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At the same time, most programs focus more on indicators that measure health status, service provision or utilization, or the success of reproductive health interventions at the subnational level (WHO, [40]). Data for these indicators come from nationally representative surveys such as the Demographic and Health Surveys and Multiple Indicator Cluster Surveys, but not all countries conduct these surveys on a regular basis or conduct them using the same population (e.g., exclusion of unmarried youth), and there are limitations to the measures derived from them (e.g., the fixed age range). In August of 2021, the Editorial Committee of I Studies in Family Planning i put out a call for abstracts for a special issue focused on indicators in sexual and reproductive health and rights. Another prevalent theme in the papers in this special issue involves the need for better measurement of psychosocial and socioecological factors that influence sexual and reproductive health-related behaviors. [Extracted from the article]

Equating contraceptive use with programmatic success is fundamentally flawed in failing to account for whether individuals desire contraceptive use; this is problematic because nonuse can reflect empowered decision‐making and use may reflect an individual's inability to refuse or discontinue a method. A rights‐based approach demands respect for individuals' freedom to weigh options and choose how their desire for pregnancy prevention can be accommodated by available methods and within the context of their own personal, social, and material constraints. We offer an alternative construct, preference‐aligned fertility management (PFM), that provides a more holistic indicator of whether one's contraceptive needs are met. PFM is more person‐centered and informative for programming than status quo measures of unmet need, demand satisfied, and contraceptive use which define a positive outcome in relation to pregnancy risk rather than one's stated preferences. The PFM approach goes beyond other recent proposals for modifying the concept of unmet need by refraining from judgment of legitimate reasons for nonuse of contraception and offers a straightforward way to capture whether people act in line with their preferences. We conclude with discussion of how we plan to measure PFM in the Innovations for Choice and Autonomy (ICAN) study in Nigeria and Uganda. [ABSTRACT FROM AUTHOR]

Globally, millions of unintended pregnancies occur each year resulting in a host of social, economic, and health‐related problems. Improving knowledge of and access to family planning services is an effective way to prevent unintended pregnancy, and research suggests that men's involvement promotes greater contraceptive uptake. To explore this issue, we assess contraceptive knowledge, attitudes, and behaviors among Sierra Leonean men who experienced an unplanned pregnancy. Findings indicate that men's participation in family planning was limited due to barriers including inadequate knowledge about contraception, poor access to services, and gender norms that consider family planning a woman's responsibility. As a result, men often resorted to a pattern of control that put the onus of contraceptive use on women and blamed women when they became pregnant, without considering their own role in pregnancy prevention. We suggest that family planning policies and interventions both engage men and address the barriers to their participation in reproductive health. [ABSTRACT FROM AUTHOR]

Recent data suggest increasing rates of emergency contraception (EC) use in Ghana, particularly in urban areas. In 2018, we collected survey data from 3,703 sexually experienced women aged 16–44 years living in low‐income settlements of Accra. We estimated the prevalence of lifetime and current EC use. Multivariate logistic regression was used to assess factors associated with current use of EC. Retrospective monthly calendar data on contraceptive use were analyzed to identify patterns of EC use, including repeat and continuous use, and uptake of other contraceptive methods in the months following EC use. Nearly 15 percent of women had ever used EC. About half of recent EC users (52 percent) used EC for at least four months cumulatively within a 12‐month window. There was no evidence of adoption of other modern methods in the months after using EC. Our results suggest that EC is a common method for pregnancy prevention in Accra, particularly among young, unmarried, highly educated women. Counseling on effective EC use and strategies that promote equitable access should be prioritized. [ABSTRACT FROM AUTHOR]

Global initiatives aim to add 120 million new family planning (FP) users by 2020; however supply-side interventions may be reaching the limits of their effectiveness in some settings. Our case study in Niger used demand analysis techniques from marketing science. We performed a representative survey (N = 2,004) on women's FP knowledge, attitudes, needs, and behaviors, then used latent class analysis to produce a segmentation of women based on their responses. We found that Nigerien women's demand for modern FP methods was low, with majorities aware of modern methods but much smaller proportions considering use, trying modern methods, or using one consistently. We identified five subgroups of women with distinct, internally coherent profiles regarding FP needs, attitudes, and usage patterns, who faced different barriers to adopting or using modern FP. Serving subgroups of women based on needs, values, and underlying beliefs may help more effectively drive a shift in FP behavior. [ABSTRACT FROM AUTHOR]

