Sample records for community-based family planning

  1. Review of performance-based incentives in community-based family planning programmes (United States)

    Bellows, Nicole M; Askew, Ian; Bellows, Benjamin


    Background One strategy for improving family planning (FP) uptake at the community level is the use of performance-based incentives (PBIs), which offer community distributors financial incentives to recruit more users of FP. This article examines the use of PBIs in community-based FP programmes via a literature search of the peer-reviewed and grey literature conducted in April 2013. Results A total of 28 community-based FP programmes in 21 countries were identified as having used PBIs. The most common approach was a sales commission model where distributors received commission for FP products sold, while a referral payment model for long-term methods was also used extensively. Six evaluations were identified that specifically examined the impact of the PBI in community-based FP programmes. Overall, the results of the evaluations are mixed and more research is needed; however, the findings suggest that easy-to-understand PBIs can be successful in increasing the use of FP at the community level. Conclusion For future use of PBIs in community-based FP programmes it is important to consider the ethics of incentivising FP and ensuring that PBIs are non-coercive and choice-enhancing. PMID:25037703

  2. Rakhaine community embraces family planning. (United States)

    Chowdhury, S M


    The Rakhaines are a small, tightly knit community of 15,000 people who occupy parts of the coastal and hilly districts of southern Bangladesh. It is a closed community with different ethnic origins and religion from other Bangladeshis. As such, they have been largely unreached by government health and family planning services. In response to the need to bring services to these people, contact was established between the Family Planning Association of Bangladesh (FPAB) and the Rakhaine in 1987 in the interest of improving family health and well-being among the Rakhaine people through the introduction of maternal and child health care and family planning. The Family Planning Services for the Rakhaine Community project of the FPAB began in Cox's Bazar and Harbang in late 1987, and spread gradually over the hilly terrain inhabited by the Rakhaine to now serve 2000 couples. Although family planning was the focal point, the project also incorporated schemes for income generation, maternal and child health care, and sanitation. At baseline, less than 25% of reproductive age couples were using contraception, but this proportion grew to 69% by 1993, higher than the national contraceptive prevalence rate of approximately 40%. Used by 41% of married women of reproductive age, the pill is the most preferred contraceptive method, followed by sterilization among 10% of women. The efforts of fieldworkers were crucial to program success. The author notes that current users have been using contraception on average for just over two years. Moreover, the level of tetanus toxoid immunization rose to 60% of pregnant women, while 75% of children are now immunized against major life-threatening diseases. Some costs are recovered, but not enough to finance the project.

  3. Techniques for overcoming community resistance to family planning programs. (United States)

    Palley, H A


    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.

  4. Integrating Family Planning and HIV Services at the Community ...

    African Journals Online (AJOL)


    Little is known on integrating HIV and family planning (FP) services in community settings. Using a cluster randomized ..... process evaluation data from several studies on facility-based ... PEPFAR blueprint: Creating an AIDS-free generation.

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

    Akaba, Godwin; Ketare, Nathaniel; Tile, Wilfred


    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.

  6. Family planning use and associated factors among pastoralist community of afar region, eastern Ethiopia. (United States)

    Alemayehu, Mussie; Lemma, Hailemariam; Abrha, Kidan; Adama, Yohannes; Fisseha, Girmatsion; Yebyo, Henock; Gebeye, Ejigu; Negash, Kassahun; Yousuf, Jemal; Fantu, Tigist; Gebregzabher, Tesfay; Medhanyie, Araya Abrha


    Ethiopia is the second most populous country in Africa with a total fertility rate (TFR) of 4.8 children per a woman and contraceptive prevalence rate (CPR) of 29 %. The overall prevalence of modern family planning in a pastoralist community, like Afar region, is low (9.1 %). This study aimed to assess family planning utilization and associated factors among married women of Afar region, Eastern Ethiopia. A community-based cross-sectional study was conducted from January 10-28, 2013 among 602 women. Multistage sampling technique was used to select the study participants. Descriptive and multiple variable logistic regression analyses were done to isolate independent predictors on utilization of family planning using SPSS 20. The overall prevalence of family planning utilization in Afar region was 8.5 % (6.2-10.7). Majority of the women (92.2 %) had used injectable. The most common reasons mentioned in the non-use of family planning methods were religion-related (85.3 %), desire to have more children (75.3 %), and husband's objection (70.1 %). Women who had a positive attitude towards family planning utilization (AOR = 4.7, 95 % CI: 2.1, 10.3), owning radio (AOR = 1.8, 95 % CI: 1.02, 4.18), and literate (AOR = 4.4, 95 % CI: 1.80, 11.08) were more likely to use family planning methods as compared to their counterparts. The increase of monthly income was also associated with the likelihood of family planning methods utilization. The odds of using family planning methods were higher among those with monthly income of $27-$55.5 (AOR = 2. 0, 95 % CI: 1.9, 4.7) and > $55 (AOR = 4. 6, 95 % CI: 1.23-17.19) as compared to women with the lowest category of monthly income ($27 and less). The low coverage of family planning in the region could be due to the influence of husband, religious and clan leader. Attitude of women towards family planning methods, possession of radio, monthly income, and educational status could influence family

  7. Community based distribution agents’ approach to provision of family planning information and services in five Nigerian States: A mirage or a reality?

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    Mojisola Fayemi


    Full Text Available Background: Reducing maternal mortality in Nigeria has received continuous attention both nationally and internationally. Objectives: This article highlights the outcome of an intervention which sought to address maternal mortality reduction through increasing contraceptive uptake in 10 rural local government areas (LGAsin five Nigerian states. Method: The community based distribution (CBD approach was used in the implementation of a three year intervention that targeted 10 LGAs. Two hundred and fifty community members were trained as community based distribution agents (CBDA to provide information on reproductive health, provide non-prescriptive family planning (FP commodities, treat minor aliment and make referrals to primary health centres within the communities. Results: Final evaluation revealed an increase in the proportion of community members who had utilised FP commodities at all, from 28% at baseline to 49%, and an increase in the proportion of current contraceptive users from 16% at baseline to 37%. An average of 50% increase in clientele patronage was also observed in the 10 LGAs’ primary health care centres. Most (96% of the interviewed CBDA agents reported that a drug-revolving system was in place to ensure that drugs and commodities were available. On-the-spot assessment of the service forms revealed that 86% of them had their activities regularly recorded in their worksheets. Some of the challenges faced by CBDA were discrimination and misconception of community members about family planning (38%, inadequate financial support (14%,and transportation problems (8%. Conclusion: This study has demonstrated that the CBD approach played a critical role in enhancing access to Reproductive Health and Family Planning information and services in the project communities.

  8. CFSC (Community and Family Study Center) study finds birth rates falling everywhere - family planning (family planning) is a factor. (United States)


    The findings of the Community and Family Study Center study, based on estimated crude birthrates and total fertility rates for 1968 and 1975, indicate that there has been a significant reduction in fertility levels of both developed and developing countries. Despite regional variations, the estimates show an average proportional decline of 8.5% in total fertility rates between 1968 and 1975. Of the 148 nations studied, 113 were in developing regions and 35 in the developed regions. Information on important social and economic development factors, such as life expectancy, literacy, percent of labor force in agriculture, per capita income, and family planning program strength were gathered for each country. Analyses of these data are reported in "The Public Interest" (to be published) "Population Reference Bulletin," October 1978, and a paper presented at the 1978 Population Association of America Meetings in Atlanta, Georgia. The recent change in fertility affected 81% of the world's population, primarily the peoples of Asia, Latin America, and North America. The total fertility rate in the world in 1968 was 4635 and declined to 4068 in 1975. More substantial declines occurred in Asia and Latin America, where the number of fewer births 1000 women would bear under a given fertility schedule declined by 845 births and 617 births, respectively. As more research is conducted to investigate the underlying causes of this decline, it is likely to confirm the important role that family planning programs have had in developing nations. Although major improvements in the socioeconomic well-being of the developing areas continue as an essential goal, the need to maintain the organized provision of family planning services should not be understated.

  9. Community Education for Family Planning in the U.S.: A Systematic Review. (United States)

    Carter, Marion W; Tregear, Michelle L; Moskosky, Susan B


    Community education may involve activities that seek to raise awareness and promote behavior change, using mass media, social media, and other media or interpersonal methods in community settings. This systematic review evaluated the evidence of the effects of community education on select short- and medium-term family planning outcomes. Using an analytic approach drawn from the U.S. Preventive Services Task Force, multiple databases were searched for articles published from January 1985 through February 2011 describing studies of community education related to family planning in the U.S. Included articles were reviewed and assessed for potential bias using a standardized process in 2011. An updated, targeted review for the 2011-2014 period was conducted in early 2015. Seventeen papers were identified. Most (nine) related to mass media interventions; three involved targeted print media, two involved text messaging or e-mail, two described outcome workers conducting community education, and one involved community theater. Study designs, strength of evidence, and levels of possible bias varied widely. Twelve of 15 studies that addressed outcomes such as increased awareness found positive associations with those outcomes, with six also reporting null findings. Seven of eight studies that addressed use of services reported positive associations, with two also reporting null findings. The targeted, additional review identified two other studies. Evidence related to community education for family planning purposes is limited and highly variable. As goals of community education are usually limited to shorter-term outcomes, the evidence suggests that a range of approaches may be effective. Published by Elsevier Inc.

  10. Determinants of family planning use among married women in bale eco-region, Southeast Ethiopia: a community based study. (United States)

    Gonie, Alemayehu; Wudneh, Alemayehu; Nigatu, Dejene; Dendir, Zelalem


    Family planning is the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. Providing family planning could prevent maternal deaths by allowing women to delay motherhood, space births, avoid unintended pregnancies and abortions, and stop childbearing when they reach their desired family size. Despite the fact that family planning is advantageous for maternal and newborn health and the services and commodities are free of charge, the reason of not using modern family planning methods is unclear in Bale Eco-Region. Therefore, this study assessed the contraceptive prevalence rate and its determinants among women in Bale Eco-Region, Ethiopia. A community-based cross-sectional study design (both quantitative and qualitative methods) was conducted from December 2016 to February 2017. Five hundred sixty-seven women were successfully interviewed using structured and pre-tested questionnaire. A multistage sampling technique was employed. Data were entered into Epi-data version 3.1 and exported to SPSS version 21. Logistic regression analyses were done and a significant association was declared at p-value less than 0.05. All focus group discussions and key informant interviews were recorded and analyzed thematically. The overall contraceptive prevalence rate was 41.5%. Injectable (48.1%), implants (22.6%) and pills (20.0%) were the most contraceptive methods utilized by study participants. Spousal (husband's) opposition (38.8%), religious beliefs (17.7%), concern and fear of side effects (14.8%), and distance of family planning service (5.9%) were the reasons for not using contraceptive methods. Having more than seven deliveries (AOR = 2.98, CI = 1.91-6.10, P = 0.000) and having birth interval less than 24 months between the last two children (AOR = 3.8, CI = 13.41-21.61, P = 0.003) were significantly associated with utilization of contraceptive methods. Low

  11. Family planning practices of rural community dwellers in cross River State, Nigeria. (United States)

    Etokidem, A J; Ndifon, W; Etowa, J; Asuquo, E F


    Nigeria is the most populous nation in Africa and the seventh most populous in the world. Despite a high fertility rate of 5.5 per woman and a high population growth rate of 3.2%, Nigeria's contraceptive prevalence is 15%, which is one of the lowest in the world. The objective of this study was to determine the knowledge of family planning and family planning preferences and practices of rural community women in Cross River State of Nigeria. This was a cross-sectional study involving 291 rural women. Convenience sampling method was used. The women were assembled in a hall and a semi-structured questionnaire was administered to every consenting woman until the sample size was attained. Data obtained from the study were analyzed using the Statistical Package for the Social Sciences version 20 and presented in tables as frequencies and percentages as well as figures. Association between categorical variables was explored using chi-square test. Binary logistic regression was also performed to determine predictors of use of at least one family planning method at some point in time. Fifty (17.2%) respondents were using at least one family planning method. One hundred and ninety-eight (68.3%) respondents had used at least one family planning method at some point in time. Reasons given for not using any family planning method included "Family planning is against my religious beliefs" (56%); "it is against our culture" (43.8%); "I need more children" (64.9%); "my partner would not agree" (35.3%); "family planning does not work" (42.9%); "it reduces sexual enjoyment" (76%); and "it promotes unfaithfulness/infidelity" (59%). Binary logistic regression conducted to predict the use of at least one family planning method at some point in time using some independent variables showed that who makes the decision regarding family planning use was the strongest predictor of family planning use (OR = 0.567; 95% CI = 0.391-0.821). This suggests that family planning uptake is more

  12. Closing the gap: the potential of Christian Health Associations in expanding access to family planning

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    Lauren VanEnk


    Full Text Available Recognizing the health impact of timing and spacing pregnancies, the Sustainable Development Goals call for increased access to family planning globally. While faith-based organizations in Africa provide a significant proportion of health services, family planning service delivery has been limited. This evaluation seeks to assess the effectiveness of implementing a systems approach in strengthening the capacity of Christian Health Associations to provide family planning and increase uptake in their communities.From January 2014 to September 2015, the capacity of three Christian Health Associations in East Africa—Caritas Rwanda, Uganda Catholic Medical Bureau, and Uganda Protestant Medical Bureau—was strengthened with the aims of improving access to women with unmet need and harmonizing faith-based service delivery contributions with their national family planning programs. The key components of this systems approach to family planning included training, supervision, commodity availability, family planning promotion, data collection, and creating a supportive environment. Community-based provision of family planning, including fertility awareness methods, was introduced across intervention sites for the first time. Five hundred forty-seven facility- and community-based providers were trained in family planning, and 393,964 people were reached with family planning information. Uptake of family planning grew substantially in Year 1 (12,691 and Year 2 (19,485 across all Christian Health Associations as compared to the baseline year (3,551. Cumulatively, 32,176 clients took up a method during the intervention, and 43 percent of clients received this service at the community level. According to a provider competency checklist, facility- and community-based providers were able to adequately counsel clients on new fertility awareness methods. Integration of Christian Health Associations into the national family planning strategy improved through

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

    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.

  14. Village family planning volunteers in Indonesia: their role in the family planning programme. (United States)

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


    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.

  15. Family planning in contermporary reproductive health and rights ...

    African Journals Online (AJOL)

    Key strategies to promote family planning include domestication of provisions of international conventions on family planning into state laws, and ensuring their implementation; development of community friendly family planning services; establishment of effective family planning commodities logistics management system; ...

  16. Attitudes toward family planning. (United States)

    Gille, H


    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

  17. Family planning practices of rural community dwellers in cross River ...

    African Journals Online (AJOL)

    Results: Fifty (17.2%) respondents were using at least one family planning method. One hundred and ninety-eight (68.3%) respondents had used at least one family planning method at some point in time. Reasons given for not using any family planning method included “Family planning is against my religious beliefs” ...

  18. Assessment of Family Planning Services at Community Pharmacies in San Diego, California

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    Sally Rafie


    Full Text Available Levonorgestrel emergency contraception and other contraceptive methods are available over-the-counter (OTC; however youth continue to face a number of barriers in accessing healthcare services, including lack of knowledge of the method, fear of loss of privacy, difficulties in finding a provider, and cost. A descriptive, nonexperimental, cross-sectional study of a sample of 112 community pharmacies in San Diego, California was conducted between December 2009 and January 2010 to assess community pharmacy practices related to the availability and accessibility of family planning health pharmacy services and products, particularly to youth. A majority (n = 79/112, 70.5% of the pharmacies carried a wide selection of male condoms; however, the other OTC nonhormonal contraceptive products were either not available or available with limited selection. A majority of the pharmacies sold emergency contraception (n = 88/111, 78.6%. Most patient counseling areas consisted of either a public or a semi-private area. A majority of the pharmacy sites did not provide materials or services targeting youth. Significant gaps exist in providing family planning products and services in the majority of community pharmacies in San Diego, California. Education and outreach efforts are needed to promote provision of products and services, particularly to the adolescent population.

  19. An Asset-Based Approach to Tribal Community Energy Planning

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, Rachael A. [Pratt Inst., Brooklyn, NY (United States). City and Regional Planning; Martino, Anthony [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Materials, Devices, and Energy Technologies; Begay, Sandra K. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Materials, Devices, and Energy Technologies


    Community energy planning is a vital component of successful energy resource development and project implementation. Planning can help tribes develop a shared vision and strategies to accomplish their energy goals. This paper explores the benefits of an asset-based approach to tribal community energy planning. While a framework for community energy planning and federal funding already exists, some areas of difficulty in the planning cycle have been identified. This paper focuses on developing a planning framework that offsets those challenges. The asset-based framework described here takes inventory of a tribe’s capital assets, such as: land capital, human capital, financial capital, and political capital. Such an analysis evaluates how being rich in a specific type of capital can offer a tribe unique advantages in implementing their energy vision. Finally, a tribal case study demonstrates the practical application of an asset-based framework.

  20. Family planning costs and benefits. (United States)


    Government sponsored family planning programs have had major success in declining birth rates in Barbados, China, Cuba, Hong Kong, Indonesia, Korea, Mexico, Singapore, Sri Lanka, Taiwan, and Thailand. Non- government programs have had similar success in Brazil and Colombia. These programs have been estimated as preventing over 100 million births in China and 80 million in India. Research indicates that family planning programs can produce a 30-50% drop in fertility. Family planning information and some contraceptives can be best distributed through community organizations. Research also indicates male opposition has been a major factor in wider acceptance of family planning. Surveys indicate that 50% of the woman who want no additional children are not using any birth control. Many governments do not have the resource and money to implement programs. In the developing countries if those who were able to prevent the unwanted births had birth control, the population increases in those countries would have been 1.3% versus 2.2%. In earlier family planning programs foreign assistance paid over 80% of the cost, and national governments 20%; today this is reversed. The World Bank estimates that for major improvements in population growth and women's health, $7 billion will be needed yearly by the year 2000. The countries that have had the similar goals in development of human resources, social services, health, and education. They have attended to the status of women, female employment, and maternal and child health. Estimates are that 1.3 billion couples and individuals will need family planning services by the year 2000, and this will be a formidable task. This key elements of successful family planning programs are community participation, decentralization, and training.

  1. Use of family planning methods in Kassala, Eastern Sudan

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    Mamoun Mona


    Full Text Available Abstract 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.

  2. Some factors affecting acceptance of family planning in Manus. (United States)

    Avue, B; Freeman, P


    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.

  3. [Effect of development of rural commodity economy on family planning]. (United States)

    Chen, X


    The paper discusses the effects of the changes of rural income level on family planning practice based a survey of 200 rural families in a affluent vegetable producing area of suburban Beijing. In 1984, 99.7% of child birth followed the local birth planning, and 99.1% of families with one child received One Child Certificates. The annual per capita income of the 200 families was 1,092 yuan (1 US$ = 3.7 yuan) in 1984 even higher than the community average. The number of children was negatively associated with the per capita income and per capita consumption except families with 4 children, most of whom have grown up. The rural mechanization in the community has greatly increased the need for skills and technology rather than strong laborers. The provision of community welfare programs and the increased living standard changed the value of children and also changed people's perception in favor of gender equality. Among families with 1 or 2 children, most preferred to have girls. And among families with more children, the preferred family size is smaller than the actual size, which shows a tendency towards favoring a small family. Among 1 child families, 58.7% considered 1 boy and 1 girl to be ideal, and 37.7% was happy with the only child. As the community becomes richer, both the community and individual families increased their investment in education. The spending on education per child was over 2 times as high in 1 child families than the families with more children. The educational status of parents is positively associated with the exception of children's future education and current spending on education. The concern of parents over children's education is an important factor in improving the quality of labor force. Women of higher education status are more acceptable to contraception and family planning policy. The relatively high level of education of the community has been conducive to it fertility decline.

  4. Access to emergency hormonal contraception from community pharmacies and family planning clinics (United States)

    Lewington, Gaye; Marshall, Kay


    Aims To evaluate differences in the time taken to access progestogen-only emergency hormonal contraception (EHC) by young women from family planning (FP) or community pharmacy settings. Methods An observational study of 203 women requesting EHC from FP clinics and community pharmacies in South-west Kent Primary Care Trust (PCT) from December 2002 to October 2003. Results Access to EHC from community pharmacy was significantly faster than from FP clinics (16 h vs. 41 h, P < 0.001). Older teenagers tended to seek EHC more quickly and were more likely to have had a contraceptive failure rather than have used no contraception at all. Conclusion The results provide further support for pharmacist involvement in the supply of EHC. PMID:16669854

  5. Engaging the Community Cultural Wealth of Latino Immigrant Families in a Community-Based Program (United States)

    Gil, Elizabeth


    The purpose of this qualitative case study utilizing ethnographic methods was to understand how family members' participation in Digital Home, a community-based technology program in an urban mid-sized Midwestern city, built on and fostered Latino immigrant families' community cultural wealth (Yosso, 2005) in order to increase their abilities to…

  6. Advocacy for International Family Planning: What Terminology Works? (United States)

    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.

  7. Cultivating men's interest in family planning in rural El Salvador. (United States)

    Lundgren, Rebecka I; Gribble, James N; Greene, Margaret E; Emrick, Gail E; de Monroy, Margarita


    A pilot project in rural El Salvador tested the integration of family planning into a water and sanitation program as a strategy for increasing male involvement in family planning decison making and use. The organizations involved posited that integrating family planning into a resource management and community development project would facilitate male involvement by diffusing information, by referring men and women to services, and by expanding method choice to include the new Standard Days Method through networks established around issues men cared about and were already involved in. This article examines data from a community-based household survey to assess the impact of the intervention and finds significant changes in contraceptive knowledge, attitudes, and behavior from baseline to endline. Because the differences between baseline and endline are greater than the differences between participants and nonparticipants at endline, the study demonstrates the power of informal networks for spreading information.

  8. Postpartum family planning: current evidence on successful interventions

    Directory of Open Access Journals (Sweden)

    Blazer C


    Full Text Available Cassandra Blazer, Ndola Prata Bixby Center for Population, Health, and Sustainability, School of Public Health, University of California, Berkeley, CA, USA Abstract: We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations. Keywords: postpartum period, family planning, birth spacing, interventions, systematic review, contraception, less developed countries

  9. Developing a vision and strategic action plan for future community-based residency training. (United States)

    Skelton, Jann B; Owen, James A


    The Community Pharmacy Residency Program (CPRP) Planning Committee convened to develop a vision and a strategic action plan for the advancement of community pharmacy residency training. Aligned with the profession's efforts to achieve provider status and expand access to care, the Future Vision and Action Plan for Community-based Residency Training will provide guidance, direction, and a strategic action plan for community-based residency training to ensure that the future needs of community-based pharmacist practitioners are met. National thought leaders, selected because of their leadership in pharmacy practice, academia, and residency training, served on the planning committee. The committee conducted a series of conference calls and an in-person strategic planning meeting held on January 13-14, 2015. Outcomes from the discussions were supplemented with related information from the literature. Results of a survey of CPRP directors and preceptors also informed the planning process. The vision and strategic action plan for community-based residency training is intended to advance training to meet the emerging needs of patients in communities that are served by the pharmacy profession. The group anticipated the advanced skills required of pharmacists serving as community-based pharmacist practitioners and the likely education, training and competencies required by future residency graduates in order to deliver these services. The vision reflects a transformation of community residency training, from CPRPs to community-based residency training, and embodies the concept that residency training should be primarily focused on training the individual pharmacist practitioner based on the needs of patients served within the community, and not on the physical location where pharmacy services are provided. The development of a vision statement, core values statements, and strategic action plan will provide support, guidance, and direction to the profession of pharmacy to

  10. Planning for Community Based Tourism in a Remote Location

    Directory of Open Access Journals (Sweden)

    Sharon Harwood


    Full Text Available Remote areas are difficult to access, tend to lack critical infrastructure, are highly susceptible to shocks in the marketplace, and are perceived by industry to possess limited development opportunities. Accordingly a community orientated and territorial approach to development planning in a remote area will be more successful than a top down industry based approach [1]. Given the limitations of being remote, the case study community examined in this research manages and sustains a bird watching tourism product within a global market place. This paper examines how a remotely located community in the Arfak Mountains of West Papua overcomes these difficulties and plans for community based tourism (CBT in their locale.

  11. Gender Responsive Community Based Planning and Budgeting ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... Responsive Community Based Planning and Budgeting Tool for Local Governance ... in data collection, and another module that facilitates gender responsive and ... In partnership with UNESCO's Organization for Women in Science for the ...

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

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


    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.

  13. Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities. (United States)

    Lengerich, Eugene J; Kluhsman, Brenda C; Bencivenga, Marcyann; Allen, Regina; Miele, Mary Beth; Farace, Elana


    In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure

  14. Utilisation of family planning techniques among women: an ...

    African Journals Online (AJOL)

    Utilisation of family planning by women will promote sustainable development and general wellbeing of women at the rural community. The study assessed utilization of family planning techniques among women in the rural area of Lagos state. Sixty respondents were randomly selected for the study. Structured interview ...

  15. Prevalence and factors associated with unmet need for family planning among the currently married reproductive age women in Shire-Enda- Slassie, Northern West of Tigray, Ethiopia 2015: a community based cross-sectional study. (United States)

    Gebre, Gelawdiwos; Birhan, Nigussie; Gebreslasie, Kahsay


    Unmet family planning is one of the common causes for low contraceptive prevalence rate in developing countries including Ethiopia. Thus, this study designed to assess the prevalence and associated factors of unmet need in Shire Endaslassie town, Northern west of Tigray, Ethiopia. A community based cross sectional study design was employed. Multistage sampling technique was employed and data were collected using a semi-structured questionnaire by interviewer administered technique. Questionnaires were reviewed and checked for completeness, accuracy and consistency. Reviewed data were entered to Epi info 7 and analyzed by SPSS version 20 statistical software. Variables with P-value of less than 0.2 in bivariate analyses were entered for multivariate analysis and AOR at 95% CI with p-value of less than 0.05 were considered as significant variables. The overall unmet need for family planning in the study area was 109(21.4%). 74(14.5%) for spacing and 35(6.9%) for limiting. Age group of 35-39 and >=40 (AOR= 2.7,95%CI:1.1,6.5), (AOR = 2.65, 95%CI:1.10, 6.40) respectively, decided numbers of desired children more than five (AOR = O.48, 95%CI: 0.28, 0.80), discussions of client with heath care providers (AOR = 6.32, 95%CI: 2.56, 15.58), previous use of modern family planning (AOR = 2.29, 95%CI, 1.20, 4.34) were significantly associated with unmet need for family planning. Unmet need for family planning in the study area was high, so continuous discussion on modern family planning with community health workers and encouraging of women to decide desired numbers of children of less than five in general are better to be strengthened.

  16. Community based study on married couples' family planning knowledge, attitude and practice in rural and urban Gambia. (United States)

    Jammeh, Sulayman S S; Liu, Chieh-Yu; Cheng, Su-Fen; Lee-Hsieh, Jane


    Family planning services have been free of charge and available in all the health facilities in the Gambia since 1975 yet contraceptive prevalence is only 17.5% and even 6% in some areas. Since the last census in 2003, there existed no available data on married couples' contraception status. To explore married couples' family planning knowledge, attitudes, and practices in rural and urban Gambia and to analyze what factors may affect such knowledge, attitudes and practices. Quantitative cross-sectional study design was used. Through convenience sampling, 176 men and 235 women representing a total of 176 couples participated. A structured questionnaire was used for data collection. The mean scores of the married couples family planning knowledge, attitudes, and practices were 19.00 ± 6.11(ranging from 0 to 64), 6.90 ± 3.08 (0 to 14) and 4.69 ± 3.3 (0 to 19) respectively. Urban residents had higher scores on family planning practice than rural residents (pfamily planning knowledge, attitude and practice in Gambia", as well as suggesting broader health intervention programs in health education and promotion.

  17. Family planning education. (United States)

    Hamburg, M V


    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

  18. Healthy Children, Strong Families 2: A randomized controlled trial of a healthy lifestyle intervention for American Indian families designed using community-based approaches. (United States)

    Tomayko, Emily J; Prince, Ronald J; Cronin, Kate A; Parker, Tassy; Kim, Kyungmann; Grant, Vernon M; Sheche, Judith N; Adams, Alexandra K


    Background/Aims Few obesity prevention trials have focused on young children and their families in the home environment, particularly in underserved communities. Healthy Children, Strong Families 2 is a randomized controlled trial of a healthy lifestyle intervention for American Indian children and their families, a group at very high risk of obesity. The study design resulted from our long-standing engagement with American Indian communities, and few collaborations of this type resulting in the development and implementation of a randomized clinical trial have been described. Methods Healthy Children, Strong Families 2 is a lifestyle intervention targeting increased fruit and vegetable intake, decreased sugar intake, increased physical activity, decreased TV/screen time, and two less-studied risk factors: stress and sleep. Families with young children from five American Indian communities nationwide were randomly assigned to a healthy lifestyle intervention ( Wellness Journey) augmented with social support (Facebook and text messaging) or a child safety control group ( Safety Journey) for 1 year. After Year 1, families in the Safety Journey receive the Wellness Journey, and families in the Wellness Journey start the Safety Journey with continued wellness-focused social support based on communities' request that all families receive the intervention. Primary (adult body mass index and child body mass index z-score) and secondary (health behaviors) outcomes are assessed after Year 1 with additional analyses planned after Year 2. Results To date, 450 adult/child dyads have been enrolled (100% target enrollment). Statistical analyses await trial completion in 2017. Lessons learned Conducting a community-partnered randomized controlled trial requires significant formative work, relationship building, and ongoing flexibility. At the communities' request, the study involved minimal exclusion criteria, focused on wellness rather than obesity, and included an active

  19. Do mobile family planning clinics facilitate vasectomy use in Nepal? (United States)

    Padmadas, Sabu S; Amoako Johnson, Fiifi; Leone, Tiziana; Dahal, Govinda P


    Nepal has a distinct topography that makes reproductive health and family planning services difficult to access, particularly in remote mountain and hill regions where over a quarter of modern contraceptive users rely exclusively on vasectomy. A three-level random intercept logistic regression analysis was applied on data from the 2011 Nepal Demographic and Health Survey to investigate the extent of influence of mobile family planning clinics on the odds of a male or a female sterilization, adjusting for relevant characteristics including ecological differences and random effects. The analyses included a sample of 2014 sterilization users, considering responses from currently married women of reproductive ages. The odds of a male sterilization were significantly higher in a mobile clinic than those in a government hospital (odds ratio, 1.65; 95% confidence interval, 1.21-2.25). The effects remained unaltered and statistically significant after adjusting for sociodemographic and clustering effects. Random effects were highly significant, which suggest the extent of heterogeneity in vasectomy use at the community and district levels. The odds of vasectomy use in mobile clinics were significantly higher among couples residing in hill and mountain regions and among those with three or more sons or those with only daughters. Mobile clinics significantly increase the uptake of vasectomy in hard-to-reach areas of Nepal. Reproductive health interventions should consider mobile clinics as an effective strategy to improve access to male-based modern methods and enhance gender equity in family planning. Family planning interventions in hard-to-reach communities could consider mobile clinic as an effective strategy to promote male-based modern methods. Improving access to vasectomy could substantially reduce unmet need for family planning in countries experiencing rapid fertility transition. Copyright © 2014 Elsevier Inc. All rights reserved.

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

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


    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.


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION: Understanding of family planning scenario among different societies and communities, which by and large reside in urban slum areas, might prove useful in increasing family planning acceptance by them and decreasing population growth. Unmet need is a valuable indicator for assessing the achievements of national family planning programs. OBJECTIVES: The present study was undertaken with the objectives to estimate unmet need for family planning among the married women of reproductive age group (15 - 49 years in urban slums of Lucknow and to determine the various factors that influence the unmet need. METHODS: A community based cross - sectional study was conducted in slums of Lucknow City from February 2014 to September 2014. A total 452 married women in reproductive age group were interviewed through house to house survey with the help of a pre - designed, pre - tested and semi - structured questionnaire. RESULTS: The total unmet need for family planning was 69.0%. Multivariate logistic regression revealed socioeconomic status upper lower and below (OR 2.7; 95% CI 1.5 - 5.1; p = 0.00; duration of marriage less than 1 year (OR 1.8; 95% CI 1.1 - 2.9; p = 0.01; less number of live issues (OR 1.6; 95% CI 1.1 - 2.5; p = 0.00; working status of women (OR 1.9; 95% CI 1.1 - 2.9; p = 0.03; social class i.e. OBC and SC/ST (OR 2.3; 95% CI 1.1 - 4.6; p = 0.02 were found to be independent predictors of unmet need of family planning. CONCLUSION: The present study revealed that unmet need for family planning was quite high among women belonging to social class i.e. OBC and SC/ST, with low socioeconomic status, duration of marriage less than one year less number of live issues and working status of the women.

  2. Microcredit, family planning programs, and contraceptive behavior: evidence from a field experiment in Ethiopia. (United States)

    Desai, Jaikishan; Tarozzi, Alessandro


    The impact of community-based family planning programs and access to credit on contraceptive use, fertility, and family size preferences has not been established conclusively in the literature. We provide additional evidence on the possible effect of such programs by describing the results of a randomized field experiment whose main purpose was to increase the use of contraceptive methods in rural areas of Ethiopia. In the experiment, administrative areas were randomly allocated to one of three intervention groups or to a fourth control group. In the first intervention group, both credit and family planning services were provided and the credit officers also provided information on family planning. Only credit or family planning services, but not both, were provided in the other two intervention groups, while areas in the control group received neither type of service. Using pre- and post-intervention surveys, we find that neither type of program, combined or in isolation, led to an increase in contraceptive use that is significantly greater than that observed in the control group. We conjecture that the lack of impact has much to do with the mismatch between women's preferred contraceptive method (injectibles) and the contraceptives provided by community-based agents (pills and condoms).

  3. Concept and Method of Asset-Based Community Development Planning: A Case Study on Minlecun Community in Chongqing’s Yuzhong District

    Institute of Scientific and Technical Information of China (English)

    Huang; Ling; Liu; Yang; Xu; Jianfeng


    With the transformation of the Chinese economy from an extensive growth to intensive development, city development is also gradually turning from incremental construction to stock management. Community, as a basic unit of human settlements, is an important platform to build and improve the social governance capability. In 2013, Shiyoulu Jiedao Offi ce of Yuzhong District led the 1st urban community development planning, which was a milestone of Chongqing’s city regeneration and governance innovation. This paper focuses on two key issues: how to understand the community values and make the community development planning based on the above, and how to integrate with the local forces so that the community development planning can be integrated into the action plan. Combined with the practice of Minlecun Community Development Planning, using the concept of asset-based community development, a comprehensive survey is conducted on community assets(including three aspects of physical, human, and social capital), and a community comprehensive planning strategy is formulated which covers two parts: the optimization of community spaces and the upgrading of community governance. The paper explores the local-based community planning theories and methods from such aspects as value attitude, public participation, role transformation of urban planners, and others.

  4. Family Planning: Between Rejection And Acceptance In Islam ...

    African Journals Online (AJOL)

    Family Planning: Between Rejection And Acceptance In Islam. ... factor for health workers and policy makers to impact positively on their communities. ... who are likely to work in such communities for effective negotiation and application of ...

  5. Improving family planning services delivery and uptake: experiences from the "Reversing the Stall in Fertility Decline in Western Kenya Project". (United States)

    Amo-Adjei, Joshua; Mutua, Michael; Athero, Sherine; Izugbara, Chimaraoke; Ezeh, Alex


    In this paper, we reflect on our experiences of implementing a multipronged intervention to improve sexual and reproductive health outcomes. The project used family planning as its entry point and was implemented in two high fertility counties-Busia and Siaya in Kenya. The intervention, implemented by a seven-member consortium, involved: family planning services delivery; regular training of service providers to deliver high quality services; monitoring and evaluation; strengthening of commodity chain delivery and forecasting; school-based and out-of-school based sexuality education; and advocacy and stakeholder engagements at the community, county and national levels. Over a 5-year period, the project contributed to raising demand for family planning considerably, evidenced in fertility decline. It also improved the capacity of family planning services providers, increased commitment and awareness of county government and other community stakeholders on the importance of investments in family planning. Our collaborations with organisations interested in sexual and reproductive health issues substantially enhanced the consortium's ability to increase demand for, and supply of family planning commodities. These collaborations are proving useful in the continuity and sustainability of project achievements.

  6. Community Alternatives for Love and Limits (CALL: A community-based family strengthening multi-family intervention program to respond to adolescents at risk

    Directory of Open Access Journals (Sweden)

    David Wilkerson


    Full Text Available Family strengthening has become a source of growing interest, research, and program design in the fields of prevention and treatment for problems of youth delinquency, school failure, alcohol, tobacco and other drug abuse (ATOD. Despite many studies that illustrate the positive outcomes of family strengthening programs and family-focused interventions, their use in communities has not advanced commensurate with their promise. This article offers a rationale for why programming efforts should continue to be directed towards family strengthening efforts as opposed to youth-focused only interventions. In addition, a community-based, family-strengthening alternative is described that addresses issues of youth delinquency while reducing barriers associated with availability, accessibility, and cost.

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

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


    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 family planning services when integrated with community-based services in Jharkhand.

  8. The strategies, experiences and future challenges of the information component in the Indonesian Family Planning Programme. (United States)

    Suyono, H


    In 1957, the Indonesian Planned Parenthood Federation was established. In 1970, the National Family Planning Board (BKKBN) was created. The current contraceptive prevalence rate is 45-50%. The family planning program began with a health-oriented approach. To promote acceptance, religious leaders were asked to provide legitimacy to the program. Through their efforts, it became possible to include all the means and medication used for family planning services within the program. In developing an IEC strategy to encourage couples to accept family planning, 3 main factors were studied: 1) the types of innovations that were to be introduced, 2) the characteristics of the Indonesian community, and 3) the need for an IEC strategy to convey the programs messages the community and make the community itself the agent of the innovation being introduced. The elements of the strategy were introduced stage by stage to avoid unnecessary debate. Another strategic step was the introduction of family planning using a community approach. A 3rd strategic step was a shift from couples as family planning acceptors to the introduction of the norm of a small, happy, and prosperous family. The 1st stage, expansion of program coverage, 1) promoted the need for and desirability of family planning to make the small and happy family the norm and 2) supplied contraceptives and information about contraceptives throughout Indonesia. The 2nd stage, the program maintenance approach, included 1) an increase in the frequency of visits to villages by mobile family planning teams, 2) the integration of family planning activities with other health-related activities, and 3) giving people a wider choice of methods and helping them to choose the most suitable method for them. The 3rd stage made family planning a community activity, integrated within the economic and social fabric of community life. The general strategy of the IEC program is to make the various target groups full family planning

  9. [Some reflections on the introduction of family planning into businesses in Cameroon]. (United States)

    Ngambi Kunga


    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

  10. Health Seeking Behavior and Family Planning Services Accessibility in Indonesia

    Directory of Open Access Journals (Sweden)

    Niniek Lely Pratiwi


    Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.

  11. Removing barriers to rehabilitation: Theory-based family intervention in community settings after brain injury. (United States)

    Stejskal, Taryn M


    Rehabilitation professionals have become increasingly aware that family members play a critical role in the recovery process of individuals after brain injury. In addition, researchers have begun to identify a relationship between family member caregivers' well-being and survivors' outcomes. The idea of a continuum of care or following survivors from inpatient care to community reintegration has become an important model of treatment across many hospital and community-based settings. In concert with the continuum of care, present research literature indicates that family intervention may be a key component to successful rehabilitation after brain injury. Yet, clinicians interacting with family members and survivors often feel confounded about how exactly to intervene with the broader family system beyond the individual survivor. Drawing on the systemic nature of the field of marriage and family therapy (MFT), this article provides information to assist clinicians in effectively intervening with families using theory-based interventions in community settings. First, a rationale for the utilization of systems-based, as opposed to individual-based, therapies will be uncovered. Second, historically relevant publications focusing on family psychotherapy and intervention after brain injury are reviewed and their implications discussed. Recommendations for the utilization of systemic theory-based principles and strategies, specifically cognitive behavioral therapy (CBT), narrative therapy (NT), and solution-focused therapy (SFT) will be examined. Descriptions of common challenges families and couples face will be presented along with case examples to illustrate how these theoretical frameworks might be applied to these special concerns postinjury. Finally, the article concludes with an overview of the ideas presented in this manuscript to assist practitioners and systems of care in community-based settings to more effectively intervene with the family system as a whole

  12. Participatory land use planning for community based forest ...

    African Journals Online (AJOL)

    Participatory land use planning for community based forest management in South-Eastern Nigeria. FE Bisong, A Animashaun. Abstract. No Abstract. Lwati: A Journal of Contemporary Research Vol. 4 () 2007: pp.329-347. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  13. Postpartum family planning: current evidence on successful interventions. (United States)

    Blazer, Cassandra; Prata, Ndola


    We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations.

  14. Phase Transitions in Planning Problems: Design and Analysis of Parameterized Families of Hard Planning Problems (United States)

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


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

  15. Family planning: the unfinished agenda. (United States)

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


    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.

  16. Community development planning

    International Nuclear Information System (INIS)

    Gray, S.I.


    The focus of this paper will be methods of local community involvement in the community development planning efforts which will be required at the recommended sites. Community development planning will include capital improvement plans, housing plans, zoning changes, business development plans and other community service and fiscal plans required to meet the projected needs of new residents as a result of the repository construction and operation. This paper will present, (1) the need for community planning, (2) methods of responding to community planning needs, (3) current community planning issues to be addressed. 2 references, 1 figure

  17. Family Planning in a Sub-district near Kumasi, Ghana: Side Effect ...

    African Journals Online (AJOL)


    African Journal of Reproductive Health September 2011; 15(3): 121 ... women recognized at least one family planning method, half of all recent or ... use of Primolut N tablets, addressing real and perceived side effects of family ... planning programs, research and policy. ... Utah to improve the quality of life in communities.

  18. Knowledge Networking for Family Planning: The Potential for Virtual Communities of Practice to Move Forward the Global Reproductive Health Agenda

    Directory of Open Access Journals (Sweden)

    Megan O’Brien


    Full Text Available This paper highlights experience from five years of using virtual communication tools developed by the World Health Organization Department of Reproductive Health and Research (WHO/RHR and its partners in the Implementing Best Practices (IBP in Reproductive Health Initiative to help bridge the knowledge-to-practice gap among family planning and reproductive health professionals. It explores how communities of practice and virtual networks offer a unique low-cost way to convene public health practitioners around the world to share experiences. It offers examples of how communities of practice can contribute to the development and dissemination of evidence-based health information products, and explores the potential for online networking and collaboration to enhance and inform program design and management. The paper is intended to inform the reproductive health community, as well as others working in health and development, of the potential for using virtual communities of practice to work towards achieving common goals and provide some examples of their successful use.

  19. Medical Students' Knowledge of Fertility Awareness-Based Methods of Family Planning. (United States)

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


    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  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.

