of contraception has been established and maintained since the 1980s. This is characterized by long-term contraceptive use which is still dominant in current China. In addition, China's total contraceptive prevalence rates remain at the highest level across the globe from 1980 to 2010. However, the overall method composition of contraceptive use within China has changed since the mid-1990s. Over the study period, the prevalence rate of sterilization increased from 30.21% in 1980 to 46.47% of married women of reproductive age (20-49 years) in 1994 and then declined to 31.7% in 2010. At the same time, intrauterine device usage increased (39.83% in 1980 to 48.15% in 2010), as did oral contraception (0.3% in 1980 to 0.98% in 2010) and condom usage (2.35% in 1980 to 9.32% in 2010). The results from the multinomial logit model show that an individual's contraceptive choice depends not only on individual characteristics, including ethnicity, age, education level, household registration, region, number of living children and sex of the last living child, but also on the strength of family planning policies. A positive coefficient indicates that the looser the strength of family planning policies is, the more likely the individual is to choose condoms or another short-term contraceptive method. Long-term contraceptive use is still dominant in China. In fact, over the 30-year period (1980-2010) and in comparative world perspective, China continues to have the highest total contraceptive prevalence rate. Additionally, an individual's contraceptive choice is jointly influenced by the strength of family planning policies and individual characteristics. Copyright © 2012 Elsevier Inc. All rights reserved.

Jordan's 2002 to 2012 Fertility Stall and Parallel USAID Investments in Family Planning: Lessons From an Assessment to Guide Future Programming

PubMed Central

Spindler, Esther; Bitar, Nisreen; Solo, Julie; Menstell, Elizabeth; Shattuck, Dominick

2017-01-01

Health practitioners, researchers, and donors are stumped about Jordan's stalled fertility rate, which has stagnated between 3.7 and 3.5 children per woman from 2002 to 2012, above the national replacement level of 2.1. This stall paralleled United States Agency for International Development (USAID) funding investments in family planning in Jordan, triggering an assessment of USAID family planning programming in Jordan. This article describes the methods, results, and implications of the programmatic assessment. Methods included an extensive desk review of USAID programs in Jordan and 69 interviews with reproductive health stakeholders. We explored reasons for fertility stagnation in Jordan's total fertility rate (TFR) and assessed the effects of USAID programming on family planning outcomes over the same time period. The assessment results suggest that the increased use of less effective methods, in particular withdrawal and condoms, are contributing to Jordan's TFR stall. Jordan's limited method mix, combined with strong sociocultural determinants around reproduction and fertility desires, have contributed to low contraceptive effectiveness in Jordan. Over the same time period, USAID contributions toward increasing family planning access and use, largely focused on service delivery programs, were extensive. Examples of effective initiatives, among others, include task shifting of IUD insertion services to midwives due to a shortage of female physicians. However, key challenges to improved use of family planning services include limited government investments in family planning programs, influential service provider behaviors and biases that limit informed counseling and choice, pervasive strong social norms of family size and fertility, and limited availability of different contraceptive methods. In contexts where sociocultural norms and a limited method mix are the dominant barriers toward improved family planning use, increased national government investments toward synchronized service delivery and social and behavior change activities may be needed to catalyze national-level improvements in family planning outcomes. PMID:29284697

Yielding impressive results. The Egyptian experience in family planning communication campaign has been an exemplary model for many developing countries.

PubMed

Wafai, M

1994-09-01

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 planning IEC has been an exemplary model for many developing countries.

Linking population, fertility, and family planning with adaptation to climate change: perspectives from Ethiopia.

PubMed

Rovin, Kimberly; Hardee, Karen; Kidanu, Aklilu

2013-09-01

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.

Population and population policy in Pakistan.

PubMed

Mauldin, W P

1963-02-01

Pakistan is a divided country with different religious groups represented. Since independence in 1941, the Muslim population has increased more rapidly than the Hindu population, the West Pakistan population more rapidly and steadily than the East Pakistan population. In the late 1950s the Pakistan government initiated a family planning program. The program has trained medical and paramedical personnel in family planning, added family planning services to existing medical centers, planned for a National Research Institute of Family Planning, employed mobile units to reach outlying areas, conducted limited clinical studies on some contraceptives, and used mass media advertising. Only India and Japan are doing more with government-sponsored family planning. A weak organizational structure and an inadequate number of trained personnel are the main weakness of the program. It is too early to assess the success of the program. A 10-point reduction in annual birth rates will be considered successful.

Health is primary: Family medicine for America's health.

PubMed

Phillips, Robert L; Pugno, Perry A; Saultz, John W; Tuggy, Michael L; Borkan, Jeffrey M; Hoekzema, Grant S; DeVoe, Jennifer E; Weida, Jane A; Peterson, Lars E; Hughes, Lauren S; Kruse, Jerry E; Puffer, James C

2014-10-01

More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to "renew the specialty to meet the needs of people and society," some of which bore important fruit. Family Medicine for America's Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). Family Medicine for America's Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support effective care; improving research underpinning primary care; and actively engaging patients, policy makers, and payers to develop an understanding of the value of primary care. The communications plan, called Health is Primary, will complement these strategies. Eight family medicine organizations have pledged nearly $20 million and committed representatives to a multiyear implementation team that will coordinate these plans in a much more systematic way than occurred with FFM. Family Medicine for America's Health is a new commitment by 8 family medicine organizations to strategically align work to improve practice models, payment, technology, workforce and education, and research to support the Triple Aim. It is also a humble invitation to patients and to clinical and policy partners to collaborate in making family medicine even more effective. © 2014 Annals of Family Medicine, Inc.

Family planning in conflict: results of cross-sectional baseline surveys in three African countries

PubMed Central

2011-01-01

Background Despite the serious consequences of conflict for reproductive health, populations affected by conflict and its aftermath face tremendous barriers to accessing reproductive health services, due to insecurity, inadequate numbers of trained personnel and lack of supplies. Family planning is often particularly neglected. Methods In six conflict-affected areas in Sudan, northern Uganda and the Democratic Republic of Congo, household surveys of married or in-union women of reproductive age were conducted to determine baseline measures of family planning knowledge, attitudes and behaviors regarding contraception. Health facility assessments were carried out to assess baseline measures of family planning services availability. Data were double-entered into CSPro 3.2 and exported to SAS 9.2, which was used to calculate descriptive statistics. The studies' purposes were to guide program activities and to serve as a baseline against which program accomplishments could be measured. Results Knowledge of modern contraceptive methods was low relative to other sub-Saharan African countries, and use of modern methods was under 4% in four sites; in two sites with prior family planning services it was 12% and 16.2%. From 30% to 40% of women reported they did not want a child within two years, however, and an additional 12% to 35% wanted no additional children, suggesting a clear need for family planning services. The health facilities assessment showed that at most only one-third of the facilities mandated to provide family planning had the necessary staff, equipment and supplies to do so adequately; in some areas, none of the facilities were prepared to offer such services. Conclusions Family planning services are desired by women living in crisis situations when offered in a manner appropriate to their needs, yet services are rarely adequate to meet these needs. Refugee and internally displaced women must be included in national and donors' plans to improve family planning in Africa. PMID:21752241

[Spending on private health insurance plans of Brazilian families: a descriptive study with data from the Family Budget Surveys 2002-2003 and 2008-2009].

PubMed

Garcia, Leila Posenato; Ocké-Reis, Carlos Octávio; de Magalhães, Luís Carlos Garcia; Sant'Anna, Ana Claudia; de Freitas, Lúcia Rolim Santana

2015-05-01

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.

Opening end-of-life discussions: how to introduce Voicing My CHOiCES™, an advance care planning guide for adolescents and young adults.

PubMed

Zadeh, Sima; Pao, Maryland; Wiener, Lori

2015-06-01

Each year, more than 11,000 adolescents and young adults (AYAs), aged 15-34, die from cancer and other life-threatening conditions. In order to facilitate the transition from curative to end-of-life (EoL) care, it is recommended that EoL discussions be routine, begin close to the time of diagnosis, and continue throughout the illness trajectory. However, due largely to discomfort with the topic of EoL and how to approach the conversation, healthcare providers have largely avoided these discussions. We conducted a two-phase study through the National Cancer Institute with AYAs living with cancer or pediatric HIV to assess AYA interest in EoL planning and to determine in which aspects of EoL planning AYAs wanted to participate. These results provided insight regarding what EoL concepts were important to AYAs, as well as preferences in terms of content, design, format, and style. The findings from this research led to the development of an age-appropriate advance care planning guide, Voicing My CHOiCES™. Voicing My CHOiCES™: An Advanced Care Planning Guide for AYA became available in November 2012. This manuscript provides guidelines on how to introduce and utilize an advance care planning guide for AYAs and discusses potential barriers. Successful use of Voicing My CHOiCES™ will depend on the comfort and skills of the healthcare provider. The present paper is intended to introduce the guide to providers who may utilize it as a resource in their practice, including physicians, nurses, social workers, chaplains, psychiatrists, and psychologists. We suggest guidelines on how to: incorporate EoL planning into the practice setting, identify timepoints at which a patient's goals of care are discussed, and address how to empower the patient and incorporate the family in EoL planning. Recommendations for introducing Voicing My CHOiCES™ and on how to work through each section alongside the patient are provided.

The impacts of health, education, family planning and electrification programs on fertility, mortality and child schooling in East Java, Indonesia.

PubMed

Wirakartakusumah, M D

1988-06-01

This paper examines the effects of public health, family planning, education, electrification, and water supply programs on fertility, child mortality, and school enrollment decisions of rural households in East Java, Indonesia. The theoretical model assumes that parents maximize a utility function, subject to 1) a budget constraint that equates income with expenditures on children (including schooling and health inputs), and 2) a production function that relates health inputs to child survival possibilities. Public programs affect prices of contraceptives, schooling and health inputs, and environmental conditions that in turn affect child survival. Data are taken from the 1980 East Java Population Survey, the Socio-economic Survey, and the Detailed Village Census. The final sample consists of 3170 rural households with married women of childbearing age. Ordinary least squares and logit regressions of recent fertility, child mortality, and school enrollment on program and household variables yielded the following findings. 1) The presence of maternal and child health clinics reduced fertility but not mortality. 2) The presence of public health centers strongly reduced mortality but not fertility. 3) The presence of contraceptive distribution centers had no effect on fertility. 4) School attendance rates were influenced positively by the availability of primary and secondary schools. 5) Health and family planning programs had no effects on schooling. 6) The availability of public latrines reduced fertility and mortality. 7) The water supply variable did not affect the dependent variables when ordinary least squares techniques were applied but had statistically significant impact when logit methods were used. 8) Electricity supply had little effect on the dependent variables. 9) The mother's schooling had a strong positive correlation with children's schooling but no effect on fertility or mortality. 10) Household expenditures were related positively to school attendance and negatively to mortality. 11) There was little or no interaction between household variables and presence of government programs. 12) Subprovincial area measures of service availability appeared more appropriate for public health and family planning services, while village-level measures appeared more appropriate for schooling.

Family and Consumer Sciences: A Facility Planning and Design Guide for School Systems.

ERIC Educational Resources Information Center

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…

Family Planning in the Balance

PubMed Central

Hwang, Ann C.; Stewart, Felicia H.

2004-01-01

Family planning has long been acknowledged as an effective public health intervention. In recent years, however, family planning has come under increased scrutiny from conservative politicians and constituents. National US policies instituted since 2001 are resulting in cutbacks in family planning programs worldwide. In the long run, these conservative initiatives may set back several decades of progress in reproductive health and reproductive rights. In promoting an ideologically driven approach to sexual and reproductive health, the recent policy developments threaten to subvert ethical standards of medical care and the principle of evidence-based policy. PMID:14713687

A religion for planning. As a religion which aims to organize the lives of its people, Islam must foster planning.

PubMed

Damad, M

1996-01-01

Islam is not simply a religion, but it is also a social system, a culture, and a civilization. Values, ideals, and goals are therefore inherent to Islam. Islamic legislation is comprehensive, dealing with questions of faith, worship, moral behavior, social interaction, and business dealings. Islam also includes a system of legislation, taxation, family formation, community development, social structure, and international relations. Several general precepts of Islam provide a context for the proper formation of the Muslim family in a changing society and support the principle of family planning whenever justified. As a religion which aims to organize the lives of its people, Islam must foster family planning. This paper considers some of the basic characteristics of Islam which are relevant to family planning.

Evaluating the impact a proposed family planning model would have on maternal and infant mortality in Afghanistan.

PubMed

Rahmani, Ahmad Masoud; Wade, Benjamin; Riley, William

2015-01-01

This study aimed to assess the potential impact a proposed family planning model would have on reducing maternal and infant mortality in Afghanistan. Afghanistan has a high total fertility rate, high infant mortality rate, and high maternal mortality rate. Afghanistan also has tremendous socio-cultural barriers to and misconceptions about family planning services. We applied predictive statistical models to a proposed family planning model for Afghanistan to better understand the impact increased family planning can have on Afghanistan's maternal mortality rate and infant mortality rate. We further developed a sensitivity analysis that illustrates the number of maternal and infant deaths that can be averted over 5 years according to different increases in contraceptive prevalence rates. Incrementally increasing contraceptive prevalence rates in Afghanistan from 10% to 60% over the course of 5 years could prevent 11,653 maternal deaths and 317,084 infant deaths, a total of 328,737 maternal and infant deaths averted. Achieving goals in reducing maternal and infant mortality rates in Afghanistan requires a culturally relevant approach to family planning that will be supported by the population. The family planning model for Afghanistan presents such a solution and holds the potential to prevent hundreds of thousands of deaths. Copyright © 2013 John Wiley & Sons, Ltd.