This article describes datasets for the FPwatch Project, a comprehensive facility-based family planning survey conducted by Population Services International in five countries in Africa and Asia from 2015 to 2017. Contents cover research design and background, methodology, sample selection, data collection, an overview of FPwatch indicators, and quality assurance measures taken. These datasets from the Democratic Republic of Congo, Ethiopia, India, Myanmar, and Nigeria complement other facility-based family planning surveys and are unique in their large-scale, standardized methodology, and comprehensive sampling approach. In addition, all datasets but Myanmar (private only) include both private and public facilities, a feature that gives a more complete picture of the family planning supply environment. Because of these factors, the data is well suited to inform global family planning efforts. [ABSTRACT FROM AUTHOR]

A correction to the article "Revising the FP Quality of Care Framework in the Context of Rights-based Family Planning" is presented.

A common reason for nonuse of modern contraceptives is concern about side effects and health complications. This article provides a detailed characterization of the belief that modern contraceptives cause infertility, and an examination of how this belief arises and spreads, and why it is so salient. We conducted focus group discussions and key informant interviews in three rural communities along Kenya's eastern coast, and identified the following themes: (1) the belief that using modern contraception at a young age or before childbirth can make women infertile is widespread; (2) according to this belief, the most commonly used methods in the community were linked to infertility; (3) when women observe other women who cannot get pregnant after using modern contraceptives, they attribute the infertility to the use of contraception; (4) within the communities, the primary goal of marriage is childbirth and thus community approval is rigidly tied to childbearing; and, therefore (5) the social consequences of infertility are devastating. These findings may help inform the design of programs to address this belief and reduce unmet need. [ABSTRACT FROM AUTHOR]

This article provides updated estimates of trends in modern contraceptive use among young adult women (aged 15-24) who have had sex, using Demographic and Health Survey data from 23 sub-Saharan African countries (1990-2014). In East/South Africa, parous women had higher modern contraceptive use than nulliparous women and larger increases in modern contraceptive use over time. In the West/Central region, nulliparous women had higher modern contraceptive use than parous women and larger increases in modern contraceptive use over time. Most of the increase in modern contraceptive use was driven by an increase in short-acting-rather than long-acting-methods across regions and parity groups. Although parous women had higher unmet need for family planning in both regions, nulliparous women had larger increases in unmet need for family planning over time in the East/South region. Decomposition analysis suggests that increases in use of modern contraceptives are largely driven by increases in the rate of contraceptive use rather than changes in the parity composition of women. [ABSTRACT FROM AUTHOR]

This study examines recent levels, patterns, and determinants of traditional contraceptive method use, based on pooled data from the 2003, 2008, and 2013 Philippines Demographic and Health Surveys. Most contraceptive users in the Philippines rely on modern methods, but over the past ten years traditional method use has continued to account for about a third of all contraceptive use. Results show women in 2003 and 2008 were more likely to use periodic abstinence (rhythm) over modern methods compared with women in 2013, while withdrawal rather than modern methods was preferred more by women in 2013 than in 2003. The characteristics of women who use traditional methods have changed little over the past decade. Knowing the characteristics of traditional contraceptive method users can help establish policies and programs that promote more effective contraceptive use, including encouraging users of traditional contraceptive methods to switch to the more effective modern methods. [ABSTRACT FROM AUTHOR]

Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013. Overall, integration was associated with higher modern method contraceptive prevalence and knowledge, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Evidence for change in unmet need for FP was limited, although two of the three evaluations that measured unmet need suggested possible improvements associated with integrated services. However, improving access to FP services through integration was not always sufficient to increase the use of more effective (noncondom) modern methods among women who wanted to prevent pregnancy. Integration efforts, particularly in contexts where contraceptive use is low, must address community-wide and HIV-specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care. [ABSTRACT FROM AUTHOR]

Research and programs for female sex workers (FSWs) tend to focus exclusively on HIV prevention, with little attention paid to how pregnancy affects their lives. We examine the circumstances surrounding pregnancy and childbirth among women selling sex in Ethiopia. In Adama City, researchers asked 30 FSWs aged 18 and older who had ever been pregnant to participate in in-depth interviews. The women reported on pregnancies experienced both before and after they had begun selling sex. They identified some of the fathers as clients, former partners, and current partners, but they did not know the identities of the other fathers. Missed injections, skipped pills, and inconsistent condom use were causes of unintended pregnancy. Abortion was common, typically with a medication regimen at a facility. Comprehensive sexual and reproductive health services should be provided to women who sell sex, in recognition and support of their need for family planning and their desire to plan whether and when to have children. [ABSTRACT FROM AUTHOR]

