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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]

Coale (1973) pointed out that a first step in the transition to modern contraceptive use involves making calculated choices with respect to fertility and use of contraception. As women become aware of the fertility choices, they are likely to actively seek information and become engaged in reproductive decision making. Research studies on the role of social network on contraceptive decision making in Zambia are few and far. The objective of this study is to examine women's strategies and approaches to fertility decision making in Zambia. The sample is gathered from two poor income neighborhoods in Kitwe, Zambia. The sample consists of women from 163 households. Latent class analysis provides a useful technique for identifying the presence of distinct strategies with respect to birth control. Though several heterogeneous categories with respect to various reproductive strategies were expected, only two categories were identified. The first category (latent class) is composed of women who engage in spousal communication with respect to fertility, acquire information though seeking and receiving advices from close social relations on reproductive issues, and are aware of the high cost of raising children. Implications of our finding for family planning programs are discussed. [ABSTRACT FROM AUTHOR]

Objectives To analyse the acceptability and patterns of use of the levonorgestrel releasing-intrauterine system (LNG-IUS) and the etonogestrel releasing-subdermal implant (ENG implant) among young European women. Methods A total of 454 women aged 20-35 years opting to switch their method of contraception from oral contraception to the LNG-IUS or ENG implant, were recruited in an observational study in four different European countries (France, Ireland, Slovakia and the United Kingdom). The present paper reports the interim results of the study at 12 months of observation. Results Data from 311 subjects (211 using the LNG-IUS and 100 using the ENG implant), with at least one follow-up visit after insertion, were analysed. The cumulative continuation rates at 12 months for the LNG-IUS and ENG implant were 93% and 86%, respectively. Most women were satisfied with their method of contraception after one year of follow-up (80% in the LNG-IUS group and 66% in the ENG implant group). Conclusions Both the LNG-IUS and the ENG implant are highly acceptable contraceptive options among women with previous experience of oral contraceptive use. The highest continuation and satisfaction rates were observed with the LNG-IUS. [ABSTRACT FROM AUTHOR]

This study analyzes longitudinal data from couples in rural Nepal to investigate the influence of spousal communication about family planning on their subsequent contraceptive use. The study expands current understanding of the communication-contraception link by (a) exploiting monthly panel data to conduct an event history analysis, (b) incorporating both wives' and husbands' perceptions of communication, and (c) distinguishing effects of spousal communication on the use of four contraceptive methods. The findings provide new evidence of a strong positive impact of spousal communication on contraceptive use, even when controlling for confounding variables. Wives' reports of communication are substantial explanatory factors in couples' initiation of all contraceptive methods examined. Husbands' reports of communication predict couples'subsequent use of male-controlled methods. This analysis advances our understanding of how marital dynamics--as well as husbands' perceptions of these dynamics--influence fertility behavior, and should encourage policies to promote greater integration of men into family planning programs. [ABSTRACT FROM AUTHOR]