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

PubMed

Ngambi Kunga

1990-01-01

Cameroon has announced that it favors family planning as a means of improving family welfare. In the local context, family planning would refer to spacing and to a lesser extent limiting births, as well as combatting infertility. This work argues that, at a time of deep economic and financial crisis for Cameroon and of growing need and demand for family planning services, the introduction of employment-based family planning services could reinforce the family planning activities of the government and private agencies. The work broadly outlines national family planning policy, identifies weaknesses of proposed family planning strategies, and points out the advantages of employment-based services. Cameroon's infant mortality rate of 90/1000 live births and maternal mortality of 420/100,000 are partly related to its very high fertility rate, closely spaced births, and early pregnancy. The national family planning program goal is to promote health and wellbeing by preventing early and unwanted pregnancies and illnesses in high-risk groups. A decline in unwanted births would be achieved through voluntary use of contraception. The main strategy would be an ambitious IEC program to inform the population of the advantages of family planning using mass media, print materials, and interpersonal communication. The general objectives of the IEC program would be to reduce maternal mortality to 300/100,000 and infant mortality from 90 to 70/1000 and increase contraceptive prevalence from 3 to 20% by 1994. Family planning services and commercial distribution centers would be created, taking advantage of existing health facilities wherever possible as well as community based systems of service delivery for the population not yet served by the traditional distribution system. Experience with the IEC strategy in other countries demonstrates that there is a great disproportion between the population touched by IEC and contraceptive prevalence. The strategy would probably be more effective if it were oriented toward a more limited population group. Interpersonal communication is often a more effective medium for IEC than is communication based on the mass media, and the place of work constitutes an ideal arena for interpersonal communication. An IEC strategy would have more impact in difficult-to-reach rural population if it were reinforced by an employment-based program. Workers as a group are more disposed to conscious decision making about family sizes than are other categories of persons. Employment-based services could benefit workers, their spouses, and perhaps the neighboring population. Employers would benefit from the improved health of the workers, from the greater continuity of employment of female workers not requiring maternity leaves, and from lessened expenditures related to the family size of the workforce, such as health care costs. A cost-benefit analysis of an employment-based family planning would demonstrate the savings to be realized by the program, especially over time.

Health Is Primary: Family Medicine for America’s Health

PubMed Central

Phillips, Robert L.; Pugno, Perry A.; Saultz, John W.; Tuggy, Michael L.; Borkan, Jeffrey M.; Hoekzema, Grant S.; DeVoe, Jennifer E.; Weida, Jane A.; Peterson, Lars E.; Hughes, Lauren S.; Kruse, Jerry E.; Puffer, James C.

2014-01-01

PURPOSE More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to “renew the specialty to meet the needs of people and society,” some of which bore important fruit. Family Medicine for America’s Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). METHODS Family Medicine for America’s Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. RESULTS The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support effective care; improving research underpinning primary care; and actively engaging patients, policy makers, and payers to develop an understanding of the value of primary care. The communications plan, called Health is Primary, will complement these strategies. Eight family medicine organizations have pledged nearly $20 million and committed representatives to a multiyear implementation team that will coordinate these plans in a much more systematic way than occurred with FFM. CONCLUSIONS Family Medicine for America’s Health is a new commitment by 8 family medicine organizations to strategically align work to improve practice models, payment, technology, workforce and education, and research to support the Triple Aim. It is also a humble invitation to patients and to clinical and policy partners to collaborate in making family medicine even more effective. PMID:25352575

Awareness and Determinants of Contraceptive use among Nursing Mothers in Bellary, Karnataka.

PubMed

Rao, Bhavya S; Mathada, Veerendrakumar Chowdapur

2016-01-01

The nursing mothers, who have already delivered a child in recent period, may prefer to avoid or delay future pregnancy, or may not even have given a thought about it. Among those who prefer to delay next pregnancy, many are unaware of family planning practices. This is mainly influenced by the prevailing sociodemographic factors in their families. To study the prevailing Knowledge, Attitude and Practice of contraception and the influence of sociodemographic factors on family planning practices among the healthy nursing mothers. A cross-sectional study was conducted among 2500 healthy breast feeding mothers who delivered at Medical College Hospital (MCH), Vijayanagara Institute of Medical Sciences(VIMS), Bellary during Dec 2011 to Nov 2013. They were interviewed using a pre structured questionnaire in the post natal wards on 2(nd) to 7(th) postpartum day. Later these mothers were educated and counseled regarding various suitable contraceptive methods. The data collected were analysed using percentage and chi- square test. The proportion of willingness for contraception is more among women in the age group 19-29 years, among literate husband and wife, among women belonging to nuclear families and with higher socioeconomic status. Muslim women were least receptive to contraceptive advice. Regarding awareness of contraceptive methods only 46% had knowledge regarding family planning methods. A total of 43% mothers opted to limit family size. Among 16% of mothers who did not want to limit family size, 70% had no male child. In most of the families, final decision regarding family planning method was taken by husband alone or by elders. The most important reason for lack of family planning practices was lack of awareness (57.2%). Many of the nursing mothers are not aware of contraceptive practices. But these women are very receptive to contraceptive advice. Also, the decision of family planning depends not only on the couples but even on elders of the family. Hence, a combined family approach to educate and counsel the entire family including elders is needed. The major determinant is education of the entire family regarding family planning practices.

Birth control practices and levels of development in India.

PubMed

Karan, P P; Bladen, W A; Singh, G

1978-11-01

The paper examines the acceptance of birth control practices in India, and examines the relationhsip of these patterns to levels of economic development. A study of selected couples with markedly low incomes revealed that fertility tended to increase until a certain level of per capita income was reached. From this level onward, fertility and desired family size goals declined with increasing economic status. The study reveals an association in India between those less developed states and poor acceptance of family planning. The level of medical and administrative personnel for family planning services is superior in the more developed states and, logically, adoption of family planning practices is also higher. In higher-income states, characterized by relatively higher spatial mobility and literacy rates, the spread of family planning practices is relatively rapid. In less developed states, characterized by poorly developed centralized systems of communication and distribution, a lower spatial mobility of people, and a lower diffusion of knowledge through personal contact, family planning methods tend to spread very slowly or become less and less popular. A classification of Indian states as related to their acceptance of formal family planning policy and governmental efforts has been helpful in developing regionally-oriented program strategies for the future. Such strategies would take into account varying socioeconomic, cultural and administrative infrastructure differences in order to better assure delivery of services. As India also faces a shortage of trained physicians and personnel for the National Family Planning program, a regionally-based spatial allocation policy must be formulated that will divert some family planning personnel from states with high-acceptance patterns to the more densely populated, less developed regions of the country.

Armored Family of Vehicles (AFV). Phase 1 Report. Book 7. Volume 11

DTIC Science & Technology

1987-08-31

Armored Family of Vehicles. Specific requirements and products are described which initiate the training development process and a training management ...approach for the TRADOC and proponent schools to plan, develop, manage and integrate the training subsystem(s) for the Armored Family of Vehicles...Procedures. q. Charter, Armored Family of Vehicles. r. Operational and Organizational (O&W) Plan for AFV. s. System MANPRINT Management Plan for AFV

The pediatrician and family planning in a very poor community. An appraisal of experiences in the Tufts Delta Health Center, Bolivar County, Mississippi.

PubMed

Hansen, C M

1972-06-01

Family planning services should be of prime interest to all pediatricians because of their direct relationship to the health and well-being of mothers and children. The Tufts Delta Health Center is a pilot demonstration project in community health services which serves a poor rural black population in northern Bolivar County in Mississippi. 154 women were seen for family planning services during the first 1 1/2 years. They were given oral contraceptives or IUDs and during the initial 15 months of the program, contraception was effective in 82% of the cases. 62% of the original 154 mothers were still effective contraceptors after about 3 1/2 years in the program. Family planning services are important where maternal and infant death rates are high, since they allow for child spacing in poor families which may already have large numbers of children. Due to lack of funds or inability to obtain oral contraceptives on behalf of the physician, many patients were unable to practice family planning before this program. Family planning represents only one of a number of services that must be made available to poor families in the context of their total health needs.

Comparison of the perspectives of managers, employees and clients regarding the individual barriers of family planning counseling in healthcare centers of isfahan in 2012.

PubMed

Taheri, Safoura; Ehsanpour, Soheila; Kohan, Shahnaze; Farzi, Saba; Jaafarpour, Molouk; Direkvand-Moghaddam, Ashraf

2014-03-01

Family planning is a lifestyle that is selected voluntarily and is based on the knowledge, attitude and responsible decision making by couples in order to promote the health and welfare of the family and the advancement of the society. In this regard, family planning counseling plays an important role in making informed decisions if used properly and in a responsible way. Detection of individual barriers in family planning counseling based on the viewpoints of managers, employees and clients who are key participants in the healthcare service provision is a major step towards appropriate planning to modify or eliminate such barriers. The present study was conducted with the goal of comparing managers', employees' and clients' viewpoints about individual barriers in family planning counseling in health care centers in Isfahan in 2012. This was a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 employees and 126 clients in medical health care centers in Isfahan in 2012. The managers and employees were selected by census sampling, and the clients were recruited through convenient random sampling. The data collection tool was a researcher-designed questionnaire, which was designed in two sections of fertility and personal characteristics, and viewpoint measurement. Descriptive and inferential statistical tests were used to analyze the data. The obtained results showed significant differences between mean scores of viewpoints in three groups of managers, employees and clients concerning individual barriers in family planning counseling. In addition, most of the managers, employees and clients reported individual barriers as an intermediate level barrier in the process of family planning counseling. Results indicate that subjects in three studied groups hold different views regarding the individual barriers in family planning counseling. This difference in the perspectives may be a factor that affects the quality of the provided services. Therefore, it is necessary for the healthcare providers to consider the main concerns of their clients regarding family planning.

Attitudes toward family planning.

PubMed

Gille, H

1984-06-01

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

Risk Selection into Consumer-Directed Health Plans: An Analysis of Family Choices within Large Employers

PubMed Central

McDevitt, Roland D; Haviland, Amelia M; Lore, Ryan; Laudenberger, Laura; Eisenberg, Matthew; Sood, Neeraj

2014-01-01

Objective To identify the degree of selection into consumer-directed health plans (CDHPs) versus traditional plans over time, and factors that influence choice and temper risk selection. Data Sources/Study Setting Sixteen large employers offering both CDHP and traditional plans during the 2004–2007 period, more than 200,000 families. Study Design We model CDHP choice with logistic regression; predictors include risk scores, in addition to family, choice setting, and plan characteristics. Additional models stratify by account type or single enrollee versus family. Data Collection/Extraction Methods Risk scores, family characteristics, and enrollment decisions are derived from medical claims and enrollment files. Interviews with human resources executives provide additional data. Principal Findings CDHP risk scores were 74 percent of traditional plan scores in the first year, and this difference declined over time. Employer contributions to accounts and employee premium savings fostered CDHP enrollment and reduced risk selection. Having to make an active choice of plan increased CDHP enrollment but also increased risk selection. Risk selection was greater for singles than families and did not differ between HRA and HSA-based CDHPs. Conclusions Risk selection was not severe and it was well managed. Employers have effective methods to encourage CDHP enrollment and temper selection against traditional plans. PMID:24800305

Thai family planner uses humor, good sense.

PubMed

Cantlay, C

1984-01-01

This article is a proflie of Khun Mechai, a leader in the Thai family planning field who was instrumental in creating the community-based contraceptive distribution program which began in 1973 with the 1st in a series of grants from the International Planned Parenthood Federation (IPPF). The community-based distribution program is active in some 16,000 villages and neighborhoods throughout Thailand. The Community-Based Family Planning Service (CBFPS) was established in 1974 with Khun Mechai as secretary general to coordinate the efforts of the nationwide network. The CBFPS has been linked with a massive, humorous, and creative campaign of "desensitization": Khun Mechai passes out condoms at official dinners, and honors the king's birthday with an annual free vasectomy marathon. As a result of his efforts, family planning is no longer a taboo topic and no longer the exclusive province of government bureaucrats and medical professionals. Khun Mechai's basic concern is in improving access to family planning services by overcoming physical and sociocultural distance and by providing an acceptable method of service delivery. All family planning activities of the Population and Community Development Association, the CBFPS parent organization, are voluntary. Links have been created between family planning and personal and community betterment to help motivate acceptance. Khun Mechai became acquainted with the country' development needs as a young economist with the National Economic and Social Development Board. His family planning activities grew out of his conviction that rapid, unplanned population growth is Thailand's and the world's single most serious problem. An incremental approcah with insistence on individual and local responsibility for development is essential to his philosphy and personality.

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

PubMed Central

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

2015-01-01

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

Family planning Indonesia.

PubMed

Singarimbun, M

1968-06-01

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

Even with the best of intentions: paternal involvement and the theory of planned behavior.

PubMed

Perry, Armon Rashard; Langley, Cheri

2013-06-01

Implicit in much of the fatherhood discourse is the assumption that if fathers want to take an active role in their children's lives, they could and would do so. While research has highlighted the factors associated with fathers' involvement, very few, if any, of these studies have been guided by a theory that accounts for both fathers' involvement intentions and their ability to follow through on those intentions. The theory of planned behavior and its emphasis on attitudes, the beliefs of significant others, and whether one has control over engaging in behavior is a conceptual fit to respond to questions related to the complex nature of paternal involvement. Using data from the Fragile Families and Child Well-being Study, the purpose of this study was to test the utility of the theory of planned behavior in predicting fathers' involvement intentions and reports of involvement. The results revealed that the theory of planned behavior can be useful in examining paternal involvement and should be used in future research to enhance the fatherhood literature. © FPI, Inc.

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

ERIC Educational Resources Information Center

Hardy, James M.

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

Pakistan: family planning expands in non-governmental organizations.

PubMed

1977-01-01

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

A call for collaboration on respectful, person-centered health care in family planning and maternal health.

PubMed

Holt, Kelsey; Caglia, Jacquelyn M; Peca, Emily; Sherry, James M; Langer, Ana

2017-02-02

Striking tales of people judged, disrespected, or abused in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services are commonly exchanged among friends and families throughout the world while remaining sorely under-addressed in global health. Disrespect and abuse of individuals and providers in health services across the RMNCAH continuum must be stopped through collaborative, multi-tiered efforts. A new focus on health care quality in the Sustainable Development Goals offers an opportunity to seriously reexamine user experiences and their impact on health care utilization. The new framework provides an opening to redress the insidious problem of negative interactions with care across the RMNCAH services continuum and redraft the blueprint for service delivery and performance measurement, placing individuals and their needs at the center. Both the maternal health and family planning fields are at a turning point in their histories of defining and addressing individuals' experiences of care. In this commentary, we review these histories and the current state-of-the-art in both fields. Though the approaches and language in each sub-field vary, person-centered care principles related to the essential role of individuals' preferences, needs and values, and the importance of informed decision-making, respect, privacy and confidentiality, and non-discrimination, are integral to all. Promoting respectful, person-centered care also requires recognizing the factors that lead to poor treatment of clients, including gender norms and unsupportive working conditions for providers. Lessons can be learned from innovative efforts across the continuum to support health care providers to provide respectful, person-centered care. Efforts in the maternal health and family planning fields to define respectful, person-centered care provide a useful foundation from which to connect across the continuum of RMNCAH services. Now is the time to creatively work together to develop new approaches for promoting respectful treatment of individuals in all RMNCAH services.