  20. Engaging Men in Family Planning: Perspectives From Married Men in Lomé, Togo. (United States)

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


    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

  1. Family planning services quality as a determinant of use of IUD in Egypt

    Directory of Open Access Journals (Sweden)

    Montana Livia


    Full Text Available Abstract Background Both availability and quality of family planning services are believed to have contributed to increasing contraceptive use and declining fertility rates in developing countries. Yet, there is limited empirical evidence to show the relationship between the quality of family planning services and the population based prevalence of contraceptive methods. This study examined the relationship between quality of family planning services and use of intrauterine devices (IUD in Egypt. Methods The analysis used data from the 2003 Egypt Interim Demographic and Health Survey (EIDHS that included 8,445 married women aged 15–49, and the 2002 Egypt Service Provision Assessment (ESPA survey that included 602 facilities offering family planning services. The EIDHS collected latitude and longitude coordinates of all sampled clusters, and the ESPA collected these coordinates for all sampled facilities. Using Geographic Information System (GIS methods, individual women were linked to a facility located within 10 km of their community. A facility-level index was constructed to reflect the quality of family planning services. Four dimensions of quality of care were examined: counseling, examination room, supply of contraceptive methods, and management. Effects of quality of family planning services on the use of IUD and other contraceptive methods were estimated using multinomial logistic regression. Results are presented as relative risk ratios (RRR with significance levels (p-values. Results IUD use among women who obtained their method from public sources was significantly positively associated with quality of family planning services (RRR = 1.36, p Conclusion This study is one among the few that used geographic information to link data from a population-based survey with an independently sampled health facility survey. The findings demonstrate that service quality is an important determinant of use of clinical contraceptive methods in Egypt

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

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


    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 family planning issues was less reported within the control group, both in the case of men and women ((p = 0.031) and (p 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

  3. Male involvement in maternal healthcare through Community- based Health Planning and Services: the views of the men in rural Ghana. (United States)

    Bougangue, Bassoumah; Ling, How Kee


    The need to promote maternal health in Ghana has committed the government to extend maternal healthcare services to the door steps of rural families through the community-based Health Planning and Services. Based on the concerns raised in previous studies that male spouses were indifferent towards maternal healthcare, this study sought the views of men on their involvement in maternal healthcare in their respective communities and at the household levels in the various Community-based Health Planning and Services zones in Awutu-Senya West District in the Central Region of Ghana. A qualitative method was employed. Focus groups and individual interviews were conducted with married men, community health officers, community health volunteers and community leaders. The participants were selected using purposive, quota and snowball sampling techniques. The study used thematic analysis for analysing the data. The study shows varying involvement of men, some were directly involved in feminine gender roles; others used their female relatives and co-wives to perform the women's roles that did not have space for them. They were not necessarily indifferent towards maternal healthcare, rather, they were involved in the spaces provided by the traditional gender division of labour. Amongst other things, the perpetuation and reinforcement of traditional gender norms around pregnancy and childbirth influenced the nature and level of male involvement. Sustenance of male involvement especially, husbands and CHVs is required at the household and community levels for positive maternal outcomes. Ghana Health Service, health professionals and policy makers should take traditional gender role expectations into consideration in the planning and implementation of maternal health promotion programmes.

  4. Implementation and acceptability of strategies instituted for engaging men in family planning services in Kibaha district, Tanzania. (United States)

    Msovela, Judith; Tengia-Kessy, Anna


    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

  5. A Community-Based Intervention Program to Enhance Family Communication and Family Well-being: The Learning Families Project in Hong Kong

    Directory of Open Access Journals (Sweden)

    Chen Shen


    Full Text Available BackgroundFamily communication is important to maintain family relationships and family well-being. To enhance family communication and family well-being, a community-based “Learning Families Project,” based on the social ecological model was developed in Kwun Tong in Hong Kong, a district with high prevalence of family problems.MethodsThis quasi-experimental study included two nearby government subsidized low-rent housing estates separated by busy main roads, as the intervention [Tsui Ping (South Estate] and control (Shun Tin Estate estate. The main intervention was resident training programs, such as talks, day camps, and thematic activities. No program was implemented in the control estate. Participants in the intervention group received assessments before the intervention (T1, immediately after the intervention (T2, and 6 weeks after the intervention (T3. Control group participants were assessed at baseline (March to April 2011 and follow-up (December 2011 to March 2012. Assessments of family communication (time and perceived adequacy and family well-being (harmony, happiness, and health at T1 and T3 were obtained in the intervention group to examine within-group changes. In addition, these differences in outcomes in the intervention group were compared with those in the control group to examine the effectiveness of the intervention.ResultsFamily communication time and perceived communication adequacy increased significantly in the intervention group (n = 515 with a small effect size (Cohen effect d: 0.10 and 0.24, respectively. Compared with the control group (n = 476, the improvements in family communication time and perceived communication adequacy (Cohen effect d: 0.13 and 0.14, respectively, and perceived family harmony and happiness (Cohen effect d: 0.12 and 0.12, respectively were significantly greater in the intervention group, adjusting for age and education, suggesting the intervention was effective in improving

  6. A Community-Based Intervention Program to Enhance Family Communication and Family Well-being: The Learning Families Project in Hong Kong. (United States)

    Shen, Chen; Wan, Alice; Kwok, Lit Tung; Pang, Sally; Wang, Xin; Stewart, Sunita M; Lam, Tai Hing; Chan, Sophia Siu Chee


    Family communication is important to maintain family relationships and family well-being. To enhance family communication and family well-being, a community-based "Learning Families Project," based on the social ecological model was developed in Kwun Tong in Hong Kong, a district with high prevalence of family problems. This quasi-experimental study included two nearby government subsidized low-rent housing estates separated by busy main roads, as the intervention [Tsui Ping (South) Estate] and control (Shun Tin Estate) estate. The main intervention was resident training programs, such as talks, day camps, and thematic activities. No program was implemented in the control estate. Participants in the intervention group received assessments before the intervention (T1), immediately after the intervention (T2), and 6 weeks after the intervention (T3). Control group participants were assessed at baseline (March to April 2011) and follow-up (December 2011 to March 2012). Assessments of family communication (time and perceived adequacy) and family well-being (harmony, happiness, and health) at T1 and T3 were obtained in the intervention group to examine within-group changes. In addition, these differences in outcomes in the intervention group were compared with those in the control group to examine the effectiveness of the intervention. Family communication time and perceived communication adequacy increased significantly in the intervention group ( n  = 515) with a small effect size (Cohen effect d : 0.10 and 0.24, respectively). Compared with the control group ( n  = 476), the improvements in family communication time and perceived communication adequacy (Cohen effect d : 0.13 and 0.14, respectively), and perceived family harmony and happiness (Cohen effect d : 0.12 and 0.12, respectively) were significantly greater in the intervention group, adjusting for age and education, suggesting the intervention was effective in improving family communication and

  7. Sex education and family planning services for young adults: alternative urban strategies in Mexico. (United States)

    Townsend, J W; Diaz de May, E; Sepúlveda, Y; Santos de Garza, Y; Rosenhouse, S


    In Mexico, youth face difficulties in obtaining reliable information on sex education and family planning through existing community programs. Two alternative strategies to provide these services are being tested in poor urban areas of Monterrey. In one experimental area, Integrated Youth Centers were established, which provide sex education and family planning services as well as counseling, academic tutoring, and recreational activities. In another area, trained young adults and community counselors work through informal networks to provide sex education and family planning information. Both utilization and the cost of these services are examined in the context of plans for expanding coverage in Mexico-U.S. border areas.

  8. Improving Access to Quality Care in Family Planning: WHO's Four Cornerstones of Evidence-based Guidance

    Institute of Scientific and Technical Information of China (English)

    Shang-chun WU; Yan ZOU; K Church; O Meirik


    The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainlyface to the policy-makers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines- Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the linicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grassroot providers.

  9. Comparison of attitudes related with family planning methods before and after effective family planning counseling.

    Directory of Open Access Journals (Sweden)

    Esra Esim Büyükbayrak


    Full Text Available Objective: To evaluate the effect of family planning counseling on the changeover of the family planning method and to determine level of knowledge of participants on family planning methods and their attitude towards changeover of the method after counseling. Setting: Kartal education and reseach hospital obstetrics and gynecology clinic, department of family planning. Patients. 500 consecutive women applying to family planning department for any reason. Interventions: Effective family planning counseling service was given to each participant then a questioner containin 14 questions was applied with face to face technique. Main Outcome Measures: Attitude towards family planning counseling, comparison of the preference of family planning method before and after family planning counseling service and influential sociodemographic parameters on method choise were studied. Results: 45,2% of the participants were not taken family planning counseling service before. knowledge on family planning methods was sufficient in 25,2% of the participants, insufficient in 56,8% of the participants and 18% of the participants reported that they have no idea. 57,8% of the participants change mind about family planning counseling. 52,2% of the participants changeover perious method after counseling. 99,4% of the participants said that family planning counseling service should be given to every women. Preference of family planning method before and after family planning counseling service was statistically significantly different (p<0.01. Educational level, income and age were found to be influential sociodemographic factors for method preference. Conclusions: Effective family planning counseling service is found to have favorable effect on attitude and knowledge about family planning methods. Modern method usage increase as educational level and income of the participants increase.

  10. Getting closer to people: family planning provision by drug shops in Uganda (United States)

    Akol, Angela; Chin-Quee, Dawn; Wamala-Mucheri, Patricia; Namwebya, Jane Harriet; Mercer, Sarah Jilani; Stanback, John


    %, followed by clinics (33%) and CHWs (31%). Conclusion: Drug shops can be a viable and convenient source of short-acting contraceptive methods, including DMPA, serving as a complement to government services. Family planning programs in Uganda and elsewhere should consider including drug shops in the network of community-based family planning providers. PMID:25611480

  11. Community and health systems barriers and enablers to family planning and contraceptive services provision and use in Kabwe District, Zambia. (United States)

    Silumbwe, Adam; Nkole, Theresa; Munakampe, Margarate Nzala; Milford, Cecilia; Cordero, Joanna Paula; Kriel, Yolandie; Zulu, Joseph Mumba; Steyn, Petrus S


    Unmet need for contraception results in several health challenges such as unintended pregnancies, unwanted births and unsafe abortions. Most interventions have been unable to successfully address this unmet need due to various community and health system level factors. Identifying these inhibiting and enabling factors prior to implementation of interventions forms the basis for planning efforts to increase met needs. This qualitative study was part of the formative phase of a larger research project that aimed to develop an intervention to increase met needs for contraception through community and health system participation. The specific study component reported here explores barriers and enablers to family planning and contraceptive services provision and utilisation at community and health systems levels. Twelve focus group discussions were conducted with community members (n = 114) and two with healthcare providers (n = 19). Ten in-depth interviews were held with key stakeholders. The study was conducted in Kabwe district, Zambia. Interviews/discussions were translated and transcribed verbatim. Data were coded and organised using NVivo 10 (QSR international), and were analysed using thematic analysis. Health systems barriers include long distances to healthcare facilities, stock-outs of preferred methods, lack of policies facilitating contraceptive provision in schools, and undesirable provider attitudes. Community level barriers comprise women's experience with contraceptive side effects, myths, rumours and misconceptions, societal stigma, and negative traditional and religious beliefs. On the other hand, health systems enablers consist of political will from government to expand contraceptive services access, integration of contraceptive services, provision of couples counselling, and availability of personnel to offer basic methods mix. Functional community health system structures, community desire to delay pregnancy, and knowledge of contraceptive

  12. Understanding advance care planning within the South Asian community. (United States)

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


    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.

  13. Core competency model for the family planning public health nurse. (United States)

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


    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.

  14. Moving from Survival to Fulfillment: A Planning Framework for Community Schools (United States)

    Shaia, Wendy E.; Finigan-Carr, Nadine


    Community schooling is an effective tool for combating the effects of poverty by integrating academic, social service, health, and economic supports for students, families, and community members. But this is complex work, requiring extraordinarily careful planning and assessment. This article suggests a planning framework that can help community…

  15. Family planning management for the migrant population in sending areas. Urban family planning programme. (United States)


    This brief article was adapted from a report by the Longchang County Government, Sichuan Province, China, at the National Conference on Urban Family Planning Programs. The Longchang County family planning program has shifted emphasis since 1990 toward management of out-migrant workers. Overpopulation in the family planning region resulted in each person having about one-sixth of an acre (0.6 mu) of land. There were about 200,000 surplus rural workers. 75,000 migrants left the region in 1995, of which 70,300 had signed birth control contracts and had received family planning certificates. Family planning township agencies in Longchang County increased their IEC and counseling services for migrants and their families. The Longchang County family planning program maintained family planning contacts in receiving areas in order to obtain pregnancy and birth information on the migrant population. During 1991-95 the number of unplanned births declined from 1394 to 71, and 97% of the births were planned.

  16. Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges (United States)

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


    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

  17. Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges. (United States)

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


    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.

  18. Konference Community, work and family

    Czech Academy of Sciences Publication Activity Database

    Křížková, Alena


    Roč. 10, č. 1 (2009), s. 61-63 ISSN 1213-0028. [Community, Work and Family III. International Conference: Innovation and Sustainability. Utrecht, 16.04.2009-18.04.2009] R&D Projects: GA AV ČR 1QS700280503; GA ČR GA403/09/1839; GA AV ČR IAA700280804 Institutional research plan: CEZ:AV0Z70280505 Keywords : Work / life balance * gender equality Subject RIV: AO - Sociology, Demography

  19. Pilot Trial of an Electronic Family Medical History in US Faith-Based Communities. (United States)

    Newcomb, Patricia; Canclini, Sharon; Cauble, Denise; Raudonis, Barbara; Golden, Paulette


    In spite of the acknowledged importance of collecting family health information, methods of collecting, organizing, and storage of pedigree data are not uniformly utilized in practice, though several electronic tools have been developed for the purpose. Using electronic tools to gather health information may empower individuals to take responsibility in managing their family health history. The purpose of this study was to describe the feasibility and outcomes of introducing small groups to the My Family Health Portrait tool in faith-based communities using faith community nurses (FCNs). This pilot project adopted a mixed methods approach to assess the potential of an educational intervention delivered by FCNs for increasing the use of electronic technologies for organizing and storing family health histories among the general public. Treatment and control groups were recruited from four faith-based communities in north Texas using a parallel-groups quasi-experimental design. Qualitative data were gleaned from field notes made by investigators interacting with FCNs and observing their teaching. A majority of respondents believed that knowing one's health history and passing it on to family and medical personnel is important. Those receiving face-to-face instruction on the electronic tool were significantly more likely to have written down family health information than the control group who received only an informational handout (χ(2) = 5.96, P = .015). Barriers to teaching about and using the electronic tool included FCNs' lack of facility with computers in the educational context and FCN and respondent mistrust of electronic storage for family health information. © The Author(s) 2014.

  20. Motivations and Constraints to Family Planning: A Qualitative Study in Rwanda’s Southern Kayonza District (United States)

    Farmer, Didi Bertrand; Berman, Leslie; Ryan, Grace; Habumugisha, Lameck; Basinga, Paulin; Nutt, Cameron; Kamali, Francois; Ngizwenayo, Elias; Fleur, Jacklin St; Niyigena, Peter; Ngabo, Fidele; Farmer, Paul E; Rich, Michael L


    Background: While Rwanda has achieved impressive gains in contraceptive coverage, unmet need for family planning is high, and barriers to accessing quality reproductive health services remain. Few studies in Rwanda have qualitatively investigated factors that contribute to family planning use, barriers to care, and quality of services from the community perspective. Methods: We undertook a qualitative study of community perceptions of reproductive health and family planning in Rwanda’s southern Kayonza district, which has the country’s highest total fertility rate. From October 2011 to December 2012, we conducted interviews with randomly selected male and female community members (n = 96), community health workers (n = 48), and health facility nurses (n = 15), representing all 8 health centers’ catchment areas in the overall catchment area of the district’s Rwinkwavu Hospital. We then carried out a directed content analysis to identify key themes and triangulate findings across methods and informant groups. Results: Key themes emerged across interviews surrounding: (1) fertility beliefs: participants recognized the benefits of family planning but often desired larger families for cultural and historical reasons; (2) social pressures and gender roles: young and unmarried women faced significant stigma and husbands exerted decision-making power, but many husbands did not have a good understanding of family planning because they perceived it as a woman’s matter; (3) barriers to accessing high-quality services: out-of-pocket costs, stock-outs, limited method choice, and long waiting times but short consultations at facilities were common complaints; (4) side effects: poor management and rumors and fears of side effects affected contraceptive use. These themes recurred throughout many participant narratives and influenced reproductive health decision making, including enrollment and retention in family planning programs. Conclusions: As Rwanda

  1. Understanding Program Planning Theory and Practice in a Feminist Community-Based Organization (United States)

    Bracken, Susan J.


    The purpose of this article is to discuss feminist-program-planning issues, drawing from a critical ethnographic study of a Latin American feminist community-based organization. The research findings discuss the centrality of feminist identity to understanding and analyzing day-to-day program-planning process issues within a feminist…

  2. Exploring Community Stakeholders' Perceptions of the Enhancing Family Well-being Project in Hong Kong: A Qualitative Study. (United States)

    Chu, Joanna T W; Chan, Sophia S; Stewart, Sunita M; Zhou, Qianling; Leung, Charles Sai-Cheong; Wan, Alice; Lam, Tai Hing


    Community engagement is a powerful tool in bringing about positive social and community change. Community stakeholders possess critical experience and knowledge that are needed to inform the development of community-based projects. However, limited literature is available on the practical experience involved with planning and implementing community-based family programs. Even less has been published documenting efforts in Chinese communities. This paper explores community stakeholders' experiences with the enhancing family well-being project-part of a citywide project entitled the "FAMILY Project," aimed at promoting family health, happiness, and harmony in Hong Kong. This qualitative evaluation examined the perspectives of community stakeholders. Four focus groups with social workers ( n  = 24) and six in-depth interviews with steering committee members were conducted from December 2012 to May 2013 in Hong Kong. Focus groups and in-depths interview were audiotaped, transcribed, and analyzed using thematic analysis techniques. Rich accounts were given by our respondents on various aspects of the project. Main themes and subthemes were identified and grouped into four categories (project conception, project implementation, project consolidation, and the overall impact of the project). Respondents described the practical challenges associated with the project (e.g., recruitment, balancing scientific research, and lack of resources) and identified the elements that are important to the success of the project. These included the commitment to a shared goal, multi-agency collaboration, and a platform for knowledge exchange. Finally, respondents perceived benefits of the project at both the individual and community level. Our project sheds light on many of the practical considerations and challenges associated with a designing and implementing a community-based family intervention project. Community stakeholders input provided important information on their perceived

  3. The Importance of Documenting and Including Traditional Wisdom in Community-Based Ecotourism Planning

    Directory of Open Access Journals (Sweden)

    Vesna Đukić


    Full Text Available This article accords to the theory of community-based tourism, which represents a concept that respects natural and cultural resources of a particular community and encourages participation of its members in the process of tourist product creation. The article operates in the planning phase and aims to give insights into the process of establishing the groundwork for community-based tourism. The key element is documenting and illustrating everything that could be a part of what is known as “traditional wisdom,” namely, the skills and knowledge of traditional life practices. The methods of case study, content analysis, and observation of the village of Omoljica, Serbia, were used. The positive aspect of this locality is reflected in the existing short-term initiatives of organizations and individuals engaging in preserving traditional practices, but without systematic, long-term planning and management of community-based tourism, these individual efforts to revalue traditional life practices would stay unrecognizable and invisible for visitors and stakeholders. Thus, the main goal of this article is to understand the relation between short-term bottom-up initiatives and long-term top-down strategic planning of specific ecotourism destinations, one that would embrace the traditional ways of rural community life. The contribution of this study, in addition to documenting and illustrating “traditional wisdom” of the specific rural community placed in the protected area which encompasses a particular local social system, will be reflected in the creation of a set of guidelines for sustainable, rural, community-based ecotourism as a soft-driver development of protected areas near big cities of the postsocialist countries.

  4. Islamic logics, reproductive rationalities: family planning in northern Pakistan. (United States)

    Varley, Emma


    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.

  5. A cost analysis of family planning in Bangladesh. (United States)

    Fiedler, J L; Day, L M


    This article presents a step-down cost analysis using secondary data sources from 26 Bangladesh non-government organizations (NGOs) providing family planning services under a US Agency for International Development-funded umbrella organization. The unit costs of the NGOs' Maternal-Child Health (MCH) clinics and community-based distribution (CBD) systems were calculated and found to be minimally different. Several simulations were conducted to investigate the impact of alternative cost-reduction measures. The more general financial analysis proved more insightful than the unit cost analysis in terms of identifying means by which to improve the efficiency of the family planning operations of these NGOs. The analysis revealed that 56 per cent of total expenditures in the two-tiered umbrella's organizational structure are incurred in management operations and overheads. Of the remaining 44 per cent of project expenditures, 39 per cent is spent on the CBD program and 5 per cent on the MCH clinics. Within the CBD program, most resources are spent providing 4 million contacts (two-thirds of the annual total) which do not involve contraceptive re-supply. The clinics devote more resources to providing MCH services than to providing family planning services. The findings suggest that significant savings could be generated by containing administrative costs, improving operational efficiency, and reducing unnecessary or redundant fieldworker contacts. The magnitude of the potential savings raises a fundamental question about the continued viability and sustainability of this supply-driven CBD strategy.

  6. Medicaid program; state plan home and community-based services, 5-year period for waivers, provider payment reassignment, and home and community-based setting requirements for Community First Choice and home and community-based services (HCBS) waivers. Final rule. (United States)


    This final rule amends the Medicaid regulations to define and describe state plan section 1915(i) home and community-based services (HCBS) under the Social Security Act (the Act) amended by the Affordable Care Act. This rule offers states new flexibilities in providing necessary and appropriate services to elderly and disabled populations. This rule describes Medicaid coverage of the optional state plan benefit to furnish home and community based-services and draw federal matching funds. This rule also provides for a 5-year duration for certain demonstration projects or waivers at the discretion of the Secretary, when they provide medical assistance for individuals dually eligible for Medicaid and Medicare benefits, includes payment reassignment provisions because state Medicaid programs often operate as the primary or only payer for the class of practitioners that includes HCBS providers, and amends Medicaid regulations to provide home and community-based setting requirements related to the Affordable Care Act for Community First Choice State plan option. This final rule also makes several important changes to the regulations implementing Medicaid 1915(c) HCBS waivers.

  7. Pilot of "Families for Health": community-based family intervention for obesity. (United States)

    Robertson, W; Friede, T; Blissett, J; Rudolf, M C J; Wallis, M; Stewart-Brown, S


    To develop and evaluate "Families for Health", a new community based family intervention for childhood obesity. Programme development, pilot study and evaluation using intention-to-treat analysis. Coventry, England. 27 overweight or obese children aged 7-13 years (18 girls, 9 boys) and their parents, from 21 families. Families for Health is a 12-week programme with parallel groups for parents and children, addressing parenting, lifestyle change and social and emotional development. Change in baseline BMI z score at the end of the programme (3 months) and 9-month follow-up. Attendance, drop-out, parents' perception of the programme, child's quality of life and self-esteem, parental mental health, parent-child relationships and lifestyle changes were also measured. Attendance rate was 62%, with 18 of the 27 (67%) children completing the programme. For the 22 children with follow-up data (including four who dropped out), BMI z score was reduced by -0.18 (95% CI -0.30 to -0.05) at 3 months and -0.21 (-0.35 to -0.07) at 9 months. Statistically significant improvements were observed in children's quality of life and lifestyle (reduced sedentary behaviour, increased steps and reduced exposure to unhealthy foods), child-parent relationships and parents' mental health. Fruit and vegetable consumption, participation in moderate/vigorous exercise and children's self-esteem did not change significantly. Topics on parenting skills, activity and food were rated as helpful and used with confidence by most parents. Families for Health is a promising new childhood obesity intervention. Definitive evaluation of its clinical effectiveness by randomised controlled trial is now required.

  8. Using Community-Based Participatory Research to Identify Environmental Justice Issues in an Inner-City Community and Inform Urban Planning. (United States)

    Mansyur, Carol Leler; Jeng, Hueiwang Anna; Holloman, Erica; DeBrew, Linwood


    The Southeast CARE Coalition has been using community-based participatory research to examine environmental degradation in the Southeast Community, Newport News, Virginia. A survey was developed to collect assessment data. Up to 66% of respondents were concerned about environmental problems in their community. Those with health conditions were significantly more likely to identify specific environmental problems. The top 5 environmental concerns included coal dust, air quality, crime, water quality, and trash. The community-based participatory research process is building community capacity and participation, providing community input into strategic planning, and empowering community members to take control of environmental justice issues in their community.

  9. Offering the full range of contraceptive options: a survey of interest in vasectomy training in the US family planning community. (United States)

    Nguyen, Brian T; Jochim, Andrea L; Shih, Grace H


    To assess current practices regarding female and male sterilization counseling and provision, as well as determine interest in providing vasectomy among family planning specialists. Members of the US-based network of family planning fellowship physicians (current fellows, graduates and faculty) received a Web-based survey from November 2015 through January 2016 regarding current sterilization preferences and practices, as well as interest in obtaining training in vasectomy counseling and procedure. Nearly 60% (n=178/302) of family planning fellowship providers responded to the survey. While 62% (111/178) of respondents reported counseling their patients about vasectomy at least most of the time and 57% (102/178) recommended vasectomy over female sterilization, few (8/178; 4 trained in family medicine and 4 trained in obstetrics and gynecology) had performed a vasectomy in the last year. Nearly 90% (158/178) of respondents were somewhat or very interested in receiving training on vasectomy counseling; 58% (103/178) desired procedural training. Desire for training was associated with being male and receiving residency training in family medicine. Few family planning fellowship physicians provide vasectomy, and the majority expressed being at least somewhat interested in receiving further training. Vasectomy is more effective, safer and less expensive than female sterilization but is less common than female sterilization. One barrier to vasectomy access is the low number of vasectomy providers. Creating a structured vasectomy training program through the family planning fellowship may help to increase the number of vasectomy providers. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Family life clinics for Gulf state: Bahrain FPA helps bring a family planning breakthrough. (United States)


    Family life clinics which will provide family planning services alongside maternal and child health services and general counseling are opening in health centers throughout Bahrain and in the main hospital at Manama. Bahrain, a small island in the Arabian Gulf, formed its first Family Planning Association (FPA) just 4 years ago; and this new initiative is seen as a direct result of cooperation between FPA and the government. To spread family planning awareness and services particularly to the poorer section of the population, Bahrain's FPA developed in various stages. Stage 1, in 1975, was to attract and educate volunteers and channel their interest into special committees dealing with programs; public relations; child welfare; legal and medical affairs; research; and conferences and education. Stage 2 came with the need to coordinate the work and set up a 2-person staff and an office. Stage 3 developed with the first field campaign. Door-to-door visiting was tried but was not popular with volunteers or residents. Approaching the population through community clubs and institutions was tried with much success. The new family life clinics are the latest stage of a fruitful cooperation between FPA and the Ministry of Labor and Social Affairs. In addition to the new family life clinics, an active effort to improve family planning awareness has continued using national seminars and mass media. Fund-raising is under way for a mobile,clinic which will provide health services and methods of contraception, to which there is still substantial resistance, to many on the island who have no exposure to the mass media. Wide acceptance of the need for family planning for the sake of mothers, the family, and the child is growing in Bahrain.

  11. Interventions to Increase Male Attendance and Testing for Sexually Transmitted Infections at Publicly-Funded Family Planning Clinics. (United States)

    Fine, David; Warner, Lee; Salomon, Sarah; Johnson, David M


    We assessed the impact of staff, clinic, and community interventions on male and female family planning client visit volume and sexually transmitted infection testing at a multisite community-based health care agency. Staff training, clinic environmental changes, in-reach/outreach, and efficiency assessments were implemented in two Family Health Center (San Diego, CA) family planning clinics during 2010-2012; five Family Health Center family planning programs were identified as comparison clinics. Client visit records were compared between preintervention (2007-2009) and postintervention (2010-2012) for both sets of clinics. Of 7,826 male client visits during the time before intervention, most were for clients who were aged male visits (4,004 to 8,385; Δ = +109%); for comparison clinics, male visits increased modestly (3,822 to 4,500; Δ = +18%). The proportion of male clinic visits where chlamydia testing was performed increased in intervention clinics (35% to 42%; p males yielded similar findings for male client volume and chlamydia testing. The number of female visits declined nearly 40% in both comparison (21,800 to 13,202; -39%) and intervention clinics (30,830 to 19,971; -35%) between preintervention and postintervention periods. Multilevel interventions designed to increase male client volume and sexually transmitted infection testing services in family planning clinics succeeded without affecting female client volume or services. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.


    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.


    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


    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.

  14. Women's experiences with family planning. (United States)

    Gupte, M


    India's family planning programs target rural women because they do not have political power. Interviews with those in Maharashtra show their lack of choice and low access to resources and their need for safe contraception. In 2 rural villages, for every dead child, a woman bears, on average, 2 more children. When a child dies, villagers first suspect the mother of having performed voodoo or witchcraft. Other suspected women are deserted women, widows, and menstruating women. Health and family planning services are not based on people's perceptions of body, anatomy, illness, and cure. People are not informed about interventions, particularly contraception. Women are not comfortable with contraceptives, and when physician ignore genuine symptoms and sequelae, it reinforces women's suspicions about contraceptives. Sterilizations performed in camps result in more side effects than individually performed sterilizations. During 1975-1977, women were kidnapped and sterilized under very unhygienic conditions. Common complaints after sterilization are menstrual disturbances and lower back pain. Many private physicians treat these complaints by performing hysterectomy. Women rarely are involved in the decision-making process determining whether or not they should undergo sterilization. They are often given false promises, if they accept sterilization. Indian women have little choice in contraceptives. The low biodegradability of condoms poses a disposal problem. Health workers often dispose of IUDs, pills, and condoms which they claim have been accepted. Auxiliary nurse midwives are pressured to meet family planning targets, so they harass women to accept contraception. Village women do not trust them. Health workers often steal cases from each other. Many complain that minorities are responsible for the population explosion, but the minority's family size is basically the same as that of the majority. Low access to general health services and harassment to fulfill family

  15. Knowledge attitude to modern family planning methods in Abraka ...

    African Journals Online (AJOL)

    Objective:. To assess the level of regard and misconceptions of modern family planning methods in Abraka communities. Methods: The interviewer\\'s administered questionnaire method was used to gather the required information from 657 respondents randomly chosen from PO, Ajalomi, Erho, Oria, Otorho, Umeghe, ...

  16. Planning community-based assessments of HIV educational intervention programs in sub-Saharan Africa. (United States)

    Kelcey, Ben; Shen, Zuchao


    A key consideration in planning studies of community-based HIV education programs is identifying a sample size large enough to ensure a reasonable probability of detecting program effects if they exist. Sufficient sample sizes for community- or group-based designs are proportional to the correlation or similarity of individuals within communities. As a result, efficient and effective design requires reasonable a priori estimates of the correlational structure among individuals within communities. In this study, we investigate the degree of correlation among individuals within communities and regions using samples of sixth-grade adolescents from 609 local area district communities and 122 regions in 15 sub-Saharan African nations. We develop nation-specific and international summaries of these correlations using variance partitioning coefficients from multilevel models and subsequently assess the extent to which different types of background variables delineate key sources of these correlations. The results suggest persistent differences among communities and regions and that the degree of correlation among individuals within communities varied considerably by nation. The findings underscore the importance of empirically derived values of design parameters that are anchored in evidence specific to the outcome, nation and context of the planned study. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email:

  17. Perspectives on community gardens, community kitchens and the Good Food Box program in a community-based sample of low-income families. (United States)

    Loopstra, Rachel; Tarasuk, Valerie


    Growing recognition of the problem of household food insecurity in Canada has meant public health practitioners are looking for effective ways to ameliorate this problem in their communities. Community gardens, community kitchens, and food box programs can offer nutritious foods for comparably lower costs, however, the uptake and perceptions of these programs in populations at risk of food insecurity have not been evaluated. Building on a previous finding of low program participation among 485 families living in high-poverty neighbourhoods in Toronto, the objective of this study was to understand reasons for non-participation. One year after the baseline study, 371 families were interviewed a second time and were asked to provide their reasons for not participating in community gardens, community kitchens, or the Good Food Box program. Responses were analyzed by inductive content analysis. At follow-up, only 12 families had participated in a community garden, 16 in a community kitchen, and 4 in the Good Food Box program. Reasons for non-participation grouped under two themes. First, families expressed that programs were not accessible because they lacked the knowledge of how or where to participate or because programs were not in their neighbourhoods. Second, programs lacked fit for families, as they were not suited to busy schedules, interests, or needs. This study provides unique perspective on participation in community food programs among food-insecure families and suggests that these programs may not be effective options for these families to improve their food access.

  18. Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh. (United States)

    Ahmed, Salahuddin; Norton, Maureen; Williams, Emma; Ahmed, Saifuddin; Shah, Rasheduzzaman; Begum, Nazma; Mungia, Jaime; Lefevre, Amnesty; Al-Kabir, Ahmed; Winch, Peter J; McKaig, Catharine; Baqui, Abdullah H


    Short birth intervals are associated with increased risk of adverse maternal and neonatal health (MNH) outcomes. Improving postpartum contraceptive use is an important programmatic strategy to improve the health and well-being of women, newborns, and children. This article documents the intervention package and evaluation design of a study conducted in a rural district of Bangladesh to evaluate the effects of an integrated, community-based MNH and postpartum family planning program on contraceptive use and birth-interval lengths. The study integrated family planning counseling within 5 community health worker (CHW)-household visits to pregnant and postpartum women, while a community mobilizer (CM) led community meetings on the importance of postpartum family planning and pregnancy spacing for maternal and child health. The CM and the CHWs emphasized 3 messages: (1) Use of the Lactational Amenorrhea Method (LAM) during the first 6 months postpartum and transition to another modern contraceptive method; (2) Exclusive, rather than fully or nearly fully, breastfeeding to support LAM effectiveness and good infant breastfeeding practices; (3) Use of a modern contraceptive method after a live birth for at least 24 months before attempting another pregnancy (a birth-to-birth interval of about 3 years) to support improved infant health and nutrition. CHWs provided only family planning counseling in the original study design, but we later added community-based distribution of methods, and referrals for clinical methods, to meet women's demand. Using a quasi-experimental design, and relying primarily on pre/post-household surveys, we selected pregnant women from 4 unions to receive the intervention (n = 2,280) and pregnant women from 4 other unions (n = 2,290) to serve as the comparison group. Enrollment occurred between 2007 and 2009, and data collection ended in January 2013. Formative research showed that women and their family members generally did not perceive

  19. Tay Sachs and Related Storage Diseases: Family Planning (United States)

    Schneiderman, Gerald; And Others


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

  20. Micro-regional planning: evidence-based community buy-in for health development in five of Mexico’s poorest rural districts

    Directory of Open Access Journals (Sweden)

    Arrizón Ascencio


    Full Text Available Abstract Background Community participation was a core tenet of Primary Health Care as articulated in the 1970s. How this could be generated and maintained was less clear. This historical article describes development of protocols for evidence-based community mobilisation in five local administrative units (municipios in the Mexican state of Guerrero between 1992 and 1995. Methods A sample of five to eight sentinel sites represented each of the most impoverished municipalities of the poorest five of the state's seven regions. A 1992 baseline survey of diarrhoea and its actionable determinants provided the substrate for discussion with local planners and communities. Municipal planners used different strategies to promote participation. In one municipality, new health committees took control of water quality. In another, municipal authorities hired health promoters; a song promoted oral rehydration, and house-to-house interpersonal discussions promoted chlorination. In the poorest and most mountainous municipality, radio casera (home-made radio soap operas used local "stars". In the largest and most disparate municipality, a child-to-family scheme relied on primary and secondary school teachers. The research team assessed outcomes at intervals and used the results to reinforce local planning and action. Results Diarrhoea rates declined in all five municipalities, and there were several positive intermediate outcomes from the communication strategies – changing knowledge, household practices and uptake of services. There was a strong link between specific contents of the communication package and the changing knowledge or practices. Conclusions Apart from these evidence-based interventions, other factors probably contributed to the decline of childhood diarrhoea. But, by monitoring implementation of planning decisions and the impact this has at community level, micro-regional planning can stimulate and reinforce actions likely to improve the

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

    Munyakazi, A


    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

  2. Dr. Haryono Suyono, National Family Planning Coordinating Board, Indonesia. (United States)


    The goal of the Indonesian family planning program has been to institutionalize both the concept and the norm of a small, happy and prosperous family in a manner that is acceptable to all. To this end, a larger role for the private sector in family planning (FP) has been promoted. While the government program has been very effective in the villages, it was not as effective in the urban areas where there are more diverse populations. Several meetings were held to develop a strategy for FP programs in the urban areas involving both the nongovernment organizations (NGOs) and commercial enterprises. It was agreed that several model programs would be developed through the NGOs with funds coming from both international health organizations and the National Family Planning Coordinating Board. It was hoped that the NGOs would develop into self-sufficient organizations. 1 urban activity that has just started is a specially designed social marketing project aimed at increasing the involvement and commitment of males through a condom distribution scheme. Another promising development is the shifting of the management and implementation of FP programs from the government to the community itself. A primary emphasis is to activate the private sector to expand its role in providing FP information and services. The overall strategy is to create a climate that will make it easier for people to increase their role in family planning service delivery and acceptance through mobilization of resources, funds, facilities and infrastructure so that acceptors will gradually pay for family planning services by themselves according to their needs.

  3. Impact of a community gardening project on vegetable intake, food security and family relationships: a community-based participatory research study. (United States)

    Carney, Patricia A; Hamada, Janet L; Rdesinski, Rebecca; Sprager, Lorena; Nichols, Katelyn R; Liu, Betty Y; Pelayo, Joel; Sanchez, Maria Antonia; Shannon, Jacklien


    This community-based participatory research project used popular education techniques to support and educate Hispanic farmworker families in planting and maintaining organic gardens. Measures included a pre- post gardening survey, key informant interviews and observations made at community-based gardening meetings to assess food security, safety and family relationships. Thirty-eight families enrolled in the study during the pre-garden time period, and four more families enrolled in the study during the post-garden period, for a total of 42 families enrolled in the 2009 gardening season. Of the families enrolled during the pre-gardening time period there were 163 household members. The mean age of the interviewee was 44.0, ranging from 21 to 78 years of age. The median number of occupants in a household was 4.0 (range: 2-8), Frequency of adult vegetable intake of "Several time a day" increased from 18.2 to 84.8%, (P gardening season, the sum of the frequencies of "Sometimes" and "Frequently" worrying in the past month that food would run out before money was available to buy more was 31.2% and the sum of these frequencies dropped to 3.1% during the post garden period, (P = 0.006). The frequency of skipping meals due to lack of money was not statistically significantly different before and after the gardening season for either adults or children. Analysis of text responses and key informant interviews revealed that physical and mental health benefits were reported as well as economic and family health benefits from the gardening study, primarily because the families often worked in their gardens together. A community gardening program can reduce food insecurity, improve dietary intake and strengthen family relationships.

  4. Improving productivity levels: family planning services for factory workers. (United States)

    Darmokusumo, H V


    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.

  5. The politics of Latin American family-planning policy. (United States)

    Weaver, J L


    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.

  6. The long-term demographic role of community-based family planning in rural Bangladesh. (United States)

    Phillips, J F; Hossain, M B; Arends-Kuenning, M


    Experimental studies demonstrating the effectiveness of nonclinical distribution of contraceptives are typically conducted in settings where contraceptive use is low and unmet need is extensive. Determining the long-term role of active outreach programs after initial demand is met represents an increasingly important policy issue in Asia, where contraceptive prevalence is high and fixed service points are conveniently available. This article examines the long-term rationale for household family planning in Bangladesh-where growing use of contraceptives, rapid fertility decline, and normative change in reproductive preferences are in progress, bringing into question the rationale for large-scale deployment of paid outreach workers. Longitudinal data are analyzed that record outreach encounters and contraceptive use dynamics in a large rural population. Findings demonstrate that outreach has a continuing impact on program effectiveness, even after a decade of household visitation. The policy implications of this finding are reviewed.

  7. Delivering high-quality family planning services in crisis-affected settings I: program implementation. (United States)

    Curry, Dora Ward; Rattan, Jesse; Nzau, Jean Jose; Giri, Kamlesh


    In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). SAFPAC's strategy focuses on 4 broad interventions drawn from public health best practices in more stable settings: competency-based training for providers, improved supply chain management, regular supervision, and community mobilization to influence attitudes and norms related to family planning. Between July 2011 and December 2013, the initiative reached 52,616 new users of modern contraceptive methods across the 5 countries (catchment population of 698,053 women of reproductive age), 61% of whom chose long-acting methods of implants or intrauterine devices. Prudent use of data to inform decision making has been an underpinning to the project's approach. A key approach to ensuring sustained ability to train and supervise new providers has been to build capacity in clinical skills training and supervision by establishing in-country training centers. In addition, monthly supervision using simple checklists has improved program and service quality, particularly with infection prevention procedures and stock management. We have generally instituted a "pull" system to manage commodities and other supplies, whereby health facilities place resupply orders as needed based on actual consumption patterns and stock-alert thresholds. Finally, reaching the community with mobilization

  8. A template for integrated community sustainability planning. (United States)

    Ling, Christopher; Hanna, Kevin; Dale, Ann


    This article describes a template for implementing an integrated community sustainability plan. The template emphasizes community engagement and outlines the components of a basic framework for integrating ecological, social and economic dynamics into a community plan. The framework is a series of steps that support a sustainable community development process. While it reflects the Canadian experience, the tools and techniques have applied value for a range of environmental planning contexts around the world. The research is case study based and draws from a diverse range of communities representing many types of infrastructure, demographics and ecological and geographical contexts. A critical path for moving local governments to sustainable community development is the creation and implementation of integrated planning approaches. To be effective and to be implemented, a requisite shift to sustainability requires active community engagement processes, political will, and a commitment to political and administrative accountability, and measurement.

  9. Federal Republic of Germany: family planning, family policy and demographic policy. (United States)

    Zuhlke, W


    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.

  10. A study of acceptors and non-acceptors of family planning methods among three tribal communities. (United States)

    Mutharayappa, R


    Primary data were collected from 399 currently married women of the Marati, Malekudiya, and Koraga tribes in the Dakshina Kannada district of Karnataka State in this study of the implementation of family planning programs in tribal areas. The Marati, Malekudiya, and Koraga tribes are three different endogamous tribal populations living in similar ecological conditions. Higher levels of literacy and a high rate of acceptance of family planning methods, however, have been observed among these tribes compared to the rest of the tribal population in the state. 46.4% of currently married women aged 15-49 years in the tribes were acceptors of family planning methods, having a mean 3.7 children. The majority of acceptors opted for tubectomy and vasectomy. The adoption of spacing methods is less common among tribal people. Most acceptors received their operations through government health facilities. They were motivated mainly by female health workers and received both cash and other incentives to accept family planning. The main reason for non-acceptance of family planning among non-acceptors was the desire to conceive and bear more children. The data indicate that most of the tribal households are nuclear families with household size more or less similar to that of the general population. They have a higher literacy rate than the rest of the tribal population in the state, with literacy levels between males and females and between the three tribes being quite different; the school enrollment ratio is relatively higher for both boys and girls.

  11. Culture Development Planning in the Special Region of Yogyakarta (Management Planning of Cultural Heritage in Kotagede District based on Community Empowerment Conservation Model

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    Eko Suryanti


    Full Text Available The Special Region of Yogyakarta is a cultural rich city with excellent cultural resources. Yogyakarta should manage their assets with long-term planning to keep the sustainability. There is a very unique planning process due to a combination of political, technocratic, participatory, top down and bottom up approaches. This planning process is comprehensive or integrated because its involved many actor from multisectoral, multidisciplinary, multi regulatory, and multi planning documents, etc. Local wisdoms have been coloring the planning documents. This study describe and analyze the cultural development planning in Yogyakarta especially on the Management Planning in Kotagede Cultural Heritage District. We used qualitative descriptive approach methods and Miles and Huberman analysis methods. Participation of community and Non Governmental Organization (NGO in conservation planning of cultural heritage in this area is very significant in simplify the government task because people have been more literate in planning, have database of cultural assets, and capable of making their own decisions for the future of the region. Participatory rural appraisal (PRA dan Rapid Rural Appraisal (RRA were integrated in the planning process of Kotagede Heritage District management, thus it becomes a model of cultural heritage with community empowerment-based conservation. Keywords: culture development planning, comprehensive planning, heritage cultural district, community empowerment-based conservation.