We estimate the relationship between unmet need for contraception and coital frequency using data from the most recent Standard Demographic and Health Surveys conducted from 2005 to 2015. Individual-level analyses include 55 countries (n=245,732 women). The dependent variable is women's report of any sex in the last four weeks; the independent variable is current unmet need. Bivariate ecological results using country averages indicate that prevalence of unmet need is significantly negatively correlated with the proportion reporting recent sexual activity. Multivariate regression of individual-level data show that the overall odds ratio of having had sex in the last four weeks is 3.23 and 2.97 for women with met contraceptive need for spacing and limiting fertility, respectively, compared with women with unmet contraceptive need. These results suggest that current estimates of unmet need exaggerate the risk of unintended pregnancy because coital frequency is not uniform with respect to unmet need. Findings also suggest that, despite being categorized as having unmet need, many women may still be taking measures to control their fertility through regulating the tempo of marital coitus, thus reducing their risk of unintended pregnancy. [ABSTRACT FROM AUTHOR]

Panel survey data collected in rural northern Ghana asked women about the "wantedness" status of their children. Parous women were asked whether they wanted more children, while those who had never had a child were asked whether they wanted to have children in the future; those who said that they did not want to have any more children in the future were asked whether they wanted to become pregnant when they last became pregnant and, if so, whether they wanted to become pregnant at the time, or would have preferred to be pregnant earlier or later. This article analyzes longitudinal responses to these questions over a 10-year period. Birth and survival histories of subsequently born children linked to preference data permit investigation of the question: are "wanted" children more likely to survive than "unwanted" children? Hazard models are estimated to determine whether children born to women who indicated that they did not want to have a child at the time they did, or did not want any more children in the future, have a higher risk of mortality relative to children who were reported wanted at the time of pregnancy. Results show no significant differences in adjusted mortality risks between children who were reported to be wanted and those reported to be unwanted. [ABSTRACT FROM AUTHOR]

This article evaluates the effects of involving men in family planning counseling in Jordan using a randomized experiment. We randomly assigned a sample of 1,247 married women to receive women-only counseling, couples counseling, or no counseling. We measured the effects of each type of counseling on family planning use, knowledge, attitudes, and spousal communication about family planning. Compared to no counseling, couples counseling led to a 54 percent increase in uptake of modern methods. This effect is not significantly different from the 46 percent increase in modern method uptake as a result of women-only counseling. This outcome may be due, in part, to lower rates of compliance with the intervention among those assigned to couples counseling compared to women-only counseling. To realize the possible added benefits of involving men, more tailored approaches may be needed to increase men's participation. [ABSTRACT FROM AUTHOR]

In conflict-affected settings such as Somalia, emergency contraception (EC) has the potential to serve as an important means of pregnancy prevention. Yet Somalia remains one of the few countries without a registered progestin-only EC pill. In 2014, we conducted a qualitative, multi-methods study in Mogadishu to explore awareness of and perceptions of need for EC. Our project included 10 semi-structured key informant interviews, 20 structured in-person interviews with pharmacists, and four focus group discussions with married and unmarried Somali women. Our findings reveal a widespread lack of knowledge of both existing family planning methods and EC. However, once we described EC, participants expressed enthusiasm for expanding access to post-coital contraception. Our results shed light on why Somalia continues to be a global exception with respect to an EC product and suggest possible politically and culturally acceptable and effective avenues for introducing EC into the health system. [ABSTRACT FROM AUTHOR]

Contraception following delivery or an induced abortion reduces the risk of an early unintended pregnancy and its associated adverse health consequences. Unmet need for contraception during the postpartum period and contraceptive counseling and services following abortion have been the focus of efforts for the last several decades. This article provides an introduction to the more focused contributions that follow in this special issue. We discuss the validity and measurement of the concept of unmet need for family planning during the postpartum period. We then present key findings on postpartum contraceptive protection, use dynamics, and method mix, followed by an assessment of interventions to improve postpartum family planning. The evidence on postabortion contraceptive uptake and continuation of use remains thin, although encouraging results are noted for implementation of comprehensive abortion care and for the impact of post-abortion contraceptive counseling and services. Drawing on these studies, we outline policy and program implications for improving postpartum and post-abortion contraceptive use. [ABSTRACT FROM AUTHOR]