The integrated project: a promising promotional strategy for primary health care.

PubMed

Daniel, C; Mora, B

1985-10-01

The integrated project using parasite control and nutrition as entry points for family planning practice has shown considerable success in promoting health consciousness among health workers and project beneficiaries. This progress is evident in the Family Planning, Parasite Control and Nutrition (FAPPCAN) areas. The project has also mobilized technical and financial support from the local government as well as from private and civic organizations. The need for integration is underscored by the following considerations: parasite control has proved to be effective for preventive health care; the integrated project uses indigenous community health workers to accomplish its objectives; the primary health care (PHC) movement depends primarily on voluntary community participation and the integrated project has shown that it can elicit this participation. The major health problems in the Philippines are: a prevalence of communicable and other infectious diseases; poor evironmental sanitation; malnutrition; and a rapid population growth rate. The integrated program utilizes the existing village health workers in identifying problems related to family planning, parasite control and nutrition and integrates these activities into the health delivery system; educates family members on how to detect health and health-related problems; works out linkages with government agencies and the local primary health care committee in defining the scope of health-related problems; mobilizes community members to initiate their own projects; gets the commitment of village officials and committe members. The integrated project operates within the PHC. A health van with a built-in video playback system provides educational and logistical support to the village worker. The primary detection and treatment of health problems are part of the village health workers' responsibilities. Research determines the project's capability to reactivate the village primary health care committees and sustain community commitment. The project initially covered 4 villages. Implementation problems included: inactive village health workers, inadequate supervision and monitoring of PHC, a lack of commitment of committee members, and the lack of financial support.

IPPF Co-operative Information Service (ICIS). May 1978.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This annotated bibliography of documents on family planning is divided into nine sections: (1) family planning and bio-medical science; (2) social sciences related to family planning; (3) international conferences; (4) Africa; (5) Americas: (6) Asia; (7) Europe; (8) the Middle East; and (9) Oceania. Also included is a list of general reference…

Successful Family Planning Programs. Draper World Population Fund Report, No. 4, Summer 1977.

ERIC Educational Resources Information Center

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…

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

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

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

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

PubMed

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

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

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

PubMed

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

2016-12-01

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

Visits to Registered Nurses

PubMed Central

Parker, Emese C.; Kong, Kevin; Watts, Leslie A.; Schwarz, Eleanor B.; Darney, Philip D.; Thiel de Bocanegra, Heike

2017-01-01

Background In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. Aims The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A.B. 2348 (January 1, 2013 to June 30, 2014). Methods A descriptive observational design using administrative databases was used. Family PACT claims were retrieved for RN visits and contraception. Paid claims for contraceptive dispensing and/or administration visits by physicians, nurse practitioners, certified nurse midwives, and physician assistants were compared before and after the implementation of A.B. 2348 at practice sites where RN visits were and were not utilized. Contraceptive methods and administration procedures were identified using Healthcare Common Procedure Coding System codes, National Drug Codes, and Common Procedural Terminology codes. Claims data for healthcare facilities were abstracted by site location based on a unique combination of National Provider Identifier (NPI), NPI Owner, and NPI location number. Results RN visits were found mainly in Northern California and the Central Valley (73%). Sixty-eight percent of RN visits resulted in same-day dispensing and/or administration of hormonal (and/or barrier) methods. Since benefit implementation, RN visits resulted in a 10% increase in access to birth control dispensing and/or administration visits. RN visits were also associated with future birth control acquisition and other healthcare utilization within the subsequent 30 days. Discussion RN visits, though underutilized across the state, have resulted in increased access to contraception in some communities, an effect that may continue to grow with time and can serve as a model for other states. PMID:28604507

Visits to Registered Nurses: An Opportunity to Increase Contraceptive Access in California.

PubMed

Parker, Emese C; Kong, Kevin; Watts, Leslie A; Schwarz, Eleanor B; Darney, Philip D; Thiel de Bocanegra, Heike

In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A.B. 2348 (January 1, 2013 to June 30, 2014). A descriptive observational design using administrative databases was used. Family PACT claims were retrieved for RN visits and contraception. Paid claims for contraceptive dispensing and/or administration visits by physicians, nurse practitioners, certified nurse midwives, and physician assistants were compared before and after the implementation of A.B. 2348 at practice sites where RN visits were and were not utilized. Contraceptive methods and administration procedures were identified using Healthcare Common Procedure Coding System codes, National Drug Codes, and Common Procedural Terminology codes. Claims data for healthcare facilities were abstracted by site location based on a unique combination of National Provider Identifier (NPI), NPI Owner, and NPI location number. RN visits were found mainly in Northern California and the Central Valley (73%). Sixty-eight percent of RN visits resulted in same-day dispensing and/or administration of hormonal (and/or barrier) methods. Since benefit implementation, RN visits resulted in a 10% increase in access to birth control dispensing and/or administration visits. RN visits were also associated with future birth control acquisition and other healthcare utilization within the subsequent 30 days. RN visits, though underutilized across the state, have resulted in increased access to contraception in some communities, an effect that may continue to grow with time and can serve as a model for other states.

Readiness to participate in advance care planning: A qualitative study of renal failure patients, families and healthcare providers.

PubMed

Hutchison, Lauren A; Raffin-Bouchal, Donna S; Syme, Charlotte A; Biondo, Patricia D; Simon, Jessica E

2017-09-01

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.

Work-Family Planning Attitudes among Emerging Adults

ERIC Educational Resources Information Center

Basuil, Dynah A.; Casper, Wendy J.

2012-01-01

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

Core competency model for the family planning public health nurse.

PubMed

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

2014-01-01

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

United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey.

PubMed

Seidman, Dominika; Carlson, Kimberly; Weber, Shannon; Witt, Jacki; Kelly, Patricia J

2016-05-01

The Centers for Disease Control and Prevention defines HIV prevention as a core family planning service. The HIV community identified family planning visits as key encounters for women to access preexposure prophylaxis (PrEP) for HIV prevention. No studies explore US family planning providers' knowledge of and attitudes towards PrEP. We conducted a national survey of clinicians to understand barriers and facilitators to PrEP implementation in family planning. Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed. Among 604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers (physicians, nurse practitioners, midwives or physicians assistants). Among potential prescribers, 38% correctly defined PrEP [95% confidence interval (CI): 32.5-42.8], 37% correctly stated the efficacy of PrEP (95% CI: 32.0-42.4), and 36% chose the correct HIV test after a recent exposure (95% CI: 30.6-40.8). Characteristics of those who answered knowledge questions correctly included age less than 35 years, practicing in the Northeast or West, routinely offering HIV testing, providing rectal sexually transmitted infection screening or having seen any PrEP guidelines. Even among providers in the Northeast and West, the proportion of respondents answering questions correctly was less than 50%. Thirty-six percent of respondents had seen any PrEP guidelines. Providers identified lack of training as the main barrier to PrEP implementation; 87% wanted PrEP education. To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing. US family planning providers have limited knowledge about HIV PrEP and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure that family planning clients access comprehensive HIV prevention methods. Copyright © 2016 Elsevier Inc. All rights reserved.

42 CFR 456.201 - UR plan required for inpatient mental hospital services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for...

DO FAMILY PLANNING PROGRAMS DECREASE POVERTY? EVIDENCE FROM PUBLIC CENSUS DATA

PubMed Central

Bailey, Martha J.; Malkova, Olga; Norling, Johannes

2014-01-01

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

Men in Bangladesh play a role in family planning.

PubMed

Ahsan, S B

1992-08-01

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

Population growth is a variable open to change

NASA Astrophysics Data System (ADS)

Potts, M.

2016-12-01

The absolute number of people and the rate of population growth have an impact on climate mitigation, adaptation and possible conflict. Half the pregnancies in the US are unintended. Robust quantitative evidence from California demonstrates that improving access to family planning is the single most cost-effective way of mitigating our carbon footprint. Globally, there are 80 million unintended pregnancies annually. Many non-evidence barriers deprive women of the information and means required to separate sex from childbearing. Between 1960 and 1990, meeting the need for family planning led to a rapid fall in family size in much of Asia. Since 1990, funding for family planning has collapsed and fertility decline has stalled. The UN projects that by 2100 global population will increase by 3.8 billion (equal to world population in 1975). 80% of this growth will be in Africa. Studies project that climate change will undermine crop yields in parts of Africa, especially the Sahel. A high ratio of young males to the rest of the population is a risk factor in conflict. Today, only 1% of overseas assistance is allocated to family planning. Based on analysis of the past, doubling that investment would accelerate fertility decline, facilitating climate mitigation and adaptation, and possibly reducing conflict. Population and family planning were pushed off the international agenda by unacceptably and tragic episodes of coercion in China and India. However, there is compelling data that when voluntary family planning is widely available then family size can fall rapidly, as occurred in the Islamic Republic of Iran, where fertility fell more rapidly than in any other country in history. Family planning is listening to what women want not telling people want to do. Population growth is a variable open to change in a human rights framework. Population and family planning are variables relevant to the scientific agenda of the AGU.

Assessing attachment in school-aged children: Do the School-Age Assessment of Attachment and Family Drawings work together as complementary tools?

PubMed

Carr-Hopkins, Rebecca; De Burca, Calem; Aldridge, Felicity A

2017-07-01

Our goal was to identify an assessment package that could improve treatment planning for troubled children and their families. To assess the validity of our tools, we tested the relations among the School-Age Assessment of Attachment, the Family Drawing and children's risk status. We used the Dynamic-Maturational Model of Attachment and Adaptation to interpret the assessments in the hope of identifying a gradient of risk, and explore whether a new coding method improved the validity of Family Drawings and their utility as a tool to complement the School-Age Assessment of Attachment. The participants were 89 children, aged between 5 and 12 years; 32 children were involved with mental health services or child protection. Each child completed a School-Age Assessment of Attachment and a Family Drawing. Both assessments differentiated between clinical and normative referrals with moderate effect sizes when dichotomizing risk versus non-risk attachment. When the analysis incorporated a gradient of six attachment classifications, the effect sizes decreased, but specificity of risk increased. The School-Age Assessment of Attachment had greater validity for discriminating risk, and type of risk, than the Family Drawings. With a School-Age Assessment of Attachment and family history, the Family Drawing can provide information about distress that some children do not provide verbally. Integration of the two assessment tools alongside information about parental and family functioning appears to be the key to formulating children's problems.

The impact of system of care support in adherence to wraparound principles in Child and Family Teams in child welfare in North Carolina.

PubMed

Snyder, Elizabeth H; Lawrence, C Nicole; Dodge, Kenneth A

2012-04-01

North Carolina is one of a growing number of states to implement family meeting models in child welfare as a way to engage families, while simultaneously addressing complex familial needs and child safety issues. However, much is still unknown regarding how family meetings actually operate in child welfare, underscoring a clear need for further evaluation of this process. Utilizing direct observational data of Child and Family Team (CFT) meetings, collected as part of two separate evaluations of the North Carolina Division of Social Service's Multiple Response System (MRS) and System of Care (SOC) initiatives, the purpose of the current study was to examine whether the support provided by SOC improved fidelity to the CFT model in child welfare. The observations were conducted using the Team Observation Measure consisting of 78 indicators that measure adherence to ten domains associated with high quality family team meetings (e.g., collaborative, individualized, natural supports, outcomes based, strengths-based). Findings indicate that receiving SOC support in child welfare leads to a more collaborative and individualized decision-making process with families. Meeting facilitators in SOC counties were better prepared for CFTs, and had greater ability to lead a more robust and creative brainstorming process to develop a family-driven case plan. The current study also provides a much needed description of the CFT meeting process within child welfare using a direct observational measure.

Comics: a medium for today's development messages.

PubMed

Opilas, E A

1978-03-01

Filipino illustrated magazines, or the comics, may yet prove to be the most effective media, if not the most effective, for spreading the country's development messages. Long criticized by intellectuals and the social elite, the comics have been grossly underrated in their potential to inform, persuade, and even influence the life-style of the people. The government's Commission on Population (Popcom) has developed an information-education-communication program using the comics, among other media, to disseminate stories on family planning, responsible parenthood, and related topics. Its best quality is popular appeal, and for publishers and distribution outlets, the comics provide good business. A review of these materials shows that their themes reflect the following topics or issues: 1) population trends and consequences; 2) socioeconomic benefits of family planning; 3) customs which influence family planning; 4) family planning concepts; 5) family planning methods; 6) human sexuality and reproduction; 7) the husband-wife relationship; 8) guides for family planning motivation or communication; and 9) guides for teaching family planning. The materials were developed with 4 qualities in mind so as to attract audience or reader interest: simplicity, familiarity, realism, and attractiveness of materials. The consensus is that in the comics, population and development agencies may have found a "secret weapon" in getting these messages across, and that this new-found use for the illustrated magazines may be giving them a new respectability without in any way diminishing their popular appeal.

Do family-planning workers in China support provision of sexual and reproductive health services to unmarried young people?

PubMed

Tu, Xiaowen; Cui, Nian; Lou, Chaohua; Gao, Ersheng

2004-04-01

To ascertain the perspectives of family-planning service providers in eight sites in China on the provision of sexual and reproductive health services to unmarried young people. Data were drawn from a survey of 1927 family-planning workers and 16 focus group discussions conducted in eight sites in China in 1998-99. Family-planning workers recognized the need to protect the sexual health of unmarried young people and were unambiguous about the need for government agencies to provide information and education on sexual and reproductive health to unmarried young people; however, perceptions about the appropriate age for and content of such education remained conservative. While about 70% of family-planning workers were willing to provide contraceptives to unmarried young people, and about 60% approved government provision of contraceptive services to unmarried young people, only one quarter agreed that the services could be extended to senior high schools. Family-planning workers in China are ambivalent about the provision of sexual and reproductive health services to unmarried young people, which potentially poses a significant obstacle to the adoption of safe sex behaviours by young people, as well as to the provision of sexual and reproductive health information and services to young unmarried people in China. Training programmes for family-planning workers are urgently needed to address this issue.

Women know FP better.