  12. Egypt boosts family planning. (United States)


    A $4 million Agency for International Development (AID) agreement was signed in Cairo September 30 which will help the Egyptian government increase family planning services. The project is in response to a request for up to $17 million of AID funds for family planning programs during the next 3 years. The funds will pay for: contract advisors to provide short-term in-country training of physicians, architectural and engineering services to renovate a hospital for family planning and obstetrics/gynecology training, and a field training site for family planning service providers. Some Egyptians will receive training in specialized areas in the U.S. and other countries. More than $1.5 million of the $4 million will finance local costs of goods and services required. In addition, it is anticipated that U.S.-owned local currencies will be obligated for direct support of U.S. technical personnel. Over the 3-year life of the project the $17 million from AID plus $664,000 of U.S.-owned local currency will cover 44% of the total costs of selected Egyptian family planning activities. The Egyptian government will contribute at least $18.4 million and the U.N. Fund for Population Activities and the International Bank for Reconstruction and Development will contribute $4.3 million.


    Directory of Open Access Journals (Sweden)

    Arjit Kumar


    Full Text Available Background: Utilization of family planning methods, their side effects and the factors influencing their uses. Aims: To study the family planning practices/methods among the married women of reproductive age (15- 45yrs. Study Design: Community-based study. Study Subjects: The Women of reproductive age groups (15-45yrs adopting family planning methods & those residing in urban slums of, Lucknow. Sample size: 540, Study Period : July 2009 to July 2011. Sampling Technique: thirty cluster sampling. Result: The acceptance of family planning methods both temporary and permanent methods increased with level of literacy of women. About 53.40 % adopted I.U.C.D, 38.83% O.C pills & only 7.77% of their partners used condoms. 66.6% have undergone laparoscopic & 33.4% mini-lap sterilization. Vasectomy was not done for even a single partner. More number of illiterate and primary educated accepted permanent method after 3 or more children than higher educated who accepted it after 1 or 2 children. Among acceptors of permanent methods, total 70.27 % were experiencing side effects and among temporary method users, it accounted 23.30%. Conclusions: Acceptance in family planning is associated with increasing age, nuclear family & level of literacy. IUCD is the most accepted one among all the temporary methods. Vasectomy and newer contraceptives were not at all used.

  14. Family planning advice and postpartum contraceptive use among low-income women in Mexico. (United States)

    Barber, Sarah L


    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.

  15. Provision of Family Planning Services in Tanzania: A Comparative ...

    African Journals Online (AJOL)

    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 ...

  16. Community-based asthma care: trial of a "credit card" asthma self-management plan. (United States)

    D'Souza, W; Crane, J; Burgess, C; Te Karu, H; Fox, C; Harper, M; Robson, B; Howden-Chapman, P; Crossland, L; Woodman, K


    Although asthma self-management plans are widely recommended as essential in the long-term treatment of adult asthma, there have been few studies examining their use. Our objective was to assess the effect of a "credit card" adult asthma self-management plan in a community experiencing major health problems from asthma, by means of a before and after intervention trial of the efficacy of the "credit card" plan, when introduced through community-based asthma clinics. The participants were 69 Maori people with asthma. The "credit card" plan consisted of written guidelines for the self-management of asthma, based on self-assessment of asthma severity, printed on a plastic card. On one side, management guidelines were based on the interpretation of peak expiratory flow rate (PEFR) recordings, whilst the reverse side was based on symptoms. The outcome measures used were before and after comparison of markers of asthma morbidity and requirement for acute medical treatment; and a structured questionnaire assessing the acceptability and use of the credit card plan. Following the introduction of the plan, the mean PEFR increased from 347 to 389 l.min-1, the percentage of nights woken fell from 30.4 to 16.9%, and the number of days "out of action" fell from 3.8 to 1.7%. The requirements for acute medical treatment also fell during the intervention period. Most participants commented favourably on the content and usefulness of the plan. In the situation of worsening asthma, 28% of subjects found the peak flow side of the card most helpful, 7% the symptoms side, and 48% found both sides equally helpful.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Prevalence and determinants of unmet need for family planning in Kishanganj district, Bihar, India

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    Kanchan Lata


    Full Text Available Background: Unmet need is a valuable indicator for assessing the achievements of national family planning programs. The present study was undertaken with the objectives to determine the magnitude of unmet need for family planning among the married women of reproductive age group (15-49 years, to evaluate the various factors that influence the unmet need and to explore the common reasons for unmet need for family planning. Methods: A community based, cross-sectional study was conducted from February to April 2012 in Laucha village in Kishanganj, Bihar through multistage sampling. Married women aged 15-49 years, who were permanent residents of the village, were selected by complete enumeration (330 in total and interviewed through house to house survey with the help of a pre-designed, pre-tested and semi-structured questionnaire. Results: The total unmet need for family planning was 23.9%; 9.4% for spacing births and 14.5% for limiting births. The unmet need varied significantly with age (p < 0.05 and was highest in ≤ 19 years age group (33.7%. It was also significantly higher among illiterates, those with low monthly per capita income, among Muslims and among those having more than two living issues (p < 0.05. Husband’s disapproval (34.2%, lack of awareness (27.8% and fear of side effects (24.1% were common reasons behind the unmet need. Conclusion: the unmet need for family planning was quite high among the respondents and associated with various bio-social determinants that should be considered while planning for scaling-up the program.

  18. Prevalence and determinants of unmet need for family planning in Kishanganj district, Bihar, India

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    Kanchan Lata


    Full Text Available Background: Unmet need is a valuable indicator for assessing the achievements of national family planning programs. The present study was undertaken with the objectives to determine the magnitude of unmet need for family planning among the married women of reproductive age group (15-49 years, to evaluate the various factors that influence the unmet need and to explore the common reasons for unmet need for family planning. Methods: A community based, cross-sectional study was conducted from February to April 2012 in Laucha village in Kishanganj, Bihar through multistage sampling. Married women aged 15-49 years, who were permanent residents of the village, were selected by complete enumeration (330 in total and interviewed through house to house survey with the help of a pre-designed, pre-tested and semi-structured questionnaire. Results: The total unmet need for family planning was 23.9%; 9.4% for spacing births and 14.5% for limiting births. The unmet need varied significantly with age (p < 0.05 and was highest in ≤ 19 years age group (33.7%. It was also significantly higher among illiterates, those with low monthly per capita income, among Muslims and among those having more than two living issues (p < 0.05. Husband’s disapproval (34.2%, lack of awareness (27.8% and fear of side effects (24.1% were common reasons behind the unmet need. Conclusion: the unmet need for family planning was quite high among the respondents and associated with various bio-social determinants that should be considered while planning for scaling-up the program.

  19. Factors affecting public dissatisfaction with urban family physician plan: A general population based study in Fars Province. (United States)

    Imanieh, Mohammad Hadi; Mirahmadizadeh, Alireza; Imani, Bahareh


    Understanding the level of public satisfaction with a family physician plan as well as the relevant factors in this respect, can be employed as valuable tools in identifying quality of services. To determine the factors affecting public dissatisfaction with an urban family physician plan in Iran. This cross-sectional study was conducted from January 2014 through June 2015 on Fars Province residents in Iran, selected based on cluster sampling method. The data collection instrument was comprised of a two-part checklist including demographic information and items related to dissatisfaction with the family physician plan, specialists, para-clinic services, pharmacy, physicians on shift work, emergency services, and family physician assistants. Data were described by SPSS 20. In this study, 1,020 individuals (524 males, 496 females) were investigated. Based on the results, the most frequent factor affecting dissatisfaction with physicians was their single work shifts and unavailability (53%). In terms of dissatisfaction with family physicians' specialist colleagues and para-clinic services, the most common factors were related to difficulty in obtaining a referral form (41.5%) and making appointments (21.6%), respectively. Given the level of dissatisfaction with pharmacies, the significant factor was reported to be excessive delay in medication delivery (31.6%); and in terms of physicians on shift work and emergency services, the most important factor was lower work hours for family physicians (9.2%). It seems that, the most common causes of dissatisfaction with the urban family physician plan are due to the short duration of services, obtaining a referral form and making appointments, and providing prescribed medications.

  20. Community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women in India

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    Jyothi Ramesh


    Conclusions: Nurses play a vital role in educating women and creating awareness regarding modern and safe family planning methods. These methods are effective and essential to avoid unwanted pregnancy and thus greatly impact the health of women.

  1. 42 CFR 441.20 - Family planning services. (United States)


    ... 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. ...

  2. Safety and Acceptability of Community-Based Distribution of Injectable Contraceptives: A Pilot Project in Mozambique. (United States)

    Jacinto, Ana; Mobaracaly, Mahomed Riaz; Ustáb, Momade Bay; Bique, Cassimo; Blazer, Cassandra; Weidert, Karen; Prata, Ndola


    Mozambique has witnessed a climbing total fertility rate in the last 20 years. Nearly one-third of married women have an unmet need for family planning, but the supply of family planning services is not meeting the demand. This study aimed to explore the safety and effectiveness of training 2 cadres of community health workers-traditional birth attendants (TBAs) and agentes polivalentes elementares (APEs) (polyvalent elementary health workers)-to administer the injectable contraceptive depot-medroxyprogesterone acetate (DMPA), and to provide evidence to policy makers on the feasibility of expanding community-based distribution of DMPA in areas where TBAs and APEs are present. A total of 1,432 women enrolled in the study between February 2014 and April 2015. The majority (63% to 66%) of women in the study started using contraception for the first time during the study period, and most women (over 66%) did not report side effects at the 3-month and 6-month follow-up visits. Very few (less than 0.5%) experienced morbidities at the injection site on the arm. Satisfaction with the performance of TBAs and APEs was high and improved over the study period. Overall, the project showed a high continuation rate (81.1%) after 3 injections, with TBA clients having significantly higher continuation rates than APE clients after 3 months and after 6 months. Clients' reported willingness to pay for DMPA (64%) highlights the latent demand for modern contraceptives. Given Mozambique's largely rural population and critical health care workforce shortage, community-based provision of family planning in general and of injectable contraceptives in particular, which has been shown to be safe, effective, and acceptable, is of crucial importance. This study demonstrates that community-based distribution of injectable contraceptives can provide access to family planning to a large group of women that previously had little or no access. © Jacinto et al.

  3. Effect of family planning interventions on couple years of protection in Malawi. (United States)

    Lemani, Clara; Kamtuwanje, Nenani; Phiri, Billy; Speizer, Ilene S; Singh, Kavita; Mtema, Olive; Chisanu, Ndidza; Tang, Jennifer H


    The primary objective was to assess the effect of family planning interventions at two health facilities in Malawi on couple years of protection (CYP). A prospective quasi-experimental design was used to compare CYP and uptake of long-acting reversible contraception (LARC) between two intervention facilities (Area 25 Health Center and Kasungu District Hospital) and two nonintervention facilities (Mkanda Health Center and Dowa District Hospital). The interventions included community mobilization and demand generation for family planning, and training and mentoring of providers in LARC insertion. Monthly data were collected from 1 year prior to intervention implementation until 2 years thereafter. From the pre-intervention year to the second post-intervention year, CYP increased by 175.1% at Area 25, whereas it decreased by 33.8% at Mkanda. At Kasungu and Dowa, CYP increased by 90.7% and 64.4%, respectively. Uptake of LARC increased by 12.2% at Area 25 r, 6.2% at Kasungu, and 2.9% at Dowa, but decreased by 3.8% at Mkanda. The interventions led to an increase in CYP and LARC uptake. Future family planning programs should sensitize communities about family planning and train providers to provide all contraceptives so that women can make informed decisions and use the contraceptive of their choice. © 2018 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  4. Level of male involvement and associated factors in family planning services utilization among married men in Debremarkos town, Northwest Ethiopia. (United States)

    Kassa, Mihretie; Abajobir, Amanuel Alemu; Gedefaw, Molla


    Men's participation is crucial to the success of family planning programs and women's empowerment and associated with better outcomes in reproductive health such as contraceptive acceptance and continuation, and safer sexual behaviors. Limited choice and access to methods, attitudes of men towards family planning, perceived fear of side-effects, poor quality of available services, cultural or religious oppositions and gender-based barriers are some of the reasons for low utilization of family planning. Hence, this study assessed the level of male involvement in family planning services utilization and its associated factors in Debremarkos town, Northwest Ethiopia. A community-based cross-sectional study was conducted from October to November, 2013. Multi-stage sampling technique was used to select 524 eligible samples. Data were collected by using semi-structured questionnaires. Epi Info and SPSS were used to enter and analyze the data; univariate, bivariate and logistic regression analyses were performed to display the outputs. Only 44 (8.4%) respondents were using or directly participating in the use of family planning services mainly male condoms. The reasons mentioned for the low participation were the desire to have more children, wife or partner refusal, fear of side effects, religious prohibition, lack of awareness about contraceptives and the thinking that it is the only issue for women. Opinion about family planning services, men approval and current use of family planning methods were associated with male involvement in the services utilization. In this study, the level of male involvement was low. Lack of information, inaccessibility to the services and the desire to have more children were found to be the reasons for low male involvement in family planning services utilization. Governmental and nongovernmental organizations, donors and relevant stakeholders should ensure availability, accessibility and sustained advocacy for use of family planning

  5. Donor funding for family planning: levels and trends between 2003 and 2013. (United States)

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


    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.

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


    Grollman, C; Cavallaro, FL; Duclos, D; Bakare, V; Martínez Álvarez, M; Borghi, J


    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 o...

  7. Family Planning Supply Environment in Kinshasa, DRC: Survey Findings and Their Value in Advancing Family Planning Programming (United States)

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


    Background: Modern contraceptive prevalence was 14.1% in 2007 in Kinshasa, the capital city of the Democratic Republic of the Congo (DRC). Yet virtually nothing was known about the family planning supply environment. Methods: Three surveys of health facilities were conducted in 2012, 2013, and 2014 to determine the number, spatial distribution, and attributes of sites providing family planning services. The 2012 and 2013 surveys aimed to identify the universe of family planning facilities while obtaining a limited set of data on “readiness” to provide family planning services (defined as having at least 3 modern methods, at least 1 person training in family planning in the last 3 years, and an information system to track distribution of products to clients) and output (measured by couple-years of protection, or CYP). In contrast, the 2014 survey, conducted under the umbrella of the Performance Monitoring and Accountability 2020 (PMA2020) project, was based on 2-stage cluster sampling. This article provides detailed analysis of the 2012 and 2013 surveys, including bivariate and multivariate analysis of correlates of readiness to provide services and of output. Results: We identified 184 health facilities that reported providing at least 1 contraceptive method in 2012 and 395 facilities in 2013. The percentage of sites defined as “ready” to provide services increased from 44.1% in 2012 to 63.3% in 2013. For the 3-month period between January and March 2013, facilities distributed between 0 and 879.2 CYP (mean, 39.7). Nearly half (49%) of the CYP was attributable to implants, followed by IUDs (24%), CycleBeads (11%), and injectables (8%). In 2013, facilities supported by PEPFAR (n = 121) were more likely than other facilities to be rated as ready to provide services (Pplanning implementing agencies (Pplanning in the DRC in many ways, including mobilizing partners to increase contraceptive access and increasing donor investment in family planning in the DRC

  8. Faculty Development for Medical School Community-Based Faculty: A Council of Academic Family Medicine Educational Research Alliance Study Exploring Institutional Requirements and Challenges. (United States)

    Drowos, Joanna; Baker, Suzanne; Harrison, Suzanne Leonard; Minor, Suzanne; Chessman, Alexander W; Baker, Dennis


    Community-based faculty play a large role in training medical students nationwide and require faculty development. The authors hypothesized that positive relationships exist between clerkships paying preceptors and requiring faculty development, and between protected clerkship directors' time and delivering face-to-face preceptor training, as well as with the number or length of community-based preceptor visits. Through under standing the quantity, delivery methods, barriers, and institutional support for faculty development provided to community-based preceptors teaching in family medicine clerkships, best practices can be developed. Data from the 2015 Council of Academic Family Medicine's Educational Research Alliance survey of Family Medicine Clerkship Directors were analyzed. The cross-sectional survey of clerkship directors is distributed annually to institutional representatives of U.S. and Canadian accredited medical schools. Survey questions focused on the requirements, delivery methods, barriers, and institutional support available for providing faculty development to community-based preceptors. Paying community-based preceptors was positively correlated with requiring faculty development in family medicine clerkships. The greatest barrier to providing faculty development was community-based preceptor time availability; however, face-to-face methods remain the most common delivery strategy. Many family medicine clerkship directors perform informal or no needs assessment in developing faculty development topics for community-based faculty. Providing payment to community preceptors may allow schools to enhance faculty development program activities and effectiveness. Medical schools could benefit from constructing a formal curriculum for faculty development, including formal preceptor needs assessment and program evaluation. Clerkship directors may consider recruiting and retaining community-based faculty by employing innovative faculty development delivery

  9. Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq

    Directory of Open Access Journals (Sweden)

    Al-Taee Waleed G


    Full Text Available Abstract Background The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. Methods An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students was exposed to the experimental model and the control group (56 students received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999–2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. Results The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. Conclusion A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established.

  10. Indonesia's family planning story: success and challenge. (United States)

    Hull, T H; Hull, V J; Singarimbun, M


    clinics. The strong community structures on Bali encourage birth control use. Bali, which is predominantly Hindi, is more receptive to the IUD than Java, which is predominantly Muslim. In East Java, the authoritarian bureaucracy makes efficient use of its money. Central Java is making slow but steady progress in family planning. In West Java, fieldworkers are teamed with paramedics; there, door-to-door contraceptive supply was more effective than the clinic system. In many areas traditional methods, i.e., herbs, massage, total abstinence for long periods of time, etc., were favored. More educated women often do not use contraceptives for fear of side effects. The need for family planning on the outer Indonesian islands is not as great, but programs are being set under way. These programs are the beginning of an attempt to alleviate problems that could be encountered if Indonesia's population growth continues unchecked.

  11. Attitudes of physicians providing family planning services in Egypt about recommending intrauterine device for family planning clients. (United States)

    Aziz, Mirette; Ahmed, Sabra; Ahmed, Boshra


    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.

  12. Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research. (United States)

    Byrne, Abbey; Morgan, Alison; Soto, Eliana Jimenez; Dettrick, Zoe


    Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women's empowerment and educational, social and economic participation, national development and environmental protection. To strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH), the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply-demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period. In Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow-up cards. Modelling showed varying marginal impact and costs

  13. Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research

    Directory of Open Access Journals (Sweden)

    Byrne Abbey


    Full Text Available Abstract Background Unmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women’s empowerment and educational, social and economic participation, national development and environmental protection. Methods To strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH, the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply–demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period. Results In Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow

  14. Perspectives of planning from the point of view of professional Family Health Strategy.

    Directory of Open Access Journals (Sweden)

    Polyana da Costa RIBEIRO


    Full Text Available The article looks at similarities and differences of the community diagnosis within the local planning of family health teams in Teresina. Was based on case study and focus group with teams belonging to the same territorial basis, involving hospital, health center of urban and rural area. Discusses three analytical dimensions: planning process, diagnosis in the planning of health teams and facilities/limits. It was evidenced that the planning is in its incipient, short-term, individualized and unsatisfactory demand needs. The interventions of the social actors have not involved sustainable actions, reflecting the verticality of the programmes and of distortions in the deployment process of the teams. Urge vigilance to managers with the organizational foundation of primary care, which is the diagnosis, in addition to implementing strategies for men’s health, adolescent, bedridden and caregivers and collective education, neglected.

  15. Family planning and health: the Narangwal experiment. (United States)

    Faruqee, R


    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.

  16. Incorporating AIDS prevention activities into a family planning organization in Colombia. (United States)

    Vernon, R; Ojeda, G; Murad, R


    Three AIDS prevention activities were incorporated into the services offered by PROFAMILIA in two operations research projects. The activities included: (1) informative talks given both to the general public and to members of target groups by PROFAMILIA's community marketing (CM) program field workers (or instructors); (2) the establishment of condom distribution posts in meeting places of target groups; and (3) mass-media information campaigns on AIDS prevention. Community-based distributors were able to successfully provide information on AIDS to their regular audiences as well as to deliver information and condoms to special target groups without negatively affecting family planning information/education/communication activities and contraceptive sales. A radio campaign that promoted condom use for AIDS prevention did not affect public perceptions about the condom and did not jeopardize PROFAMILIA's image.

  17. BOUNCE: A community-based mother–daughter healthy lifestyle intervention for low-income Latino families (United States)

    The primary purpose of this study was to assess the efficacy of a family-based exploratory community study titled BOUNCE (Behavior Opportunities Uniting Nutrition, Counseling, and Exercise), to increase physical fitness and activity in low-income Latino mothers and daughters. The BOUNCE study consis...

  18. How can policy strengthen community support for children in military families? (United States)

    Boberiene, Liepa V; Hornback, Bradley J


    The extraordinary demands of recent wars have increased burdens on many military families and existing systems of care. The sacrifices made by service members are made also by their children and families, and these sacrifices can have long-term consequences. Therefore, military children and families cannot go unrecognized and unsupported. Policy responses should be less about diagnosing and treating individuals and more about recognizing and supporting families' and communities' resilience in the face of wartime deployment. Policy should focus on identifying military children in diverse communities and supporting them where they live, learn, and receive care. A range of community-based prevention strategies could decrease stress before it escalates into serious mental health issues. Efforts to develop family resilience during deployment and reintegration are extremely important in facilitating children's healthy development and veterans' recovery. Military personnel should partner with community leaders to implement effective programs providing emotional, social, and practical support to families. Emphasizing family cohesion, community social support, and comprehensive programs through education and health care organizations would go a long way in fostering families' resilience. At the same time, pro- grams should be monitored and evaluated, and military and civilian researchers should share data on family risk and resilience to improve evidence- based approaches. Such efforts would benefit not only military children, but also larger populations as programs improve family and community capacity to support thriving and mitigate challenges in the face of adversity.

  19. Community Vision and Interagency Alignment: A Community Planning Process to Promote Active Transportation. (United States)

    DeGregory, Sarah Timmins; Chaudhury, Nupur; Kennedy, Patrick; Noyes, Philip; Maybank, Aletha


    In 2010, the Brooklyn Active Transportation Community Planning Initiative launched in 2 New York City neighborhoods. Over a 2-year planning period, residents participated in surveys, school and community forums, neighborhood street assessments, and activation events-activities that highlighted the need for safer streets locally. Consensus among residents and key multisectoral stakeholders, including city agencies and community-based organizations, was garnered in support of a planned expansion of bicycling infrastructure. The process of building on community assets and applying a collective impact approach yielded changes in the built environment, attracted new partners and resources, and helped to restore a sense of power among residents.

  20. Social class and family size as determinants of attributed machismo, femininity, and family planning: a field study in two South American communities. (United States)

    Nicassio, P M


    A study was conducted to determine the way in which stereotypes of machismo and femininity are associated with family size and perceptions of family planning. A total of 144 adults, male and female, from a lower class and an upper middle class urban area in Colombia were asked to respond to photographs of Colombian families varying in size and state of completeness. The study illustrated the critical role of sex-role identity and sex-role organization as variables having an effect on fertility. The lower-class respondents described parents in the photographs as significantly more macho or feminine because of their children than the upper-middle-class subjects did. Future research should attempt to measure when this drive to sex-role identity is strongest, i.e., when men and women are most driven to reproduce in order to "prove" themselves. Both lower- and upper-middle-class male groups considered male dominance in marriage to be directly linked with family size. Perceptions of the use of family planning decreased linearly with family size for both social groups, although the lower-class females attributed more family planning to spouses of large families than upper-middle-class females. It is suggested that further research deal with the ways in which constructs of machismo and male dominance vary between the sexes and among socioeconomic groups and the ways in which they impact on fertility.

  1. Indonesia. B. The building of a successful population-family planning programme. (United States)

    Suyono, H


    Indonesia's population and family planning program is one of the most successful in the world, but much work must be done to meet the reduction in fertility targets set by the government. The goal is a birthrate of 22/1000 by the year 1990, a 50% decrease from the 1970 birthrate. With eligible couples entering the program at a rate of 600,000-750,000, a hard job lies ahead. The basic tenets which have made the Indonesia program strong will be used to meet the goals for 1990. The first of these is political commitment, meaning that all government leaders, from the President to the village chief, back the program and work actively for its success. Along with political commitment is the use of cultural values. The javanese society is feudal, in the sense that people try to respect elders, both leaders in the village and beyond. Thus, when the President speaks in favor of family planning, it carries considerable weight and significance. The village chief speaks favorably of family planning and that means the villagers are receptive to trying it. Another important cultural tenet is that of mutual help, or what is termed "gotong royong." This system goes back for centuries and forms the basis of village interaction. It is simply that people help each other for the common good. The National Family Planning Coordinating Board (BKKBN), with the help of the formal and informal leaders, has defined family planning as something which is for the mutual benefit of the entire community. A 3rd tenet of the program is flexibility. The BKKBN has continually experimented with various approaches. With flexibility comes some risk. The BKKBN has managed to maintain a system whereby it is possible to take risks, and this element of flexibility has benefitted the program greatly. Ownership is another important tenet of the program. The community feels that the program is theirs and that they can decide the activities of the acceptor groups and that they are responsible for maintaining and

  2. Wujiang's service-oriented family planning programme. (United States)

    Zhu, H


    Wujiang City in south Jiangsu Province is a county-level city, well known for its economic development and effective family planning program. Family planning is practiced voluntarily by the people. The growth rate of the city's population has decreased to 5.47/1000; the proportion of planned births has increased to 98%; and the total fertility rate has declined to 1.5. There are 34 towns (and townships) and 883 administrative villages under the jurisdiction of the city. The living standard has improved significantly. The successful implementation of family planning is largely due to the quality services delivered to farmers, especially women of reproductive age. In an interview, Mme. Ji and Mme. Shen, chiefs of the Wujiang Family Planning Committee, describe the services they deliver. The information, education, and communication (IEC) program is focused on population schools (city, town, township, and village), which deliver information to middle school students, premarital youth, and women who are pregnant, lying-in, or menopausal. Pamphlets on marriage and reproductive health are published by the county population school. Family planning service centers, which deliver contraceptive and technical services, were established in every town and township in 1993. Ultrasound scans are available and have been used to diagnose diseases, including cancer. Over 3000 women have been helped. Misuse of fetal sex identification is banned. The Family Planning Committee and the technical service centers in the city provide counselling services on fewer, healthier births; maternal and child health care; reproductive health; and treatment of infertility. There are several kinds of insurance related to family planning; these include old age support for the parents of only-children, safety insurance for only-children, and old age insurance for newlyweds. The insurance premium is shared by the couple (100 yuan) and the township (400 yuan). Only-child couples, two-daughter families

  3. Incentives to promote family planning. (United States)

    Heil, Sarah H; Gaalema, Diann E; Herrmann, Evan S


    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. 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. 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. 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. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. A methodology integrating Petri nets and knowledge-based systems to support process family planning

    NARCIS (Netherlands)

    Zhang, Linda L.; Xu, Qianli; Helo, Petri


    Planning production processes for product families have been well recognised as an effective means of achieving successful product family development. However, most existing approaches do not lend themselves to planning production processes with focus on the optimality of the cohort of a product

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

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


    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.

  6. [Some psychological problems in family planning work]. (United States)

    Chen, J


    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.

  7. Community-centered family health history: a customized approach to increased health communication and awareness. (United States)

    O'Leary, James; Edelson, Vaughn; Gardner, Nicora; Gepp, Alejandra; Kyler, Panelpha; Moore, Penelope; Petruccio, Claudia; Williams, Marc; Terry, Sharon; Bowen, Deborah


    There has been little study of whether family health history (FHH) tools used by individuals, families, and communities inspire measurable changes in communication and behavior. The Community-Centered Family Health History (CCFHH) project was a collaborative endeavor among national and community-based organizations with an interest in genetics education and health. Using community- based participatory research principles as a foundation, CCFHH examined whether the Does It Run In the Family? toolkit, a set of two customizable booklets on health and genetics, encourages discussion and collection of FHH information across diverse communities. Five communities across the country measured the utility of customized versions of the Does It Run In the Family? toolkit. Each community partner recruited families, consisting of two or more blood relatives, to use the toolkit for 3 months, discuss it among their family members, and consider the implications of the health information. Pre- and postintervention surveys measured family communication about family history and disease risk and the use of FHH information in health care provider interactions. After aggregate, cross-community analysis of individual responses, from pre- to post-toolkit use family members showed increases in communication about family history of disease risk (p < .05) and in awareness about FHH (p < .05). These findings indicate that diverse communities are receptive to FHH intervention, and tailored health educational materials can lead to increased conversations and awareness about health issues across communities.

  8. Family-Directed Transition Planning Guide. (United States)

    Colorado State Dept. of Education, Denver. Div. of Special Education Services.

    This guide to family-directed transition planning is intended to help parents and students with disabilities take leading roles in the process of transition from school to post-school activities. First, a letter to families examines the challenge of change and the transition process. Section 2 examines regulations that affect transition planning,…

  9. Adaptation and implementation of family-based treatment enhanced with dialectical behavior therapy skills for anorexia nervosa in community-based specialist clinics. (United States)

    Accurso, Erin C; Astrachan-Fletcher, Ellen; O'Brien, Setareh; McClanahan, Susan F; Le Grange, Daniel


    Although family-based therapy (FBT) is a well-established treatment for anorexia nervosa, its implementation and effectiveness in clinical settings has been neglected. A group of seven therapists at a community-based eating disorders clinic were trained in skills-enhanced FBT and provided treatment to 11 youth with anorexia nervosa. Family-based skills training, which borrowed heavily from dialectical behavior therapy, was introduced in four additional sessions and then integrated throughout the remainder of FBT. FBT was perceived as appropriate and acceptable by all participants. Therapists reported high treatment fidelity. There was a large improvement in weight and moderate improvement in caregiver-reported eating disorder psychopathology but no clinically significant change by youth report. This study provides preliminary data on the implementation and effectiveness of FBT in the community.

  10. Sewing machines and bank loans, farming and family planning. (United States)

    Sai, F A; Nsarkoh, J D


    Half of a $10,000 grant was given by the International Planned Parenthood Federation (IPPF) to finance the rural development project activities of Danfa, a village of about 835 people in Ghana. In this community the women are hard working but doubly disadvantaged. Along with a high illiteracy rate, the women are limited by inadequate income due to underemployment, under productivity, unfavorable farming conditions, and a lack of resources. Large families, frequent pregnancies, poor mother and child health, and high infant mortality all make matters worse for both the rural farm wife and her family. The project began with a nucleus of women that soon grew to between 24-30. Members soon formed small groups according to their occupational interests. The women grasped the self-help idea immediately. Once or twice a month there were demonstrations and the group worked together in such activities as making soap and pomade, preparing meals, and sewing. Meetings generally ended with a general group brainstorming and then members gathered in smaller groups to review their activities and plan for the future. During the 1st year of the project the men in the group rarely attended meetings. The group gave priority attention to their community's urgent need for working capital. 15 women farmers who met the criteria determined by the group received loans in the 1st round; only 8 satisfied the criteria in the 2nd round. At the beginning of the small loans scheme, the group decided to seek bigger loans from the bank if members proved credit worthy. This requirement was satisfied, and the group began negotiations for a loan with the Agricultural Development Bank. The group received the total group loan. The Ghana Home Science Association considers the project to be successful in several respects. Team spirit has developed the group, and the women play important and respected roles. Family planning problems are regularly presented for discussion, but it is difficult to correlate

  11. Service Locator - Family Planning Title X (United States)

    U.S. Department of Health & Human Services — This locator tool will help you find Title X family planning centers that provide high quality and cost-effective family planning and related preventive health...

  12. Family planning and reproductive health supply stockouts: problems and remedies for faith-based health facilities in Africa

    Directory of Open Access Journals (Sweden)

    Amy M. Metzger


    distances to depots, and problems maintaining the cold chain. Conclusions: By studying the supply chains of faith-based health facilities, Christian Connections for International Health (CCIH and its members have created new awareness among FBOs and international agencies of the importance and challenges of these systems and have suggested actions toward improvement. The Alliance of Christian Faith-Based Organizations for Family Planning (ACFBOFP formed in Cameroon to strengthen commodity security may be a good model for other FBOs to consider. Cost recovery models with stronger quantification and forecasting systems, including trained staff, can help meet the FP and RH needs of families and can help assure the long-term sustainability of FBO health systems. This study can serve as a frame of reference as we move forward, anticipating an acceleration in interest to strengthen FBO supply chains to reach as many communities as possible with available, quality supplies and services.

  13. Applying social science and public health methods to community-based pandemic planning. (United States)

    Danforth, Elizabeth J; Doying, Annette; Merceron, Georges; Kennedy, Laura


    Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 ('swine flu') outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.

  14. An evaluation of a family planning mobile job aid for community health workers in Tanzania. (United States)

    Braun, Rebecca; Lasway, Christine; Agarwal, Smisha; L'Engle, Kelly; Layer, Erica; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa


    The global rapid growth in mobile technology provides unique opportunities to support community health workers (CHWs) in providing family planning (FP) services. FHI 360, Pathfinder International and D-tree International developed an evidence-based mobile job aid to support CHW counseling, screening, service provision and referrals, with mobile forms for client and service data, and text-message reporting and reminders. The purpose of this study is to evaluate the acceptability and potential benefits to service quality from the perspective of CHWs and their clients. The mobile job aid was piloted in Dar es Salaam, Tanzania. Data collection tools included a demographic survey of all 25 CHWs trained to use the mobile job aid, in-depth interviews with 20 of the CHWs after 3 months and a survey of 176 clients who received FP services from a CHW using the mobile job aid after 6 months. Both CHWs and their clients reported that the mobile job aid was a highly acceptable FP support tool. CHWs perceived benefits to service quality, including timelier and more convenient care; better quality of information; increased method choice; and improved privacy, confidentiality and trust with clients. Most clients discussed multiple FP methods with CHWs; only 1 in 10 clients reported discussion of all 9 methods. This research suggests that mobile phones can be effective tools to support CHWs with FP counseling, screening and referrals, data collection and reporting, and communication. Challenges remain to support informed contraceptive choice. Future research should focus on implementation, including scale-up and sustainability. Mobile job aids can uniquely enhance FP service provision at the community level through adherence to standard protocols, real-time feedback and technical assistance, and provision of confidential care. This study can inform future efforts to support and expand the role of CHWs in increasing FP access and informed contraceptive choice. Copyright © 2016

  15. Africa: the new family planning frontier. (United States)

    Caldwell, John C; Caldwell, Pat


    Sub-Saharan Africa will be the family planning frontier of the twenty-first century. Fertility levels and population growth rates are still high, and family planning programs suited to the region are still being developed. Nevertheless, by the end of the twentieth century, fertility transition was under way in Southern Africa and a few countries elsewhere. Successful regional family planning in the twenty-first century will depend upon stronger political leadership, the development of family planning programs that meet the needs of all segments of society and not only currently married women, assistance to the market, and a recognition of the central importance of hormonal methods, especially injectables. Problems include stagnation in economic growth and in child mortality decline, as well as the persistence of the AIDS epidemic.

  16. Incarcerated women's relationship-based strategies to avoid drug use after community re-entry. (United States)

    Snell-Rood, Claire; Staton-Tindall, Michele; Victor, Grant


    While recent research has stressed the supportive role that family and friends play for incarcerated persons as they re-enter the community, drug-using incarcerated women re-entering the community often have to rely on family, community, and intimate relationships that have played a role in their substance abuse and criminalization. In this study the authors conducted qualitative analysis of clinical sessions with rural, drug-using women (N = 20) in a larger prison-based HIV risk reduction intervention in Kentucky during 2012-2014 to examine incarcerated women's perceptions of the role of their family, community, and intimate relationships in their plans to decrease their substance abuse upon community re-entry. Women stressed the obstacles to receiving support in many of their family and drug-using relationships after community re-entry. Nonetheless, they asserted that changes in their relationships could support their desires to end their substance abuse by setting limits on and using their positive relationships, particularly with their children, to motivate them to change. Interventions to promote incarcerated women's health behavior changes-including substance abuse-must acknowledge the complex social environments in which they live.

  17. Family conflict, emotional security, and child development: translating research findings into a prevention program for community families. (United States)

    Cummings, E Mark; Schatz, Julie N


    The social problem posed by family conflict to the physical and psychological health and well-being of children, parents, and underlying family relationships is a cause for concern. Inter-parental and parent-child conflict are linked with children's behavioral, emotional, social, academic, and health problems, with children's risk particularly elevated in distressed marriages. Supported by the promise of brief psycho-educational programs (e.g., Halford et al. in Journal of Family Psychology 22:497-505, 2008; Sanders in Journal of Family Psychology 22:506-517, 2008), the present paper presents the development and evaluation of a prevention program for community families with children, concerned with family-wide conflict and relationships, and building on Emotional Security Theory (Davies and Cummings in Psychological Bulletin 116:387-411, 1994). This program uniquely focuses on translating research and theory in this area into brief, engaging programs for community families to improve conflict and emotional security for the sake of the children. Evaluation is based on multi-domain and multi-method assessments of family-wide and child outcomes in the context of a randomized control design. A series of studies are briefly described in the programmatic development of a prevention program for conflict and emotional security for community families, culminating in a program for family-wide conflict and emotional security for families with adolescents. With regard to this ongoing program, evidence is presented at the post-test for improvements in family-wide functioning, consideration of the relative benefits for different groups within the community, and preliminary support for the theoretical bases for program outcomes.

  18. Building Communities of Learners. A Collaboration among Teachers, Students, Families, and Community. (United States)

    McCaleb, Sudia Paloma

    This book suggests an approach to education that includes students' family members as valuable citizens in a community of learners which also includes students, teachers, and other members of the community at large. Part 1 examines current trends in parental involvement and the hidden assumptions on which many such programs are based. It is argued…

  19. source of information on family planning among married men in ...

    African Journals Online (AJOL)


    This is a questionnaire base study targeting 350 married men in Ekpoma. Participation was by choice and the ... KEYWORDS: Family planning, Information source, Married men, Contraceptive, Nigeria. INTRODUCTION. Organized family ... 1988 population policy played a key role in raising demand and supply for family ...

  20. [Psychosocial research and family planning services in Mexico]. (United States)

    Urbina Fuentes, M; Vernon Carter, R


    the best ways of providing family planning education for physicians, nurses, students, promoters, husbands, or other population groups. The greatest effort appears to have focused on development of educational materials for illiterates. Evaluative research on messages transmitted in IEC campaigns has however been abundant since the start of the programs. Careful studies of IEC c ampaigns in 1980-81 indicated that they improved knowledge of basic aspects of family planning considerably but had little effect on values and beliefs associated with family planning. Data on new acceptors in Mexico have come primarily from institutional registration systems, special studies, and as a subproduct of demographic surveys. Careful studies done by private organizations have provided information needed to reformulate commercial distribution programs and design supporting IEC campagns for their users and agents. Evaluative service studies have focuses on identifying factors in differential continuation rates for different methods and programs. Research on service delivery in rural areas has helped identify the most productive type of community worker and has uncovered causes of dissatisfaction and high turnover among workers which impairs their performance.

  1. Exploring Collaborative and Community Based Planning in Tourism Case Study Sitia-Cavo Sidero Project


    Katsouli, Penelope


    The present paper has explored the policy planning and development in emerging tourism settings in Sitia. Comprehensively, this study, in the name of sustainable development, focused on the extent of collaborative and community-based planning. For that reason exploratory research has been used; the context and the structure of this paper aimed to uncover the socially constructed reality of Sitia's stakeholders, within the dynamic environment, and respond to and questions. Therein significant ...

  2. Studies in Family Planning, Number 38. Beyond Family Planning. (United States)

    Berelson, Bernard

    This paper, published by The Population Council, reviews 29 proposals dealing with population controls beyond the current efforts of national programs of voluntary family planning. The proposals are subsumed under eight descriptive categories which are: (1) Extensions of voluntary fertility control; (2) Establishment of involuntary fertility…

  3. Indonesia's family planning program works toward self-sufficiency. (United States)

    Kunii, C


    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.

  4. A Congressional view: access to family planning important. (United States)

    Pelosi, N


    The US Congress has become reluctant to appropriate funds for family planning assistance in developing countries. In the Congress, international family planning has misguidedly and mistakenly become the battleground over abortion. It is unfortunate that the majority in the 104th and 105th Congress have undertaken a concerted attack on US support for international family planning by reducing needed funding and saddling the program with onerous restrictions. While the Congress debates international family planning funding, women, children, and families around the world are suffering the consequences of reduced and/or restricted access to family planning services. Cutting and/or restricting international family planning funds produces a devastating effect on the health and well-being of women and children in developing countries, and in the long term, the consequences will be overpopulation leading to poverty, malnutrition, urban crowding, environmental degradation, and the depletion of the world's resources.

  5. Strength-based well-being indicators for Indigenous children and families: A literature review of Indigenous communities' identified well-being indicators. (United States)

    Rountree, Jennifer; Smith, Addie


    Mainstream child and family well-being indicators frequently are based on measuring health, economic, and social deficits, and do not reflect Indigenous holistic and strength-based definitions of health and well-being. The present article is a review of literature that features Indigenous communities' self-identified strength-based indicators of child and family well-being. The literature search included Indigenous communities from across the world, incorporating findings from American Indians and Alaska Natives, First Nations, Native Hawaiians, Māori, Aboriginal Australians, and Sámi communities. Sorting the identified indicators into the quadrants of the Relational Worldview, an Indigenous framework for well-being based on medicine wheel teachings that views health and well-being as a balance among physical, mental, contextual, and spiritual factors, the authors discuss the findings.

  6. A family-centered, community-based system of services for children and youth with special health care needs. (United States)

    Perrin, James M; Romm, Diane; Bloom, Sheila R; Homer, Charles J; Kuhlthau, Karen A; Cooley, Carl; Duncan, Paula; Roberts, Richard; Sloyer, Phyllis; Wells, Nora; Newacheck, Paul


    To present a conceptual definition of a family-centered system of services for children and youth with special health care needs (CYSHCN). Previous work by the Maternal and Child Health Bureau to define CYSHCN has had widespread program effects. This article similarly seeks to provide a definition of a system of services. Comprehensive literature review of systems of services and consensus panel organized to review and refine the definition. Policy research group and advisors at multiple sites. Policy researchers, content experts on CYSHCN, family representatives, and state program directors. Definition of a system of services for CYSHCN. This article defines a system of services for CYSHCN as a family-centered network of community-based services designed to promote the healthy development and well-being of these children and their families. The definition can guide discussion among policy makers, practitioners, state programs, researchers, and families for implementing the "community-based systems of services" contained in Title V of the Social Security Act. Critical characteristics of a system include coordination of child and family services, effective communication among providers and the family, family partnership in care provision, and flexibility. This definition provides a conceptual model that can help measurement development and assessment of how well systems work and achieve their goals. Currently available performance objectives for the provision of care for CYSHCN and national surveys of child health could be modified to assess systems of services in general.

  7. Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa.

