Back to home pageUnited States of America (New York) INTERNATIONAL FAMILY PLANNING PERSPECTIVES DECEMBER 1992 - VOLUME 18, NUMBER 4 93.76.01 - English - Ann LARSON, Tropical Health Program, University of Queensland, Herston (Australie), and S.N. MITRA, Mitra and Associates, Dhaka (Bangladesh) Family Planning in Bangladesh: An Unlikely Success Story (p. 123- 129, 144) The results of two independent national surveys conducted in 1989 show that Bangladesh has achieved a moderate level of contraceptive use: among currently married women under 50 years old, 31% use a contraceptive method and almost 25% use a modern method. In addition, 44% of ever-married women younger than 50 have used a method at some time. The method mix, historically characterized by use of a wide range of methods, is increasingly dominated by oral contraceptives, which accounted for 29% of use in 1989. Reflecting the increase in contraceptive prevalence, the total fertility rate declined from seven lifetime births during the mid-1970s to about five lifetime births by the end of the 1980s. Mean desired family size in 1989, however, was three children, indicating that there may still be considerable unmet need for family planning services. (BANGLADESH, FAMILY PLANNING, CONTRACEPTIVE METHODS) 93.76.02 - English - Minja Kim CHOE, Program on Population, East-West Center, Honolulu, Hawaii (U.S.A.) et al. Progression to Second and Third Births in China: Patterns and Covariates in Six Provinces (p. 130-136, 149) Data on ever-married women of reproductive age from six Chinese provinces were obtained from the 1987 In-depth Fertility Survey, Phase II, to examine whether government population policies related to child mortality, rural residence, ethnic group and gender of the firstborn child, or individual characteristics such as educational level and living standard, are more important in determining which women have more than one child. Among women who had a first birth during 1977-1987, the proportions in each province who had a second birth within 10 years of the first ranged from 30% to 93%, and the proportions who had a third birth within 10 years of their second ranged from 15% to 80%. While all covariates proved important, the most significant covariate for predicting a second birth, particularly in areas where few women have more than one child, was the death of the previous child. Having a daughter the first time also had a strong positive effect on the likelihood of having a second birth in some areas. While living standard had a significant effect on the likelihood of having a second birth in some areas, the findings do not support conjecture that rural families with the economic means to pay the penalties are more likely to have a second child. The results for third births were similar to those for second births. (CHINA, WOMEN, BIRTH ORDER) 93.76.03 - English - Barbara JANOWITZ and John H. BRATT, Economics of Family Planning Unit, Family Health International, Research Triangle Park, NC (U.S.A.) Costs of Family Planning Services: A Critique of the Literature (p. 137-144) Estimates of the costs of providing family planning services have been used to assert that some types of programs are more efficient than others. However, variations in costs may exist because of differences in the mixes of services or in the demand for services and the availability of alternative services. Moreover, cost estimates may vary simply because researchers used different methodologies, treated program output in widely varying ways or did not always take differences in program settings into account. The authors recommend that a common methodology be developed for determining the costs of family planning so that better comparisons can be made, program characteristics can be fully understood before comparisons are attempted and programs from clearly different settings are not directly compared. (FAMILY PLANNING PROGRAMME, COSTS) 93.76.04 - English - Niki COTTEN, Family Health International, Research Triangle Park, NC (U.S.A.) et al. Early Discontinuation of Contraceptive Use in Niger and the Gambia (p. 145-149) In 1989 and 1990, studies were conducted among 650 new contraceptive users in Niger and 570 in the Gambia to assess the extent of and reasons for contraceptive discontinuation within the first eight months of acceptance. Approximately 30% of new family planning clients discontinued contraceptive use within that time. Side effects, travel by either partner, spousal disapproval, and desired pregnancy were the principal reasons given for stopping use, although in some cases clients may have simply offered what they felt was an acceptable reason. Discontinuation was higher among clients who felt they did not receive adequate counseling than it was among those who felt they had. (NIGER, GAMBIA, CONTRACEPTIVE DROPOUTS) MARCH 1993 - VOLUME 19, NUMBER 1 93.76.05 - English - Naomi RUTENBERG, The Futures Group, Washington, DC (U.S.A.), and Evelyn LANDRY, Association for Voluntary Surgical Contraception, New York (U.S.A.) A Comparison of Sterilization Use and Demand from the Demographic and Health Surveys (p. 4-13) Data from 26 countries that participated in the first phase of the Demographic and Health Surveys show that the percentage of couples who rely on sterilization and the proportion of total contraceptive use accounted for by sterilization