PubMed

1989-03-01

A widely-publicized, well-received educational quiz show in Jakarta, Indonesia, proved most effective in familiarizing people with family planning and good contraceptive methods. The show's success demonstrated the ability of non-governmental organizations (NGO) to organize and carry out projects with the technical and administrative assistance of the National Family Planning Coordinating Board (NFPCB). This was the main component of the Self-reliant Family Planning Festival broadly aimed at encouraging people to accept and practice family planning, especially condoms, at their own expense, while emphasizing the role of men in assuming responsibility for family planning. Information and motivational messages on family planning were conveyed through the festival's exhibitions, consultations, bazaar, and song and dance routines. 30 men and 35 women were randomly selected from an audience of 1,850 to participate in the quiz show component. Participants responded to questions on family planning, many of which addressed condoms, with 14 women and 4 men finally winning home electric goods for their correct answers. Women respondents were more knowledgeable of the issues than men. Regardless of whether they provided correct responses, men were, however, more confident in their choices than women. The festival's success has attracted the interest and expected funding of commercial companies for future festivals. Governmental and non-governmental parties have also expressed their interest in contracting with the NFPCB for the sale of condoms in foreign markets.

Objective necessity of socialist family planning: a trial discussion.

PubMed

Li, R

1985-07-01

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

Family welfare.

PubMed

Sinha, N K

1992-01-01

Between 1901-1921, India gained 12.9 million people because mortality remained high. The death rate fell between 1921-1951, but birth rates remained the same. Therefore 110 million people were added--2 times the population increase between 1891-1921. Between 1951-1981, the population increased to 324 million. Socioeconomic development was responsible for most of the downward trend in the birth rate during the 20th century. Even though large families were the norm in early India, religious leaders encouraged small family size. The 1st government family planning clinics in the world opened in Mysore and Bangalore in 1930. Right before Independence, the Bhore Committee made recommendations to reduce population growth such as increasing the age of marriage for girls. Since 1951 there has been a change in measures and policies geared towards population growth with each of the 7 5-Year Plans because policy makers applied what they learned from each previous plan. The 1st 5-Year Plan emphasized the need to understand what factors contribute to population growth. It also integrated family planning services into health services of hospitals and health centers. The government was over zealous in its implementation of the sterilization program (2nd 5-Year Plan, 1956-1961), however, which hurt family planning programs for many years. As of early 1992, sterilization, especially tubectomy, remained the most popular family planning method, however. The 7th 5-Year Plan changed its target of reaching a Net Reproductive Rate of 1 by 2001 to 2006-2011. It set a goal of 100% immunization coverage by 1990 but it did not occur. In 1986, the Ministry of Health and Family Welfare planned to make free contraceptives available in urban and rural areas and to involve voluntary organizations. The government needs to instill measures to increase women's status, women's literacy, and age of marriage as well as to eliminate poverty, ensure old age security, and ensure child survival and development.

Providing quality family planning and MCH services in the urban areas: the YKB experience.

PubMed

1986-06-01

In Indonesia, the provision of family planning services to the community for a fee through a privately operated clinic is a relatively new concept. The idea to charge patients for family planning services came up during several meetings sponsored by the National Family Planning Coordinating Board (NFPCB) in its effort to increase family planning acceptance in urban areas. NFPCB realized that while the village family planning program was very effective, the urban family planning program was lagging behind for several reasons: while its services were free, most government-run clinics were open only in the morning, making it inconvenient for working mothers to avail themselves of the services; government operated clinics were crowded; since the services were free, they were perceived to be not of good quality; and there was a limited range of contraceptives and drugs available in the government operated clinics. In 1980, the Yayasan Kusuma Buana (YKB), a private nonprofit health and family planning organization in Jakarta, was asked by the Badan Koordenasi Keluarga Berencana Nasional (BKKBN) to set up a semi-commercial, urban family planning clinic as a pilot project. The clinic was established in an area where most of the residents belonged to the lower middle income group. After almost 3 years, the clinic became self-reliant and was used by the YKB as a basis for expanding the project. Currently, there are 9 such clinics in Jakarta and YKB is helping 10 other Indonesian cities to set up their own clinics. This paper considers the main components of YKB's strategy for planning and managing the clinic and and provides an analysis of the YKB experience in operating a successful family planning and maternal and child health program in the urban areas. To become self-reliant and at the same time have a successful family planning and health program, clinics should have the following characteristics: integrated services; competent and attractive clinic personnel; a strategic location; longer clinic hours; and a reasonable fee structure. A variety of outreach activities have been found to be useful in generating communiting interest in the YKB clinics, including inviting mothers groups to hold their meetings on the clinic premises. Information/education/communication materials in the form of posters, leaflets, booklets, flipcharts, and magnetic boards are needed to support community outreach and promotional activities. Those who plan to undertake the creation of a private clinic should keep in mind the following points if success is to be realized: community outreach is critical; clinic services should be adapted to community needs; adequate staff training and support should be provided; services should be expanded; and ties with government organizations, medical organizations, and community groups should be established and maintained.

42 CFR 456.200 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan... requirements for a written utilization review (UR) plan for each mental hospital providing Medicaid services...

Reproductive goals and family planning attitudes in Pakistan: a couple-level analysis.

PubMed

Mahmood, N

1998-01-01

This paper examined reproductive goals and family planning attitudes at the couple level in Pakistan. Data were based on the responses of the 1260 matched couples in the 1990-91 Pakistan Demographic and Health Survey. The questions integrated in the interview were on desired fertility, family size ideas, son preference, and family planning attitude. Findings of the analysis showed that about 60% of the couples have given similar responses (agreeing either positively or negatively) to several fertility-related questions, whereas the remaining 40% differ in their attitudes. This divergence may partly be of the environmental factors such as spouse rural background, lack of education, and minimal communication between spouses. This implies that a couple's joint approval, discussion of family planning, and husband's desire for no more children have the strongest effect on promoting contraceptive use. Thus, it is concluded that the role of couple agreement is important in promoting the use of family planning, and men should be made equal targets of such programs in Pakistan.

Can mass media advetising increase contraceptive use?

PubMed

Udry, J R; Clark, L T; Chase, C L; Levy, M

1972-07-01

A $330,000 multimedia advertising campaign was undertaken in 4 U.S. cities (Columbus, Ohio; Memphis, Tennessee; Altoona, Pennsylvania; Jackson, Mississippi) November 1970-May 1971 by the Family Planning Evaluation project (University of North Carolina) to evaluate the cost and effectiveness of commercial advertising in increasing contraceptive utilization among active fertile individuals. The ads ran on radio, television, in special editions of Life and Look, and in local daily, ethnic, and community newspapers. The level of complaints was below what had been anticipated, and there was no unacceptable community opposition even in the saturation cases. The level of awareness was higher during the campaign for television and radio advertising but not for newspaper and magazine advertising (interviews). The number of "new" patients to family planning clinics was low (ranging from 24 to 444) and it appears that mass media advertising is not an effective recruitment technique. No differences were found in new prescription sales of oral contraceptives or sales of condoms between the media sites and their controls during the 6-month campaign. Mass media campaigns might be more effective in non-US settings where contraceptive knowledge is not great and usage is not widespread.

People Without Choice. Report of the 21st Anniversary Conference of the International Planned Parenthood Federation.

ERIC Educational Resources Information Center

Abel-Smith, Brian

Based on the premise that all people have a right to free choice in matters of family planning, the International Planned Parenthood Federation (IPPF) Conference proceedings included discussions on worldwide contraceptive practices, planned parenthood and socio-economic development, legal influences, and cultural barriers to family planning. Over…

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

PubMed

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

2015-01-01

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

Family therapy with deaf persons: the systemic utilization of an interpreter.

PubMed

Harvey, M A

1984-06-01

This paper discusses the theory and practice of providing family therapy to families in which there are hearing parents and at least one Deaf child, particularly regarding the optimal utilization of an interpreter. The therapist must be knowledgeable about the psychosocial effects of deafness, the cultural aspects of deafness, and preferably be able to use American Sign Language and Signed English. The therapeutic benefit of utilizing an interpreter extends far beyond simply facilitating communication between each family member whose primary-language is either spoken English or Sign Language. The presence of an interpreter helps the therapist to modify family rules that deny the implications of deafness and prohibit the use of Sign Language, to modify the balance of power in the family, and to encourage participants to exhibit the ego defense mechanisms of projection and transference. The family therapist can utilize those subtle yet profound influences to therapeutic advantage.

Law Panel in action.

PubMed

Odulana, J

In September 1976 the Africa Regional Council (ARC) of IPPF created a Law Panel to 1) advise the ARC on the emphasis of laws and parenthood programs in the region, 2) investigate legal obstacles to family planning and ways of removing them, 3) institute a monitoring service on laws and court decisions affecting planned parenthood, and 4) prepare a list of lawyers and legal reformers by country. The panel has 1) recommended adoption of an IPPF Central Medical Committee and Central Law Panel statement on sterilization, adolescent fertility control, and the use of medical and auxiliary personnel in family planning services with guidelines for Africa; 2) appointed National Legal Correspondents to carry on the monitoring service mentioned above in 18 countries; and 3) discussed solutions to problems in delivering family planning services with family planning associations in Tanzania, Zambia, Mauritius, Madagascar, and Kenya. Laws governing family planning education and services, marriage, divorce, and maternity benefits in these countries are summarized. In 1978 the panel will hold 2 workshops on law and the status of women.

Family Planning in Five Continents: Africa, America, Asia, Europe, Oceania. December 1976 Update.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This document gives highlights of the family planning situation in many countries of the world. Its purpose is to provide a quick reference source for those who work in family planning. Population statistics are included for five continents and many countries. Data for the continents include population in 1976, projected population in 2000,…

Population and Family Planning Education, Report of a Seminar (Holte, Denmark, July 3-28, 1972).

ERIC Educational Resources Information Center

1972

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…

Family Planning: Its Impact on the Health of Women and Children.

ERIC Educational Resources Information Center

Maine, Deborah

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,…

42 CFR 59.5 - What requirements must be met by a family planning project?

Code of Federal Regulations, 2010 CFR

2010-10-01

...). If an organization offers only a single method of family planning, it may participate as part of a... status. (5) Not provide abortion as a method of family planning. A project must: (i) Offer pregnant women...) about which the pregnant woman indicates she does not wish to receive such information and counseling...

45 CFR 1357.15 - Comprehensive child and family services plan requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... descriptive addendum addressing specifically the family preservation and family support services available. (3... must describe any evaluation and research activities underway or planned with which the State agency is...

45 CFR 1357.15 - Comprehensive child and family services plan requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... descriptive addendum addressing specifically the family preservation and family support services available. (3... must describe any evaluation and research activities underway or planned with which the State agency is...

45 CFR 1357.15 - Comprehensive child and family services plan requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... descriptive addendum addressing specifically the family preservation and family support services available. (3... must describe any evaluation and research activities underway or planned with which the State agency is...

45 CFR 1357.15 - Comprehensive child and family services plan requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... descriptive addendum addressing specifically the family preservation and family support services available. (3... must describe any evaluation and research activities underway or planned with which the State agency is...

45 CFR 1357.15 - Comprehensive child and family services plan requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... descriptive addendum addressing specifically the family preservation and family support services available. (3... must describe any evaluation and research activities underway or planned with which the State agency is...

Implenting family planning in a Ministry of Health: organizational barriers at the state and district levels.

PubMed

Simmons, R S; Ashraf, A

1978-01-01

1. Family planning occupied a subordinate position in the medical and health bureaucracy almost two decades after its introduction. Senior Ministry officials accorded low priority to formal program objectives, while the State Family Planning Officer, the highest state official concerned solely with the family planning program, suffered from a relatively subordinate position in the Directorate and a lack of authority and support. Within the medical profession, family planning was held in low esteem, and the medical and health bureaucracies did not have a mechanism for selecting personnel on the basis of interest and commitment. 2. Organizational adjustment to family planning in the Ministry of Health was a slow and painful process, absorbing the energy and attention of Ministry officials for almost a decade. The repeated reorganizations of the district setup revolving around the division of labor between medical, health, and family planning acitvities and between the rural and urban program, led to months of almost total inertia and detracted substantially from the supervisory capacity of the officials involved. 3. Decision making and guidance suffered from the quick turnover of the Secretary, the most powerful administrator in the Ministry. In Uttar Pradesh Secretaries stayed barely long enough to begin to understand the complex organizational setup of the program. 4. Multiple and often conflicting lines of authority characterized the relationships between the higher and lower echelons within the Ministry. This was accentuated when the District Family Planning Officer was placed under the administrative control of the District Magistrate. While intended to "energize" family planning through the association of the most prestigious and powerful district official with the program, this organizational arrangement resulted in conflicting instructions to the staffs of the primary health centers. 5. The organizational behavior of the Ministry of Health was shaped by the interplay of the various "professional cultures" of its key actors. The generalist administrators' short time horizon and eagerness to produce quantitative results clashed with the specialists' emphasis upon long-term goals and technical constraints; the politician's defense of the interest of his constituents clashed with the administrator's desire to defend his autonomy. The calculus of political survival made support for family planning goals a costly burden that few politicians have been willing to shoulder. As the party system does not reward the advocacy of family planning, ministers emphasize those programs within their ministry or those decisions within their discretion that correspond to the demands of their constituents.

Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya

PubMed Central

Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

2016-01-01

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 drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Conclusions: Drug shops and pharmacies offer an important and under-leveraged mechanism for expanding family planning access to women in urban Nigeria and Kenya, and potentially elsewhere. Vulnerable and harder-to-reach groups such as younger, unmarried women and women who do not yet have children are the most likely to benefit from increased access to family planning at drug shops and pharmacies. PMID:28031299

Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya.

PubMed

Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

2016-12-23

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. 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. 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 drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Drug shops and pharmacies offer an important and under-leveraged mechanism for expanding family planning access to women in urban Nigeria and Kenya, and potentially elsewhere. Vulnerable and harder-to-reach groups such as younger, unmarried women and women who do not yet have children are the most likely to benefit from increased access to family planning at drug shops and pharmacies. © Corroon et al.

How to develop a tele-ICU model?