It has been widely documented in patrilocal and strongly patrilineal settings in India that the presence and influence of mothers-in-law in the household may affect fertility decisions made by young couples. However, not much is known about how intra-family relationships per se influence choice of contraceptive method and timing of use. To understand patterns of family planning decision-making, we carried out short, open-ended interviews in rural Madhya Pradesh in 2005 with 60 mothers-in-law, 60 sons and 60 daughters-in-law from the same families. Mothers-in-law were found to have an important influence on family decisions pertaining to activities within the household. They were also likely to influence the number of sons their daughters-in-law had and the timing of their daughters-in-law being sterilised, but they did not seem to have the same authority or influence with regard to decisions on the use of reversible contraceptive methods, which were mainly being made by young couples themselves. The findings show the flexibility and transformability of intra-family interactions, even within a hierarchically-ordered kinship system that is often considered an obstacle to improving reproductive health and gender equity. Given the right information, and availability of and access to reversible methods, young couples in rural Madhya Pradesh are increasingly making contraceptive choices for themselves. Dans les environnements patrilocaux et fortement patrilinéaires de l'Inde, le fait que la présence et l'influence des belles-mères dans le ménage affectent les décisions des jeunes couples sur la fécondité a été largement documenté. Néanmoins, on connaît mal la manière dont les rapports au sein de la famille influencent en eux-mêmes le choix de la méthode contraceptive et le moment de son utilisation. Pour comprendre les modalités de décision en matière de planification familiale, nous avons mené de brefs entretiens ouverts dans le Madhya Pradesh rural avec 60 belles-mères, 60 fils et 60 brus des mêmes familles. Nous avons constaté que les belles-mères exerçaient une forte influence sur les décisions familiales concernant les activités dans le ménage. Elles tendaient aussi à influer sur le nombre de fils qu'avaient leurs brus et le moment où celles-ci étaient stérilisées, mais elles ne semblaient pas avoir la même autorité ou influence sur le choix des méthodes contraceptives réversibles, qui dépendait principalement des jeunes couples eux-mêmes. Ces conclusions montrent la souplesse et la capacité de transformation des interactions dans la famille, même dans un système de parenté ordonné hiérarchiquement qui est souvent considéré comme un obstacle à l'amélioration de la santé génésique et de l'équité. Avec des informations exactes, la disponibilité de mesures réversibles et la possibilité d'y avoir accès, les jeunes couples du Madhya Pradesh rural font de plus en plus par eux-mêmes leurs choix contraceptifs. En India se ha documentado ampliamente en ámbitos patrilocales y muy patrilineales que la presencia e influencia de suegras en el hogar podría afectar las decisiones de parejas jóvenes en cuanto a la fertilidad. Sin embargo, se sabe poco acerca de cómo las relaciones intrafamiliares en sí influyen en la elección del método anticonceptivo y en el momento en que se empieza a utilizar. Para entender los patrones de la toma de decisiones sobre la planificación familiar, en 2005 realizamos entrevistas abiertas cortas, en las zonas rurales de Madhya Pradesh, con 60 suegras, 60 hijos y 60 nueras de las mismas familias. Se encontró que las suegras tienen una importante influencia en las decisiones de la familia respecto a las actividades del hogar. Además, era probable que influyeran en el número de hijos que tenían sus nueras y en el momento en que sus nueras eran esterilizadas, pero aparentemente no tenían la misma autoridad o influencia en cuanto a decisiones sobre el uso de métodos anticonceptivos reversibles, las cuales eran tomadas principalmente por parejas jóvenes. Los hallazgos muestran la flexibilidad y transformabilidad de las interacciones intrafamiliares, incluso en un sistema de parentesco de orden jerárquico que a menudo es visto como un obstáculo para mejorar la salud reproductiva y la equidad de género. Con la información correcta y la disponibilidad y accesibilidad de métodos reversibles, las parejas jóvenes en las zonas rurales de Madhya Pradesh cada vez más están tomando decisiones anticonceptivas por sí mismas. [ABSTRACT FROM AUTHOR]

Objectives. We examined correlates of condom use among a national random probability sample of sexually experienced young adults aged 15 to 24 years (n = 7686) in South Africa. Methods. Using data from the Reproductive Health and HIV Research Unit National Youth Survey, we conducted gender-stratified bivariate and multivariate logistic regression analyses to determine predictors of whether respondents had used a condom during their most recent sexual intercourse. Results. Condom use at sexual debut and talking with one's first sexual partner about condoms were the most significant predictors of condom use at most recent intercourse. Other significant predictors included high condom use self-efficacy, optimism about the future, and reported behavior change attributable to HIV/AIDS. Young adults who were married or had been involved in a relationship for 6 months or more were significantly less likely to have used a condom during their most recent sexual intercourse. Conclusions. Our findings point to the importance of exposing youths to sexuality education before their sexual debut as well as voluntary counseling and testing and programming that supports young adults, particularly young women, in making informed decisions about sexual intercourse and condoms. (Am J Public Health. 2007;97:1241-1248.) [ABSTRACT FROM AUTHOR]

This study uses data from the 2004 Malawi Demographic and Health Survey to assess the reach of selected radio programs about family planning and health in Malawi and their effect on condom use and discussion of family planning. The results show that such radio programs in Malawi reach a broad audience: eight of the 12 programs were heard by at least half of the respondents, although women were less effectively reached than men. For both women and men, the radio programs were found to have a significant impact on family planning discussion with one's partner. The programs' effect on condom use was limited, however. A positive association was found with ever use of condoms, but no association was found with condom use at last intercourse. This limited impact suggests that such radio communication campaigns need to be informed by research identifying the specific constraints to current condom use in Malawi. [ABSTRACT FROM AUTHOR]