Unmet need for contraception is highest within 12 months post-delivery, according to research. Using longitudinal data from the Nairobi Urban Health and Demographic Surveillance System, we assess the dynamics of contraceptive use during the postpartum period among women in Nairobi's slums. Results show that by 6 months postpartum, 83 percent of women had resumed sexual activity and 51 percent had resumed menses, yet only 49 percent had adopted a modern contraceptive method. Furthermore, almost half of women discontinued a modern method within 12 months of initiating use, with many likely to switch to another short-term method with high method-related dissatisfaction. Women who adopted a method after resumption of menses had higher discontinuation rates, though the effect was much reduced after adjusting for other variables. To reduce unmet need, effective intervention programs are essential to lower high levels of discontinuation and encourage switching to more effective methods. [ABSTRACT FROM AUTHOR]

Several charts related to the demographic survey on Nigeria conducted by the country's government authority National Population Commission in 2013 are presented including fertility rates, ideal number of children among women, and percentages of the desire to stop childbearing among married women.

Several charts related to the demographic survey on the Philippines conducted by the government authority Philippine Statistics Authority in 2013 are presented including fertility rates, ideal number of children among women, and percentages of the desire to stop childbearing among married women.

Unmet need for contraception has been a central indicator for monitoring the progress of family planning programs for 25 years. The purpose of this article is to provide a broad context for the more focused contributions that follow in this special issue. The validity and measurement of the concept of unmet need are discussed. We then present regional trends among married women since 1970. Major reductions in unmet need have been achieved, with the clear exception of sub-Saharan Africa. Less success can be claimed in addressing the needs of sexually active unmarried women, who contribute nearly 20 percent to overall unmet need in developing countries. Prominent reasons for unmet need in settings where contraceptive uptake is low include social resistance and insufficient information concerning methods. As contraceptive use increases, the importance of these reasons wanes, but concerns regarding side effects and health impact remain a barrier, and discontinued users now constitute a large proportion of those with unmet need. Drawing on these reasons, we outline measures to further reduce unmet need. [ABSTRACT FROM AUTHOR]

Natural methods of contraception were widely used in developed countries until the late 1960s to space and limit childbirth. In France, when the first contraceptive surveys were conducted, researchers noticed that the use of natural methods was underreported, and questions to correct for this bias were subsequently added. The Demographic and Health Surveys do not currently include questions specific to natural methods. We added such questions to the standard DHS question regarding current contraceptive use when we conducted the Health and Demographic Surveillance System of Ouagadougou (2010 Ouaga HDSS) health survey in Burkina Faso among 758 women aged 15-49. Doing so enabled us to find a notable increase in the proportion of women in union who reported practicing contraception: 58 percent, compared with 38 percent in Ouagadougou in the 2010 Burkina Faso DHS. Thirty-two percent of women reported using modern medical methods or condoms in both surveys, but use of natural methods was much greater in the 2010 Ouaga HDSS health survey (26 percent) than in the 2010 Burkina Faso DHS (5 percent). Many women classified as having unmet need for family planning in Ouagadougou by the DHS data are in fact users of natural methods. Additional questions that would measure use of natural methods more completely should be tested in different settings. [ABSTRACT FROM AUTHOR]

This report describes the purpose for developing a quantitative goal for the London Summit on Family Planning held in July 2012, the methodology behind its formulation, and the lessons learned in the process. The London Summit has evolved into the global initiative known as FP2020, and the goal has become '120 by 20,' or reaching 120 million additional users of modern contraceptive methods by 2020 in the world's poorest countries. The success of FP2020 will first be evaluated on the basis of quantitative verification to determine that the '120 by 20' goal was reached. More important, however, is the extent to which the goal today serves as a global rallying cry to mobilize resources and leadership around current family planning programs, with a focus on voluntary family planning and quality of care, and with an emphasis on meeting girls' and women's unmet needs and their right to practice contraception. We hope this article provides greater transparency and understanding of the FP2020 goal, and that the global goal spurs annual monitoring of progress toward national goals in the world's poorest countries. [ABSTRACT FROM AUTHOR]