PubMed

Rogove, Herb

2012-01-01

The concept of the tele-ICU (intensive care unit) is about 30 years old and more hospitals are utilizing it to cover multiple hospitals in their system or for hospitals that lack on-site critical care coverage such as in the rural setting. Doing a needs analysis, picking the appropriate committee to oversee development of the correct model, choosing quality metrics to measure, and designing an implementation plan that has a timeline is how the process should begin. Research including visitation to established programs and connecting with professional societies are helpful. Developing both a business and financial plan will optimize the value of a tele-ICU program. The innovative ICU nursing director will help to integrate a telemedicine program seamlessly with the on-site program to insure a successful program that benefits patients, their families, the ICU staff, and the hospital.

Impact of Affordable Care Act coverage expansion on women's reproductive preventive services in the United States.

PubMed

Arora, Prachi; Desai, Karishma

2016-08-01

The Affordable Care Act (ACA) expansion mandated the private health plans to cover women's preventive services starting August 2012. With limited and contradictory evidence, this study intends to assess the impact of ACA on the utilization rates and the cost burden of women's reproductive preventive service. A pre-post analysis was conducted using a nationally representative sample of females (aged 15-44years, n=4397) participating in the 2011-2013 National Survey of Family Growth. The utilization rates and cost burdens were compared for six services using bivariate and multivariable logistic regression models. After the ACA expansion, there wasn't a significant increase in the utilization rates of birth control/prescription (33.7% vs. 30.7%), birth control counseling (17.7% vs. 16.9%), sterilization counseling (3.3% vs. 3.5%), STI counsel/test/treat (15% vs. 14.6%) and HIV screening (24.1% vs. 23.1%). Respondents paying through insurance increased after ACA, but out-of-pocket spending (cost-sharing) didn't decrease for respondents. Type of insurance was an important predictor of utilization rates with publicly insured having significantly higher Odds Ratio (OR) or likelihood of receiving birth control counseling (OR:1.71), sterilization counseling (OR:2.67), STI counsel/test/treat (OR:1.54) and HIV screening (OR:1.69) compared to privately insured. The early-on impact of ACA expansion on utilization rates of women's reproductive preventive services didn't appear to be significant. Private health plans, however, might have expanded their coverage but burden of cost sharing still existed. Future research should evaluate the long term impact of ACA expansion on women's health and the economic gains. Copyright © 2016 Elsevier Inc. All rights reserved.

Library Bulletin [International Planned Parenthood Federation, May 1976].

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This loose-leaf collection includes a brief discussion of usage procedures for International Planned Parenthood Federation (IPPF) libraries. A set of annotated bibliographies follows, including descriptions of documents on the following topics: family planning and biomedical science, social sciences related to family planning, education and…

Women's attitudes towards mechanisms of action of family planning methods: survey in primary health centres in Pamplona, Spain.

PubMed

de Irala, Jokin; Lopez del Burgo, Cristina; Lopez de Fez, Carmen M; Arredondo, Jorge; Mikolajczyk, Rafael T; Stanford, Joseph B

2007-06-27

Informed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes. Cross-sectional survey in a sample of 755 potentially fertile women, aged 18-49, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, self-administered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects. The response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects. Information about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.

Agency leads in family planning assistance.

PubMed

1989-01-01

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

The feminist position on family planning in Spain.

PubMed

Navarro, M V

1984-04-01

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

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

PubMed

Varley, Emma

2012-01-01

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

Uphold "three stresses" to improve family planning implementation.

PubMed

1994-02-01

Shandong Peninsula, China, includes 24 towns, 4 townships, and 1006 villages with a total 1992 population of 754,000. Due to the family planning program (instituted in the mid 1950s), and its emphasis on the "three stresses" since 1983, the rate of natural increase was maintained for the past decade at 6.59/1000. Marriage and childbirth has been deferred and the annual rate of planned births is 99%. Neonatal mortality is below 10/1000 and life expectancy is 76 years. There have been 260,000 births averted. In 1966, national commendation was given for the achievements in family planning. The city now ranks 12th among the top 100 counties that are the most economically developed. Success was linked with an effective IEC programs. Changing public opinion was accomplished by placing family planning slogans and cards in windows of public places and commercial centers. Contests were held, and performances publicized family planning. There are 1162 population schools in the county which have trained 10,000 family planning publicity workers and about 400,000 others since 1987. Radio and television stations have broadcast regular programs on family planning and population twice a week since 1987. Everyone has radio sets and 90% have televisions. IEC promotion has also been concerned with social security and alleviating poverty. Contraceptive prevalence among reproductive age women is now 91%. After 25 years of family planning operation, the "three stresses" were introduced and popularized in 1983. The goal was no early marriages, no early births, no induced abortions, and no unwanted births. The program strengthened family planning agencies, promoted women's services, oversaw birth quotas, and distributed contraceptives at the grassroots level. By 1991, the city began promoting control of population growth and improvement in human resources. The "four priorities" were formulated by the city for acceptors; housing sites, business licenses, recruitment of only-child parents for work, and nursery and kindergarten admissions for only children and employment of only children. Retirees with-only child certificates will receive an additional 5% pension.

Advance care planning in a multi-cultural family-centric community: A qualitative study of healthcare professionals', patients' and caregivers' perspectives.

PubMed

Menon, Sumytra; Kars, Marijke; Malhotra, Chetna; Campbell, Alastair V; van Delden, J J M

2018-05-15

Advance care planning has been shown to improve end-of-life care but it was developed in the USA and most research has been conducted in western communities. We aimed to study the attitudes and perceptions of patients with life-limiting illnesses, informal caregivers, doctors, nurses and medical social workers regarding advance care planning in a multi-cultural family-centric community. We conducted an explorative qualitative study, using focus groups and individual in-depth interviews. We used purposive sampling techniques to recruit 61 adults (15 doctors, 13 nurses, 5 medical social workers, 15 patients and 13 caregivers) from multiple healthcare settings across the country. The participants are genuinely anxious about the implementation of advance care planning. They had positive and negative expectations of advance care planning. Many were confused about the legal framework for healthcare decision-making and expected advance care planning to be of limited value because family members, rather than the patient, were usually the key decision-makers. A nuanced approach to advance care planning which considers the family network is required in multi-cultural family centric communities. Policies should be reconciled to create a more consistent message that respects patients, the family, and is legally coherent. Further research could focus on adaptations of advance care planning to promote its acceptance in such communities. Copyright © 2018. Published by Elsevier Inc.

Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors.

PubMed

Ngugi, Anthony K; Agoi, Felix; Mahoney, Megan R; Lakhani, Amyn; Mang'ong'o, David; Nderitu, Esther; Armstrong, Robert; Macfarlane, Sarah

2017-01-01

Knowledge of utilization of health services and associated factors is important in planning and delivery of interventions to improve health services coverage. We determined the prevalence and factors associated with health services utilization in a rural area of Kenya. Our findings inform the local health management in development of appropriately targeted interventions. We used a cluster sample survey design and interviewed household key informants on history of illness for household members and health services utilization in the preceding month. We estimated prevalence and performed random effects logistic regression to determine the influence of individual and household level factors on decisions to utilize health services. 1230/6,440 (19.1%, 95% CI: 18.3%-20.2%) household members reported an illness. Of these, 76.7% (95% CI: 74.2%-79.0%) sought healthcare in a health facility. The majority (94%) of the respondents visited dispensary-level facilities and only 60.1% attended facilities within the study sub-counties. Of those that did not seek health services, 43% self-medicated by buying non-prescription drugs, 20% thought health services were too costly, and 10% indicated that the sickness was not serious enough to necessitate visiting a health facility. In the multivariate analyses, relationship to head of household was associated with utilization of health services. Relatives other than the nuclear family of the head of household were five times less likely to seek medical help (Odds Ratio 0.21 (95% CI: 0.05-0.87)). Dispensary level health facilities are the most commonly used by members of this community, and relations at the level of the household influence utilization of health services during an illness. These data enrich the perspective of the local health management to better plan the allocation of healthcare resources according to need and demand. The findings will also contribute in the development of community-level health coverage interventions that target the disadvantaged household groups.

Family Planning and Deforestation: Evidence from the Ecuadorian Amazon.

PubMed

Sellers, Samuel

2017-06-01

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

Family Planning and Deforestation: Evidence from the Ecuadorian Amazon

PubMed Central

Sellers, Samuel

2017-01-01

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

Return to sexual activity and modern family planning use in the extended postpartum period: an analysis of findings from seventeen countries.

PubMed

Borda, Maria R; Winfrey, William; McKaig, Catharine

2010-12-01

Unintended pregnancies can lead to poor maternal and child health outcomes. Family planning use during the first year postpartum has the potential to significantly reduce at least some of these unintended pregnancies. This paper examines the relationship of menses return, breastfeeding status, and postpartum duration on return to sexual activity and use of modern family planning among postpartum women. This paper presents results from a secondary data analysis of Demographic and Health Surveys from 17 countries. For postpartum women, the return of menses, breastfeeding status, and postpartum duration are significantly associated with return to sexual activity in at least 10 out of the 17 countries but not consistently associated with family planning use. Only menses return had a significant association with use of modern family planning in the majority of countries. These findings point to the importance of education about pregnancy risk prior to menses return.

Effects of an entertainment-education radio soap opera on family planning behavior in Tanzania.

PubMed

Rogers, E M; Vaughan, P W; Swalehe, R M; Rao, N; Svenkerud, P; Sood, S

1999-09-01

An entertainment-education radio soap opera introduced in Tanzania in 1993 was evaluated by means of a field experimental design in which the radio program was broadcast by seven mainland stations of Radio Tanzania. An eighth station broadcast alternative programming from 1993 to 1995, its listenership serving as a comparison area in which contemporaneous changes in family planning adoption were measured. The soap opera was subsequently broadcast nationwide from 1995 to 1997. Data about the effects of the radio soap opera were gathered in five annual surveys of about 2,750 households in the comparison and the treatment areas and from a sample of new family planning adopters in 79 health clinics. The soap opera had strong behavioral effects on family planning adoption; it increased listeners' self-efficacy regarding family planning adoption and influenced listeners to talk with their spouses and peers about contraception.

Open letter to Pope John Paul II.

PubMed

Sai, F

1991-01-01

In an Open Letter to Pope John Paul II, written on World Population Day (July 11) 1991, Dr. Fred Sai, President of International Planned Parenthood Federation (IPPF), called for a dialogue on voluntary family planning as a means of avoiding unwanted pregnancy. A half million women die each year from pregnancy-related causes--a death toll that could be dramatically reduced by universal access to low cost, effective contraception. Family planning further represents the best protection against abortion. The Catholic Church's vehement opposition to abortion and family planning methods other than periodic abstinence is in marked contrast to its support to human rights in other settings. The Church has supported struggles for economic ju stice in and among nations, sided with the poor, and advocated for transitions to democracy. At the same time, the family planning movement--which has as its overall objective the protection of the health and welfare of women, children, and families--is viewed by the Vatican as a vehicle for the enslavement rather than liberation of women. The opening of a sensitive dialogue between the Catholic Church and supporters of voluntary family planning could help couples make sound moral decisions about their families and contribute to saving the lives of millions of women, most of them poor.

Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and status in Cambodia

PubMed Central

2011-01-01

Background Cost of delivering reproductive health services to low income populations will always require total or partial subsidization by government and/or development partners. Broadly termed "demand-side financing" or "output-based aid", these strategies include a range of interventions that channel government or donor subsidies to the user rather than the service provider. Initial pilot assessments of reproductive health voucher programs suggest that they can increase access, reduce inequities, and enhance program efficiency and service quality. However, there is a paucity of evidence describing how these programs function in different settings for various reproductive health services. Methods/Design Population Council, funded by the Bill and Melinda Gates Foundation, intends to generate evidence around the "voucher and accreditation" approaches to improving the reproductive health of low-income women in Cambodia. The study comprises of four populations: facilities, providers, women of reproductive age using facilities, and women and men who have been pregnant and/or used family planning within the previous 12 months. The study will be carried out in a sample of 20 health facilities that are accredited to provide maternal and newborn health and family planning services to women holding vouchers from operational districts in three provinces: Kampong Thom, Kampot and Prey Veng and a matched sample of non-accredited facilities in three other provinces. Health facility assessments will be conducted at baseline and endline to track temporal changes in quality-of-care, client out-of-pocket costs, and utilization. Facility inventories, structured observations, and client exit interviews will be used to collect comparable data across facilities. Health providers will also be interviewed and observed providing care. A population survey of about 3000 respondents will also be conducted in areas where vouchers are distributed and similar non-voucher locations. Discussion A quasi-experimental study will investigate the impact of the voucher approach on improving reproductive health behaviors, reproductive health status and reducing inequities at the population level and assess effects on access, equity and quality of care at the facility level. If the voucher scheme in Cambodia is found effective, it may help other countries adopt this approach for improving utilization and access to reproductive health and family planning services. PMID:21864405

Factors predicting use of mental health and social services by children 6-16 years old: findings from the Ontario Child Health Study.

PubMed

John, L H; Offord, D R; Boyle, M H; Racine, Y A

1995-01-01

Correlates of mental health and social service utilization are examined based on Ontario Child Health Study data. Findings indicate that psychiatric disorder as a predictor of service use may be confounded by school performance and parental use of services, thus calling into question the extent to which program planning should be based on prevalence rates of child psychiatric disorder. Children from low-income families tend to make greater use of available services, suggesting that programs need to be tailored more specifically to their needs.

State Performance-Based Regulation Using Multiyear Rate Plans for U.S. Electric Utilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lowry, Mark Newton; Makos, Matt; Deason, Jeff

Electric utilities today must contain costs at a time when many need to modernize aging systems and all face major changes in technologies, customer preferences and competitive pressures.Most U.S. electric utility facilities are investor-owned, subject to rate and service regulation by state public utility commissions. Regulatory systems under which these utilities operate affect their performance and ability to meet these challenges. In this business environment, multiyear rate plans have some advantages over traditional rate regulation.The report focuses on key design issues and provides case studies of the multiyear rate plan approach, applicable to both vertically integrated and restructured states. Markmore » Newton Lowry and Matt Makos of Pacific Energy Group Research and Jeff Deason of Berkeley Lab authored the report; Lisa Schwartz, Berkeley Lab, was project manager and technical editor.The report is aimed primarily at state utility regulators and stakeholders in the state regulatory process. The multiyear rate approach also provides ideas on how to streamline oversight of public power utilities and rural electric cooperatives for their governing boards.Two key provisions of multiyear rate plans strengthen cost containment incentives and streamline regulation: 1. Reducing frequency of rate cases, typically to every four or five years 2. Using an attrition relief mechanism to escalate rates or revenue between rate cases to address cost pressures such as inflation and growth in number of customers, independently of the utility’s own cost Better utility performance can be achieved under well-designed multiyear rate plans while achieving lower regulatory costs. Benefits can be shared between utilities and their customers. But plans can be complex and involve significant changes in the regulatory system. Designing plans that stimulate utility performance without undue risk and share benefits fairly can be challenging.This report discusses the rationale for multiyear rate plans and their usefulness under modern business conditions. It then explains critical plan design issues and challenges and presents results from numerical research that considers the extra incentive power achieved under different plan provisions. Next, the report presents several case studies of utilities that have operated under formal multiyear rate plans or, for various reasons, have stayed out of rate cases for more than a decade. These studies consider the effect of multiyear rate plans and rate case frequency on utility cost, reliability and other performance dimensions.« less

Observations concerning family planning education in China.