are rising in Asia, Latin America and a few countries in Sub-Saharan Africa. As of the mid-1980s, more than 25% of married women of childbearing age were relying on sterilization (either female or male) in Brazil, the Dominican Republic, El Salvador, Sri Lanka and Thailand. While sterilization rates are still modest in most of Sub-Saharan Africa, two countries - Botswana and Kenya - have a sterilization prevalence rate of 5%. Approximately, one-half of the demand for contraception to limit family size has been satisfied by female sterilization in the Dominican Republic, El Salvador, Sri Lanka and Thailand. In Bolivia, Botswana, Egypte, Indonesia, Kenya, Morocco, Peru, and Trinidad and Tobago, where sterilization programs are new or not a major component of family planning services, one-quarter or less of the demand for contraception has been met by sterilization. Among women who said they would prefer sterilization as their future method, 80% or more in 13 of the 16 countries for which data are available could name a source of sterilization. In 11 or 17 countries, one-third or more of the women who said they would consider sterilization had never used a modern method of contraception. In 10 of 17 countries, more than 50% of women considering sterilization live in rural areas, and in all 17, the majority of women considering sterilization have only a primary school education. (DEVELOPING COUNTRIES, FAMILY PLANNING, CONTRACEPTION, STERILIZATION) 93.76.06 - English - Anastasia J. GAGE- BRANDON, Demographic and Health Surveys, Institute for Resource Development/Macro International Inc., Columbia, MD (U.S.A.), and Dominique MEEKERS, Department of Sociology, Pennsylvania State University, University Park, Pennsylvania, Philadelphia (U.S.A.) Sex, Contraception and Childbearing before Marriage in Sub-Saharan Africa (p. 14-18, 33) In Sub-Saharan Africa, sexual activity, contraceptive use and childbearing among never-married women aged 15-24 differs significantly among countries. Analysis of Demographic and Health Surveys data for seven countries reveals that in some, such as Botswana and Liberia, more than 75% of unmarried women have had sexual intercourse, while in Burundi only 4% have done so. Although more than 75% of unmarried, sexually experienced young women in the countries studied know of at least one modern contraceptive method, less than 30% of these women in most countries have ever used a modern method. Childbearing among unmarried women is almost nonexistent in Burundi (2%) and very low in Ghana (9%), but it is fairly common in Botswana (42%) and Liberia (34%). (AFRICA SOUTH OF SAHARA, SEXUALITY, WOMEN, SPINSTERS, PREMARITAL PREGNANCY, FERTILITY) 93.76.07 - English - Karen G. FOREIT, The Futures Group, Washington, DC (U.S.A.) et al. Effectiveness and Cost-Effectiveness of Postpartum IUD Insertion in Lima, Peru (p. 19-24, 33) The effectiveness and cost-effectiveness of postpartum family planning service provision were assessed in a study of 1,560 women giving birth in 1988-1989 at the largest hospital of the Peruvian Social Security Institute (IPSS). Contraceptive counseling and temporary methods were offered to one ward of postpartum women, while a second ward, acting as a control group, was discharged without being offered comparable services. In the second half of the study period, almost 90% of the experimental group accepted family planning prior to discharge, and 25% of the women received an IUD. Six months after delivery, 82% of the members of the experimetal group were using a contraceptive method, with 40% using an IUD; by comparison, 69% of controls were using a method, and 27% an IUD. Because in-patient IUD insertion was estimated to cost $9.38 per woman, compared with $24.16 for an interval insertion, implementing postpartum family planning services in all IPSS hospitals in Lima could save 3-5% of the annual projected IPSS family planning budget for Lima and free up 6% of the current outpatient delivery capacity. (PERU, FAMILY PLANNING, CHILDBIRTH, CONTRACEPTION, IUD) 93.76.08 - English - Pempelani MUFUNE, Social Development Studies, University of Zambia, Lusaka (Zambia), Kwaku OSEI-HWEDIE and Lengwe-Katembula MWANSA, Department of Social Work, University of Botswana, Gaborone (Botswana) Attitudes toward Risky Sexual Behaviour and Reactions to People Infected with HIV among Zambian Students (p. 25-27, 30) According to a randomized study conducted in early 1990, the majority of Zambian students hold conservative attitudes toward risky sexual behavior. Overall, 74% disapproved of premarital sex and 84% disapproved of extramarital affairs. In addition, 64% said they disapproved of people who had more than one sexual partner; 74% disagreed with the statement that to be "really somebody", a person should have more than one partner. Nevertheless, 22% reported that their best friend had two or more partners. Many students reported negative reactions to people infected with HIV: 32% said they should be quarantined, and 38% said they should not be allowed to work in offices with others. Moreover, 45% thought HIV-infected children should not share classrooms with uninfected children, and 47% said they would not swim in a pool with a person infected with HIV. (ZAMBIA, COLLEGE STUDENTS, SEXUALITY, SEXUAL BEHAVIOUR, AIDS)
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