This study uses a quasi-experimental design to determine the impact of new family planning clinics on knowledge, contraceptive use, and unmet need for family planning among married women in poor urban areas of six secondary cities of Pakistan. Baseline (n = 5,338) and endline (n = 5,502) population surveys were conducted during 1999-2000 and 2001-02 in four study sites and two control sites. Exit interviews with clients identified the sociodemographic and geographic characteristics of clinic users. The results show that the clinics contributed to a 5 percent increase in overall knowledge of family planning methods and an increase in knowledge of female sterilization and the IUD of 15 percent and 7 percent, respectively. Distinct effects were found on contraceptive uptake, including an 8 percent increase in female sterilization and a 7 percent decline in condom use. Unmet need for family planning declined in two sites, whereas impacts on the other sites were variable. Although the new clinics are located within poor urban communities, users of the services were not the urban poor, but rather were select subgroups of the local population., Pakistan's family planning program has achieved meager success over the past four decades, despite Pakistan's being one of the first countries in South Asia to make a commitment to fertility [...]

In 1994, South Africa underwent a transition from the institutionalized racism of an apartheid state to a nonracial democracy. This study uses data from two surveys conducted in the style of the Demographic and Health Surveys to compare patterns and predictors of racial differences in modern contraceptive use in the late- and post-apartheid periods. Age-group-specific logistic regression models show that despite strong state family planning programs targeting black women, these women were less likely than nonblacks to practice modern contraception both before and after the political transition, even after controlling for large racial-group differences in sociodemographic characteristics and the distribution of socioeconomic resources. Black, colored, Indian, and white women show different patterns of contraceptive use across their reproductive careers; in particular, young, unmarried black and colored women show high levels o fuse. Use of injectable contraceptives is also high among black and colored women, whereas injectables are not the primary method used by Indian or white women. These findings are discussed in light of their research and policy implications., Contraception has long been a politically contested issue in South Africa, a country where until recently, a ruling white minority population legislated to control many aspects of nonwhite women's lives, [...]

Despite a decline infertility, an increase in contraceptive prevalence, and a wide expansion of family planning programs in Iran and Turkey, a large proportion of "birth limiters" rely on withdrawal to avoid pregnancy. Adopting a comparative approach, this study draws on data from the 2000 Iran DHS and 2003 Turkey DHS to examine the determinants of the practice of withdrawal among birth limiters. Multivariate logistic regression analyses were employed to estimate the likelihood of withdrawal use among two representative samples of birth limiters. Higher education and wealth were associated with greater likelihood of withdrawal use among birth limiters in Iran, while an inverse association was found in Turkey. Older age was positively associated with withdrawal in both countries, whereas having more than four children was inversely related to use. Study results suggest that family planning and reproductive health programs in Iran and Turkey should be aware of the groups that have high rates of withdrawal use, should educate couples in the effective use of withdrawal, and should encourage the use of more effective modern methods and emergency contraceptives when appropriate. [ABSTRACT FROM AUTHOR]

In this article, the author discusses the contraceptive security strategies, without long-acting (LA) and permanent methods (PM) of family planning. It analyzes 13 countries and two regions including Albania, Burkina Faso, and Egypt, where recent contraceptive security strategies were written and publicly available. It investigates the problematic language defining contraceptive security.

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. [ABSTRACT FROM AUTHOR]

This article examines the determinants of contraceptive and abortion behavior and how each of these influences the other, with an emphasis on the role of women's life-course stage and experience. We base our approach on life-course theory, which argues that behavior is influenced by current circumstances as well as experiences over the life course. We use data collected for every pregnancy experienced by 2,444 women in Madhya Pradesh, India, to explore use of temporary contraceptive methods (both modern and traditional) and sterilization, as well as abortion attempts. We use logistic regression to model whether women took these actions in a given pregnancy interval, including past experience with contraception in the abortion analyses and with abortion in the contraceptive analyses. The results suggest that life-course factors play a role in shaping behavior. Moreover, past use of contraceptives has a significant effect on attempted abortion and vice versa. Finally, we find that this relationship changes as women age and accumulate experience. [ABSTRACT FROM AUTHOR]

The article presents a study on the aspects of contraceptive-use dynamics and disparities in switching contraceptive methods among different groups motivated by the levels of method-related discontinuation. The study uses the data from the recent Demographic and Health Survey (DHS) contraceptive calendar to analyze the contraceptive-use dynamics. It states that single-decrement life tables were used to examine the discontinuation for method-related reasons, giving couples the hypothetical cause-specific probabilities of stopping use. The results of the study, which reinforce the recent DHS data, show that reasons for discontinuation of methods implies dissatisfaction, side effects, and health concerns with the prompt switching influenced by women's education.