    Directory of Open Access Journals (Sweden)

    Edwin Wouters

    Full Text Available Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1 receive the support from a community-based health worker or (2 to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors-such as age, health status and coping styles-our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family's changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those

  8. Study findings on evaluation of integrated family planning programme performance. (United States)


    In 1976 the United Nations's Economic and Social Commission for Asia and the Pacific launched a comparative study on integrated family planning programs in a number of countries in the region. In November 1979 the study directors from the participating countries meet in Bangkok to discuss the current status of the studies in their countries. The Korean and Malaysian studies were completed, the Bangladesh study was in the data collecting phase, and the Pakistani research design phase was completed. The meeting participants focused their attention on the findings and policy implications of the 2 completed studies and also discussed a number of theorectical and methodological issues which grew out of their research experience. The Malaysian study indicated that group structure, financial resources, and the frequency and quality of worker-client contact were the most significant variables determining program effectiveness. In the Korean Study, leadership, financial resources, and the frequency and quality of contact between agencies were the key variables in determining program effectiveness. In the Malaysian study there was a positive correlation between maternal and child health service performance measures and family planning service performance measures. This finding supported the contention that these 2 types of service provision are not in conflict with each other but instead serve to reinforce each other. Policy implications of the Korean study were 1) family planning should be an integral part of all community activities; 2) family planning workers should be adequately supported by financial and supply allocations; and 3) adequate record keeping and information exchange procedures should be incorporated in the programs.

  9. Community-level effect of the reproductive health vouchers program on out-of-pocket spending on family planning and safe motherhood services in Kenya. (United States)

    Obare, Francis; Warren, Charlotte; Kanya, Lucy; Abuya, Timothy; Bellows, Ben


    Although vouchers can protect individuals in low-income countries from financial catastrophe and impoverishment arising from out-of-pocket expenditures on healthcare, their effectiveness in achieving this goal depends on whether both service and transport costs are subsidized as well as other factors such as service availability in a given locality and community perceptions about the quality of care. This paper examines the community-level effect of the reproductive health vouchers program on out-of-pocket expenditure on family planning, antenatal, delivery and postnatal care services in Kenya. Data are from two rounds of cross-sectional household surveys in voucher and non-voucher sites. The first survey was conducted between May 2010 and July 2011 among 2,933 women aged 15-49 years while the second survey took place between July and October 2012 among 3,094 women of similar age groups. The effect of the program on out-of-pocket expenditure is determined by difference-in-differences estimation. Analysis entails comparison of changes in proportions, means and medians as well as estimation of multivariate linear regression models with interaction terms between indicators for study site (voucher or non-voucher) and period of study (2010-2011 or 2012). There were significantly greater declines in the proportions of women from voucher sites that paid for antenatal, delivery and postnatal care services at health facilities compared to those from non-voucher sites. The changes were also consistent with increased uptake of the safe motherhood voucher in intervention sites over time. There was, however, no significant difference in changes in the proportions of women from voucher and non-voucher sites that paid for family planning services. The results further show that there were significant differences in changes in the amount paid for family planning and antenatal care services by women from voucher compared to those from non-voucher sites. Although there were greater

  10. Family planning services for incarcerated women: models for filling an unmet need. (United States)

    Sufrin, Carolyn; Baird, Sara; Clarke, Jennifer; Feldman, Elizabeth


    Purpose Incarcerated women around the globe are predominantly of reproductive age. Most of these women have been pregnant before, and many want to be sexually active and avoid pregnancy upon release. Yet few of these women are on a regular method of contraception. Providing contraceptive services for women in custody benefits individual and public health goals of reducing unintended pregnancy. This policy briefing reviews evidence for an unmet need for family planning in the correctional setting, and policy implications for expanding services. The paper aims to discuss these issues. Design/methodology/approach The authors describe four model programs in the USA with established contraceptive services on site, highlighting practical steps other facilities can implement. Findings Correctional facilities health administrators, providers, advocates, and legislators should advance policies which should counsel women on family planning and should make a range of contraceptive methods available before release, while remaining sensitive to the potential pressure these women may feel to use birth control in this unique environment. Practical implications Family planning services for incarcerated women benefits individuals, facilities, and the community. Social implications Policies which enable correctional facilities to provide comprehensive family planning to incarcerated women - including reproductive life goals counseling and contraceptive method provision - promote equity in access to critical reproductive health services and also provide broad scale population level benefits in preventing unintended pregnancy or enabling counseling for healthy pregnancies for a group of women who often have limited access to such services. Originality/value This policy briefing highlights an area of health care in prisons and jails which gets little attention in research and in policy circles: family planning services for incarcerated women. In addition to reviewing the importance of

  11. Hispanic Community College Students: Acculturation, Family Support, Perceived Educational Barriers, and Vocational Planning (United States)

    Fiebig, Jennifer Nepper; Braid, Barbara L.; Ross, Patricia A.; Tom, Matthew A.; Prinzo, Cara


    A multiple logistic regression model was used to determine the associations between the role of acculturation, perception of educational barriers, need for family kin support, vocational planning, and expectations for attaining future vocational goals against the demographic variables (gender, age, being the oldest child, the first to attend…

  12. Family Planning: Bosnian, Russian, Spanish, Nuer. (United States)

    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…

  13. HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity. (United States)

    Flattum, Colleen; Draxten, Michelle; Horning, Melissa; Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Garwick, Ann; Kubik, Martha Y; Story, Mary


    Involvement in meal preparation and eating meals with one's family are associated with better dietary quality and healthy body weight for youth. Given the poor dietary quality of many youth, potential benefits of family meals for better nutritional intake and great variation in family meals, development and evaluation of interventions aimed at improving and increasing family meals are needed. This paper presents the design of key intervention components and process evaluation of a community-based program (Healthy Home Offerings via the Mealtime Environment (HOME) Plus) to prevent obesity. The HOME Plus intervention was part of a two-arm (intervention versus attention-only control) randomized-controlled trial. Ten monthly, two-hour sessions and five motivational/goal-setting telephone calls to promote healthy eating and increasing family meals were delivered in community-based settings in the Minneapolis/St. Paul, MN metropolitan area. The present study included 81 families (8-12 year old children and their parents) in the intervention condition. Process surveys were administered at the end of each intervention session and at a home visit after the intervention period. Chi-squares and t-tests were used for process survey analysis. The HOME Plus program was successfully implemented and families were highly satisfied. Parents and children reported that the most enjoyable component was cooking with their families, learning how to eat more healthfully, and trying new recipes/foods and cooking tips. Average session attendance across the ten months was high for families (68%) and more than half completed their home activities. Findings support the value of a community-based, family-focused intervention program to promote family meals, limit screen time, and prevent obesity. NCT01538615.

  14. Video: useful tool for delivering family planning messages. (United States)

    Sumarsono, S K


    In 1969, the Government of Indonesia declared that the population explosion was a national problem. The National Family Planning Program was consequently launched to encourage adoption of the ideal of a small, happy and prosperous family norm. Micro-approach messages are composed of the following: physiology of menstruation; reproductive process; healthy pregnancy; rational family planning; rational application of contraceptives; infant and child care; nutrition improvement; increase in breastfeeding; increase in family income; education in family life; family health; and deferred marriage age. Macro-approach messages include: the population problem and its impact on socioeconomic aspects; efforts to cope with the population problem; and improvement of women's lot. In utilizing the media and communication channels, the program encourages the implementation of units and working units of IEC to produce IEC materials; utilizes all possible existing media and IEC channels; maintains the consistent linkage between the activity of mass media and the IEC activities in the field; and encourages the private sector to participate in the production of IEC media and materials. A media production center was set up and carries out the following activities: producing video cassettes for tv broadcasts of family planning drama, family planning news, and tv spots; producing duplicates of the video cassettes for distribution to provinces in support of the video network; producing teaching materials for family planning workers; and transfering family planning films into video cassettes. A video network was developed and includes video monitors in family planning service points such as hospitals, family planning clinics and public places like bus stations. In 1985, the program will be expanded by 50 mobile information units equipped with video monitors. Video has potentials to increase the productivity and effectiveness of the family planning program. The video production process is

  15. Shifting away from doorstep distribution of contraceptives in urban Bangladesh: effects on discontinuation and acceptance of family planning. (United States)

    Routh, S; Jahan, S A


    This paper examined the effects of alternative service-delivery strategies with regard to dropouts among the current pill and condom users who, before the intervention, were supplied with the methods by the fieldworkers at their homes in an operations research conducted by the Centre for Health and Population Research in urban Bangladesh. Moreover, the effects of the selective home visitation approach on acceptance of modern family planning methods among current nonusers were assessed. Two program areas of the Concerned Women for Family Planning in Dhaka City, one each at Wari and Siddiquebazar, served as the comparison areas. Data for the analyses came from the service records of the fieldworkers and community-based surveys. Results showed that the contraceptive prevalence rate (CPR) considerably increased in both the intervention areas: from the pre-intervention level of 63% to 68% at the Hazaribag primary health care clinic (PHCC) intervention area and from 55% to 57% at the Gandaria community service points (CSPs) intervention area. The corresponding increases at the two comparison areas were from 61% to 63% at Wari and from 60% to 63% at Siddiquebazar. The quantitative growth in the CPR in the PHCC-based strategy clearly indicated the comparative advantage of the clinic-based strategy in terms of sustainable program performance over conventional doorstep CBD- and CSP-based strategies.

  16. Practical education in family planning: integrative review

    Directory of Open Access Journals (Sweden)

    Creusa Ferreira da Silva


    Full Text Available Objectives: To identify educational practices in family planning, facilitating factors, difficulties and resulting impacts. Method: This is an integrative literature review, using the three descriptors: "family planning", "health education" and "contraception"; In the databases of the Scientific Electronic Library Online (SciELO, Latin American and Caribbean Literature in Health Sciences (LILACS and Nursing Database (BDENF, were searched in January and February 2016. Results: Regarding the accomplishment of educational practices, most of the studies pointed out its accomplishment. The difficulties and facilitators aspects were related to the management of the health service, professional competence and users. Guarantee of family rights and autonomy were the impacts pointed out. Conclusion: The study showed that educational practices in family planning are tools to be encouraged as a guarantee and respect for sexual and reproductive rights. Descriptors: family planning; education in health; contraception.

  17. Contraceptive social marketing and community-based distribution systems in Colombia. (United States)

    Vernon, R; Ojeda, G; Townsend, M C


    Three operations research experiments were carried out in three provinces of Colombia to improve the cost-effectiveness of Profamilia's nonclinic-based programs. The experiments tested: (a) whether a contraceptive social marketing (CSM) strategy can replace a community-based distribution (CBD) program in a high contraceptive use area; (b) if wage incentives for salaried CBD instructors will increase contraceptive sales; and (c) whether a specially equipped information, education, and communication (IEC) team can replace a cadre of rural promoters to expand family planning coverage. All three strategies proved to be effective, but only the CSM system yielded a profit. Despite this, Profamilia discontinued its CSM program soon after the experiment was completed. Unexpected government controls regulating the price and sale of contraceptives in Colombia made the program unprofitable. As a result, family planning agencies are cautioned against replacing CBD programs with CSM. Instead, CBD programs might adopt a more commercial approach to become more efficient.

  18. Old and new ways: family planning in Kenya. (United States)

    Antarsh, L


    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.

  19. Work, Family and Community Support as Predictors of Work-Family Conflict: A Study of Low-Income Workers (United States)

    Griggs, Tracy Lambert; Casper, Wendy J.; Eby, Lillian T.


    This study examines relationships between support from work, family and community domains with time- and strain-based work-family conflict in a sample of low-income workers. Results reveal significant within-domain and cross-domain relationships between support from all three life domains with work--family conflict. With respect to family support,…


    Directory of Open Access Journals (Sweden)

    Adilson Ribeiro dos Santos


    Full Text Available The Municipal Health Plan is an important planning tool in the management at the Unified Health System and at the same time, a mechanism for popular participation. This study aims to report the experience of the Municipal Health Plan’s workshop conducted by a Family Health Program team in a municipality in the south of Bahia Construção do Plano Municipal de Saúde. in the year 2014. This is an experience report that consolidates itself as a descriptive research tool that presents a reflection about an action that addresses a situation experienced in the professional interest of the scientific community. The workshop included the team and community members’ participation. The population's health problems follow a national trend, highlighting problems like diabetes, hypertension, worms, abuse of alcohol and other drugs inaddition to viruses. The health system problems reveal the weaknesses in local management of the Unified Health System by the insufficiency and/or lack of resources such as drugs, tests, equipment maintenance and others. Therefore, we emphasize the importance of the Municipal Health Plan as a management tool of the Unified Health System that allows closeness between users, workers and managers, as well as being a space for policy vocalization, contributing to the real effectiveness of the Unified Health System, based on participatory planning in accordance with the needs of users.

  1. Women's attitudes towards receiving family planning services from ...

    African Journals Online (AJOL)

    These are age, level of education, knowledge about family planning benefits and districts. Conclusion: Women's perception towards family planning services delivered by CHWs in Western region in Kenya is quite low. To improve the demand and supply for family planning services in this region, there is need to invest a ...

  2. A Community-Based Continuing Care Program for the Elderly Disabled. An Evaluation of Planned Intermittent Hospital Readmission (United States)

    Robertson, Duncan; And Others


    Utilizing flexible community-supporting services integrated with a hospital-based program of planned intermittent relief of the patients' supporters, patients (N=50) were maintained in the community at an average cost of 79.5 hospital bed days per patient per annum. The Continuing Care Program is an alternative to institutionalization. (Author)

  3. Funding for international family planning attacked. (United States)

    Kaeser, L


    US funding for foreign assistance has been jeopardized in recent years in the context of dwindling public support for foreign aid. To stymie the provision of international family planning program assistance and services overseas, Congressional opponents of family planning and abortion are offering amendments to foreign aid legislation at every possible opportunity. State Department reauthorization legislation is the current target of family planning opponents' efforts. Reauthorization is the process by which Congress indicates its ongoing support for a program, makes any necessary changes, and sets new funding ceilings. The global gag rule joined UNFPA funding cuts on the 1997 State Department reauthorization bill, H.R. 1757, which passed the House of Representatives in early June. If successfully appended to the State Department bill, the gag rule would prevent the US from funding any organization in a developing country which provides legal abortion services or communicates with its government on abortion-related policy, regardless of whether that organization used its own non-US funds. These restrictions and cuts to international family planning program assistance could adversely affect family planning programs, leading to less contraceptive use and higher rates of abortion, maternal morbidity, and maternal mortality. President Bill Clinton has promised to veto the bill if both houses of Congress accept the restrictions. These issues will probably arise on the annual appropriations legislation which funds US operations overseas.

  4. National Needs of Family Planning Among US Men Aged 15 to 44 Years (United States)

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


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

  5. The home-based maternal record: a tool for family involvement in health care. (United States)

    Shah, P M; Shah, K P; Belsey, M A


    The home-based maternal record offers an opportunity for family involvement in health care. Home-based records of maternal health have been used in several developing countries, and have led to increased detection and monitoring of women at high risk for complications during pregnancy. Home-based cards that include menstrual information remind health workers to educate and motivate women for family planning, and serve as a source of health statistics. Records that use pictures and symbols have been used by illiterate traditional birth attendants, and had an accurate completion rate of over 90%. The WHO has prepared a prototype record and guidelines for local adaptation. The objectives were to provide continuity of care throughout pregnancy, ensure recognition of at-risk women, encourage family participation in health care, an provide data on maternal health, breastfeeding, and family planning. The guidelines have been evaluated and results show that the records have improved the coverage, acceptability, and quality of MCH/FP care. The records have also led to an increase in diagnosis and referral of at-risk women and newborns, and the use of family planning and tetanus toxoid immunization has increased in the 13 centers where the reports are being used. Focus group discussions have shown that mothers, community members, primary health workers, and doctors and nurses liked the records. It is important to adapt criteria for high-risk conditions to the local areas where the records will be used to ensure the relevance of risk diagnosis. The evidence shows that home-based maternal and child records can be an important tool in the promotion of self-reliance and family participation in health care. In addition, home-based records can be used for the implementation of primary health care at the local level, and serve as a resource for data collection.

  6. A community-based qualitative study of intergenerational resilience with Palestinian refugee families facing structural violence and historical trauma. (United States)

    Atallah, Devin G


    The purpose of this study was to explore resilience processes in Palestinian refugee families living under Israeli occupation for multiple generations. Qualitative methods, critical postcolonial theories, and community-based research approaches were used to examine intergenerational protective practices and to contribute to reconceptualizations of resilience from indigenous perspectives. First, the researcher developed a collaborative partnership with a nongovernmental organization (NGO) in a UN refugee camp in the occupied West Bank. Then, with the support of this NGO, semistructured group and individual interviews were completed with a total of 30 participants ( N = 30) ranging in age from 18 to 90 years old coming from 5 distinct extended family networks. Using grounded theory situational analysis, the findings were organized in a representation entitled Palestinian Refugee Family Trees of Resilience (PRFTR). These findings explain resilience in terms of three interrelated themes: (a) Muqawama/resistance to military siege and occupation; (b) Awda/return to cultural roots despite historical and ongoing settler colonialism; and (c) Sumoud/perseverance through daily adversities and accumulation of trauma. The study findings shed light on how Palestinian families cultivate positive adaptation across generations and highlight how incorporating community-based perspectives on the historical trauma and violent social conditions of everyday life under occupation may be critical for promoting resilience. Results may be relevant to understanding the transgenerational transmission of trauma and resilience within other displaced communities internationally.

  7. Development and evaluation of a training workshop for lay health promoters to implement a community-based intervention program in a public low rent housing estate: The Learning Families Project in Hong Kong. (United States)

    Lai, Agnes Y; Stewart, Sunita M; Wan, Alice; Fok, Helen; Lai, Hebe Y W; Lam, Tai-Hing; Chan, Sophia S


    This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled "Learning Families Project", under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees' knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees' reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents' survey results before and after participating in the community activities delivered by the trainees. The trainees' learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen's d: 0.5-1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen's d: 0.4-0.6). The application of planning skills to implement community activities was higher at one year (Cohen's d: 0.4), compared with baseline. At one year, the residents' survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical

  8. Values clarification as a technique for family planning education. (United States)

    Toohey, J V; Valenzuela, G J


    A Spanish language family planning education program utilizing the dynamics of values clarification has been designed and implemented in the state of Oaxaca, Mexico. The design of the program features three basic personality identification activities to help individuals identify other dimensions of adult life expression than child rearing. In addition, a series of simple and precise scenarios specifically related to family planning are presented. Each scenario is accompanied by a set of valuing questions that direct the learner to respond to the scenario. The activity booklet is entitled, "Clarification De Valores En La Planificacion Familar." The booklet requires the learner to make responses to the learning materials. Responses are then used as a basis for inferring that people are comprehending and above all personalizing knowledge about themselves and their culture and family planning. The program is cross cultural and can be used in Spanish speaking communities in the U.S. Its English language form can be used with English speaking target populations. Statistical analysis of seven critical categories of the program indicated that the shifts in attitudes from pre-to post-values, whether positive or negative (desirable or undesirable), were not significant at the .05 level of confidence. It should, however, be noted that small shifts in the rate of natural increase, or rate of natural decrease for population growth can have a dramatic effect on population growth when multiplied by time.

  9. Capturing Complexities of Relationship-Level Family Planning Trajectories in Malawi. (United States)

    Furnas, Hannah E


    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.

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

    Wafai, M


    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

  11. Providing choices for a marginalized community. A community-based project with Malaysian aborigines. (United States)

    Kaur, P


    In 1991, the Family Planning Association (FPA) of the Malaysian state of Perak initiated a community-based development project in the remote Aborigine village of Kampung Tisong. The community consists of approximately 34 households who survive on an average income of about US $37. Malnutrition is pervasive, even minor ailments cause death, more serious afflictions are prevalent, and the closest government clinic is 20 kilometers away and seldom used by the Aborigines. 70% of the children have access to education, but parental illiteracy is a serious educational obstacle. The goals of the FPA program are to 1) promote maternal and child health and responsible parenthood, 2) provide health education, 3) encourage women to seek self-determination, and 4) encourage the development of self-reliance in the community as a whole. The first step was to survey the community's culture, beliefs, and health status with the help of the Aborigines Department and the village headman. After a series of preliminary meetings with other agencies, the FPA began to provide activities including health talks, health courses and demonstrations, medical examinations and check-ups, and first aid training. Environmental protection and sanitation measures were included in the educational activities, and following the traditional "mutual aid system," a small plot of land was cleared for vegetable production. Vegetable gardens and needlecraft will become income-producing activities for the women. Attempts to motivate the women to use family planning have been hindered by the fact that the health of 2 women deteriorated after they began using oral contraceptives. Positive changes are occurring slowly and steadily, however, and the FPA has been instrumental in having the settlement included in a program for the hardcore poor which will provide new housing and farming projects.

  12. Family planning use and its associated factors among women in the extended postpartum period in Addis Ababa, Ethiopia. (United States)

    Gebremedhin, Almaz Yirga; Kebede, Yigzaw; Gelagay, Abebaw Addis; Habitu, Yohannes Ayanaw


    Postpartum period is an important entry point for family planning service provision; however, women in Ethiopia are usually uncertain about the use of family planning methods during this period. Limited studies have been conducted to assess postpartum family planning use in Addis Ababa, in particular and in the country in general. So, this study was conducted to assess postpartum family planning use and its associated factors among women in extended postpartum period in Kolfe Keranyo sub city of Addis Ababa. A community-based cross sectional study was conducted from May to June 2015 on 803 women who have had live births during the year (2014) preceding the data collection in the sub city. The multi-stage cluster sampling technique was used to select study participants. Data were collected by interviewer administered structured questionnaire, entered into EPI INFO version 7 and analyzed by SPSS Version 20. Bivariable and Multivariable logistic regression models were employed to see the presence and strength of the association between the dependent and independent variables by computing the odds ratios with a 95% confidence intervals and p -values. The prevalence of postpartum family planning use was 80.3% (95% CI: 74.5, 83.1). Marriage, (AOR 0.09, 95% CI: 0.03, 0.22), menses resumption after birth, (AOR 2.12, 95% CI: 1.37, 3.41), length of time after delivery, (AOR 2.37, 95% CI: 1.18, 4.75), and history of contraceptive use before last pregnancy, (AOR 0.12, 95% CI: 0.07, 0.18) were the factors associated with postpartum family planning use. The prevalence of postpartum family planning use was high and the main factors associated with it were marriage, menses resumption, length of time after delivery, and history of previous contraceptive use. Therefore women should get appropriate information about the possibility of exposure to pregnancy prior to menses resumption by giving special emphasis to those who had no previous history of contraceptive use and exposure to

  13. Introducing the World Health Organization Postpartum Family Planning Compendium. (United States)

    Sonalkar, Sarita; Gaffield, Mary E


    The postpartum period offers multiple opportunities for healthcare providers to assist with family planning decision making. However, there are also many changing factors during the first year after delivery that can affect family planning choices. Given that several different documents have addressed WHO guidance on postpartum family planning, the electronic WHO Postpartum Family Planning Compendium ( has been introduced. This resource integrates essential guidance on postpartum family planning for clinicians, program managers, and policy makers. The development of the Compendium included consultations with family planning experts, key international stakeholders, and web developers. Once the website had been created, user testing by family planning experts allowed for improvements to be made before the official launch. Future directions are adaptation of the website into a mobile application that can be more easily integrated to low-resource settings, and translation of the content into French and Spanish. © 2016 World Health Organization. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  14. Family emergency preparedness plans in severe tornadoes. (United States)

    Cong, Zhen; Liang, Daan; Luo, Jianjun


    Tornadoes, with warnings usually issued just minutes before their touchdowns, pose great threats to properties and people's physical and mental health. Few studies have empirically investigated the association of family emergency preparedness planning and observed protective behaviors in the context of tornadoes. The purpose of this study was to examine predictors for the action of taking shelter at the time of tornadoes. Specifically, this study investigated whether having a family emergency preparedness plan was associated with higher likelihood of taking shelter upon receiving tornado warnings. This study also examined the effects of socioeconomic status and functional limitations on taking such actions. A telephone survey based on random sampling was conducted in 2012 with residents in Tuscaloosa AL and Joplin MO. Each city experienced considerable damages, injuries, and casualties after severe tornadoes (EF-4 and EF-5) in 2011. The working sample included 892 respondents. Analysis was conducted in early 2013. Logistic regression identified emergency preparedness planning as the only shared factor that increased the likelihood of taking shelter in both cities and the only significant factor in Joplin. In Tuscaloosa, being female and white also increased the likelihood of taking shelter. Disability was not found to have an effect. This study provided empirical evidence on the importance of having a family emergency preparedness plan in mitigating the risk of tornadoes. The findings could be applied to other rapid-onset disasters. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

  15. Service-Learning in the Financial Planning Curriculum: Expanding Access to the Community (United States)

    Annis, Paul M.; Palmer, Lance; Goetz, Joseph


    Service-learning projects are a cornerstone of student experiential learning. Such programs have proven to be mutually beneficial to communities and students within a variety of family and consumer sciences courses. However, there is a paucity of literature addressing service-learning efforts within the field of financial planning. There is an…

  16. Reproductive goals and family planning attitudes in Pakistan: a couple-level analysis. (United States)

    Mahmood, N


    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.

  17. [Paper on sterilization in the family planning programs of Colombia: a national debate]. (United States)

    Rizo, A; Roper, L


    During 1984, family planning became the object of heated public debate in Colombia. In particular, considerable controversy surrounded the practice of sterilization. In Colombia in 1980, 49% of married women were practicing family planning. The main protagonist has been Profamilia, an IPPF affliate, which runs clinics and advisory services throughout Colombia. Sterilization is performed quite extensively on men of at least 28 years and women of 25 with 3 living children. Further activities of Profamilia include community distribution and social marketing programs. Many of the health facilities used are those of the Ministry of Public Health. The Minister of Health responded to criticism levelled by the Catholic church and others by instituting an investigation into alleged practices of mass sterilization. Profamilia declared publicy that sterilization was performed only under certain conditions, after waiting periods, and under no circumstances with coersion. Various groups including medical associations publicy supported Profamilia. Although recognizing the need for families to be limited in size, religious and other commentators suggested that sterilization was often presented as a solution to family ills, and that it represented foreign involvement in Colombian social policy. The opposing opinions were that church-supported natural family planning was not an effective enough strategy. The ministry has resolved to invoke more stringent screening of women desiring sterilization to include natural family planning in its programs, and to deal with international organizations only on the ministry level. The number of sterilizations has diminished. The controversy helped to expose political weaknesses of Profamilia's programs (e.g. the use of monetary incentives; lack of supervision).

  18. Special Report: Banjul Islam Conference endorses family planning. (United States)


    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.

  19. My university. What I learned from the Productive Cooperative Movement to Promotion of Humanistic Family Planning. (United States)

    Kunii, C


    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.

  20. [Diversification is the financial alternative for family planning]. (United States)

    Castro Villamil, R


    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

  1. Renewing focus on family planning service quality globally. (United States)

    Hancock, Nancy L; Stuart, Gretchen S; Tang, Jennifer H; Chibwesha, Carla J; Stringer, Jeffrey S A; Chi, Benjamin H


    Reducing the global unmet need for contraception is currently a priority for many governments, multi-lateral initiatives, non-governmental organizations, and donors. Evidence strongly suggests that the provision of quality family planning services can increase uptake, prevalence, and continuation of contraception. While an accepted framework to define the components of family planning service quality exists, translating this framework into assessment tools that are accessible, easily utilized, and valid for service providers has remained a challenge. We propose new approaches to improve the standardization and accessibility of family planning service quality assessment tools to simplify family planning service quality evaluation. With easier approaches to program evaluation, quality improvements can be performed more swiftly to help increase uptake and continuation of contraception to improve the health of women and their families.

  2. Family planning education helps build self-esteem. (United States)

    Choudhary, P


    I got married at the age of 20. In our community, generally girls are married off at 15 or 16, but my marriage was delayed according to my father's and my wishes. I did not desire to have my first child immediately. My husband and I are very young and I did not want to assume maternal responsibilities so early in life. Picking up courage, I spoke to my husband. On learning that he had similar views, I was very relieved. I belong to a middle-class family. Due to an absence of a high school in the village. I was forced to drop out of school. Young girls in our community are not allowed to move freely within the village, much less the outside world. But when I was 19, I got the opportunity to gain a lot of information on family planning, health, personal hygiene and good nutrition as part of the Better Life Project. I also learned beauty skills, embroidery, knitting and video film-making. Often I share the information and skills I learned with others. I have even advised my brother's wives about proper child care and immunization. Now that I have a good relationship with the unmarried sister of my husband, I sometimes tell her whatever I have learned. I have felt a great change in myself. My earlier inhibitions in talking to people have dropped, and I can entertain and speak freely with guests who come home. I am more confident about traveling outside my village to other places alone or with company. Learning to operate a video camera and producing a film was my favorite experience. I discovered that I can do what is normally said to be the work of boys only. Sometimes I think that if I had not learned new skills, I would not have been able to share my feelings about family planning with my husband. My mother-in-law is also agreeable to our decision about waiting to have children because both my brothers-in-law have large families. However, I have to face my sisters-in-law who taunt me about my childless status. The problem now is that my husband is not satisfied

  3. Family Based Premarital Teenager Education in Islamic Education Perspective in Kaili Community in Palu

    Directory of Open Access Journals (Sweden)

    Andi Markarma


    Full Text Available The widespread of premarital pregnancy is caused by rampant  promiscuity among female teenagers. The promiscuity occurs due to lack parents’ supervision. Female teenagers  often break  religious, ethical, moral and customary norms. Therefore,  it is important to provide teenagers with pre-marriage education materials. Islam teaches its adherents not to be in hurry in everything except in five things: burial of corpse, paying debts, serving travelers, repenting, and marrying. This study attempts to examine family-based premarital sex education in Islamic education perspectives in the Kaili community in the Palu Valley. The researcher used a quantitative-descriptive approach to see the relationship of research variables. The results show that, the majority of housewife knowledge about premarital education is very low. This certainly affect the lack of premarital sex  education of their young daughters. Low knowledge of housewives and young female regarding premarital sex  education because families do  not teach and socialize moral, ethical, and ethical values effectively in their communities.

  4. Recruiting patients for postgraduate medical training in a community family planning clinic: how do patients want to be asked? (United States)

    Heathcote, Jennifer


    To look at patients' views about the way in which they are recruited to assist with postgraduate medical training (i.e. Who is the best person to ask patients to participate? When is the best time for patients to be asked?) and to compare these with clinical practice. Questionnaire surveys of 103 female family planning clinic (FPC) patients and 40 Diploma of the Faculty of Family Planning (DFFP) instructing doctors. Patients were recruited from the waiting room of a community FPC, and DFFP instructing doctors from the North West of England were recruited at an updating meeting. Patients preferred to be recruited by non-medical staff (i.e. receptionist and nurses). Few patients wanted to be asked by the training doctor. Only 9% would find it difficult to refuse a receptionist, 47% would find it difficult to refuse the instructing doctor and 65% would find it difficult to refuse the training doctor. In practice, the commonest person to recruit patients is the instructing doctor. Patients wanted to be given some time to consider the request; this was not always given. Patients may feel coerced into seeing training doctors because they find it difficult to refuse requests, particularly when they are being recruited by doctors. Non-medical staff may be more appropriate for the initial recruitment of patients. Patients need time to consider their involvement. The provision of written information may be useful. Further research is indicated to empower patients' decision-making and reduce the likelihood of coercion.

  5. Family planning uses traditional theater in Mali. (United States)

    Schubert, J


    Mali's branch of the International Planned Parenthood Federation has found a vehicle that effectively conveys the idea of family planning through the use of contraception, a method that blends the country's cultural heritage and modern technology. Despite becoming the first sub-Saharan francophone country to promote family planning, Mali only counted 1% of its population using a modern method of contraception. So with the aid of The Johns Hopkins University/Population COmmunication Services (JHU/PCS), the Association Malienne pour la Protection et la Promotion de la Famille (AMPPF) developed several programs to promote contraception, but none were more successful than the Koteba Project, which used Mali's traditional theater form to communicate the message. While comical, the Koteba generally deals with social issues -- it informs and entertains. This particular Koteba told the story of two government employees, one with two wives and many children, the other with one wife and few children. The first one sees nothing but family problems: fighting wives and delinquent children. The second one, who had used family planning, enjoys a peaceful home. Upon hearing of his friend's successes with family planning, the tormented government employee becomes convinced of its needs, and persuades his wives to accompany him to a family planning clinic. Developed at a cost of approximately US $3000 and televised nationwide, the Koteba proved effective. A survey of 500 people attending an AMPPF clinic revealed that 1/4 of them remembered the program. With the success of the Koteba, JHU/PCS and AMPPF are now exploring other traditional channels of communication.

  6. New awareness campaign increases appeal of family planning. (United States)


    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.

  7. Contraception. Family planning: by whom and for whom? (United States)

    Stemerding, B


    Many people consider family planning to be the cure for population growth and its consequences (poverty, child mortality, morbidity, depletion of natural resources, and environmental degradation). International organizations support family planning programs and population-political strategies control their operations. Other key players in family planning are the pharmaceutical industry, the churches, and governments. Women tend not be involved in developing population and family planning policies, however, but instead implement the policies. Population planners are generally not interested in family planning methods which give women control over their own bodies, e.g., female-controlled barrier methods. In fact, they distrust them because the planners consider women to be unreliable. Besides, the low effectiveness of these methods means women need to rely on abortion, which is a problem in many developing countries, e.g., Latin America. Further, family planning programs must meet predetermined goals, so their service is lacking, e.g., limited supply of contraceptives and not enough time to provide information to clients. Family planning revolves around women. For example, they encourage them to talk their partners into approving the women's use of contraception, but this is almost always difficult for women in developing countries. Provision of family planning cannot be successful without society accepting and treating women as full citizens. In addition, society needs to realize that women have a sexuality separate from men. Political will is needed for these changes in attitude. The international women's movement does not agree on the degree which women can control contraceptives themselves. Women's groups are working to improve the position and independence of women and contraception is just 1 factor which can help them achieve this goal. The Women's Sexuality and Health Feminist Collective in Sao Paulo, Brazil, is an example of a coalition of women's health

  8. A cost-benefit analysis of the Mexican Social Security Administration's family planning program. (United States)

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


    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.

  9. School Community Connectedness and Family Participation at School (United States)

    Dove, Meghan K.; Zorotovich, Jennifer; Gregg, Katy


    Family involvement in a child's education is a complex system that extends beyond the presence of partnerships between families, schools, and the community (Epstein, 2011). By measuring families' feelings of connectedness and membership to the school community, this study explores families' motivations for participating in their child's learning…

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

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


    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.

  11. Determinants of unmet need for family planning among currently married women in Dangila town administration, Awi Zone, Amhara regional state; a cross sectional study. (United States)

    Genet, Ewnetu; Abeje, Gedefaw; Ejigu, Tadese


    Unmet need for family planning is a major problem of developing countries. Evidences about unmet need for family planning and associated factors are not enough in Dangila town. Therefore, this study was done to assess the magnitude and determinants of unmet need for family planning among currently married women in Dangila town. Community based cross sectional study design was used to collect data from a total of 551 currently married women from February to March 2014. Data were collected using pretested structured interviewer administered questionnaire after written consent was obtained from respondents. Collected data were edited, coded, and entered to SPSS version 16.0. Bivariate and multivariable logistic regression analyses were done to identify determinants of unmet need for family planning. This study revealed that 17.4 % of married women had unmet need for family planning. In this study, women who were housewife/farmers were about 7 [OR = 6.81 (1.91-24.29)] times more likely to have unmet need compared to employed women. Women who were not counseled about family planning by health workers [OR = 6.76 (3.17-14.42)], women whose partner had non-supportive attitude for family planning use [OR = 3.34 (1.26-8.90)] and rural women [OR = 17.65 (4.35-71.67)] were also more likely to have unmet need for family planning. About 33 %, 32 %, 23.5 % and 11.8 % of women mentioned less perceived risk of pregnancy due to breast feeding, fear of side effects, partner opposition and religious prohibition respectively as reasons for not using contraceptives at the time of interview. The level of unmet need for family planning in the study area is still high compared to the target set (10 %) in the national family planning guide plan of Ethiopia to be achieved by the end of 2015. Therefore, it is important to strengthen counseling and partner involvement in Dangila town to reduce unmet need for family planning.

  12. Promotion of family planning services in practice leaflets. (United States)

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


    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.

  13. Personal and family attributes of pregnant teenagers: findings from a community-based study in Sri Lanka. (United States)

    Fernando, Dulitha N; Gunawardena, Nalika S; Weerasinghe, Manuj Chrishantha


    Teenage pregnancies are associated with negative outcomes. Prevention requires understanding them and their families. This study aimed to describe personal and family attributes of pregnant teenagers in Sri Lanka. This was a community-based study in Sri Lanka among 510 pregnant teenagers. Half (50%) of the subjects were 19 years of age at the time of pregnancy. A majority (79.8%) had studied up to grades 6-11. Confidence in decision-making (80.7%) and in refusing unnecessary requests (88.3%) was "excellent" in a majority. Mean age of marriage/co-habiting was 17.6 years. For 31%, marriage/cohabiting was a sudden decision taken jointly with their partner (81.6%) and 83% reported being "legally" married. Substantial proportions of mothers (17.6%) and fathers (13.9%) had not attended school, and 33.1% mothers had worked abroad. Teenagers reported the death of a parent (14.1%), parental separation (10.9%) and being brought up by relatives (20%). Only a few rated strictness of rules/regulations (32.4%), freedom to discuss problems regarding puberty (25.5%), love affairs (12.7%) and sexuality (26.7%) as excellent/good. Of the spouses, 12.9% were <20 years, 71.9% had low education and 98.8% were employed. A majority had "planned" the pregnancy, and for 79.8%, the reason was "husband's wish to have a baby". Pregnant teenagers were mostly in their late teens, from poor families and with low formal education. Though teenagers showed confidence in decision-making, the decision to have a pregnancy had mostly been their spouses. Parents and spouses of the teenagers were also young, less educated and poor. There was evidence of poor parenting practices.

  14. Family intervention in Indigenous communities: emergent issues in conducting outcome research. (United States)

    Turner, Karen; Sanders, Matthew


    Indigenous children and youth are at greater risk of emotional and behavioural problems than non-Indigenous youth, with family life stresses and parenting style identified as common risk factors. There is substantial evidence that parenting programs can improve family relationships and improve child outcomes, however little research has focused on Indigenous communities. Our team is conducting research to evaluate a culturally sensitive adaptation of a mainstream intervention, the Group Triple P---Positive Parenting Program, for Indigenous families. This paper shares some of the insights into research and clinical issues gained as non-Indigenous researchers working with urban, rural and remote Indigenous communities. The experience of the research team and feedback from practitioners and parents have been drawn on for this discussion. Parenting programs need to be sensitive to the political and cultural context in which parenting takes place, flexibly incorporate cultural practices and expectations, and develop an evidence base of outcomes for families in diverse communities. As research is needed to evaluate the acceptability and effectiveness of these programs, culturally sensitive research practices are also necessary and the value of program evaluation and its benefit to the community must be clear. Community acceptance of the research process and the intervention itself is vital and may be influenced by community perceptions, current priorities, and local issues. If our overall aim is to increase the skilled health and mental health workforce in Indigenous communities and their use of evidence-based interventions, ongoing collaborative relationships between research institutions and service providers will serve to further this aim.

  15. Communication, knowledge, social network and family planning ...

    African Journals Online (AJOL)

    Family planning utilization in Tanzania is low. This study was cross sectional. It examined family planning use and socio demographic variables, social networks, knowledge and communication among the couples, whereby a stratified sample of 440 women of reproductive age (18-49), married or cohabiting was studied in ...

  16. Parenting in Planned Lesbian Families

    NARCIS (Netherlands)

    Bos, Henny


    This thesis reports on a study on lesbian families in which the children were born to the lesbian relationship (planned lesbian families). How strong is the desire of lesbian mothers to have a child, and what are their motivations? How do lesbian mothers experience parenthood? What do they strive

  17. Stakeholder perceptions of a total market approach to family planning in Nicaragua. (United States)

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


    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.

  18. Family planning and the controversial contraceptives. (United States)

    Dias Saxena, F


    India was one of the first countries in the world to launch a national family planning program in an apparent effort to help women gain access to birth control measures and reduce population growth. Family planning acquired a different meaning and emphasis in the 1960s, however, when a clause in the US PL480 wheat import policy demanded that India speed its implementation of birth control measures if the country wanted food aid. Women in India were therefore expected to consume contraceptives with dangerous and unknown side effects in order to quality the country for food aid. Women rejected this stipulation. By the 1980s, it was acknowledged that family planning programs in India had failed to produce a decline in the birth rate and that no sign of change was on the horizon despite the investment of substantial funds to that end, the input of expert assistance, and the establishment of appropriate infrastructure in the country. Experts and policy makers blamed women for having misused the pill and sought alternative methods which would not require user compliance. Norplant and norethisterone enanthate (Net-en) were subsequently developed. Policymakers, experts, and the press have now been clamoring for the right to conduct Norplant trials despite reported side effects. The drug's ability to prevent pregnancy is more important for family planning experts. The author notes that the emphasis has been upon contraceptive methods for women instead of men because men were not expected to take responsibility for family planning. She also notes that feminists are opposed to Norplant and Net-en, and hopes that the government withdraws them from the market.

  19. "Guji, Guji, Angela]" Family planning programme. (United States)

    She, W


    Demand for contraception and sterilization among women in Tibet is high. In 1966, when a family planning service team was sent to Namling County by the Maternal and Child Health Hospital (MCHH) of the Region, more than 500 women from six local townships arrived at the county MCHH seeking surgical sterilization. Since only one doctor was available to do ligation, most of the women were turned away; however, they would not leave until they were given a written appointment for a future date. In 1996, a 27-year-old Tibetan mother from Baxoi County, who had 5 children, traveled for 2 days, with 2 of her children, to a county town to be sterilized. A woman from Tingri County, who had 4 children, reached a county hospital only to be asked to return home; again, there were only one or two doctors available. She gave birth to a 5th child and returned to the hospital; again, the doctor was unavailable. Since then, she has delivered a 6th child. According to Bai Lang (secretary of the County Party committee), who spoke before the Regional Family Planning Committee, Namling County's nationally recognized poverty could have been alleviated if family planning had been implemented earlier. Family planning policy has been accepted well there.

  20. Aid for family planning in Egypt. (United States)


    A $5 million credit has been approved by the International Development Association, an affilate of the World Bank, to help finance a population project in Egypt. The project provides for the construction, equipping and furnishing of 22 general health centers, 12 polyclinics, 3 centers for training nursing teachers and 3 centers for in service training. 100 and 50 multipurpose vehicles will be provided to improve mobility of family planning services. Also included are a study on the maintenance of health facilities, 3 evaluation studies of family planning acceptors, an experimental home visiting program to inform and motivate people on family planning, and assistance in the production of health education material useful for family planning information and motivation. Simple demographic facts illustrate the seriousness of the population problem in Egypt. The current population of 35 million will be double by the year 2000 if the present 2.5% annual increase continues. This will put strains on a country whose population density quadrupled during the last century, and which stands to day at 950 persons per square kilometer of habitable land, a density rivalled by only 2 or 3 other countries in the world. The IDA credit will cover about 1/2 of the project's expense. The Egyptian government will finance the local costs. full text

  1. Quality of family planning services in Northwest Ethiopia | Fantahun ...

    African Journals Online (AJOL)

    Background: The unmet need for family planning services in Ethiopia is believed to be high (36%) while the already available services do not appear to be optimally used by potential clients. It is thus expected that an assessment and improvement of the quality of family planning services could enhance family planning ...