PubMed

Hamburg, M V

1981-11-01

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

45 CFR 286.70 - Who submits a Tribal Family Assistance Plan?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 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 SERVICES...

The Individual Family Support Plan: A Tool to Assist Special Populations of Gifted Learners.

ERIC Educational Resources Information Center

Damiani, Victoria B.

1996-01-01

This article describes Project Mandela, a federally funded enrichment and family support program for special populations (such as culturally diverse and economically disadvantaged) of gifted learners. Eighty-seven families participated in development of Individual Family Support Plans to enhance children's educational progress. The project found…

45 CFR 286.165 - How is a Tribal Family Assistance Plan amended?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false How is a Tribal Family Assistance Plan amended? 286.165 Section 286.165 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN...

An approach to family planning for Indochinese refugee women.

PubMed

Presswell, N J

1982-08-01

Family planning services were introduced in Vietnam by the Americans about 20 years ago, but on a limited basis. Many of the Vietnamese refugee women have had no contact with such services. Abortion was illegal until 1975 in South Vietnam, but since the takeover, abortion clinics have been available as part of the public hospital system. Family planning was available in some of the refugee camps. Most of the Vietnam refugees fled their country by boat. Before their acceptance by Australia, the Vietnamese refugees have health checks by the Australian Commonwealth Health Department in the country of transit. Shortly after their arrival in Australia, health screening is done by the State Health Department. The majority of refugees are accommodated in migrant hostels for the 1st 3-12 months. Family planning is incorporated into Eastbridge Hostel's orientation program. During participation in some family planning discussion groups with the Indochinese refugees, it was observed that the women were particularly shy and hesitant to talk about sexual concerns in a large group or in mixed company. As personal matters are dealt with in the family, it is preferable to have a female as a discussion leader and interpreter. Visual aids such as a display of contraceptive devices, a model showing female anatomy and a family planning film for non-English speaking migrants are particularly useful. As a female doctor using a female interpreter the aim was to provide an accessible service for Indochinese women with family planning inquiries or gynecological problems. It is important that the interpreter is present in the consulting room. Nonverbal cues are most important and particular attention should be paid to establishing eye contact with the patient. Simple miming techniques or the use of diagrams may be helpful in reinforcing the work of the interpreter. When listening to the patient, it is useful to look and listen for nonverbal cues from them. Between February 1980 and May 1981, 60 Indochinese women presented with gynecological problems. Approximately 50% of these women had either not been using an effective method of family planning or had been using the rhythm method. A considerable number of the women who were using a reliable method of contraception began doing so either in the country of transit or in Australia, and probably in the postnatal period. The majority of women requesting family planning chose an oral contraceptive (OC) agent. Indochinese women seem more reluctant that Australian women to select surgically related procedures such as IUD insertion or tubal ligation. The different cultural background of the Indochinese refugees influences both attitudes toward family planning and the communication process in the family planning consultation.

Perceptions of emergency nurses during the human swine influenza outbreak: a qualitative study.

PubMed

Lam, Kam Ki; Hung, Shuk Yu Maria

2013-10-01

The primary aim of this study was to explore the perception of Hong Kong emergency nurses regarding their work during the human swine influenza pandemic outbreak. In this exploratory, qualitative study, 10 emergency nurses from a regional hospital in Hong Kong were recruited using purposive sampling. Semi-structured, face-to-face individual interviews were conducted. Qualitative content analysis was utilized to analyze the transcripts. The three following categories emerged from the interview data: concerns about health, comments on the administration, and attitudes of professionalism. Nurses viewed the human swine influenza as a threat to their personal and families' health. However, nurses perceived that the severity of the disease was exaggerated by the public. Improvements in planning the circulation of information, allocation of manpower, and utilization of personal protective equipment were indicated. The emergency nurses demonstrated a sense of commitment and professional morale in promoting a high quality of nursing care. Various factors affecting the perceptions of emergency nurses toward their professional duties during the influenza pandemic were identified. By understanding these perceptions, appropriate planning, policies, and guidelines can be formulated to meet the healthcare needs of patients during future pandemic outbreaks. Copyright © 2012 Elsevier Ltd. All rights reserved.

U.S. Women's Intended Sources for Reproductive Health Care

PubMed Central

Hall, Kelli Stidham; Patton, Elizabeth W.; Zochowski, Melissa K.; Davis, Matthew M.; Dalton, Vanessa K.

2016-01-01

Abstract Introduction: The current sociopolitical climate and context of the Affordable Care Act have led some to question the future role of family planning clinics in reproductive health care. We explored where women plan to get their future contraception, pelvic exam/pap smears, and sexually transmitted infection testing, with a focus on the role of family planning clinics. Methods: Data were drawn from a study of United States adults conducted in January 2013 from a national online panel. We focused on English-literate women aged 18–45 years who answered items on intended sources of care (private office/health maintenance organization [HMO], family planning clinic, other, would not get care) for reproductive health services. We used Rao-Scott F tests to compare intended sources across sociodemographic groups, and logistic regression to model odds of intending to use family planning clinics. Probability weights were used to adjust for the complex sampling design. Results: The response rate was 61% (n = 2,182). Of the 723 respondents who met the inclusion criteria, approximately half intended to use private offices/HMOs. Among some subgroups, including less educated (less than high school), lower annual incomes (<$25,000) and uninsured women, the proportion intending to use family planning clinics was higher than the proportion intending to use private office/HMO in unadjusted analyses. Across all service types, unmarried and uninsured status were associated with intention to use family planning clinics in multivariable models. Conclusions: While many women intend to use private offices/HMOs for their reproductive health care, family planning clinics continue to play an important role, particularly for socially disadvantaged women. PMID:26501690

Women's experiences seeking publicly funded family planning services in Texas.

PubMed

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

2015-06-01

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. 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. 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. 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. Copyright © 2015 by the Guttmacher Institute.

Posing a hidden political threat. Pakistan. No attempt has been made at the national level to evolve a religious consensus on the subject of family planning.

PubMed

Khan, L A

1996-01-01

Pakistan was the first developing country to be concerned about the population problem. The first family planning/population related efforts in Pakistan spawned from the nongovernmental sector in the form of the establishment of the Family Planning Association of Pakistan in 1953. The efforts of the association were then later acknowledged in the First Five-Year Public Sector Development Plan which made a lump sum provision of Rs. 5 million for population activities. The First Five-Year Plan (1955-60) recognized that measures should be taken to limit the size of the Pakistani family in order to reduce the incidence of malnutrition and overcrowding. There has never been an organized and consistent religious opposition to family planning in Pakistan. Islamic provisions in the constitution and diverse views of different groups of religious leaders do, however, pose an ongoing hidden political threat to the government which could be exploited through their street power in urban areas. The author notes that the governments in Pakistan will always be reluctant to aggressively promote family planning. Under these circumstances, the government must seek the cooperation of credible nongovernmental organizations which tend to operate through community-based volunteers who generally have more influence in persuading communities to accept a given point of view. Greater involvement of local community groups in a planned and meaningful way will broaden the base of program promoters and supporters across the country and will create a climate conducive to large-scale adoption of the small family norm as a way of life.

Family Planning Needs and Behavior of Mexican American Women: A Study of Health Care Professionals and Their Clientele.

ERIC Educational Resources Information Center

Jorgensen, Stephen R.; Adams, Russell P.

1987-01-01

The accuracy of family planning health care professionals' perceptions of the practices and needs of Mexican-American women was compared with actual needs and practices. Discrepancies were found in reports of problems in obtaining family planning services, fertility-related values, and the acceptability of female sterilization as a birth control…

42 CFR 59.3 - Who is eligible to apply for a family planning services grant?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Who is eligible to apply for a family planning services grant? 59.3 Section 59.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... is eligible to apply for a family planning services grant? Any public or nonprofit private entity in...

42 CFR 59.3 - Who is eligible to apply for a family planning services grant?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Who is eligible to apply for a family planning services grant? 59.3 Section 59.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... is eligible to apply for a family planning services grant? Any public or nonprofit private entity in...

42 CFR 59.3 - Who is eligible to apply for a family planning services grant?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Who is eligible to apply for a family planning services grant? 59.3 Section 59.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... is eligible to apply for a family planning services grant? Any public or nonprofit private entity in...

42 CFR 59.3 - Who is eligible to apply for a family planning services grant?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible to apply for a family planning services grant? 59.3 Section 59.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... is eligible to apply for a family planning services grant? Any public or nonprofit private entity in...

42 CFR 59.3 - Who is eligible to apply for a family planning services grant?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Who is eligible to apply for a family planning services grant? 59.3 Section 59.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... is eligible to apply for a family planning services grant? Any public or nonprofit private entity in...

The crucial role of the private sector.

PubMed

Barberis, M; Paxman, J M

1986-12-01

Private support for the development of family planning programs continues to grow and now includes industries that provide family planning services, commercial outlets that distribute contraceptives, community groups that help to build demand, private medical practitioners who include contraception as a part of health care, organizations that provide technical and financial assistance to developing country programs, pharmaceutical firms, and foundations that underwrite contraceptive research. Although the mix of private and public programs differs from country to country, these 2 family planning programs complement each other and often work in close partnership. The private sector has the advantages of being able to pioneer innovative programs the public sector is unwilling or unable to pursue, to bring foreign financial and technical assistance to developing countries without political implications, and to achieve financially self-sustaining family planning efforts that are linked to other development efforts. In many countries, the private sector has been instrumental in developing a national family planning program and in eliminating barriers to family planning in countries with restrictive laws and policies. The private sector has been especially important in pioneering grassroots programs that improve the status of women through education, health care, training, and economic opportunity.

Family planning management of the floating population in Xi'an city.

PubMed

1996-12-01

This article describes the population of migrants living in Xincheng District of Xi'an City, China. Xincheng district is a commercial center that includes the largest wholesale market in northwest China, Kangfulu Market in Sanfuwan village. The resident population of the district amounts to about 450,000 people. 72,000 additional population are the floating population of migrants, of whom about 50% are women of childbearing age. The district established stringent family planning policies in order to limit unplanned childbearing. Family planning policies were the collaborative work among staff members from departments of industry and commerce, labor, education, finance, public health, civil affairs, family planning, and other related agencies. Management of family planning is based on subdistrict committees, resident committees, and local permanent population. These individuals and groups provide registration for temporary residence, verify birth certificates, establish contraceptive status, and encourage landlords to disseminate birth control information among their tenants. The population around Kangfulu Market includes about 800 permanent residents and about 3000- 6000 migrants. The village authorities provide family planning and medical services free of charge to migrants. Villagers register migrant children in schools and offer business help to the newcomers. These efforts have contributed to fewer births among migrants.

Substantial gains with existing resources: the Tongan experience.

PubMed

Tufui, V

1986-11-01

Tonga has a relatively high rate of population growth that is moderated by emigration. There has been a decline in fertility, however. Family planning was introduced in Tonga during the 1950s. The Tongan Family Planning Association (TFPA) is a non-government organization established and recognized by the Tongan government. The Japanese Organization for International Cooperation in Family Planning (JOICEP) approved of and funded an integrated TFPA-JOICEP project on health education and family planning motivation as well as a national seminar. TFPA projects for 1986 include: youth development; women's development; men's development; and health education, family planning motivational integrated approaches in development and family planning. A station wagon serves as a mobile clinic. A doctor and his staff hold clinics or meet with women in the villages to demonstrate contraceptive use and to discuss reproduction and fertilization. Other organizations which provide FP services are: the Government Health Services and the MCH Department; the Catholic Mission; and the Seventh Day Adventist Mission. Tongan health services are largely a governmental responsibility and are provided free of charge. There are 4 main hospitals and 6 health centers with a total of 325 hospital beds.

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

PubMed

Portes, M

1983-01-01

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

United States of America (country/area statements).

PubMed

1985-09-01

This statement presented to the Committee on Population of the UN Economic and Social Commission for Asia and the Pacific (ESCAP) cites the goal of population assistance contained in the preamble of the Report of the International Conference on Population, which was to improve the population's standard of living and quality of life. ESCAP program activities should embody various points from the International Conference on population at Mexico City, including an emphasis on the mutually reinforcing roles of population and other development programs, well developed family planning programs in which abortion is not presented as a method of family planning, measures to ensure full integration of women into all phases of development, research to develop improved methods of contraception and service delivery, and important roles for nongovernmental organizations and the private sector. The US position on population assistance has 3 main elements: the expansion of voluntary family planning services throughout the developing world, the unacceptability of abortion as a family planning method, and the need for wise economic policies in addition to family planning services. In some countries family planning can alleviate high population growth rates which seriously overburden already inadequate resources, and in others family planning is more important to the health and welfare of individual mothers and children. The US agrees with the opinion of the Mexico City Conference that private sector organizations can make significant contributions in family planning. During the past 2 decades, the US has provided over $US2500 million in population assistance to developing countries through bilateral agreements, multilateral institutions, and private organizations. The US intends to continue its support for population programs which slow population growth, promote economic development, and respect internationally recognized human rights. Coercion in family planning programs cannot be reconciled with the principle that all couples and individuals have the basic right to decide freely and responsably the number and spacing of their children and to have the information and means to do so. Voluntarism is an essential element in population programs because family planning touches the most intimate areas of the lives of couples, because longterm change in fertility behavior is achieved only when the choices reflect the free decisions of couples, because user-preferences and the motivation of providers to improve program acceptability are compromised by coercion, and because voluntarism is a basic human right.

Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement.