Several charts and graphs are presented which offer information on the results of the "Bangladesh Demographic and Health Survey 2007" (BDHS) including the percentage contribution of women who were surveyed, percentage distribution of individuals who use modern contraception methods, and the prevalence of contraceptive use among married women.

A randomized community trial of a family planning outreach program was conducted in Rakai District, Uganda. Five communities received standard services; six intervention communities received additional family planning information, counseling, and contraceptive methods from government service providers and community-based volunteer agents using social marketing and other strategies. Condom use was promoted in all of the communities. The community-based family planning outreach program was implemented in two phases--1999-2000 (early) and 2001(late)--and its impact was evaluated by means of population surveys in 2002-03. At follow-up, hormonal contraceptive prevalence was 23 percent in the intervention communities, compared with 20 percent in the control communities. The differential was greater in the early-intervention communities than the late-intervention communities. Pregnancy rates at follow-up were 15 percent in the control and 13 percent in the intervention communities. No differentials in condom use were found between study arms. Family planning outreach via social marketing can significantly increase hormonal contraceptive use and decrease pregnancy rates, but the impact of this outreach program was modest. [ABSTRACT FROM AUTHOR]

Research on the determinants of condom use in sub-Saharan Africa has focused on the personal characteristics of individuals and, more recently, on community characteristics such as levels of development and of contraceptive availability. Two additional community characteristics, however--the restraining influence exerted by social networks and traditional community institutions (both theorized to decline with population growth) and the degree of interpersonal communication concerning HIV/AIDS--should also be factored into research. This study uses data from the 2003 Zambia Sexual Behaviour Survey and other surveys to conduct multilevel analyses to assess the influence of each of these various characteristics on condom use in Zambia. The results show that condom use increases with interpersonal communication concerning HIV/ AIDS, community infrastructural development, and access to condoms, and decreases with population growth rate and density. The findings suggest that condom-promotion efforts should be attentive to community-level social norms, population trends, and informal social relationships and interpersonal communication. [ABSTRACT FROM AUTHOR]

Fertility preferences are revised in the light of changing life and reproductive circumstances. Over time, an individual's fertility preferences may fluctuate along a continuum. In this study, we describe typical patterns of change (or stability) in individual fertility preferences over a period of five years using a prospective panel study of women of reproductive age in six communities in southern Ghana. We investigate whether patterns of change are consistent with women's reproductive life circumstances by first comparing responses between successive interviews and then over multiple interviews using latent class analysis. We find that approximately 20 percent of the sample changed their fertility preference from one interview to the next. Women who had attained or exceeded their ideal family size show considerable stability in their desire to stop childbearing over multiple interviews. This desire does not waver even when they experience unwanted pregnancies. The attainment of ideal family size appears to be an important correlate of preference stability. [ABSTRACT FROM AUTHOR]

This study examines the effects of rural–urban return migration on women's family planning and reproductive health attitudes and behavior in the sending areas of rural China. Based on data from a survey of rural women aged 16–40 in Sichuan and Anhui Provinces in 2000, our study finds that migrant women returning from cities to the countryside, especially those who have been living in a large city, are more likely than nonmigrant women to adopt positive family planning and reproductive health attitudes and behavior in their rural communities of origin. We find, moreover, that living in a rural community where the prevalence of such return migrant women is higher is positively associated with new fertility and gender attitudes and with knowledge of self-controllable contraceptives. The findings of significant rural-urban return-migration effects have important policy implications for shaping family planning and reproductive health attitudes and behaviors in rural China. [ABSTRACT FROM AUTHOR]