  2. Comparative Study of the Characteristics of Family Planning Service ...

    African Journals Online (AJOL)

    In logistics regression analysis family planning was significantly lower in the illiterate. Positive husband\\'s attitude had the strongest association (0R 9.3, 95% CI 4.6,18.7) with family planning, in addition to programs that create demand for smaller well-spread children, IEC and family planning services should target men and ...

  3. Implementation of a Family Planning Clinic-Based Partner Violence and Reproductive Coercion Intervention: Provider and Patient Perspectives. (United States)

    Miller, Elizabeth; McCauley, Heather L; Decker, Michele R; Levenson, Rebecca; Zelazny, Sarah; Jones, Kelley A; Anderson, Heather; Silverman, Jay G


    Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers. Copyright © 2017 by the Guttmacher Institute.

  4. The Healthy Children, Strong Families Intervention: Design and Community Participation (United States)

    Adams, Alexandra K.; LaRowe, Tara L.; Cronin, Kate A.; Prince, Ronald J.; Wubben, Deborah P.; Parker, Tassy; Jobe, Jared B.


    Healthy Children, Strong Families (HCSF) is a 2-year, community-driven, family-based randomized controlled trial of a healthy lifestyles intervention conducted in partnership with four Wisconsin American Indian tribes. HCSF is composed of 1 year of targeted home visits to deliver nutritional and physical activity curricula. During Year 1, trained…

  5. The feminist position on family planning in Spain. (United States)

    Navarro, M V


    The Spanish feminist movement had its origins in the early 1970; in 1975 the first offical feminist conference made the following demands on the public authorities; 1) to abolish all sections of the Criminal Code which restrict women's freedom to control of their own bodies through making illegal information on and the purchase of contraceptives, 2) to decriminalize abortion, 3) to create family planning centers and to legalize contraceptives and provide them through the social security system, and 4) to include sex information in study courses. The distribution and sale of contraceptives was not legalized until 1978 and induced abortion is still a criminal offense. Nevertheless, after the 1975 meetins, a Coordinating Organization was established for the family planning committees that were functioning in the different feminist organizations. The problem of where to obtain contraceptives was solved by a group of feminist women which opened the 1st family planning center in Spain in 19779 This center was managed directly by members of the group. This and similar efforts culminated in the origin of the Movement for Movement for Family Planning that demanded in 1978; 1) the provision of sex information confronting the dominant sexual ideology and which is made a ccompulsory subject from school age, for both sexes; 2) free access to contraception for everyone; 3) the legalization of abortion, 4) the development of extensive information campaign on the problems of conception and contraception; and 5) the creation of independent, self-managed, family planning centers. There is now a Coordinating Organization of Family Planning Centers that was established in 1982. The socialist government is determined to create a public network of family planning centers.

  6. Guided preparedness planning with lay communities: enhancing capacity of rural emergency response through a systems-based partnership. (United States)

    McCabe, O Lee; Perry, Charlene; Azur, Melissa; Taylor, Henry G; Gwon, Howard; Mosley, Adrian; Semon, Natalie; Links, Jonathan M


    Community disaster preparedness plans, particularly those with content that would mitigate the effects of psychological trauma on vulnerable rural populations, are often nonexistent or underdeveloped. The purpose of the study was to develop and evaluate a model of disaster mental health preparedness planning involving a partnership among three, key stakeholders in the public health system. A one-group, post-test, quasi-experimental design was used to assess outcomes as a function of an intervention designated Guided Preparedness Planning (GPP). The setting was the eastern-, northern-, and mid-shore region of the state of Maryland. Partner participants were four local health departments (LHDs), 100 faith-based organizations (FBOs), and one academic health center (AHC)-the latter, collaborating entities of the Johns Hopkins University and the Johns Hopkins Health System. Individual participants were 178 community residents recruited from counties of the above-referenced geographic area. Effectiveness of GPP was based on post-intervention assessments of trainee knowledge, skills, and attitudes supportive of community disaster mental health planning. Inferences about the practicability (feasibility) of the model were drawn from pre-defined criteria for partner readiness, willingness, and ability to participate in the project. Additional aims of the study were to determine if LHD leaders would be willing and able to generate post-project strategies to perpetuate project-initiated government/faith planning alliances (sustainability), and to develop portable methods and materials to enhance model application and impact in other health jurisdictions (scalability). The majority (95%) of the 178 lay citizens receiving the GPP intervention and submitting complete evaluations reported that planning-supportive objectives had been achieved. Moreover, all criteria for inferring model feasibility, sustainability, and scalability were met. Within the span of a six-month period

  7. Aligning Funding and Need for Family Planning: A Diagnostic Methodology (United States)

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


    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

  8. Development of project wings home visits, a mental health intervention for Latino families using community-based participatory research. (United States)

    Garcia, Carolyn; Hermann, Denise; Bartels, Anna; Matamoros, Pablo; Dick-Olson, Linda; Guerra de Patino, Janeth


    As the Latino population in the United States experiences rapid growth, the well-being of Latino adolescents is a growing concern because of their high rates of mental health problems. Latino adolescents have higher rates of mental health problems than their peers, including depressive symptoms, suicide attempts, and violence. Sophisticated, realistic health promotion efforts are needed to reduce these risk behaviors and enhance protective factors. Parents and schools can be key protective factors, or assets, in adolescents' lives. This article details the steps undertaken to develop Project Wings Home Visits, a collaborative school-based, community-linked mental health promotion intervention for Latino adolescents and their families. Core to the intervention is the use of a community health worker model to provide home-based outreach and education to parents of Latino adolescents. The intervention was developed using a community-based participatory research approach that involved the cooperation of a community health care system, a public high school, and a university. Our process demonstrates the benefits, strengths, and challenges of using community-based participatory research in creating and implementing health promotion interventions.

  9. China's first family planning publicity month. (United States)

    Shen, G


    China conducted its 1st nationwide Family Planning Publicity Month in 1983, from New Year's Day to Spring Festival (February 13). The campaign emphasized the rural areas and focused on explaining why family planning is a state policy. The most noticeable achievements of this campaign were that every household became familiar with the fact that family planning is a basic state policy. The majority of the population take this policy seriously, realizing that strict control of population growth is both a good and imperative policy. More than 1,830,000 propaganda columns and photo exhibitions were displayed, 5,900,000 radio and television programs broadcast, 2,010,000 theatrical performances, movie and slide showings presented, and 97,000,000 copies of materials published for public dissemination. The activities were varied and interesting, vivid and lively, and purposeful and persuasive. 1 of the most effective methods of publicizing population control has been the presentation of comparative statistics. This aspect of the campaign was a specific and lively form of education in population theory and practice. The presentation of statistics that show the relationship among population, land use, grain produce, and income enabled the population to reason out why population growth needs to match economic and social development. Another important accomplishment of the publicity month was that a large number of couples of reproductive age became convinced of the need to use contraception. According to the incomplete statistics, 8,860,000 people had surgical operations for birth control. The universal promotion of ligations by either partner of a reproductive couple who already had given birth to a 2nd child was an important development of family planning technique promoted simultaneously with the promotion of IUDs. The increase in the number of people doing family planning work was another achievement of the publicity month. More than 15,240,000 publicity personnel and 760

  10. Private sector joins family planning effort. (United States)


    Projects supported by the Directorate for Population (S&T/POP) of the U.S. Agency for International Development and aimed at increasing for-profit private sector involvement in providing family planning services and products are described. Making products commercially available through social-marketing partnerships with the commercial sector, USAID has saved $1.1 million in commodity costs from Brazil, Dominican Republic, Ecuador, Indonesia, and Peru. Active private sector involvement benefits companies, consumers, and donors through increased corporate profits, healthier employees, improved consumer access at lower cost, and the possibility of sustained family planning programs. Moreover, private, for-profit companies will be able to meet service demands over the next 20 years where traditional government and donor agency sources would fail. Using employee surveys and cost-benefit analyses to demonstrate expected financial and health benefits for businesses and work forces, S&T/POP's Technical Information on Population for the Private Sector (TIPPS) project encourages private companies in developing countries to invest in family planning and maternal/child health care for their employees. 36 companies in 9 countries have responded thus far, which examples provided from Peru and Zimbabwe. The Enterprise program's objectives are also to increase the involvement of for-profit companies in delivering family planning services, and to improve the efficiency and effectiveness of private volunteer organizations in providing services. Projects have been started with mines, factories, banks, insurance companies, and parastatals in 27 countries, with examples cited from Ghana and Indonesia. Finally, the Social Marketing for Change project (SOMARC) builds demand and distributes low-cost contraceptives through commercial channels especially to low-income audiences. Partnerships have been initiated with the private sector in 17 developing countries, with examples provided from

  11. Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali


    Gold, Judy; Burke, Eva; Ciss?, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan


    Background: Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Program Description: Potential franchisees are generally identified from CSCOMs who have worked with MSI outrea...

  12. Family planning and contraceptive decision-making by economically disadvantaged, African-American women (United States)

    Hodgson, Eric J.; Collier, Charlene; Hayes, Laura; Curry, Leslie; Fraenkel, Liana


    Background Significant racial disparities exist in the US unplanned pregnancy rate. We conducted a qualitative study using the theory of planned behavior as a framework to describe how low-income, African-American women approach family planning. Study Design Structured focus groups were held with adult, low-income, non-pregnant, African-American women in Connecticut. Data were collected using a standardized discussion guide, and audio-taped and transcribed. Four, independent researchers coded the transcripts using the constant comparative method. Codes were organized into over-arching themes. Results Contraceptive knowledge was limited with formal education often occurring after sexual debut. Attitudes about contraception were overtly negative with method effectiveness being judged by the experience of side effects. Family and friends strongly influence contraceptive decisions while male partners are primarily seen as a barrier. Contraceptive pills are perceived as readily accessible although compliance is considered a barrier. Conclusions Contraception education should occur before sexual debut, should involve trusted family and community members, and should positively frame issues in terms of achieving life goals. PMID:23177266

  13. Planning of community heating systems modernization and development

    International Nuclear Information System (INIS)

    Mroz, Tomasz M.


    New approach to community heating systems modernization and development planning process has been proposed. It is based on the general decision making aid algorithm. The proposed algorithm takes into account both demand and supply side of community heat market modernization and development. The first step of algorithm - analytical step, refers to data base creation, which is needed for the description of community heating system energy, ecology and economic characteristics. Analysis of those characteristics allows for the identification of heating system market modernization and development potential scenarios. The second algorithm step - decision step, allows for the identification of the most compromise scenarios of system modernization and development. To make the planning process more transparent and to increase the influence of decision makers on the planning process the ELECTRE III method was chosen as the tool of decision aid. The ELECTRE III method is based on the construction of outranking relation and definition of pseudo-criterion. The iteration mode of method application allows the decision maker and analyst for the investigation of the sensitivity of final solution to the changing preference model. One of the methods of statistics - the creditability of mean range method was used for the determination of initial definition of pseudo-criterion. Proposed algorithm and decision aid method were employed for the case study analysis referring to the choice of the heating system for new developing urban area. (author)

  14. Theory and Praxis in Community Based Language Development: preliminary findings from applications of the Guide for Planning the Future of Our Language


    Eberhard David M.


    This study will provide a critique of preliminary results obtained from the application of the ‘Guide for Planning the Future of Our Language’ (Hanawalt, Varenkamp, Lahn, & Eberhard 2015) in minority speech communities. This recent methodological tool was developed to enable and empower minoritized language groups to do their own language planning and to control their own language development. The tool is based on a theoretical approach to community based language development known as the ‘Su...

  15. Cost-effectiveness of USAID's regional program for family planning in West Africa. (United States)

    Shepard, Donald S; Bail, Richard N; Merritt, C Gary


    Between 1994 and 1996, the United States Agency for International Development (USAID) closed 23 country missions worldwide, of which eight were in West and Central Africa. To preserve United States support for family planning and reproductive health in four countries in that region, USAID created a subregional program through a consortium of US-based groups that hired mainly African managers and African organizations. This study assesses cost-effectiveness of the program through an interrupted time-series design spanning the 1990s and compares cost-effectiveness in four similar countries in which mission-based programs continued. Key indicators include costs, contraceptive prevalence rates, and imputed "women-years of protection." The study found that, taking into account all external financing for population and family planning, the USAID West Africa regional approach generated women-years of protection at one-third the cost of the mission-based programs. This regional approach delivered family planning assistance in West Africa cost-effectively, and the findings suggest that regional models may work well for many health and population services in small countries.

  16. Perceptions about family planning and contraceptive practice in a marital dyad. (United States)

    Lee, Taewha; Lee, Hyeonkyeong; Ahn, Hyun Mi; Jang, Younkyoung; Shin, Hyejeong; Kim, Myeong Seon


    To examine couple interactions to predict wives' contraceptive use as well as that of their husbands in rural Ethiopia. Previous studies stated that men's power and their preferences regarding family planning have a significant role in the adoption of contraception, as well as women's general reproductive health. Spousal communication on reproductive matters helped couples to be aware of each other's perspectives and enhanced the usage of family planning through shared decision-making. A cross-sectional descriptive design was used to analyse the Actor and Partner effects within the marital dyad. The study sample included 389 married couples who were recruited from households in seven enumeration areas randomly selected from Hetosa Woreda in Ethiopia. We used a face-to-face interview survey. Data were collected between 22 October and 21 November 2010 and analysed using descriptive statistics, chi-squared test, t-test, Pearson's correlation and the Actor-Partner interdependence model. There were significant differences in perceptions about family planning, contraceptive knowledge and contraceptive use between wives and husbands. Wives' perceptions about family planning affected theirs as well as that of their husbands' knowledge and use of contraceptive methods. However, husbands' perceptions about family planning did not affect their knowledge and use of contraceptive methods, but did influence their wives'. The application of couple data enhanced our understanding of the complex interactions between wives and husbands, which may lead to novel dyadic-based interventions to improve family planning practice. Couples must be educated and informed not only about the adoption of contraception, but also about reproductive rights and responsibilities through changes in educational and motivational strategies. © 2013 John Wiley & Sons Ltd.

  17. A comparison of the individualized education plan and the individualized family service plan. (United States)

    Decker, B


    The individualized education plan (IEP) and the individualized family service plan (IFSP) are mandated for children with special needs. Occupational therapists participate in the development of both the IEP and the IFSP. This paper summarizes the similarities and the differences in the mandated components. The components addressed are (a) information about the child's status, (b) information about the family, (c) outcomes for the child and family, (d) intervention services, (e) other services, (f) dates and duration of services, (g) selection of a case manager, and (h) transition plans.

  18. Community and evidence-based approaches to healthcare ...

    International Development Research Centre (IDRC) Digital Library (Canada)


    Apr 29, 2016 ... This project developed community connections, shared cross-cultural teaching experiences, and fostered local community partnerships. Participants in the course were encouraged to continue providing evidence-based care throughout their careers. UniLúrio now plans to include the community-based ...

  19. Health knowledge, attitudes and practices of family planning service providers and clients in Akwapim North District of Ghana. (United States)

    Atuahene, Margaret Duah; Afari, Esther Oku; Adjuik, Martin; Obed, Samuel


    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

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

    NARCIS (Netherlands)

    Kakoko, D.C.; Ketting, E.; Kamazima, S.R.; Ruben, R.


    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

  1. The YMCA Healthy, Fit, and Strong Program: a community-based, family-centered, low-cost obesity prevention/treatment pilot study. (United States)

    Schwartz, Robert P; Vitolins, Mara Z; Case, L Douglas; Armstrong, Sarah C; Perrin, Eliana M; Cialone, Josephine; Bell, Ronny A


    Many resources are available for adults, but there are few community-based programs for overweight and obese children. Community engagement may be instrumental in overcoming barriers physicians experience in managing childhood obesity. Our objective was to design and test the feasibility of a community-based (YMCA), family-centered, low-cost intervention for overweight and obese children. Children 6-11 years over the 85th BMI percentile for age and sex were recruited to YMCA sites in four North Carolina communities. The children had physical activity sessions three times weekly for 3 months (one activity session weekly was family night). The parents received a once-weekly nutrition education class conducted by a registered dietitian using the NC Eat Smart Move More curriculum (10 sessions). Changes in BMI were measured at 3, 6, and 12 months and diet and activity behaviors at 3 and 12 months after baseline. Significant reductions were observed in BMI percentile for age and BMI z-scores at 3, 6, and 12 months. Improvements occurred in dietary and physical activity behaviors, including drinking fewer sugar-sweetened beverages, spending more time in physically active behaviors, and spending less time in sedentary behaviors. The program was low-cost, and qualitative comments suggest the parents and children benefited from the experience. This low-cost YMCA-based intervention was associated with BMI reductions and positive nutritional and activity behavior changes, providing an additional strategy for addressing childhood obesity in community settings.

  2. Pakistan: family planning expands in non-governmental organizations. (United States)


    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.

  3. Knowledge, Attitude and Practice of Family Planning amongst ...

    African Journals Online (AJOL)

    alphabétisation, la haute connaissance et le taux d'approbation du planning familial, l'influence socio-culturelle des hommes sur leurs femmes demeure un obstacle majeur à l'utilisation du planning familial moderne dans cette région du Nigeria.

  4. Community Social Organization: A Conceptual Linchpin in Examining Families in the Context of Communities (United States)

    Mancini, Jay A.; Bowen, Gary L.; Martin, James A.


    The concept of social organization provides an important framework for understanding families in the context of communities and focuses our attention on norms, networks, and associated processes that typify community life. We discuss the significance of community for understanding family outcomes, discuss challenges in defining community context,…

  5. Community oriented interprofessional health education in Mozambique: one student/one family program. (United States)

    Ferrão, L J; Fernandes, Tito H


    In the remote northern region of Mozambique the ratio of doctors to patients is 1:50,000. In 2007, Lúrio University initiated an innovative, "One Student/One Family" program of teaching and learning for health professions students, to complement their traditional core curriculum. All students of each of the school's six health degree programs complete a curriculum in "Family and Community Health" in each year of their training. Groups of six students from six different health professions training programs make weekly visits to communities, where each student is allocated to a family. Students learn from their families about community life and health issues, within a community where 80% of the population still lacks access to modern health care and rely on indigenous doctors and traditional remedies. In turn, students transmit information to families about modern health care and report to the faculty any major health problems they find. The educational/experiential approach is interprofessional and community-oriented. The main perceived advantages of the program are that it is applied and problem-based learning for students, while simultaneously providing needed healthcare services to the community. The major disadvantages include the complexity of coordinating multidisciplinary groups, the time and distance required of students in traveling to communities, and interpretation of multiple reports with variable data. This community-oriented education program involving students from six disciplines uses nontraditional teaching/learning methods is the basis of the ex libris of Lúrio University.

  6. Recruitment and Lessons Learned from a Community-Based Intervention Program: The Learning Families Project in Hong Kong

    Directory of Open Access Journals (Sweden)

    Joanna T. W. Chu


    Full Text Available BackgroundRecruitment is central to any research project, and recruitment itself should be well documented and researched. We describe our recruitment efforts for a community-based research project—entitled the Learning Families Project—conducted in Hong Kong.MethodsIn collaboration with community stakeholders, residents from a public housing estate were recruited to participate in family programs aimed at enhancing family well-being. Various recruitment strategies were employed including the distribution of 19,200 leaflets, 688 posters, a banner, a kick-off ceremony, 10 promotion activities, 1,000 direct calls, word of mouth, 51 mobile counters, and 10 door-to-door visits. Drawing on field notes, research logs, short questionnaires, and focus group conducted with our community partners and residents, we describe and discuss our recruitment strategies, challenges, and lessons learned.ResultsOver a 9-month period, 980 participants were recruited and participated in our study, exceeding our recruitment goal (860 participants. Several observations were made including active recruitment strategies (i.e., door-to-door and mobile counter being more effective than passive strategies (i.e., posters and leaflets; the importance of raising project awareness to facilitate recruitment; and the challenges encountered (i.e., burn-out and loss of motivation of staff, decreased community capacity in collaborating in research projects.ConclusionThe lessons learned include the importance of engaging Chinese communities, utilizing a positive outreach approach, and setting realistic expectations. Although similar recruitment strategies have been reported the West, a number of cultural differences should be taken into account when working with Chinese population. Further research is needed to examine the effectiveness of tailoring recruitment strategies to various populations.

  7. Recruitment and Lessons Learned from a Community-Based Intervention Program: The Learning Families Project in Hong Kong. (United States)

    Chu, Joanna T W; Wan, Alice; Stewart, Sunita M; Ng, Kwok Tung; Lam, Tai Hing; Chan, Sophia S


    Recruitment is central to any research project, and recruitment itself should be well documented and researched. We describe our recruitment efforts for a community-based research project-entitled the Learning Families Project-conducted in Hong Kong. In collaboration with community stakeholders, residents from a public housing estate were recruited to participate in family programs aimed at enhancing family well-being. Various recruitment strategies were employed including the distribution of 19,200 leaflets, 688 posters, a banner, a kick-off ceremony, 10 promotion activities, 1,000 direct calls, word of mouth, 51 mobile counters, and 10 door-to-door visits. Drawing on field notes, research logs, short questionnaires, and focus group conducted with our community partners and residents, we describe and discuss our recruitment strategies, challenges, and lessons learned. Over a 9-month period, 980 participants were recruited and participated in our study, exceeding our recruitment goal (860 participants). Several observations were made including active recruitment strategies (i.e., door-to-door and mobile counter) being more effective than passive strategies (i.e., posters and leaflets); the importance of raising project awareness to facilitate recruitment; and the challenges encountered (i.e., burn-out and loss of motivation of staff, decreased community capacity in collaborating in research projects). The lessons learned include the importance of engaging Chinese communities, utilizing a positive outreach approach, and setting realistic expectations. Although similar recruitment strategies have been reported the West, a number of cultural differences should be taken into account when working with Chinese population. Further research is needed to examine the effectiveness of tailoring recruitment strategies to various populations.

  8. Quality of Family Planning Services in Primary Health Centers of ...

    African Journals Online (AJOL)

    Background: 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 ...

  9. Developing community-based preventive interventions in Hong Kong: a description of the first phase of the family project. (United States)

    Stewart, Sunita M; Fabrizio, Cecilia S; Hirschmann, Malia R; Lam, Tai Hing


    This paper describes the development of culturally-appropriate family-based interventions and their relevant measures, to promote family health, happiness and harmony in Hong Kong. Programs were developed in the community, using a collaborative approach with community partners. The development process, challenges, and the lessons learned are described. This experience may be of interest to the scientific community as there is little information currently available about community-based development of brief interventions with local validity in cultures outside the West. The academic-community collaborative team each brought strengths to the development process and determined the targets for intervention (parent-child relationships). Information from expert advisors and stakeholder discussion groups was collected and utilized to define the sources of stress in parent-child relationships. Themes emerged from the literature and discussion groups that guided the content of the intervention. Projects emphasized features that were appropriate for this cultural group and promoted potential for sustainability, so that the programs might eventually be implemented at a population-wide level. Challenges included ensuring local direction, relevance and acceptability for the intervention content, engaging participants and enhancing motivation to make behavior changes after a brief program, measurement of behavior changes, and developing an equal partner relationship between academic and community staff. This work has public health significance because of the global importance of parent-child relationships as a risk-factor for many outcomes in adulthood, the need to develop interventions with strong evidence of effectiveness to populations outside the West, the potential application of our interventions to universal populations, and characteristics of the interventions that promote dissemination, including minimal additional costs for delivery by community agencies, and high

  10. Financing family planning services: is categorical legislation still needed? (United States)

    Mcfarlane, D R; Meier, K J


    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

  11. Family planning and social position of women. (United States)

    Begum, Hasna


    This presentation began with at least three biases: (i) Acceptance of a secular approach to the problem of artificially controlling human reproduction; (ii) acceptance of an absolute egalitarian position in matter of choices and applications of family planning methods; and (iii) acceptance of the view that a small family gives women more opportunities to flourish as humans. The conclusion of the presentation is: though in implementing family planning programmes much deviation from the egalitarian principle could be found, in reality the implementation itself does bring about some opportunities for women to enhance their position in society. Undoubtedly the malpractices in family planning programmes cause death and miseries to women. But, until better methods are invented for both male and female sexes to replace the harmful ones and the male members of the society feel equal responsibility in matters of controlling reproduction, women have now no other choice but to accept the lesser evil.

  12. The attitudes and activities of pastors and faith leaders in Zimbabwe on the use of family planning methods among their members

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    Moses Alikali


    Full Text Available Background: Faith leaders are important gatekeepers in disseminating reproductive health messages and influencing positive behaviour change within communities. Faith leaders are seen as the most powerful, visible, and reachable form of authority, even trusted more than governments or non-profit organizations. In addition to providing counsel and advice aimed at enhancing health and wellbeing of the worshippers, faith leaders also play an important role in advocating and influencing what is taught in schools and what services are provided in healthcare facilities. Because of this influence, faith leaders often have an unparalleled opportunity—indeed, a moral obligation—to prioritize conversations about family planning, advocating, and closing the contraception gap.The overall objective of this study was to ascertain the attitude and activities of pastors and faith leaders in Zimbabwe on the use of family planning methods among their members. The result revealed that some faith leaders believed that spreading information about family planning education was the responsibility of the government and tended to avoid such responsibility. However, through training on family planning advocacy, much can be achieved. Methods: Qualitative study methods were used to better understand the attitude and activities of pastors and faith leaders in Zimbabwe on the use of family planning methods among their members. The participants of this survey were drawn from 8 of 10 provinces in Zimbabwe, which include: Bulawayo, Harare, Manicaland, Mashonaland Central, Mashonaland East, Mashonaland West, Masvingo, and Matabeleland North.Paper-based questionnaires were answered by 24 pastors and 26 faith leaders in Zimbabwe (Table 1 through personal face-to-face meetings, while interviews were conducted with a select few pastors and faith leaders. The samples were drawn from randomly selected churches in Zimbabwe. Data was analysed using Epi info 7 and Microsoft Excel

  13. Integration of family planning with poverty alleviation. (United States)

    Peng, P


    The Chinese Communist Central Committee and the State Council aim to solve food and clothing problems among impoverished rural people by the year 2000. This goal was a priority on the agenda of the recent October 1996 National Conference on Poverty Alleviation and Development and the 1996 National Conference of the State Family Planning Commission. Poverty is attributed to rapid population growth and underdevelopment. Poverty is concentrated in parts of 18 large provinces. These provinces are characterized by Family Planning Minister Peng as having high birth rates, early marriage and childbearing, unplanned births, and multiple births. Overpopulation is tied to overconsumption, depletion of resources, deforestation, soil erosion, pollution, shortages of water, decreases in shares of cultivated land, degraded grasslands, and general destruction of the environment. Illiteracy in poor areas is over 20%, compared to the national average of 15%. Mortality and morbidity are higher. Family planning is harder to enforce in poor areas. Pilot programs in Sichuan and Guizhou provinces are promoting integration of family planning with poverty alleviation. Several conferences have addressed the integrated program strategies. Experience has shown that poverty alleviation occurs by controlled population growth and improved quality of life. Departments should "consolidate" their development efforts under Communist Party leadership at all levels. Approaches should emphasize self-reliance and public mobilization. The emphasis should be on women's participation in development. Women's income should be increased. Family planning networks at the grassroots level need to be strengthened simultaneously with increased poverty alleviation and development. The government strategy is to strengthen leadership, mobilize the public, and implement integrated programs.

  14. Work-Family Planning Attitudes among Emerging Adults (United States)

    Basuil, Dynah A.; Casper, Wendy J.


    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…

  15. An Evaluation of a Train-the-Trainer Workshop for Social Service Workers to Develop Community-Based Family Interventions

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    Agnes Y. Lai


    Full Text Available IntroductionEvaluation studies on train-the-trainer workshops (TTTs to develop family well-being interventions are limited in the literature. The Logic Model offers a framework to place some important concepts and tools of intervention science in the hands of frontline service providers. This paper reports on the evaluation of a TTT for a large community-based program to enhance family well-being in Hong Kong.MethodsThe 2-day TTT introduced positive psychology themes (relevant to the programs that the trainees would deliver and the Logic Model (which provides a framework to guide intervention development and evaluation for social service workers to guide their community-based family interventions. The effectiveness of the TTT was examined by self-administered questionnaires that assessed trainees’ changes in learning (perceived knowledge, self-efficacy, attitude, and intention, trainees’ reactions to training content, knowledge sharing, and benefits to their service organizations before and after the training and then 6 months and 1 year later. Missing data were replaced by baseline values in an intention-to-treat analysis. Focus group interviews were conducted approximately 6 months after training.ResultsFifty-six trainees (79% women joined the TTT. Forty-four and 31 trainees completed the 6-month and 1-year questionnaires, respectively. The trainees indicated that the workshop was informative and well organized. The TTT-enhanced trainees’ perceived knowledge, self-efficacy, and attitudes toward the application of the Logic Model and positive psychology constructs in program design. These changes were present with small to large effect size that persisted to the 1 year follow-up. The skills learned were used to develop 31 family interventions that were delivered to about 1,000 families. Qualitative feedback supported the quantitative results.ConclusionThis TTT offers a practical example of academic-community partnerships that

  16. The Search Conference as a Method in Planning Community Health Promotion Actions (United States)

    Magnus, Eva; Knudtsen, Margunn Skjei; Wist, Guri; Weiss, Daniel; Lillefjell, Monica


    Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives. Significance for public health This article describe and discuss how the Search conference can be used as a method when working with knowledge based health promotion actions in local communities. The article describe the sequences of the conference and shows how this have been adapted when planning and prioritizing health promotion actions in three Norwegian municipalities. The significance of the article is that it shows how central elements in the planning of health promotion actions, as participation and involvements as well as evidence was a fundamental thinking in how the conference were accomplished. The article continue discussing how the method function as both a top-down and a bottom-up strategy, and in what way working evidence based can be in conflict with a bottom-up strategy. The experiences described can be used as guidance planning knowledge based health promotion actions in communities. PMID:27747199

  17. An approach to family planning for Indochinese refugee women. (United States)

    Presswell, N J


    Family planning services were introduced in Vietnam by the Americans about 20 years ago, but on a limited basis. Many of the Vietnamese refugee women have had no contact with such services. Abortion was illegal until 1975 in South Vietnam, but since the takeover, abortion clinics have been available as part of the public hospital system. Family planning was available in some of the refugee camps. Most of the Vietnam refugees fled their country by boat. Before their acceptance by Australia, the Vietnamese refugees have health checks by the Australian Commonwealth Health Department in the country of transit. Shortly after their arrival in Australia, health screening is done by the State Health Department. The majority of refugees are accommodated in migrant hostels for the 1st 3-12 months. Family planning is incorporated into Eastbridge Hostel's orientation program. During participation in some family planning discussion groups with the Indochinese refugees, it was observed that the women were particularly shy and hesitant to talk about sexual concerns in a large group or in mixed company. As personal matters are dealt with in the family, it is preferable to have a female as a discussion leader and interpreter. Visual aids such as a display of contraceptive devices, a model showing female anatomy and a family planning film for non-English speaking migrants are particularly useful. As a female doctor using a female interpreter the aim was to provide an accessible service for Indochinese women with family planning inquiries or gynecological problems. It is important that the interpreter is present in the consulting room. Nonverbal cues are most important and particular attention should be paid to establishing eye contact with the patient. Simple miming techniques or the use of diagrams may be helpful in reinforcing the work of the interpreter. When listening to the patient, it is useful to look and listen for nonverbal cues from them. Between February 1980 and May 1981

  18. Fertility desire and family-planning demand among HIV-positive ...

    African Journals Online (AJOL)

    Little information exists about desire to have children and family-planning use among HIV-positive individuals and how this may vary according to individual, social, health and demographic characteristics, especially in developing countries. To assess these topics in Ethiopia, a facility-based cross-sectional study was ...

  19. Implementing Community-based Health Planning and Services in impoverished urban communities: health workers' perspective. (United States)

    Nwameme, Adanna Uloaku; Tabong, Philip Teg-Nefaah; Adongo, Philip Baba


    Three-quarters of sub-Saharan Africa's urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries where the urban poor have become a group much afflicted by complex health problems associated with their living conditions, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility. Adopting Ghana's rural Community-Based Health Planning and Service (CHPS) programme in urban areas is challenging due to the differences in social networks and health challenges thus making modifications necessary. The Community Health Officers (CHOs) and their supervisors are the frontline providers of health in the community and there is a need to analyze and document the health sector response to urban CHPS. The study was solely qualitative and 19 in-depth interviews were conducted with all the CHOs and key health sector individuals in supervisory/coordinating positions working in urban CHPS zones to elicit relevant issues concerning urban CHPS implementation. Thematic content data analysis was done using the NVivo 7 software. Findings from this appraisal suggest that the implementation of this urban concept of the CHPS programme has been well undertaken by the health personnel involved in the process despite the challenges that they face in executing their duties. Several issues came to light including the lack of first aid drugs, as well as the need for the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme and more indepth training for CHOs. In addition, the need to provide incentives for the volunteers and Community Health Committee members to sustain their motivation and the CHOs' apprehensions with regards to furthering their education and progression in their careers were key concerns raised. The establishment of the CHPS concept in the urban environment albeit challenging has been

  20. Married women's decision making power on family planning use and associated factors in Mizan-Aman, South Ethiopia: a cross sectional study. (United States)

    Belay, Abeba Daniel; Mengesha, Zelalem Birhanu; Woldegebriel, Manay Kifle; Gelaw, Yalemzewod Assefa


    Women's use of family planning service is influenced by many factors, especially by their decision making power. A woman's decision-making power, be it individual or decision made in collaboration with a partner, is the most important factor in the use of family planning in a household. The purpose of this study was to assess the impact of women's decision making power on family planning use and its associated factors. A community-based cross-sectional study was conducted on married women in the child bearing age. The women who were living in Mizan city were selected using the simple random sampling method. Trained nurses collected the data by interview, using a structured and pre-tested questioner. Bivariable and multivariable binary logistic regression analysis was used to identify the associated factors, and the odds ratio with a 95% CI was computed to assess the strength of the association. Collinearity was also assessed by looking at standard errors in the final fitted model. Overall, more than two-thirds [67.2%: 95% CI (63-71%)] of the married women were found to be more autonomous to decide family planning use. Secondary education [AOR: 9.04, 95% CI: (4.50, 18.16)], government employment [AOR: 4.84, 95% CI: (2.03, 11.52)], being wives of government employed spouses [AOR 2.71, 95% CI: (1.24, 7.97)], having husbands with college or university education [AOR: 11.29, 95% CI: (4.66, 27.35)], and being in the younger age [AOR: 0.27, 95% CI :(0.09, 0.75)] were significantly associated with women's decision-making power on family planning. In this study, women had a high decision making power in family planning use. Age category (34-44-years), formal education, and occupational status had effects on women's decision making power. Promoting parental adult education and engaging women in out of house employment is essential to improve their decision making power in using family planning.

  1. Family planning use: prevalence, pattern and predictors among ...

    African Journals Online (AJOL)

    Introduction: High fertility,high birth rates and low family planning prevalence rate is a common feature in developing countries with consequent rapid population growth. Family planning has saved the lives and protected the health of millions of women and children. This study aims to ascertain prevalence, pattern and ...

  2. Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models. (United States)

    Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

    Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

  3. Status of women and family planning: the Indian case. (United States)

    Vaidyanathan, K E


    This article examines the extent to which the status of women is related to awareness, knowledge, and practice of family planning in India. It uses both macro-level data for the states of India and date from household surveys and field studies to assess the extent of interaction between the women's status indicators and family planning indicators. Results show a definite statistical relationship between women's status and women's ability to control fertility. The strongest relationship to adoption of family planning is the educational attainment of women, followed by age at marriage, and women's work participation, particularly in nonagricultural activities. Evidence from various surveys on the effects of crucial variables on reproductive behavior include 1) a marked reduction in fertility with increases in the educational level; 2) lower fertility for working women, and especially for non-manual workers; 3) a reduction in fertility with increases in age at marriage; and 4) a higher percentage of couples practicing family planning who have 2 or more surviving children, particularly if they have boys. A 1972 survey of 3 Indian states showed that 1) husbands impose a variety of restrictions on wives, with rural husbands placing more restrictions than urban husbands; 2) women's role in decision making in household affairs is positively correlated with the degree of awareness and knowledge of contraceptives as well as adoption of family planning; and 3) interspousal communication was significantly related to the practice of family planning in both rural and urban areas. In conclusion, to help encourage adoption of family planning and reduce fertility, India should 1) emphasize education for women, 2) enforce the legal minimum age at marriage, 3) promote employment opportunities for women, 4) improve women's role in decision making, and 5) encourage interspousal communication in family affairs.


    Directory of Open Access Journals (Sweden)

    Norma Amalia Rodríguez-Barrera


    Full Text Available The modern university has the mission of training of competent professionals, able to preserve, develop and promote the strengthening of cultural development of students and the community through academic, research and social work practice processes. This paper aims to present the results of Community action in the university context Career Early Childhood Education, to raise the cultural development of families. The intervention was designed according to three basic processes: planning, implementation, evaluation and control, and to ensure, as previous steps, the study programs of disciplines and subjects of the race, for determining the didactic treatment of the required content Community intervention from academic, scientific and practical work; of the main needs of the community and preparing students for the fulfillment of the tasks. The research was conducted with the application of a quasi-experiment Teaching and the use of theoretical, empirical (interview, observation, document analysis and for the collection and statistical data processing methods. The comparison of results between the experimental and control groups before and after application of the Community intervention allowed to check their effectiveness from raising the cultural development of families in the experimental group, in the motivational-regulative dimensions, cognitive, attitudinal and communication. The essential differences in the results of each dimension not only differ significantly between the groups, but all of them is able to distinguish very well the cultural development of families applied after the intervention actions.

  5. Developing community-based preventive interventions in Hong Kong: a description of the first phase of the family project

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    Stewart Sunita M


    Full Text Available Abstract Background This paper describes the development of culturally-appropriate family-based interventions and their relevant measures, to promote family health, happiness and harmony in Hong Kong. Programs were developed in the community, using a collaborative approach with community partners. The development process, challenges, and the lessons learned are described. This experience may be of interest to the scientific community as there is little information currently available about community-based development of brief interventions with local validity in cultures outside the West. Methods The academic-community collaborative team each brought strengths to the development process and determined the targets for intervention (parent-child relationships. Information from expert advisors and stakeholder discussion groups was collected and utilized to define the sources of stress in parent-child relationships. Results Themes emerged from the literature and discussion groups that guided the content of the intervention. Projects emphasized features that were appropriate for this cultural group and promoted potential for sustainability, so that the programs might eventually be implemented at a population-wide level. Challenges included ensuring local direction, relevance and acceptability for the intervention content, engaging participants and enhancing motivation to make behavior changes after a brief program, measurement of behavior changes, and developing an equal partner relationship between academic and community staff. Conclusions This work has public health significance because of the global importance of parent-child relationships as a risk-factor for many outcomes in adulthood, the need to develop interventions with strong evidence of effectiveness to populations outside the West, the potential application of our interventions to universal populations, and characteristics of the interventions that promote dissemination, including minimal

  6. Thai midwives brought into family planning. (United States)


    In Thailand "granny" midwives are being tested and trained to take part in modern family planning and public health programs. In Malaysia a survey of conditions relating to an increase in induced early termination or abortion of pregnancies is in progress. The International Development Research Centre (IDRC) supports these projects as well as others in Asia. Local paramedical workers, like the "barefoot doctors" in China, are being trained. In Thailand a growth plan is attempting to reduce the annual rate of population increase from about 3.3% to 2.5%. Many granny midwives have been contacted. Several methods of incentive and training are being tried and will be evaluated. Eventually granny midwives in all of Thailand's 60,000 villages will be enlisted in the national planning program. Of Thailand's 6 million married women of reproductive age less than half use modern birth control methods. Abortion is illegal in Thailand which is a predominantly Buddhist country. The project in Malaysia is being carried out by the University of Malaysia and the Federation of Family Planning Associations. Abortion is also illegal in Islamic Malaysia, although there are illegal abortion clinics. Trends so far reported to IDRC indicate that 1) lower class women are more cooperative interviewees than others, 2) most couples use some method of birth control, 3) many wish to interrupt their pregnancies, 4) poorer families have more children than wealthier ones, 5) the Chinese and Indian people show a greater tendency to limit families than do the Malays, and 6) most couples want 3 or 4 children.

  7. Setting Ambitious yet Achievable Targets Using Probabilistic Projections: Meeting Demand for Family Planning. (United States)

    Kantorová, Vladimíra; New, Jin Rou; Biddlecom, Ann; Alkema, Leontine


    In 2015, governments adopted 17 internationally agreed goals to ensure progress and well-being in the economic, social, and environmental dimensions of sustainable development. These new goals present a challenge for countries to set empirical targets that are ambitious yet achievable and that can account for different starting points and rates of progress. We used probabilistic projections of family planning indicators, based on a global data set and Bayesian hierarchical modeling, to generate illustrative targets at the country level. Targets were defined as the percentage of demand for family planning satisfied with modern contraceptive methods where a country has at least a 10 percent chance of reaching the target by 2030. National targets for 2030 ranged from below 50 percent of demand satisfied with modern contraceptives (for three countries in Africa) to above 90 percent (for 41 countries from all major areas of the world). The probabilistic approach also identified countries for which a global fixed target value of 75 percent demand satisfied was either unambitious or has little chance of achievement. We present the web-based Family Planning Estimation Tool (FPET) enabling national decision makers to compute and assess targets for meeting family planning demand. © 2017 The Population Council, Inc.

  8. Financial Therapy and Planning for Families with Special Needs Children

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    Mitzi Lauderdale


    Full Text Available This study examines factors associated with the likelihood of having a plan that includes a special needs trust among families that have disabled minor children. Descriptive analyses indicate that the top two reasons families provide for not having a plan are the inability to save and no perceived need. Among families that do indicate having a plan, most do not include a special needs trust. Multivariate analyses reveal that professional involvement (financial, legal, and mental health professionals is a key factor to increasing the likelihood of having a plan with a special needs trust. Families that have met with a financial advisor are 23 times more likely, and families who are encouraged to create a plan by a mental health professional are almost three times more likely, to have a plan that includes a special needs trust. Results from this study suggest that financial therapists are uniquely positioned to educate and ensure that appropriate plans are in place to provide for the future of children with special needs.