PubMed

Mpunga, Dieudonné; Lumbayi, J P; Dikamba, Nelly; Mwembo, Albert; Ali Mapatano, Mala; Wembodinga, Gilbert

2017-06-27

To determine the availability and quality of family planning services within health facilities throughout the Democratic Republic of the Congo (DRC). Data were collected for the cross-sectional study from April 2014 to June 2014 by the Ministry of Public Health. A total of 1,568 health facilities that reported data to the National Health Information System were selected by multistage random sampling in the 11 provinces of the DRC existing at that time. Data were collected through interviews, document review, and direct observation. Two dependent variables were measured: availability of family planning services (consisting of a room for services, staff assigned to family planning, and evidence of client use of family planning) and quality of family planning services (assessed as "high" if the facility had at least 1 trained staff member, family planning service delivery guidelines, at least 3 types of methods, and a sphygmomanometer, or "low" if the facility did not meet any of these 4 criteria). Pearson's chi-square test and odds ratios (ORs) were used to test for significant associations, using the alpha significance level of .05. We successfully surveyed 1,555 facilities (99.2%) of those included in the sample. One in every 3 facilities (33%) offered family planning services as assessed by the index of availability, of which 20% met all 4 criteria for providing high-quality services. Availability was greatest at the highest level of the health system (hospitals) and decreased incrementally with each health system level, with disparities between provinces and urban and rural areas. Facilities in urban areas were more likely than in rural areas to meet the standard for high-quality services ( P <.001). Public facilities were less likely than private facilities to have high-quality services ( P =.02). Among all 1,555 facilities surveyed, 14% had at least 3 types of methods available at the time of the survey; the most widely available methods were male condoms, combined oral contraceptive pills, and progestin-only injectable contraceptives. Availability and quality of family planning services in health facilities in the DRC remain low, with inequitable distribution of services throughout the country. To improve access to and use of family planning, efforts should focus on improving availability and quality at lower health system levels and in rural areas where the majority of the population lives. © Mpunga et al.

Identifying the Factors That Facilitate or Hinder Advance Planning by Persons With Dementia

PubMed Central

Hirschman, Karen B.; Kapo, Jennifer M.; Karlawish, Jason H. T.

2009-01-01

We performed semistructured interviews with 30 family members of patients with advanced dementia to identify the factors that facilitate or hinder advance planning by persons with dementia. All interviews were analyzed using qualitative data analysis techniques. The majority (77%) of family members reported that their relative had some form of written advance directive, and at least half reported previous discussions about health care preferences (57%), living situation or placement issues (50%), and finances or estate planning (60%) with the patient. Family members reported some themes that prompted planning and others that were barriers to planning. Events that most often triggered planning were medical, living situation, or financial issues associated with a friend or family member of the patient (57%). Barriers to planning included both passive and active avoidance. The most common form of passive avoidance was not realizing the importance of planning until it was too late to have the discussion (63%). The most common form of active avoidance was avoiding the discussion (53%). These data suggest potentially remediable strategies to address barriers to advance planning discussions. PMID:18580595

Managed Care Plans: Getting Good Care for Your Child

MedlinePlus

... AAP Find a Pediatrician Family Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting ... Your Community Healthy Children > Family Life > Medical Home > Health Insurance > Managed Care Plans: Getting Good Care for Your ...

Family Planning Policy Environment in the Democratic Republic of the Congo: Levers of Positive Change and Prospects for Sustainability.

PubMed

Mukaba, Thibaut; Binanga, Arsene; Fohl, Sarah; Bertrand, Jane T

2015-06-17

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?

A randomized controlled trial of the impact of a family planning mHealth service on knowledge and use of contraception.

PubMed

Johnson, Douglas; Juras, Randall; Riley, Pamela; Chatterji, Minki; Sloane, Phoebe; Choi, Soon Kyu; Johns, Ben

2017-01-01

mHealth, or the use of mobile phones for health, is a promising but largely untested method for increasing family planning knowledge in developing countries. This study estimates the effect of m4RH, an mHealth service in Kenya that provides family planning information via text message, on consumers' knowledge and use of contraception. We randomly assigned new consumers of the m4RH service to receive either full access or limited access to m4RH. We collected data on outcomes by sending questions directly to consumers via text message. Response rates to the text message surveys ranged from 51.8% to 13.5%. Despite relatively low response rates, response rates were very similar across the full-access and limited-access groups. We find that full access to m4RH increased consumers' scores on a test of contraceptive knowledge by 14% (95% confidence interval: 9.9%-18.2%) compared to a control group with limited access to m4RH. m4RH did not increase consumers' use of contraception, likelihood of discussing family planning with their partners, or likelihood of visiting a clinic to discuss family planning. Text messages may increase family planning knowledge but do not, by themselves, lead to behavior change. Text messages can be an effective method of increasing family planning knowledge but may be insufficient on their own to cause behavior change. Copyright © 2016 Elsevier Inc. All rights reserved.

Should family planning include STD services?

PubMed

Finger, W R

1994-05-01

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

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

PubMed

Zuhlke, W

1989-01-01

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

Demand-Side Management and Integrated Resource Planning: Findings from a Survey of 24 Electric Utilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schweitzer, M.

1991-01-01

Integrated resource planning differs from traditional utility planning practices primarily in its increased attention to demand-side management (DSM) programs and its integration of supply- and demand-side resources into a combined resource portfolio. This report details the findings from an Oak Ridge National Laboratory (ORNL) survey of 24 electric utilities that have well-developed integrated planning processes. These utilities account for roughly one-third of total capacity, electricity generation, and DSM-program expenditures nationwide. The ORNL survey was designed to obtain descriptive data on a national sample of utilities and to test a number of hypothesized relationships between selected utility characteristics and the mixmore » of resources selected for the integrated plan, with an emphasis on the use of DSM resources and the processes by which they are chosen. The survey solicited information on each utility's current and projected resource mix, operating environment, procedures used to screen potential DSM resources, techniques used to obtain public input and to integrate supply- and demand-side options into a unified plan, and procedures used in the final selection of resources for the plan.« less

Assessing the Local Need for Family and Child Care Services: A Small Area Utilization Analysis.

ERIC Educational Resources Information Center

Percy, Andrew; Carr-Hill, Roy; Dixon, Paul; Jamison, James Q.

2000-01-01

Describes study of administrative data from Northern Ireland on the costs of family and child care services, using small area utilization modeling, to derive a new set of needs indicators that could be used within the family and child care capitation funding formula. Argues that small area utilization modeling produces a fairer and more equitable…

The effect of administration family planning policy on maternal and child health.

PubMed

Zabin, L S

1983-09-01

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 is permissible to support family planning but not mandatory as it has been in the past. Several legislative measures regarding abortion before Congress last year were not enacted, measures which might have been a serious threat to the provision of legal abortion. It is legislatively that abortion service is in most danger, with Administration forces committed to making it illegal under almost all conditions. Not all policies of this Administration are subject to control by the Congress. The parental notification regulations promulgated by the Department of Health and Human Services are an example of policy responsive to the concept that government can decide what is good for the American Family.

The impact of freedom on fertility decline.

PubMed

Campbell, Martha M; Prata, Ndola; Potts, Malcolm

2013-01-01

Although fertility decline often correlates with improvements in socioeconomic conditions, many demographers have found flaws in demographic transition theories that depend on changes in distal factors such as increased wealth or education. Human beings worldwide engage in sexual intercourse much more frequently than is needed to conceive the number of children they want, and for women who do not have access to the information and means they need to separate sex from childbearing, the default position is a large family. In many societies, male patriarchal drives to control female reproduction give rise to unnecessary medical rules constraining family planning (including safe abortion) or justifying child marriage. Widespread misinformation about contraception makes women afraid to adopt modern family planning. The barriers to family planning can be so deeply infused that for many women the idea of managing their fertility is not considered an option. Conversely, there is evidence that once family planning is introduced into a society, then it is normal consumer behaviour for individuals to welcome a new technology they had not wanted until it became realistically available. We contend that in societies free from child marriage, wherever women have access to a range of contraceptive methods, along with correct information and backed up by safe abortion, family size will always fall. Education and wealth can make the adoption of family planning easier, but they are not prerequisites for fertility decline. By contrast, access to family planning itself can accelerate economic development and the spread of education.

The impact of freedom on fertility decline

PubMed Central

Campbell, Martha M; Prata, Ndola; Potts, Malcolm

2013-01-01

Although fertility decline often correlates with improvements in socioeconomic conditions, many demographers have found flaws in demographic transition theories that depend on changes in distal factors such as increased wealth or education. Human beings worldwide engage in sexual intercourse much more frequently than is needed to conceive the number of children they want, and for women who do not have access to the information and means they need to separate sex from childbearing, the default position is a large family. In many societies, male patriarchal drives to control female reproduction give rise to unnecessary medical rules constraining family planning (including safe abortion) or justifying child marriage. Widespread misinformation about contraception makes women afraid to adopt modern family planning. The barriers to family planning can be so deeply infused that for many women the idea of managing their fertility is not considered an option. Conversely, there is evidence that once family planning is introduced into a society, then it is normal consumer behaviour for individuals to welcome a new technology they had not wanted until it became realistically available. We contend that in societies free from child marriage, wherever women have access to a range of contraceptive methods, along with correct information and backed up by safe abortion, family size will always fall. Education and wealth can make the adoption of family planning easier, but they are not prerequisites for fertility decline. By contrast, access to family planning itself can accelerate economic development and the spread of education. PMID:23296851

American Families and the Future: Analyses of Possible Destinies.

ERIC Educational Resources Information Center

Settles, Barbara H., Ed.; And Others

Noting the increasing challenges faced by families today, this book explores demographic, social and economic, and technological issues affecting the dynamics of and planning process for family well-being. Chapters in the book are: (1) "Expanding Choice in Long Term Planning for Family Futures" (Barbara H. Settles); (2) "Recent Demographic Change:…

Family Health and Family Planning.

ERIC Educational Resources Information Center

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

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

A new study of China's population control during the past ten years.

PubMed

Wei, J

1989-02-01

This paper summarizes the control of population in China in the past 10 years and the changes that are occurring. Recently, an increase in the number of family members has directly influenced socioeconomic status by increasing family income and improving living conditions. Rural families have no incentives to control the number of children born. The cyclic effect of the 1962-73 baby boom is also causing a recent surge in population. China has studied these problems and has taken the following measures: new family planning systems have been established; population has been controlled macroscopically and flexibility is allowed at an individual level; governmental family planning organizations have been set up and financed; family planning education has been increased; family planning services have been enforced; incentives and restrictions have been implemented. China must work as a whole to enact and enforce these policies. Families must show restraint in childbearing. The only way for this to be accomplished is by decreasing the socioeconomic incentives to have children. Finally, reforms should be in tune with changing situations.

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

PubMed Central

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

2015-01-01

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

Calling a Spade a Spoon: Are Non-American Donors Likely to Need the Same "Reshaping" of Terms for International Family Planning?

PubMed

Norman, Wendy V; Mazza, Danielle

Dyer et al., in their article "International Family Planning: How Political and Religious Conservatives Respond and How to Shape Messaging for Successful Advocacy" (2016), have found that American religious and political conservatives respond favorably to the concepts underlying Family Planning, yet unfavorably to the term itself. We cite Canadian and Australian perspectives to argue that the Dyer finding that the term "Family Planning" is synonymous with abortion (or so nearly so to make it "unfundable" without a term change) is not a consideration in at least two countries, and may not be relevant outside the American context. Irrespective of the language that may be necessary for fundraising among American donors to elicit support for international Family Planning initiatives, there exists a clear need to establish common understanding on reproductive health issues. Now more than ever, we must identify effective terminology and disseminate facts that support women and their families to achieve their reproductive goals, and thus contribute to improved health, education and economic prosperity throughout our global village.

Incentives to promote family planning

PubMed Central

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

2012-01-01

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

Why 529 College Savings Plans Favor the Fortunate. Charts You Can Trust

ERIC Educational Resources Information Center

Aldeman, Chad

2011-01-01

As college costs have continued to rise, states have offered families a way to save for their child's education. Private savings accounts, known as 529 savings plans, allow a family's investment to grow tax-free until a child is ready for college. Today, every state sponsors at least one 529 plan, and families have more than 10 million accounts,…

The Lincoln Parish Family Planning Program and Its Implications for Reducing Reproductive Wastage in the Rural Poor.

ERIC Educational Resources Information Center

Beasley, Joseph D.; And Others

The Lincoln Parish Family Planning Program, a 1968 pilot study designed in cooperation with the Louisiana State Board of Health, is described. The major purpose of the program was to design a program of medical care for the rural poor which would provide mothers in Lincoln Parish with information and services needed to plan family size. Sections…

Development of a Medicare Beneficiary Comprehension Test: Assessing Medicare Part D Beneficiaries' Comprehension of Their Benefits

PubMed Central

Aruru, Meghana V.; Salmon, J. Warren

2013-01-01

Background Medicare Part D, the senior prescription drug benefit plan, was introduced through the Medicare Modernization Act of 2003. Medicare beneficiaries receive information about plan options through multiple sources, and it is often assumed by consumer health plans and healthcare providers that beneficiaries can understand and compare plan information. Medicare beneficiaries are older, may have cognitive problems, and may not have a true understanding of managed care. They are more likely than younger persons to have inadequate health literacy, thereby demonstrating significant gaps in knowledge and information about healthcare. Objective To develop a Medicare Beneficiary Comprehension Test (MBCT) to evaluate Medicare beneficiaries' understanding of Part D plan concepts, as presented in the 2008 Medicare & You handbook. Methods A 10-question MBCT was developed using a case-vignette approach that required beneficiaries to read portions of the Medicare & You handbook and answer Part D–related questions associated with healthcare decision-making. The test was divided into 2 sections: (I) insurance concepts and (II) utilization management/appeals and grievances to cover standard terminology, as well as newer utilization management and appeals and grievances procedures that are unique to Part D. The test was administered to 100 beneficiaries at 2 sites—a university geriatrics clinic and a private retirement facility. Beneficiaries were tested for cognition and health literacy before being administered the test. Results The mean score on the MBCT was 3.5 of a maximum of 5, with no statistical difference found between both sites. Ten faculty members and 4 graduate students assessed the content validity of the instrument using a 4-point Likert rating rubric. The construct validity of the instrument was assessed using a principal components analysis with varimax rotation. The principal components analysis yielded 4 factors that were labeled as “Plan D concepts,” “managed care/utilization management,” “cost-sharing,” and “plan comparisons.” The factor analysis indicated that the test is multidimensional and did measure the construct. Conclusions Medicare beneficiaries' understanding of Part D may play a key role in the management of their drug use and health and the associated outcomes. The MBCT and its pending revisions can be administered to beneficiaries with differing health outcomes. Medicare beneficiaries are often faced with several pieces of information involving a complex array of choices amidst bewildering plan options. It is crucial that beneficiaries and/or their family members involved in the decision-making process understand the plan benefits to truly make an informed decision. As the number of Medicare beneficiaries increases over the coming years with the baby boomers, it becomes even more imperative that the elderly have improved access to treatments that can achieve desirable outcomes. Measuring comprehension by Medicare beneficiaries may be an initial step toward understanding more complex issues, such as treatment adherence, decision-making, and, ultimately, trends in healthcare utilization and outcomes. PMID:24991375

Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components

PubMed Central

Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren

2016-01-01

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 family planning counseling and services before leaving the facility, especially because fertility returns rapidly (within 2 to 3 weeks); postabortion family planning services can be quickly replicated to multiple sites with high acceptance rates. Voluntary family planning uptake by method should always be monitored to document program and provider performance. In addition, vacuum aspiration and misoprostol should replace sharp curettage to treat incomplete abortion for women who meet eligibility criteria. PMID:27571343

[Cost of family planning care in 10-19 years old teenagers].