Calls for increased inclusion of men in matters of reproductive health emphasize the need for research into vasectomy acceptability and decision making. Vasectomy is a safe, simple and effective method of contraception, but is underused worldwide. METHODS: Focus group discussions and in-depth interviews were conducted with potential and actual sterilization clients and their partners in the Kigoma Region of Tanzania. Content analysis was used to search for emergent themes related to vasectomy decision making. RESULTS: Six themes emerged as overarching factors contributing to the vasectomy decision-making process: economics, spousal influence, religion, provider reputation and availability, uncertainty about the future, and poor vasectomy knowledge and understanding. There was substantial communication between partners regarding the vasectomy decision, and wives had a strong influence on the outcome; however, men and women agreed that husbands would resist vasectomy if wives initially raised the topic. Vasectomy acceptance is limited by the scarcity of skilled vasectomy providers and by the fact that men and women hold many of the same misunderstandings about vasectomy, including a fear of decreased sexual performance as a result of the procedure. CONCLUSIONS: Spousal discussions are important in the decision to get a vasectomy, but these discussions should be initiated by the male partner. Programs need to educate men about contraceptive options, including vasectomies. Detailed, culturally relevant knowledge of the barriers and facilitators individuals experience during their decisionmaking process will enable vasectomy promotion programs to more successfully target appropriate populations. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to examine factors associated with the acceptability of coitus interruptus, or withdrawal, as a contraceptive method among a cohort of Latinas. Method: We conducted face-to-face interviews with a cohort of young, urban Latinas in Chicago to assess factors associated with willingness to use withdrawal. Findings: Two hundred seventy-three sexually experienced women aged 13-25 years were included in the analysis. Respondents were predominately Mexican American (83.9%) and born in the United States (69.2%) or Mexico (27.1%). One hundred sixty-two women expressed willingness to use withdrawal, In a multivariable analysis, factors associated with willingness to use withdrawal included belief in its efficacy, having communicated with one's partner about waiting to have sex, and lack of knowledge of oral contraceptives. Conclusion: Beliefs, knowledge, partner variables and contraceptive attitudes were important factors related to the acceptability of withdrawal among a cohort of Latinas. [ABSTRACT FROM AUTHOR]

There is growing evidence that the information women receive about family planning from their social network is influential in their decisions to use a contraceptive method. Less is known, however, regarding the role individuals play in constructing their social network and, thereby, determining the nature of its influence. This study examined the criteria women use to select their family planning discussion partners and the individual-level factors that promote the addition of a contraceptive user to one's discussion network. Sociometric data were collected in November 1997 and February 1999 from all currently married women aged 15 to 49 years in three villages of Dang District in the Mid-Western Region of Nepal (panel N = 281). Preference for women from one's ethnic group and the strategic selection of contraceptive users was observed. Contraceptive use and attitudes toward family planning were both positively associated with the addition of a contraceptive user to one's discussion network, suggesting that women seek contraceptive users to confirm their existing beliefs and behaviors. Understanding the dynamics of social network formation can assist programs to better utilize the behavior change potential of peer networks. [ABSTRACT FROM AUTHOR]

Four pooled Demographic and Health Survey data sets are used to examine the determinants of contraceptive method choice in rural Tanzania for the period from 1991 to 1999. The individual data are linked to facility surveys conducted in the same communities so that the impact of Tanzania's family planning program can be examined. The focus of the study is an examination of the effect on method choice of the three major components of Tanzania's family planning program: logistical support, trained providers, and communications programs. The statistical methods employed correct for the potential endogeneity of family planning message recall. Simulations are used to quantify the impact of the important policy variables. All three components of the program are shown to have had an impact on modern method choice. [ABSTRACT FROM AUTHOR]

The authors draw on (1) the hierarchy-of-effects (HOE) model, (2) the stages-of-change (SOC) model, (3) social learning theory (SLT), and (4) the diffusion of innovations (DOI) to synthesize a staged model through which communication messages have effects on individual behavior change by stimulating (1) involvement with media characters and role modeling of their actions, and (2) interpersonal communication. Data from a field experiment in Tanzania on the effects of an entertainment-education radio soap opera, Twende na Wakati (Let's Go With the Times), on the adoption of family planning, are analyzed in light of a six-staged model of communication effects. It is found that (1) the model provides a useful framework for understanding the effects of an entertainment-education program, and (2) the radio soap opera promoted progress through the stages for family planning adoption in the treatment area in three of the four years of broadcast, and in the comparison area after broadcasts of the radio program began there. [ABSTRACT FROM AUTHOR]

The Catholic Church reaffirmed its traditional opposition to birth regulation in 1968 with the encyclical, Humanae Vitae, a response unexpected by many Church members and outsiders alike. To understand this reaffirmation, the arguments in the birth-control debate are organized according to Burke's triad of motivational orders - nature, reason, and authority. This analysis suggests that, whereas the arguments in Humanae Vitae were based on authority, this stance offered a flexibility not possible by grounding arguments in either nature or in reason. [ABSTRACT FROM AUTHOR]