  9. Increasing advance personal planning: the need for action at the community level. (United States)

    Waller, Amy; Sanson-Fisher, Rob; Ries, Nola; Bryant, Jamie


    Advance personal planning is the process by which people consider, document and communicate their preferences for personal, financial and health matters in case they lose the ability to make decisions or express their wishes in the future. Advance personal planning is most often undertaken by individuals who are seriously ill, often in the context of a medical crisis and/or at the time of admission to hospital. However, the clinical utility and legal validity of the planning process may be compromised in these circumstances. Patients may lack sufficient capacity to meaningfully engage in advance personal planning; there may be insufficient time to adequately reflect on and discuss wishes with key others; and there may also be limited opportunity for inter-professional input and collaboration in the process. Here, we propose an agenda for research to advance the science of advance personal planning by promoting a 'whole community' approach. Adoption of advance personal planning at a community level may be achieved using a variety of strategies including public media campaigns, intervening with professionals across a range of health care and legal settings, and mobilising support from influential groups and local government. One potentially promising method for encouraging earlier adoption of advance personal planning among a broader population involves a community action approach, whereby multiple evidence-based strategies are integrated across multiple access points. Community action involves calling on community members, professionals, community and/or government organisations to work collaboratively to design and systematically implement intervention strategies with the aim of bringing about desired behaviour change. An example of a community action trial to improving uptake and quality of advance personal planning is described. While promising, there is a need for rigorous evidence to demonstrate whether a community action approach is effective in

  10. Barriers to Use of Family Planning Methods Among Heterosexual Mexican Couples. (United States)

    Arias, María Luisa Flores; Champion, Jane Dimmitt; Soto, Norma Elva Sáenz; Tovar, Marlene; Dávila, Sandra Paloma Esparza


    Family planning has become increasingly important as a fundamental component of sexual health and as such is offered via public health systems worldwide. Identification of barriers to use of family planning methods among heterosexual couples living in Mexico is indicated to facilitate access to family planning methods. Barriers to family planning methods were assessed among Mexican heterosexual, sexually active males and females of reproductive age, using a modified Spanish version of the Barriers to the Use of Family Planning Methods scale (Cronbach's alpha = .89, subscales ranging from .53 to .87). Participants were recruited via convenience sampling in ambulatory care clinics within a metropolitan area in Central Mexico. Participants included 52 heterosexual couples aged 18-35 years (N = 104). Sociodemographic comparisons by gender identified older age and higher education, income, and numbers of sexual partners among men than women. More men (50%) than women (25%) were currently using family planning methods; however, 80% overall indicated intentions for its use. Overall, male condoms were used and intended for use most often by men than women. Significant gender-specific differences were found, with men (71.15%) reporting no family planning barriers, whereas women (55.66%) reported barriers including low socioeconomic status, medical concerns, and stigma. The modified Spanish translation demonstrated usefulness for measuring barriers to family planning methods use in Mexico among heterosexual males and females of reproductive age. Barriers identified by Mexican women in this study may be addressed to reduce potential barriers to family planning among Mexican populations.

  11. Achieving success with family planning in rural Afghanistan. (United States)

    Huber, Douglas; Saeedi, Nika; Samadi, Abdul Khalil


    Afghan women have one of the world's highest lifetime risks of maternal death. Years of conflict have devastated the country's health infrastructure. Total fertility was one of the world's highest, contraceptive use was low and there were no Afghan models of success for family planning. We worked closely with communities, providing information about the safety and non-harmful side-effects of contraceptives and improving access to injectable contraceptives, pills and condoms. Regular interaction with community leaders, mullahs (religious leaders), clinicians, community health workers and couples led to culturally acceptable innovations. A positive view of birth spacing was created by the messages that contraceptive use is 300 times safer than pregnancy in Afghanistan and that the Quran (the holy book of Islam) promotes two years of breastfeeding. Community health workers initiated the use of injectable contraceptives for the first time. The non-for-profit organization, Management Sciences for Health, Afghan nongovernmental organizations and the Ministry of Public Health implemented the Accelerating Contraceptive Use project in three rural areas with different ethnic populations. The contraceptive prevalence rate increased by 24-27% in 8 months in the project areas. Men supported modern contraceptives once they understood contraceptive safety, effectiveness and non-harmful side-effects. Injectable contraceptives contributed most to increases in contraceptive use. Community health workers can rapidly increase contraceptive use in rural areas when given responsibility and guidance. Project innovations were adopted as best practices for national scale-up.

  12. Men in Bangladesh play a role in family planning. (United States)

    Ahsan, S B


    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.

  13. Correlates of the desired family size among Indian communities. (United States)

    Joshi, N V; Gadgil, M; Patil, S


    The People of India database of the Anthropological Survey of India documents 631 cultural, ecological, and economic traits of the 4635 communities to which the entire Indian population is assigned. Focusing on 1342 communities of South India, we looked for correlates of low (1 or 2 children) and high (4 or more children) desired family size (DFS) reported as the norm for any given community by key informants. We found 10 cultural and 18 economic traits to be significantly correlated to high DFS and 21 cultural and 9 economic traits to low DFS. The economic traits so identified are compatible with high family size being desired by parents who have little capability of investing in quality of offspring, but whose children contribute economically from an early age. In contrast, communities desiring low family size are part of the modern intensive agriculture/organized industry/services sector and invest heavily in educating their children. A composite index based on 27 economic traits (CEI) has a high predictive value with respect to the DFS for the entire set of 4635 Indian communities. The 31 cultural traits highly correlated to high or low DFS constitute 5 clusters that can be identified as characterizing scheduled tribes, scheduled castes, rural and landless lower castes, urban upper castes, and Moslems. Whereas economic traits have similar influence on DFS within each of these ethnic categories, Moslems demonstrate a significantly higher DFS for lower values of CEI.

  14. Compulsion in family planning: the fundamental considerations. (United States)

    Pethe, V P


    Focus is on some of the basic issues and considerations involved in the question of compulsion in family planning, which in terms of current contraceptive technology, only means compulsory sterilization. Pressures have been increasing to implement more stringent measures to control population growth in most of the developing countries throughout the world. During the Emergency in India (1975-1977) the government at that time, along with some individuals and groups, deemed it necessary to adopt the drastic measure of compulsory sterilization. The six sections of the discussion deal with the following: 1) compulsory family planning as rational or ethical choice basic issues; 2) neo-Malthusian thesis on compulsion - fallacies, dangers and inadequacies; 3) ethical and philosophical problems - premise of irresponsible procreation; 4) individual rights versus societal interests; 5) elitism in social policy and cost benefit considerations; and 6) international consensus against compulsion. All forums, under the auspices of the United Nations, of which India is a member, have rejected coercion and reiterated repeatedly that every individual has a basic human right to decide how many children to have and at what intervals. The most recent forum to endorse the human right to family size was the World Population Conference held at Bucharest in 1974. The 14 conditions spelled out by the United Nations Fund for Population Activity for effecting a free and responsible choice in family size may form a sound basis for a comprehensive policy concerning family planning in India. The coercive measures adopted during the Emergency are responsible for a backlash in India and retarding the progress of the family planning movement.

  15. India's misconceived family plan. (United States)

    Jacobson, J L


    India's goal of reducing the national birth rate by 50% by the year 2000 is destined to failure in the absence of attention to poverty, social inequality, and women's subordination--the factors that serve to perpetuate high fertility. There is a need to shift the emphasis of the population control effort from the obligation of individual women to curtail childbearing to the provision of the resources required for poor women to meet their basic needs. Female children are less likely to be educated or taken for medical care than their male counterparts and receive a lower proportion of the family's food supply. This discrimination stems, in large part, from parents' view that daughters will not be able to remunerate their families in later life for such investments. The myth of female nonproductivity that leads to the biased allocation of family resources overlooks the contribution of adult women's unpaid domestic labor and household production. Although government statistics state that women comprise 46% of India's agricultural labor force (and up to 90% of rural women participate in this sector on some basis), women have been excluded systematically from agricultural development schemes such as irrigation projects, credit, and mechanization. In the field of family planning, the Government's virtually exclusive focus on sterilization has excluded younger women who are not ready to terminate childbearing but would like methods such as condoms, diaphragms, IUDs, and oral contraceptives to space births. More general maternal-child health services are out of reach of the majority of poor rural women due to long distances that must be travelled to clinics India's birth rate could be reduced by 25% by 2000 just by filling the demand for quality voluntary family planning services. Without a sustained political commitment to improve the status of women in India, however, such gains will not be sustainable.

  16. Defining Motivational Intensity of Need for Family Planning in Africa

    African Journals Online (AJOL)

    AJRH Managing Editor

    Keywords: Unmet need, contraceptive use, intention to use family planning. Résumé ... not using family planning because of health concerns or ..... insurance plans cover contraception as an employee right and/or as a means of reducing.

  17. Institutional Formation of Family Planning in the District Sukabumi and the Bitung

    Directory of Open Access Journals (Sweden)

    Moh. Ilham A. Hamudy


    Full Text Available This study is about the implementation of family planning (KB in regional affairs. Nevertheless, this study focuses on the establishment of institutional care and family planning in the area set up. The purpose of this study is to get a complete picture of the role of family planning agencies that had stood alone in implementing family planning matters that have been handed over to the local government. By using the methods of descriptive and qualitative approach, this study found several things. First, there is impression of conflicts of interest (sectoral ego between Ministry of Home Affairs (MoHA and National Population and Family Planning Board (BKKBN on forming a population and family planning (BKKBD institutions in province, county and city. Second, the two regions, Sukabumi County and Bitung City that have shaped BKKBD has focused attention in supporting the success of family planning programs. Third, the integration of family planning into the regional medium-term development plan, as did the City of Bitung and Sukabumi County, ensure the sustainability of the program and budgeted in the regional budget revenue and expenditure (APBD. Finally, this study concludes, coordination and synchronization policies on family planning should be done by the BKKBN and MoHA.

  18. Home/community-based services: a two-tier approach. (United States)

    Aponte, H J; Zarski, J J; Bixenstine, C; Cibik, P


    A two-tier model for work with high-risk families is presented. It combines multiple-family groups in the community with home-based family therapy for individual families. The ecostructural conceptual framework of the model is discussed, and its application is illustrated by a case vignette.

  19. Attitude of Women towards Family Planning in Selected Rural ...

    African Journals Online (AJOL)

    ... the desired attitudinal and behavioral changes towards family planning is yet to be ... from selected rural areas in Ibadan towards family planning using the Health ... The study revealed that the socio-economic status of mothers significantly ...

  20. Human capital identification process: linkage for family medicine and community medicine to mobilize the community. (United States)

    Tanasugarn, Chanuantong; Thongbunjob, Krid


    Community diagnosis and approach has shifted from a professional focus to a community focus. The information system has also been developed to reflect socio-cultural information. This new system has been established throughout the country and is being recorded in the computer system. However these data still lack human capital information to promote community mobilization. The present study aims to develop a process which reflects human capital from the insider and outsider points of view and which builds on the existing work system of primary care service, family medicine, and community medicine. The present study applies the participatory action research design with mixed methods including community grand-tour, household survey socio-metric questionnaire and focus group discussion in order to gather insider view of human capital. A key instrument developed in the present study is the socio-metric questionnaire which was designed according to the community grand tour and household survey results. The findings indicate that the process is feasible and the insider point of view given a longer evidence based list of the human capital. The model enhanced a closer relationship between professional and community people and suggested the realistic community mobilizer name list. Human capital identification process is feasible and should be recommended to integrate in the existing work process of the health staff in family and community practice.

  1. Family, maternal, and child health through photovoice. (United States)

    Wang, Caroline C; Pies, Cheri A


    (1) To introduce photovoice, a participatory action research methodology, for use by MCH program managers to enhance community health assessments and program planning efforts, (2) to enable community people to use the photovoice methodology as a tool to record, reflect, and communicate their family, maternal, and child health assets and concerns, and (3) to educate community leaders about family, maternal, and child health issues from a grassroots perspective. Photovoice is based upon the theoretical literature on education for critical consciousness, feminist theory, and community-based approaches to documentary photography. Picture This Photovoice project took place in Contra Costa, an economically and ethnically diverse county in the San Francisco Bay area. Sixty county residents of ages 13-50 participated in 3 sessions during which they received training from the local health department in the techniques and process of photovoice. Residents were provided with disposable cameras and were encouraged to take photographs reflecting their views on family, maternal, and child health assets and concerns in their community, and then participated in group discussions about their photographs. Community events were held to enable participants to educate MCH staff and community leaders. The photovoice project provided MCH staff with information to supplement existing quantitative perinatal data and contributed to an understanding of key MCH issues that participating community residents would like to see addressed. Participants' concerns centered on the need for safe places for children's recreation and for improvement in the broader community environment within county neighborhoods. Participants' definitions of family, maternal, and child health assets and concerns differed from those that MCH professionals may typically view as MCH issues (low birth weight, maternal mortality, teen pregnancy prevention), which helped MCH program staff to expand priorities and include

  2. Family Resiliency, Family Needs, and Community Reintegration in Persons with Brain Injury (United States)

    Frain, Julianne; Dillahunt-Aspillaga, Tina; Frain, Michael; Ehkle, Sarah


    Purpose: The purpose of the study was to measure predictors of community reintegration and empirically test the resiliency model of family stress, adjustment, and adaptation in persons with traumatic brain injury (TBI). The study also aimed to measure family needs by surveying caregiving family members through the use of the Family Needs…

  3. Effectiveness of Family Planning Methods (United States)

    ... women in a year Effectiveness of Family Planning Methods Implant Reversible Intrauterine Device (IUD) Permanent Male Sterilization ... 0.5 % Diaphragm 12 % How to make your method most effective After procedure, little or nothing to ...

  4. An ounce of prevention. Is family planning disappearing from the healthcare picture? (United States)

    Hirshbein, N


    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.

  5. [Promotion of community-based care in Africa: example of community general practice in Benin]. (United States)

    Caplain, Roland; Yacoubou, Ismaïl; Adedemy, Didier; Sani, Alidou; Takam, Sandrine; Desplats, Dominique


    Considerable effort has been made to provide rural African populations with basic health care, but the quality of this care remains unsatisfactory due to the absence of first-line GPs. This is a paradoxical situation in view of the large number of physicians trained in medical schools in French-speaking Africa and Madagascar. of the lack of GPs working in rural areas is a real concern, as many young doctors remain unemployed in cities. For more than 20 years, the NGO Santé Sud has proposed a Community General Medicine concept, which, combined with a support system, has allowed the installation of more than 200 community GPs in Mali and Madagascar. The advantage of this concept is that it provides family medicine and primary health care in the same practice. Since 2009, Santé Sud supports an installation project in rural areas of northern Benin, where community GPs work independently, as a complementary partner of the public sector. Since 2013, the installation process comprises a university degree created with the University of Parakou Faculty of Medicine. Based on this experience in Benin, the authors show that the presence of a first-line general practitioner is an original strategy that provides a major contribution to health promotion : reducing health inequalities between rural and urban populations, allowing women to receive medically assisted childbirth close to home, developing family planning activities, education and health care for chronic diseases, strengthening health coverage by participating in vaccination campaigns, etc. Due to their functions and proximity, community GPs represent an added value for health promotion.

  6. Factors that enable nurse-patient communication in a family planning context: a positive deviance study. (United States)

    Kim, Young Mi; Heerey, Michelle; Kols, Adrienne


    Family planning programmes in developing countries need a better understanding of nurse-patient communication in order to improve the quality of counselling. To identify factors in the clinic and in the community that enable nurses and patients to communicate effectively with one another. The study explored the personal experiences of nurses and patients who communicate especially effectively during family planning consultations (so-called "positive deviants"). Sixty-four randomly selected public clinics located in East Java, Indonesia. Seven positive deviant nurses and 32 positive deviant patients were identified from among 64 nurses and 768 patients who participated in an earlier patient coaching study. Flooding prevented 5 patients from participating in the study, reducing their number to 27. Investigators conducted: (1) a content analysis of qualitative data collected by structured in-depth interviews and focus-group discussions (FGDs) with positive deviant nurses and patients, and (2) analyses of variance (ANOVA) of quantitative data on clinic, nurse, and patient characteristics. Positive deviant nurses identified four factors, listed in rough order of importance, that helped them communicate effectively: independent study to strengthen their knowledge and skills; communication aids; feedback from colleagues; and motivation stemming from a desire to help people, patients' appreciation, husband's support, and increased income. Positive deviant patients identified five enabling factors: motivation due to their need for a service; confidence in their own communication skills; positive feedback from nurses; belief in patients' right and responsibility to communicate with nurses; and communication aids. Insights from positive deviant nurses and patients suggest that efforts to improve nurse-patient communication should go beyond conventional communication skills training. Managers should consider a mix of clinic-based interventions (such as peer feedback

  7. Community Dialogue to Shift Social Norms and Enable Family Planning: An Evaluation of the Family Planning Results Initiative in Kenya (United States)

    Creanga, Andreea A.; Galavotti, Christine; Wamalwa, Emmanuel


    Introduction Use of family planning (FP) is powerfully shaped by social and gender norms, including the perceived acceptability of FP and gender roles that limit women’s autonomy and restrict communication and decision-making between men and women. This study evaluated an intervention that catalyzed ongoing community dialogues about gender and FP in Siaya county, Nyanza Province, Kenya. Specifically, we explored the changes in perceived acceptability of FP, gender norms and use of FP. Methods We used a mixed-method approach. Information on married men and women’s socio-demographic characteristics, pregnancy intentions, gender-related beliefs, FP knowledge, attitudes, and use were collected during county-representative, cross-sectional household surveys at baseline (2009; n11 = 650 women; n12 = 305 men) and endline (2012; n21 = 617 women; n22 = 317 men); exposure to the intervention was measured at endline. We assessed changes in FP use at endline vs. baseline, and fitted multivariate logistic regression models for FP use to examine its association with intervention exposure and explore other predictors of use at endline. In-depth, qualitative interviews with 10 couples at endline further explored enablers and barriers to FP use. Results At baseline, 34.0% of women and 27.9% of men used a modern FP method compared to 51.2% and 52.2%, respectively, at endline (pwomen, but this association was not significant for men. Women’s use of modern FP was significantly associated with higher spousal communication, control over own cash earnings, and FP self-efficacy. Men who reported high approval of FP were significantly more likely to use modern FP if reporting high approval of FP and more equitable gender beliefs. FP dialogues addressed persistent myths and misconceptions, normalized FP discussions, and increased its acceptability. Public examples of couples making joint FP decisions legitimized communication and decision-making with spouses about FP especially for

  8. The Filipino male as a target audience in family planning. (United States)

    Vitug, W


    Since the official launching of the Philippine Population Program in 1970, family planning campaigns have substantially addressed themselves to women. The suggestion to devote equal, if not more, attention to men as family planning targets had been raised by Dr. Mercado as early as 1971. It was not until 1978, that the deliberate inclusion of males as a target audience in family planning became a matter of policy. The Population Center Foundation (PCF), from 1979 to 1982, carried out research projects to determine the most suitable approaches and strategies to reach Filipino men. The objectives of the PCF's Male Specific Program are: 1) to test alternative schemes in promoting male family planning methods through pilot-testing of family planning clinics for men, 2) to develop teaching materials geared toward specific segments of the male population, 3) to undertake skills training in male-specific motivational approaches for program professionals, and 4) to assess the extent of the husband's role in family planning. An important finding of 1 study was that most outreach workers were female stood in the way of the motivation process, thus hampering the campaign. While the consultative motivational skills training improved knowledge, attitudes, and skills of outreach workers with regard to vasectomy and the motivation process, there were certain predispositions that were hindering the fieldworkers' effectiveness in motivating target clients. Overall, in-depth, 1-to-1 motivation in dealing with men is needed to strengthen internalization of family planning values.

  9. Protective Factors for Youth Exposed to Violence in Their Communities: A Review of Family, School, and Community Moderators. (United States)

    Ozer, Emily J; Lavi, Iris; Douglas, Laura; Wolf, Jennifer Price


    This review provides a comprehensive investigation of the pattern and strength of findings in the literature regarding the environmental moderators of the relationship between exposure to community violence and mental health among children and adolescents. Twenty-nine studies met criteria for inclusion in our analysis of family, school, and community variables as moderators. Dependent variables included internalizing (e.g., anxiety, depression, posttraumatic stress disorder) and externalizing symptoms (e.g., aggression, substance use). Effect sizes for the interactions of exposure to violence and potential moderators were summarized by their patterns of protective processes. The majority of studies in the literature examined family characteristics as moderators of the exposure to violence-symptom relationship, rather than school- or community-level factors. Our results indicated more consistent patterns for (a) close family relationships and social support for internalizing symptoms and (b) close family relationships for externalizing symptoms. Overall, the most common type of protective pattern was protective-stabilizing, in which youth with higher levels of the environmental attribute demonstrate relative stability in mental health despite exposure to violence. We found no consistent evidence that parental monitoring-a dimension inversely associated with exposure to violence in prior studies-moderated the relationship between exposure to violence and symptoms. The study emphasizes the importance of strengthening family support for young people's exposure to community violence; more research is needed to provide a solid evidence base for the role of school and community-level protective factors for youth exposed to violence.

  10. Family planning and family vision in mothers after diagnosis of a child with autism spectrum disorder. (United States)

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


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

  11. "Natural family planning": effective birth control supported by the Catholic Church. (United States)

    Ryder, R E


    During 20-22 September Manchester is to host the 1993 follow up to last year's "earth summit" in Rio de Janeiro. At that summit the threat posed by world overpopulation received considerable attention. Catholicism was perceived as opposed to birth control and therefore as a particular threat. This was based on the notion that the only method of birth control approved by the church--natural family planning--is unreliable, unacceptable, and ineffective. In the 20 years since E L Billings and colleagues first described the cervical mucus symptoms associated with ovulation natural family planning has incorporated these symptoms and advanced considerably. Ultrasonography shows that the symptoms identify ovulation precisely. According to the World Health Organisation, 93% of women everywhere can identify the symptoms, which distinguish adequately between the fertile and infertile phases of the menstrual cycle. Most pregnancies during trials of natural family planning occur after intercourse at times recognised by couples as fertile. Thus pregnancy rates have depended on the motivation of couples. Increasingly studies show that rates equivalent to those with other contraceptive methods are readily achieved in the developed and developing worlds. Indeed, a study of 19,843 poor women in India had a pregnancy rate approaching zero. Natural family planning is cheap, effective, without side effects, and may be particularly acceptable to the efficacious among people in areas of poverty.

  12. Listening, sharing understanding and facilitating consumer, family and community empowerment through a priority driven partnership in Far North Queensland. (United States)

    Haswell-Elkins, Melissa; Reilly, Lyndon; Fagan, Ruth; Ypinazar, Valmae; Hunter, Ernest; Tsey, Komla; Gibson, Victor; Connolly, Brian; Laliberte, Arlene; Wargent, Rachael; Gibson, Teresa; Saunders, Vicki; McCalman, Janya; Kavanagh, David


    This paper provides an example of a mental health research partnership underpinned by empowerment principles that seeks to foster strength among community organizations to support better outcomes for consumers, families and communities. It aims to raise awareness among researchers and service providers that empowerment approaches to assist communities to address mental health problems are not too difficult to be practical but require long-term commitment and appropriate support. A collaborative research strategy that has become known as the Priority Driven Research (PDR) Partnership emerged through literature review, consultations, Family Wellbeing Program delivery with community groups and activities in two discrete Indigenous communities. Progress to date on three of the four components of the strategy is described. The following key needs were identified in a pilot study and are now being addressed in a research-based implementation phase: (i) gaining two-way understanding of perspectives on mental health and promoting universal awareness; (ii) supporting the empowerment of carers, families, consumers and at-risk groups through existing community organizations to gain greater understanding and control of their situation; (iii) developing pathways of care at the primary health centre level to enable support of social and emotional wellbeing as well as more integrated mental health care; (iv) accessing data to enable an ongoing process of analysis/sharing/planning and monitoring to inform future activity. One of the key learnings to emerge in this project so far is that empowerment through partnership becomes possible when there is a concerted effort to strengthen grassroots community organizations. These include social health teams and men's and women's groups that can engage local people in an action orientation.

  13. Effectiveness of participatory planning for community management of fisheries in Bangladesh. (United States)

    Sultana, Parvin; Abeyasekera, Savitri


    This study provides statistical evidence that support for community-based management of resources was more effective when initiated through a process known as participatory action plan development (PAPD). Thirty-six sites were studied where community management of fisheries was facilitated by NGOs. All involved community participation and establishing local fisheries management institutions. However, communities were able to take up more conservation-related interventions and faced fewer conflicts in the 18 sites where a PAPD was the basis for collective action and institution development. This indicates the value and effectiveness of adopting good practice in participatory planning, such as PAPD, which helps diverse stakeholders find common problems and solutions for natural resource management.

  14. Family Planning and Deforestation: Evidence from the Ecuadorian Amazon. (United States)

    Sellers, Samuel


    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.

  15. Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People. (United States)

    Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna


    Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the

  16. Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People (United States)

    Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna


    ABSTRACT Background: Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention—youth-friendly social franchisee training and quality monitoring—with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Methods: Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees—private providers accredited by MSM—are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher

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

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


    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

  18. Group versus individual family planning counseling in Ghana: a randomized, noninferiority trial. (United States)

    Schwandt, Hilary M; Creanga, Andreea A; Danso, Kwabena A; Adanu, Richard M K; Agbenyega, Tsiri; Hindin, Michelle J


    Group, rather than individual, family planning counseling has the potential to increase family planning knowledge and use through more efficient use of limited human resources. A randomized, noninferiority study design was utilized to identify whether group family planning counseling is as effective as individual family planning counseling in Ghana. Female gynecology patients were enrolled from two teaching hospitals in Ghana in June and July 2008. Patients were randomized to receive either group or individual family planning counseling. The primary outcome in this study was change in modern contraceptive method knowledge. Changes in family planning use intention before and after the intervention and intended method type were also explored. Comparisons between the two study arms suggest that randomization was successful. The difference in change in modern contraceptive methods known from baseline to follow-up between the two study arms (group-individual), adjusted for study site, was -0.21, (95% confidence interval: -0.53 to 0.12) suggesting no difference between the two arms. Group family planning counseling was as effective as individual family planning counseling in increasing modern contraceptive knowledge among female gynecology patients in Ghana. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Research and organizational issues for the implementation of family work in community psychiatric services. (United States)

    Jones, Adrian; Scannell, Tony


    The need for evidence-based practice (EBP) to guide and develop mental health services remains fundamental for modern services. Aim. To discuss issues that impact upon implementation of EBP and practice development using family work (FW) as an example. A selection of the FW literature was reviewed drawing on sources including the Cochrane Library, Cinahl and Medline. Keywords used were FW, community mental health team and research design. Centralized policy initiatives and guidelines that are themselves guided by evidence of randomized controlled trials predominantly risk alienating practitioners and clients/carers. Family work has some demonstrable clinical benefits although models differ and the active therapeutic agent remains unclear. Its adoption into routine care is also hindered by a productivity management outlook that seeks to maximize stretched resources and whose values are likely to be internalized by practitioners. The dichotomous position of previous research and practice development make implementation of EBP difficult and highlights the need for strategic planning that embraces both factors. The current drive to increase EBP requires a bi-directional process of influence that allows individual practitioners and clients/carers to become producers of evidence and not simply recipients. The authors support wider adoption of case study research designs to reflect the unpredictable nature of mental health care. Adoption of assertive community treatment models within community services is most likely to promote the excellence management model and accommodate EBP such as FW.

  20. The role of family planning communications--an agent of reinforcement or change. (United States)

    Chen, E C


    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.

  1. Best management practices for creating a community wildfire protection plan (United States)

    Pamela J. Jakes; Christine Esposito; Sam Burns; Antony S. Cheng; Kristen C. Nelson; Victoria E. Sturtevant; Daniel R. Williams


    A community wildfire protection plan (CWPP) is a means of bringing local solutions to wildland fire management. In developing and implementing CWPPs, communities assume a leadership role in reducing wildfi re risk on federal and nonfederal land. In this publication, we identify best management practices for CWPP development and implementation based on the experiences...

  2. Family Therapy in the Black Community. (United States)

    McAdoo, John Lewis

    The field of family therapy is a relatively new one, growing and gaining wider acceptance in the areas of social work, psychiatry, psychology, and community mental health. It has influenced the shift from individually oriented theory and techniques to a social systems approach, emphasizing the relationship between family members. While research…

  3. Advertising family planning in the press: direct response results from Bangladesh. (United States)

    Harvey, P D


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

  4. Family and Community: (Re)Telling Our Own Story (United States)

    Byrne, Anne; O'Mahony, Deirdre


    In this article, the authors explore the consequences of an American 1930s classic anthropological study for a contemporary rural community in the west of Ireland. The contribution of family, kin, and community relations to sustaining a rural way of life was the primary focus of Arensberg and Kimball's study of Irish farm families published as…

  5. Review of quality assessment tools for family planning programmes in low- and middle-income countries. (United States)

    Sprockett, Andrea


    Measuring and tracking the quality of healthcare is a critical part of improving service delivery, clinic efficiency and health outcomes. However, no standardized or widely accepted tool exists to assess the quality of clinic-based family planning services in low- and middle-income countries. The objective of this literature review was to identify widely used public domain quality assessment tools with existing or potential application in clinic-based family planning programmes. Using PubMed, PopLine, Google Scholar and Google, key terms such as ‘quality assessment tool’, ‘quality assessment method’, ‘quality measurement’, ‘LMIC’, ‘developing country’, ‘family planning’ and ‘reproductive health’ were searched for articles, identifying 20 relevant tools. Tools were assessed to determine the type of quality components assessed, divided into structure and process components, level of application (national or facility), health service domain that can be assessed by the tool, cost and current use of the tool. Tools were also assessed for shortcomings based on application in a low- and middle-income clinic-based family planning programme, including personnel required, re-assessment frequency, assessment of structure, process and outcome quality, comparability of data over time and across facilities and ability to benchmark clinic results to a national benchmark. No tools met all criteria, indicating a critical gap in quality assessment for low- and middle-income family planning programmes. To achieve Universal Health Coverage, agreed on in the Sustainable Development Goals and to improve system-wide healthcare quality, we must develop and widely adopt a standardized quality assessment tool.

  6. Family planning program: world review 1974. Introduction. (United States)

    Watson, W B; Lapham, R J


    The 1974 Population Conference at Bucharest was marked with controversy between developed and developing countries, with the latter strongly critical of aid for population control but less for social and economic development. The Plan of Action which was finally approved emphasized the importance of social and economic factors in relation to population growth while recommending that couples in all nations should have access to family planning information. Different regions of the world, however, have widely divergent population policies and goals. The Asia-Pacific region of the developing world, which has 3/4 of the population of the developing world, has articulated a strong stance in favor of reducing birth rates at Post-Bucharest Consultation. Government-supported family planning programs are seen as a high priority item to reduce rapid population growth. Rapid population growth is not seen as a high-priority problem in most African, Arab, and Latin American countries. Population problems will be solved with economic and social advancement. There is more concern in Latin America for family planning as a "human right" issue than to promote demographic goals. Latin America was also concerned with migration/urbanization issues. All of the Regional Consultations after Bucharest favored a greater emphasis on population in development planning, concern for the problems caused by migration and urbanization, improvement in the status of women, and support for the reduction of mortality levels. Some 74 countries containing 93% of the population of the developing world, supported family planning, with only 4 populous countries -- Burma, Ethiopia, Peru, and North Korea not in support. More than 98% of the population of Asia lives in countries which support family planning; the figures are 94% for Latin America, 90% for the Middle East and North Africa and 64% for Sub-Saharan Africa. The governments of 39 countries with a combined population of 2.3 billion have stated that

  7. Watch out for the blue circle: a breakthrough in family planning promotional strategy. (United States)



    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.

  8. Male Involvement in Family Planning Decision Making in Ile-Ife ...

    African Journals Online (AJOL)


    ORIGINAL RESEARCH ARTICLE. Male Involvement ... However, fertility and family planning research and .... design, employing both quantitative and qualitative research .... Table 2: Types of family planning methods known to male residents ...

  9. World population growth, family planning, and American foreign policy. (United States)

    Sharpless, J


    The US decision since the 1960s to link foreign policy with family planning and population control is noteworthy for its intention to change the demographic structure of foreign countries and the magnitude of the initiative. The current population ideologies are part of the legacy of 19th century views on science, morality, and political economy. Strong constraints were placed on US foreign policy since World War II, particularly due to presumptions about the role of developing countries in Cold War ideology. Domestic debates revolved around issues of feminism, birth control, abortion, and family political issues. Since the 1960s, environmental degradation and resource depletion were an added global dimension of US population issues. Between 1935 and 1958 birth control movements evolved from the ideologies of utopian socialists, Malthusians, women's rights activists, civil libertarians, and advocates of sexual freedom. There was a shift from acceptance of birth control to questions about the role of national government in supporting distribution of birth control. Immediately postwar the debates over birth control were outside political circles. The concept of family planning as a middle class family issue shifted the focus from freeing women from the burdens of housework to making women more efficient housewives. Family planning could not be taken as a national policy concern without justification as a major issue, a link to national security, belief in the success of intervention, and a justifiable means of inclusion in public policy. US government involvement began with agricultural education, technological assistance, and economic development that would satisfy the world's growing population. Cold War politics forced population growth as an issue to be considered within the realm of foreign policy and diplomacy. US government sponsored family planning was enthusiastic during 1967-74 but restrained during the 1980s. The 1990s has been an era of redefinition of

  10. Family Violence Prevention Programs in Immigrant Communities: Perspectives of Immigrant Men (United States)

    Simbandumwe, Louise; Bailey, Kim; Denetto, Shereen; Migliardi, Paula; Bacon, Brenda; Nighswander, Maggie


    The Strengthening Families in Canada Family Violence Prevention Project was aimed at engaging immigrant and refugee communities in family violence prevention. The project, which received support from the Community Mobilization Program, National Crime Prevention Strategy, involved a partnership of four community health and education organizations.…

  11. Place-Based Partnerships on Behalf of Children, Families and Communities: Energy Express. (United States)

    Butera, Gretchen; Richason, Dan; Phillips, Ruthellen

    Energy Express is an 8-week summer nutrition and literacy program in low-income West Virginia communities. Multi-age groups of eight children in grades 1-6 work with college student mentors for 3 1/2 hours each day, eating breakfast and lunch served family-style and creating print-rich environments that support their emerging literacy. The program…

  12. Family Planning and Family Vision in Mothers after Diagnosis of a Child with Autism Spectrum Disorder (United States)

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


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

  13. Promoting Family Literacy through the Five Pillars of Family and Community Engagement (FACE) (United States)

    Kuo, Nai-Cheng


    Family literacy involves factors beyond what is done at home between parents and children. To help preservice teachers develop their understanding of the multiple dimensions of family literacy, this study uses the five pillars of family and community engagement (FACE)--early literacy, family involvement, access to books, expanded learning, and…

  14. Planning a Family: Priorities and Concerns in Rural Tanzania ...

    African Journals Online (AJOL)

    Planning a Family: Priorities and Concerns in Rural Tanzania. T Marchant, AK Mushi, R Nathan, O Mukasa, S Abdulla, C Lengeler, JRM Armstrong Schellenberg. Abstract. A fertility survey using qualitative and quantitative techniques described a high fertility setting (TFR 5.8) in southern Tanzania where family planning use ...

  15. Knowledge, attitude and practice of family planning among pregnant ...

    African Journals Online (AJOL)

    Knowledge, attitude and practice of family planning among pregnant women at Grace Specialist Hospital. ... Background: Unwanted pregnancy is a common event in our environment and many of them will end in an unsafe abortion. ... Education and religion did not significantly affect the use of a family planning method.

  16. The Impact of Desired Family Size Upon Family Planning Practices in Rural East Pakistan (United States)

    Mosena, Patricia Wimberley


    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)

  17. Advancing Care for Family Caregivers of persons with dementia through caregiver and community partnerships. (United States)

    White, Carole L; Overbaugh, Kristen J; Pickering, Carolyn E Z; Piernik-Yoder, Bridgett; James, Debbie; Patel, Darpan I; Puga, Frank; Ford, Lark; Cleveland, James


    There are currently 15 million Americans who provide over 80% of the care required by their family members with Alzheimer's disease and other dementias. Yet care for caregivers continues to be fragmented and few evidence-based interventions have been translated into routine clinical care and therefore remain inaccessible to most family caregivers. To address this gap, the Caring for the Caregiver program is being developed at UT Health San Antonio, School of Nursing to improve support services and health outcomes for family caregivers. Our purpose is to describe the engagement process undertaken to assess caregiver and community needs and how findings are informing program development. We are using a model of public engagement that consists of communication of information, collection of information from stakeholders, and collaboration where stakeholders are partners in an exchange of information to guide program activities. An assessment of the community was undertaken to identify resources/services for family caregivers. Subsequently, stakeholders were invited to a community-academic forum to discuss strategies to build on existing strengths for family caregiving and to identify gaps in care. Detailed notes were taken and all discussions were recorded and transcribed for analysis. Data were analyzed using thematic content analysis. We conducted site visits with 15 community agencies, interviewed 13 family caregivers, and attended community events including support groups and health and senior fairs. Fifty-three diverse stakeholders attended the community-academic forum. Participants identified existing assets within our community to support family caregivers. Consistent among groups was the need to increase awareness in our community about family caregivers. Themes identified from the discussion were: making the invisible visible, you don't know what you don't know, learning too late, and anticipating and preparing for the future. Incorporating caregiver and

  18. Men's knowledge and spousal communication about modern family planning methods in Ethiopia. (United States)

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


    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.

  19. Women's experiences after Planned Parenthood's exclusion from a family planning program in Texas. (United States)

    Woo, C Junda; Alamgir, Hasanat; Potter, Joseph E


    We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006-2010 (NSFG). (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. Requiring low-income family planning patients to switch healthcare providers has adverse consequences. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. A community engagement process for families with children with disabilities: lessons in leadership and policy. (United States)

    Vargas, Claudia María; Arauza, Consuelo; Folsom, Kim; Luna, María del Rosario; Gutiérrez, Lucy; Frerking, Patricia Ohliger; Shelton, Kathleen; Foreman, Carl; Waffle, David; Reynolds, Richard; Cooper, Phillip J


    This article examines a community engagement process developed as part of leadership training for clinical trainees in the Oregon Leadership Education for Neurodevelopmental and Related Disabilities (LEND) Program in a complex community with diverse families who have children with disabilities. The goal is to examine the process and lessons learned for clinical trainees and their mentors from such a process. This is a case study conducted as community-engaged action research by participant-observers involved in the Cornelius community for the past 4 years. The authors include faculty members and clinical trainees of the Oregon LEND Program at the Oregon Health & Science University, families with children with disabilities in the community, and city officials. It is a critical case study in that it studied a community engagement process in one of the poorest communities in the region, with an unusually high population of children with disabilities, and in a community that is over half Latino residents. Lessons learned here can be helpful in a variety of settings. Community engagement forum, community engagement processes, a debriefing using a seven-element feasibility framework, and trainee evaluations are key elements. A community engagement forum is a meeting to which community members and stakeholders from pertinent agencies are invited. Community engagement processes used include a steering committee made up of, and guided by community members which meets on a regular basis to prioritize and carry out responses to problems. Trainee evaluations are based on a set of questions to trigger open-ended responses. Lessons learned are based on assessments of initial and long-term outcomes of the community engagement processes in which families, community members, local officials and LEND trainees and faculty participate as well as by trainee participant-observations, end of year evaluations and trainee debriefings at the time of the initial community assessment forum

  1. Factors influencing family planning practice among reproductive age married women in Hlaing Township, Myanmar. (United States)

    Lwin, Myo Min; Munsawaengsub, Chokchai; Nanthamongkokchai, Sutham


    To study the factors that influence the family planning practice among married, reproductive age women in Hlaing Township, Myanmar. Cross-sectional survey research was conducted among 284 married, reproductive age women using stratified random sampling. The data were collected through questionnaire interviews during February and March 2012 and analyzed by frequency, percentage, Chi-square test, and multiple logistic regression. The proportion of families practicing family planning was 74.7%, contraceptive injection being the most commonly used method. The factors influencing family planning practice were attitude towards family planning, 24-hour availability of family planning services, health worker support, and partner and friends support. The women with a positive attitude toward family planning practiced family planning 3.7 times more than women who had a negative attitude. If family planning services were available for 24 hours, then women would practice 3.4 times more than if they were not available for 24 hours. When women got fair to good support from health workers, they practiced 15.0 times more on family planning and 4.3 times more who got fair to good support from partners and friends than women who got low support. The factors influencing family planning practice of married, reproductive age women were attitude toward family planning, 24-hour availability of family planning services, health worker support, and partner and friends support. The findings suggest that empowerment of health workers, training of volunteers, pharmacists and contraceptive drug providers, encouraging inter-spousal communication, and peer support, as well as an integrated approach to primary health care in order to target different populations to change women's attitudes on family planning, could increase family planning practice among Myanmar women.

  2. Utilization and determinants of modern family planning among ...

    African Journals Online (AJOL)


    planning increases with women's education, and creating a conductive environment for ... Key words: Family planning, Modern methods, Utilization, Reproductive age, Partner discussion .... Traditional methods consist of periodic abstinence,.

  3. Determinants of unmet need for family planning in rural Burkina Faso: a multilevel logistic regression analysis. (United States)

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


    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.

  4. Malaysia family-planning centers strive to maintain gains won in 15-year period. (United States)

    Roemer, R


    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.

  5. Remediation plans in family medicine residency (United States)

    Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert


    Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

  6. Days La Familia community drug and alcohol prevention program: Family-centered model for working with inner-city Hispanic families. (United States)

    Hernandez, L P; Lucero, E


    Substance abuse among Hispanics is on the increase despite national efforts toward reducing it. Researchers and service providers have recognized the specific need for better prevention models that address the issues of poor Hispanics. La Familia is a community-based ATOD prevention program that targets Hispanic families with high-risk youth from 6 to 11 years old, and attempts to reduce identified risk factors while building on culturally relevant protective factors. During the 2 years, the program has enrolled 219 youth and their families utilizing existing community networks and aggressive outreach. The program resulted in a 92% retention rate and over 80% attendance per session. As a result of the program, families became more willing to discuss ATOD issues openly and made positive steps toward empowerment.

  7. Effect of strategic planning education on attitudes and perceptions of independent community pharmacy owners/managers. (United States)

    Harrison, Donald L


    To assess the impact of formal education program participation on the attitudes and perceptions of independent community pharmacy owners/managers toward strategic planning. Cross-sectional study. United States; June 4-July 30, 2004. Nationwide random sample of 1,250 owners/managers of independent community pharmacies. Mailed survey. Strategic planning formal education program participation. Comprehensiveness of strategic planning. Attitudes and perceptions of owners/managers of independent community pharmacies toward strategic planning. A total of 527 (42.1%) usable questionnaires were returned. Only 124 (23.5%) respondents indicated that they participated in a formal strategic planning education program. However, of the 141 (26.85%) respondents who indicated that they had conducted strategic planning for their community pharmacy, 111 (89.5%) had participated in a formal strategic planning education program. A significant association was detected between formal education program participation and the conducting of strategic planning (Pstrategic planning based on program participation (Pstrategic planning rating than those respondents who did not participate in an educational program (Pstrategic planning education program participation and the conducting of strategic planning by owner/managers of independent community pharmacies, and those participating in such programs have significantly different attitudes and perceptions toward the conducting of strategic planning and have a significantly higher comprehensiveness of strategic planning rating.




    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

  9. Family, Community, and Educational Outcomes in South Asia (United States)

    Chudgar, Amita; Shafiq, M. Najeeb


    In this article, we review research on the economics and sociology of education to assess the relationships between family and community variables and children's educational outcomes in South Asia. At the family level, we examine the variables of family socioeconomic status (SES), parental education, family structure, and religion and caste. At…

  10. Implementing Trauma-Informed Partner Violence Assessment in Family Planning Clinics. (United States)

    Decker, Michele R; Flessa, Sarah; Pillai, Ruchita V; Dick, Rebecca N; Quam, Jamie; Cheng, Diana; McDonald-Mosley, Raegan; Alexander, Kamila A; Holliday, Charvonne N; Miller, Elizabeth


    Intimate partner violence (IPV) and reproductive coercion (RC) are associated with poor reproductive health. Little is known about how family planning clinics implement brief IPV/RC assessment interventions in practice. We describe the uptake and impact of a brief, trauma-informed, universal IPV/RC assessment and education intervention. Intervention implementation was evaluated via a mixed methods study among women ages 18 and up receiving care at one of two family planning clinics in greater Baltimore, MD. This mixed methods study entailed a quasi-experimental, single group pretest-posttest study with family planning clinic patients (baseline and exit survey n = 132; 3-month retention n = 68; retention rate = 52%), coupled with qualitative interviews with providers and patients (total n = 35). Two thirds (65%) of women reported receiving at least one element of the intervention on their exit survey immediately following the clinic-visit. Patients reported that clinic-based IPV assessment is helpful, irrespective of IPV history. Relative to those who reported neither, participants who received either intervention element reported greater perceived caring from providers, confidence in provider response to abusive relationships, and knowledge of IPV-related resources at follow-up. Providers and patients alike described the educational card as a valuable tool. Participants described trade-offs of paper versus in-person, electronic medical record-facilitated screening, and patient reluctance to disclose current situations of abuse. In real-world family planning clinic settings, a brief assessment and support intervention was successful in communicating provider caring and increasing knowledge of violence-related resources, endpoints previously deemed valuable by IPV survivors. Results emphasize the merit of universal education in IPV/RC clinical interventions over seeking IPV disclosure.