PubMed

Martínez-Ramírez, E A; Villarreal-Ríos, E; Vargas-Daza, E R; Galicia-Rodríguez, L; Martínez-González, L

2016-09-01

To identify the costs of family planning care in adolescents. Longitudinal study of the cost of care for family planning carried out in 2015 in a group of individuals with age limits of 10 and 19 years in a unit first level of health care in the state of Queretaro, Mexico. The profile of use of family planning (FP) was created for the teen was performed services through counseling, provision of contraception and review of intrauterine device (IUD) in a year; cost projections for the population of adolescents and different coverage scenarios between 5 and 100% were made. The average annual cost was 228.84 Mexican pesos. Ideally the identified cost was 2,708.94 pesos. The projection with 20 % coverage was 207,251,330 pesos. The average annual family planning consultations was 0.9. The most commonly used method was with medroxyprogesterone-estradiol at doses of 25 and 5 mg. The cost of planning in adolescents is low, taking into account the costs that the care of high-risk pregnancies and associated comorbidities.

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

PubMed Central

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

2015-01-01

Background: While Rwanda has achieved impressive gains in contraceptive coverage, unmet need for family planning is high, and barriers to accessing quality reproductive health services remain. Few studies in Rwanda have qualitatively investigated factors that contribute to family planning use, barriers to care, and quality of services from the community perspective. Methods: We undertook a qualitative study of community perceptions of reproductive health and family planning in Rwanda’s southern Kayonza district, which has the country’s highest total fertility rate. From October 2011 to December 2012, we conducted interviews with randomly selected male and female community members (n = 96), community health workers (n = 48), and health facility nurses (n = 15), representing all 8 health centers’ catchment areas in the overall catchment area of the district’s Rwinkwavu Hospital. We then carried out a directed content analysis to identify key themes and triangulate findings across methods and informant groups. Results: Key themes emerged across interviews surrounding: (1) fertility beliefs: participants recognized the benefits of family planning but often desired larger families for cultural and historical reasons; (2) social pressures and gender roles: young and unmarried women faced significant stigma and husbands exerted decision-making power, but many husbands did not have a good understanding of family planning because they perceived it as a woman’s matter; (3) barriers to accessing high-quality services: out-of-pocket costs, stock-outs, limited method choice, and long waiting times but short consultations at facilities were common complaints; (4) side effects: poor management and rumors and fears of side effects affected contraceptive use. These themes recurred throughout many participant narratives and influenced reproductive health decision making, including enrollment and retention in family planning programs. Conclusions: As Rwanda continues to refine its family planning policies and programs, it will be critical to address community perceptions around fertility and desired family size, health worker shortages, and stock-outs, as well as to engage men and boys, improve training and mentorship of health workers to provide quality services, and clarify and enforce national policies about payment for services at the local level. PMID:26085021

Health knowledge, attitudes and practices of family planning service providers and clients in Akwapim North District of Ghana.

PubMed

Atuahene, Margaret Duah; Afari, Esther Oku; Adjuik, Martin; Obed, Samuel

2016-01-01

Family planning services help save lives by reducing women's exposure to risks of child birth and abortion. While family planning services provide measures to prevent unintended pregnancies and time the formation of families, the acceptability and coverage is still very low worldwide. Some of the reasons for this include poor quality of service, unavailability of range of methods, fear of opposition from partners, side effects and health concerns among others.About 40 % of the world's 215,000 annual deaths in childbirth occur in the Sub-Saharan region. In Ghana, urban-rural fertility differences range from two to three children. The acceptability and coverage of family planning are still low and in the study area in particular. We sought to examine factors that contribute to low acceptability and coverage of family planning services in a sub-urban community with a design of quantitative cross-sectional. Ethical approval was given by the Ghana Health Service. Midwives and community health nurses who provide family planning services were interviewed. Exit-interview was also conducted with women receiving a variety of outpatient services. Most of the women in this study (48.7 %) were in the 25-34 age range and were either married (42.8 %) or cohabiting (40.5 %). Majority of these women (67.7 %) have middle/Junior high level of formal education with a modal parity of two. Sixty eight (68) clients were identified as current family planning users. About 6.0 % and 4.5 % were dissatisfied about auditory and visual privacy during counselling respectively. This was confirmed by providers who attributed it to inappropriate facility layout. Most of the clients (79.1 %) were not given educational materials although 88.8 % were talked to about family planning and this could be due to unavailability of these hand-outs.Though clients show satisfaction of services received, providers did not follow standard protocols with as much as 73.7 % faced with challenges in provision of services which were attributed to improper facility layout and lack of furniture. About 77.2 % were willing to provide short term methods, while 91.2 % wanted to provide long term methods. As much as 93.3 % of the women said they would have liked providers give more detailed information on family planning. While most of the women (88.3 %) used injectables, only 6.1 % and 0.9 % used Implants and IUD respectively. Finding ways to improve client privacy through good facility layout will ensure visual and auditory privacy to enhance family planning service provision and uptake. Continuous competency training will assist providers design innovative action plans and meet client satisfaction needs.

Family planning hotline.

PubMed

Dabbs, K

1970-01-01

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

Excavating Culture: Disentangling Ethnic Differences from Contextual Influences in Parenting

PubMed Central

le, Huynh-Nhu; Ceballo, Rosario; Chao, Ruth; Hill, Nancy E.; Murry, Velma McBride; Pinderhughes, Ellen E.

2013-01-01

Historically, much of the research on parenting has not disentangled the influences of race/ethnicity, SES, and culture on family functioning and the development of children and adolescents. This special issue addresses this gap by disentangling ethnic differences in parenting behaviors from their contextual influences, thereby deepening understanding of parenting processes in diverse families. Six members of the Parenting section of the Study Group on Race, Culture and Ethnicity (SGRCE) introduce and implement a novel approach toward understanding this question. The goal of this project is to study culturally related processes and the degree to which they predict parenting. An iterative process was employed to delineate the main parenting constructs (warmth, psychological and behavioral control, monitoring, communication, and self-efficacy), cultural processes, and contextual influences, and to coordinate a data analytic plan utilizing individual datasets with diverse samples to answer the research questions. PMID:24043923

Continuing education in physical rehabilitation and health issues of agricultural workers.

PubMed

Wilhite, Carla S; Jaco, Linda

2014-01-01

Limited attention has been devoted to the cultural and practice competencies needed by occupational therapy and physical therapy professionals who provide services to farming families impacted by chronic health or disability issues. Agricultural occupational safety and health should represent a continuum of services responsive to individuals, families, and agricultural communities across a life span and range of health status changes. Physical rehabilitation professionals have a key role in impacting an agricultural producer's sense of self-efficacy and capacities for returning to agricultural living and work. However, demonstration of competency is essential in providing person-centered rehabilitation services of assessment, evaluation, treatment planning, interventions, referrals, and discharge issues. The paper highlights methods utilized by a state AgrAbility program and a former National AgrAbility Project to develop a model of continuing education programming for occupational and physical therapists that evaluate and treat agricultural workers after acute injury or exacerbation of chronic health conditions.

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

This appendix summarizes building characteristics used to determine heating and cooling loads for each of the five building types in each of the four regions. For the selected five buildings, the following data are attached: new and existing construction characteristics; new and existing construction thermal resistance; floor plan and elevation; people load schedule; lighting load schedule; appliance load schedule; ventilation schedule; and hot water use schedule. For the five building types (single family, apartment buildings, commercial buildings, office buildings, and schools), data are compiled in 10 appendices. These are Building Characteristics; Alternate Energy Sources and Energy Conservation Techniques Description, Costs,more » Fuel Price Scenarios; Life Cycle Cost Model; Simulation Models; Solar Heating/Cooling System; Condensed Weather; Single and Multi-Family Dwelling Characteristics and Energy Conservation Techniques; Mixed Strategies for Energy Conservation and Alternative Energy Utilization in Buildings. An extensive bibliography is given in the final appendix. (MCW)« less

Family Communication, Risk Perception and Cancer Knowledge of Young Adults from BRCA1/2 Families: a Systematic Review.

PubMed

Young, Alison L; Butow, Phyllis N; Vetsch, Janine; Quinn, Veronica F; Patenaude, Andrea F; Tucker, Katherine M; Wakefield, Claire E

2017-12-01

Understanding challenges in familial communication of cancer risk has informed genetic service delivery. Parent-child interactions have received considerable attention, but few studies focus on young adulthood experiences within BRCA1/2 families. Young adults are approaching, or at a life stage where awareness of hereditary cancer risk is vital for informed choice of risk management options. This review assesses family communication, risk perception and cancer knowledge held by 18-40 year old individuals who have a parent with a BRCA1/2 gene mutation or carry the gene mutation themselves. Thirteen papers met the inclusion criteria. One utilized a 'mixed methods' methodology and the remaining used a qualitative approach. Findings were synthesized into themes and reported narratively. In general, parents are communicating openly about genetic risk with young adult offspring, but there is evidence that some young adults are withholding information from their parents about their own test results. Risk perception is influenced by a family history of cancer, childbearing plans and health providers' advice. Misconceptions about genetic risk appear to be common and gaps in hereditary cancer knowledge are evident. It is unclear whether incorrect knowledge was passed from parents to offspring. Health providers need to provide developmentally appropriate services for emerging adults (18-25 years old), with particular support in navigating through risk management options.

Planned Parenthood Federation of America: Its Role as Provider of Information Services.

ERIC Educational Resources Information Center

Roberts, Gloria A.

1985-01-01

Planned Parenthood Federation of America was established in 1916 to fulfill the need to provide family planning information and services to women. The Katharine Dexter McCormick Library serves organizational goals by publishing family planning bibliographies, performing literature searches on in-house database, and providing reference services to…

Watch out for the blue circle: a breakthrough in family planning promotional strategy.

PubMed

Sumarsono

1989-07-01

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.

"If I have only two children and they die… who will take care of me?" -a qualitative study exploring knowledge, attitudes and practices about family planning among Mozambican female and male adults.

PubMed

Capurchande, Rehana; Coene, Gily; Roelens, Kristien; Meulemans, Herman

2017-08-22

By focusing upon family planning counselling services, the Mozambican government has significantly enhanced the general health of female and male clients. However, little is known about the experiences of family planning by female and male adults. This article focuses on knowledge, attitudes and practices regarding contraceptive methods and fertility intentions. An in-depth qualitative study of female and male clients was conducted in two settings in Maputo province - Ndlavela and Boane. A total of sixteen in-depth interviews, four informal conversations, and observations were equally divided between both study sites. The analysis followed a constructionist approach. Three steps were considered in the analysis: examining commonalities, differences and relationships. Although there was a high level of family planning knowledge, there were discrepancies in clients' everyday practices. Male and female clients are confronted with a variety of expectations concerning fertility intentions and family size, and are under pressure in numerous ways. Social pressures include traditional expectations and meanings connected to having children, as well as religious factors. Short interaction time between clients and health workers is a problem. Additionally, imposed contraceptive methods, and typically brief conversations about birth control between couples only adds to the burden. Because family planning is largely viewed as a woman's concern, most clients have never attended counselling sessions with their partners. Attitudes towards responsibility for contraceptive use and risk-taking are strongly gendered. Female and male clients have differing expectations about contraceptive use and fertility intentions. They participate differently in family planning programs leading to their inconsistent and ambivalent practices as well as vague perceptions of risk-taking. Therefore, policymakers must address the reasons behind ambivalence and inconsistency regarding contraceptives and family planning.

Evidence That The Citizenship Mandate Curtailed Participation In Oregon’s Medicaid Family Planning Program

PubMed Central

Angus, Lisa; DeVoe, Jennifer

2016-01-01

The 2005 federal Deficit Reduction Act made proof of citizenship a requirement for Medicaid eligibility. We examined the effects on visits to Oregon’s Medicaid family planning services eighteen months after the citizenship requirement was implemented. We analyzed 425,381 records of visits that occurred between May 2005 and April 2008 and found that, compared to the eighteen-month period before the mandate went into effect, visits declined by 33 percent. We conclude that Medicaid citizenship documentation requirements have been burdensome for Oregon Family Planning Expansion Project patients and costly for health care providers, reducing access to family planning and preventive measures and increasing the strain on the safety net. PMID:20368600

Evidence that the citizenship mandate curtailed participation in Oregon's Medicaid family planning program.

PubMed

Angus, Lisa; Devoe, Jennifer

2010-04-01

The 2005 federal Deficit Reduction Act made proof of citizenship a requirement for Medicaid eligibility. We examined the effects on visits to Oregon's Medicaid family planning services eighteen months after the citizenship requirement was implemented. We analyzed 425,381 records of visits that occurred between May 2005 and April 2008 and found that, compared to the eighteen-month period before the mandate went into effect, visits declined by 33 percent. We conclude that Medicaid citizenship documentation requirements have been burdensome for Oregon Family Planning Expansion Project patients and costly for health care providers, reducing access to family planning and preventive measures and increasing the strain on the safety net.