Short birth intervals can have adverse consequences for maternal and infant outcomes. Optimal birth spacing is often presumed to be achieved through the practice of family planning and use of contraceptives, yet most of the available research does not address explicitly the contribution of contraceptive-method use to birth spacing or maternal and infant survival. We conducted a systematic literature review to assess the body of evidence linking contraceptive use to birth-interval length. Fourteen studies published in English between 1980 and 2008 met our eligibility criteria for inclusion. The findings from these studies are mixed but suggest that the use of contraceptives is protective against short birth intervals. Although results are favorable, many of the studies and methodologies employed are dated. More current research is needed to determine the impact of contraceptive-method use on birth-interval length in order to inform the promotion of family planning for reducing maternal and infant morbidity and mortality through birth spacing. [ABSTRACT FROM AUTHOR]

Several charts depicting the results of the Demographic and Health Survey conducted in Namibia for the year 2006-2007 which include trends of fertility, methods use for birth control, and the assistance during delivery are presented.

The last comprehensive literature review to examine the effectiveness of family planning (FP) services in delivering STI and HIV prevention and care was published in 2000. This review updates that report by examining evidence of the impact of integrating any component of STI or HIV prevention, care, and treatment into a family planning setting in developing countries. Forty-four reports were identified from a comprehensive search of published databases and “grey literature.” The weight of evidence demonstrates that integrated services can have a positive impact on client satisfaction, improve access to component services, and reduce clinic-based HIV-related stigma, and that they are cost-effective. Evidence of FP services reaching men and adolescents and of their impact on health outcomes is inconclusive. Several studies found that providers frequently miss opportunities to integrate care and that the capacity to maintain the quality of care is also influenced by many programmatic challenges. The range of experiences indicates that managers need to determine appropriate health-care service-delivery models based on a consideration of epidemiological, structural, and health-systems factors. [ABSTRACT FROM AUTHOR]

Egypt and Tunisia began their fertility transition at almost identical fertility levels and at roughly the same time period, yet the difference in the pace of decline has been such that the total fertility rate (TFR) in Tunisia reached replacement level by the year 2001, whereas the TFR in Egypt remains above three live births per woman. This article draws on the secondary literature and on several nationally representative surveys from the two countries between 1978 and 2005 to provide empirical evidence of the difference in the pace of fertility decline and to analyze the determinants of the differential. Findings include (a) variation across the two countries in the consistency of fertility decline among the segments of the population leading the transition; (b) that the success of each country's family planning program was influenced by the role of political leaders and the extent of the program's integration within socioeconomic development objectives; (c) that the impact of contraception on TFR decline became an important factor in the mid-1980s; and (d) that the greatest determinant of the discrepancy in the pace of fertility decline is the disparity in age at marriage, which rose more significantly in Tunisia than in Egypt. The latter finding indicates that reaching replacement fertility in Egypt hinges primarily on further declines in marital fertility, resulting from reduction of wanted fertility and from an expansion of family planning program coverage and improved efficiency of service delivery and use. [ABSTRACT FROM AUTHOR]

Several charts depicting the results of the Demographic and Health Survey conducted in Pakistan for the year 2006-2007 which include fertility, contraception, and the marital status are presented.

Widely used dichotomous categorical measures of pregnancy intentions do not represent well the complexity of factors involved in women's intentions. We used a variety of exploratory statistical methods to examine measures of pregnancy intention in the 2002 National Survey of Family Growth (N = 3,032 pregnancies). Factor analyses identified two key dimensions of pregnancy intentions (desire and mistiming) and two smaller nondimensional categories (overdue and don't care). Desire included both affective and cognitive variables, as well as partner-specific factors. Similar pregnancy-intention dimensions were found for adolescent and adult women, across socioeconomic status, and among racial and ethnic groups. Both desire and mistiming were highly predictive of the decision to abort or continue the pregnancy. These analyses strongly support prior demographic thinking about the importance of both the timing of pregnancy and wanting a baby, but suggest that multidimensional rather than simple categorical measures of pregnancy intentions should be used. [ABSTRACT FROM AUTHOR]

In this article the author discusses the need of urgent family planning (FP) programs in Sub-Saharan Africa. He explains the need of family planning programs before meeting the region's goal for health, equity, poverty-alleviation, and economic development. He further discusses various topics related to FP including trends and status of family planning, unmet need for modern contraception, and fertility and population growth.