  11. The impact of family planning clinic programs on adolescent pregnancy. (United States)

    Forrest, J D; Hermalin, A I; Henshaw, S K


    During the 1970s, there was a decline in adolescent childbearing in the United States and, among teenagers who were sexually active, there was a decline in pregnancy rates as well. To what extent was increased enrollment by teenagers in federally funded family planning clinics responsible for these declines? Areal multivariate analysis reveals that adolescent birthrates were reduced between 1970 and 1975 as the result of enrollment by teenagers in family planning clinics, independent of the effects of other factors also affecting fertility, such as poverty status, education and urbanization. Using a model which controls for differences in adolescent sexual activity in different areas in 1970 and 1975, the analysis found that for every 10 teenage patients enrolled in family planning clinics in 1975, about one birth was averted in 1976. Other multivariate models, which did not control for differences in sexual activity, showed changes in the same direction, though of smaller dimension. Since the family planning program averts not only births but also pregnancies that result in abortions and miscarriages, an estimate was made of the total number of pregnancies averted by the program. Based on the proportion of unintended pregnancies among adolescents that resulted in live births in 1976 (36 percent), it was estimated that for every 10 teen patients enrolled in 1975, almost three pregnancies were averted in the following year. Over the 1970s, an estimated 2.6 million unintended adolescent pregnancies were averted by the program--944,000 births, 1,376,000 abortions and 326,000 miscarriages. In 1979 alone, an estimated 417,000 unintended pregnancies were prevented by the program.

  12. A review of family health's latest evaluation of the demographic impact of the Louisiana Family Planning Program. (United States)

    Gettys, J O; Atkins, E H; Mary, C C


    The report, "Recent Trends in Louisiana Fertility," released in January 1973 is reviewed. This report was distinguished from other Louisiana Family Planning Program evaluations of demographic impact by several features: 1) Louisiana crude birth rates are compared with those of the United States and Mississippi; 2) differences in age-specific nonwhite fertility rates in Louisiana between 1965 and 1971 are compared with corresponding differences in Mississippi; and 3) the concepts of "parity components of age-specific rates" and "excess births" are introduced into the discussion of Louisiana fertility trends. According to the reviewers, no scientific or even psudoscientific analysis of the Louisiana Family Planning Program has ever been published or made available by the Family Health Foundation to any state agency. They contend that the so-called evaluations of the demographic impact of the Louisiana Family Planning Program are textbook examples of customized statistics. It is suggested that the family planning program services may contribute to increased natality and that the family planning program workers are more highly motivated to retain their jobs than to bring down the brith rate. The reviewers are not convinced that the statisticians on the Family Health Foundation are responsible for all of the narrative that accompanies their charts and tables.

  13. Social accountability and education revives health sub-centers in India and increases access to family planning services

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    Susan Otchere


    Full Text Available Background: Uttar Pradesh (UP is the most populous state in India. The maternal mortality ratio, infant mortality rate, and fertility rates are all higher than the national average. Sixty percent of UP inhabitants live in rural communities. The reasons behind the poor state of health and services in many areas of UP are inadequate knowledge and availability in communities of healthy behaviors, and information on available government health services. Methods: World Vision, Inc. implemented a three-and-half year mobilizing plan for maternal and neonatal health through a birth spacing and advocacy project (MOMENT, partnering with local organizations in rural Hardoi and urban slums of Lucknow districts in UP. World Vision used print, audio, visual media, and house-to-house contacts to educate communities on timing and spacing of pregnancies; and the benefits of seeking and using maternal and child health services (MCH including immunization and family planning (FP.This paper focuses on World Vision’s social accountability strategy – Citizen Voice and Action (CVA and interface meetings – used in Hardoi that helped educate and empower Village Health Sanitation and Nutrition Committees (VHSNCs and village leaders to access government untied funds to improve community social and health services. Results: Forty VHSNCs were revived in 24 months. Nine local leaders accessed government untied funds. In addition, increased knowledge of the benefits of timing and spacing of pregnancies, maternal child health, family planning services, and access to community entitlements led the community to embrace and contribute their time to rebuild and re-open 17 non-functional Auxiliary Nurse Midwife (ANM sub-centers. Seventeen ANMs received refresher training to provide quality care. Sub-center data showed that 1,121 and 3,156 women opted for intra-uterine contraceptive device and oral pills, respectively, and 29,316 condoms were distributed. Conclusion: In Hardoi

  14. Family planning / sex education / teenage pregnancy. (United States)


    The Alan Guttmacher Institute's State Reproductive Health Monitor provides legislative information on family planning, sex education, and teenage pregnancy. The listing contains information on pending bills; the state, the identifying legislation number, the sponsor, the committee, the date the bill was introduced, a description of the bill, and when available, the bill's status. From January through February, 1993, the bills cover a wide range of regulation and social policy including: appropriations for family planning services; Norplant implants for women receiving AFDC benefits; the requirement that health insurance policies provide coverage for contraception services; the repeal of the sterilization procedure review committee; since a need for such a committee has vanished; requiring hotels, motels, and innkeepers to offer condoms for sale to registered guests; allowing male and female public assistance recipients between ages 18-35 who submit to sterilization operations to be eligible to receive a $2,000 grant; a provision that no more children may be included in the size of the family, for the purpose of determining the amount of AFDC benefits that a family may receive, than at the time that eligibility was determined, and that before a family with 2 or more children can receive AFDC benefits, the woman must consent to and have surgically implanted Norplant or a similar reversible birth control device with a 5-year or longer effectiveness.

  15. Landscape Hazards in Yukon Communities: Geological Mapping for Climate Change Adaptation Planning (United States)

    Kennedy, K.; Kinnear, L.


    Climate change is considered to be a significant challenge for northern communities where the effects of increased temperature and climate variability are beginning to affect infrastructure and livelihoods (Arctic Climate Impact Assessment, 2004). Planning for and adapting to ongoing and future changes in climate will require the identification and characterization of social, economic, cultural, political and biophysical vulnerabilities. This pilot project addresses physical landscape vulnerabilities in two communities in the Yukon Territory through community-scale landscape hazard mapping and focused investigations of community permafrost conditions. Landscape hazards are identified by combining pre-existing data from public utilities and private-sector consultants with new geophysical techniques (ground penetrating radar and electrical resistivity), shallow drilling, surficial geological mapping, and permafrost characterization. Existing landscape vulnerabilities are evaluated based on their potential for hazard (low, medium or high) under current climate conditions, as well as under future climate scenarios. Detailed hazard maps and landscape characterizations for both communities will contribute to overall adaptation plans and allow for informed development, planning and mitigation of potentially threatening hazards in and around the communities.

  16. An assessment of implementation of Community Oriented Primary Care in Kenyan family medicine postgraduate medical education programmes

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    Ian J. Nelligan


    Full Text Available Background and objectives: Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya. Method: Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC educators, practitioners and academic stakeholders in two family medicine postgraduate programmes in Kenya. Discussions were transcribed, inductively coded and thematically analysed. Results: Two focus groups with eight family medicine postgraduate students and interviews with five faculty members at two universities were conducted. Two broad themes emerged from the analysis: expected learning outcomes and important community-based enablers. Three learning outcomes were (1 making a community diagnosis, (2 understanding social determinants of health and (3 training in participatory research. Three community-based enablers for sustainability of COPC were (1 partnerships with community health workers, (2 community empowerment and engagement and (3 institutional financial support. Conclusions: Our findings illustrate the expected learning outcomes and important communitybased enablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya.

  17. Family planning providers' role in offering PrEP to women. (United States)

    Seidman, Dominika; Weber, Shannon; Carlson, Kimberly; Witt, Jacki


    Pre-exposure prophylaxis (PrEP) provides a radically different HIV prevention option for women. Not only is PrEP the first discrete, woman-controlled method that is taken in advance of exposure, but it is both safe and highly effective, offering over 90% protection if taken daily. While multiple modalities of PrEP are in development ranging from vaginal rings to injectables and implants, only PrEP with oral tenofovir/emtricitabine is currently FDA-approved. Family planning clinics provide key access points for many women to learn about and obtain PrEP. By incorporating PrEP services into family planning care, family planning providers have the opportunity to meet women's expectations, ensure women are aware of and offered comprehensive HIV prevention options, and reverse emerging disparities in PrEP access. Despite real and perceived barriers to integrating PrEP into family planning care, providing PrEP services, ranging from education to onsite provision, is not only possible but an important component of providing high-quality sexual and reproductive healthcare to women. Lessons learned from early adopters will help guide those in family planning settings initiating or enhancing PrEP services. Copyright © 2018. Published by Elsevier Inc.

  18. 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. (United States)

    Ho, Lara S; Wheeler, Erin


    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

  19. 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 (United States)

    Ho, Lara S; Wheeler, Erin


    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

  20. 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. (United States)

    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


    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

  1. Community capacity building and sustainability: outcomes of community-based participatory research. (United States)

    Hacker, Karen; Tendulkar, Shalini A; Rideout, Catlin; Bhuiya, Nazmim; Trinh-Shevrin, Chau; Savage, Clara P; Grullon, Milagro; Strelnick, Hal; Leung, Carolyn; DiGirolamo, Ann


    For communities, the value of community-based participatory research (CBPR) is often manifested in the outcomes of increased capacity and sustainable adoption of evidence-based practices for social change. Educational opportunities that promote discourse between community and academic partners can help to advance CBPR and better define these outcomes. This paper describes a community-academic conference to develop shared definitions of community capacity building and sustainability related to CBPR and to identify obstacles and facilitators to both. "Taking It to the Curbside: Engaging Communities to Create Sustainable Change for Health" was planned by five Clinical Translational Science Institutes and four community organizations. After a keynote presentation, breakout groups of community and academic members met to define community capacity building and sustainability, and to identify facilitators and barriers to achieving both. Groups were facilitated by researcher-community partner teams and conversations were recorded and transcribed. Qualitative analysis for thematic content was conducted by a subset of the planning committee. Important findings included learning that (1) the concepts of capacity and sustainability were considered interconnected; (2) partnership was perceived as both a facilitator and an outcome of CBPR; (3) sustainability was linked to "transfer of knowledge" from one generation to another within a community; and (4) capacity and sustainability were enhanced when goals were shared and health outcomes were achieved. Community capacity building and sustainability are key outcomes of CBPR for communities. Co-learning opportunities that engage and mutually educate both community members and academics can be useful strategies for identifying meaningful strategies to achieve these outcomes.




  3. Community-Based Tourism - Option for Forest-Dependent Communities in 1A IUCN Protected Areas? Cameroon Case Study

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    Burgin Shelley


    Full Text Available In developing countries, ‘exponential’ growth in IUCN protected lands has occurred in the last 25 years. Approximately 6% of protected areas are ‘Strict Nature Reserve[s]’ (1A with emphasis on conservation and strict restrictions on human access. Before Bakossi Forest Reserve (Cameroon had 1A protection, 95% of local families used the Reserve for their livelihood. They farmed cash crops, collected fire wood, timber, and food with incomes equivalent to US$35,000/annually/family. Post-protection, the Reserve’s local communities lacked support to develop alternative livelihoods, and 75% reported being intercepted illegally trespassing by Reserve guards. Without illegal activity economic impacts would have been substantially greater. Protection has also meant foregone national income from timber and coffee exports. We used Bakossi Forest Reserve as a case study to identify issues facing local communities excluded from the Reserve that traditionally provided their livelihood. We also investigated potential alternative family livelihoods based on critical evaluation of the literature. We identified ‘exceptional’ community-based tourism potential. We also found that Cameroon was the first African country to develop community-based forestry with the dual roles of conservation and poverty alleviation. Using this model, community-based tourism could be a cost-effectively initiative to deliver the same dual roles as community-based forestry.

  4. Brighter Smiles Africa--translation of a Canadian community-based health-promoting school program to Uganda. (United States)

    Macnab, A J; Radziminski, N; Budden, H; Kasangaki, A; Zavuga, R; Gagnon, F A; Mbabali, M


    PROJECT GOAL: To adapt a successful Canadian health-promoting school initiative to a Ugandan context through international partnership. Rural children face many health challenges worldwide; health professionals in training understand these better through community-based learning. Aboriginal leaders in a Canadian First-Nations community identified poor oral health as a child health issue with major long-term societal impact and intervened successfully with university partners through a school-based program called "Brighter Smiles". Makerere University, Kampala, Uganda (MUK) sought to implement this delivery model for both the benefit of communities and the dental students. MUK identified rural communities where hospitals could provide dental students with community-based learning and recruited four local schools. A joint Ugandan and Canadian team of both trainees and faculty planned the program, obtained ethics consent and baseline data, initiated the Brighter Smiles intervention model (daily at-school tooth-brushing; in-class education), and recruited a cohort to receive additional bi-annual topical fluoride. Hurdles included: challenging international communication and planning due to inconsistent internet connections; discrepancies between Canadian and developing world concepts of research ethics and informed consent; complex dynamics for community engagement and steep learning curve for accurate data collection; an itinerant population at one school; and difficulties coordinating Canadian and Ugandan university schedules. Four health-promoting schools were established; teachers, children, and families were engaged in the initiative; community-based learning was adopted for the university students; quarterly team education/evaluation/service delivery visits to schools were initiated; oral health improved, and new knowledge and practices were evident; an effective international partnership was formed providing global health education, research and health care

  5. Mobile Technology for Improved Family Planning (MOTIF): the development of a mobile phone-based (mHealth) intervention to support post-abortion family planning (PAFP) in Cambodia. (United States)

    Smith, Chris; Vannak, Uk; Sokhey, Ly; Ngo, Thoai D; Gold, Judy; Free, Caroline


    The objective of this paper is to outline the formative research process used to develop the MOTIF mobile phone-based (mHealth) intervention to support post-abortion family planning in Cambodia. The formative research process involved literature reviews, interviews and focus group discussions with clients, and consultation with clinicians and organisations implementing mHealth activities in Cambodia. This process led to the development of a conceptual framework and the intervention. Key findings from the formative research included identification of the main reasons for non-use of contraception and patterns of mobile phone use in Cambodia. We drew on components of existing interventions and behaviour change theory to develop a conceptual framework. A multi-faceted voice-based intervention was designed to address health concerns and other key determinants of contraception use. Formative research was essential in order to develop an appropriate mHealth intervention to support post-abortion contraception in Cambodia. Each component of the formative research contributed to the final intervention design.

  6. Comparison of family planning in Cuba and Ireland. (United States)

    Smyth, Suzie; Stronge, Shirley


    Family planning gives individuals and couples control and choice over the number of children they have and the timing of their births. Developments in reproductive health have resulted in major changes in the options for family planning, providing more choice and control over fertility. This article explores reproductive health in the Republic of Cuba and the Republic of Ireland, with a focus on contraceptive use and termination of pregnancy as methods of family planning. The predominant religion in both countries is Catholicism, which promotes the right to life of the unborn child. The two countries have adopted different approaches to the availability of both contraception and termination of pregnancy. Cuba has offered free access to contraception and termination of pregnancy since the 1960s to reduce maternal mortality. In Ireland, contraception was not widely available until 1995 and termination of pregnancy is available only in extremely limited circumstances.

  7. An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy

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    Tina Karwalajtys


    Full Text Available Tina Karwalajtys1, Janusz Kaczorowski2,31Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 2Primary Care & Community Research, Child & Family Research Institute, Vancouver, BC, Canada; 3Department of Family Practice, University of British Columbia, Vancouver, BC, CanadaAbstract: Cardiovascular disease (CVD is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.Keywords: risk factors, blood pressure determination, community health services, community health planning, public health practice

  8. Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents (United States)

    Kirby, Kimberly C.; Versek, Brian; Kerwin, MaryLouise E.; Meyers, Kathleen; Benishek, Lois A.; Bresani, Elena; Washio, Yukiko; Arria, Amelia; Meyers, Robert J.


    We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however,…

  9. Women Leaders in High-Poverty Community Schools: Work-Related Stress and Family Impact (United States)

    Lawson, Jennifer E.


    This qualitative study explores the experiences of women administrators in high-poverty community schools, investigating four women's perspectives on work demands and the impact on their families. Their work demands are related to the characteristics of impoverished communities, whereas their work resources are based on intrinsic rewards and…

  10. Factors determining family planning in Catalonia. Sources of inequity

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    Saurina Carme


    Full Text Available Abstract Introduction In recent decades, the foreign population in Spain has increased significantly, particularly for Catalonia, an autonomous region of Spain (2.90% in 2000 and 15.95% in 2010 and in particular Girona province (6.18% in 2000 and 21.55% in 2010. Several studies have shown a lower use of family planning methods by immigrants. This same trend is observed in Spain. The objective of this paper is to determine the existence of differences and possible sources of inequity in the use of family planning methods among health service users in Catalonia (Spain by sex, health status, place of birth and socioeconomic conditions. Methods Data were taken from an ad-hoc questionnaire which was compiled following a qualitative stage of individual interviews. Said questionnaire was administered to 1094 Catalan public health service users during 2007. A complete descriptive analysis was carried out for variables related to public health service users’ sociodemographic characteristics and variables indicating knowledge and use of family planning methods, and bivariate relationships were analysed by means of chi-square contrasts. Considering the use (or non-use of family planning methods as a dependent variable and a set of demographic, socioeconomic and health status variables as explanatory factors, the relationship was modelled using mixed models. Results The analysed sample is comprised of 54.3% women and 45.7% men, with 74.3% natives (or from the EU and 25.7% economic immigrants. 54.8% use some method of family planning, the condom (46.7% and the pill (28.0% being the two most frequently used methods. Statistical modelling indicates that those factors which most influence the use of family planning methods are level of education (30.59% and 39.29% more likelihood and having children over 14 (35.35% more likelihood. With regard to the origin of the user, we observe that patients from North Africa,sub. Saharan Africa and Asia are less likely to

  11. Factors determining family planning in Catalonia. Sources of inequity. (United States)

    Saurina, Carme; Vall-Llosera, Laura; Saez, Marc


    In recent decades, the foreign population in Spain has increased significantly, particularly for Catalonia, an autonomous region of Spain (2.90% in 2000 and 15.95% in 2010) and in particular Girona province (6.18% in 2000 and 21.55% in 2010). Several studies have shown a lower use of family planning methods by immigrants. This same trend is observed in Spain. The objective of this paper is to determine the existence of differences and possible sources of inequity in the use of family planning methods among health service users in Catalonia (Spain) by sex, health status, place of birth and socioeconomic conditions. Data were taken from an ad-hoc questionnaire which was compiled following a qualitative stage of individual interviews. Said questionnaire was administered to 1094 Catalan public health service users during 2007. A complete descriptive analysis was carried out for variables related to public health service users' sociodemographic characteristics and variables indicating knowledge and use of family planning methods, and bivariate relationships were analysed by means of chi-square contrasts. Considering the use (or non-use) of family planning methods as a dependent variable and a set of demographic, socioeconomic and health status variables as explanatory factors, the relationship was modelled using mixed models. The analysed sample is comprised of 54.3% women and 45.7% men, with 74.3% natives (or from the EU) and 25.7% economic immigrants. 54.8% use some method of family planning, the condom (46.7%) and the pill (28.0%) being the two most frequently used methods. Statistical modelling indicates that those factors which most influence the use of family planning methods are level of education (30.59% and 39.29% more likelihood) and having children over 14 (35.35% more likelihood). With regard to the origin of the user, we observe that patients from North Africa,sub. Saharan Africa and Asia are less likely to use family planning methods (36.68%, 38.59% and 70

  12. Advancing Family Planning Research in Africa

    African Journals Online (AJOL)


    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA. Afr J Reprod ... contraceptive information and knowledge, gender roles, and ... The single- gender focus ... the advantages of service linkages between family planning ...

  13. Family medicine residents' practice intentions: Theory of planned behaviour evaluation. (United States)

    Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W


    To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.

  14. Building and measuring infrastructure and capacity for community health assessment and health improvement planning in Florida. (United States)

    Abarca, Christine; Grigg, C Meade; Steele, Jo Ann; Osgood, Laurie; Keating, Heidi


    COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

  15. Study protocol: incentives for increased access to comprehensive family planning for urban youth using a benefits card in Uganda. A quasi-experimental study. (United States)

    Nuwasiima, Afra; Nuwamanya, Elly; Navvuga, Patricia; Babigumira, Janet U; Asiimwe, Francis T; Lubinga, Solomon J; Babigumira, Joseph B


    The use of contraception is one of the most cost-effective public health interventions and has the potential to prevent about 30% of maternal and 10% of child deaths in developing countries. Voucher-based initiatives for family planning are an effective and viable means of increasing contraceptive use. In this paper, we present a protocol for a pilot study of a novel incentive, a family planning benefits card (FPBC) program to increase uptake of family planning services among urban poor youth in Uganda while leveraging private sector funding. The study employs both impact and health economic evaluation methods to assess the effect of the FPBC program. We propose a quasi-experimental study design with two separate pre- and post-samples to measure program effectiveness. The main outcome of the impact evaluation is the percentage change in the prevalence of modern contraceptive use and unmet need for contraception. We will also conduct model-based incremental cost-effectiveness and budget impact analyses. The main outcomes of the economic evaluation are the cost per enrolled youth and cost per pregnancy averted, and cost per disability-adjusted life-year (DALY) averted. We will also pilot a corporate social responsibility model of sponsorship for the FPBC program in partnership with local corporations. Budget impact analysis will examine the potential affordability of scaling up the FPBC program and the fiscal implications of this scale up to the corporate social responsibility (CSR) budgets of partner corporations, the government, and the individual taxpayer. In this study, we propose an impact and economic evaluation to establish the proof concept of using a FPBC program to increase uptake of family planning services among urban poor youth in Uganda. The results of this study will present stakeholders in Uganda and internationally with a potentially viable option for corporate-sponsored access to family planning in urban poor communities. MUREC1/7 No. 10

  16. Partner support for family planning and modern contraceptive use in ...

    African Journals Online (AJOL)

    Husband's/partner's support for family planning may influence a women's modern contraceptive use. Socio-demographic factors, couple communication about family planning, and fertility preferences are known to play a role in contraceptive use. We conducted logistic regression analysis to investigate the relationship ...

  17. Perceptions of and barriers to family planning services in the poorest regions of Chiapas, Mexico: a qualitative study of men, women, and adolescents. (United States)

    Dansereau, Emily; Schaefer, Alexandra; Hernández, Bernardo; Nelson, Jennifer; Palmisano, Erin; Ríos-Zertuche, Diego; Woldeab, Alex; Zúñiga, Maria Paola; Iriarte, Emma Margarita; Mokdad, Ali H; El Bcheraoui, Charbel


    In the poorest regions of Chiapas, Mexico, 50.2% of women in need of contraceptives do not use any modern method. A qualitative study was needed to design effective and culturally appropriate interventions. We used purposive maximum-variation sampling to select eight municipalities with a high proportion of residents in the poorest wealth quintile, including urban, rural, indigenous, and non-indigenous communities. We conducted 44 focus group discussions with 292 women, adolescent women, and men using semi-structured topic guides. We analyzed the data through recursive abstraction. There were intergenerational and cultural gaps in the acceptability of family planning, and in some communities family planning use was greatly limited by gender roles and religious objections to contraception. Men strongly influenced family planning choices in many households, but were largely unreached by outreach and education programs due to their work hours. Respondents were aware of many modern methods but often lacked deeper knowledge and held misconceptions about long-term fertility risks posed by some hormonal methods. Acute physical side effects also dissuaded use. The implant was a new and highly acceptable method due to ease of use, low upkeep, and minimal side effects; however, it was perceived as subject to stock-outs. Adolescent women reported being refused services at health facilities and requested more reproductive health information from their parents and schools. Mass and social media are growing sources of reproductive health information. Our study identifies a number of barriers to family planning that have yet to be adequately addressed by existing programs in Chiapas' poorest regions, and calls for reinvigorated efforts to provide effective, acceptable, and culturally appropriate interventions for these communities.

  18. Awareness and Utilization of Family Planning Methods among ...

    African Journals Online (AJOL)

    deficiency Virus (HIV) infection influence the design and background Family planning is an important preventive measure against maternal and child morbidity and mortality. This study was aimed at determining the awareness and utilization of family ...

  19. Urban Community Planning in the Context of Transition in China: Theory Interpretation and Practice Exploration Based on Relationship Reconstruction


    Jiayan  LIU


    Along with a full-scale transition in both the urban development pattern and the socio-economic development in China, the planning of urban residential pace has experienced a significant transition process from the residential area planning in traditional Danwei system, to the commercial housing estate planning in marketized housing system, then to the springing up of contemporary community planning. On the basis of an analysis of the primary goal, form, and limitations of community planning ...

  20. The search conference as a method in planning community health promotion actions

    Directory of Open Access Journals (Sweden)

    Eva Magnus


    Full Text Available Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives.

  1. Community-level Language Planning for Chinese Heritage Language Maintenance in the United States

    Directory of Open Access Journals (Sweden)

    An Chung Cheng


    Full Text Available This paper investigates the development of Chinese heritage language in the United States from the perspective of language policy and planning. The case study examines the Chinese heritage language maintenance through community-based Chinese schools (CHS, and CHS’s relationships with Chinese American community, as well as governments and non-government organizations in China, Taiwan, and the United States. The paper starts with a theoretical discussion on the definition of language policy and planning, and then describes the history and heritage language education of Chinese Americans in the United States. The paper also presents micro-level planning activities initiated by CHSs in the Chinese American community and non-government organizations. Special focus is placed on the interaction between non-government organizations in the US and governmental bodies in Taiwan and mainland China and in the United States. This paper suggests that micro planning of heritage language maintenance is beneficial when initiated in the community, but it can only be developed and sustained within the wider scope of macro-level planning from governments

  2. Do U.S. family planning clinics encourage parent-child communication? Findings from an exploratory survey. (United States)

    Jones, Rachel K


    Clinics that receive Title X funding have a mandate to encourage parent-child communication for minors seeking family planning services. Little is known about the programs and practices that clinics have adopted to achieve this goal, or whether clinics not receiving Title X funds encourage family participation. As part of a larger project examining parental engagement among adolescents using family planning clinics, 81 clinics that served 200 or more adolescent contraceptive clients in 2001 completed a questionnaire containing closed- and open-ended items. Topic areas included clinic counseling and policies regarding clients younger than 18, activities to improve parent-child communication and community relations. Frequency distributions were calculated for the prevalence of activities, and cross-tabulations were used to compare prevalence by clinic characteristics. Every clinic engaged in at least one activity to promote parent-child communication, and nine in 10 offered multiple activities. Most of the clinics used counseling sessions to talk to adolescent clients about the importance of discussing sexual health issues with parents (73-94%, depending on the reason for the visit). More than eight in 10 clinics (84%) distributed pamphlets on how to talk about these issues. A substantial minority (43%) offered or referred interested individuals to educational programs designed to improve communication. Some of these exploratory findings reflect the prevalence of activities among all U.S. family planning clinics that serve adolescent clients. Evaluation and expansion of clinic efforts to promote voluntary communication about sexual health issues between parents and children could help encourage family participation.

  3. Assessment Of Knowledge And Attitude Towards Family Planning ...

    African Journals Online (AJOL)

    Assessment Of Knowledge And Attitude Towards Family Planning Among Selected ... Among reasons for low uptake is religious belief on procreation. ... leaders as a change agent by the stakeholders to increase the uptake and use of family ...

  4. Family planning and married fulfillment. (United States)

    Burke, C


    Large numbers of children typified the Catholic family until the 60s when there was a general societal change towards smaller families. This change, which even affected Catholics, is thought to derive from 3 sources. The population explosion and its complimentary disadvantages, a change towards more egocentric values, and an increase in the importance of material values. The Western world is aging fast and fertility rates are falling to the point that an overall effect of population reduction is occurring. Children have become only an optional, instead of necessary as in previous generations, part of most couples' lifestyles in West. Careers, social status, gadgets, vacations, ease, and comfort are now commonly seen as more self- fulfilling than children. The Catholic church believes that the only reasons for family planning are natural methods used out of necessity. Vatican II clearly states that the purpose of marriage is the raising of children. It has become the opinion of many that marriage and children are only accidentally connected and that the 2 are not bound inseparably. It is the authors contention that this dualistic view of marriage and children is false. The author feels that through a marriage people can draw each other out of themselves and towards their children. Sacrificing oneself for one's children is the natural end to marriage. The author admits that family planning has been a great good to the world for the couples that need it to survive, but that couples that can have children should do so.

  5. Randomized comparison of two Internet-supported fertility-awareness-based methods of family planning. (United States)

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


    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 (pincreased significantly over time (pusers had an increase in acceptability over time. Results are tempered by the high dropout rate. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. "Natural family planning": effective birth control supported by the Catholic Church. (United States)

    Ryder, R E


    During 20-22 September Manchester is to host the 1993 follow up to last year's "earth summit" in Rio de Janeiro. At that summit the threat posed by world overpopulation received considerable attention. Catholicism was perceived as opposed to birth control and therefore as a particular threat. This was based on the notion that the only method of birth control approved by the church--natural family planning--is unreliable, unacceptable, and ineffective. In the 20 years since E L Billings and colleagues first described the cervical mucus symptoms associated with ovulation natural family planning has incorporated these symptoms and advanced considerably. Ultrasonography shows that the symptoms identify ovulation precisely. According to the World Health Organisation, 93% of women everywhere can identify the symptoms, which distinguish adequately between the fertile and infertile phases of the menstrual cycle. Most pregnancies during trials of natural family planning occur after intercourse at times recognised by couples as fertile. Thus pregnancy rates have depended on the motivation of couples. Increasingly studies show that rates equivalent to those with other contraceptive methods are readily achieved in the developed and developing worlds. Indeed, a study of 19,843 poor women in India had a pregnancy rate approaching zero. Natural family planning is cheap, effective, without side effects, and may be particularly acceptable to the efficacious among people in areas of poverty. Images p724-a p724-b p724-c p724-d p724-e p724-f p724-g PMID:8401097

  7. Policy guidelines for collective bargaining and family planning. (United States)

    Finnigan, O D; Parulan, D


    The benfits of establishing family planning through collective bargaining to both labor and management are discussed. Until workers can be convinced that their children will receive health care, education and employment, and that they will be economically secure in old age, it is difficult to convince them of the many benefits of child spacing and small family size. In 1953, it was calculated by management in a Japanese steel factory that about 70% of all acidents could be attributable to difficulties in the private lives of employees. In order to ease problems in the home, collective agreements were initiated by management in the Nippon Express Company to provide family planning services. Labor agreed as long as the workers were to share in the economic awards which came from participation. Costs of implementing the family planning programs were fully offset by the decrease in expenditure on family allowances, confinement, nursing, and so on. In India some ten estates began a program in which a certain amount of money is paid into an account for every month that a woman does not become pregnant. If the woman becomes pregnant, she forfeits a substantial amount of the fund. This money comes directly from the funds which would normally have to be set aside to provide for maternity and child support programs. Certain guidelines are presented in the paper to outline the areas of responsibility of labor and management in the provision of family planning services. Among the many possibilities mentioned is the idea that both labor and management could look into the conceivability of plowing back a portion of whatever savings are accrued by management into a pension scheme to compensate workers for the loss of labor caused by having fewer children than were previously anticipated.

  8. Theory of planned behaviour and the family business


    Kuiken, Andrea


    The theory of planned behaviour is a theory originating from psychology. Over time, the theory has been applied to a variety of research areas. In business administration, the theory is used to gain insight into the ethical behaviour of managers, the adoption of new products and entrepreneurship. The family business context is a specific context, in which the family has a strong influence on the strategic decisions of the business. Current application of the theory of planned behaviour in fam...

  9. Occupational Therapy in Multidisciplinary Residency in Family and Community Health

    Directory of Open Access Journals (Sweden)

    Luzianne Feijó Alexandre Paiva


    Full Text Available In this study, we report the experiences of occupational therapist during the Multidisciplinary Residency Program in Family and Community Health in Fortaleza, Ceará state, Brazil. With the creation of the Support Center for Family Health – NASF, occupational therapists began to participate more effectively in the Family Health Strategy of the Brazilian National Health System. Given this rocess, the category, which historically has trained its professionals following the biomedical model, is faced with the challenge to build a new field of knowledge. Objective: To analyze the inclusion of occupational therapy in the Family Health Strategy within the scope of Multidisciplinary Residency. Methodology: This is a descriptive study of qualitative approach, which was based on the experience of four occupational therapy resident students, performed through the documental analysis of field diaries, scientific papers, and case studies produced between 2009 and 2011. Results: The occupational therapists as well as the other NASF professionals operated the logic of Matrix Support to the Family Health teams, sharing their knowledge and assisting in resolving complex cases of the families, groups, and communities served. In this context, we found people with different relationships with their doings and a reduced repertoire of activities. The occupational therapists invested in the creation or consolidation of groups in the Family Health Centers and in the territory, which also stood as living and socializing spaces, focusing on prevention and health promotion.

  10. Succession Planning for Community Colleges: A Study of Best Practices (United States)

    McMaster, Susan Marie


    The purpose of this study is to apply best practices for succession planning to community colleges. Succession planning is relevant to management practices in community colleges because there is a surge in retirements in higher education from the "baby boomer" generation. Community colleges need to implement a succession plan to ensure…

  11. [Family and career planning in young physicians]. (United States)

    Buddeberg-Fischer, Barbara; Stamm, Martina; Klaghofer, Richard


    The study investigates in what way physicians integrate their desire to have children into their career planning. Within the framework of a prospective cohort study of Swiss medical school graduates on career development of young physicians, beginning in 2001, 534 participants (285 women, 249 men) were assessed in January 2007, in terms of having children, planning to have children, the career aspired to and the work-family balance used or planned. Among the study participants, 19% (54) of the women and 24% (59) of the men have children. Of the others 88% plan to start a family in the future. Female physicians with children are less advanced in their careers than women without children; for male physicians no such difference can be observed. Of the female physicians with children or the desire for children 42% aspire to work in a practice, 28% to a clinical and only 4% to an academic career. Of the male physicians with children or the desire for children one third aspire to work in a practice, one third to a clinical and 14% to an academic career. The preferred model of work repartition of female physicians with children is father full time/mother part time or both parents part time; the preferred model of male physicians is father full time/mother part time or not working. Children are an important factor in the career and life planning of physicians, female physicians paying more attention to an even work-family balance than male physicians. Copyright 2008 S. Karger AG, Basel.

  12. Community Mobilization and Readiness: Planning Flaws which Challenge Effective Implementation of 'Communities that Care' (CTC) Prevention System. (United States)

    Basic, Josipa


    This article reviews the experience of implementing a community approach to drug use and youth delinquency prevention based on the 'Communities that Care' (CTC) system implemented in one Croatian county consisting of 12 communities, 2002 to 2013 (Hawkins, 1999; Hawkins & Catalano, 2004). This overview explores selected critical issues which are often not considered in substance use(r) community intervention planning, implementation as well as in associated process and outcome assessments. These issues include, among others, the mobilization process of adequate representation of people; the involvement of relevant key individual and organizational stakeholders and being aware of the stakeholders' willingness to participate in the prevention process. In addition, it is important to be aware of the stakeholders' knowledge and perceptions about the 'problems' of drug use and youth delinquency in their communities as well as the characteristics of the targeted population(s). Sometimes there are community members and stakeholders who block needed change and therefore prevention process enablers and 'bridges' should be involved in moving prevention programming forward. Another barrier that is often overlooked in prevention planning is community readiness to change and a realistic assessment of available and accessible resources for initiating the planned change(s) and sustaining them. All of these issues have been found to be potentially related to intervention success. At the end of this article, I summarize perspectives from prevention scientists and practitioners and lessons learned from communities' readiness research and practice in Croatian that has international relevance.

  13. Ethnic Disparities in Contraceptive Use and Its Impact on Family Planning Program in Nepal

    Directory of Open Access Journals (Sweden)

    Mukesh Mishra


    Full Text Available Objective: Regardless of three decades of implementation of family planning program in Nepal, need offamily planning services is largely unmet. Systematic studies, evaluating the impact of family program onseveral ethnic groups of Nepal has not been carried out in large scale. This study sheds light on theinvestigation of, whether the use of contraceptives varies among different ethnic groups in Nepal andwhat are the predictors of contraceptive variance in ethnic groups in Nepal.Materials and methods: The study is based on data collected from Nepal Demographic Health Survey(NDHS 2006. Multilevel logistic regression analyses of 10793 married women of reproductive agenested within 264 clusters from the surveys were considered as the sample size. Individual, household,and program variables were set and a multilevel logistic regression model was fitted to analyze thevariables, using GLLAMM command in STATA-9.Results: Multilevel logistic regression analysis indicated that Muslims, Dalits and Terai madheshi womenwere significantly less likely to use modern contraceptives compared to the Brahmins and Chhetries(Higher Castes. Women who were exposed to family planning information in radio were more likely touse modern contraceptives than women not exposed to radio information (OR=1.22, P> 0.01. An odd ofusing contraceptives by Newar was (OR 1.09, P>0.05, the highest among all ethnic groups. Exposure ofwomen to family planning messages through health facilities, family planning workers, and means ofcommunication, increased the odds of using modern contraceptives. However, impact of the familyplanning information on contraceptive use varied among ethnicity.Conclusion: Special attention need to be paid, in particular to the ethnicity, while formulating familyplanning policies in Nepal, for better success rate of family planning intervention programs.

  14. Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial

    Directory of Open Access Journals (Sweden)

    Daivadanam Meena


    in the rural areas of Kerala. We aim to develop, implement and evaluate a group-based peer support programme that will address cultural and family determinants of lifestyle risks, including family decision-making regarding adoption of healthy dietary and physical activity patterns. Furthermore, we believe that this approach will be feasible, acceptable and effective in these communities; with the potential for scale-up in other parts of India.

  15. Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial. (United States)

    Daivadanam, Meena; Absetz, Pilvikki; Sathish, Thirunavukkarasu; Thankappan, K R; Fisher, Edwin B; Philip, Neena Elezebeth; Mathews, Elezebeth; Oldenburg, Brian


    evaluate a group-based peer support programme that will address cultural and family determinants of lifestyle risks, including family decision-making regarding adoption of healthy dietary and physical activity patterns. Furthermore, we believe that this approach will be feasible, acceptable and effective in these communities; with the potential for scale-up in other parts of India.

  16. Family planning and fertility decline: a global overview. (United States)

    Tabah, L


    Family planning and development policy concerns are not incompatible. The emphasis on development policies at the 1974 World Population Conference at Bucharest did not mean that world governments had lost interest in the population and family planning issue. Although worldwide attitudes toward family planning have become more and more favorable, this has not yet meant great impact on world demographic trends. The "inertia factor," i.e., the effects of high birthrates in the previous generation, will camouflage declining birthrates for some time to come. The trend of fertility reduction which was perceptible only among small populations a few years ago is also becoming manifest in larger Third World countries. Mortality rate declines have slowed down but there is no rising mortality due to starvation in any country. At present, food demand exceeds availability for 80% of the Third World population. It is predicted that the food deficit will increase 70% by the year 2000.

  17. Sexual and gender based violence against men in the Democratic Republic of Congo: effects on survivors, their families and the community. (United States)

    Christian, Mervyn; Safari, Octave; Ramazani, Paul; Burnham, Gilbert; Glass, Nancy


    Media and service provider reports of sexual and gender based violence (SGBV) perpetrated against men in armed conflicts have increased. However, response to these reports has been limited, as existing evidence and programs have primarily focused on prevention and response to women and girl survivors of SGBV. This study aims to contribute to the evidence of SGBV experienced by males by advancing our understanding of the definition and characteristics of male SGBV and the overlap of health, social and economic consequences on the male survivor, his family and community in conflict and post-conflict settings. The qualitative study using purposive sampling was conducted from June-August 2010 in the South Kivu province of Eastern DRC, an area that has experienced over a decade of armed conflict. Semi structured individual interviews and focus group discussions were conducted with adult male survivors of SGBV, the survivors' wife and/or friend, health care and service providers, community members and leaders. This study found that SGBV against men, as for women, is multi-dimensional and has significant negative physical, mental, social and economic consequences for the male survivor and his family. SGBV perpetrated against men and boys is likely common within a conflict-affected region but often goes unreported by survivors and others due to cultural and social factors associated with sexual assaults, including survivor shame, fear of retaliation by perpetrators and stigma by community members. All key stakeholders in our study advocated for improvements and programs in several areas: (1) health care services, including capacity to identify survivors and increased access to clinical care and psychosocial support for male survivors; (2) economic development initiatives, including microfinance programs, for men and their families to assist them to regain their productive role in the family; (3) community awareness and education of SGBV against men to reduce stigma and

  18. Factors influencing utilization of Natural Family Planning among ...

    African Journals Online (AJOL)

    -10 children. This means they did not know what impact large families will have on the poverty stricken households. There is some ignorance about NFP methods. They are more used to artificial harmful methods of Family Planning. Therefore ...

  19. Knowledge, attitude and practice of family planning among Igbo women of south-eastern Nigeria. (United States)

    Ikechebelu, J I; Joe-Ikechebelu, N N; Obiajulu, F N


    A total of 200 Nigerian women visiting Nnamdi Azikiwe University Teaching Hospital's antenatal clinic were interviewed about their knowledge, attitude and practice of family planning. About 90% were literate. Their knowledge (80%) and approval (87%) of family planning was high, but the practice of modern family planning was low (25%) with most women involved in Billings/safe period (56%). The common methods used were Billings/safe period, condom, withdrawal and the intrauterine contraceptive device (IUCD). A total of 81.5% of the respondents are still willing to give birth while 77% agreed that their last pregnancy was planned. A total of 58.5% of respondents were educated about family planning in the antenatal clinic. The most common source of family planning information was mass media, closely followed by health workers, while the most common single reason for non-practice of family planning was rejection by the husband. We therefore conclude that despite the high education/literacy with the attendant and high knowledge and approval rate of family planning in this part of Nigeria, the practice of family planning is still low, especially due to partner objection. Policy makers should therefore increase male involvement in family planning programmes and pursue a more aggressive public awareness campaign.

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

    Ackerson, Kelly; Zielinski, Ruth


    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

  1. Thinking Ethically about Families, Communities, and Technology. (United States)

    Frankel, Mark S.