Previous research has demonstrated the predominance of personal (rather than mass media) communications in recruitment of people to adopt contraception. In this analysis, we focus on the activity of contraceptors in recruiting their peers to contraception. Which users are more likely to influence peers to adopt? The effects of social, demographic, information, attitude climate, and conversation predictors on influence are estimated by Multiple Classification Analysis. An especially striking finding is that contraceptors who have high contact with family planning communications in mass media are more likely to influence peers. But mass media are seldom mentioned by contraceptors as important sources of influence in their own recruitment. These results suggest that mass media messages have an indirect effect on adoption by nourishing interpersonal communications. The data also show that social and demographic statuses are unrelated to influence on peers. This does not concur with the classic diffusion-ofinnovations paradigm. We suggest that the results reflect two simultaneous processes involved in contraceptive adoption: adjustment and innovation. The data come from a national survey of West Malaysian women enrolled in the national family planning program. [ABSTRACT FROM AUTHOR]

The article discusses the impact of communication on the decision of women to try and use injectable contraceptives. Communication programs relate to potential users the advantages, side effects and health concerns related to injectables. Interactive media such as telephone hotlines can be helpful in persuading women hesitant about injectables. A community meeting is one interactive way to disseminate information regarding injectables and other family planning methods.

This article presents an editorial on sexual and reproductive rights. The author writes that the topic has been hijacked by people who claim to support life, but the results of their efforts has allowed for high mortality rates from unsafe abortions and other obstetric complications. Children under five are also vulnerable because of the policies influenced by "right-to-life" groups. The deaths and morbidity could be prevented by proper education and access to professional health care providers. The author exhorts people in various professions to learn about the responsibilities they have towards protecting these rights.

This article discusses a U.S. campaign aimed at educating women on emergency contraception methods. This campaign, developed by the American College of Obstetricians and Gynecologists (ACOG), advocates that women obtain a prescription for emergency contraceptive measures in advance from their physicians as a precautionary measure. ACOG views emergency contraception as vital to family planning and a potentially crucial factor in mitigating abortion and unplanned pregnancy rates in the U.S. The plan was also developed to combat various barriers that make it difficult for women to obtain these medications.

Focuses on the participation of men in reproductive health and family planning. Perspectives on men's participation in family planning; Reason there is a changing perspective on the role of men in reproductive health; Gender, communication and decision-making; Program lessons.

Background: On January 1, 2000, Texas began enforcement of a law that requires physicians to notify a parent of a minor child seeking an abortion at least 48 hours before the procedure. Methods: We assessed changes in the rates in Texas of abortions and births (events per 1000 age-specific population) before enforcement of the parental notification law (1998 to 1999) and after enforcement (2000 to 2002). We did this by comparing the rate changes among minors 15 to 17 years of age at the time of conception (i.e., those who were subject to the law) with those of teens 18 years of age at the time of conception (i.e., those who were not subject to the law). Results: After enforcement of the law, abortion rates fell by 11 percent among 15-year-olds (rate ratio, 0.89; 95 percent confidence interval, 0.83 to 0.94), 20 percent among 16-year-olds (rate ratio, 0.80; 95 percent confidence interval, 0.76 to 0.85), and 16 percent among 17-year-olds (rate ratio 0.84; 95 percent confidence interval, 0.80 to 0.87), relative to the rates among 18-year-olds. Among the subgroup of minors 17.50 to 17.74 years of age at the time of conception (who would have been subject to the parental notification law in early pregnancy), birth rates rose by 4 percent relative to those of teens 18.00 to 18.24 years of age (rate ratio, 1.04; 95 percent confidence interval, 1.00 to 1.08). The adjusted odds ratio for having an abortion after 12 weeks' gestation among minors 17.50 to 17.74 years of age as compared with 18-year-olds was 1.34 (95 percent confidence interval, 1.10 to 1.62). Conclusions: The Texas parental notification law was associated with a decline in abortion rates among minors from 15 to 17 years of age. It was also associated with increased birth rates and rates of abortion during the second trimester among a subgroup of minors who were 17.50 to 17.74 years of age at the time of conception. N Engl J Med 2006;354:1031-8. [ABSTRACT FROM AUTHOR]

The article examines the limitations of the reproduction research on family planning approach to population dynamics. However, the lines that traditionally separate department from department and discipline from discipline still operate as if demographic problems were somehow unrelated to the biological sciences. Nevertheless, in terms of the sophisticated knowledge on which an effective assault can be based. Biologists and demographers, apparently, have yet to recognize the points at which their disciplines intersect.