This study draws upon data from the 2004 Slow Fertility Transition survey, a follow-up to the 2003 Egypt Interim Demographic and Health Survey, to investigate obstacles to achieving replacement fertility. To account for the likelihood of embracing the two-child ideal, the analysis adopts a framework with the acronym APA: Acceptance of the two-child ideal, Preference for that ideal, and Achievement of that preference. The framework posits a hierarchy among the three and hypothesizes that each depends on a set of factors, including gender stratification, economic expectations, perception of the costs and benefits of having children, and the costs of fertility regulation. The results indicate that son preference and the perceived low cost of childrearing are major obstacles to the acceptance of the two-child family. Son preference, other discriminatory gender attitudes, optimistic economic expectations, and fear of contraceptive side effects are associated with a low preference for and ambivalence about having only two children. Given a decisive preference, lower socioeconomic status and strong son preference are the major obstacles to the achievement of the two-child ideal. [ABSTRACT FROM AUTHOR]

This study assesses the effects of a communication campaign designed to encourage young people in northern Nigeria to use modern family planning methods to avoid unwanted pregnancies. The analyses are based on a sample of 819 sexually experienced women. Using multivariate probit regression, we attempt to correct for possible endogeneity among campaign exposure, contraceptive ideation, and contraceptive use. Our analysis reveals that the direct effect of campaign exposure on the probability of contraceptive use is only marginally significant, but the effect of exposure on contraceptive ideation is robust, as is the effect of contraceptive ideation on contraceptive use. The findings demonstrate not only the success of the program but also the relevance of incorporating ideation into analytic models assessing the effects of communication campaigns. [ABSTRACT FROM AUTHOR]

The article presents several charts demonstrating the results of a demographic and health survey held in Zimbabwe from 2005 to 2006.

Research on how religion shapes contraceptive practices and fertility has paid insufficient attention to how people interpret religious teachings. This study draws on ethnographic fieldwork in Degollado, Mexico, to describe generational and social-contextual differences in how women interpret and use religious doctrine to achieve their fertility desires without jeopardizing their standing as devout Catholics. Contrasting the family planning beliefs and practices of young Mexican women with those of older women (many of whom are the younger women's parents and in-laws), in a rural town in which the religious regulation of everyday life is pervasive, reveals how a common set of religious teachings and principles can be used to guide two different generational strategies for fertility regulation. The ethnographic data presented here highlight the creativity with which people use religious frameworks to justify their behavior. Research exploring how religion--and culture more broadly--influences fertility and contraceptive use should give greater attention to the dynamic interplay between cultural beliefs and institutions, social context, and interpretive agency. (STUDIES [ABSTRACT FROM AUTHOR]

The article presents results from the Dominican Republic Demographic and Health Survey 2002. The study was directed by the Centro de Estudios Sociales y Demográficos (CESDEM) and assisted by Measure DHS+/ORC Macro. Various statistics on fertility, contraception, marital status and child delivery are presented.

The article discusses the results of the Egypt Demographic and Health Survey 2005. The research was conducted by the Egypt Ministry of Health and Population in cooperation with the National Population Council. Various statistics on fertility, contraception, marital status and child delivery are presented.

The article presents the results of demographic and health survey of Tanzania for 2004-2005. It was conducted by the National Bureau of Statistics of the United Republic of Tanzania and United States Agency for International Development. The subjects of the survey include 9,735 households with complete interviews of 10, 329 women aged 15-49 and 2,635 men of the same ages. It focuses on the rate of fertility, methods used by women in contraception, percentage distribution of married women who applied contraceptives, and the highest educational level attained by the surveyed women. Summary of results is expressed in charts and tables.

This study examines the direction and result of efforts of nongovernmental organizations (NGOs) in the area of reproductive and sexual health in Uzbekistan. It focuses specifically on the institutional, structural, epidemiological, and cultural forces responsible for the exclusion of sexual health issues from reproductive health campaigns in the most populous Central Asian country. In Uzbekistan, as in other countries of the region, significant international support was given to NGOs providing reproductive health services in the mid-to-late-1990s, well into the early period of the HIV/AIDS pandemic and after the 1994 mandate of the International Conference on Population and Development for the inclusion of sexual health as a key reproductive health component. Examining the exclusion of sexual health issues from reproductive health campaigns in Uzbekistan highlights problems relating to time lags in program and evaluative development and the difficulties NGOs experienced in balancing donor-state agendas with recipient-state priorities. Findings question standard assumptions regarding the advantageous structural aspects of NGOs, in terms of flexibility, responsive agenda generation, and state independence. [ABSTRACT FROM AUTHOR]