    The merger of science and commerce has become the dominant global force, giving rise to concerns about the use of genetic knowledge; ethical issues concerning justice, destiny, and perfectability; and the consequences for families and communities. Family and consumer science professionals should work to combat misunderstanding and misuse of…

  2. Recruiting and retaining family caregivers to a randomized controlled trial on mindfulness-based stress reduction. (United States)

    Whitebird, Robin R; Kreitzer, Mary Jo; Lewis, Beth A; Hanson, Leah R; Crain, A Lauren; Enstad, Chris J; Mehta, Adele


    Caregivers for a family member with dementia experience chronic long-term stress that may benefit from new complementary therapies such as mindfulness-based stress reduction. Little is known however, about the challenges of recruiting and retaining family caregivers to research on mind-body based complementary therapies. Our pilot study is the first of its kind to successfully recruit caregivers for a family member with dementia to a randomized controlled pilot study of mindfulness-based stress reduction. The study used an array of recruitment strategies and techniques that were tailored to fit the unique features of our recruitment sources and employed retention strategies that placed high value on establishing early and ongoing communication with potential participants. Innovative recruitment methods including conducting outreach to health plan members and generating press coverage were combined with standard methods of community outreach and paid advertising. We were successful in exceeding our recruitment goal and retained 92% of the study participants at post-intervention (2 months) and 90% at 6 months. Recruitment and retention for family caregiver interventions employing mind-body based complementary therapies can be successful despite many challenges. Barriers include cultural perceptions about the use and benefit of complementary therapies, cultural differences with how the role of family caregiver is perceived, the use of group-based designs requiring significant time commitment by participants, and travel and respite care needs for busy family caregivers. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion (United States)

    Miller, Elizabeth; Decker, Michele R.; McCauley, Heather L.; Tancredi, Daniel J.; Levenson, Rebecca R.; Waldman, Jeffrey; Schoenwald, Phyllis; Silverman, Jay G.


    Background This study examined the efficacy of a family planning clinic-based intervention to address intimate partner violence (IPV) and reproductive coercion. Study Design Four free-standing urban family planning clinics in Northern California were randomized to intervention (trained family planning counselors) or standard-of-care. English-and Spanish-speaking females ages 16-29 years (N=906) completed audio computer-assisted surveys prior to a clinic visit and 12 to 24 weeks later (75% retention rate). Analyses included assessment of intervention effects on recent IPV, awareness of IPV services, and reproductive coercion. Results Among women reporting past 3-month IPV at baseline, there was a 71% reduction in the odds of pregnancy coercion among participants in intervention clinics compared to participants from the control clinics that provided standard of care. Women in the intervention arm were more likely to report ending a relationship because the relationship was unhealthy or unsafe regardless of IPV status (AOR 1.63, 95% CI 1.01 – 2.63). Conclusions Results of this pilot study suggest that this intervention may reduce risk for reproductive coercion from abusive male partners among family planning clients and support such women to leave unsafe relationships. PMID:21310291

  4. Cabinet decision creating a family planning section in the Ministry of Manpower. (United States)


    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.

  5. 75 FR 80054 - Input for a Strategic Plan for Federal Youth Policy (United States)

    2010-12-21 , to promote effective community-based efforts to reduce the factors that put youth at...) basic needs: health, safety, and wellness; (2) school, family, and community engagement and connections... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Input for a Strategic Plan for...

  6. Family Planning Behavior and Small Family Concept Acceptance in Two Different Geographical Characteristics Municipality of South Klaten, Klaten, Central Java

    Directory of Open Access Journals (Sweden)

    P Priyono


    Full Text Available The research aim to know the family planning behaviour, the acceptance small family norm and the influential factors in two villages that have different geographical aspect. The behaviour involve the knowledge, the attitude and the practice where as the influential factors involve education, accupation, values of children, income, children still born and family size desired. The research areas are chosen purposive in two villages that have different geographical aspect, social aspect and cultural aspect. The aspect are: 1 location and topography, 2 socialy  structure, and 3 the achievement of effective acceptor. Based on the three aspects, Ngalas village (developing and Sumberejo (developed are chosen as research areas. The recorded as ative acceptor (recordedin RI/PUS/1991 form. The respondents are chosen by cencus at two neighborhoord association at every village. There are six variables in this research are assumed influence the periode of the contraceptives use, such as education, occupation status, values of children, family income, children still born, and family size desired. There are three variables are assumed influence the small family norm, such as education, occupation status, and values of children. The data was analyzed by frequency table, crosee table, and statistical analysis (Q square and Regresion. The data was always compared between the two villages. The analysis use computer by Microsoft Program.  The research result showed that Sumberejo was better than Ngalas in the knowledge, the attitude, and the practice of family planning. Most of the people who live in Sumberejo understood the contraception device well (52,4%, where as in Ngalas (26,8%. Both of them agreed on using contraception device (more than 70%. The respondent who live in Sumberejo used IUD (40% and MOW/MOP (23,23%. They had used of the contraception device for 4.8 years on an average. Mean  while the respondents in Ngalas use IUD (23,68% and MOW/MOP (2

  7. Source of information on family planning among married men in ...

    African Journals Online (AJOL)

    Population in Nigeria is turning into an issue that needs public alertness. Informing men on family planning services and contraceptives is extremely necessary. For this will promote more favorable attitudes and increase their involvement. This study aimed at investigating the source of family planning information for married ...

  8. Family Planning in the Context of Latin America's Universal Health Coverage Agenda. (United States)

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


    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

  9. 42 CFR 59.4 - How does one apply for a family planning services grant? (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false How does one apply for a family planning services... GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does one apply for a family planning services grant? (a) Application for a grant under this subpart shall...

  10. Family-Centered Early Intervention Visual Impairment Services through Matrix Session Planning (United States)

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


    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.…

  11. Family planning as public policy. (United States)


    The inclusion of constitutional provisions and laws regarding family planning and the creation of the Population Commission in the Philippines are examples of the growing recognition in many developing countries that proper and humane control of population growth is a key factor in economic progress. Similar provisions have recently appeared in Thailand, Mexico, and the Brazilian state of Rio de Janeiro. Awareness of the need for adequate public education to ensure the success of family planning programs has resulted in the formation of commissions for that purpose in Australia, Belgium, Chile, Ecuador, Egypt, El Salvador, Guatemala, Italy, Mexico, New Zealand, Portugal, and Sri Lanka. Voluntary sterilization is gradually gaining support. 3 South Asian nations (Pakistan, Singapore, and New Zealand) were among 12 to liberalize laws in 1974 and 1975. However, the prevailing opinion is that a massive public education program will have to be waged before acceptance becomes widespread in the region. Singapore's sterilization law can be used as a guideline for other nations in the area contemplating policy changes.

  12. [On family planning policy in Brazil]. (United States)

    Berquo, E


    Brazil's population could vary from a minimum of 164.5 million to a maximum of 183.5 million at the turn of the century. The increase in population is due essentially to a decline in mortality, since natality has remained steady, averaging 6.2 children/woman. During the 1st 4 years of the 1980s, a 19% drop in natality was registered, with the greatest reduction occurring in the East-Central (25%) region, testimony to an increased presence of highly effective contraceptive means. 65% of all married women between the ages of 15 and 44 use contraceptives, placing Brazil among the most developed countries (U.S.A., 68%). The main contraceptive method used is sterilization, preferred even by very young women, median age 29, as evidenced by a study in Sao Paulo. The choice of contraceptives, however, is limited. During the military dictatorship family planning was put in the hands of private organizations (BEMFAM since 1965, CEPAIMC since 1975) and recent policies have emphasized a hands-off attitude leaving birth control decisions to the family nucleus. The economic crisis, at the end of the 1970s, modified this position. In order to avoid that, only the wealthy classes have access to family planning means, the government increasingly plays an active role in providing information and assistance. A not-for-profit institution, ABEPF (Brazilian Association for Family Planning Entities), the largest of its kind in Latin America, organizes and promotes private initiative programs. Acting as a true syndicate, each clinic affiliated with the association receives training of professionals and equipment for installation of laboratories and consulting rooms. Various women's rights movements have been active and succeeded in influencing political parties.

  13. Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services. (United States)

    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


    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.

  14. [The social-political-environmental and health reality of families belonging to a vulnerable community]. (United States)

    Marzari, Carla Kowalski; Backes, Dirce Stein; Backes, Marli Stein; Marchiori, Mara Teixeira; Souza, Martha Teixeira de; Carpes, Adriana Dornelles


    The scope of this paper is to ascertain the perception of community leadership, health professionals and users regarding citizenship status and the enhancement of the healthcare conditions of families belonging to a vulnerable community. This is an exploratory study of a qualitative nature, guided by theory based on data. Data were collected between July and December 2009, by means of interviews with four community health leaders, a team of eight family health team professionals and twelve health users. The codification of the data resulted in the following categories: Understanding the social conditions, the political conditions, the environmental conditions and the health conditions of families in a vulnerable community. The conclusions reached were, that if on the one hand the social security and health policies made it possible to reduce poverty and local inequalities, on the other hand they do not ensure the requisite enhancement of citizenship or even the improvement of health conditions.

  15. Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali (United States)

    Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan


    Background: Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Program Description: Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. Methods and Results: The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Conclusion: Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing

  16. Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali. (United States)

    Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan


    Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing, can successfully create demand for a broad range of family

  17. Growing Right Onto Wellness (GROW): a family-centered, community-based obesity prevention randomized controlled trial for preschool child-parent pairs. (United States)

    Po'e, Eli K; Heerman, William J; Mistry, Rishi S; Barkin, Shari L


    Growing Right Onto Wellness (GROW) is a randomized controlled trial that tests the efficacy of a family-centered, community-based, behavioral intervention to prevent childhood obesity among preschool-aged children. Focusing on parent-child pairs, GROW utilizes a multi-level framework, which accounts for macro (i.e., built-environment) and micro (i.e., genetics) level systems that contribute to the childhood obesity epidemic. Six hundred parent-child pairs will be randomized to a 3-year healthy lifestyle intervention or a 3-year school readiness program. Eligible children are enrolled between ages 3 and 5, are from minority communities, and are not obese. The principal site for the GROW intervention is local community recreation centers and libraries. The primary outcome is childhood body mass index (BMI) trajectory at the end of the three-year study period. In addition to other anthropometric measurements, mediators and moderators of growth are considered, including genetics, accelerometry, and diet recall. GROW is a staged intensity intervention, consisting of intensive, maintenance, and sustainability phases. Throughout the study, parents build skills in nutrition, physical activity, and parenting, concurrently forming new social networks. Participants are taught goal-setting, self-monitoring, and problem solving techniques to facilitate sustainable behavior change. The GROW curriculum uses low health literacy communication and social media to communicate key health messages. The control arm is administered to both control and intervention participants. By conducting this trial in public community centers, and by implementing a family-centered approach to sustainable healthy childhood growth, we aim to develop an exportable community-based intervention to address the expanding public health crisis of pediatric obesity. © 2013.

  18. Family planning knowledge and current use of contraception among the Mru indigenous women in Bangladesh: a multivariate analysis

    Directory of Open Access Journals (Sweden)

    Islam MR


    Full Text Available M Rakibul Islam1, Gunnar Thorvaldsen21Bangladesh Agricultural University, Bangladesh; 2Norwegian Historical Data Centre, University of Tromsø, NorwayBackground: This article aims to understand the family planning (FP knowledge and current use of contraception and its predictors among women of the Mru people – the most underprivileged indigenous community in Bangladesh.Methods: In this study, 374 currently married Mru women were interviewed and selected purposively from three upazilas (administrative subdistricts of the Bandarban area, where most of the Mru people live. The association between the variables was assessed in bivariate analysis using the Chi-square test and binary logistic regression models were employed to explore the predictors of FP knowledge and current use of contraception among the Mru women.Results: Only about 40% of respondents had ever heard FP messages or about FP methods – two-fifths of the national figure (99.9%. The current use of contraception was much lower (25.1% among the Mru people than at the national level (55.8%. Among both modern and traditional methods, the contraceptive pill ranked first. About two-thirds (66.0% of married women used this method – more than two times than the national figure (28.5%. On the other hand, the prevalence of male methods was comparatively lower than at the national level. Logistic regression models revealed that place of residence, religion, age, school attendance, husband's school attendance, service provided in the community, distance to the service center, and exposure to mass media had significant effects on knowledge of FP and on use of contraception.Conclusion: Education for mothers and vernacular language-based doorstep FP programs with special emphasis on awareness are suggested for the community.Keywords: family planning, contraceptive use, the Mru, logistic regression, Bangladesh

  19. Developing a Parent-Centered Obesity Prevention Program for 4-H Families: Implications for Extension Family Programming (United States)

    Benke, Carrie J.; Bailey, Sandra J.; Martz, Jill; Paul, Lynn; Lynch, Wesley; Eldridge, Galen


    Planning youth and family programming in the 21st century is daunting given family members' busy schedules. This is even more challenging when planning programs in rural areas, where there are vast distances between communities. This article discusses a research and educational outreach project that uses best practices in program development…

  20. Master plans for pedestrian and bicycle transportation: community characteristics. (United States)

    Steinman, Lesley; Doescher, Mark; Levinger, David; Perry, Cynthia; Carter, Louise; Eyler, Amy; Aytur, Semra; Cradock, Angie L I; Evenson, Kelly R; Heinrich, Katie; Kerr, Jacqueline; Litt, Jill; Severcan, Yucel; Voorhees, Carolyn


    Recent research demonstrates the importance of targeting the built environment to support individual physical activity, particularly for people experiencing health disparities. Master plans to promote biking and/or pedestrians (BPMPs) are a potential method for environmental change. This descriptive study aims to provide a snapshot of plan attributes and better understand demographic, social and transportation characteristics of communities with BPMPs. We collected a census sample of BPMPs from 4 states. Population and commuting data were obtained from national statistics. 294 master plans were included, with most plans representing municipalities. 62% of plans targeted biking only, one-fifth targeted biking and walking, and 15% targeted walking only. The sampled locations have a similar demographic profile as the overall U.S. for median age and household income, people of color, high school education, and income inequality. The degree of racial diversity of sampled communities is slightly less than the U.S. average and the percentage of people who walk to work were slightly higher. Given that communities with master plans have a similar profile as the overall U.S., BPMPs could feasibly be spread to communities throughout the country. Further research is planned to describe BPMPs in detail toward informing future plan development.

  1. Predictors of needs for community and financial resources for families of pre-school children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Bertule D.


    Full Text Available An understanding of predictors of family needs for the families of preschool children with cerebral palsy (CP is important for provision of efficient and cost-effective services. The aim of this study was to identify the characteristics of children, families and services that are risk factors to meeting family needs for community and financial resources. 234 parents of pre-school children with CP completed a modified version of the Family Needs Survey (FNS, the Measure of Processes of Care (MPOC-20, and a demographic questionnaire. The gross motor function level and communication function level of children were classified on the basis of the Gross Motor Function Classification System (GMFCS and the Communication Function Classification System (CFCS respectively. Two hierarchical multiple regression models were generated to determine the predictors of unmet family needs. The socialisation and communication skills of children, as well as caregiver employment and family income levels were significant predictors of family needs for community resources (adjusted R2=0.44. Significant risk factors in terms of family needs for financial resources included the child's gross motor limitations, caregiver employment, low levels of family income and no ability to receive services on the basis of enabling and partnership principles (adjusted R2=0.51. A child's limitations in terms of communication, gross motor functions and socialisation, as well as the socioeconomic status of the child's family, must be taken into account when planning services for families with preschool children with CP.

  2. Ties That Bind: Family and Community. First Edition. Our Human Family Series. (United States)

    Clay, Rebecca

    This book examines the cultural universal of family and community from a multicultural perspective. The text is written for juveniles, and includes many color photographs. Chapters include: (1) "Families Are Everywhere"; (2) "The Americas"; (3) "Africa"; (4) "Europe and the Middle East"; (5) "Asia"; and (6) "Australia and the South Pacific." The…

  3. Family planning knowledge, attitude and practice among married couples in Jimma Zone, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Tizta Tilahun

    Full Text Available BACKGROUND: Understanding why people do not use family planning is critical to address unmet needs and to increase contraceptive use. According to the Ethiopian Demographic and Health Survey 2011, most women and men had knowledge on some family planning methods but only about 29% of married women were using contraceptives. 20% women had an unmet need for family planning. We examined knowledge, attitudes and contraceptive practice as well as factors related to contraceptive use in Jimma zone, Ethiopia. METHODS: Data were collected from March to May 2010 among 854 married couples using a multi-stage sampling design. Quantitative data based on semi-structured questionnaires was triangulated with qualitative data collected during focus group discussions. We compared proportions and performed logistic regression analysis. RESULT: The concept of family planning was well known in the studied population. Sex-stratified analysis showed pills and injectables were commonly known by both sexes, while long-term contraceptive methods were better known by women, and traditional methods as well as emergency contraception by men. Formal education was the most important factor associated with better knowledge about contraceptive methods (aOR = 2.07, p<0.001, in particular among women (aOR(women = 2.77 vs. aOR(men = 1.49; p<0.001. In general only 4 out of 811 men ever used contraception, while 64% and 43% females ever used and were currently using contraception respectively. CONCLUSION: The high knowledge on contraceptives did not match with the high contraceptive practice in the study area. The study demonstrates that mere physical access (proximity to clinics for family planning and awareness of contraceptives are not sufficient to ensure that contraceptive needs are met. Thus, projects aiming at increasing contraceptive use should contemplate and establish better counseling about contraceptive side effects and method switch. Furthermore in all family planning

  4. Family planning and contraceptive practices among parturients in a ...

    African Journals Online (AJOL)

    Background: Family size predetermination and birthing according to schedule is a strong determinant of family stability as it allows proper resource allocation and management. Aims: To determine the family planning practices among parturients and determine the factors that can influence the uptake of contraceptives in the ...

  5. Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools (United States)

    Jacobson, Linda; Rollins, S. Kwesi; Brown, Janet; Naviasky, Heather


    This "Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools" report updates the community school case studies through a description of ongoing developments in Cincinnati, OH; Evansville, IN; Multnomah County, OR; and Tulsa, OK and adds to that knowledge base of early learning and…

  6. Alternative models for academic family practices

    Directory of Open Access Journals (Sweden)

    Yarnall Kimberly SH


    Full Text Available Abstract Background The Future of Family Medicine Report calls for a fundamental redesign of the American family physician workplace. At the same time, academic family practices are under economic pressure. Most family medicine departments do not have self-supporting practices, but seek support from specialty colleagues or hospital practice plans. Alternative models for academic family practices that are economically viable and consistent with the principles of family medicine are needed. This article presents several "experiments" to address these challenges. Methods The basis of comparison is a traditional academic family medicine center. Apart of the faculty practice plan, our center consistently operated at a deficit despite high productivity. A number of different practice types and alternative models of service delivery were therefore developed and tested. They ranged from a multi-specialty office arrangement, to a community clinic operated as part of a federally-qualified health center, to a team of providers based in and providing care for residents of an elderly public housing project. Financial comparisons using consistent accounting across models are provided. Results Academic family practices can, at least in some settings, operate without subsidy while providing continuity of care to a broad segment of the community. The prerequisites are that the clinicians must see patients efficiently, and be able to bill appropriately for their payer mix. Conclusion Experimenting within academic practice structure and organization is worthwhile, and can result in economically viable alternatives to traditional models.

  7. Unmet Needs of Family Planning Among Women: A Cross-Sectional Study in a Rural Area of Kanchipuram District, Tamil Nadu, South India. (United States)

    Vishnu Prasad, R; Venkatachalam, J; Singh, Zile


    Global contraceptive usage was 63.3 % in 2010 which was 9 % more than that in 1990. NFHS-III 2005-2006 revealed that the contraceptive prevalence rate was 56 % while in the past decade it was 48 %. In India, female sterilization is the most commonly preferred method of contraception accounting for 76 %, while in Tamil Nadu it was 90 %. Thus, this study aims at measuring the prevalence of unmet needs of family planning and its determinants in a rural area of Kancheepuram district, Tamil Nadu. The study was carried out as a community-based cross-sectional study in Chunambed panchayat, a rural area in Kanchipuram District, Tamil Nadu, India, among 505 women of age group 15-49 years. Cluster random sampling was done to select the households to include in the study. In every household, all the available and eligible women were explained about the study and recruited after obtaining informed consent. Chi-square test was applied for finding the difference in proportion, and p value <0.05 was considered statistically significant. The prevalence of unmet need for family planning in our study population was nearly 31 %; it was even more for younger age groups and for the women whose family size was less. 51.7 % of the participants were currently using a contraceptive measure and very few of their partners used contraception. Government health facilities were the major source of contraceptive service and majority of our participants were well aware about the various contraceptive methods. Unmet needs of family planning were high in our study population, and the knowledge about the contraceptive use and family planning was found to be fairly adequate.

  8. Fertility and prospects of family planning in The Three Towns. (United States)

    Adam, A Y


    This article studies fertility and prospects of family planning in the Three Towns based on data from the survey on the beginning of family limitation in Khartoum province (1975). The data was obtained using a stratified random sample design of currently married women, using the 1973 census records as the sample frame. Family planning is a recent development in the Three Towns. The inherent difficulties (political, administrative, economic and cultural), of organizing an effective program are numerous and complex. The main problem facing the program at present is ignorance rather than failure to act on information already acquired. Most people do not know that fertility control is possible. Lack of communication, rather than lack of motivation is the issue the program should address itself to. Due to social attitudes, much more attention should be given to contacting husbands, informing and motivating them. A material stimulus towards successful encouragement is that contraceptives should be widely available and cheap in relation to the incomes of the masses. This opens a door of economic responsibilities that can not be met by the association alone. Therefore, contacts with philanthropic institutions and individuals, domestically and internationally, are necessary for getting financial help.

  9. The Family Check-Up and Service Use in High-Risk Families of Young Children: A Prevention Strategy with a Bridge to Community-Based Treatment

    NARCIS (Netherlands)

    Leijten, Patty; Shaw, Daniel S.; Gardner, Frances; Wilson, Melvin N.; Matthys, Walter; Dishion, Thomas J.


    Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up—known to reduce disruptive behavior problems in young children—can provide

  10. The family check-up and service use in high-risk families of young children: a prevention strategy with a bridge to community-based treatment

    NARCIS (Netherlands)

    Leijten, P.; Shaw, D.S.; Gardner, F.; Wilson, M.N.; Matthys, W.; Dishion, T.J.


    Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up—known to reduce disruptive behavior problems in young children—can provide

  11. Utilising Planning and Financing Strategies in the Management of Community Development Projects in Enugu State, Nigeria (United States)

    Obetta, Chukwuemeka K.; Oreh, Catherine I.


    Utilisation of community management strategies is an approach to governance that is based on community and organisational involvement. Communities with development projects have formed community projects management committees (CPMCs) that are encouraged to adopt the community management strategy in the planning and financing of community…

  12. Taking Steps Together: A Family- and Community-Based Obesity Intervention for Urban, Multiethnic Children (United States)

    Anderson, John D.; Newby, Rachel; Kehm, Rebecca; Barland, Patricia; Hearst, Mary O.


    Objectives: Successful childhood obesity intervention models that build sustainable behavioral change are needed, particularly in low-income, ethnic minority communities disparately affected by this problem. Method: Families were referred to Taking Steps Together (TST) by their primary care provider if at least one child had a body mass index…

  13. Women, microcredit and family planning practices: a case study from rural Ghana. (United States)

    Norwood, Carolette


    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.

  14. Planning for the succession process among Galician family businesses. Brief comparison with Portuguese family businesses

    Directory of Open Access Journals (Sweden)

    Susana Barbeito Roibal


    Full Text Available A research project on Galician family owned businesses, financed by the University of A Coruña from 2004 to 2005, analyzed results from 57 of these companies that earned a profit of more than 5 million euro in 2003. One of the aspects examined in this project, which is the aim of this article, shows the importance that Galician family business owners pay to the planning for the succession process. Literature on family owned businesses emphasizes the importance of planning in successful occurrences. The obtained results increasingly show changes in the significance that the Galician family business owners give to our focus of study, almost reaching the level of importance that literature has given to the succession process in the last decade.

  15. Process evaluation of a community-based adolescent obesity prevention project in Tonga. (United States)

    Fotu, Kalesita F; Moodie, Marj M; Mavoa, Helen M; Pomana, Siosifa; Schultz, Jimaima T; Swinburn, Boyd A


    The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP) conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents) to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention. MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models. While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns. The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider than the target group), but the dose and frequency of activities were

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

    Bell, Melissa M


    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.

  17. Women’s experiences after Planned Parenthood’s exclusion from a family planning program in Texas☆ (United States)

    Woo, C. Junda; Alamgir, Hasanat; Potter, Joseph E.


    Objective We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. Study Design We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006–2010 (NSFG). Results (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. Conclusions Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. Implications Requiring low-income family planning patients to switch healthcare providers has adverse consequences. PMID:26680757

  18. The Impact of Reproductive Health Legislation on Family Planning Clinic Services in Texas (United States)

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


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

  19. Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning: a community-based study. (United States)

    Cussen, Alexandra; Sciberras, Emma; Ukoumunne, Obioha C; Efron, Daryl


    This study examined the relationship between family functioning and attention-deficit/hyperactivity disorder (ADHD) symptoms in an Australian community-based sample. Children were screened for ADHD in their second year of formal schooling. Two hundred and two (202) primary caregivers completed validated measures of family quality of life (QoL), parent mental health, parenting styles and parental relationship quality. Compared with controls, parents of children screening positive for ADHD reported poorer family QoL in the domains of emotional impact (mean difference [MD] -20.1; 95% CI -38.2 to -1.9, p = 0.03) and impact on family activities (MD -17.2; 95% CI -27.9 to -6.5, p = 0.002), less parental warmth (MD -3.4; 95% CI -6.0 to -0.9, p = 0.01) and higher parental depression (MD 6.8; 95% CI 1.8 to 11.7, p = 0.009) and anxiety (MD 6.2; 95% CI 1.7 to 10.6, p = 0.008) after adjusting for socio-demographic characteristics and child conduct symptoms. Parents of children screening positive for ADHD reported higher stress (MD 4.5; 95% CI 1.2 to 7.1, p = 0.007) and more inconsistent (MD 3.0; 95% CI 1.2 to 4.8, p = 0.002) and hostile (MD = 2.2; 95% CI 1.0 to 3.4, p = 0.001) parenting after adjusting for socio-demographic factors only. No difference in parental relationship quality and parental inductive reasoning was identified. These findings suggest a strong association between poor family functioning and ADHD symptoms and carry implications for comprehensive ADHD management and the importance of seeing the child within the family context.

  20. Planning for strategic change? A participative planning approach for community hospitals. (United States)

    MacDonald, S K; Beange, J E; Blachford, P C


    Strategic planning is becoming to hospitals what business case analysis is to private corporations. In fact, this type of planning is becoming essential for the professional management of Ontario hospitals. The participative strategic planning process at Toronto East General Hospital (TEGH) is an example of how a professionally structured and implemented strategic planning process can be successfully developed and implemented in a community hospital. In this article, the environmental factors driving planning are reviewed and the critical success factors for the development and implementation of a strategic plan are examined in the context of TEGH's experience.

  1. Involving Families and Communities in CSPAP Development Using Asset Mapping (United States)

    Allar, Ishonté; Elliott, Eloise; Jones, Emily; Kristjansson, Alfgeir L.; Taliaferro, Andrea; Bulger, Sean M.


    The purpose of this article is to provide an introduction to asset mapping as a systematic approach to facilitating increased family and community involvement in comprehensive school physical activity programs (CSPAP). It includes a brief summary of the literature related to the importance of family and community in children's physical activity…

  2. Barriers to Offering Vasectomy at Publicly Funded Family Planning Organizations in Texas. (United States)

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


    Few publicly funded family planning clinics in the United States offer vasectomy, but little is known about the reasons this method is not more widely available at these sources of care. Between February 2012 and February 2015, three waves of in-depth interviews were conducted with program administrators at 54 family planning organizations in Texas. Participants described their organization's vasectomy service model and factors that influenced how frequently vasectomy was provided. Interview transcripts were coded and analyzed using a theme-based approach. Service models and barriers to providing vasectomy were compared by organization type (e.g., women's health center, public health clinic) and receipt of Title X funding. Two thirds of organizations did not offer vasectomy on-site or pay for referrals with family planning funding; nine organizations frequently provided vasectomy. Organizations did not widely offer vasectomy because they could not find providers that would accept the low reimbursement for the procedure or because they lacked funding for men's reproductive health care. Respondents often did not perceive men's reproductive health care as a service priority and commented that men, especially Latinos, had limited interest in vasectomy. Although organizations of all types reported barriers, women's health centers and Title X-funded organizations more frequently offered vasectomy by conducting tailored outreach to men and vasectomy providers. A combination of factors operating at the health systems and provider level influence the availability of vasectomy at publicly funded family planning organizations in Texas. Multilevel approaches that address key barriers to vasectomy provision would help organizations offer comprehensive contraceptive services.

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

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


    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.

  4. Partners Plus: Families and Caregivers in Partnerships. A Family-Centered Guide to Respite Care. Trainer's Workshop Manual [and] Community Planning Manual [and] A Family Manual [and] Caregiver Manual. (United States)

    Ownby, Lisa L.; Hooke, Amanda C.; Moore, Dee Wylie; Garland, Corinne W.; Frank, Adrienne

    Four manuals on implementing the Partners Respite Model, which provides respite care for children with disabilities or chronic illnesses, comprise this document. The Community Planning Manual offers a step-by-step guide to replication of the Partners Respite Model and is divided into sections on developing the Partners program, implementing the…

  5. Client Satisfaction And Decision Making Amongst Females Visiting Family Planning Clinics In Hyderabad, Pakistan. (United States)

    Memon, Arbia; Hamid, Saima; Kumar, Ramesh


    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.

  6. Integration opportunities for HIV and family planning services in Addis Ababa, Ethiopia: an organizational network analysis. (United States)

    Thomas, James C; Reynolds, Heidi; Bevc, Christine; Tsegaye, Ademe


    Public health resources are often deployed in developing countries by foreign governments, national governments, civil society and the private health clinics, but seldom in ways that are coordinated within a particular community or population. The lack of coordination results in inefficiencies and suboptimal results. Organizational network analysis can reveal how organizations interact with each other and provide insights into means of realizing better public health results from the resources already deployed. Our objective in this study was to identify the missed opportunities for the integration of HIV care and family planning services and to inform future network strengthening. In two sub-cities of Addis Ababa, we identified each organization providing either HIV care or family planning services. We interviewed representatives of each of them about exchanges of clients with each of the others. With network analysis, we identified network characteristics in each sub-city network, such as referral density and centrality; and gaps in the referral patterns. The results were shared with representatives from the organizations. The two networks were of similar size (25 and 26 organizations) and had referral densities of 0.115 and 0.155 out of a possible range from 0 (none) to 1.0 (all possible connections). Two organizations in one sub-city did not refer HIV clients to a family planning organization. One organization in one sub-city and seven in the other offered few HIV services and did not refer clients to any other HIV service provider. Representatives from the networks confirmed the results reflected their experience and expressed an interest in establishing more links between organizations. Because of organizations not working together, women in the two sub-cities were at risk of not receiving needed family planning or HIV care services. Facilitating referrals among a few organizations that are most often working in isolation could remediate the problem, but the

  7. Socio-economic development of Dongguan County promoted by family planning. (United States)

    Hu, F


    Because of its geographical position and its population of over 1.19 million, Dongguan County in Guangdong Province, China occupies an important position in the family planning program of the whole province, and country. In the 1st 10 days of July 1985, the Family Planning Commission of Guangdong Province conducted a survey of Dongguan County. The results show 6 remarkable changes: 1) both rural and urban people are more and more likely to practice family planning on their own accord. (The total fertility rate dropped from 5.9 in the early years of the People's Republic to 2.05 in 1982); 2) women, released from heavy household chores, have become a vital new force for the development of industrial production (The gross industrial output value of the town industry increased by 87.57% from 1987 to 1984.); 3) the living standard of both rural and urban people improved along with more flourishing industrial and agricultural production; 4) educational work and population quality have improved; 5) moral culture has progressed (Family planning is commonly practiced.); and 6) social development has occurred, such as purification of tap water, and the building of cultural, sport, and recreational facilities. The County Family Planning commission achieved its successes by political mobilization policies, scientific birth control, and good services. Their main approaches include 1) associating political mobilization with the local reality; 2) popularizing knowledge of birth control science and life science through special schools, training courses, lectures, and research; 3) rewarding 1-child families with material benefits; and 4) improving living conditions of widowed and childless old people to alleviate worries of sonless households.

  8. Extending the Literate Community: Reading and Writing with Families. (United States)

    Shockley, Betty


    Describes a first grade teacher's efforts to expand the boundaries of her literate classroom community and include the families of her students. Describes how all students' families participated, each in their own way, in reading and journaling together, and in the "Family Stories" project. (SR)

  9. Improving information for community-based adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Huq, Saleemul


    Community-based adaptation aims to empower local people to cope with and plan for the impacts of climate change. In a world where knowledge equals power, you could be forgiven for thinking that enabling this type of adaptation boils down to providing local people with information. Conventional approaches to planning adaptation rely on 'expert' advice and credible 'science' from authoritative information providers such as the Intergovernmental Panel on Climate Change. But to truly support the needs of local communities, this information needs to be more site-specific, more user-friendly and more inclusive of traditional knowledge and existing coping practices.

  10. Experience of domestic violence routine screening in Family Planning NSW clinics. (United States)

    Hunter, Tara; Botfield, Jessica R; Estoesta, Jane; Markham, Pippa; Robertson, Sarah; McGeechan, Kevin


    This study reviewed implementation of the Domestic Violence Routine Screening (DVRS) program at Family Planning NSW and outcomes of screening to determine the feasibility of routine screening in a family planning setting and the suitability of this program in the context of women's reproductive and sexual health. A retrospective review of medical records was undertaken of eligible women attending Family Planning NSW clinics between 1 January and 31 December 2015. Modified Poisson regression was used to estimate prevalence ratios and assess association between binary outcomes and client characteristics. Of 13440 eligible women, 5491 were screened (41%). Number of visits, clinic attended, age, employment status and disability were associated with completion of screening. In all, 220 women (4.0%) disclosed domestic violence. Factors associated with disclosure were clinic attended, age group, region of birth, employment status, education and disability. Women who disclosed domestic violence were more likely to have discussed issues related to sexually transmissible infections in their consultation. All women who disclosed were assessed for any safety concerns and offered a range of suitable referral options. Although routine screening may not be appropriate in all health settings, given associations between domestic violence and sexual and reproductive health, a DVRS program is considered appropriate in sexual and reproductive health clinics and appears to be feasible in a service such as Family Planning NSW. Consistent implementation of the program should continue at Family Planning NSW and be expanded to other family planning services in Australia to support identification and early intervention for women affected by domestic violence.

  11. The role of traditional organization on family planning acceptance in Indonesia. (United States)

    Ancok, D


    visits had no effect. Another study found field worker and supervisor activities and community contraceptive distributors to be significant factors affecting contraceptive prevalence. The use of traditional organizations can be effective in other countries if the community conditions are the same. The following traditional organizations are described: simpan pinjam (savings and loan associations), arisan (rotating credit association), perkumpulan kematian (burial association), lumbung paceklik (emergency rice stores), kebatinan (mysticism group), pengajian (prayer group), and banjar (a residential group of 100 household heads). The banjar takes care of every aspect of a person's life and is compulsory and meets regularly. a 1976 study indicated the banjar as ideal for use in promoting FP, particularly if dynamic. Modern organizations at the village level, which were used to involve new acceptors, are also described. The Paguyuban KB (Family Planning Acceptors Group) promoted the program and was responsible for contraceptive distribution.

  12. Assessing the integration of health center and community emergency preparedness and response planning. (United States)

    Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M


    To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

  13. Facilitating State-Wide Collaboration around Family Planning Care in the Context of Zika. (United States)

    Dehlendorf, Christine; Gavin, Loretta; Witt, Jacki; Moskosky, Susan

    Family planning providers have an important role to play in the response to the public health challenge posed by Zika. In the United States, there are high rates of unintended pregnancy, especially in states most at risk for mosquito-borne transmission of the Zika virus. This paper describes efforts by eight of these states (Arizona, California, Florida, Georgia, Louisiana, Mississippi, South Carolina, and Texas) to build capacity for quality family planning care in the context of Zika. Drawing on resources developed by the Office of Population Affairs, including a toolkit for family planning care in the context of Zika, agencies and stakeholders involved in the family planning delivery system in Southern states at risk for mosquito-borne transmission met over several months in the summer of 2016 to coordinate efforts to respond to the risk of Zika in their jurisdictions. Through proactive communication and collaboration, states took steps to integrate Zika-related family planning care, including screening for Zika risk and providing appropriate, client-centered counseling. Challenges faced by the states included not having family planning included as a component of their state's Zika response effort, limited funding for family planning activities, and the need for robust communication networks between multiple state and federal agencies. The efforts described in this paper can help other states to integrate family planning into their Zika response. This is relevant to all states; even when mosquito-borne transmission is not occurring or expected, all states experience travel-related and sexually transmitted Zika infections. Copyright © 2017 Jacobs Institute of Women's Health. All rights reserved.

  14. [Journalism and family planning in Guinea-Bissau. Putting the accent on birth spacing]. (United States)

    Vaz, C


    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.

  15. Evaluation of a community-based, family focused healthy weights initiative using the RE-AIM framework. (United States)

    Jung, Mary E; Bourne, Jessica E; Gainforth, Heather L


    Childhood overweight and obesity is a major public health concern. Community-based interventions have the potential to reach caregivers and children. However, the overall health impact of these programs is rarely comprehensively assessed. This study evaluated a physical activity and healthy eating family program (Healthy Together; HT) using the RE-AIM framework. Ten sites implemented the 5-week program. Thirty-nine staff members and 277 program participants (126 caregivers [M age  = 35.6] and 151 children [M age  = 13]) participated in the evaluation. Each RE-AIM dimension was assessed independently using a mixed-methods approach. Sources of data included archival records, interviews and surveys. Effectiveness outcome variables were assessed at pre- and post-intervention and 6-month follow-up. Reach: HT participants were almost entirely recruited from existing programs within sites. Effectiveness: Caregivers' nutrition related efficacy beliefs increased following HT (ps  .05). Knowledge surrounding healthy diets and physical activity increased in children and caregivers (ps evaluations can systematically highlight areas of success and challenges. Overall HT represents a feasible community-based intervention; however further support is required in order to ensure the program is effective at positively targeting the desired outcomes. As a result of this evaluation, modifications are currently being implemented to HT.


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


    This paper provides new evidence that family planning programs are associated with a decrease in the share of children and adults living in poverty. Our research design exploits the county roll-out of U.S. family planning programs in the late 1960s and early 1970s and examines their relationship with poverty rates in the short and longer-term in public census data. We find that cohorts born after federal family planning programs began were less likely to live in poverty in childhood and that these same cohorts were less likely to live in poverty as adults. PMID:25346655

  17. Using multilevel, multisource needs assessment data for planning community interventions. (United States)

    Levy, Susan R; Anderson, Emily E; Issel, L Michele; Willis, Marilyn A; Dancy, Barbara L; Jacobson, Kristin M; Fleming, Shirley G; Copper, Elizabeth S; Berrios, Nerida M; Sciammarella, Esther; Ochoa, Mónica; Hebert-Beirne, Jennifer


    African Americans and Latinos share higher rates of cardiovascular disease (CVD) and diabetes compared with Whites. These diseases have common risk factors that are amenable to primary and secondary prevention. The goal of the Chicago REACH 2010-Lawndale Health Promotion Project is to eliminate disparities related to CVD and diabetes experienced by African Americans and Latinos in two contiguous Chicago neighborhoods using a community-based prevention approach. This article shares findings from the Phase 1 participatory planning process and discusses the implications these findings and lessons learned may have for programs aiming to reduce health disparities in multiethnic communities. The triangulation of data sources from the planning phase enriched interpretation and led to more creative and feasible suggestions for programmatic interventions across the four levels of the ecological framework. Multisource data yielded useful information for program planning and a better understanding of the cultural differences and similarities between African Americans and Latinos.

  18. Integral stormwater management master plan and design in an ecological community. (United States)

    Che, Wu; Zhao, Yang; Yang, Zheng; Li, Junqi; Shi, Man


    Urban stormwater runoff nearly discharges directly into bodies of water through gray infrastructure in China, such as sewers, impermeable ditches, and pump stations. As urban flooding, water shortage, and other environment problems become serious, integrated water environment management is becoming increasingly complex and challenging. At more than 200ha, the Oriental Sun City community is a large retirement community located in the eastern side of Beijing. During the beginning of its construction, the project faced a series of serious water environment crises such as eutrophication, flood risk, water shortage, and high maintenance costs. To address these issues, an integral stormwater management master plan was developed based on the concept of low impact development (LID). A large number of LID and green stormwater infrastructure (GSI) approaches were designed and applied in the community to replace traditional stormwater drainage systems completely. These approaches mainly included bioretention (which captured nearly 85th percentile volume of the annual runoff in the site, nearly 5.4×10(5)m(3) annually), swales (which functioned as a substitute for traditional stormwater pipes), waterscapes, and stormwater wetlands. Finally, a stormwater system plan was proposed by integrating with the gray water system, landscape planning, an architectural master plan, and related consultations that supported the entire construction period. After more than 10 years of planning, designing, construction, and operation, Oriental Sun City has become one of the earliest modern large-scale LID communities in China. Moreover, the project not only addressed the crisis efficiently and effectively, but also yielded economic and ecological benefits. Copyright © 2014. Published by Elsevier B.V.

  19. Developing product families based on architectures

    DEFF Research Database (Denmark)

    Harlou, Ulf


    family master plan (PFMP). The PFMP aims at modelling product families and especially variety of product families. The results of this thesis build on research literature and experiences from the industrial partners. Extensive verifications of the theory contributions, models and tools have been carried......The subject of this PhD thesis is development of product families based on architectures. Companies are introducing more and more product variants to fulfil the market demands. These new variants add complexity to many of the processes and systems in the companies. Reuse of standard designs (i.......e. design entities) and re-use of the way new products are developed can simplify the processes and systems. Case studies show that reuse can lead to reduction of cost and time-to-market of new products. One of the means for managing reuse of standard designs within product families are architectures...

  20. 42 CFR 59.3 - Who is eligible to apply for a family planning services grant? (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible to apply for a family planning... SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.3 Who is eligible to apply for a family planning services grant? Any public or nonprofit private entity in...

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

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


    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.

  2. Evidence from cluster surveys on the association between home-based counseling and use of family planning in conflict-affected Darfur. (United States)

    Adam, Izzeldin F


    To examine the association between home counseling and awareness and use of modern family planning (FP) methods among women in internally displaced person (IDP) camps in conflict-affected West Darfur, Sudan. In a community-based cross-sectional study, two questionnaire-based surveys were performed in three camps. Home-based counseling had been introduced in March 2006. An initial survey (February 2007) and a follow-up survey (April 2009) targeted women of child-bearing age. A sample of 640 randomly selected women aged 15-49 years who had experienced pregnancy after joining the camp were interviewed for each survey. Overall, modern FP use increased from 10.9% (70/640) in 2007 to 21.6% (138/640) in 2009 (P<0.001). As compared with the initial survey, women in the follow-up survey were more likely to be aware of and to use any modern FP method (adjusted odds ratio [aOR] 5.4, 95% confidence interval [CI] 3.9-7.4; and aOR 2.8, 95% CI 2.0-4.1, respectively). Contraceptive pills were the most common modern method used. Home counseling and loss of a child under 5years were the most significant predictors of awareness and use of modern FP methods. After the introduction of home-based FP counseling for couples and FP services in clinics, women's awareness and use of modern FP methods increased in a conflict-affected setting. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Association between women's autonomy and family planning outcome in couples residing in Isfahan (United States)

    Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila


    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

  4. An integration programme of poverty alleviation and development with family planning. (United States)


    The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties ident